Fine dust and eye health

This paper aims to make recommendations for the management of eye health related to fine dust exposure. Fine dust is one of the biggest problems related to air pollution in Korea and is becoming a social issue. Fine dust can be classified into fine dust, ultrafine dust, and nanoparticles according to the size of the constituent particles. Although studies evaluating the harmful effects of particulate matter (PM) have been conducted mainly on cardiovascular and respiratory diseases, the ocular surface is a tissue that is continuously exposed to the atmosphere. Eye symptoms caused by PM exposure include eye redness, irritation, and sensation of a foreign body. Typical eye diseases caused by PM exposure include conjunctivitis, dry eye disease, and blepharitis. PM is thought to induce and exacerbate ocular surface diseases and lead to damage through oxidative stress, toxicity, and immune and inflammatory reactions on the ocular surface. For eye health management related to PM exposure, it is necessary to reduce the chance of exposure to PM in advance according to the PM forecast, avoid additional repeated exposure after PM exposure, and remove PM through eye washing and eyelid cleaning. In addition, eye drops, such as artificial tears, diquafosol, and cyclosporin A, can be used to prevent and treat ocular surface disease and deterioration of the damage. In patients who already have ocular surface disease, the harmful effects of PM exposure may be greater and more attention should be paid to eye health management.

Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea / 간호학회지

PURPOSE: The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). METHODS: The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. RESULTS: The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85. CONCLUSION: The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

Factors Influencing HPV Vaccination Intention in Mothers with Elementary School Daughters / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify the impacts of human papillomavirus (HPV) vaccination-related health belief, attitudes toward HPV vaccination, and subjective norms on HPV vaccination intent targeting mothers of elementary school daughters. METHODS: The study use a correlative survey design. The subjects of the study were 121 mothers of elementary school daughters located in metropolitan city B. All subjects agreed to participate in the study. The data were collected from September 1 to October 18, 2018, and were analyzed using descriptive statistics, Independent t-test, ANOVA with a post hoc Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression. RESULTS: Attitude toward HPV vaccination, subjective norms, vaccination plans for their children, and mother's vaccination status were significant factors influencing HPV vaccination intention. These factors accounted for 72% of the HPV vaccination intention. CONCLUSIONS: This study showed that factors affecting the intention of mothers of elementary school daughters to vaccinate against HPV were HPV vaccination attitudes, subjective norms, vaccination plans for their children, and mother's vaccination status. The biggest influencing factor was HPV vaccination attitudes. Therefore, in order to encourage mothers of elementary school daughters to vaccinate against HPVs, national-level policies should be implemented to create a social atmosphere of positive attitudes toward HPV vaccinations that also emphasizes how easy it is to get vaccinated against HPV. Based on this, mothers of elementary school daughters should be encouraged to have them vaccinated against HPV, thus contributing to improving the HPV vaccination rates of elementary school girls.

Minimizing tissue damage due to filler injection with systemic hyperbaric oxygen therapy

Recently, there is a growing interest of hyperbaric oxygen therapy in many fields of medicine. We had a 43-year-old female patient presented with severe necrosis of the nose, philtrum, and upper lip due to retrograde arterial occlusion after nasolabial fold hyaluronic acid filler injection. Our patient went through 43 sessions of systemic hyperbaric oxygen therapy from December 2, 2017 to January 18, 2018. We administered 2.8 atmosphere absolute (ATA) for 135 minutes in the first session and the remaining sessions consisted of 2.0 ATA for 110 minutes. In reporting this case, we wish to provide a warning regarding the latent risk of filler injections and share our experience about minimizing soft tissue damage in the early stages with systemic hyperbaric oxygen therapy.

