• 제목/요약/키워드: Epidemiological Model

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Intervention Mapping 설계를 통한 중학생 대상 흡연음주예방 교육프로그램 개발 (Development of a Smoking and Drinking Prevention Program for Adolescents using Intervention Mapping)

  • 계수연;최슬기;박기호
    • 한국학교ㆍ지역보건교육학회지
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    • 제12권3호
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    • pp.1-15
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    • 2011
  • Objectives: We describe the development of a smoking and drinking prevention program for adolescents, using intervention mapping. Methods: The study sample consisted of 1,000 high school second-grade students from 6 high schools in Seoul. The PRECEDE model was applied for the needs assessment. We carried out a social diagnosis by assessing the factors such as the quality of life, happiness level, and satisfaction with school life; an epidemiological diagnosis on the perceived health status, stress levels, and priority of health issues; a behavioral diagnosis on the smoking and drinking rate and the intention to smoke and drink; and an educational diagnosis on knowledge, beliefs, attitudes, self-efficacy, outcome expectations, social norms and life skills. Results: The development process included a needs assessment, identifying factors that influence smoking and drinking among adolescents. Intention, knowledge, perceived norms, perceived benefit, perceived cost, perceived susceptibility, self-efficacy, and life skills were identified as determinants. Three performance objectives were formulated to describe what an individual needs to do in order to avoid smoking and drinking. Subsequently, we constructed an intervention matrix by crossing the performance objectives with the selected determinants. Each cell describes the learning objectives of the smoking and drinking prevention program. The program used methods from the transtheoretical model, such as consciousness raising, outcome expectations, self-reevaluation, self-liberation, counterconditioning, environmental reevaluation, and stimulus control. The program deals with the effects of smoking and drinking, self-improvement, decision making, understanding advertisements, communication skills, social relationships, and assertiveness. Conclusions: By using the process of intervention mapping, the program developer was able to ensure a systematical incorporation of empirical and new data and theories to guide the intervention design. Programs targeting other health-related behavior and other methods or strategies can also be developed using this intervention mapping process.

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Association Between the XRCC3 Thr241Met Polymorphism and Cervical Cancer Risk: a Meta-analysis

  • Qin, Ling-Yan;Chen, Xu;Li, Ping;Yang, Zheng;Mo, Wu-Ning
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6703-6707
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    • 2013
  • Background: Numerous epidemiological studies have been conducted to evaluate the association between variants of the DNA repair gene XRCC3 and cancer risk. Here we focused on one XRCC3 polymorphism and development of cervical cancer, performing a meta-analysis. Methods: The pooled association between the XRCC3 Thr241Met polymorphism and cervical cancer risk was assessed by odds ratios (ORs) and their 95% confidence intervals (95%CIs). Results: A total of 5 case-control studies met the inclusion criteria. The pooled ORs for the total included studies showed no association among homozygotes TT vs. CC: OR=1.93, 95%CI=0.68-5.49, P=0.22; dominant model TT+TC vs. CC: OR=1.37, 95%CI=0.90-2.06, P=0.14; and recessive model TT vs. TC+CC: OR=1.76, 95%CI=0.68-4.55, P=0.25, but might be a slight risk factor for cervical cancer in heterozygote contrast TT vs. CT: OR= 1.33, 95%CI=1.04-1.71, P=0.02. In subgroup analysis, significant associations were found for Asians under all genetic models. Conclusions: Our meta-analysis suggested the XRCC3 Thr241Met polymorphism might not act as a cervical cancer risk factor overall. However, in subgroup analysis, a significant association was found in Asians under all genetic models. The association should be studied with a larger, stratified population, especially for Asians.

