• Title/Summary/Keyword: Confounding

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A Study on Food Intake and Associated Factors of the Urban Poor Elderly (일부 도시 영세지역 노인들의 영양상태와 관련인자에 관한 연구)

  • Cho, Bong-Soo;Kim, Don-Kyoun;Lee, Su-Ill;Cho, Byung-Mann;Kim, Young-Ook;Koh, Kwang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.1 s.49
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    • pp.59-72
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    • 1995
  • This study was carried out to analyze the food intake and associated factors of the urban poor elderly by comparing poor district, Unbong rental apartment in Bansong 2 dong with other areas in Pusan. 135 elderlies(men 36, women 99) in Unbong rental apartment, 136 elderlies(men 45, women 91) in the other areas were investigated during the period of March to August in 1994. The assumption that the study area represented poor district was satisfied because the age and sex distribution was not significantly different, and the income of the study area was significantly lower than that of the control area. The variables of hospitalized in previous 12 month, gastrointestinal problem, alcohol drinking, cigarette smoking did not differ significantly. But the variables of chronic disease, take medicine, perceived health, vitamin supplement differed significantly between two groups. Therefore some factors associated with health state in the study area are worse than those of the control area. At most of all variables, nutrients intake of the study area did not reach the recommended dietary allowances(RDA) for Koreans, and that nutrient intakes of the study area were significantly lower than those of the control area. The hypothesis of this study that nutrient status depends on economical status was proved. As for the score of nutritional knowledge, the study area was significantly lower than the control area. But as for the score of nutritional behavior, two areas were not significantly different. The latter is counter result of our hypothesis, owing to the effect of the confounding factors including education etc. As for the correlation of variables, not only economic status and educational level, but the score of nutritional knowledge effects strongly on nutrient status in the study area, the poor district. Therefore, adequate nutritional education to the elderly in e poor district should be considered.

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Interpersonal and Community Factors Related to Food Sufficiency and Variety: Analysis of Data from the 2017 Community Health Survey (식품충분성과 다양성의 개인간 및 지역사회 관련 요인: 2017년 지역사회건강조사 자료 분석)

  • Hong, Jiyoun;Hyun, Taisun
    • Korean Journal of Community Nutrition
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    • v.25 no.5
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    • pp.416-429
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    • 2020
  • Objectives: This study examined the personal, interpersonal and community factors related to food sufficiency and variety among Korean adults using data from the 2017 Community Health Survey. Methods: A total of 228,310 adults aged ≥ 19 years were classified into three groups: food sufficiency with variety, food sufficiency without variety and food insufficiency. Personal factors included sociodemographic characteristics, health behavior and health status. Interpersonal factors included social networking and social activities, and community factors included safety, natural environment, living environment, availability of public transportation and health care services. The association of food sufficiency and variety with interpersonal and community factors was assessed using multivariable logistic regression analyses. Results: Of the total sample, the food-sufficiency-without-variety group and food insufficiency group accounted for 31.5% and 3.2%, respectively. The sociodemographic factors associated with food insufficiency and non-variety were women, ≥ 65 years of age, with low education level, low household income, unemployed, single, and living in areas of small population sizes. There were significant differences in health behavior and health status, interpersonal and community factors among the three groups. Multivariable logistic regression analyses conducted after adjusting for confounding factors showed that lack of social networking and social activities and lower satisfaction derived from community environments were associated with the risk of food insufficiency and non-variety. Conclusions: Our results showed that interpersonal and community factors as well as personal factors were related to food sufficiency and variety. Therefore, public policies to help build social networks and participation in social activities, and improve community environment are needed together with food assistance to overcome the problems of food insufficiency and non-variety.

