• Title/Summary/Keyword: Confounding

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The Influence of Mothers' Native Country on Multicultural Adolescents' Seasonal Influenza Vaccinations in Multicultural Adolescents Using Data from the 13th (2017) Korea Youth Risk Behavior Web-Based Survey (어머니 출생국가가 다문화 청소년의 인플루엔자 예방접종에 미치는 영향: 제13차(2017년) 청소년 건강행태 온라인조사 자료 분석)

  • Kwon, Mi Young;Jeong, Sookyung
    • Child Health Nursing Research
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    • v.24 no.2
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    • pp.148-156
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    • 2018
  • Purpose: The aim of this study was to evaluate the influence of the mothers' native country on influenza vaccinations in adolescents in multicultural families. Methods: Data were gathered from the 13th (2017) Youth Risk Behavior Web-Based Survey. Logistic regression analyses were conducted using a complex sample data analysis method. The participants in this study had a father who was born in Korea and a mother born outside of Korea. The sample included 481 adolescents. Results: The analysis of non-adjusted confounding variables showed that influenza vaccination was higher in multicultural adolescents whose mother's native country had an annual minimum temperature less than $21^{\circ}C$ (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.20~2.74). Furthermore, when the analysis was adjusted for confounding variables, an annual minimum temperature less than $21^{\circ}C$ in the mother's native country had a statistically significant association with influenza vaccination (OR: 2.12, 95% CI: 1.36~3.29). Conclusion: Multicultural adolescents belong to a socioeconomically vulnerable class, and their health promotion behaviors are influenced by their mothers' culture. Thus, healthcare providers and school nurses should provide adolescents with appropriate information related to influenza vaccination depending on their mothers' culture and their family's cultural background.

Neurobehavioral Effects of Chronic Exposure to Organic Solvents among Dock Yard Painters (만성적 유기용제 폭로로 인한 조선업 도장공들의 신경행동학적 영향에 관한 연구)

  • Cho, Young Sook
    • 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).

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Impact of Advanced Maternal and Paternal Age on Perinatal Outcome (분만여성과 배우자의 출산연령이 산모와 신생아 합병증에 미치는 영향)

  • Lee, Min-Kyung;Shin, Hye-Sook;Lee, Yun-Jung;Kim, Ju-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.18 no.1
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    • pp.95-101
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    • 2012
  • Purpose: This study aimed to analyze the impact of advanced maternal and paternal age on perinatal outcome in Korea. Methods: We conducted a retrospective study involving 1,622 Korean women who delivered at M Woman Hospital from January to December 2010 and their spouses were included. We obtained obstetrics database which included demographic characteristics, medical and obstetrics history, course of the current pregnancy and advised perinatal outcome. Multivariable logistic regression was used to adjust for potential confounding variables. Results: Women giving birth age 35 or older were statistically significant in paternal age, gravidity, spontaneous abortion experience, method of conception, method of delivery, and multiple gestation compared to women aged <34 years. After adjusting for the confounding effects of maternal characteristics, women aged 35 or older were at increased risk for cesarean section delivery (adjusted OR 1.6, 95% CI 1.22-2.13) and preterm birth (adjusted OR 2.2, 95% CI 1.03-4.63). Conclusion: In this population of Korean women, advance maternal and paternal age is independently associated with specific adverse perinatal outcome, especially preterm birth and cesarean section delivery.

