Development of Korean Version Burnout Syndrome Scale (KBOSS) Using WHO’s Definition of Burnout Syndrome

Background@#Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO’s definition of BOS and present the cut-off points for screening. @*Methods@#We developed the KBOSS based on WHO’s definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson’s correlation. The KBOSS reliability was assessed using Cronbach’s alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score. @*Results@#The validity and reliability of the KBOSS were good. Regarding reliability, the scale’s overall Cronbach’s alpha was 0.813. Cronbach’s alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15. @*Conclusion@#The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.

Validation of general job satisfaction in the Korean Labor and Income Panel Study

BACKGROUND: The purpose of this study is to assess the validity and reliability of general job satisfaction (JS) in the Korean Labor and Income Panel Study (KLIPS). METHODS: We used the data from the 17th wave (2014) of the nationwide KLIPS, which selected a representative panel sample of Korean households and individuals aged 15 or older residing in urban areas. We included in this study 7679 employed subjects (4529 males and 3150 females). The general JS instrument consisted of five items rated on a scale from 1 (strongly disagree) to 5 (strongly agree). The general JS reliability was assessed using the corrected item-total correlation and Cronbach's alpha coefficient. The validity of general JS was assessed using confirmatory factor analysis (CFA) and Pearson's correlation. RESULTS: The corrected item-total correlations ranged from 0.736 to 0.837. Therefore, no items were removed. Cronbach's alpha for general JS was 0.925, indicating excellent internal consistency. The CFA of the general JS model showed a good fit. Pearson's correlation coefficients for convergent validity showed moderate or strong correlations. CONCLUSION: The results obtained in our study confirm the validity and reliability of general JS.

Clinical Characteristics of REM-Dependent Obstructive Sleep Apnea in Korean Adults

BACKGROUND: Rapid-eye-movement-sleep-dependent obstructive sleep apnea (REM-OSA) is a sleep breathing abnormality in which apneas/hypopneas occur mainly during REM sleep periods. However, the clinical significance of REM-OSA compared to sleep-stage-non-dependent OSA (SND-OSA) has been controversial. This study evaluated differences in the clinical features, polysomnography (PSG) characteristics, and subjective symptoms between REM-OSA and SND-OSA. METHODS: In total, 136 consecutive patients with mild-to-moderate OSA were enrolled. REM-OSA was defined as a rapid eye movement (REM):non-REM apnea-hypopnea index (AHI) ratio of >2 and a total duration of REM sleep exceeding 30 minutes. We compared the demographic, clinical, and PSG characteristics, and subject symptoms between REM-OSA and SND-OSA. RESULTS: The REM-OSA group comprised 45 (33%) of the 136 subjects. The mean age and total AHI did not differ between the groups, but there was a significant female predominance (35.6% vs. 16.5%) in the REM-OSA group. In terms of PSG parameters, subjects with REM-OSA showed a lower percentage of light sleep and a lower AHI in a supine position despite spending more sleep time in that position. Subjective sleep complaints, depression, anxiety, and health-related quality of life did not differ between the two study groups. CONCLUSIONS: The female predominance and sleep architecture differed between REM-OSA and SND-OSA in this study. The AHI in subjects with SND-OSA was dependent on sleep position rather than sleep stage. Further study is needed to elucidate the pathomechanism and clinical significance of REM-OSA.

The relationship between working condition factors and well-being

OBJECTIVES: Working conditions can exert influence on the physical, mental, and even social health of workers. Well-being is an appropriate index for the evaluation of a person's overall health. This paper investigated the association between various working conditions and worker's well-being. METHODS: Data from 10,019 interviews were collected from the second wave of the Korean Working Conditions Survey (2010) conducted by the Korea Occupational Safety and Health Agency between June and October 2010. The data from 5,995 employed workers were examined in this study. Well-being was measured through the WHO Five Well-Being Index (1998 version). Sociodemographic and working conditions were analyzed. Adjusted odds ratios for well-being were calculated with adjusted sociodemographic factors, working condition factors, or both. RESULTS: Workers' well-being was significantly higher when they were satisfied with their working conditions (OR = 1.656, 95% CI = 1.454-1.885), when their actual working hours were the same as their anticipated working hours (OR = 1.366, 95% CI: 1.120-1.666) or exceeding less than 10 hours (OR = 1.245, 95% CI: 1.004-1.543), and when their employment was stable (OR = 1.269, 95% CI: 1.098-1.467). CONCLUSIONS: This study supports the association between working condition factors and well-being in workers.