Effects of Thermal Wastewater Effluent and Hydrogen Ion Potential (pH) on Water Quality and Periphyton Biomass in a Small Stream (Buso) of Pocheon Area, Korea (포천지역 계류 (부소천)의 수질과 부착조류 생물량에 온배수와 수소이온농도 (pH) 영향)

  • Jeon, Gyeonghye;Eum, Hyun Soo;Jung, Jinho;Hwang, Soon-Jin;Shin, Jae-Ki
    • Korean Journal of Ecology and Environment
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    • v.50 no.1
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    • pp.96-115
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    • 2017
  • Understanding effects of thermal pollution and acidification has long been a concern of aquatic ecologists, but it remains largely unknown in Korea. This study was performed to elucidate the effects of thermal wastewater effluent (TWE) and acid rain on water quality and attached algae in a small mountain stream, the Buso Stream, a tributary located in the Hantan River basin. A total of five study sites were selected in the upstream area including the inflowing point of hot-spring wastewater (HSW), one upstream site (BSU), and three sites below thermal effluent merged into the stream (1 m, 10 m and 300 m for BSD1, BSD2, and BSD3, respectively). Field surveys and laboratory analyses were carried out every month from December 2015 to September 2016. Water temperature ranged $1.7{\sim}28.8^{\circ}C$ with a mean of $15.0^{\circ}C$ among all sites. Due to the effect of thermal effluent, water temperature at HSW site was sustained at high level during the study period from $17.5^{\circ}C$ (January) to $28.8^{\circ}C$ (September) with a mean of $24.2{\pm}3.7^{\circ}C$, which was significantly higher than other sites. Thermal wastewater effluent also brought in high concentration of nutrients(N, P). The effect of TWE was particularly apparent during dry season and low temperature period (December~March). Temperature effect of TWE did not last toward downstream, while nutrient effect seemed to maintain in longer distance. pH ranged 5.1~8.4 with a mean of 6.9 among all sites during the study period. The pH decrease was attributed to seasonal acid rain and snow fall, and their effects was identified by acidophilic diatoms dominated mainly by Eunotia pectinalis and Tabellaria flocculosa during March and August. These findings indicated that water quality and periphyton assemblages in the upstream region of Buso Stream were affected by thermal pollution, eutrophication, and acidification, and their confounding effects were seasonally variable.

Intakes of Energy and Nutrients and Risk of Breast Cancer - Case-Control Study in Daegu.Gyeongbuk Area, Korea - (영양소 섭취 수준과 유방암 위험 - 대구.경북지역 환자-대조군 연구 -)

  • Lee, Eun-Ju;Lee, Won-Kee;Suh, Su-Won;Suh, Bo-Hyun;Lee, Hye-Sung
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.754-766
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    • 2008
  • This study was performed to evaluate the effect of nutrient intake levels on the relative risk of breast cancer in the Daegu and Gyeongbuk area. The case subjects were 103 patients newly diagnosed as breast cancer at Kyungpook National University Hospital. The control subjects were 159 healthy women without breast cancer-related disease in the same community selected by frequency matching of age and menopausal status. The survey was administered by individual interviews by trained dietitians using semiquantitative food frequency questionnaires. The odds ratios were determined by using unconditional logistic regression after adjusting for the confounding factors found in the analysis of general characteristics of the subjects. In overall, it has been found that high consumptions of energy and carbohydrates significantly raised the relative risk of breast cancer, and that high intakes of total fat, plant fat, dietary fiber, all kinds of fatty acids, vitamin E and calcium significantly lowered the risk of breast cancer. The results of the study suggest that the possible protective factors to the breast cancer risk include a higher intakes of total fat, especially plant fat, dietary fiber, and micronutrients such as vitamin E, folic acid, calcium, phosphorus and potassium. On the other hand, high intakes of energy and carbohydrate appeared to be the risk factors.

Relationship among practicing healthy diet and metabolic syndrome indicators in adults - From the Korea National Health and Nutrition Examination Survey, 2013~2014 (성인 남녀에서 건강식생활 실천 여부와 대사증후군 지표와의 관련성 연구 : 2013~2014 국민건강영양조사 자료를 이용하여)