Clinical Factors for the Development of Posttraumatic Hydrocephalus after Decompressive Craniectomy

  • Choi, Il;Park, Hyung-Ki;Chang, Jae-Chil;Cho, Sung-Jin;Choi, Soon-Kwan;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.227-231
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    • 2008
  • Objective : Earlier reports have revealed that the incidence of posttraumatic hydrocephalus (PTH) is higher among patients who underwent decompressive craniectomy (DC). The aim of this study was to determine the influencing factors for the development of PTH after DC. Methods : A total of 693 head trauma patients admitted in our hospital between March 2004 and May 2007 were reviewed. Among thee, we analyzed 55 patients with severe traumatic brain injury who underwent DC. We excluded patients who had confounding variables. The 33 patients were finally enrolled in the study and data were collected retrospectively for these patients. The patients were divided into two groups: non-hydrocephalus group (Group I) and hydrocephalus group (Group II). Related factors assessed were individual Glasgow Coma Score (GCS), age, sex, radiological findings, type of operation, re-operation and outcome. Results : Of the 693 patients with head trauma, 28 (4.0%) developed PTH. Fifty-five patients underwent DC and 13 (23.6%) developed PTH. Eleven of the 33 study patients (30.3%) who had no confounding factors were diagnosed with PTH. Significant differences in the type of craniectomy and re-operation were found between Group I and II. Conclusion : It is suggested that the size of DC and repeated operation may promote posttraumatic hydrocephalus in severe head trauma patients who underwent DC.

Conditioning-induced cardioprotection: Aging as a confounding factor

  • Randhawa, Puneet Kaur;Bali, Anjana;Virdi, Jasleen Kaur;Jaggi, Amteshwar Singh
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.5
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    • pp.467-479
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    • 2018
  • The aging process induces a plethora of changes in the body including alterations in hormonal regulation and metabolism in various organs including the heart. Aging is associated with marked increase in the vulnerability of the heart to ischemia-reperfusion injury. Furthermore, it significantly hampers the development of adaptive response to various forms of conditioning stimuli (pre/post/remote conditioning). Aging significantly impairs the activation of signaling pathways that mediate preconditioning-induced cardioprotection. It possibly impairs the uptake and release of adenosine, decreases the number of adenosine transporter sites and down-regulates the transcription of adenosine receptors in the myocardium to attenuate adenosine-mediated cardioprotection. Furthermore, aging decreases the expression of peroxisome proliferator-activated receptor gamma co-activator 1-alpha ($PGC-1{\alpha}$) and subsequent transcription of catalase enzyme which subsequently increases the oxidative stress and decreases the responsiveness to preconditioning stimuli in the senescent diabetic hearts. In addition, in the aged rat hearts, the conditioning stimulus fails to phosphorylate Akt kinase that is required for mediating cardioprotective signaling in the heart. Moreover, aging increases the concentration of $Na^+$ and $K^+$, connexin expression and caveolin abundance in the myocardium and increases the susceptibility to ischemia-reperfusion injury. In addition, aging also reduces the responsiveness to conditioning stimuli possibly due to reduced kinase signaling and reduced STAT-3 phosphorylation. However, aging is associated with an increase in MKP-1 phosphorylation, which dephosphorylates (deactivates) mitogen activated protein kinase that is involved in cardioprotective signaling. The present review describes aging as one of the major confounding factors in attenuating remote ischemic preconditioning-induced cardioprotection along with the possible mechanisms.

Egg Consumption and Prevalence of Metabolic Syndrome in Korean Adults: Based on 2007-2008 Korean National Health and Nutrition Examination Survey (한국인의 계란 섭취와 대사증후군과의 관계: 2007-2008 국민건강영양조사 자료를 이용하여)