Quality of Life in Korean Patients with Obstructive Sleep Apnea

BACKGROUND: Obstructive sleep apnea (OSA) is a common disease, but there are few studies about the quality of life (QOL) of Korean patients with OSA. The aims of the present study were compare the QOL of patients with OSA and healthy controls, and to determine the factors that influence the QOL in these patients. METHODS: This was a casecontrol study comparing the QOL of 136 OSA patients and 126 healthy controls. For all of the subjects, QOL and the severity of subjective symptoms were evaluated using various questionnaires, including the Korean versions of the Medical Outcome Study Short Form-36 (SF-36), the Pittsburg Sleep Quality Index (PSQI-K), the Epworth Sleepiness Scale (KESS), the Insomnia Severity Index (ISI), the Beck Depression Inventory (KBDI)-2, and the Hospital Anxiety Scale (HAS). RESULTS: The QOL was worse in patients with OSA than in the controls, but there was no association between the severity of OSA and the degree of worsening of QOL. Multiple stepwise regression analysis revealed that the strongest associations were found between QOL and HAS, ISI and BDI-2 scoring in OSA patients. CONCLUSIONS: These findings demonstrate that OSA represents a considerable burden on the QOL of Koreans, and suggest that the impairment in QOL of Koreans with OSA is related to the degree of anxiety, insomnia and depression that they suffer.

Gender-wise analysis of the cephalometric factors affecting obstructive sleep apnea / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to perform gender-wise analysis of the related cephalometric factors affecting Korean patients with obstructive sleep apnea (OSA). METHODS: We examined 118 adults who had visited the Sleep Disorder Clinic Center in Keimyung university, Daegu, Korea, and evaluated them by using polysomnography (PSG) and lateral cephalograms. The patients were divided into 4 groups (male simple snorers, male OSA patients, female simple snorers, and female OSA patients) according to AHI (apnea-hypopnea index) and sex. RESULTS: The position of the hyoid bone in the female OSA group was inferior to that in the female simple snorer group. Multiple regression analysis showed that tongue length and soft palate width were significant determinants for the severity of AHI in male OSA patients. However, inferior position of the hyoid was a significant determinant only in women. CONCLUSIONS: From a cephalometric point of view, OSA in male and female adult patients may be characterized by different pathogeneses. In particular, in female OSA patients, they might be managed by individualized treatments such as hormone replacement therapy in addition to conventional treatment.

Cephalometric differences in obstructive sleep apnea between obese and non-obese Korean male patients / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to compare the cephalometric measurements of obese and non-obese Korean male patients with obstructive sleep apnea syndrome (OSA). METHODS: Eighty-seven adults who had visited the Sleep Disorder Clinic Center in Keimyung University, Daegu, Korea were examined and evaluated with polysomnography (PSG) and lateral cephalogram. They were divided into 4 groups (non-obese simple snorers, obese simple snorers, non-obese OSA patients, obese OSA patients) according to AHI (Apnea-Hypopnea Index) and BMI (Body Mass Index). RESULTS: The obese OSA group had the highest AHI among the 4 groups. The non-obese OSA group had a significantly steeper mandibular angle and shorter tongue length than the obese OSA group. The hyoid bone of the obese OSA group was positioned anterior and inferior as compared with the non-obese OSA group. Multiple regression analysis showed that tongue length in the obese OSA group and retroposition of hyoid bone in the non-obese OSA group were significant determinants for the severity of AHI. CONCLUSIONS: From a cephalometric point of view, the obese and non-obese pateints with OSA may be characterized by different pathogeneses. Therefore, they have to be managed by individualized treatment. For the obese OSA patients, weight control must be advised as a first choice and for the non-obese OSA patients, oral appliance, nasal CPAP, UPPP and others could be chosen according to the obstructive sites.

Prevalence and Related Parameters of Daytime Sleepiness in Patients with Habitual Snoring

BACKGROUND: Excessive daytime sleepiness (EDS) is a common symptom in patients with habitual snoring, including obstructive sleep apnea (OSA). However, there had been no studies for the prevalence and related factors of EDS in patients with habitual snoring in Korea. So we studied the prevalence and related factors of EDS in patients with habitual snoring. METHODS: Sixty two patients with habitual snoring were selected from our sleep center from February 2004 to January 2007. All patients were given an overnight polysomnography and then took the multiple sleep latency tests the following day. They were classified into two groups: EDS (mean sleep latency, MSL or =10 minutes). We studied the prevalence of EDS in patients with habitual snoring and compared two groups about the demographic data and polysomnographic characteristics. RESULTS: Most (72.6%) patients with habitual snoring demonstrated EDS. There were significant different parameters between the EDS group and the no EDS group, such as total sleep time, percent of slow wave sleep, snoring index, arousal index, and number of desaturation. Among these, the logistic regression analysis identified total sleep time as a significant predictive factor for daytime sleepiness. MSL correlated significantly with the percent of slow wave sleep and number of desaturation. CONCLUSIONS: Our results showed the high prevalence of EDS in patients with habitual snoring in Korea. Long total sleep time in polysomnography seems to predict EDS.