  • Bae, Yun-Jung
    • Journal of Nutrition and Health
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    • v.49 no.6
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    • pp.459-470
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    • 2016
  • Purpose: The purpose of the present study is to identify the relationship between practicing healthy diet and metabolic syndrome indicators in Koreans. Methods: This research is a cross-sectional study based on the 2013~2014 Korea National Health and Nutritional Examination Survey. This study investigated 6,748 adults aged 19 to 64 yr (19~49 yr: n = 4,230, 50~64 yr: n = 2,518) to examine practice of healthy diet and metabolic syndrome indicators. In this study, according to practicing healthy diet, we classified subjects into the "Practicing healthy diet (PHD)" group (19~49 yr: n = 1,782, 50~64 yr: n = 937) and "Non-practicing healthy diet (NPHD)" group (19~49 yr: n = 2,448, 50~64 yr: n = 1,581). PHD score was determined by adding the number of practicing factors: adequate fat intake, sodium intake ${\leq}2,000mg/day$, fruit & vegetable intake ${\geq}500g/day$, and using nutrition label information in food selection. Results: Female adults had a larger proportion of subjects who practiced a healthy diet compared to male adults (p < 0.001), and the percentages of 19~49 yr and 50~64 yr were 40.46% and 37.07%, respectively. The PHD group consumed significantly more calcium, vitamin $B_1$, $B_2$, and vitamin C density compared to the NPHD group. In 50~64 yr females, the subjects practicing healthy diet (PHD score ${\geq}2$) was inversely associated with risk of abdominal obesity (OR: 0.71, 95% CI: 0.54~0.93, p value = 0.0131) and metabolic syndrome (OR: 0.70, 95% CI: 0.52~0.94, p value = 0.0166) after adjustments for multiple confounding factors, compared with the lower PHD score (PHD score ${\leq}1$). Conclusion: Good dietary practice such as adequate fat intake, sodium intake ${\leq}2,000mg/day$, sufficient fruit & vegetable intake, and using nutrition label information in food selection could be useful in decreasing metabolic syndrome risk of Korean adults.

Association of the RORA Gene Polymorphism and Seasonal Variations in Mood and Behavior (RORA 유전자 다형성과 기분 및 행동의 계절성 변동의 연관성)

  • Kim, Hae-In;So, Soo-Jung;Yang, Hee Jung;Song, Hyun Mi;Moon, Joung Ho;Yoon, Ho-Kyoung;Kang, Seung-Gul;Park, Young-Min;Lee, Seung-Hwan;Kim, Leen;Lee, Heon-Jeong
    • Sleep Medicine and Psychophysiology
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    • v.20 no.2
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    • pp.63-68
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    • 2013
  • Objectives: Several evidence has been suggested that the circadian gene variants contribute to the pathogenesis of seasonal affective disorder. In this study, we aimed to investigate the polymorphism in RORA (Retinoid-related orphan receptor A) gene in relation to seasonal variations among healthy young adults in Seoul, Korea. Methods: A total of 507 young healthy adult subjects were recruited by advertisement. Seasonal variations were assessed by the Seasonality Pattern Assessment Questionnaire (SPAQ). Single-nucleotide polymorphism in the RORA rs11071547 gene was genotyped by PCR in 507 individuals. Considering summer type as confounding factor, we conducted analysis 478 subjects except 29 subjects of summer type. The Chi-square test was conducted to compare differences between groups of seasonals and non-seasonals. Association between genotypes and Global Seasonality Score (GSS) were tested using ANCOVA (Analysis of covariance). Results: In this sample, the prevalence of SAD was 12.1% (winter type 9.3%, summer type 2.8%). There is no significant difference in genotyping distribution of RORA rs11071547 between groups of seasonals and non-seasonals. Global seasonality score (GSS) and scores of all subscales except body weight and appetite were not significantly different between the group with C allele homozygote and the group with T allele homozygote and heterozygote (p-value 0.138). Scores of body weight and appetite were significantly higher in group with C allele homozygotes. Conclusion: These results suggest that RORA gene polymorphism play a role in seasonal variations in appetite and body weight and is associated with susceptibility to seasonal affective disorder in some degree in the population studied.