대기오염의 건강위해성 연구 - PM2.5를 중심으로 - (The Health Effects of PM2.5: Evidence from Korea)

  • 홍종호;고유경
    • 자원ㆍ환경경제연구
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    • 제12권3호
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    • pp.469-485
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    • 2003
  • 본 연구는 최근 선진국에서 기존의 미세먼지 규제대상인 PM10의 대안으로서 부각되고 있는 PM2.5의 국내 실측자료를 대상으로 미세먼지의 호흡기질환 영향을 투입반응함수를 통해 추정한 것이다. 총 3차에 걸친 110여 일의 조사기간 동안 일별 PM10, PM2.5, 온도, 습도 등을 측정하였으며, 동시에 해당 지역에 거주하는 80여명의 노인들을 대상으로 일별 역학조사 및 설문조사를 통한 각종 호흡기질환 여부를 확인하였다. 미세먼지에 따른 호흡기 반응을 나타내는 최대호기유속량(PEFR)에 대한 투입반응함수 추정 결과 미세먼지인 PM2.5에 대한 계수는 음의 값을 갖는 것으로 추정되어 미세먼지의 증가는 호흡기능의 저하를 통해 호흡기질환을 유발할 수 있는 것으로 확인되었다. 또한 10여 가지 항목에 대한 호흡기질환 증세 유무를 대상으로 이산적 선택모형인 probit모형 추정 결과 PM10은 유의한 추정치를 보이지 않은 반면, PM2.5의 증가는 각종 호흡기질환의 증가를 가져오는 것으로 추정되었다. 이는 PM2.5가 정부의 대기정책에 있어 보다 바람직한 미세먼지 규제대상이 될 수 있음을 시사하는 것이다.

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우리나라 저체중아 출생의 공간적 변동성 지도화: 베이지언적 접근 (Mapping the Geographic Variations of the Low Birth Weight cases in South Korea: Bayesian Approaches)

  • 노영희;박기호
    • 대한지리학회지
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    • 제51권3호
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    • pp.367-380
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    • 2016
  • 본 연구에서는 우리나라에서 발생한 저체중아 출생 집계 자료를 공간적으로 지도화하기 위한 기법들을 검토 비교하고, 이를 기반으로 우리나라의 LBW 지도를 작성하였다. 표준화사망률이나 조사망률 등은 역학 분야에서 지속적으로 광범위하게 사용되고 있는 지표이다. 그러나 이러한 표준화사망률은 집계 단위의 샘플 수에 영향을 많이 받는다는 단점을 가지고 있다. 이에, 본 연구에서는 베이지언 기법을 활용하여 샘플 수에 따른 통계적 변동성을 감소시키고자 하였다. 이를 위해 경험적 베이지언 기법과 풀 베이지언 기법을 모두 활용하였고, 결과적으로 유사한 통계량을 산출한 것을 확인할 수 있었다. 반면, SMR 기반의 통계량은 높은 분산을 가지고 있음을 확인하였다. 연구의 결과에 따른 통계 지도는 우리나라 저체중아 출생의 높은 위험도를 가지는 지역들을 파악할 수 있도록 한다.

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A descriptive study of on-farm biosecurity and management practices during the incursion of porcine epidemic diarrhea into Canadian swine herds, 2014

  • Perri, Amanda M.;Poljak, Zvonimir;Dewey, Cate;Harding, John CS.;O'Sullivan, Terri L.
    • Journal of Veterinary Science
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    • 제21권2호
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    • pp.25.1-25.16
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    • 2020
  • Porcine epidemic diarrhea virus (PEDV) emerged into Canada in January 2014, primarily affecting sow herds. Subsequent epidemiological analyses suggested contaminated feed was the most likely transmission pathway. The primary objective of this study was to describe general biosecurity and management practices implemented in PEDV-positive sow herds and matched control herds at the time the virus emerged. The secondary objective was to determine if any of these general biosecurity and farm management practices were important in explaining PEDV infection status from January 22, 2014 to March 1, 2014. A case herd was defined as a swine herd with clinical signs and a positive test result for PEDV. A questionnaire was used to a gather 30-day history of herd management practices, animal movements on/off site, feed management practices, semen deliveries and biosecurity practices for case (n = 8) and control (n = 12) herds, primarily located in Ontario. Data was analyzed using descriptive statistics and random forests (RFs). Case herds were larger in size than control herds. Case herds had more animal movements and non-staff movements onto the site. Also, case herds had higher quantities of pigs delivered, feed deliveries and semen deliveries on-site. The biosecurity practices of case herds were considered more rigorous based on herd management, feed deliveries, transportation and truck driver practices than control herds. The RF model found that the most important variables for predicting herd status were related to herd size and feed management variables. Nonetheless, predictive accuracy of the final RF model was 72%.

