PURPOSE: The purpose of this descriptive study was to identify the impact of workplace bullying and LMX (Leader-Member Exchange) on turnover intention among nurses. METHODS: The participants were 364 nurses from the Seoul metropolitan area who were attending a continuing education program. A structured questionnaire was used for data collection and data were analyzed using the SPSS/Window program. Hierarchical multiple regression analysis was performed to verify the effect of variables on turnover intention. RESULTS: Higher workplace bullying was associated with higher turnover intention. Workplace bullying was negatively correlated with leader-member exchange. The most influential factors for turnover intention were LMX (beta=-7.22, p<.001), work load (beta=2.96, p=.003), and workplace bullying (beta=2.64, p=.009). These factors accounted for 28% of the variance in turnover intention. CONCLUSION: The study results indicate that there is need to develop strategies to prevent workplace bullying and cultivate a good relationship between nursing managers and nurses to lower nurses' turnover intention.
Bullying* ; Data Collection ; Education, Continuing ; Intention* ; Leadership ; Nursing ; Surveys and Questionnaires ; Regression Analysis ; Seoul

A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factor in neonatal sepsis, localized infection in neonate, causative organism in nosocomial infection and the most common causative organism in neonatal sepsis in Korea. Clinical and bacteriological data were collected from thirty seven neonatal units through retrospective review of the medical records of the newborn infants who were confirmed as neonatal sepsis by isolating organisms from blood culture during one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997 and 20,869 neonates were admitted to the neonatal units. During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1 and 303 cases(42.1%) were born prematurely. The main pathogens of early onset sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative Staphylococcus( 14.4%). Gram negative bacilli including Enterobacter spp (7.2%), E.coli(5.1%), Klepsiella(4.5%), Pseudomonas(3.7%) Enterobacter faecium(3.6%) constitute 24.1%. Only two cases of group B beta-hemolytic Streptococcus were isolated. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases (1.0%) of Candida sepsis. Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%). S. epidermidis(22.0%) and S. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.
Candida ; Coagulase ; Cross Infection ; Enterobacter ; Female ; Focal Infection ; Humans ; Infant, Newborn ; Korea ; Male ; Medical Records ; Retrospective Studies ; Risk Factors ; Sepsis* ; Streptococcus ; Urinary Tract

Background: Drug-drug interactions (DDIs) in patients using oral anticancer treatment are more common than in those using injectable anticancer agents. In addition, DDIs related to anticancer treatment are known to cause clinically significant outcomes, such as treatment failure and severe toxicity. To prevent these negative outcomes, significant DDIs are monitored and managed using the information provided in drug databases. We aimed to evaluate the consistency of information on clinically significant DDIs for tyrosine kinase inhibitors (TKIs) between representative drug databases. Methods: We selected clinically significant DDIs involving medications that are co-prescribed with TKIs and met the following criteria: the severity level of DDIs was equal or greater than “D” in Lexicomp® or “major” in Micromedex® . We then analyzed the consistency of the severity classification and evidence level between the drug databases. Spearman’s correlation coefficient was used to identify the relationship between DDI information in the drug databases. Results: In total, 627 DDI pairs were identified as clinically significant; information on these was provided by Lexicomp® and Micromedex® for 571 and 438 pairs, respectively, and both drug databases provided information on 382 DDI pairs.There was no correlation between the severity and evidence level of DDIs provided in the two databases; Spearman’s correlation coefficient for Lexicomp® and Micromedex® was -0.009 (p=0.861) and -0.064 (p=0.209), respectively. Conclusion To judge the significance of DDIs, healthcare providers should consider that the information on DDIs may be different between drug information databases; hence, clinical factors must be considered concurrently.

