• Title/Summary/Keyword: Generalized estimating equation

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A Longitudinal Study of the Reciprocal Relationship between Depression and Income among Korean Older Men and Women (남녀 노인의 우울과 소득의 종단적 상호관계)

  • Lee, Jeong;Jeon, Gyeong-Suk
    • Journal of Korean Academy of Nursing
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    • v.52 no.4
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    • pp.451-463
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    • 2022
  • Purpose: This study examined the reciprocal relationships between depression and income, and gender differences in these relationships among older adults in South Korea. Methods: Using 2015 to 2019 of the Korea Welfare Panel Study (KoWePS), we studied 6,070 older adults (2,394 men and 3,676 women) aged 60 years over in 2015. The generalized estimating equation was employed to explore the effect of an individual income on depression and the reverse causal link-that of depression on income. Results: The study found the reciprocal relationships between income and depression. Income has a significant impact on depression. Higher-income was linked to decreased risks of the Center for Epidemiologic Studies Depression (CES-D) scores among older adults (B = - 0.121, p < 0.001). Estimates of the reverse causal link show that higher CES-D scores were also linked to income reduction among Korean older adults (B = - 0.007, p < 0.001). In addition, we also observed gender differences in the impact of income on depression but not in the reverse causal link. Income has more detrimental to psychological consequence for older men (B = - 0.108, p < 0.001) than older women (B = - 0.057, p < 0.001). Conclusion: The finding implies that both psychological and social protection policies for the elderly are needed in view of gender perspective.

Effects of Restorative Family Circles on People with Mental Illness and Their Families (정신질환자와 가족을 위한 회복적 가족서클 프로그램의 효과)

  • Kim, Hyo Kyung;Kim, Hyun-Jeong;Nam, Kyoung A
    • Journal of Korean Public Health Nursing
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    • v.37 no.1
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    • pp.111-124
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    • 2023
  • Purpose: This study aimed to investigate the effects of restorative family circles (RFCs) on empowerment and family support for people with mental illness, and the belief system and caring experience of their families. Methods: This study used a quasi-experiment with a non-equivalent control group pretest-posttest non-synchronized design. Ninety-two dyads of patient-family caregivers were recruited using convenience sampling and assigned to the experimental and control groups. The subjects of the experimental group participated in RFCs consisting of eight 90-minute sessions. Data were collected at three different times (pretest, posttest, follow-up test) and analyzed for the effects of RFC using the 𝑥2 test, Fisher's exact test, Mann-Whitney U test for homogeneity between groups, and generalized estimating equation models. Results: The findings of this study showed that there were significant differences in the family support for people with mental illness between the pretest and follow-up test, and also in the belief system and caring experience of the family between the pretest and posttest. Conclusion: This study revealed that family interventions based on restorative justice emphasizing community-driven conflict management could be used in psychiatric mental health nursing care for fostering a cohesive family relationship.

Impact of Reduced Working Hours and Night Work Hours on Metabolic Syndrome: A Quasi-Experimental Study

  • Hye-Eun Lee;Ichiro Kawachi
    • Safety and Health at Work
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    • v.14 no.1
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    • pp.59-65
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    • 2023
  • Objectives: Epidemiological evidence linking long working hours and shift work to metabolic syndrome remains inadequate. We sought to evaluate the impact of reducing working hours on metabolic syndrome. Methods: We compared the prevalence of metabolic syndrome among male manual workers in a manufacturing company (N = 371) before and after the introduction of policy to reduce daily work hours from 10 to 8 hours. Components of metabolic syndrome were measured in periodic health examinations before the intervention, 6-9 months after, and 1.5-2 years after the intervention. Generalized estimating equation models were used to estimate changes in the prevalence of metabolic syndrome. Analyses were stratified by day work versus shift work. Results: The results showed a significantly decreased prevalence of metabolic syndrome 6-9 months following the intervention in day workers (risk ratio = 0.68, 95% confidence interval 0.52-0.88), but the benefit disappeared after 1.5-2 years. Shift workers showed a decreased prevalence of metabolic syndrome for the whole follow-up duration after the intervention, although the change was not statistically significant. Conclusion: Reducing working hours was associated with short-term improvement in metabolic syndrome in male manual workers.

Subcortical Ischemic Change as a Predictor of Driving Cessation in the Elderly

  • Jang, Mi;Hong, Chang Hyung;Kim, Hyun-Chung;Choi, Seong Hye;Seo, Sang Won;Kim, Seong Yoon;Na, Duk L.;Lee, Yunhwan;Chang, Ki Jung;Roh, Hyun Woong;Son, Sang Joon
    • Psychiatry investigation
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    • v.15 no.12
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    • pp.1162-1167
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    • 2018
  • Objective Motor, perceptual, and cognitive functions are known to affect driving competence. Subcortical ischemic changes on brain magnetic resonance imaging (MRI) can reflect reduction in cognitive and motor performance. However, few studies have reported the relationship between subcortical ischemic changes and driving competence of the elderly. Thus, the objective of this study was to investigate the association between subcortical ischemic changes on MRI and driving abilities of the elderly. Methods Participants (n=540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort. Each participant underwent MRI scan and interview for driving capacity categorized into 'now driving' and 'driving cessation (driven before, not driving now)'. Participants were divided into three groups (mild, n=389; moderate, n=116; and severe, n=35) depending on the degree of white matter hyperintensity (WMH) on MRI at baseline. Driving status was evaluated at follow-up. Statistical analyses were conducted using ${\chi}^2$ test, analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE). Results In SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive or motor dysfunction (${\beta}=-0.110$, p<0.001). In GEE models after controlling for age, sex, education, cognitive, and motor dysfunction, more severe change in the degree of WMH was associated with faster change from 'now driving' state to 'driving cessation' state over time in the elderly (${\beta}=-0.508$, p<0.001). Conclusion In both cross-sectional and longitudinal results, the degree of subcortical ischemic change on MRI might predict driving cessation in the elderly.

