• Safety and Health at Work
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• v.9 no.4
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• pp.381-387
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• 2018

Background: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. Methods: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. Results: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiroe-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. Conclusion: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.

• Korean Journal of Occupational Health Nursing
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• v.6 no.1
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• pp.53-71
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• 1997

Across sectional study was performed to evaluate the chronic effects on central nerve system(CNS) of cumulative exposure of complex organic solvents, using neurobehavioral test. Subjects were 66 (male) dock yard painters of some large ship industry which is located in Ulsan. The neurobehavioral test battery used in this study was NCTB (Neurabehavioral Core Test Battery recommended by WHO(World Health Organization), which consisted of 7 items-Profile of mood states (POMS), Simple reaction time, Santa Ana dexterity test. Digit span, Digit symbol, Benton visual retention test and Pursuit aiming. The subjects were classified by 3 groups according to duration of employment(group 1 ; less than 9 years, group 2 ; 10-14 years, group 3 ; more than 15 years). The results of performance were analyzed considering of work duration, age, educational level, alcohol drinking, smoking and testing time as confounding factors. Benton visual retention test, pursuit aiming correct dot and sum of dot showed significant differences among the groups, and decreased with increasing work duration. It indicated that the mean scores of performance ability were lowering according to work duration. Besides, the tests that didn't show statistical significances but showed linear trends were depression-dejection, vigor, fatigue of POMS, slowest time of simple reaction time and digit span forward. Most of the neurobehavioral test items were correlated with age and educational level. After controlling of confounding factors-age and educational level, the results followed ; digit span backward was different significantly. Tension-anxiety, depression-dejection, anger-hostility of POMS, SD and slowest time of simple reaction time, Santa Ana dexterity test non-preferred hand, digit span forward, Benton visual retention test and pursuit aiming correct dot decreased with increasing of work duration. The correlation analysis was done in order to find out the relationship between subjective symptom and the scores of neurobehavioral core test battery. According to the results of analysis there were no items that had statistical significant relationship(p<0.05).

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.15 no.2
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• pp.144-152
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• 2005

To evaluate the effect of lead biomarkers including bone lead on neurobehavioral test in lead workers, 652 lead workers without any occupational exposure to organic solvent, mercury and arsenic were agreed to participate this study. For the control subjects 102 non-occupationally lead exposed blue collar workers in general manufacturing industries were also joined this study. All study subjects joined this study with written informed consent. The study variables of lead exposure were blood and patella lead. For the general characteristics of study subjects, standardized questionnaire regarding age, sex, past disease history, job duration, body mass index (BMI), drinking and smoking habit were provided. For the past history of neurotoxicity related diseases, all study subjects were interviewed by qualified occupational health physician. The results obtained were as follows: 1. Compared with controls without occupational lead exposure, lead exposed subjects had worse performance on all tests(p<0.05). 2. After adjustment for covariates (age, sex, job duration, education level, BMI, smoking and drinking status), the signs of the regression coefficients for blood lead were negative for 13 of the 14 tests. Blood lead was a significant predictor of poorer scores on 8 tests (simple reaction time(ms & root MSD), Trail-Making Test B, Digit Symbol Substitution, Purdue Pegboard assembly, Digit Span Test, Benton Visual Retention, and Purdue pegboard both hand). 3. After adjustment for covariates (age, sex, job duration, education level, BMI, smoking and drinking status), the signs of the regression coefficients for patella lead were negative for 12 of the 14 tests. Patella lead was a significant predictor of poorer scores on 8 tests (simple reaction time(ms). Purdue Pegboard assembly, Digit Span Test, Benton Visual Retention. Pursuit Aiming rest (no. of correct & no. of incorrect), Purdue pegboard non-dominant hand and both hand). With above results, blood lead and patella lead were associated with poorer performance of neurobehavioral tests. In addition, patella lead was confirmed to be better predictor of manual dexterity test in neurobehavioral test battery in lead workers

• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.170-181
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• 1996