수학적 모델을 이용한 신종인플루엔자 환자 예측 및 대응 전략 평가 (Mathematical Modeling of the Novel Influenza A (H1N1) Virus and Evaluation of the Epidemic Response Strategies in the Republic of Korea)

  • 서민아;이지현;지혜진;김영근;강대용;허남욱;하경화;이동한;김창수
    • Journal of Preventive Medicine and Public Health
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    • 제43권2호
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    • pp.109-116
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    • 2010
  • Objectives: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. Methods: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. Results: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). Conclusions: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.

Gene Polymorphism of XRCC1 Arg399Gln and Cervical Carcinoma Susceptibility in Asians: A Meta-analysis Based on 1,759 Cases and 2,497 Controls

  • Liu, Yi-Ting;Shi, Jing-Pu;Fu, Ling-Yu;Zhou, Bo;Wang, Hai-Long;Wu, Xiao-Mei
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.189-193
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    • 2013
  • Many epidemiological studies in Asian populations have investigated associations between the Arg399Gln gene polymorphism of X-ray repair cross complementing gene 1 (XRCC1) and risk of cervical carcinoma, but no conclusions have been available because of controversial results. Therefore a meta-analysis was conducted for clarification. Relevant studies were identified by searching the Pubmed, Embase, the Web of Science, Cochrane Collaboration's database, Chinese National Knowledge Infrastructure (CNKI), Wanfang database and China Biological Medicinse (CBM) until September, 2012. A total of eight studies were included in the present meta-analysis, which described 1,759 cervical carcinoma cases and 2,497 controls. Odds ratios (ORs) and corresponding 95% confidence intervals (95%CIs) as effect size were calculated by fixed-effect or random-effect models. The overall results indicated that the XRCC1-399G/A polymorphism was marginally associated with cervical carcinoma in Asians: OR (95%CI): 1.16 (1.07, 1.26) in the G/A vs G/G inheritance model, 1.24 (0.87, 1.76)in A/A vs G/G inheritance model, 1.13 (1.01, 1.27) in the dominant inheritance model and 1.18 (0.94, 1.47) in the recessive inheritance model. Subgroup analyses on sample size showed no significant correlation in the small-sample size group but the large-sample size group was consistent with the outcomes of overall meta-analysis. In the subgroup analysis by regions, we only found significant association under the G/A vs G/G inheritance model in the Chinese population. For the non-Chinese populations, no correlation was detected in any genetic inheritance model. In the Asian populations, XRCC1-399G/A gene polymorphism was implied to be associated with cervical carcinoma.

Land Use Regression 모델을 이용한 수도권 초등학교 대기오염 노출 분석 (Land Use Regression Model for Assessing Exposure and Impacts of Air Pollutants in School Children)

  • 이지영;임종한;김환철;황승식;정달영;박명숙;김정애;이재준;박노욱;강성찬
    • 한국대기환경학회지
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    • 제28권5호
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    • pp.571-580
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    • 2012
  • Epidemiologic studies of air pollution need accurate exposure assessments at unmonitored locations. A land use regression (LUR) model has been used successfully for predicting traffic-related pollutants, although its application has been limited to Europe, North America, and a few Asian region. Therefore, we modeled traffic-related pollutants by LUR then examined whether LUR models could be constructed using a regulatory monitoring network in Metropolitan area in Korea. We used the annual-mean nitrogen dioxide ($NO_2$) in 2010 in the study area. Geographic variables that are considered to predict traffic-related pollutants were classified into four groups: road type, traffic intensity, land use, and elevation. Using geographical variables, we then constructed a model to predict the monitored levels of $NO_2$. The mean concentration of $NO_2$ was 30.71 ppb (standard deviation of 5.95) respectively. The final regression model for the $NO_2$ concentration included five independent variables. The LUR models resulted in $R^2$ of 0.59. The mean concentration of $NO_2$ of elementary schools was 34.04 ppb (standard deviation of 5.22) respectively. The present study showed that even if we used regulatory monitoring air quality data, we could estimate $NO_2$ moderately well. These analyses confirm the validity of land use regression modeling to assign exposures in epidemiological studies, and these models may be useful tools for assessing health effects of long-term exposure to traffic related pollution.

