Purpose: The purpose of this study is to investigate the effect of work environment on health problems of nurses. Methods: The subjects of the study were 395 nurses who were wage workers among KWCS (Korean Working Conditions Survey) respondents in 2014. The work environments were measured by the KWCS questionnaire. Results: 48.5% of the 395 nurses had health problems. The prevalence of musculoskeletal diseases (34.7%) was the highest among all health problems. The ergonomic work environment was significantly related to musculoskeletal disorders, headache and eye strain, and fatigue. In addition, the increase in work-individual interface area was significantly related to fatigue. Conclusion The work environment of nurses affects health problems. It is therefore important to develop strategies that improve the health problems of nurses by reducing ergonomic and psycho-social risk factors.

Objective: To investigate the relationship between aircraft noise and the results of audiological evaluation on tinnitus and hearing loss among residents near United States military air-bases in Pyeongtaek city. METHODS: Residents (n=492) exposed to aircraft noise were selected from eight villages near U.S. military air-bases (K-55 and K-6) in Pyeongtaek city. Residents (n=200) from five villages located at least 10 km away from the air-base were selected for the control group. All participants completed a questionnaire on tinnitus and audiological evaluations included pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE). Statistical analyses involved a general linear model and multiple logistic regression stratified by gender and data was adjusted by age, educational level, stress response index and noise type (i.e. military, agricultural and occupational). RESULTS: The equivalent noise levels (Leq) in the vicinity of the air-field were 73.4~81.5 dB (A). Tinnitus prevalence was 47.3% and odds ratio (OR) was 2.06 (95% confidence interval (CI): 1.09~3.88) among noise-exposed males. Tinnitus prevalence was 50.8% and OR was 1.97(95% CI: 1.17~3.30) among noise-exposed females. Tinnitus handicap scores among exposed group were significantly higher in functional, emotional, and catastrophic subclasses (p<0.001). PTA revealed hearing thresholds among the exposed group of 0.5 and 1 kHz (male right ear), 0.5 and 1 kHz (female left ear) and 0.5, 1, 2, 3, 4 and 6 kHz on female right ear that were significantly higher than those of the unexposed group. No significant difference in DPOAE was observed among noise-exposed males. However, significant differences were evident for noise-exposed females at 3175 and 4007 Hz. ORs of right female ears 3175 and 4007 Hz were 1.73(95% CI: 1.01~2.99) and 1.78(95% CI: 1.01~3.15). ORs of left female ears at 3175 Hz and 4007 Hz were 1.92(95% CI: 1.10~3.36) and 2.71(95% CI: 1.49~4.91) CONCLUSIONS: Aircraft noise may adversely affect hearing function and tinnitus.
Aircraft ; Audiometry ; Ear ; Electrolytes ; Female ; Hearing ; Hearing Loss ; Humans ; Linear Models ; Logistic Models ; Male ; Military Personnel ; Noise ; Odds Ratio ; Prevalence ; Questionnaires ; Tinnitus ; United States