Objective : This study was tried to investigate the specific relationships among cognitve function, neurbehavioral symptoms, and daily living functions, as well as provide the guidline of more proper clinical approches for patients with subcortical cerebrovascular disease. Objects and Methods Subjects were 85 patients whose diagnosis was confirmed by brain CT or MRI and controls were 195 normal persons matched by educational level with the subjects. The cognitive functions were evaluated by BNA(Benton neuropsychiatric assessment), subjective neurobehavioral symptoms by SCL-90-R(Sympton Check List-90-Revised), objective neurobehavioral symptoms by NRS(Neurobehavioral Rating Scale), and daily living function symptoms by NRS(Neurobehavioral Rating Scale), and daily living function by GERRI(Geriatric Evaluation by Relative's Rating Instrument) and IADL(Instrumental Activities of Daily Living Scale). Results: 1) Subjects showed significantly lower cognitive functions than controls in all tests of BNA except Lt-Rt Orientation Test(p=0.09) and facial Recognition Test(p=0.186). 2) In subjective neurobehavioral symptoms, subjects showed significantly lower scores in all symptoms except anxiety(p=0.059), hostility(p=0.159), and phobic anxiety(p=0.849). But in objects neurobehavioral symptoms, subjects showed significantly higher in scores in psychoticism (p=0.000) and neuroticism(p=0.025) of NRS. 3) The score of social functioning of GERRI(p=0.000) and that of IADL(p=0.000) were significantly higher in subjects than in controls. 4) for correlation between cognitive and daily living functions, there were significant correlations between the scores of all items on BNA and the score of cognitive or social function of GERRI and the socre of MDL in corntrols, whereas in subjects, there were significant correlations only between the scores of BNA and the score of IADL. 5) for correlation between neuroehavioral symptoms and daily living functions, there were significant correlatons between the socre of subjective neurobehavioral symptoms and the scores of all subscales of GERRI and the score of MDL in controls. On the contrary, in subjects, there were significant correlations between the score of social function of GERRI and the score of objective neurobehavioral symptoms such as psychoticism, agitiation-hostility, and decrease d motivation-emotional withdrawl. Conclusion : Above results suggest that disturbances in specific function of brain may play a role as a predictor of impairments with specific daily living functions and also suggest that specific correlations among various functions may be useful as clinical parameters for setting of the treatment goal and for assessing the ongoing process in the treatment and rehavilitation of the patients with subcortical cerebrovascular disease.

• Journal of Preventive Medicine and Public Health
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• v.28 no.4 s.51
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• pp.911-923
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• 1995

With increased use of neurotoxic agents in manufacturing industries, hazardous effects of neurotoxic agents pose significant problems in protecting health of workers who work in these industries. A normal range of neurobehavioral performance is required to study hazardous effects of neurotoxic agents among workers. However, such reference for Korean population is not available yet. The objective of this study is to estimate a normal range of neurobehavioral test performance of female workers in Korea. Data for neurobehavioral test performance developed by the World Health Organization were obtained from 165 female workers. Study subjects, 140 production workers and 25 clerks, who voluntarily participated in this study were not occupationally exposed to neurotoxic agents. The mean age and the mean education years of them were 32 years and 10.9 years, respectively Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention tests among the Neurobehavioral Core Test Battery(NCTB) were included in the evaluation. Subjects were interviewed by a trained interviewer for their detailed occupational history $Mean({\pm}SD)$ performance of the participants were: $45.7{\pm}7.1\;and\;41.9{\pm}6.4$ in the Santa Ana dexterity test of the preferred and non-preferred hands; $45.7{\pm}7.1\;and\;41.9{\pm}6.4$ in correct dot of the pursuit aiming test; $57.7{\pm}16.0$ in the digit symbol test; $274.8{\pm}44.6$ msec in the mean simple reaction time and $70.5{\pm}69.0$ msec in the mean standard deviation of it; and $7.8{\pm}1.7$ in the Benton visual retention test. Most neurobehavioral performance scores were correlated significantly with age and educational level. Educational level was found to be a significant independent variable which was associated with all test scores. Age was significantly associated with scores of pursuit aiming and digit symbol tests.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.56-67
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• 1996

