The purpose of this work is to examine how work stressors are related to the burnout among staff in long-term care facilities for the elderly. This study offers some responses to a growing stress and burnout for the long-term care workers. The demand for long-term care workers is set to rise in light of an increasing share of older people and dependent elderly. Long-term care workers provide long-term care services to persons with a reduced degree of functional, physical or cognitive capacity. Cross-sectional survey data were collected from 216 staff in long-term care facilities. The standardised Maslach Burnout Inventory(MBI) was used to assess levels of burnout in long-term care workers. The MBI consists of 22 items using a 5-point Likert scale, measuring three sub-scales of burnout; Emotional exhaustion, Depersonalization, and Personal accomplishment. Data were analyzed using regression. This study is empirically tested the degree of association between burnout and its antecedents. The majority of differences in burnout could be explained by work stressors such as client relationship, job overload, job role conflict, and conflicts with clients' family. The study also identified workers' perceptions of their image in society and emotional support as predictors of burnout. Therefore long-term care facilities are encouraged to review their practices so that workers well-being is supported. The study findings suggest attention for organizational oriented initiatives to cope with burnout.
GRAS probiotics can be used to modulate intestinal microbiota and to alleviate various gastrointestinal disorders. In several recent studies, researchers have explored the potential expansion and usability of probiotics to reduce the risk factors associated with diseases, including obesity, hypercholesterolemia, arterial hypertension, hyperhomocysteinemia, and oxidative stress. In this review, our aim was to clarify the mechanism underlying interactions between hosts (animal or human) and probiotics and the beneficial effects of probiotics on human health.
Recently, it is continuously rising to concern about the health risk being induced by microorganisms in food such as Escherichia coli O157:H7 and Listeria monocytogenes. Various organizations and regulatory agencies including U.S.FPA, U.S.DA and FAO/WHO are preparing the methodology building to apply microbial quantitative risk assessment to risk-based food safety program. Microbial risks are primarily the result of single exposure and its health impacts are immediate and serious. Therefore, the methodology of risk assessment differs from that of chemical risk assessment. Microbial quantitative risk assessment consists of tow steps; hazard identification, exposure assessment, dose-response assessment and risk characterization. Hazard identification is accomplished by observing and defining the types of adverse health effects in humans associated with exposure to foodborne agents. Epidemiological evidence which links the various disease with the particular exposure route is an important component of this identification. Exposure assessment includes the quantification of microbial exposure regarding the dynamics of microbial growth in food processing, transport, packaging and specific time-temperature conditions at various points from animal production to consumption. Dose-response assessment is the process characterizing dose-response correlation between microbial exposure and disease incidence. Unlike chemical carcinogens, the dose-response assessment for microbial pathogens has not focused on animal models for extrapolation to humans. Risk characterization links the exposure assessment and dose-response assessment and involve uncertainty analysis. The methodology of microbial dose-response assessment is classified as nonthreshold and thresh-old approach. The nonthreshold model have assumption that one organism is capable of producing an infection if it arrives at an appropriate site and organism have independence. Recently, the Exponential, Beta-poission, Gompertz, and Gamma-weibull models are using as nonthreshold model. The Log-normal and Log-logistic models are using as threshold model. The threshold has the assumption that a toxicant is produce by interaction of organisms. In this study, it was reviewed detailed process including risk value using model parameter and microbial exposure dose. Also this study suggested model application methodology in field of exposure assessment using assumed food microbial data(NaCl, water activity, temperature, pH, etc.) and the commercially used Food MicroModel. We recognized that human volunteer data to the healthy man are preferred rather than epidemiological data fur obtaining exact dose-response data. But, the foreign agencies are studying the characterization of correlation between human and animal. For the comparison of differences to the population sensitivity: it must be executed domestic study such as the establishment of dose-response data to the Korean volunteer by each microbial and microbial exposure assessment in food.