Association between job-related stress and experience of presenteeism among Korean workers stratified on the presence of depression

BACKGROUND: Presenteeism refers to the phenomenon of working while sick. Its development can be attributed to not only somatic symptoms but also underlying social agreements and workplace atmosphere. In this study, we analyzed presenteeism among workers from various industries, focusing on job-related stress with stratification on the presence of depression. METHODS: We conducted the study with data from questionnaires filled in by different enterprises enrolled in the Federation of Korean Trade Unions. Workers' depressive symptoms were investigated using the Patient Health Questionnaire-2, while questions on job-related stress and presenteeism were derived from the short form of the Korean Occupational Stress Scale and the official Korean version of the Work-Productivity and Activity Impairment Questionnaire-General Health, respectively. Multilevel logistic analysis was conducted to determine the statistical differences derived from the differences between companies. RESULTS: In total, 930 participants (753 men and 177 women) from 59 enterprises participated in the research. We conducted multilevel logistic regression to determine the association between the variables and presenteeism, with stratification by the presence of depression. Higher job demands and higher interpersonal conflict showed significantly elevated odds ratios (ORs) in univariate models and in the multivariate multilevel model. In the final model of total population, fully adjusted by general and work-related characteristics, higher job demands (OR: 3.29, 95% confidence interval [CI]: 2.08–5.21) and interpersonal conflict (OR: 1.87, 95% CI: 1.29–2.71) had significantly higher ORs—a tendency that remained in participants without depression. CONCLUSIONS: This study reflected the factors associated with presenteeism among workers from various enterprises. The findings revealed that job-related stress was closely related to presenteeism in both the total population and in the population without depression. Thus, it emphasized interventions for managing job stress among workers to reduce presenteeism in general workers' population.

Distribution of Pathogenic Vibrio Species in the Coastal Seawater of South Korea (2017–2018)

OBJECTIVES: Pathogenic Vibrio species are widely distributed in warm estuarine and coastal environments, and can infect humans through the consumption of raw or mishandled contaminated seafood and seawater. For this reason, the distribution of these bacteria in South Korea was investigated.METHODS: Seawater samples were collected from 145 coastal area points in the aquatic environment in which Vibrio species live. Environmental data (i.e., water temperature, salinity, turbidity, and atmospheric temperature) was collected which may help predict the distribution of the species (data not shown). Seawater samples were filtered, and incubated overnight in alkaline peptone water, at 37°C. Using species-specific polymerase chain reaction methods, screening tests were performed for the hlyA, ctxA, vvhA, and tlh genes. Clones of pathogenic Vibrio species were isolated using 3 selective plating media.RESULTS: In 2017, total seawater isolation rates for Vibrio vulnificus, Vibrio cholerae (non-pathogenic, non-O1, non-O139 serogroups), and Vibrio parahaemolyticus were 15.82%, 13.18%, 65.80%, respectively. However, in 2018 isolation rates for each were 21.81%, 19.40%, and 70.05%, respectively.CONCLUSION: The isolation rates of pathogenic Vibrio species positively correlated with the temperature of seawater and atmosphere, but negatively correlated with salinity and turbidity. From 2017 to 2018, the most frequent seawater-isolated Vibrio species were V. parahaemolyticus (68.10 %), V. vulnificus (16.54%), and non-toxigenic V. cholerae (19.58%). Comprehensive monitoring, prevention, and control efforts are needed to protect the public from pathogenic Vibrio species.

The Effect of Appreciative Inquiry on Positive Psychological Capital and Organizational Commitment of New Nurses / 중환자간호학회지

PURPOSE: The purpose of this study was to determine whether appreciative inquiry (AI) is an effective intervention for increasing the positive psychological capital and organizational commitment of new nurses.METHOD: The study used a nonequivalent control group pretest-posttest design. The participants were 60 new nurses in a tertiary hospital in Seoul. The experimental group received 2 classes of AI education and in-unit AI activities. The control group received the existing education program.RESULTS: There was no statistically significant difference in the positive psychological capital and organizational commitment between the experimental group and the control group over time. Satisfaction with the AI education scored 3.69, which was higher than the average. The reason why the experimental group members were satisfied with the program was that AI education helped them to adapt and the in-unit AI activities made staff more cooperative and the atmosphere of the unit more positive.CONCLUSION: When applying AI activities to new nurses to promote positive psychological capital and organizational commitment, it is necessary to provide a workshop in which the participants can fully concentrate on education and to extend the period of use to one year in order to maintain the effect of AI activities.

