Empathy and Social Attribution Skills Moderate the Relationship between Temporal Lobe Volume and Facial Expression Recognition Ability in Schizophrenia

Objective@#While impaired facial expression recognition has been closely associated with reduced temporal lobe volume in patients with schizophrenia, this study aimed at examining whether empathy and social attribution affect such a relationship. @*Methods@#A total of 43 patients with schizophrenia and 43 healthy controls underwent a facial expression recognition task (FERT) and magnetic resonance imaging. Basic empathy scale and the social attribution task-multiple choice were used to measure empathy and social attribution. @*Results@#Patients with schizophrenia showed significant positive correlations between the total temporal lobe volume and the FERT-accuracy (FERT-ACC). Diminished temporal lobe volume predicted the impaired facial emotion recognition ability. Both empathy and social attribution played roles as moderators of the path from the left amygdala volume, left fusiform gyrus volume, both sides of the superior temporal gyrus volume, and left middle temporal gyrus volume to the FERT-ACC. In contrast, empathy alone functioned as a moderator between the right fusiform gyrus volume, right middle temporal gyrus volume, and FERT-ACC. No significant interaction was found for healthy controls. @*Conclusion@#Our results suggest that social cognition remediation training on empathy and social attribution, could buffer the negative effects of small temporal lobe volume on interpersonal emotional communication in patients with schizophrenia

Long working hours and overweight and obesity in working adults

BACKGROUND: Previous studies have identified a link between gender and the various risk factors associated with obesity. We examined obesity risk factors in working adults to identify the effects of differences in body mass index (BMI) and percentage body fat (PBF) between women and men. METHODS: A total of 1,120 adults agreed to participate in the study. Data from 711 participants, including 411 women and 300 men, were analyzed. Multiple logistic regression analysis was used to estimate the effects of risk factors on obesity and being overweight. In addition, the least-squares (LS) means of both BMI and PBF were estimated by analysis of covariance (ANCOVA) in a generalized linear model.  RESULTS: Increases in BMI and PBF were significantly related to an age > 50 years and long working hours in women after compensating for confounding factors. Using the PBF criterion, the odds ratio (OR) of being overweight or obese in women > 50 years of age who worked for > 9 h a day was 3.9 (95% confidence interval [CI], 1.05–11.00). For BMI, women who were > 50 years of age and worked for > 9 h a day were 3.82 times (95% CI, 1.31–11.14) more likely to be overweight or obese than those who were 50 years of age and long working hours in women. Further studies are needed to investigate the underlying mechanisms of this relationship and its potential implications for the prevention and management of excess weight and obesity.

An Assessment of the Needs and the Affecting Factors for Small Scale Enterprise Worker's Health Centers / 대한산업의학회지

OBJECTIVES: The aim of this paper is to assess the needs and roles of the Worker's Health Centers employed by small scale enterprises by investigating the requested services made to this type of Worker's Health Center. METHODS: The population of this research was taken from 1,145 business owners or managers of manufacturing companies employing less than fifty people in six industrial estates. Stratified sampling was used. Individual interviews were performed to assess the conditions and needs of these enterprises using a structured questionnaire and professional interviewers. RESULTS: According to the questionnaire survey, 941(82.2%) of the enterprises wish to use a Worker's Health Center. 946(83.3%) of the enterprises preferred an 'Expert visit to the enterprise or mixed' for the Delivery type. 486(42.4%) of the enterprises preferred the 'in the center of industrial complex' for the location of the Worker's Health Center. 789(69.1%) of the enterprises preferred 6-10 PM for the available open hours. A multiple regression analysis revealed a significantly positive association regarding the intention of using a Worker's Health Center and the Gyeonggi-Banwol (OR 2.49) or Gwangju-Hanam(OR 4.24) for the region. Compared to enterprises employing 1-4 worker, 30-49 worker enterprises show a 3.33 fold preference (95% CI 1.80~6.12) for the use of a Worker's Health Center. CONCLUSIONS: Generally, the intention regarding the use of a Worker's Health Center was high, Considering the time and spatial limits inherentin small scale enterprises, the 'expert visit to the enterprise' paradigm is important. It should be noted that when providing the service, a customized approach is necessary, determined by size, region, industry, and scale of the business, through the assessment of the small scale enterprises and the nature of the work environment when designing a Worker's Health Center operation.