Objective: To investigate the relationship between aircraft noise and the results of audiological evaluation on tinnitus and hearing loss among residents near United States military air-bases in Pyeongtaek city. METHODS: Residents (n=492) exposed to aircraft noise were selected from eight villages near U.S. military air-bases (K-55 and K-6) in Pyeongtaek city. Residents (n=200) from five villages located at least 10 km away from the air-base were selected for the control group. All participants completed a questionnaire on tinnitus and audiological evaluations included pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE). Statistical analyses involved a general linear model and multiple logistic regression stratified by gender and data was adjusted by age, educational level, stress response index and noise type (i.e. military, agricultural and occupational). RESULTS: The equivalent noise levels (Leq) in the vicinity of the air-field were 73.4~81.5 dB (A). Tinnitus prevalence was 47.3% and odds ratio (OR) was 2.06 (95% confidence interval (CI): 1.09~3.88) among noise-exposed males. Tinnitus prevalence was 50.8% and OR was 1.97(95% CI: 1.17~3.30) among noise-exposed females. Tinnitus handicap scores among exposed group were significantly higher in functional, emotional, and catastrophic subclasses (p<0.001). PTA revealed hearing thresholds among the exposed group of 0.5 and 1 kHz (male right ear), 0.5 and 1 kHz (female left ear) and 0.5, 1, 2, 3, 4 and 6 kHz on female right ear that were significantly higher than those of the unexposed group. No significant difference in DPOAE was observed among noise-exposed males. However, significant differences were evident for noise-exposed females at 3175 and 4007 Hz. ORs of right female ears 3175 and 4007 Hz were 1.73(95% CI: 1.01~2.99) and 1.78(95% CI: 1.01~3.15). ORs of left female ears at 3175 Hz and 4007 Hz were 1.92(95% CI: 1.10~3.36) and 2.71(95% CI: 1.49~4.91) CONCLUSIONS: Aircraft noise may adversely affect hearing function and tinnitus.
Aircraft ; Audiometry ; Ear ; Electrolytes ; Female ; Hearing ; Hearing Loss ; Humans ; Linear Models ; Logistic Models ; Male ; Military Personnel ; Noise ; Odds Ratio ; Prevalence ; Questionnaires ; Tinnitus ; United States

OBJECTIVES: Depressive symptoms are often exhibited by individuals with anxiety disorders. Comorbidity with depressive disorder is associated with more severe symptoms and poorer outcomes in the course of illness. In this study we investigated the symptomatic and sociodemographic correlates of depressive symptoms in anxiety disorders and compared them with those in major depressive disorder. METHODS: At a psychiatric ward of a university-affiliated hospital, 192 outpatients with anxiety disorders and 119 with major depressive disorder (MDD) were recruited for a consecutive sample. They completed a questionnaire that included Symptom Checklist-90-Revised (SCL-90-R), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory, and socio-demographic variables. RESULTS: Compared to those with depressive disorders, patients with anxiety disorders showed significantly lower levels of depressive symptoms. However, the difference was confined to the negative attitude sub-scale of BDI, not somatic symptoms and performance difficulty. Multiple regression analysis showed factors that a Global Severity Index of SCL-90-R, state anxiety, lower education, and older age predicted depression in anxiety disorders. In contrast, the Global Severity Index and trait anxiety were extracted for MDD. CONCLUSION: This cross-sectional study indicated that depressive symptoms in anxiety disorders can be differentiated from those of MDD so as to lower level of the core cognitive symptoms of depression. Further studies may benefit from looking at both depressive symptoms and co-morbid depressive diagnosis.
Anxiety ; Anxiety Disorders ; Comorbidity ; Cross-Sectional Studies ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Humans ; Neurobehavioral Manifestations ; Outpatients ; Surveys and Questionnaires

Background: Because persistent fever often occurs in adrenal insufficiency, it might be confused with infectious diseases. This study aimed to identify clinical characteristics and risk factors of patients with adrenal insufficiency and fever. Methods: All adult patients (n = 150) admitted to a tertiary care hospital in South Korea and diagnosed with adrenal insufficiency between 1 March 2018, and 30 June 2019, were recruited. Patients were excluded if they had: 1) proven structural problems in the adrenal or pituitary gland; 2) a history of chemotherapy within 6 months prior to the diagnosis of adrenal insufficiency; and 3) other medical conditions that may cause fever. Results: Among the included patients, 45 (30.0%) had fever at the time of the diagnosis of adrenal insufficiency. The mean C-reactive protein level was higher (11.25 ± 8.54 vs. 4.36 ± 7.13 mg/dL) in patients with fever than in those without fever. A higher proportion of patients with fever changed antibiotics (33.3% vs. 1.0%). On multivariate logistic regression analysis, female sex (odds ratio [OR], 0.32) lowered the risk of adrenal insufficiency with fever, while a history of surgery within 6 months (OR, 4.35), general weakness (OR, 7.21), and cough (OR, 17.29) were significantly associated with that. Conclusion The possibility of adrenal insufficiency should be considered in patients with fever of unknown origin, especially those with risk factors.