Evaluation of Consultation with Young Patients with Cancer and their Children in Hospice Palliative Care During Infancy, Childhood, and Adolescence / 의료커뮤니케이션

BACKGROUND: In this study, consultations with children of young patients with cancer were evaluated by dividing the child's age into infancy, childhood, and adolescence to ensure the necessity and importance of appropriate intervention, coordination, and communication.METHODS: From June 2017 to February 2019, medical records and consultation records were reviewed by selecting suitable cases among patients hospitalized in hospice palliative care unit at a Pusan national university Yangsan hospital. The consultation was conducted on several occasions by nurses, doctors and social workers from the time the patient was hospitalized to the day before death.RESULTS: The cases of consultation were as follows: female patient with stomach cancer with a child in infancy, patient with gastric cancer with a child in childhood, and male patient with rectal cancer with a child in adolescence.CONCLUSION: It is ideal for parents to initiate communication with their children on their terminal status, so multidisciplinary teams must first support the motivation. In consultations with children, we should first explain the information about the cancer status of the parents, followed by the future clinical course, estimated life expectancy, and changes related to terminal status. Additionally, we must attempt to manage the psychological and emotional concerns of children. This study may support the creation of an atmosphere for in-depth research on family interviews of young patients with cancer in Korea. We think that this will contribute as basic data for some guidelines for communication based on the age of children in consultations with patients with terminal cancer.

Implementing Competency-Based Medical Education in Internal Medicine Residency Training Program: the Process and Impact on Residents' Satisfaction

BACKGROUND: Graduate medical education is shifting from the traditional apprenticeship model to a competency-driven model. Here we describe the design and implementation of competency-based medical education (CBME) in an internal medicine residency program, and report satisfaction survey results. METHODS: We redesigned the residency curriculum as CBME to be resident-centred, systematic, focused on general internal medicine, to provide experience in various care setting, and work-based assessment. In the second year of this CBME transition, we surveyed residents' overall satisfaction using 5-point Likert scale. Feedback on their training program was also analysed. RESULTS: The overall satisfaction score was 3.24 and thirteen residents (61.9%) answered that the preceptor's practical training in an educational atmosphere and improvement through training were the merits of the training program. However, residents complained about the working condition such as work overload. CONCLUSION: With the CBME implementation, most residents expressed satisfaction with the hospital's educational environment but they suffered from overwork. Further efforts to improve the educational program and environment are warranted.

Factors Influencing Happiness among Pregnant Women in the Ecological Systems Theory

PURPOSE: This study tries to systematically understand factors that explain levels of happiness among pregnant women in the Ecological systems theory. METHODS: A descriptive, cross-sectional study was conducted with 169 pregnant women in Korea. Collected data from self-report questionnaires were analyzed by hierarchical regression analysis using the SPSS statistics 23 program. RESULTS: A total of 5 models were examined according to individual, microsystem, mesosystem, exosystem, and macrosystem in the Ecological systems theory. In the first model including individual factors, extraversion, neuroticism, and physical and psychological change constitute significant factors explaining happiness. In the second model with microsystem factors and in the third one with mesosystem factors, marital intimacy appears to be a significant factor. In the fourth model including exosystem factors, community service is a significant factor. In the final model with social atmosphere, personality (β=.15 for extraversion; β=−.30 for neuroticism), physical and psychological change (β=−.15), marital intimacy (β=.35), and community service (β= .18) turn out to be significant. These factors explain 59% of the variance of happiness in the pregnant women in Korea. CONCLUSION: Considering the fact that pregnant women's happiness is explained by microsystem and exosystem factors as well as individual factors, developing intervention programs that can promote influencing factors such as marital intimacy and community service is necessary to improve levels of happiness among pregnant women in Korea.

