The Association of Job Stress, Quality of Sleep, and the Experience of Near-Miss Errors among Nurses in General Hospitals.

This study investigated the association of job stress, quality of sleep, and near-miss error experiences among nurses working in general hospitals. A convenience sample of 195 nurses with over 3 months of work experience in a general hospital participated in the study. Statistical analyses were performed using SPSS 27.0. Factors influencing experiences of near-miss errors were examined through univariable and multivariate logistic regression. In total, 58.5% of nurses in a general hospital had experienced near-miss errors. Nurses in the upper job stress tertile (≥118) were 2.24 times more likely to encounter near-miss errors (95% CI: 1.07-4.69) and particularly 2.58 times (95% CI: 1.26-5.26) in falls and medical equipment-related near-miss errors. Nurses working more than 3 h of overtime per week had a 2.72 times higher (95% CI: 1.35-5.48) likelihood of experiencing near-miss errors related to falls and medical equipment and 4.03 times higher (95% CI: 1.92-8.45) likelihood of experiencing near-miss errors associated with examination procedures. To prevent near-miss errors among nurses in general hospitals, effective management of organizational job stress is crucial. Particularly for departments with a high level of overtime work (more than 3 h/week), it is essential to provide and manage educational programs on patient safety.

Evaluating Standardized Job Competencies for Managing Students at Risk for Anaphylaxis in Elementary School Nurses.

This study aimed to evaluate standardized job competencies of elementary school nurses in managing the health of students at risk for anaphylaxis (SRAs). A total of 166 elementary school nurses from across Korea participated in this study. The tool utilized was a list of standardized job tasks of elementary school nurses in managing SRAs' health. Seven factors were obtained from the factor analysis, with a cumulative variance explained of 68.6%. The importance-performance analysis method was employed to suggest priority areas for training. The factors placed in quadrant II included: (1) "offering psychological support", among elementary school nurses who have been provided with clinical information on anaphylaxis, (2) "providing emergency care", among those who have not been provided with clinical information on anaphylaxis, (3) the factors "utilizing individualized healthcare plans", "conducting health education and staff training", and "evaluating the student", among those who agreed that schools need legal protection to purchase epinephrine auto-injectors, and (4) the factor "preparing a school emergency system", among those with less than five years of experience as a school nurse. When planning continuing education strategies to improve elementary school nurses' management of SRAs, factors such as career experience, access to clinical information, and beliefs regarding legal protection for schools to purchase epinephrine auto-injectors should be considered.

Effectiveness of a Participatory Program for Improving the Cardiovascular and Cerebrovascular Health of Older Farmers in Rural Korea.

BACKGROUND: The aim of this study was to evaluate the effectiveness of a participatory approach to the cardiovascular and cerebrovascular (CCV) health of older farmers in rural Korea. METHODS: A nonequivalent control group pretest-posttest design was used. Participants included 58 farmers aged ≥ 60 years who were assigned to either an experimental group (n = 28) or a comparative group (n = 30). The experimental group took part in the participatory program for CCV health, while the comparative group received a conventional lecture program for CCV health. The two groups, from pretest to posttest, were compared using the generalized estimating equation (GEE) method. RESULTS: The participatory program showed a greater effect over time than the conventional lecture program for health empowerment (Χ2 = 7.92, p = 0.005) and self-efficacy in managing CCV health (Χ2 = 5.94, p = 0.015). The average rate of implemented improvements after 3 months was 88.9%, showing that the participatory program was successful. CONCLUSIONS: The participatory program for CCV health was an effective intervention for the empowerment and self-efficacy of older farmers in managing their own CCV health. Therefore, we recommend replacing lectures with participatory methods in CCV health programs for older farmers.

Propofol protects against lipopolysaccharide-induced inflammatory response in human amnion-derived WISH cells.