Analysis of Worker's Compensation Claims for the Cerebrovascular and Cardiovascular Diseases / 대한산업의학회지

OBJECTIVES: This study was performed to provide fundamental data to judge whether or not cerebro and cardiovascular diseases are work-related, by comparing the characteristics between approved and non-approved cases among the worker's compensation claims. METHODS: We collected 12,309 cerebro and cardiovascular disease claims based on the worker's compensation records of the Labor Welfare Corporation from 2000 to 2004. The approved and non-approved cases were analyzed according to factors such as the calendar year, industry, company size, occupation, gender, age group, classification of cerebro and cardiovascular diseases, fatality and underlying diseases. We used x2-test and multivariate logistic regression for the analysis. RESULTS: According to multivariate logistic regression, electricity gas and water supply (OR=4.18, 95% CI=1.43~12.17), construction (OR=2.39, 95% CI=1.22~4.69) and manufacturing (OR=2.10, 95% CI=1.08~4.07) industries had a higher approval rate than mining and quarrying industries. Service workers and sales & marketing department workers (OR=1.90, 95% CI=1.47~2.47), professionals (OR=1.83, 95% CI=1.50~2.23), technicians and associate professionals (OR=1.63, 95% CI=1.35~1.97) and legislators and senior officials and managers (OR=1.62, 95% CI=1.24~2.12) had a higher approval rate than plant and machine operators and assemblers. Female workers had a higher approval rate (OR=1.31, 95% CI=1.13~1.53) than male workers. Cerebrovascular diseases had a higher approval rate (OR=2.75, 95% CI=2.42~3.13) than cardiovascular diseases. Fatal cases had a higher approval rate (OR=6.01, 95% CI=4.89~7.38) than surviving cases. CONCLUSION: For cerebro and cardiovascular diseases, workers' compensation claims are increasing, approval rates are relatively high and factors such as industry, company size, occupation, gender and fatality are related. A remarkable difference in the approval rate was found according to industry and occupation, suggesting the need for further study to identify which factors influence the approval rate. The approval rate for intracerebral hemorrhage arising in the course of employment (COE) was significantly higher than that arising out of employment (AOE), suggesting the need to correct the approval criteria.

Developing an Occupational Stress Scale for Korean Employees / 대한산업의학회지

BACKGROUND AND PURPOSES: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and METHODS: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002- 2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Fortythree items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. RESULTS: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. CONCLUSION: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Multilevel Analysis of Risk Factors Related to Musculoskeletal Symptoms among Caterers for Elementary School Lunch Services / 대한산업의학회지

OBJECTIVES: To examine the complaint proportion and characteristics of musculoskeletal symptoms and to find risk factors of musculoskeletal symptoms among caterers for school lunch services. METHODS: The study subjects were 385 caterers who were working for school lunch services in 71 elementary schools and 114 housewives who had visited a hospital for routine health check-up. A self-recording questionnaire was used to investigate the general characteristics, labor conditions, job stress and nature of musculoskeletal symptom. Caterers were surveyed from September to October in 2003 and the housewives during September by post. The ergonomic risk factors were examined for the caterers of an elementary school in Kyonggi Province in November, 2003. RESULTS: The complaint proportion of self-reported positive musculoskeletal symptoms was 52.0% and that of severe musculoskeletal symptoms was 24.9%. Ergonomic assessment revealed that washing the dishes, carrying the soup containers and cleaning the sewage drain were highly risky activities in terms of repetitive and heavy weight-bearing motions. As for personal factors, the caterers having severe musculoskeletal symptoms had high psychological job demand. As for the workplace factors, the proportion of schools having severe musculoskeletal symptoms was significant higher where each caterer prepared more than 150 lunches. Among schools without school lunchroom, more schools had caterers having severe musculoskeletal symptoms. Using multilevel analysis, we found that the number of lunches to be prepared per caterer was a significant risk factor of severe musculoskeletal symptoms (O.R. 4.67). CONCLUSIONS: This study showed that the number of lunches prepared per caterer has a significant influence on the development of musculoskeletal disorder and that caterers work in an ergonomically highly risky job environment. The study results suggest that the number of caterers be increased to decrease the number of lunches prepared per caterer and the ergonomic environment be improved.

Maternal Exposure to Environmental Tobacco Smoke (ETS) and Pregnancy Outcome (low birth weight or preterm baby) in Prospective Cohort Study / 예방의학회지

OBJECTIVES: This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preterm baby) in a prospective cohort study. METHODS: We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2, 250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1, 712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preterm or low birth weight, and a linear regression analysis for the birth weight and gestational age. RESULTS: Higher exposure to ETS (> or =1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1hour). Maternal exposure to ETS was associated with preterm baby (adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. CONCLUSIONS: This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preterm births.