Background: Because persistent fever often occurs in adrenal insufficiency, it might be confused with infectious diseases. This study aimed to identify clinical characteristics and risk factors of patients with adrenal insufficiency and fever. Methods: All adult patients (n = 150) admitted to a tertiary care hospital in South Korea and diagnosed with adrenal insufficiency between 1 March 2018, and 30 June 2019, were recruited. Patients were excluded if they had: 1) proven structural problems in the adrenal or pituitary gland; 2) a history of chemotherapy within 6 months prior to the diagnosis of adrenal insufficiency; and 3) other medical conditions that may cause fever. Results: Among the included patients, 45 (30.0%) had fever at the time of the diagnosis of adrenal insufficiency. The mean C-reactive protein level was higher (11.25 ± 8.54 vs. 4.36 ± 7.13 mg/dL) in patients with fever than in those without fever. A higher proportion of patients with fever changed antibiotics (33.3% vs. 1.0%). On multivariate logistic regression analysis, female sex (odds ratio [OR], 0.32) lowered the risk of adrenal insufficiency with fever, while a history of surgery within 6 months (OR, 4.35), general weakness (OR, 7.21), and cough (OR, 17.29) were significantly associated with that. Conclusion The possibility of adrenal insufficiency should be considered in patients with fever of unknown origin, especially those with risk factors.

BACKGROUND: The purpose of this study was to determine the efficacy of infection-control interventions to decrease the incidence of catheter-associated bloodstream infections (CA-BSI) and to examine the sustainability of its effect during and after the intervention in Korea. MATERIALS AND METHODS: We conducted a prospective multi-strategy intervention in intensive care units (ICUs) at 3 university hospitals in Korea. The intervention consisted of education and on-site training for medical personnel involved in catheter care, active surveillance, and reinforcement of current intervention in each unit. After the intervention of 3 months, we identified CA-BSI cases of each hospital using the electronic database for 6 months. RESULTS: During the intervention, the number of CA-BSI decreased significantly compared to pre-interventional period (8.7 vs. 2.3 per 1,000 catheter days; rate ratio 0.28; 95% CI, 0.13-0.61). After the intervention, CA-BSI rate increased slightly, but was still significantly lower than that of pre-interventional period (4.3 per 1,000 catheter days; rate ratio, 0.49; 95% CI, 0.31-0.78). Reduction of gram-negative bacterial infections was noted during and after the intervention. CONCLUSIONS: A multi-strategy approach to reduce CA-BSI could be implemented in diverse settings of medical and surgical units in Korea and decreased CA-BSI rates during the intervention.
Catheters ; Electronics ; Electrons ; Gram-Negative Bacterial Infections ; Hospitals, University ; Incidence ; Intensive Care Units ; Korea ; Prospective Studies ; Reinforcement (Psychology)

Pnuemocystis jirovecii pneumonia (PJP) is one of leading causes of acute respiratory failure in patients infected with human immunodeficiency virus (HIV), and the mortality rate remains high in mechanically ventilated HIV patients with PJP. There are several reported cases who received extracorporeal membrane oxygenation (ECMO) treatment for respiratory failure associated with severe PJP in HIV-infected patients. We report a patient who was newly diagnosed with HIV and PJP whose condition worsened after highly active antiretroviral therapy (HAART) initiation and progressed to acute respiratory distress syndrome requiring veno-venous ECMO. The patient recovered from PJP and is undergoing treatment with HAART. ECMO support can be an effective life-saving salvage therapy for acute respiratory failure refractory to mechanical ventilation following HAART in HIV-infected patients with severe PJP.
Antiretroviral Therapy, Highly Active* ; Extracorporeal Membrane Oxygenation* ; HIV ; Humans ; Mortality ; Pneumocystis jirovecii* ; Pneumocystis* ; Pneumonia* ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Salvage Therapy

