PURPOSE: The purpose of this study was to identify factors affecting clinical nurses' presenteeism. METHODS: A descriptive cross-sectional design was used in which participants completed self-report questionnaires that consisted of measures for nurses' job satisfaction, job stress, professionalism and presenteeism. 267 nurses working in general hospital participated in this study. Logistic regression analysis was used to estimate predictors of the presenteeism in clinical nurses. RESULTS: 250 nurses experienced one or more health problems last one month. The group who experienced presenteeism during the last one year had significant differences in professionalism and perceived productivity. Predictors of sickness presenteeism in clinical nurses included work experience, total health problem and last 1 year absenteeism. Last 1 year absenteeism and total health problem were strongly related to presenteeism in clinical nurses. CONCLUSION: Major findings of this study indicated that in dealing with nurses' presenteeism, not only managing nurses' job stress and job satisfaction but also providing flexible work schedule and increasing staffing level as an organizational approach are necessary to be considered. Further repeated and expanded research is needed to explore the multidimensional aspects of nurses' presenteeism including a broad range of work setting and the influence of Korean nurses' organizational culture on presenteeism.
Absenteeism ; Appointments and Schedules ; Efficiency ; Hospitals, General ; Job Satisfaction ; Logistic Models ; Organizational Culture ; Surveys and Questionnaires

OBJECTIVES: The aim of this study is to examine the physical, psychological, and social factors influencing suicidal ideation among elderly Koreans. METHODS: Community Health Survey data obtained in 2013 were used for this study with a sample of 4367 elderly who reside in Gangwon province. The data were analyzed using the chi-square test and the logistic regression test to examine the relationship between suicidal ideation and other variables. RESULTS: Depression was the single most influential variable, both directly and indirectly increasing suicidal ideation. In particular, the increase of suicidal ideation among those with severe disease was affected by depression. Perceived poor social support and perceived poor health status were the two highest risk factors after depression, implying that subjective assessment of the elderly affects suicidal ideation significantly. Poor economic status and current smoking showed significantly higher risk for women only, although poor health, poor social support, and poor social activity commonly attributed to the risk of suicidal ideation in both genders. CONCLUSION: This study suggests that suicidal ideation among the elderly should be approached in a multi-perspective way considering depression, social support, and physical health. It is notable that not only lack of resources but also perceived sense of poor social and physical well-being significantly affect suicidal ideation.
Aged* ; Depression ; Female ; Gangwon-do ; Health Surveys ; Humans ; Logistic Models ; Risk Factors* ; Smoke ; Smoking ; Suicidal Ideation*

BACKGROUND: The study was performed to investigate effects of depression and health status on several factors of influencing suicidal ideation among living-alone elderly in rural area. And we assessed if depressive symptom mediates fully suicidal ideation among living-alone elderly in the rural area. METHODS: The subjects of this study used the survey data of elderly people living alone for the elderly mental health promotion project at the city health center. In the questionnaire, 200 people were interviewed by one of the public health center staffs directly. We analyzed a four step approach in which several logistic regression analyses were conducted and significance of the coefficients was examined at each step. RESULTS: The results from step 1 show that the total effect of health status(frailty) was significantly related to suicidal ideation(Exp(β)=2.198, P=0.042). In step 2, the direct effect of health status on depression was significant(Exp(β)=3.925, P<0.001) too. Step 3 analysis showed that the effect of depression on suicidal ideation was significant(Exp(β)=7.115, P=0.001). Step 4 showed that after controlling for depression, health status was not significant for suicidal ideation(P=0.322). Based on analysis results, the finding supports that suicidal ideation among living-alone elderly in the rural area was fully mediated by depressive symptom. CONCLUSIONS: Above findings imply that it is crucial to decrease depression in order to control suicidal ideation among living-alone elderly in rural area. To do that, early diagnosis and developing programs to decrease elderly depression and organizational approach according to characteristics of areas and elderly circunstances are needed.
Aged* ; Depression* ; Early Diagnosis ; Humans ; Logistic Models ; Mental Health ; Negotiating* ; Public Health ; Suicidal Ideation*

Autism spectrum disorder (ASD) can be associated with eating problems. However, currently, there is a lack of established guidelines for assessing and addressing eating behaviors in individuals with ASD. This gap in research exists due to the challenges associated with using traditional assessment methods, which may lead to discrepancies in responses and unintentional potential biases from caregivers. In this review, we provided a comprehensive overview of various eating behaviors commonly observed in individuals with ASD. These behaviors include 1) food neophobia, 2) selective eating, 3) binge eating, 4) food avoidance, 5) chewing and swallowing problems, 6) pica, 7) rumination, 8) rituals, and 9) problematic behaviors. Furthermore, we provide a perspective of utilizing digital tools: 1) augmentative and alternative communication; 2) ecological momentary assessment; and 3) video analysis, behavioral analysis, and facial expression analysis. This review explores existing assessment methods and suggests novel assessment aiding together.

