Hardiness Mediates Stress and Impact Level in ED Nurses Who Experienced a Violent Event.

INTRODUCTION: This secondary analysis examined the mediating effect of hardiness between stress and impact level in ED nurses who experienced a violent event. METHOD: This correlational study was conducted from June to August 2014. We used the visual analog scale to measure stress level, the Impact of Event Scale-Revised to measure impact level after the violent event, and the Dispositional Resilience Scale to measure hardiness. We then analyzed mediating effects with the Sobel test. Data were collected in 31 emergency medical centers located in B city in Korea. Data from 321 ED nurses who experienced a violent event were analyzed. Most nurses (91.9%) were women, with a mean age of 28.73 years. The main outcome measure was the mediating effect of hardiness between stress and impact level after ED nurses experienced violence. RESULTS: We found that both violence-related stress (B = 0.22, P < .001) and hardiness (B = -0.33, P = .037) were significant predictors of impact level from a violent event. Based on results of a Sobel test, hardiness partially mediated the relationship between violence-related stress and impact level from a violent event (Z = 2.03, P = .044). DISCUSSION: Hardiness had an effect on reducing the impact level of ED nurses who had experienced a violent event and had a mediating role in mitigating their stress. Therefore, we recommend the development of an intervention program that emphasizes the improvement of hardiness in ED nurses.

Comparing Stability of Mandibular Setback Versus 2-Jaw Surgery in Class III Patients With Minimal Presurgical Orthodontics.

PURPOSE: The aim of this study was to compare treatment time and skeletal stability between mandibular setback surgery (MS) and 2-jaw surgery (2J) with minimal presurgical orthodontics (MPO) in patients with skeletal Class III. MATERIALS AND METHODS: One hundred ninety-five patients who underwent orthognathic surgery were enrolled in this retrospective cohort study. Consecutive patients were selected based on standardized inclusion criteria: Class III malocclusion with mandibular prognathism, surgery type, and presurgical orthodontics with non-extraction for less than 6 months (MPO). Lateral cephalograms were taken before surgery (T0), 1 month after surgery (T1), and at debonding (T2). To evaluate surgical changes (T0 to T1) and postsurgical changes (T1 to T2) in skeletodental tissue, linear, angular, and dental measurements were analyzed using paired t test and independent t test. RESULTS: Thirty-one patients were allocated to the MS-MPO group (n = 16) and the 2J-MPO group (n = 15). The 2J-MPO group showed a shorter duration of postsurgical orthodontic and total surgical and orthodontic treatment than the MS-MPO group. Although the 2J-MPO group exhibited advancement and superior impaction of the maxilla from T0 to T1, posterior movement with clockwise rotation of the mandible between the 2 groups did not show a statistical difference. In addition, from T1 to T2, the MS-MPO and 2J-MPO groups presented forward and upward movement and counterclockwise rotation of the mandible, but no intergroup difference was found. CONCLUSIONS: The MS-MPO and 2J-MPO groups showed similar horizontal and vertical mandibular stability. However, the 2J-MPO group presented a shorter surgical and orthodontic treatment time than the MS-MPO group.

Comparative evaluation of the sliding plate technique for fixation of a sagittal split ramus osteotomy: finite element analysis.

OBJECTIVE: This study evaluated the stress distribution of the sliding plate (SP) and conventional miniplate (CM) fixation techniques of a sagittal split ramus osteotomy (SSRO) using 3-dimensional (3-D) finite element analysis. STUDY DESIGN: Four 3-D finite element models according to the number and shape of screw holes in the plate were simulated, and the von Mises stress was analyzed: SP with 2 round and 2 oval holes (SP-2 R2 O), SP with 2 round and 1 oval holes (SP-2 R1 O), CM with 4 round holes (CM-4 R), and CM with 3 round holes (CM-3 R). RESULTS: The fixation technique with CM-4 R showed a better stress distribution than CM-3 R, which in turn showed better results compared to the 2 different SPs. SP-2 R2 O showed the worst stress distribution in the bone and fixation components. CONCLUSIONS: The results suggest that the SP-2 R2 O technique increases the stress distribution of the plate and screws, which may reduce the stability of fixation after SSRO.