Health Related Quality of Life in Occupationally Injured Workers / 대한산업의학회지

OBJECTIVE: In order to compare and find the HRQOL and it's determinants among occupationally injured workers, TA patients and general workers, we performed a crosssectional study in Masan and Changwon city, Korea. METHODS: Cases were 169 occupationally injured workers who admitted in the hospital, and controls were 78 TA patients who admitted in the hospital and 166 general workers who worked at Ulsan industrial area. HRQOL were measured by SBQOL. We investigated confounding variables which were age, sex, marital status, employment status, family numbers, monthly income, diagnosis, treatment duration, expectation for health recovery, and expectation for return to work. We compared the HRQOL among occupationally injured workers, TA patients and general workers. We made four factors from twenty three items by factor analysis and used multiple logistic regression to find determinants on HRQOL in each group. RESULTS: There were significant differences in HRQOL between case and control. The main determinants on HRQOL from multiple logistic regression varied in each group. In occupationally injured workers, age(OR 2.73), treatment duration(> 6 months) (OR 3.09) and expectation for return to work(OR 2.62) were main determinants for HRQOL. And age(OR 1.07), marital status(OR 7.41), family members(OR 5.73), expectation for health recovery(OR 4.23) in TA patients. However, monthly income (<1,300,000 won)(OR 1.76) were main determinants for HRQOL in general workers. CONCLUSION: Return to work is major determinants of HRQOL for occupationally injured workers.

A Study on the Pre-hospital Emergency Care in workplace through the Analysis of Fatal Work-place Injuries / 대한산업의학회지

OBJECTIVES: This study was designed to evaluate the problems of pre-hospital Emergency medical care system (EMS) in workplace. We analysed 25 fatal work-place injuries during the recent 4 years and the work-place EMS of 8 enterprises located in Masan-city, Changwon-city and Kuje-island. METHODS: The safety managers and the members of Dept. of safety in the labor unions were interviewed about the work-place EMS. And we investigated on the injury reports, the work-place medical-room records and the medical records of emergency center for fatal 25 cases. RESULTS: The enterprises had the at-risk machines and processes, volatile materials and high-altitude working processes. There were duty doctors in only 3 enterprises but a few duty nurses or health-care providers in the others. The time spent for the education to the workers on safety was 24hrs/yr in 3 enterprises in 1998 but less than Bhrs in the others. There were medical service center in all enterprises but the ambulances in three. The time for activation of the ambulance was ranging from 5 minutes to 10 minutes in 6 enterprises, and from 10 minutes to 30 minutes in two. The patient transportation to the emergency center was possible within 30 minutes in all enterprises but there were no equipments for airway maintenance and shock management in all enterprises. The 15 (60%) fatal injuries were occurred at one enterprise. The 64% of casualties had the duration of job-employment more than 10yrs and the 68% were suffered the typical type of work-place injury as descending injuries, collisions and falls. Most of all primary calls for rescue were concentrated on the fire-service agencies. But in 85% of fatal injtories, the tome for the activation of ambulance was more than 10 minutes and no emergency care was taken in the field in 48 percent of casualtles. The transportation time to the emergency center was more than 30 minutes in 50 percent. It toolk from injury to death was less than one hour in the 40 percent of all cases, and from one hour to four in the 50 percent. The causes of death in the 68 percent were the head-and-neck injuries or thoracic injuries. CONCLUSIONS: We found that there was Insufficiency of the education associated with work-place injury for workers, manpower and facilities, equipments related to the work-place EMS, the problems of the delay in transportation system.

An Implementation and an Evaluation on the Problem-based Learning in Occupational & Environmental Medicine(OEM) / 한국의학교육

To introduce an OEM course of problem-based learning(PBL) on tutorial basis, we developed the case-studies on both clinical and community contexts. The 2nd grade medical students were divided into eight small groups. The case-study course was for 3 weeks from September 30 to October 14 in 1998. There were 3 steps for design of case-study course : course planning, implementation, and evaluation which were conducted by 3 tutors and 91 students. We developed 32 cases, and a student solved 3 clinical cases during 3 weeks. There were 3 cases which were the case I(metals), the case II(solvent) and the case III(systemic toxicity). The case-study program was evaluated with questionnaire survey method at the start and end of the course by students. We obtained satisfactory responses from students. Multiple-choice tests revealed that students in case-study group had significantly(P<0.05) higher score than those attended the standard lecture. We concluded that problem-based learning with specific occupational contents is well accepted by students and improves their occupational medicine knowledge.