Background: Nonobstetric surgery is sometimes required during pregnancy, and neck abscess or facial bone fracture surgery cannot be postponed in pregnant women. However, dental surgery can be stressful and can cause inflammation, and the inflammatory response is a well-known major cause of preterm labor. Propofol is an intravenous anesthetic commonly used for general anesthesia and sedation. Studies investigating the effect of propofol on human amnion are rare. The current study investigated the effects of propofol on lipopolysaccharide (LPS)-induced inflammatory responses in human amnion-derived WISH cells. Methods: WISH cells were exposed to LPS for 24 h and co-treated with various concentrations of propofol (0.01-1 µg/ml). Cell viability was measured using the MTT assay. Nitric oxide (NO) production was analyzed using a microassay based on the Griess reaction. The protein expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE 2), p38, and phospho-p38 was analyzed using western blotting. Results: Propofol did not affect the viability and NO production of WISH cells. Co-treatment with LPS and propofol reduced COX-2 and PGE2 protein expression and inhibited p38 phosphorylation in WISH cells. Conclusion: Propofol does not affect the viability of WISH cells and inhibits LPS-induced expression of inflammatory factors. The inhibitory effect of propofol on inflammatory factor expression is likely mediated by the inhibition of p38 activation.

Dexmedetomidine and LPS co-treatment attenuates inflammatory response on WISH cells via inhibition of p38/NF-κB signaling pathway.

Background: Inflammatory dental diseases that occur during pregnancy can cause preterm labor and/or intrauterine growth restriction. Therefore, proactive treatment of dental diseases is necessary during pregnancy. Dexmedetomidine (DEX) is a widely used sedative in the dental field, but research on the effect of DEX on pregnancy is currently insufficient. In this study, we investigated the effects of co-treatment with DEX and lipopolysaccharide (LPS) on inflammatory responses in human amnion-derived WISH cells. Methods: Human amnion-derived WISH cells were treated with 0.001, 0.01, 0.1, and 1 µg/mL DEX with 1 µg/mL LPS for 24 h. Cytotoxicity of WISH cells was evaluated by 3-(4,5-dimethylthiazol)-2,5-diphenyltetrazolium bromide (MTT) assay. The protein expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), p38, and nuclear factor kappa B (NF-κB) was examined by western blot analysis. The mRNA expression of pro-inflammatory cytokines such as interleukin (IL)-1ß and tumor necrosis factor (TNF)-α was analyzed by real-time quantitative polymerase chain reaction. Results: Co-treatment with DEX and LPS showed no cytotoxicity in the WISH cells. The mRNA expression of IL-1ß and TNF-α decreased after co-treatment with DEX and LPS. DEX and LPS co-treatment decreased the protein expression of COX-2, PGE2, phospho-p38, and phospho-NF-κB in WISH cells. Conclusion: Co-treatment with DEX and LPS suppressed the expression of COX-2 and PGE2, as well as pro-inflammatory cytokines such as IL-1ß and TNF-α in WISH cells. In addition, the anti-inflammatory effect of DEX and LPS co-treatment was mediated by the inhibition of p38/NF-κB activation.

The Mediating Effect of Frailty in the Relationship between Depression and Falls among Older People Living Alone in Korea.

Background: We explored the potential mediating role of frailty in the relationship between depression and falls. Methods: The participants were 1,408 community-dwelling older people living alone in South Korea. The potential mediating role of frailty in the relationship between depression and falls was evaluated through univariate and multivariate logistic regression. Baron and Kenny's three-step criteria for mediation were used to examine the mediating effect. Results: Frailty fully mediated the association between severe depression and falls in univariate (t=11.58, P<.05) and multivariate (t=10.42, P<.05) analyses. Conclusion: Frailty is a valuable target for fall interventions in severely depressed older people living alone.

Maternal Responsive Parenting Trajectories From Birth to Age 3 and Children's Self-Esteem at First Grade.

This paper examines the quality and stability of the responsive parenting practices of mothers with infants and the longitudinal links between these practices and children's self-esteem. Using data presented by the Panel Study on Korean Children, this study identified Korean mothers' responsive parenting trajectories from birth to age three and examined their associations with children's self-esteem at first grade. Korean mothers developed one of three responsive parenting patterns from birth to age three: low (19.0%), moderate (66.0%), or high (15.0%). Children's self-esteem differed according to their mother's responsive parenting trajectory. First-graders with mothers displaying the low responsive parenting trajectory were more likely to have lower self-esteem than children of mothers with the moderate responsive parenting trajectory and children of mothers with the high responsive parenting trajectory. The longitudinal link between mother-reported responsive parenting patterns during infancy and child-reported self-esteem at first grade was verified. This finding highlights the significance of early responsive parenting from mothers as a predictor of the self-esteem of children in later developmental stages.