Background: Drug-drug interactions (DDIs) in patients using oral anticancer treatment are more common than in those using injectable anticancer agents. In addition, DDIs related to anticancer treatment are known to cause clinically significant outcomes, such as treatment failure and severe toxicity. To prevent these negative outcomes, significant DDIs are monitored and managed using the information provided in drug databases. We aimed to evaluate the consistency of information on clinically significant DDIs for tyrosine kinase inhibitors (TKIs) between representative drug databases. Methods: We selected clinically significant DDIs involving medications that are co-prescribed with TKIs and met the following criteria: the severity level of DDIs was equal or greater than “D” in Lexicomp® or “major” in Micromedex® . We then analyzed the consistency of the severity classification and evidence level between the drug databases. Spearman’s correlation coefficient was used to identify the relationship between DDI information in the drug databases. Results: In total, 627 DDI pairs were identified as clinically significant; information on these was provided by Lexicomp® and Micromedex® for 571 and 438 pairs, respectively, and both drug databases provided information on 382 DDI pairs.There was no correlation between the severity and evidence level of DDIs provided in the two databases; Spearman’s correlation coefficient for Lexicomp® and Micromedex® was -0.009 (p=0.861) and -0.064 (p=0.209), respectively. Conclusion To judge the significance of DDIs, healthcare providers should consider that the information on DDIs may be different between drug information databases; hence, clinical factors must be considered concurrently.

BACKGROUND: This study was performed to identify factors associated with the utilization of tests for diabetes complication and hemoglobin A1c (HbA1c) among diabetes patients in Jeollanam-do, Korea. METHODS: The study subjects were 2,310 diabetes patients participated in 2014 community health survey in Jeollanam-do, Korea. Dependent variables were the utilizations of fundus examination, microalbuminuria test, and HbA1c test. The used statistical analysis methods were chi-square test and hierarchical regression analysis with weight in consideration of complex sample design. RESULTS: The utilization rates of fundus examination, microalbuminuria test, and HbA1c test were 25.8%, 27.4%, and 12.3%, respectively. In the results of hierarchical regression, fundus examination was significantly related to age, education level in predisposing factors, residential area in enabling factors and recognition of blood sugar, drug therapy, and subjective health status in need factors. Microalbuminuria examination was significantly related to monthly income, residential area in predisposing and health screening, recognition of blood sugar, drug therapy, diabetic education, number of chronic disease, and subjective health status in need factors. HbA1c examination was significantly related to age, education level, marital status in predisposing factors, residential area in enabling factors and drinking, recognition of blood sugar, drug therapy, and diabetic education in need factors. CONCLUSION: The results of this study were shown that perception of their disease seriousness, education about diabetes management, and accessibility of tests were important to utilization of test for diabetes complication and HbA1c. It might be necessary to the develop and strength strategies for enhancing the utilization of tests for diabetes complication and management in diabetes patients.
Asian Continental Ancestry Group ; Blood Glucose ; Causality ; Chronic Disease ; Diabetes Complications* ; Diagnostic Self Evaluation ; Drinking ; Drug Therapy ; Education ; Health Surveys ; Humans ; Jeollanam-do ; Korea ; Marital Status ; Mass Screening ; Patient Acceptance of Health Care ; Risk Factors

OBJECTIVE: To provide a systematic overview of the effects of various parameters on contrast enhancement within the same population, an animal experiment as well as a computer-aided simulation study was performed. MATERIALS AND METHODS: In an animal experiment, single-level dynamic CT through the liver was performed at 5-second intervals just after the injection of contrast medium for 3 minutes. Combinations of three different amounts (1, 2, 3 mL/kg), concentrations (150, 200, 300 mgI/mL), and injection rates (0.5, 1, 2 mL/sec) were used. The CT number of the aorta (A), portal vein (P) and liver (L) was measured in each image, and time-attenuation curves for A, P and L were thus obtained. The degree of maximum enhancement (Imax) and time to reach peak enhancement (Tmax) of A, P and L were determined, and times to equilibrium (Teq) were analyzed. In the computed-aided simulation model, a program based on the amount, flow, and diffusion coefficient of body fluid in various compartments of the human body was designed. The input variables were the concen-trations, volumes and injection rates of the contrast media used. The program generated the time-attenuation curves of A, P and L, as well as liver-to-hepatocel-lular carcinoma (HCC) contrast curves. On each curve, we calculated and plotted the optimal temporal window (time period above the lower threshold, which in this experiment was 10 Hounsfield units), the total area under the curve above the lower threshold, and the area within the optimal range. RESULTS: A. Animal Experiment: At a given concentration and injection rate, an increased volume of contrast medium led to increases in Imax A, P and L. In addition, Tmax A, P, L and Teq were prolonged in parallel with increases in injection time The time-attenuation curve shifted upward and to the right. For a given volume and injection rate, an increased concentration of contrast medium increased the degree of aortic, portal and hepatic enhancement, though Tmax A, P and L remained the same. The time-attenuation curve shifted upward. For a given volume and concentration of contrast medium, changes in the injection rate had a prominent effect on aortic enhancement, and that of the portal vein and hepatic parenchyma also showed some increase, though the effect was less prominent. A increased in the rate of contrast injection led to shifting of the time enhancement curve to the left and upward. B. Computer Simulation: At a faster injection rate, there was minimal change in the degree of hepatic attenuation, though the duration of the optimal temporal window decreased. The area between 10 and 30 HU was greatest when contrast media was delivered at a rate of 2 -3 mL/sec. Although the total area under the curve increased in proportion to the injection rate, most of this increase was above the upper threshould and thus the temporal window was narrow and the optimal area decreased. CONCLUSION: Increases in volume, concentration and injection rate all resulted in improved arterial enhancement. If cost was disregarded, increasing the injection volume was the most reliable way of obtaining good quality enhancement. The optimal way of delivering a given amount of contrast medium can be calculated using a computer-based mathematical model.
Animal ; Computer Simulation ; Contrast Media/*administration & dosage ; Dogs ; Human ; Liver/*radiography ; Support, Non-U.S. Gov't ; *Tomography, X-Ray Computed