Monitoramento de espécies fúngicas no ar atmosférico da região metropolitana de São Paulo / Monitoring of fungal species in the atmospheric air of the metropolitan region of São Paulo

Introdução: As análises de controle ambiental de ar atmosférico são realizadas caracterizando principalmente a parte química dos aerossóis. Boa parte dos aerossóis são partículas vivas ou fragmentos de micro-organismos que utilizam o ar como veículo de dispersão. A natureza dessas biopartículas é diversa, podendo conter vírus, protozoários, bactérias, fungos e outros. Os fungos dispersos no ar são chamados de anemófilos. Como as informações sobre os anemófilos da cidade de São Paulo ainda são escassas, se faz necessário fazer um levantamento destes micro-organismos e suas relações com as condições atmosféricas e os poluentes presentes no ar, permitindo adicionar informações que poderão ser úteis para os modelos climáticos e de saúde, além de poder auxiliar novos estudos na área da epidemiologia ambiental, talvez como biomarcadores de poluição. Objetivo: Analisar a frequência de diferentes gêneros fúngicos na atmosfera da região metropolitana de São Paulo e correlacionar com as condições atmosféricas e os poluentes circulantes. Materiais e Métodos: A concentração de fungos e bactérias foi analisada no ar atmosférico de São Paulo em quatro pontos, três na cidade de São Paulo, sendo um no Instituto de Astronomia, Geofísica e Ciências Atmosféricas situado na Cidade Universitária, dois no bairro Cerqueira César distintos pela altitude (andar térreo e 23º andar) e na cidade de Ibiúna, no Bairro Votorantim. Os dados sobre os poluentes foram obtidos na Companhia Ambiental do Estado de São Paulo (Cetesb) e das condições atmosféricas foram obtidos no banco de dados do Ministério da Agricultura, Pecuária e Abastecimento do país (INMET). Durante as coletas utilizamos impactadores de ar. Foram coletadas 736 amostras, durante seis anos. Após as coletas, foi feita a análise da concentração de fungos e bactérias. Após crescimento, uma colônia de cada gênero por dia de coleta/ponto foi enviada para identificação, totalizando 1630 isolados. Durante o processo de identificação de gênero foram utilizadas características fenotípicas e as espécies do gênero Aspergillus foram identificadas pelo sistema Maldi-tof. Resultados: De acordo com os resultados obtidos, as condições meteorológicas da cidade de São Paulo influenciam diretamente na concentração de fungos dispersos no ar. A diversidade fúngica variou com a região estudada. Discussão: É difícil avaliar a importância individual de cada componente do ar devido à natureza dinâmica da atmosfera. O que se sabe é que as investigações sobre bioaerossóis fúngicos e a atenção que tem sido dada às suas relações com as condições atmosféricas e a poluição são escassas. Com os resultados obtidos foi verificado que a concentração de fungos se modifica de acordo com as condições ambientais levando a crer que eles podem ser utilizados como bioindicadores de poluição. Conclusão: Como os fungos presentes no ar atmosférico são sensíveis às condições atmosféricas e à exposição a poluentes, eles podem ser utilizados como marcadores de poluição, seu monitoramento associado ao controle de poluentes e condições atmosféricas fortalece as pesquisas relacionadas ao ar atmosférico

