Objectives: Currently, more than 80% of Korean police officers are assigned to a 24-hour rotating shift system. Shift workers’ sleep patterns change frequently, which may result in circadian rhythm desynchrony and sleep disturbance. The goal of this study was to compare sleep and cognitive functioning in different shift types. In addition, we analyzed the difference in cognitive functioning depending on whether shift workers took a night nap prior to their night shift. Methods: A total of 278 police officers working in Seoul (mean age 45.27±9.00 years, 88.5% male) participated, providing demographic information and completing selfreport questionnaires [Insomnia Severity Index, Epworth Sleepiness Scale, Munich ChronoType Questionnaire (Shift-work type), Patient Health Questionnaire-9]. Participants also performed the Psychomotor Vigilance Task, Trail Making Test A & B, and Stroop Test. Results: Participants included 57 (20.5%) day workers and 221 (79.5%) shift workers. The average Insomnia Severity Index score of shift workers was significantly higher than day workers (t=-2.861, p=0.005). Shift workers also slept about 0.78 hours less than day workers (t=4.730, p<0.001). Among shift workers, 66.3% (n=128) reported they took night naps prior to their night shift, sleeping on average 1.78 hours. Shift workers who took night naps had faster reaction times on the Trail Making Test A task [F(1, 136)=5.741, p=0.018], and significantly fewer Stroop C errors [F(1, 137)=5.638, p=0.019] than those who did not. Conclusions Shift working police officers reported significantly worse insomnia symptoms and slept less compared to their non-shift-working counterparts. Taking a night nap improved focused and selective attention.

Objectives: Currently, more than 80% of Korean police officers are assigned to a 24-hour rotating shift system. Shift workers’ sleep patterns change frequently, which may result in circadian rhythm desynchrony and sleep disturbance. The goal of this study was to compare sleep and cognitive functioning in different shift types. In addition, we analyzed the difference in cognitive functioning depending on whether shift workers took a night nap prior to their night shift. Methods: A total of 278 police officers working in Seoul (mean age 45.27±9.00 years, 88.5% male) participated, providing demographic information and completing selfreport questionnaires [Insomnia Severity Index, Epworth Sleepiness Scale, Munich ChronoType Questionnaire (Shift-work type), Patient Health Questionnaire-9]. Participants also performed the Psychomotor Vigilance Task, Trail Making Test A & B, and Stroop Test. Results: Participants included 57 (20.5%) day workers and 221 (79.5%) shift workers. The average Insomnia Severity Index score of shift workers was significantly higher than day workers (t=-2.861, p=0.005). Shift workers also slept about 0.78 hours less than day workers (t=4.730, p<0.001). Among shift workers, 66.3% (n=128) reported they took night naps prior to their night shift, sleeping on average 1.78 hours. Shift workers who took night naps had faster reaction times on the Trail Making Test A task [F(1, 136)=5.741, p=0.018], and significantly fewer Stroop C errors [F(1, 137)=5.638, p=0.019] than those who did not. Conclusions Shift working police officers reported significantly worse insomnia symptoms and slept less compared to their non-shift-working counterparts. Taking a night nap improved focused and selective attention.

Purpose: The purpose of this study was to identify the factors influencing organizational commitment of staffs according to the size of long-term care facility. Methods: A cross-sectional descriptive study was designed. Data collection was conducted for a total of 315 employees in long-term care facilities located in Seoul, Gyeonggi, Gangwon, Gyeongbuk, and Chungnam. Data were collected from July 2018 to October 2018 using questionnaires which included emotional labor, job satisfaction, organizational commitment, and general characteristics. In order to confirm the differences in the size of the facility, the facilities with less than 30 beds, those with 30-99 beds, and those with more than 100 beds were analyzed. Data were analyzed using descriptive statistics, t-test, ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, Pearson's correlation analysis, and multiple regression. Results: The job satisfaction and organizational commitment were significantly different according to the size of long-term care facility. Organizational commitment was influenced by ‘external job satisfaction’ in less than 30 beds, was influenced by ‘external job satisfaction, and attentiveness to required display rules of emotional labor’ in 30~99 beds, and then was influenced by ‘type of job, and internal job satisfaction’ in more than 100 beds. The predict variables accounted for 23.0%, 41.0%, and 34.0% of organizational commitment respectively. Conclusion These findings show that tailored interventions should be provided depending on the size of facility in order to increase organizational commitment. In addition, organizational commitment programs should be developed by considering strategies to reduce the emotional labor and to increase job satisfaction.

BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) is beneficial in treatment of stroke or head and neck cancer. The situation for dementia is unknown. Presently, results, complications, and survival of PEG patients with or without dementia were assessed. METHODS: In a retrospective analysis of 67 patients, gender, age, diagnosis, laboratory results, complications, tube change, early death and death were compared in dementia (n=5) and non-dementia (n=62) patients (average age 68.7 years). RESULTS: Patient clinical characteristics were not different, except for the proportion of gender. Complications occurred in 11 cases (16.4%). Wound infection was the most common complication followed by Mallory-Weiss tear, tube leakage, fever and pneumonia. Twenty six patients (38.8%) died during the follow-up period, and the 30 day mortality rate was 2.7%. Average survival of dementia and non-dementia patients was 12 months and 25 months, respectively. Dementia patients showed a tendency for shorter survival, although it was insignificant (p=0.068). Dementia was the only predictor of mortality that showed significance (p=0.006). CONCLUSION: In this study there was a tendency for shorter survival in dementia patients and dementia was the only significant predictor of mortality.
Clinical Laboratory Techniques ; Dementia ; Fever ; Follow-Up Studies ; Gastrostomy ; Head and Neck Neoplasms ; Humans ; Mallory-Weiss Syndrome ; Pneumonia ; Retrospective Studies ; Stroke ; Wound Infection

Nephrogenic diabetes insipidus (DI) secondary to chronic urinary tract obstruction is a rare disease. The exact cause is unknown but it is likely that increased collecting duct pressures cause damage to the tubular epithelium, resulting in insensitivity to the action of arginine-vasopressin (AVP). A 77-year-old man complaining of polyuria and polydipsia was treated with alpha glucosidase inhibitor under the impression of polyuria due to diabetes mellitus. But his symptoms did not improve. Water deprivation and AVP administration study revealed that the patient had nephrogenic DI. Urinary tract obstruction due to an enlarged prostate was suggested as a principal cause of nephrogenic DI. The patient underwent transurethral resection of the prostate and bilateral subcapsular orchiectomy. After surgery, the urine osmolarity was normalized and the patient became symptom-free. We report a case of nephrogenic DI due to obstructive uropathy which was cured by surgery eliminating obstruction.
Adenocarcinoma/ultrasonography ; Adenocarcinoma/radionuclide imaging ; Adenocarcinoma/pathology ; Adenocarcinoma/complications* ; Aged ; Case Report ; Constriction, Pathologic/etiology ; Diabetes Insipidus, Nephrogenic/etiology* ; Human ; Male ; Prostatic Neoplasms/ultrasonography ; Prostatic Neoplasms/radionuclide imaging ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/complications* ; Urologic Diseases/etiology*

Background: and Purpose The importance of the quality of life (QOL) of carers has been increasingly recognized as it has a wide range of effects on the psychological, emotional, and social outcomes of patients with Parkinson’s disease (PD). Understanding their QOL is important as it reflects their unique characteristics; however, there have been few studies on this in Korea. This study aimed to translate and validate the Korean version of the Parkinson’s Disease Questionnaire–Carer (PDQ-Carer). Methods: This was a methodological study that included a translation process and a crosssectional investigation. The Korean version of the scale was developed using back translation, semantic adjustment, and pretests. The final version was self-administered by 125 Korean family carers. Cronbach’s alpha values were used to assess the internal consistency of the PDQ-Carer. Exploratory and confirmatory factor analyses were used to validate the translated scale. Results: Exploratory factor analysis identified four factors that accounted for 64.51% of the variance. A modified model using modification indices was found to fit the data well in the confirmatory factor analysis. That factor analysis supported the structure of the original four factors with relocation of several items that reflected Korean culture. Cronbach’s alpha values were 0.96 for the total scale, 0.93 for personal and social activities, 0.89 for strain, 0.85 for anxiety and depression, and 0.85 for self-care. Conclusions This study verified that the Korean version of the PDQ-Carer can be used to acquire important information about the multidimensional aspects of the QOL of Korean carers for patients with PD.

Background/Aims: We compared the post-treatment overall survival (OS) and recurrence-free survival (RFS) between patients with Child-Turcotte-Pugh (CTP) class-A and single small (≤3 cm) hepatocellular carcinoma (HCC) treated by surgical resection (SR) and radiofrequency ablation (RFA). Methods: We retrospectively analyzed 391 HCC patients with CTP class-A who underwent SR (n=232) or RFA (n=159) as first-line therapy for single small (≤3 cm) HCC. Survival was compared according to the tumor size (≤2 cm/2–3 cm) and the presence of cirrhosis. Inverse probability of treatment weighting (IPW) method was used to estimate the average causal effect of treatment. Results: The median follow-up period was 64.8 months (interquartile range, 0.1–162.6). After IPW, the estimated OS was similar in the SR and RFA groups (P=0.215), and even in patients with HCC of ≤2 cm (P=0.816) and without cirrhosis (P=0.195). The estimated RFS was better in the SR group than in the RFA groups (P=0.005), also in patients without cirrhosis (P<0.001), but not in those with HCC of ≤2 cm (P=0.234). The weighted Cox proportional hazards model with IPW provided adjusted hazard ratios (95% confidence interval) for OS, and the RFS after RFA versus SR were 0.698 (0.396–1.232) (P=0.215) and 1.698 (1.777–2.448) (P=0.005), respectively. Conclusions SR was similar for OS compared to RFA, but was better for RFS in patients with CTP class-A and single small (≤3 cm) HCC. The RFS was determined by the presence or absence of cirrhosis. Hence, SR rather than RFA should be considered in patients without cirrhosis to prolong the RFS, although there is no OS difference.