한국어판 폐경 특이형 삶의 질 측정도구의 신뢰도와 타당도 검증 (Validity and Reliability of the Korean Version of the Menopause-Specific Quality of Life)

  • 박진희;배선형;정영미
    • 대한간호학회지
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    • 제50권3호
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    • pp.487-500
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    • 2020
  • Purpose: This study aimed to evaluate the validity and reliability of the Korean version of Menopause-Specific Quality of Life (MENQOL). Methods: The MENQOL was translated into Korean according to algorithm of linguistic validation process. A total of 308 menopausal women were recruited and assessed using the Korean version of MENQOL (MENQOL-K), the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), and Center for Epidemiological Studies Depression Scale (CES-D-K). In estimating reliability, internal consistency reliability coefficients were calculated. Validity was evaluated through criterion validity and construct validity with confirmatory factor analyses using SPSS 23.0 and AMOS 25.0 software. Results: In item analyses, the "increased facial hair" symptom was excluded because of the low contribution of MENQOL-K. The confirmatory factor analysis supported good fit and reliable scores for MENQOL-K model, and the four-factor structure was validated (χ2=553.28, p<.001, NC=1.84, RMSEA=.05, AGIF=.85, AIC=765.28). The MENQOL-K consists of 28 items in 4 domains, including vasomotor (3 items), psychosocial (7 items), physical (15 items), and sexual subscales (3 items). There was an acceptable criterion validity with moderately significant correlation between MENQOL-K and WHOQOL-BREF. The Cronbach's α for the 4 subsacles ranged from .80 to .93. Conclusion: The MENQOL-K is a valid and reliable scale to measure condition-specific quality of life for perimenopausal and postmenopausal women. It can be used to assess the impact of menopausal symptoms on the quality of life of Korean women in clinical trials.

인삼섭취와 암발생과의 관련성에 관한 연구 - 강화코호트연구 - (A Study on the Association Between Ginseng Intake and Incidences of Cancer - Kangwha Cohort Study -)

  • 변주선;오희철;홍재석;손태용;이상욱
    • Journal of Preventive Medicine and Public Health
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    • 제36권4호
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    • pp.367-372
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    • 2003
  • Objectives : There are many concerns about ginseng as a cancer chemopreventive substance, but there have been few epidemiological studies on ginseng, This study sought to examine the relationships between ginseng intake and cancer incidence in the Kangwha cohort. Methods ; Between March 1985 and December 1999, 2697 males, aged 55 or over, as of 1985, were followed up for their cancer incidence. The cancer incidence rate, standardized incidence ratio and risk ratios were calculated according to ginseng intake. A Cox proportional hazard model was used to adjust for age at entry, smoking, alcohol intake, hypertension, and body mass index. Results & Conclusions : The ginseng intake group had the same cancer (C00-C97) incidences (Standardized Incidence Ratio: SIR=1.11, 95% Confidence Interval=0.97-1.27) and the same risk ratio (RR=1.09, 95% Confidence Interval=0.85-1.41) as the no-intake group. Analyzing the subjects that had followed up from 1990, however, the ginseng intake group had lower cancer incidences at all sites (RR=0.79, 95% Confidence Interval=0.58-1.09). This was a cohort study to try and evaluate the association between ginseng intake and the incidences of cancer, The results of this study provide no clear conclusions on the cancer preventive effects of ginseng. Therefore, further study is needed in the future.