Allometric Equations for Estimating the Carbon Storage of Maple Trees in an Urban Settlement Area (정주지 단풍나무의 탄소저장량 추정 상대생장식)

  • Hojin Kim;Gyeongwon Baek;Byeonggil Choi;Jihyun Lee;Jeongmin Lee;Yowhan Son;Choonsig Kim
    • Journal of Korean Society of Forest Science
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    • v.112 no.1
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    • pp.32-39
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    • 2023
  • Using the logarithmic methods and the generalized method of moments (GMM), this study developed carbon storage equations for maple trees (Acer palmatum Thunb.) planted in an urban settlement area. A total of 20 maple trees of various ages and diameters were destructively harvested to determine their dry weight and carbon concentration by component. The allometric equations with DBH and DBH2×H as independent variables were developed to estimate the carbon storage for each tree component. The carbon concentration of tree components was the highest in stem wood (49.8%) and lowest in stem bark (46.5%). Allometric equations to estimate the carbon storage of tree components (stem, root, aboveground, and total) showed a similar coefficient of determinations (R2) between the allometric equations of the logarithmic method (0.7494-0.9036) and the GMM (0.7085-0.8847). However, the R2 values of the leaves and branches were in the range of 0.3027 to 0.6380, lower than those of the R2 of the other tree components. These results indicate that the carbon storage of maple trees growing in urban settlement areas can be efficiently predicted from the equations of GMM methods in the case of a small sample size or the heteroscedasticity of logarithmic equations.

A Study on the Calculation Method for Flexural Strength of One-way Hollow Slabs (일방향 중공슬래브의 휨강도 산정방법에 관한 연구)

  • Kim, Hyun-Su;Lim, Jun-Ho;Kang, Joo-Won
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.25 no.6
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    • pp.541-548
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    • 2012
  • The hollow slab has advantages that its self-weight does not greatly increase notwithstanding the increase of its thickness and its flexural performance does not significantly degrade in comparison with general reinforced concrete slab. However, the utilization of the hollow slab is currently being underestimated in spite of structural system that enables economic design of building and construction of eco-friendly structure. the significant reasons for this situation is that the method of structural analysis and design for hollow slab is not generalized. In this study, to consider practical compressive zone of hollow slab, the equation for its flexural strength is proposed by the volume of compressive stress block according to neutral axis location in hollow section assumed. Existing estimation method of flexural strength of hollow slab considering only compressive zone above hollow part is evaluated as the most conservative method and the method estimating flexural strength by two alternative cross-section of hollow slab is evaluated as more practical method.

Study for Revision of the Korean Patient Classification System (한국형 환자분류체계의 개정연구)

  • Song, Kyung Ja;Choi, Woan Heui;Choi, Eun Ha;Cho, Sung-Hyun;Yu, Mi;Park, Mi Mi;Lee, Joongyub
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.113-126
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    • 2018
  • Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from $1^{st}$ to $30^{th}$ April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.

Influence of Anhedonia and Self-Esteem on Daily-Life Decision-Making in Patients with Schizophrenia (조현병 환자들의 일상적 의사결정 과정에서 무쾌감증 및 자아존중감의 영향)

  • Kim, Soo-Jeong;Kim, Min-Kyeong;Hong, Yeon-Ju;Lee, Seon-Koo;Kim, Jae-Jin
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.155-161
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    • 2017
  • Objectives Decision-making in patients with schizophrenia has been known to be inefficient in both cognitive and affective aspects. The purpose of this study was to investigate the influence of anhedonia and self-esteem on the decision-making process in schizophrenia. Methods Twenty patients with schizophrenia and 21 healthy controls performed the 'apparel purchase decision-making task', during which they were asked to respond to the preference, fitness, and price suitability, before making the final purchase decision. Generalized estimating equation and correlation analysis were conducted to explore for the difference of decision making patterns and influential factors between the two groups. Results The patients showed lower odds ratio (OR) of the fitness on the apparel purchase decision than the controls [OR 0.190 ; 95% confidence interval (CI) 0.047-0.762, p = 0.019). In the patient group, there was no correlation between the number of purchased trials and the severity of anhedonia, but the number of purchased trials was negatively correlated with the Rosenberg Self-Esteem Scale score at a trend level (R = -0.436, p = 0.055). Conclusions Patients with schizophrenia considered the fitness of clothes less than healthy controls on apparel purchasing decisions. Schizophrenia patients with lower self-esteem were intended to buy more clothes.

The Association Between Oxidative Stress and Depressive Symptom Scores in Elderly Population: A Repeated Panel Study

  • Han, Changwoo;Lim, Youn-Hee;Hong, Yun-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.5
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    • pp.260-274
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    • 2016
  • Objectives: Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population. Methods: From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores. Results: A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ${\geq}8$ was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42). Conclusions: Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.

The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study

  • Nakao, Motoyuki;Ishihara, Yoko;Kim, Cheol-Hong;Hyun, In-Gyu
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.3
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    • pp.130-139
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    • 2018
  • Objectives: Air pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea. Methods: Patients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL. Results: Lower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than $10{\mu}m$ in diameter ($PM_{10}$). Lower social functioning scores were associated with high PM less than $2.5{\mu}m$ in diameter and nitrogen dioxide ($NO_2$) concentrations. High $NO_2$ concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when $PM_{10}$, $NO_2$, or ozone ($O_3$) concentrations were high, regardless of COPD severity. High $PM_{10}$ concentrations were associated with worsened wheezing, particularly in COPD patients. Conclusions: The results suggest that PM, $NO_2$, and $O_3$ cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.