A live attenuated zoster vaccine (ZOSTAVAX(TM), Merck & Co., Inc.) was approved by the Korea Ministry of Food and Drug Safety in 2009. However, the immunogenicity and safety of the vaccine has not been assessed in Korean population. This is multi-center, open-label, single-arm study performed with 180 healthy Korean adults > or =50 yr of age. The geometric mean titer (GMT) and geometric mean fold rise (GMFR) of varicella zoster virus (VZV) antibodies were measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) at 4 weeks post-vaccination. Subjects were followed for exposure to varicella or herpes zoster (HZ), the development of any varicella/varicella-like or HZ/HZ-like rashes, and any other clinical adverse experiences (AEs) for 42 days post-vaccination. For the 166 subjects included in the per-protocol population, the GMT at Day 1 was 66.9. At 4 weeks post-vaccination, the GMT for this population was 185.4, with a GMFR of 2.8 (95% CI, 2.5-3.1). Of the 180 subjects vaccinated, 62.8% experienced > or =1 AE, with 53.3% of subjects reporting injection-site AEs. The most frequently reported injection-site AEs were erythema (45.0%) with the majority being mild in intensity. Overall, 44 (24.4%) subjects experienced > or =1 systemic AE, 10 (5.5%) subjects experienced a systemic vaccine-related AE, and 3 (1.7%) subjects experienced > or =1 serious AE not related to vaccine. No subjects reported a VZV-like rash. There was no subject of death and no subject discontinued due to an adverse event. A single dose of zoster vaccine induced VZV-specific gpELISA antibody response and was generally well-tolerated in healthy Korean adults > or =50 yr of age (registry at www.clinicaltrial.gov No. NCT01556451).
Aged ; Antibodies, Viral/blood ; Enzyme-Linked Immunosorbent Assay ; Erythema/etiology ; Female ; Herpes Zoster/*prevention & control ; Herpes Zoster Vaccine/adverse effects/*immunology ; Herpesvirus 3, Human/immunology ; Humans ; Male ; Middle Aged

OBJECTIVE: To investigate the effects of cardiovascular risk factors on hearing loss by vascular damage, such as in atherosclerosis. METHOD: This study was conducted as a part of a study for the health effects of air-craft noise from 13 July 2005 to 13 January 2006. In this study 810 residents were selected from 13 villages in Pyeongteck City. Participants in this study were stratified by gender. Individuals, who had conductive hearing loss, were excluded form this investigation. Cardiovascular risk factors were divided into medical risk factors (mean arterial pressure (MAP), blood glucose, triglyceride) and behavioral risk factors (smoking, alcohol). The degree of atherosclerosis was determined by aPWV. Pure tone air conduction hearing thresholds were obtained at frequencies of 1000 and 4000 Hz. As for statistic data analysis, multiple linear regression models were used to evaluate the relationship between factors on hearing loss and aortic pulse wave velocity. Structural Equation Modeling was used to analyze the relationship between factors. RESULTS: According to multiple linear regression models among males, age, aircraft noise, aPWV were associated with hearing loss. In females, age and aircraft noise were associated with hearing loss. Thus cardiovascular risk factors were not directly involved in hearing loss. However, cardiovascular risk factors such as alcohol, MAP in males and MAP, blood glucose in females were statistically significant (p<0.05) on aPWV according to multiple linear regression modeling. According to analysis of structural equation modeling, an indirect relationship was observed between cardiovascular risk factors and hearing loss by atherosclerosis, which was measured by aPWV. In males, medical risk factors were significantly associated with atherosclerosis (beta+/-SE: 0.07+/-0.03, p=0.03). Atherosclerosis was also associated with hearing loss (beta+/-SE: 2.01+/-0.89, p=0.03). In females, medial risk factors was significantly associated with atherosclerosis (beta+/-SE: 0.08+/-0.02, p=0.00), but atherosclerosis was not significantly associated with hearing loss. CONCLUSION: Although noise exposure is a known major threat to hearing loss, understanding of cardiovascular risk factors associated with hearing loss also take a significant role in preventing hearing loss. Therefore, scrutinization of the etiologic factors for hearing disability may introduce a detailed strategy to abate the prevalence of hearing loss.
Aircraft ; Arterial Pressure ; Atherosclerosis ; Blood Glucose ; Female ; Hearing ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Linear Models ; Male ; Noise ; Prevalence ; Pulse Wave Analysis ; Risk Factors ; Statistics as Topic ; Temefos