Purpose: This study was done to build and verify a model of clinical nurses' turnover intention using organizational characteristics, job satisfaction and job embeddedness. Methods: The study participants were 389 hospital nurses. SPSS and AMOS 22.0 program were used to analyze the data and the modeling of turnover intention. Results: A total of 41% of turnover intention was explained by job satisfaction, job embeddedness and organizational characteristics. Nurses with higher job satisfaction and job embeddedness showed lower turnover intention, while organizational characteristics had an indirect effect on their turnover intention. It was found that organizational characteristics had positive effects on both job satisfaction and job embeddedness, and job embeddedness played a mediating role between organizational characteristics and turnover intention. Conclusion: To reduce nurses' turnover intention, hospitals' organizational characteristics should be considered. Nurse managers should strive to increase nurses' job satisfaction and job embeddedness through an understanding of the factors of organizational characteristics such as organizational fairness, nursing work environment, motivation, organizational citizenship behavior, and transformational leadership.
Recently, obesity has become a worldwide public health concern and the use of anorectic drugs has drastically increased. In this study, sibutramine and phendimetrazine, representative marketed anorectics, were repeatedly administered per os on a daily basis into C57BL/6 mice and the effects of these drugs on food intakes, body weight changes and gene expression profiles were monitored for up to following 7 days. Methamphetamine, which has a potent anorectic effect, was used as a positive control. Anorectic effects were sustained only for two days by phendimetrazine or methamphetamine, but for six days by sibutramine. The modulations of gene expressions in the hypothalamus and the striatum were investigated using microarrays on day 2 and day 7 post-administration, which corresponded to the anorectic period and a return of appetite respectively, for all three drugs tested. Differences in overall gene expression profiles in the stratum on day 2 for sibutramine and phendimetrazine seems to reflect difference between the two in terms of the onsets of drug tolerance. According to microarray findings, the Ankrd26 gene appears to have an important anorectic role, whereas the up-regulation of the olfaction system appeared to be involved in the drug tolerance of anorectics. The microarray data presented in this study demonstrates the usefulness of gene expression analysis for gathering information on the efficacy and safety of anorectic drugs.
Technological innovation has been regarded as the core competence for the economic growth of individual, as well as organization and country. Pharmaceutical innovation, what we call new medicines, influence people's longevity and productivity by increasing output per hour worked. Therefore, using claims data on virtually all the drugs and diseases of over 550,000 people enrolled in National Health Insurance Program in Korea, we examined the impact of the vintage (original FDA and KFDA approval year) of drugs used to treat a patients from July 1st to December 31st in 2002 on the patient's mortality at the end of 2004, controlling for demographic characteristics(age and sex), utilization of medical services, and the nature and complexity of illness. We found that people using newer drugs are less likely to die at the end of 2004, conditional on covariates. The estimated mortality rates were declining with respect to drug vintage for 1970s, 1980s and 1990s and highly significant. In addition to estimating the model for the entire sample, we estimated the model separately for several disease categories classified by Korean Classification of Disease. Estimates of three drug vintage variables for subgroups of people with (1)neoplasms, (2)endocrine, nutritional and metabolic diseases, and (3)the diseases of circulatory system displayed similar patterns.
This document was prepared to review and summarize the analytical methods for airborne and bulk asbestos. Basic principles, shortcomings and advantages for asbestos analytical instruments using phase contrast microscopy(PCM), polarized light microscopy(PLM), X-ray diffractometer (XRD), transmission electron microscopy(TEM), scanning electron microscopy(SEM) were reviewed. Both PCM and PLM are principal instrument for airborne and bulk asbestos analysis, respectively. If needed, analytical electron microscopy is employed to confirm asbestos identification. PCM is used originally for workplace airborne asbestos fiber and its application has been expanded to measure airborne fiber. Shortcoming of PCM is that it cannot differentiate true asbestos from non asbestos fiber form and its low resolution limit ($0.2{\sim}0.25{\mu}m$). The measurement of airborne asbestos fiber can be performed by EPA's Asbestos Hazard Emergency Response Act (AHERA) method, World Health Organization (WHO) method, International Standard Organization (ISO) 10312 method, Japan's Environmental Asbestos Monitoring method, and Standard method of Indoor Air Quality of Korea. The measurement of airborne asbestos fiber in workplace can be performed by National Institute for Occupational Safety and Health (NIOSH) 7400 method, NIOSH 7402 method, Occupational Safety and Health Administration (OSHA) ID-160 method, UK's Health and Safety Executive(HSE) Methods for the determination of hazardous substances (MDHS) 39/4 method and Korea Occupational Safety and Health Agency (KOSHA) CODE-A-1-2004 method of Korea. To analyze the bulk asbestos, stereo microscope (SM) and PLM is required by EPA -600/R-93/116 method. Most bulk asbestos can be identified by SM and PLM but one limitation of PLM is that it can not see very thin fiber (i.e., < $0.25{\mu}m$). Bulk asbestos analytical methods, including EPA-600/M4-82-020, EPA-600/R-93/116, OSHA ID-191, Laboratory approval program of New York were reviewed. Also, analytical methods for asbestos in soil, dust, water were briefly discussed. Analytical electron microscope, a transmission electron microscope equipped with selected area electron diffraction (SAED) and energy dispersive X-ray analyser(EDXA), has been known to be better to identify asbestiform than scanning electron microscope(SEM). Though there is no standard SEM procedures, SEM is known to be more suitable to analyze long, thin fiber and more cost-effective. Field emission scanning electron microscope (FE-SEM) imaging protocol was developed to identify asbestos fiber. Although many asbestos analytical methods are available, there is no method that can be applied to all type of samples. In order to detect asbestos with confidence, all advantages and disadvantages of each instrument and method for given sample should be considered.