Comparison Study of the Pulmonary Function and Serum Carboxyhemoglobin Level Between the Traffic Policmen and Clerk Policemen (교통경찰과 비 교통경찰의 폐기능과 혈중 Carboxyhemoglobin 수치에 대한 비교연구)

  • Kim, Sung Min;Cheon, Gyu Rak;Kim, Young Wook;Kim, Joon Hyung;Lee, Ho Hak;Hong, Soon Chang;Lee, Seung Hee;Park, Sang Joon;Chung, Joon Oh;Kim, Yun Kwon;Kim, So Yon;Kim, Young Jung;Cho, Min Koo;Lee, Gwon Jun;Lee, Kyung In
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.560-569
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    • 2003
  • Background : A large number of pollutants such as sulfur dioxide, nitric oxide, carbon monoxide, particulate matter, and ozone influence on the body. These pollutants put a burden on the lung and the sequelae resulting from the oxidative stress are thought to contribute to the development of fibrotic lung disease, emphysema, chronic bronchitis and lung cancer. Also, carbon monoxide generated from the incomplete combustion of carbon-containing compounds is an important component of air pollution caused by traffic exhaust fumes and has the toxic effect of tissue hypoxia and produce various systemic and neurologic complications. The objective of this study is to compare the difference of pulmonary function and serum carboxyhemoglobin(CO-Hb) level between the traffic policemen and clerk policemen. Method : Three hundred and twenty-nine of traffic policemen, and one hundred and thirty clerk policemen were included between 2001 May and 2002 August. The policemen who took part in this study were asked to fill out a questionnaire which included questions on age, smoking, drinking, years of working, work-related symptoms and past medical history. The serum CO-Hb level was measured by using carboxyoximeter. Pulmonary function test was done by using automated spirometer. Additional tests, such as elecrocardiogram, urinalysis, chest radiography, blood chemistry, and CBC, were also done. Results : $FEV_1(%)$ was $97.1{\pm}0.85%$, and $105.7{\pm}1.21%$(p<0.05). FVC(%) was $94.6{\pm}0.67%$, and $102.1{\pm}1.09%$, respectively(p<0.05). Serum CO-Hb level was $2.4{\pm}0.06%$, and $1.8{\pm}0.08%$(p<0.05). After correction of confounding factors (age, smoking), significant variables were FVC(%), $FEV_1(%)$ and serum CO-Hb level(%)(p<0.05). Conclusion : Long exposure to air pollution may influence the pulmonary function and serum CO-Hb level. But, further prospective cohort study will be needed to elucidate detailed influences of specific pollutants on pulmonary function and serum carboxyhemoglobin level.

A Habitat Characteristic of Population of Khingan Fir(Abies Nephrolepis) in Seoraksan National Park Using Landscape Indices (경관지수를 활용한 설악산국립공원 아고산대 분비나무개체군의 서식지 특성)

  • Lee, Ho-young;Park, Hong-chul;Lee, Na-yeon;Lee, Ho
    • Korean Journal of Environment and Ecology
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    • v.34 no.2
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    • pp.170-178
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    • 2020
  • There are few landscape ecological analyses of Khingan fir (Abies nephrolepis) and other habitats of the sub-alpine zone in South Korea. In this study, we tried to quantitatively interpret and assess the habitat characteristics by analyzing 15 landscape indices according to the differences in tree layer coverage, in the Khingan fir habitat growing naturally in the sub-alpine zone of Seoraksan National Park. It was difficult to identify the tendency of landscape ecology to increase and decrease the tree layer coverage in the study site, which was the entire Khingan fir habitat in Seoraksan National Park. However, the Khingan fir habitat was found to be generally low in coverage, and population density as the tree layer coverage of less than 50 percent accounts for 85 percent of the total habitat. Moreover, the Khingan fir habitat in the 10 to 50 percent range was fragmented into a total of 286 patches, making it relatively less connected to the habitat. The total edge length and edge density, which could determine the edge effect of the main part according to the physical form, were the highest in the habitat of 26 to 50 percent coverage, indicating a relatively high impact from outside than habitats of other coverages. The shape with the tree layer coverage of between 10 and 50 percent was more complex even with patches of the same size, and it is believed that these characteristics make it more susceptible to habitat fragmentation and external confounding. We expect that the results of this study can be useful for time series analysis of spatial expansion or reduction of the Khingan fir habitat in Seoraksan National Park and provide the reference data for the morphological change and movement of patches and the connectivity and break-off between forests.