  • Kim, Hyo-Jin;Park, Kyong
    • Korean Journal of Community Nutrition
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    • v.16 no.3
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    • pp.364-374
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    • 2011
  • There is a great public concern that higher consumption of eggs may increase the risk of chronic disease due to high levels of cholesterol in eggs. In contrast to this concern, limited studies have examined this relationship, and the study results have been inconsistent. This study was to evaluate the cross-sectional associations between egg consumption, blood markers and metabolic syndrome in Korean adults. We analyzed data from the combined 2007-2008 Korean National Health and Nutrition Examination Survey (KNHANES). Egg intakes were assessed using a food frequency questionnaire. Metabolic syndrome was ascertained using criteria of the NCEP ATP III (2001) and abdominal obesity criteria of the WHO. In 5,548 subjects, 937 subjects were defined as having metabolic syndrome. In linear regression models, subjects reporting one or more egg consumption per day had significantly lower levels of triglyceride, fasting blood glucose and blood pressure, and a higher level of HDL cholesterol, compared to those who rarely consumed eggs (P-trends < 0.05). After adjustments for potential confounding factors, the associations were no longer significant except for total cholesterol, showing higher levels with frequent egg consumption. More frequent intakes of egg (1 egg or more/day) were associated with lower risk of metabolic syndrome in a logistic regression model (OR: 0.69, 95% CI: 0.50-0.96), but this association also became insignificant after adjustments for multiple confounding factors (OR: 1.05, 95% CI: 0.71-1.57). In healthy Korean adults, frequent intakes of eggs did not adversely affect the risk of metabolic syndrome. Further studies are needed to confirm this finding.

Effect of perceived stress on general health and oral health status in elderly: results from the Korea national health and nutrition examination survey 2014 (노인의 스트레스 인지가 전반적인 건강상태 및 구강건강상태에 미치는 영향)

  • Choi, Eun-Sil;Cho, Han-A
    • Journal of Korean society of Dental Hygiene
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    • v.17 no.5
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    • pp.899-910
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    • 2017
  • Objectives: This study was conducted to identify the rates of perceived stress of elderly people over 65 years old and to confirm the influence of stress on general health and oral health status. Methods: Using data from the National Health and Nutrition Survey for 2014, 1,472 people over 65 years of age were selected as final subjects. Stress was used as an independent variable and dependent variables were included physical health (perceived health status), mental health (depression), and oral health (perceived oral health status). The following confounding variables were adjusted for the current study: demographic characteristics (gender, age, education level, house income) and health - related characteristics (drinking, smoking, exercise, frequency of tooth brushing, using oral care product, dental exam, comorbidity, restrict activity). Complex sampling analysis was applied and logistic regression was performed to determine the effects of stress on physical health, mental health and oral health status. Odds ratio (OR) and 95% confidence interval (95% Confidence Interval, 95% CI) were calculated. Results: Logistic regression indicated that stress was significantly associated with low physical health (OR=2.18, 95%CI: 1.49-3.20), low mental health (OR=8.68, 95%CI: 4.98-15.11), low oral health (OR=1.53, 95%CI: 1.06-2.21) after adjusting for confounding variables. Conclusions: The perceived stress of the elderly was found to be related to the general health and oral health status. Therefore, it is necessary to evaluate stress as a predictor of health risk for the health promotion of the elderly on multidisciplinary assessment and continuous evaluation. In addition, health support policies should be provided to achieve good health status for elderly.

Relationship between the Exposure to Ozone in Seoul and the Childhood Asthma-related Hospital Admissions according to the Socioeconomic Status (사회경제수준에 따른 오존과 소아천식 관련 입원의 상관성 연구)

  • Son, Ji-Young;Kim, Ho;Kim, Sun-Young;Lee, Jong-Tae
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.1
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    • pp.81-86
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    • 2006
  • Background: A number of studies have reported associations between the ambient air pollution concentrations and various health outcomes. Especially, ozone is well known for primary risk factor of asthma attacks. The results of a recent study indicate that the size of the effect on health outcomes due to air pollution varied according to several conditions, including age, gender, race and the socioeconomic status. Therefore, this study was conducted to examine the associations of ozone with the childhood asthma hospitalizations as stratified by the socioeconomic status (SES) at the community level in Seoul, Korea, 2002. Methods: SES at aggregated levels was measured on the basis of average regional health-insurance rate per citizen in the area. We applied the generalized additive model to analyze the effect of ozone on asthma after controlling for the potential confounding variables that were capable of influencing the results. Results: Our analysis showed that the number of children who were hospitalized for asthma increased as the SES of the residence area decreased. The estimated relative risks of hospitalization for asthma, as stratified by the SES of the community level, were 1.12 (95% confidence interval 1.00-1.25) in districts with the highest SES levels, 1.24 (95% CI=1.08-1.43) within the moderate SES levels, and 1.32 (95% CI=1.11-1.58) in the districts with the lowest SES levels. Conclusions: Our analysis showed that exposure to air pollution did not equally affect the health status of individuals. This suggests that not only the biological-sensitivity markers, but also the SES of the subjects should be considered as potentially confounding factors.