Temperament Types at Age 3 and Smartphone Overdependence at Age 10.

Few studies have addressed the longitudinal links between early temperament types and later problematic smartphone use. This study aims to identify children's early temperament types at age 3 and to examine the link between the temperament types and smartphone overdependence at age 10. This study utilized a population-based data set presented by the Panel Study on Korean Children. Based on emotionality, activity, and sociability levels at age 3, children were clustered into similar temperament types. Links between the early temperament types and the risks of smartphone overdependence at age 10 were identified through analyses of covariances and binary logistic regressions. Three early temperament types were identified among Korean children: reactive (28.1%), sociable (37.2%), and cautious (34.8%). Children's smartphone dependence at age 10 differed according to the temperament types identified at age 3. Compared to children with the sociable temperament type, children with the reactive type or the cautious type had an increased risk of smartphone overdependence. The link between temperament types at age 3 and smartphone overdependence at age 10 was meaningful. The cautious children were the most vulnerable group to the risk of smartphone overdependence. Temperament type identification in early years may be a useful measure for screening groups of children who are at risk for problematic smartphone use and need proactive interventions.

Effects of a Worksite-Based Self-Management Program in Traditional Retail Market Workers: Longitudinal Associations with Metabolic Parameters.

(1) Background: This study explored the effects of a worksite-based self-management program on metabolic parameters in traditional retail market workers during a 3-year period. (2) Methods: Seventy traditional retail market workers who completed 3 years of follow-up were included in this study. The worksite-based self-management program was developed to help traditional retail market workers manage metabolic parameters themselves based on the following content: (I) using a metabolic syndrome action checklist, (II) counseling, (III) creating improvement action plans, and (IV) evaluating implemented improvements. (3) Results: The rates of implemented improvements showed success. Fasting blood sugar and triglycerides showed yearly reductions from baseline for 3 years, which eventually led to a decreased metabolic syndrome score and maintenance of metabolic parameters in the normal range for 3 years. (4) Conclusions: A worksite-based self-management program on metabolic parameters in traditional retail market workers was effective. It improved their intention to self-assess and cope their health problems and eventually decreased their metabolic syndrome score. It should be considered for the primary prevention of metabolic syndrome among traditional retail market workers.

Effect of air cleaner on stress hormones of pig and pork quality.

The objective of this study is to investigate effect of air cleaner operated during pig breeding period on stress hormones of pigs and their pork quality. The stress hormones (cortisol, epinephrine and norepinephrine) in blood sample of pigs reared in the housing rooms with or without air cleaner have been measured according to a pig's rearing stage: 0 day (farrowing), 21st day (farrowing-weaning), 70th day (weaning-nursery), 140th day (nursery-growing), and 180th day (growing-fattening). The comparison of pork quality according to the application of an air cleaner was performed through the carcass analysis of the pigs shipped from swine house. The levels of cortisol, epinephrine, and norepinephrine in pigs reared in housing rooms with and without air cleaners were found to be within the range of normal reference values. Among pork quality evaluation items, the thickness of intermuscular fat and final carcass grade of pigs raised in housing room with air cleaner was generally superior to those of pigs raised in housing room without air cleaner (p < 0.05). Based on the results obtained from this study, it is concluded that air cleaner does not have a significant effect on reducing pig stress but contributes to improving pork quality in pig breeding.

Factors Included in T1DM Continuing Education for Korean School Nurses: A Systematic Review.

(1) Background: The aim of this systematic review was to identify key factors for inclusion in continuing education for Korean school nurses to improve their competence in managing students with type 1 diabetes mellitus (T1DM). (2) Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. (3) Results: Twelve studies were included in this systematic literature review. The factors identified for inclusion in continuing education on Type 1 diabetes mellitus included 6 competencies. These were strengthening competence in managing students with Type 1 diabetes mellitus, facilitating networking with experts and peers, the perspective of the school nurse as a leader, use of a type 1 diabetes mellitus-specific evidence-based standardized approach of care, supporting self-management to promote healthy learners, and communication and collaboration between key stakeholders. Identified barriers to accessing continuing education on type 1 diabetes mellitus were work demands, difficulty taking time off during the school year, and limited support from administrators. (4) Conclusions: Based on the findings of this study, online or e-learning continuing education on type 1 diabetes mellitus must be developed for school nurses who manage students with this condition.