OBJECTIVES: The purpose of this study was to examine the reliability and validity of the Korean version of the Behavior Problems Inventory (BPI-01) among children and adolescents aged between 3 and 18. METHODS: The control group consisting of one hundred children and adolescents was recruited from schools and the patient group consisting of forty one children and adolescents with autism spectrum disorder were recruited from a hospital. We compared the measurements of both groups. To assess the concurrent validity of the BPI-01, we compared the problem behavior index of the Korean Scale of Independent Behavior-Revised (K-SIB-R) and, to assess the discriminant validity, we compared the Korean version of the Child Behavior Checklist (K-CBCL). The Cronbach's alpha of the BPI-01 was measured to assess its reliability. Correlation analyses between the BPI-01 and the other scale were carried out to examine the former's concurrent and discriminant validity. RESULTS: The patient group showed a significantly higher score for all three subscales of the BPI than the control group. The Cronbach's alpha was 0.92 for the total severity score of the BPI and ranged between 0.67–0.89 for each subscale in the patient group. All subscales of the BPI-01's, i.e., self injurious behavior, stereotyped behavior and aggressive/destructive behavior, were significantly correlated with the corresponding subscales of the K-SIB-R. The BPI-01 generally did not demonstrate any significant correlation with emotional items such as anxiety/depression in the K-CBCL. Especially, the BPI-01's stereotyped behavior subscale showed little correlation with externalizing behaviors such as social problems and aggressive behaviors. CONCLUSION: This study found that the Korean version of BPI-01 is a reliable and valid behavior rating instrument for problem behavior in developmental disabilities among children and adolescents.
Adolescent* ; Autism Spectrum Disorder ; Checklist ; Child Behavior ; Child* ; Developmental Disabilities ; Humans ; Problem Behavior ; Reproducibility of Results ; Self-Injurious Behavior ; Social Problems ; Stereotyped Behavior

OBJECTIVE: This study compared the symptomatic emotional traits of elderly South Korean patients with hwa-byung and those with depression. METHODS: We enrolled 58 patients with hwa-byung, 180 patients with depression, and 181 healthy control subjects. All participants completed the Hwa-byung Scale, Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI), Geriatric Depression Scale (GDS), State Trait Anger Expression Inventory (STAXI), Reaction Inventory (RI), and Aggression Questionnaire (AQ). Chi-square tests and a one-way analysis of variance with Games-Howell post-hoc tests were used to compare demographic variables and scores. RESULTS: A binary logistic regression analysis was used to examine risk factors for hwa-byung. Scores in the hwa-byung group were higher than those in the depression group for the HDRS; BDI; GDS; trait anger STAXI subscale (trait anger temperament and trait anger reaction); state anger and anger expression STAXI subscales (anger-in, anger-out, and anger control); physical and verbal aggression as well as anger and hostility AQ subscales; and disturbance, embarrassing circumstances, personal disrespect, and unpleasant encounters RI subscales. A binary logistic regression analysis demonstrated that the state anger STAXI subscale, verbal aggression and anger AQ subscales, and unpleasant encounters RI subscale were significantly associated with hwa-byung. CONCLUSION: Elderly patients with hwa-byung had more severe anger traits and states as well as higher depression severity compared to those diagnosed with clinical depression. Excessive anger and anger reactivity to unpleasant factors may be risk factors for hwa-byung, whereas the appropriate expression (rather than suppression) of anger may decrease the risk of hwa-byung.
Aged* ; Aggression ; Anger ; Depression* ; Ethnopsychology ; Hostility ; Humans ; Logistic Models ; Risk Factors ; Temperament

BACKGROUND: Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. METHODS: Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. RESULTS: All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. CONCLUSIONS: C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.
Anti-Bacterial Agents ; Biopsy ; Cholangitis ; Coxiella burnetii ; Eosinophils ; Fever ; Fibrin ; Granuloma ; Hepatitis ; Humans ; Hyperbilirubinemia ; Liver ; Q Fever

BACKGROUND: Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. METHODS: Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. RESULTS: All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. CONCLUSIONS: C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.
Anti-Bacterial Agents ; Biopsy ; Cholangitis ; Coxiella burnetii ; Eosinophils ; Fever ; Fibrin ; Granuloma ; Hepatitis ; Humans ; Hyperbilirubinemia ; Liver ; Q Fever

BACKGROUND: Human papillomavirus (HPV)-related tonsillar squamous cell carcinoma (TSCC) has recently been characterized as a distinct subset with a favorable prognosis. The prevalence and clinicopathologic significance of HPV-related TSCC in Koreans are not well known. METHODS: HPV in situ hybridization (ISH) accompanied by p53, p16, pRb, and cyclin D1 immunohistochemical staining were performed on 89 resection cases of TSCC from 2000 through 2010. RESULTS: HPV was detected by ISH in 59 of 89 cases (66.3%). HPV-positive TSCCs were more common in younger ages (p=0.005), and tumor sizes were smaller in the HPV-positive compared to the HPV-negative group (p=0.040). Positive HPV staining was significantly correlated with p16 expression (p<0.001), pRb inactivation (p=0.003), and cyclin D1 down-regulation (p<0.001) but not with p53 expression (p=0.334). Seventeen cases that showed p16-immunopositivity with HPV-negativity by ISH were retested by HPV typing; HPV DNA was not detected in all cases. There was no significant difference between HPV-positive and HPV-negative patients either in the disease-specific survival (DSS, p=0.857) or overall survival (p=0.910). Furthermore, pRb-inactivated cases showed better DSS (p=0.023), and p53-positive cases showed worse DSS (p=0.001). CONCLUSIONS: Although high HPV prevalence was noted, it was not correlated with histopathologic findings or survival benefit. In addition to p53 expression, pRb inactivation along with p16 overexpression and down-regulation of cyclin D1 are thought to be important pathogenetic steps for developing TSCCs.
Carcinoma, Squamous Cell ; Cell Cycle ; Cyclin D1 ; Cyclin-Dependent Kinase Inhibitor p16 ; DNA ; Down-Regulation ; Humans ; In Situ Hybridization ; Prevalence ; Prognosis ; Tonsillar Neoplasms ; Tumor Suppressor Protein p53