Introduction: Atmospheric air environmental control analyzes are carried out mainly characterizing the chemical part of the aerosols. Much of the aerosols are live particles or fragments of microorganisms that use air as the dispersing vehicle. The nature of these bioparticles is diverse and may contain viruses, protozoa, bacteria, fungi and others. Fungi dispersed in the air are called anemophils. As the information about anemophils in the city of São Paulo is still scarce, it is necessary to survey these microorganisms and their relationships with atmospheric conditions and pollutants present in the air, allowing the addition of information that may be useful for climate models and health, in addition to being able to support new studies in the area of environmental epidemiology, perhaps as biomarkers of pollution. Objective: To analyze the frequency of different fungal genera in the atmosphere of the metropolitan region of São Paulo and to correlate with atmospheric conditions and circulating pollutants. Materials and Methods: The concentration of fungi and bacteria was analyzed in the air of São Paulo in four points, three in the city of São Paulo, one in the Institute of Astronomy, Geophysics and Atmospheric Sciences located in the University City, two in the district of Cerqueira César distinguished by altitude (ground floor and 23rd floor) and in the city of Ibiúna, Votorantim District. Data on the pollutants were obtained from Companhia Ambiental do Estado de São Paulo (Cetesb) and the weather conditions were obtained from the Ministry of Agriculture, Livestock and Supply (INMET) database. During the collection, we use air impactors. A total of 736 samples were collected for six years. After collection, the concentration of fungi and bacteria was analyzed. After growth, a colony of each genus per day of collection/point was sent for identification, totaling 1630 isolates. During the process of genus identification, phenotypic characteristics were used and the species of the genus Aspergillus were identified by the Maldi-tof system. Results: According to the results obtained, the meteorological conditions of the city of São Paulo directly influence the concentration of fungi dispersed in the air. Fungal diversity varied with the studied region. Discussion: It is difficult to assess the individual importance of each component of air due to the dynamic nature of the atmosphere. What is known is that research on fungal bioaerosols and the attention paid to its relations with weather and pollution are scarce. With the results obtained, it was verified that the fungi concentration modifies according to the environmental conditions leading to the belief that they can be used as bioindicators of pollution. Conclusion: As fungi present in atmospheric air are sensitive to atmospheric conditions and exposure to pollutants, they can be used as pollution markers; their monitoring associated with pollutant control and atmospheric conditions strengthens atmospheric air-related research

Experience of nursing students about the barriers to patient education: a qualitative study in Iran / 한국의학교육

PURPOSE: Patient education is a dynamic and continuous process that should be implemented during the entire time of hospital stay and even afterward. Studies have shown the typically poor quality of patient education in Iran and its failure to convey the required knowledge and skills to patients. The purpose of this study was to survey the experience of nursing students in regard to the challenges of patient education in hospitals. METHODS: This qualitative study was conducted using the conventional qualitative content analysis approach on a sample of 21 undergraduate nursing students (4th semester and beyond), which was drawn from the Qom Nursing and Midwifery School through purposive sampling with maximum variation. Data were collected through semi-structured interviews conducted over a period of 45 to 75 minutes, and were analyzed using the conventional qualitative content analysis. RESULTS: Results were derived from the experiences of 21 nursing students (nine males, 12 females) about the research subject. The primary themes identified in the study were the student-related, patient-related, instructor-related, education environment-related, and curriculum-related barriers to patient educations. CONCLUSION: Participants believed that patient education in Iranian hospitals is faced with many challenges. Nursing instructors and curriculum planners should ensure more emphasis on patient education at the initial semesters of nursing education curriculum and make sure that it is included in the evaluation of students. Hospital officials should provide a dedicated education environment with suitable facilities, tools, and atmosphere for patient education. Also, special education programs need to be developed for less educated patients.

Successful treatment of central retinal artery occlusion using hyperbaric oxygen therapy

Central retinal artery occlusion (CRAO) is considered an ophthalmologic emergency. The prognosis of this disease is very poor. Currently, there is no generally effective therapy available to treat CRAO. Hyperbaric oxygen therapy (HBOT) can increase the volume of oxygen delivered to the ischemic retinal tissue until spontaneous or assisted reperfusion occurs. We report the case of a patient who experienced sudden visual loss due to CRAO that was treated with HBOT. The patient was an 81-year-old woman who presented with CRAO in her right eye (OD). She exhibited “hand motion” visual acuity before treatment. She underwent three sessions of HBOT at a pressure of 2.8 atmospheres absolute, performed over 3 days. After 4 days in hospital, her visual acuity improved to 0.4 (OD) for far vision and 0.5 (OD) for near vision. Her vision was stable without the supply of oxygen; therefore, she was discharged.