[Validity and Reliability of ARQ-K (Korean Version of the Assault Response Questionnaire) for Emergency Department Nurses in Korea].

PURPOSE: To investigate the validity and reliability of the Korean Version of the Assault Response Questionnaire (ARQ-K) measuring the intensity of reaction to victimization of emergency nurses in Korea. METHODS: An internal consistency reliability and construct validity using exploratory and confirmatory factor analysis were conducted using SPSS WIN (20.0) and AMOS (20.0). Survey data were collected from 321 nurses who worked in 3 levels - wide regional emergency centers, regional emergency centers, appointed emergency centers - of emergency care facilities in Busan, Korea. RESULTS: The Cronbach's alpha values regarding internal consistency were .77~.93 for the subscales of ARQ-K. Factor loadings of the 26 items on the four subscales ranged from .59 to .84. The four-subscale model was validated by confirmatory factor analysis (χ²/df=3.85, p<.001, RMR=.06, GFI=.80, NFI=.81, TLI=.83, CFI=.85, RMSEA=.09). CONCLUSION: This study shows that the Korean Version of the Assault Response Questionnaire is a valid and reliable instrument to assess nurses' reaction to victimization of emergency nurses in Korea.

Evaluation of soft tissue changes around the lips after bracket debonding using three-dimensional stereophotogrammetry.

OBJECTIVE: To evaluate the changes in soft tissue around the lips after orthodontic bracket debonding using three-dimensional (3-D) stereophotogrammetry. MATERIALS AND METHODS: 3-D facial images of 20 subjects (10 men and 10 women; mean age, 26.81 ± 7.23 years) were taken with a white light scanner before and after debonding the labial brackets. Two images acquired from each subject were superimposed, and 15 soft tissue landmarks around the lips were plotted and analyzed. Statistical analysis was performed using both paired and independent t-tests (P < .05). RESULTS: There were no significant changes in position of any landmark on the x (left-right)- or y (vertical)-axes after removal of the brackets. However, the landmarks in the oral commissures and lower lip (LLP, -0.55 mm; Li, -0.44 mm; Ch-L, -0.56 mm, all P < .05) on the z (anteroposterior)-axis showed statistically significant differences. There were no significant positional changes of most landmarks on the x-, y-, or z- axes after bracket removal among the various genders and lip thicknesses. CONCLUSIONS: There was a slight retrusion in the oral commissure and lower lip areas after debonding, but no changes were found in the upper lip area. This study showed that 3-D stereophotogrammetry can be useful in evaluating facial soft tissue changes in orthodontic patients.

Inhibition of NF-kappaB acetylation and its transcriptional activity by Daxx.

We propose a biochemical mechanism by which Daxx modulates NF-kappaB transcriptional activity. Both chromatin immunoprecipitation (ChIP) assay and electrophoretic mobility shift assay (EMSA) have confirmed Daxx-mediated repression of transcriptional competence of NF-kappaB in HeLa cells. Overexpression of Daxx repressed the expression of NF-kappaB-regulated genes such as I kappa B alpha and IL8. Co-immunoprecipitation assay revealed the existence of intermolecular association between endogenous Daxx and p65 subunit of NF-kappaB stimulated by TNFalpha. Here, we suggest that Daxx-mediated repression of NF-kappaB transactivation correlates with the inhibition of p65 acetylation by Daxx. Based on the finding that the Daxx binding N-terminal side of p65 includes the major sites of acetylation mediated by p300/CBP, we further propose that the physical interaction between Daxx and p65 provides a functional framework for the inhibition of p65 acetylation by p300/CBP and subsequent repression of NF-kappaB transcriptional activity.