Zolpidem Use and Risk of Fracture in Elderly Insomnia Patients

  • Kang, Dong-Yoon;Park, So-Young;Rhee, Chul-Woo;Kim, Ye-Jee;Choi, Nam-Kyong;Lee, Joong-Yub;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.4
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    • pp.219-226
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    • 2012
  • Objectives: To evaluate the risk of fractures related with zolpidem in elderly insomnia patients. Methods: Health claims data on the entire South Korean elderly population from January 2005 to June 2006 were extracted from the Health Insurance Review and Assessment Service database. We applied a case-crossover design. Cases were defined as insomnia patients who had a fracture diagnosis. We set the hazard period of 1 day length prior to the fracture date and four control periods of the same length at 5, 10, 15, and 20 weeks prior to the fracture date. Time independent confounding factors such as age, gender, lifestyle, cognitive function level, mobility, socioeconomic status, residential environment, and comorbidity could be controlled using the case-crossover design. Time dependent confounding factors, especially co-medication of patients during the study period, were adjusted by conditional logistic regression analysis. The odds ratios and their 95% confidence intervals (CIs) were estimated for the risk of fracture related to zolpidem. Results: One thousand five hundred and eight cases of fracture were detected in insomnia patients during the study period. In our data, the use of zolpidem increased the risk of fracture significantly (adjusted odds ratio [aOR], 1.72; 95% CI, 1.37 to 2.16). However, the association between benzodiazepine hypnotics and the risk of fracture was not statistically significant (aOR, 1.00; 95% CI, 0.83 to 1.21). Likewise, the results were not statistically significant in stratified analysis with each benzodiazepine generic subgroup. Conclusions: Zolpidem could increase the risk of fracture in elderly insomnia patients. Therefore zolpidem should be prescribed carefully and the elderly should be provided with sufficient patient education.

The relationship between sleep duration and the number of remaining teeth among the elderly using data from the Korean National Health and Nutrition Examination Survey (KNHANES) (노인의 수면시간과 현존치아 수와의 관련성 : 제6기 국민건강영양조사 자료를 이용하여)

  • Kim, Nam-Suk;Yoon, Jung-Won;Lee, Jung-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.5
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    • pp.731-742
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    • 2019
  • Objectives: To analyze the association between sleep duration and the number of remaining teeth in people aged 65 years or older in order to provide basic data for improving sleep quality and developing oral health programs for teeth maintenance. Methods: The raw data for the analysis were obtained from the sixth Korean National Health and Nutrition Examination Survey (KNHANES) dataset, conducted between 2013 and 2015. The 4,340 subjects included in the study underwent oral examinations and then proceeded to answer related questions. The collected data were analyzed using SPSS (ver 23.0) program via composite samples, with the calculations for mean, standard deviation, chi-square test, and logistic return analysis being performed. Results: An analysis of the effect of sleep duration on the number of remaining teeth among people aged >65 years old showed that if the confounding variables were not corrected for, the risk of having less than 9 hours of sleep was 1.40 times higher (95% CI: 1.06-1.86). However, this was not statistically significant in models that corrected for gender, age, and other confounding variables (p>0.05). Conclusions: The association between sleep duration among the elderly with their number of remaining teeth was confirmed. Therefore, measures to improve sleep quality and oral care practices to maintain the remaining teeth in people over 65 years old should be developed.