Factors Influencing Patient Safety Nursing Activities of Nurses in Long-term Care Hospitals / 간호행정학회지

PURPOSE: The purpose of this study was to identify factors influencing patient safety nursing activities of nurses working in long-term care hospitals. METHODS: The participants were 126 nurses working in 8 long-term care hospitals in B city. Data were collected from June 26 to July 10, 2017. SPSS/WIN 23.0 was used for analysis with t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and hierarchical multiple regression. RESULTS: The factors influencing patient safety nursing activities in participants were general characteristics, career in present long-term care hospital, (β=−.23, p=.008), safety control (β=.29, p=.002) and intention to report (β=.19, p=.037); on the personal side, informal communication (β=−.31, p=.005) for the organizational side. These factors contributed 39% of the total variance in patient safety nursing activities. CONCLUSION: In the organizational dimension of long-term care hospital, formal communication channels should be strengthened to officially direct or report patient safety rather than using informal communication. In order to improve the sense of safety control, which is a personal side of long-term care hospital nurses, it is necessary to provide awareness and education about the continuous safety control and positively prepare the reporting atmosphere to increase long-term care hospital nurses' intention to report.

Exploring Decision-Making Factors of Psychiatric Nurses in the Application of Seclusion and Restraint: Applying Focus Group Interviews / 정신간호학회지

PURPOSE: The purpose of this study was to explore psychiatric nurses' decision making in the use of seclusion and restraint (SR). METHODS: Data were collected using focus group interviews. Two focus group interviews were held with a total of 10 psychiatric nurse participants. All interviews were recorded and transcribed, and data were analyzed using qualitative content analysis. RESULTS: Eleven categories emerged from three main themes. All the themes describe factors that participants took into account when deciding whether to implement SR: 1) Personal factors area: ‘Personal attributes of nurses,’ ‘Attitude of nurses regarding SR,’ ‘Nurses’ ‘physical and emotional states,’ ‘Negative experiences of nurses related to SR’; 2) Relational factors area: ‘The level of cooperation between nurses and doctors,’ ‘Role models created by seniors and colleagues,’ ‘The level of support by nursing assistants,’ ‘Therapeutic relations with patients’; and 3) Environmental factors area: ‘Poor nursing work environment,’ ‘Atmosphere of ward regarding SR,’ and ‘Social atmosphere to raise alarm about SR.’ CONCLUSION: These findings should be considered in the evaluation of the use of SR in psychiatric hospital settings and appropriate strategies used to help minimize the use of restraint.

Influence of water absorption on flexural strength and elastic modulus in several resinous teeth splinting materials

PURPOSE: The purpose of this study was to compare flexural strength and elastic modulus of several splinting materials dependent on water absorption. MATERIALS AND METHODS: Three different materials; LightFix, G-FIX, G-aenial Universal Flo; were used in this study. Thirty rectangular bar specimens (25 × 2 × 2 mm) of each materials were prepared. Fifteen specimens of each materials were stored in 100% relative humidity atmosphere, 37℃ for 24 hours. The other specimens were stored in distilled water, 37℃ for 30 days. Flexural strength and elastic modulus were calculated using Universal testing machine. One-way ANOVA and Scheffe's post hoc test at 95% level of significance were used on all test results. RESULTS: In LightFix, flexural strength and elastic modulus were significantly decreased after aging. In G-FIX, there was no significant change in flexural strength and elastic modulus after aging. In Gaenial Universal Flo, flexural strength was significantly decreased, but elastic modulus did not change significantly. Statistical analysis reveals that flexural strength and elastic modulus increased in the order of LightFix, G-FIX, G-aenial Flo in both 24 hours and 30 days. CONCLUSION: It could be deduced from this study that flexural strength and elastic modulus of some resins could be changed when it aged in oral environment. Thus this should be considered when choosing a resin to perform a resin-bonded splint.