A cephalometric and dental cast study of obstructive sleep apnea patients / 대한치과교정학회지

To evaluate the cephalometric and dental characteristics of obstructive sleep apnea (OSA) patients, 23 OSA patients and 15 control, non-OSA, patients who visited the Sleep Disorder Clinic Center, Keimyung University were investigated. Patients who suffered from apnea-hypopnea episodes over 10 times per hour were diagnosed as having OSA after polysomnograph testing. Impressions were taken with alginate. Cephalometric radiographs were taken at maximum intercuspation. The dental cast measurements, including transpalatal width, intercanine width, intermolar width and palatal depth did not differ between the control and OAS groups and did not have a positive correlation with the apnea-hypopnea index (AHI). Upper airway width was statistically narrower than the control group. Upper airway width had a low negative correlation with AHI, but, lower airway width had a low positive correlation, and, the higher the AHI score, the longer the mandibular border to hyoid distance.

The treatment of an impacted canine related with a miniplate inserted for mandibular fracture / 대한치과교정학회지

This case report describes the treatment of an impacted tooth in relation to pediatric mandibular fracture. A 10-year-old girl presented with an impacted mandibular canine related with a miniplate in the left mandibular body area. An ordinary surgical traction ended in failure. Good occlusion was established by removal of the miniplate. It would be considered important to make an exact diagnosis of the cause and remove the mechanical obstruction instantly for successful orthodontic treatment of an impacted tooth.

An Evaluation of Apnea-Hypopnea Index, Sleep Questionnaires, Oropharyngeal Findings and Cephalometric Parameters in Patients with Snoring

BACKGROUND: Although obstructive sleep apnea (OSA) is a common disorder, it often goes undiagnosed due to limited availability of the polysomnography (PSG) and a lack of interest in this condition. The aim of this study was to investigate the relationship between severities of obstructive sleep apnea, sleep questionnaires, oropharyngeal findings and cephalometric parameters in patients whom snore. METHODS: Fifty-seven (46 males) patients presenting snoring or other symptoms of OSA were evaluated retrospectively at the sleep disorder clinic in Keimyung University, Dongsan Medical Center were included in this study. All patients completed an overnight polysomnography, several sleep questionnaires and oropharyngic and cephalometric examinations. The sleep questionnaires included the Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI). The oropharyngeal examinations included tonsil grade and modified Mallampati grade. RESULTS: There were altogether 42 (38 male) patients diagnosed with OSA. The mean age of the patients was 42.4 +/- 12.8 years, the body mass index (BMI) was 26.1 +/- 2.7 kg/m2 and the apnea-hypopnea index (AHI) was 28.1 3 +/- 0.3. Sex difference (male), BMI, tonsil grade and some parameters of the cephalometric examination had a significant positive correlation with the AHI. However, the AHI correlated poorly with the sleep questionnaires. CONCLUSIONS: Although tonsil grade, modified Mallampati grade and some parameters of the cephalometric examination can be utilized as a useful method to evaluate OSA, the AHI correlated poorly with self-reported sleep questionnaires. These findings suggest that the severity of sleep apnea should be quantified with both physiologic and subjective measures.

Comprehensive treatment of obstructive sleep apnea: The role of department of dentistry in sleep clinic

The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree and site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.

A longitudintal study of soft-tissue profile changes in Korean adults aged from 24 to 32 years / 대한치과교정학회지

The purpose of this study was to evaluate the soft-tissue profile changes from 24 to 32 years of age in Korean adults. The subjects used in this study consisted of 17 males and 8 females. The data obtained from the lateral cephalograms taken at age 24 and 32, were analyzed statistically. The obtained results were as follows : 1. During the observation period, there were no significant changes in the hard-tissue measurements in both sexes (p>0.05). 2. In the anteroposterior measurements of soft-tissue, the males had significant increase in chin area (Pog', Gn'), and the females had significant decrease in lower lip (LI) (p<0.05). 3. In the vertical measurements of soft-tissue, both sexes showed the increased tendency in upper lip length(Sn-Sto) where the males showed significant increase (p<0.05). 4. In general, the females and males had the increased tendency in soft-tissue thickness, especially significant increase in chin area (Pog', Gn') (p<0.05).