Understanding the level of a person's perception of changes that have occurred on the face after orthodontic treatment is critical to the process of orthodontic diagnosis and treatment planning. The purpose of this study was to determine the level of perception of profile and frontal changes in lower facial height. Forty students attending art school participated in a study evaluating the level of a participant's perception of changes in the lower facial height. Participants compared computer-graphic frontal and profile photographs with balanced proportions and photograph simulations of 1, 2, 3, and 4 mm changes in lower facial height from stomion to the chin. At least a 2 mm change in lower facial height for the profile view and 3 mm in the frontal view was needed to be perceived after orthodontic treatment. The level of a person's perception of the change in lower facial height was more sensitive in the profile view than in the frontal view, and information about facial changes given prior to evaluation enhanced the level of perception.
Chin ; Diagnosis ; Humans

The Elfvingia applanata (EA), Hericium erinaceum (HE),Grifola frondosa (GF), Pholiota nameko (PN), Pleurotus eryngii (PE), Trametes suaveolens (TS), Fomes fomentarius (FF), and Inonotus obliquus (IO) could produce the endo- (EN) and exo-biopolymer (EX) in submerged culture. The highest anti-complementary activity of the EN was exhibited by PN (49.1%), followed by HE (38.6%), TS (37.0%),and FF (33.0%),whereas the high activity of the EX was found with GF (59.8%),followed by HE (36.3%),TS (30.8%),and IO (28.8%). The EN of P. nameko (EN-PN) and EX of G. frondosa (EX-GF) were found to contain 78.6% and 41.2% carbohydrates, while 21.4% and 58.8% protein, respectively. The sugar and amino acid compositions of EN-PN and EX-GF were also analyzed in detail.
Agaricales* ; Carbohydrates ; Coriolaceae ; Pholiota ; Pleurotus ; Trametes

The purpose of this study was to evaluate and compare the shear bond strength of orthodontic brackets depending on the variety of adhesives and whether saliva exists, by using self-etching primer (SEP). Groups were divided according to the type of adhesive into resin adhesive (Transbond XT) and resin-modified glass ionomer cement (Fuji Ortho LC). One group of resin adhesive used XT primer after etching with 37% phosphoric acid, and the other group used self-etching primer. One group of resin-modified glass ionomer cement only used etching for bonding, and the other group used SEP. Each of the groups were also classified by whether saliva was contaminated or not, and then the shear bond strength was measured. The results showed that when using resin adhesive, the shear bond strength of SEP was lower than the XT primer. In the resin-modified glass ionomer cement groups, the shear bond strength which depends on the priming method, did not have a meaningful difference statistically. When saliva was contaminated, the group which used SEP, regardless of the adhesive variety, had a greater shear bond strength than the normal priming group. From these results, SEP showed a shear bond strength that is possible to be used clinically, regardless of the adhesive variety. It can especially be clinically useful to use SEP to bond brackets even on tooth surfaces contaminated with saliva, because it offers the appropriate bonding strength as well as shorter treatment time and easy application.
Adhesives* ; Glass Ionomer Cements ; Orthodontic Brackets* ; Saliva* ; Tooth

Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC. Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed. Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different. Conclusion Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.