Anti-inflammatory effects of dexmedetomidine on human amnion-derived WISH cells.

Background: To maintain the normal pregnancy, suppression of inflammatory signaling pathway is a crucial physiologic response. Dexmedetomidine has been used for labor analgesia or supplement of inadequate regional analgesia during delivery. And it has been reported that dexmedetomidine has an anti-inflammatory effect. In this study, we examined the influence of dexmedetomidine on the expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2) and inflammatory cytokines in lipopolysaccharide (LPS)-stimulated human amnion-derived WISH cells. In addition, we evaluated the association of mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-κB) pathway in anti-inflammatory effect of dexmedetomidine. Methods: Human amnion-derived WISH cells were pretreated with various concentrations of dexmedetomidine (0.001-1 µg/ml) for 1 h and after then treated with LPS (1 µg/ml) for 24 h. MTT assay was conducted to evaluate the cytotoxicity. Nitric oxide (NO) production was analyzed using Griess-reaction microassay. RT-PCR was performed for analysis of mRNA expressions of COX-2, PGE2, tumor necrosis factor (TNF)-α and interlukin (IL)-1ß. Protein expressions of COX-2, PGE2, p38 and NF-κB were analyzed by western blotting. Results: LPS and dexmedetomidine had no cytotoxic effect on WISH cells. There was no difference in NO production after dexmedetomidine pretreatment. The mRNA and protein expressions of COX-2 and PGE2 were decreased by dexmedetomidine pretreatment in LPS-treated WISH cells. Dexmedetomidine also attenuated the LPS-induced mRNA expression of TNF-α and IL-1ß. The activation of p38 and NF-κB was suppressed by dexmedetomidine pretreatment in LPS-treated WISH cells. Conclusion: We demonstrated that dexmedetomidine pretreatment suppressed the expressions of inflammatory mediators increased by LPS. In addition, this study suggests that anti-inflammatory effect of dexmedetomidine on WISH cells was mediated by the inhibitions of p38 and NF-κB activation.

Optimal effect-site concentration of remifentanil to prevent hemodynamic changes during nasotracheal intubation using a video laryngoscope.

BACKGROUND: Nasotracheal intubation is the most commonly used method to secure the field of view when performing surgery on the oral cavity or neck. Like orotracheal intubation, nasotracheal intubation uses a laryngoscope. Hemodynamic change occurs due to the stimulation of the sympathetic nervous system. Recently, video laryngoscope with a camera attached to the end of the direct laryngoscope blade has been used to minimize this change. In this study, we investigated the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses during nasotracheal intubation with a video laryngoscope. METHODS: Twenty-one patients, aged between 19 and 60 years old, scheduled for elective surgery were included in this study. Anesthesia was induced by slowly injecting propofol. At the same time, remifentanil infusion was initiated at 3.0 ng/ml via target-controlled infusion (TCI). When remifentanil attained the preset Ce, nasotracheal intubation was performed using a video laryngoscope. The patient's blood pressure and heart rate were checked pre-induction, right before and after intubation, and 1 min after intubation. Hemodynamic stability was defined as an increase in systolic blood pressure and heart rate by 20% before and after nasotracheal intubation. The response of each patient determined the Ce of remifentanil for the next patient at an interval of 0.3 ng/ml. RESULTS: The Ce of remifentanil administered ranged from 2.4 to 3.6 ng/ml for the patients evaluated. The estimated optimal effective effect-site concentrations of remifentanil were 3.22 and 4.25 ng/ml, that were associated with a 50% and 95% probability of maintaining hemodynamic stability, respectively. CONCLUSION: Nasotracheal intubation using a video laryngoscope can be successfully performed in a hemodynamically stable state by using the optimal remifentanil effect-site concentration (Ce50 , 3.22 ng/ml; Ce95 , 4.25 ng/ml).

Korean mothers' alcohol consumption trajectories from childbirth to 6 years postpartum and children's executive function difficulties at first grade.