Purpose: This study aimed to investigate the prevalence of musculoskeletal symptoms (MSSs) and their correlation with subjective health condition (SHC) among emergency medical technicians (EMTs). Methods: A self-reported questionnaire was disseminated to EMTs (N=257) at emergency medical institutions and fire stations. Results: The prevalence of MSSs was very high in the studied EMTs: 88.3% reported having MSSs. The most commonly affected site was the lower back (73.9%) followed by the neck (56.8%) and the shoulder (55.6%). MSSs were more common in women than in men, and its frequency increased with age. MSSs in the neck and shoulder were more increased in EMTs with < 1 year of service. MSSs in the hand / wrist / finger or leg / foot were significantly increased in EMTs of emergency medical institutions than those of fire stations. Job satisfaction was significantly lower in those with MSSs of the lower back. The subjective heath condition was decreased with age, marriage, or smoking. There was significant corelation between MSSs and SHC. Conclusion: This study suggests that MSSs are a reasonably common problem for EMTs, and that solutions need to be imposed such as some actual tasks or items related to work postures, work control, and work organization.
The World Health Organization (WHO) tries to accomplish the goal of 'smoke free society', and developed countries regard the nicotine as an addictive drug. In order to better protect human health, all parties are required to adopt and implement effective legislative, executive, administrative or other measures for tobacco control in accordance with Article 4 the Framework Convention on Tobacco Control (FCTC). In order to achieve the objective of the FCTC and its protocols and to implement its provisions, Korea need to take an attention on the U.S. Family Smoking Prevention And Tobacco Control Act of 2009 and Final Rule. It is need to integrate and centralize of tobacco safety administration and smoking prevention for the national health promotion.
This study investigates the change in the fine particulate matter (PM2.5) concentration and World Health Organization (WHO) air quality index (AQI) in East Asia (EA) under Shared Socioeconomic Pathways (SSPs). AQI is an indicator of increasing levels about health concern, divided into six categories based on PM2.5 annual concentrations. Here, we utilized the ensemble results of UKESM1, the climate model operated in Met Office, UK, for the analysis of long-term variation during the historical (1950~2014) and future (2015~2100) period. The results show that the spatial distributions of simulated PM2.5 concentrations in present-day (1995~2014) are comparable to observations. It is found that most regions in EA exceeded the WHO air quality guideline except for Japan, Mongolia regions, and the far seas during the historical period. In future scenarios containing strong air quality (SSP1-2.6, SSP5-8.5) and medium air quality (SSP2-4.5) controls, PM2.5 concentrations are substantially reduced, resulting in significant improvement in AQI until the mid-21st century. On the other hand, the mild air pollution controls in SSP3-7.0 tend to lead poor AQI in China and Korea. This study also examines impact of increased in PM2.5 concentrations on downward shortwave energy at the surface. As a result, strong air pollution controls can improve air quality through reduced PM2.5 concentrations, but lead to an additional warming in both the near and mid-term future climate over EA.
Purpose: The purpose of this paper was to investigate opinions and experiences of hospital CEOs' and QI managers toward the National Hospital Evaluation Program which was implemented in 2004 and to recommend various strategies to improve the program. Methods: We conducted a mail survey with CEOs and QI managers' of 78 hospitals with 500 beds or more that participated the 2004 National Hospital Evaluation Program. Results: About 70.8% of the participating CEOs and 64.0% of the QI managers felt that the objectives of the evaluation program weren't fully achieved. Most respondents said that the current program required a partial or an overall change. Evaluation Criteria was the most often cited area for a change. Many respondents pointed out the importance of including clinical quality indicators in the evaluation tool. Conclusions: To upgrade hospital services with better quality, it is most important to first reach consensus on objectives and approaches of the evaluation program among various players. For a consistent planning and implementation, it is urgent to set up a more systematic organization and financing mechanism. Also, evaluation approaches, including evaluation criteria, methods, patient satisfaction assessment, as well as ways to summarize and publicize each hospital's performance should be improved.
Le, Thi Huong;Nga, Thi Thu Vu;Nguyen, Ngoc Dung;Le, Thi Thanh Xuan;Kim, Bao Giang;Phan, Thi Hai;Doan, Thu Huyen;Luong, Ngoc Khue;Nguyen, Tuan Lam;Hoang, Van Minh;Pham, Thi Quynh Nga
Asian Pacific Journal of Cancer Prevention
/
제17권sup1호
/
pp.17-23
/
2016
The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%-3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.
Background: To evaluate the quality of chronic care provided by public health centers located in a South Korean metropolitan city using a modified Assessment of Chronic Illness Care (ACIC). Methods: We conducted self-evaluation surveys and collected data using a modified ACIC from twenty five public health centers. Cultural validity of the original ACIC was examined by the public health and nursing science experts. Based on expert reviews, cognitive interviews, pre-test results, five items of the original ACIC that were not relevant were deleted. The response scale was changed from twelve-point Likert scale to Guttman scale but its scoring system was maintained. Results: Eighty eight percent of public health centers in this study reported that their overall quality of chronic care was at a limited or basic level. About 68% of the centers reported that the organization was as reasonably good or fully developed to provide chronic care. On the other hand, 96% of the public health centers reported that the clinical information system was at a very limited or basic support level. The decision support, the integration of Chronic Care Model components, the delivery system design, the community linkages, and the self-management support were evaluated as limited or basic level of support by more than half of the public health centers, respectively. Conclusion: In a metropolitan area of South Korea, quality of chronic care in public health centers was not found to reach acceptable levels of services. It is critical to enhance the quality of chronic care in public health centers.
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