Prevalence and Predictors of Nocturia in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성수면무호흡증 환자의 야간뇨 유병률 및 관련인자)

  • Kang, Hyeon Hui;Lee, Jongmin;Lee, Sang Haak;Moon, Hwa Sik
    • Sleep Medicine and Psychophysiology
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    • v.21 no.1
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    • pp.14-20
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    • 2014
  • Objectives: Several studies suggest that nocturia may be related to obstructive sleep apnea syndrome (OSAS). The mechanism by which OSAS develops nocturia has not been determined. The present study aimed to determine the prevalence of nocturia among adults with OSAS and to identify factors that may be predictive in this regard. Methods: Retrospective review of clinical and polysomnographic data obtained from patients evaluated at the sleep clinics of the St. Paul's Hospital between 2009 and 2012. The urinary symptoms were assessed on the basis of the International Prostate Symptom Score (IPSS). Pathologic nocturia was defined as two or more urination events per night. OSAS was defined as apnea-hypopnea index (AHI) ${\geq}5$. A multivariate analysis using logistic regression was performed to examine the relationship between polysomnographic variables and the presence of pathologic nocturia, while controlling for confounding factor. Results: A total of 161 men >18 years of age (mean age $46.7{\pm}14.1$), who had been referred to a sleep laboratory, were included in the present study. Among these, 27 patients with primary snoring and 134 patients with obstructive sleep apnea were confirmed by polysomnography. Nocturia was found in 53 patients with OSAS (39.6%) and 8 patients with primary snoring (29.6%). The AHI was higher in patients with nocturia than in those without nocturia (p=0.001). OSAS patients with nocturia had higher arousal index (p=0.044), and lower nadir oxyhemoglobin saturation (p=0.001). Multiple regression analysis showed that age (${\beta}$=0.227, p=0.003), and AHI (${\beta}$=0.258, p=0.001) were associated with nocturia, and that the presence of pathologic nocturia was predicted by age (OR 1.04 ; p=0.004) and AHI (OR 1.02 ; p=0.001). Conclusion: Nocturia is common among patients with OSAS. The strongest predictors of nocturia are age and AHI in patients with OSAS.

Relationship between Sleep Disturbances and Cognitive Impairments in Older Adults with Depression (노인성 우울증 환자에서 수면 장애와 인지기능 저하의 관련성)

  • Lee, Hyuk Joo;Lee, Jung Suk;Kim, Tae;Yoon, In-Young
    • Sleep Medicine and Psychophysiology
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    • v.21 no.1
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    • pp.5-13
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    • 2014
  • Objectives: Depression, sleep complaints and cognitive impairments are commonly observed in the elderly. Elderly subjects with depressive symptoms have been found to show both poor cognitive performances and sleep disturbances. However, the relationship between sleep complaints and cognitive dysfunction in elderly depression is not clear. The aim of this study is to identify the association between sleep disturbances and cognitive decline in late-life depression. Methods: A total of 282 elderly people who underwent nocturnal polysomnography in a sleep laboratory were enrolled in the study. The Korean version of the Neuropsychological Assessment Battery developed by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) was applied to evaluate cognitive function. Depressive symptoms were assessed with the geriatric depression scale (GDS) and subjective sleep quality was measured using the Pittsburg sleep quality index (PSQI). Results: The control group ($GDS{\leq}9$) when compared with mild ($10{\leq}GDS{\leq}16$) and severe ($17{\leq}GDS$) depression groups, had significantly different scores in the Trail making test part B (TMT-B), Benton visual retention test part A (BVRT-A), and Stroop color and word test (SCWT)(all tests p<0.05). The PSQI score, REM sleep duration, apnea-hypopnea index and oxygen desaturation index were significantly different across the three groups (all indices, p<0.05). A stepwise multiple regression model showed that educational level, age and GDS score were predictive for both TMT-B time (adjusted $R^2$=35.6%, p<0.001) and BVRT-A score (adjusted $R^2$=28.3%, p<0.001). SCWT score was predicted by educational level, age, apnea-hypopnea index (AHI) and GDS score (adjusted $R^2$=20.6%, p<0.001). Poor sleep quality and sleep structure alterations observed in depression did not have any significant effects on cognitive deterioration. Conclusion: Older adults with depressive symptoms showed mild sleep alterations and poor cognitive performances. However, we found no association between sleep disturbances (except sleep apnea) and cognitive difficulties in elderly subjects with depressive symptoms. It is possible that the impact of sleep disruptions on cognitive abilities was hindered by the confounding effect of age, education and depressive symptoms.