PURPOSE: This study aims to identify Korean mothers' alcohol consumption trajectories during early parenthood (from birth to 6 years postpartum) and to examine associations between these trajectories and their children's executive function difficulties at first grade (age 7). METHODS: Participants were 1010 mothers and their children, a subset of the Panel Study of Korean Children. Mothers' postpartum alcohol consumption trajectories were identified using growth mixture modeling. Children's executive function difficulties by the trajectories were examined using factorial analysis of covariance. RESULTS: Korean mothers' alcohol consumption trajectories during early parenthood were heterogeneous. Mothers developed one of four alcohol consumption patterns: stable low use (49.9%), increasing use (25.0%), chronic modest use (18.3%), and chronic high use (6.8%). Children's executive function difficulties as evaluated by first grade teachers differed by mothers' postpartum alcohol consumption trajectories. Children of chronic high users displayed more difficulties in planning-organization, behavioral control, and attention-concentration than did children of the other groups of mothers. CONCLUSIONS: Mothers' chronic and excessive postpartum alcohol consumption during early parenthood can be a significant risk factor for difficulties in children's early executive function development. Early screening for mothers with unhealthy alcohol consumption habits is critical. Special attention and support should be afforded to their children's development and school adjustment.

Anti-inflammatory effect of remifentanil in lipopolysaccharide-stimulated amniotic epithelial cells.

BACKGROUND: Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells). METHODS: WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B (NF-κB) and p38 and the expression of interleukin (IL)-1ß, tumor necrosis factor (TNF)-α, cyclooxygenase (COX)2, and prostaglandin E (PGE)2 were quantified using western blotting and RT-PCR, respectively. RESULTS: Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of NF-κB, and expression of COX2 and PGE2 in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of IL-1ß and TNF-α expression was also observed with RT-PCR. CONCLUSION: Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.

Propofol Suppresses LPS-Induced Inflammation in Amnion Cells via Inhibition of NF-κB Activation.

Background: Preterm labor is a leading risk factor for neonatal death and long-term impairment and linked closely with inflammation. Non-obstetric surgery is occasionally needed during pregnancy and the anesthetic drugs or surgery itself can give rise to inflammation. Here, we examined the influence of propofol pretreatment on the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) after lipopolysaccharide (LPS) stimulation. In addition, we evaluated the expression of pro-inflammatory cytokines and nuclear factor kappa B (NF-κB). Methods: Human amnion-derived WISH cells were used to investigate the effect of propofol on the LPS-induced expression of inflammatory substances involved in preterm labor. For the experiment, WISH cells were pretreated with various concentrations propofol (0.01-10 µg/ml) for 1 h and then treated with LPS (1 µg/ml) for 24 h. Cytotoxicity was evaluated using MTT assay. PGE2 concentration was assessed by ELISA. Protein expressions of COX-2, PGE2 and NF-κB were analyzed by western blotting analysis. RT-PCR was used for analysis of mRNA expression of COX-2, PGE2, interlukin (IL)-1ß and tumor necrosis factor (TNF)-α. Results: Propofol showed no cytotoxicity on the WISH cells. LPS-induced PGE2 production and COX-2 and PGE2 expression were decreased after propofol pretreatment. Propofol also attenuated the LPS-induced mRNA expression of IL-1ß and TNF-α. Moreover, the activation of NF-κB was inhibited by propofol pretreatment on LPS-stimulated WISH cells. Conclusion: We demonstrated that propofol suppresses the expression of inflammatory substances enhanced by LPS stimulation. Furthermore, this inhibitory effect of propofol on the inflammatory substance expression is mediated by suppression of NF-κB activation.

Sex differences in metabolic risk indicator of dementia in an elderly urban Korean population: A community-based cross-sectional study.

AIM: The aim of the present study was to evaluate the age-specific prevalence of dementia, and develop a metabolic risk indicator for dementia according to sex. METHODS: This cross-sectional study was carried out from September 2007 through December 2012 with 19 935 elderly participants in metropolitan Seoul, Korea. Multiphase assessments were used to measure metabolic risk factors and confirm dementia according to sex. Specifically, multivariate logistic regression analyses were used to identify how elderly men and women differed in regard to metabolic risk indicators of dementia. RESULTS: The adjusted prevalence rates of dementia in elderly Seoul residents were estimated at 4.9%, 6.1% and 5.6% in men, women and the overall population, respectively. Stroke conferred an odds ratio of 5.14 (95% CI 3.91-6.77) and 2.55 (95% CI 2.01-3.25) in men and women, respectively. Additionally, within the female population, diabetes mellitus conferred an odds ratio of 1.29 (95% CI 1.09-1.53), whereas alcohol consumption conferred an odds ratio of 0.77 (95% CI 0.61-0.97). CONCLUSIONS: Stroke played a primary role as a metabolic risk indicator of dementia in elderly men, while diabetes mellitus and alcohol abstinence were important metabolic risk factors in elderly women. Taken together, the data show that when designing preventative measures against dementia based on metabolic risk, sex needs to be taken into account. Geriatr Gerontol Int 2017; 17: 2136-2142.