Particulate Matter and Cognitive Function / 신경정신의학

The term “particulate Matter (PM)” refers to the mixture of small-sized solid particles and liquid droplets floating in the air, and is referred to as PM₁₀ ( < 10 µm), PM(2.5) ( < 2.5 µm) and PM(1.0). Much PM is an anthropogenic substance generated by transportation or industrial activities, which is transformed into a second toxic substance by chemical reactions in the atmosphere. PM reaches the brain directly through olfactory transport, or through the blood-brain barrier during systemic circulation. PM that enters the local cerebral circulation causes neuroinflammation through microglial cells and endotoxins. According to previous studies, greater PM exposure results in lower brain volume, especially white matter. Among neurodevelopmental disorders, the correlation between the occurrence of autism spectrum disorder and exposure to PM is widely known. Other studies have found that exposure to PM was associated with low cognitive function and increased rate of cognitive aging. PM can also cause pathology of early Alzheimer's disease and increases the risk of Alzheimer's dementia and mild cognitive impairment.

Effects of Perceived Daily Stress and Sense of Humor on Quality of Life among School-Age Children

PURPOSE: Quality of life is important to everyone including school-age children. Therefore this study was done to identify the effects perceived daily stress and sense of humor on quality of life for these children. METHODS: The study was a cross-sectional, descriptive study design with 371 participants from 5th and 6th grade children in 5 elementary schools. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 24.0 program. RESULTS: Factors influencing quality of life in school-age children were daily stress, sense of humor, satisfaction with daily life, academic performance and home atmosphere. These variables explained 63.0% of quality of life in school-age children. CONCLUSION: Results showed that lower daily stress and higher sense of humor are associated with higher quality of life. Therefore, to improve quality of life in school-age children, healthcare providers should develop intervention programs considering these factors.

The Association of Workplace Psychosocial Factors and Musculoskeletal Pain Among Korean Emotional Laborers

BACKGROUND: Many studies have reported negative psychological or physical effects of emotional labor. Relationship between work-related musculoskeletal disorder and psychosocial factors has been reported. To manage organizational and psychosocial factors of musculoskeletal disorder with work place intervention among emotional laborers, the factors contributing to musculoskeletal pain must be identified and clarified. METHODS: Data from the fourth Korean Working Conditions Survey was analyzed. Based on the questionnaire, we selected emotional laborers and included 3,979 participants, excluding participants whose variables were of interest to the researcher. Weight variable was applied. The association with musculoskeletal pain and psychosocial factors, such as workload, monotonous work, job control, social support, and job satisfaction, was investigated. RESULTS: Univariate analysis demonstrated that there was a statistically significant relationship between social support, job satisfaction, and musculoskeletal pain. In multivariate analysis, job satisfaction showed a strong correlation with musculoskeletal pain at all sites. Social support was significantly associated with backache. Monotonous work seemed to reduce the pain in the neck and/or upper limbs. Job control and work intensity were not significantly associated with musculoskeletal pain. CONCLUSION: In this study, job satisfaction was significantly associated with musculoskeletal pain, and social support among the social psychological stressors could reduce musculoskeletal pain. However, unlike previously known, the presence of monotonous work resulted in reduced musculoskeletal pain. The results of this study will help to establish the direction of improvement of atmosphere in the workplace to prevent the musculoskeletal pain of emotional laborers.

Course quality management based on monitoring by students at a medical school / 한국의학교육

PURPOSE: This study aims to develop a system of course monitoring by students and evaluate the course quality management system (CQMS) implemented as an educational assessment tool. METHODS: This research was conducted in accordance with the ADDIE model which is a well-known instructional design model. The ADDIE process includes needs analysis, design of the course monitoring and course evaluation, development of evaluation forms, implementation of course monitoring, and evaluation of the program. RESULTS: To meet the need for a system that can replace the traditional lecture evaluation approach, this study developed and implemented a new course evaluation system. In comparison with the quantitative evaluation method, course monitoring by students provided more qualitative information on classes and courses from the students' perspective. The students' realistic description helped know how student felt the atmosphere of class and what kinds of teaching style students preferred. However, some view that the evaluation by the four monitoring members was less reliable. CONCLUSION: This study proposed a course quality management based on students' monitoring which emphasized the narrative evaluation to help to identify the strengths and weaknesses of the classes and gather qualitative information from the students' perspective that can be used to improve the courses. It is expected that providing the monitoring members with better orientation could help manage the quality of the courses using the monitoring system.