Journal of the Korean Association of Geographic Information Studies
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v.20
no.2
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pp.60-74
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2017
To facilitate prevention of highly pathogenic avian influenza (HPAI), a GIS is widely used for monitoring, investigating epidemics, managing HPAI-infected farms, and eradicating the disease. After the outbreak of foot-and-mouth disease in 2010 and 2011, the government of the Republic of Korea (ROK) established the GIS-based Korean Animal Health Integrated System (KAHIS) to avert livestock epidemics, including HPAI. However, the KAHIS is not sufficient for controlling HPAI outbreaks due to lack of responsibility in fieldwork, such as sterilization of HPAI-infected poultry farms and regions, control of infected animal movement, and implementation of an eradication strategy. An outbreak prediction model to support efficient HPAI control in the ROK is proposed here, constructed via analysis of HPAI outbreak patterns in the ROK. The results show that 82% of HPAI outbreaks occurred in Jeolla and Chungcheong Provinces. The density of poultry farms in these regions were $2.2{\pm}1.1/km^2$ and $4.2{\pm}5.6/km^2$, respectively. In addition, reared animal numbers ranged between 6,537 and 24,250 individuals in poultry farms located in HPAI outbreak regions. Following identification of poultry farms in HPAI outbreak regions, an HPAI outbreak prediction model was designed using factors such as the habitat range for migratory birds(HMB), freshwater system characteristics, and local road networks. Using these factors, poultry farms which reared 6,500-25,000 individuals were filtered and compared with number of farms actually affected by HPAI outbreaks in the ROK. The HPAI prediction model shows that 90.0% of the number of poultry farms and 54.8% of the locations of poultry farms overlapped between an actual HPAI outbreak poultry farms reported in 2014 and poultry farms estimated by HPAI outbreak prediction model in the present study. These results clearly show that the HPAI outbreak prediction model is applicable for estimating HPAI outbreak regions in ROK.
Lee, Jin Hwa;Lee, Kyoung Eun;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
Tuberculosis and Respiratory Diseases
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v.66
no.4
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pp.280-287
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2009
Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.
Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTIs) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus(PIV), influenza virus (Flu), and adenovirus(ADV), etc. Our purpose was to determine seasonal epidemiology and clinical characteristic features of each viral infection. Methods : Nasopharyngeal aspirate(NPA)s were collected from 4,554 hospitalized children diagnosed as LRTIs on the first day of admission. The study period was from September 1998(Autumn) through May 2003(Spring). Respiratory viruses were detected in 881(19 percent) cases by isolation of the virus or by antigen detection method using indirect immunofluorescent staining. We reviewed the medical records of 837 cases retrospectively. Results : The identified pathogens were RSV in 485 cases(55 percent), PIV in 152 cases(17 percent), FluA in 114 cases(13 percent), ADV in 79 cases(9 percent) and FluB in 51 cases(6 percent). Outbreaks of RSV occurred every year, mostly in the November through December period and of PIV in the April through June period. LRTIs by FluA reached the highest level in January, 2002. FluB infection showed an outbreak in April, 2002. The clinical diagnoses of viral LRTIs were bronchiolitis in 395 cases(47 percent), pneumonia in 305 cases(36 percent), croup in 73 cases(9 percent) and tracheobronchitis in 64 cases(8 percent). Conclusion : Viruses are one of the major etiologic agents of acute LRTIs in chidren. Therefore, we must continue to study their seasonal occurrence and clinical features to focus on management, and also for reasons of prevention.
Lim, Si On;Park, Hye Ri;Jung, Na Young;Park, Cho Eun;Kanwal, Sumaira;Chung, Ki Wha
Journal of Life Science
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v.31
no.5
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pp.453-463
/
2021
Hearing loss is a group of clinically and genetically heterogeneous disorders characterized by congenital- to adult-onset deafness with frequent additional symptoms such as myopathy, nephropathy, and optic disorders. It is commonly divided into two types: syndromic, with no other symptoms, and nonsyndromic, with other symptoms. Autosomal recessive hearing loss is relatively frequent in Pakistan, which may be due in part to frequent consanguineous marriages. This study was performed by whole exome sequencing to determine the genetic causes in two Pakistani consanguineous families with autosomal recessive hearing loss. We identified a pathogenic homozygous variant (p.Leu326Gln in MYO7A) in a family with prelingual-onset hearing loss and two variants of uncertain significance (p.Val3094Ile in GPR98 and p.Asp56Gly in PLA2G6) in a family with early-onset hearing loss concurrent with muscular atrophy. The missense mutations in MYO7A and PLA2G6 were located in the highly conserved sites, and in silico analyses predicted pathogenicity, while the GPR98 mutation was located in the less conserved site, and most in silico analysis programs predicted its nonpathogenic effect. Homozygosity mapping showed that both alleles of the homozygous mutations identified in each family originated from a single founder; spread from this single source might be due to consanguineous marriages. This study will help provide exact molecular diagnosis and treatment for autosomal recessive hearing loss patients in Pakistan.