Associations of adverse childhood experiences with depression and alcohol abuse among Korean college students.

This study investigated adverse childhood experiences of Korean college students and the impact such experiences have on students' depression and alcohol abuse. Using an online questionnaire, 939 college students were surveyed regarding their adverse childhood experiences, depressive symptoms and alcohol use habits. About half of the participants claimed to have experienced at least one adversity in their childhood. Eight percent of participants reported experiencing four or more categories of adversity. The correlations between adverse childhood experiences and depressive symptoms, alcohol abusive behaviors, and the comorbid condition of the two outcomes were significant when students' gender, geographical regions, maternal and paternal education, and family incomes were adjusted. Graded associations of cumulated adverse childhood experiences with the outcome variables were evident. These findings strengthen the link between child maltreatment and adult public health issues carrying socioeconomic burdens, two matters that have not been extensively studied in Korean contexts.

Relationship between Clinical Parameters and Brain Structure in Sporadic Amyotrophic Lateral Sclerosis Patients According to Onset Type: A Voxel-Based Morphometric Study.

BACKGROUND AND PURPOSE: Amyotrophic lateral sclerosis (ALS) is a rapidly progressing, phenotypically heterogeneous neurodegenerative disease affecting mainly the motor neuron system. The present voxel-based morphometry (VBM) study investigated whether patterns of brain atrophy differ among sporadic ALS subtypes. MATERIAL AND METHODS: Sporadic ALS patients (n = 62) with normal cognition and age-matched healthy controls (n = 57) were included in the study. ALS patients were divided into limb- and bulbar-onset groups according to clinical manifestations at symptom onset (n = 48 and 14, respectively). Clinical measures were ALS Functional Rating Scale-Revised (ALSFRS-R) score, disease duration, and forced vital capacity (FVC). Patterns of brain atrophy between ALS subgroups were compared by VBM. RESULTS: In limb-onset ALS patients, atrophy was largely confined to the motor cortex and adjacent pre- and postcentral regions. However, in the bulbar-onset group, affected regions were more widespread and included these same areas but also extended to the bilateral frontotemporal and left superior temporal and supramarginal gyri, and multiple regression analysis revealed that their ALSFRS-R scores were associated with extensive loss of gray matter while FVC was related to atrophy in subcortical regions of the left superior temporal gyrus. In limb-onset ALS patients, disease duration was related to the degree of atrophy in the motor and adjacent areas. CONCLUSION: Sporadic ALS subtypes show different patterns of brain atrophy. Neural networks related to limb and bulbar motor functions in each ALS subtype may underlie their distinct patterns of cerebral atrophy. That is, more extensive cortical and subcortical atrophy is correlated with greater ALSFRS-R severity and shorter disease duration in the bulbar-onset subtype and may explain the poor prognosis of these patients.

Analysis of Workplace Health Education Performed by Occupational Health Managers in Korea.

PURPOSE: To evaluate workplace health education as practiced by occupational health managers based on standardized job tasks and suggest priority tasks and areas to be trained. METHODS: The study was conducted between November 10, 2013 and April 30, 2014. The tool used in this study was standardized job tasks of workplace health education for occupational health managers which was developed through methodological steps. It was evaluated by 233 worksite occupational health managers. Data were analyzed using SPSS 21.0. RESULTS: Predicting variables of workplace health education performance were the "analysis and planning" factor, type of enterprise, and form of management. Healthcare professionals and occupational health managers who managed the nonmanufacturing industry showed high importance and low performance level in "analysis and planning" factor. CONCLUSIONS: "Analysis and planning" skill is priority training area for healthcare professionals and occupational health managers who managed nonmanufacturing industry. It is necessary to develop a training curriculum for occupational health managers that include improving analysis of worksites and plans for a health education program.