Objectives : This study was designed to find clinical factors that could be differentiated by the lateralization of lesion and also find clinical factors to predict the lateralization of lesion. Methods : The subjects were 65 cooperative inpatients and outpatients with non-traumatic subcortical cerebrovascular disease without neurologic and psychiatric history from January 1995 to September 1995 ; 48 patients in Kyung Hee University, Oriental Medicine Hospital, 35 patients in Anam Hospital, Korea University were examined as subjects, but authors excluded 20 patients whose data were incomplete or who had uncertain lesions on brain CT or MRI. The 65 patients were divided into three groups-group with left hemispheric lesion, group with right hemispheric lesion, group with both hemispheric lesion-according to the finding of brain imaging study. Their cognitive functions were evaluated by the Benton Neuropsychological Assessment(BNA), their subjective neurobehavioral symptoms by Symptom Check List-90-R(SCL-90-R), their objective neurobehavioral symptoms by Neurobehavioral Rating Scale, and their daily living functions by Geriatric Evaluation by Relative's Rating Instrument(GERRl) and Instrumental Activities of Daily Living Scale(IADLs). Results : The results were as follows : 1) The results of cognitive function test indicated that the group with right hemispheric lesion showed low functions in Tactile Form Perception(left), the group with left hemispheric lesion showed low functions in Finger localization(right), the group with right hemispheric lesion showed low functions in Finger Localization(left). 2) Though, there were little significant differences in subjective neurobehavioral symptoms, the group with right hemispheric lesion showed higher scores in all symptoms except hostility. 3) Though, there were little significant differences in objective neurobehavioral symptoms, the group with both hemispheric lesion showed higher scores in cognition, guilty/disinhibition, the group with left hemispheric lesion showed higher scores in lability of mood, the group with right hemispheric lesion showed highest scores in psychotism, neurotism, agitation-hostility and decreased motivation/emotional withdrawal. 4) There were little significant differences among three groups in Daily Living Functions, but the group with right hemispheric lesion showed the lowest functions in Instrumental Activities of Daily Living. 5) As a result of discriminant analysis on each factor's contribution to the prediction of lesion, Finger Localization(left), Phoneme Discrimination and Tactile Form Perception(right) showed that they had the potentiality to predict lesion. Conclusion : The results suggest that there are little significant differences among the groups of three non-traumatic subcortical cerebrovascular disease in cognitive functions, but the group with right hemispheric lesion showed more serious and various changes in subjective and objective neurobehavioral symptoms, and showed low functions in Instrumental Activities of Daily Living. This results suggest the possibility that the decline of the daily living function in the group with right hemispheric lesion were due to various symptoms, not due to cognitive dysfunction. The confirmation of the possibility should be worked out through the follow-up study of some groups containing cortical lesion. Apart from these findings, Finger Localization, Tactile Form Perception(right) and Phoneme Discrimination suggest that they can be used as clinically valuable cognitive parameters that predict the lateralization of lesion in non-traumatic cerebrovascular disease.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.4
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• pp.49-58
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• 2021

Purpose : This study investigates the effects of the application of traditional occupational therapy and the korean computerized cognition training system on the cognitive function and performance of daily activities of stroke patients with cognitive impairment. Methods : From inpatients referred for rehabilitation treatment at L Rehabilitation Hospital located in Busan, 20 patients diagnosed with stroke from April 05. 2021 to May 02. 2021 (study period) were selected, They were divided into two, an experimental group consisting of 10 subjects who underwent a computerized cognitive rehabilitation program and traditional occupational therapy in combination and a control group of 10 subjects who underwent traditional occupational therapy alone. In order to measure the cognitive function of the subjects before the intervention, two assessment tests were conducted: a Neurobehavioral Cognitive Status Examination (NCSE), which evaluates stroke-related cognitive ability, and a Functional Independence Measure (FIM) test, which evaluates life activities. Then, both groups received a total of 20 training sessions at 30 minutes per session, five times a week for four weeks. Results : A statistically significant difference was found in cognitive function between before and after the cognitive training for both the experimental group and the control group. For the FIM scores, statistically significant differences were observed after intervention in the categories of handling personal matters and social cognition, and in the total score. The average scores of the remaining items also improved. Conclusion : The results of this study showed that both the computerized cognition rehabilitation program and the traditional occupational therapy had a positive effect on the improvement of cognitive function in stroke patients.