Purpose: This study sought to predict the reasons for skipping breakfast by adolescents aged 13-18 years using the 7th Korea National Health and Nutrition Examination Survey (KNHANES). Methods: The participants included 1,024 adolescents. The data were analyzed using a complex-sample t-test, the Rao Scott χ2-test, and the classification and regression tree (CART) algorithm for decision tree analysis with SPSS v. 27.0. The participants were divided into two groups, one regularly eating breakfast and the other skipping it. Results: A total of 579 and 445 study participants were found to be breakfast consumers and breakfast skippers respectively. Breakfast consumers were significantly younger than those who skipped breakfast. In addition, breakfast consumers had a significantly higher frequency of eating dinner, had been taught about nutrition, and had a lower frequency of eating out. The breakfast skippers did so to lose weight. Children who skipped breakfast consumed less energy, carbohydrates, proteins, fats, fiber, cholesterol, vitamin C, vitamin A, calcium, vitamin B1, vitamin B2, phosphorus, sodium, iron, potassium, and niacin than those who consumed breakfast. The best predictor of skipping breakfast was identifying adolescents who sought to control their weight by not eating meals. Other participants who had low and middle-low household incomes, ate dinner 3-4 times a week, were more than 14.5 years old, and ate out once a day showed a higher frequency of skipping breakfast. Conclusion: Based on these results, nutrition education targeted at losing weight correctly and emphasizing the importance of breakfast, especially for adolescents, is required. Moreover, nutrition educators should consider designing and implementing specific action plans to encourage adolescents to improve their breakfast-eating practices by also eating dinner regularly and reducing eating out.
Cho, Hye Kyung;Sohn, Jin A;Kim, Hae Soon;Sohn, Sejung
Clinical and Experimental Pediatrics
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v.52
no.2
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pp.234-241
/
2009
Purpose : We investigated the relationship between thyroid hormone and serum tumor necrosis factor (TNF-${\alpha}$), interleukin (IL-6) and N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) in patients with Kawasaki disease (KD). Methods : Serum levels of thyroid hormone, TNF-${\alpha}$, IL-6, and NT-proBNP were measured in 52 KD patients in the acute and subacute phase and 10 patients with acute febrile illness (control group). TNF-${\alpha}$ and IL-6 were determined by sandwich enzyme-linked immunosorbent assay (ELISA). Echocardiography was performed to detect coronary artery lesions (CAL) in KD patients. Results : Low $T_3$ syndrome occurred in 63.5% of KD patients. $T_3$ in the acute phase of KD was lower than that in the control. In KD patients, $T_3$ was lowered in the acute phase and elevated in the subacute phase, whereas TNF-${\alpha}$, IL-6 and NT-proBNP were elevated in the acute phase and decreased in the subacute phase. NT-proBNP, and IL-6 were higher in patients with low $T_3$ than in those with normal $T_3$. In addition, $T_3$ inversely correlated with IL-6 and NT-proBNP. Of the 4 patients with CAL, 3 had very low $T_3$. Compared with intravenous immunoglobulin (IVIG)-responsive patients, IVIG-resistant patients had lower $T_3$ and higher IL-6 and NT-proBNP. Conclusion : $T_3$ decreases in the acute phase of KD and normalizes in the subacute phase without thyroid hormone replacement. Low $T_3$ may be partially induced by IL-6 rather than TNF-${\alpha}$, and is strongly associated with high NT-proBNP. $T_3$ in KD may be used for the differential diagnosis, monitoring the activity of the disease, and predicting the severity of inflammation.
Purpose : The purpose of this study is to provide preliminary information on the hospice care needs of hospice volunteers. Methods : The sample of this study was obtained from those who completed the hospice volunteer education program in three different areas in Korea. This study was conducted by a self-administered questionnaire. The sample analyzed for this study contained 88 hospice volunteers. Frequency, percentage, mean, standard deviation, and logistic regression analysis were performed to produce the findings of this study. Results : The characteristics of the study sample were $40{\sim}49$ aged, middle class, christianity, married women with high school diplomas. They attended at the hospice center with less than 1 year experience. Majority of them had no family members who received a hospice care. The hospice care was strongly required in the field of information, particularly regarding their diseases and treatments. The identified hospice care needs were the prevention and treatment of gangrene in the field of physical needs, the maintenance of closer relationship with their doctors in the field of emotional needs, and the support of supporting medical insurance in the field of socioeconomic needs. The significant predictors were 'having hospice care taker among family members' in the field of the total hospice care needs and physical needs. Two predictable variables were found in the field of emotional needs. However, none were found to be a predictable variable in the field of information and socioeconomic needs. Conclusion : The findings or this study have a weekness of generalizability due to the sampling methodology used in this study. Thus, further research should be designed in relation to this topic with a probability sampling method.
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