• Title/Summary/Keyword: Generalized estimating equation

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Determining Optimal Cut-off Score for the Braden Scale on Assessment of Pressure Injury for Tertiary Hospital Inpatients (상급종합병원 입원환자의 욕창발생 위험예측을 위한 Braden Scale의 타당도 검증)

  • Park, Sook Hyun;Choi, hyeyeon;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.24-33
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    • 2023
  • Purpose : This study aims to establish an optimal cut-off score on the Braden scale for the assessment of pressure injury to detect pressure injury risks among inpatients in a South Korean tertiary hospital. Methods : This retrospective study used electronic medical records, from January to December 2022. A total of 654 patients were included in the study. Of these, 218 inpatients with pressure injuries and 436 without pressure injuries were classified and analyzed using 1:2 Propensity Score Matching (PSM), and the generalized estimating equation was performed using SPSS Version 26 and the R Machlt package program. Results : The cut-off value on the Braden scale for distinguishing pressure injury was 17 points, and the AUC (area under the ROC curve) was 0.531 (0.484-0.579). The sensitivity was 56.6% (45.5-67.7%) and the specificity was 69.7% (66.0-73.4%). With 17 points, the Braden scale cut-off distinguished those who had pressure injuries from those who did not at the time of admission (p < .03). In the pressure injury group, the Braden score on the day of the pressure injury was 14, with significant results in all subcategories except the moisture category. Conclusion : Our findings revealed that a cut-off value of 17 was optimal for predicting the risk of pressure injuries among tertiary hospital inpatients. Future studies should evaluate the optimal cut-off values in different clinical environments. Additionally, it is necessary to conduct multicenter large sample studies to verify the effectiveness of a 17 value in PI risk assessments.

Relationship between Compulsory Employment System for persons with Disabilities and Health Status (장애인 의무고용제도와 건강상태 간의 연관성)

  • You, Jin Ha;Kim, Ye Won;Yang, Jeong Min;Kim, Jae Hyun
    • Korea Journal of Hospital Management
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    • v.27 no.2
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    • pp.53-66
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    • 2022
  • Aim : The purpose of this study is to investigate the influence of the awareness level of the mandatory employment system for the disabled and the help of the employment increase on the health status of the disabled. Based on this, the purpose of this study is to raise awareness of the compulsory employment system for the disabled and to suggest a way to improve the health of the disabled. Methods : In this study, the first data of the second wave of the 2016-2018 Employment Panel Survey for the Disabled was used to analyze the participation of the disabled in economic activities. a total of 1,648 subjects were analyzed using the chi-square test and generalized estimating equation (GEE). Results : Compared to the group knowing about the compulsory employment system for the disabled, in the group who did not know about the compulsory employment system, the cognitive level was significantly higher for subjective health status (Odds Ratio [OR]: 1.573, 95% Confidence Interval [CI]: 1.252-1.977) and chronic diseases (OR: 1.407, 95% CI: 1.091-1.816), Compared to the group that the compulsory employment system for the disabled is helpful in increasing employment, the group that said it was not helpful at all had depression feel (OR: 2.330, 95% CI: 1.219-4.452) and subjective health status (OR: 2.052, 95% CI: 1.232. -3.416) significantly affected. Conclusion : It was found that the lower the level of awareness and help of the compulsory employment system for the disabled, the negative impact on their health status. Therefore, it is necessary to promote employment growth by raising awareness of the employment system for the disabled. Furthermore, in order to improve the health of the disabled, public relations plans to increase the understanding of the disabled on the system and policies to protect the disabled people who lose their will to work due to difficulties in accessing employment were enacted, and Changes to a disability-friendly working environment should be activated so that participants can participate.

Analysis of Estimation Technique for Solid Sediments in Combined Sewer Systems (합류식 관거 내 고형물 퇴적량 산정기법 분석)

  • Lee, Jae-Soo
    • Journal of Korea Water Resources Association
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    • v.39 no.5 s.166
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    • pp.405-415
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    • 2006
  • The deposition of sewer solids during dry weather in combined sewer systems results in a loss of flow capacity that may restrict flow and cause a local flooding and enhanced solids deposition. Sewer solid accumulations in drainage systems also create the 'first-flush' phenomena during wet weather runoff periods. In order to solve these problems, measurement of these loadings for a given sewer system for extended period is needed but this task is very difficult and extremely expensive. In this study, generalized procedures for estimating sewer sediment solid during dry weather in combined sewer systems developed by the U. S. Environmental Protection Agency were applied in a drainage system in Korea. As result, the appropriate equation can be selected and applied according to the available data. However, the estimated solid sediment shows considerable difference between methods which classified by model and estimation methods of variable. The estimated values using equations (1) $\sim$ (4) are greater than that of equations (5) $\sim$ (9) and intermediate models show greater values than elaborate or simplest models. The comparison between simulated and measured solid deposition is difficult due to the absent of measurement data, but this estimation method can be used usefully for the management of sewer solid with reduction of cost and effort if the measurement is carried out and the equation is adjusted according to the actual drainage systems in Korea.

Changes of Self-efficacy, Depression, and Posttraumatic Growth in Survivors with Breast Cancer Participating Breast Cancer Prevention Volunteering (유방암예방 자원봉사활동에 참여한 유방암 생존자들의 자기효능감, 우울 및 외상 후 성장의 변화)

  • Yi, Myungsun;Cha, Jieun;Ryu, Youngmi
    • The Journal of the Korea Contents Association
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    • v.14 no.4
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    • pp.256-266
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    • 2014
  • Purpose : This study was to explore the long-term effects of breast cancer prevention volunteering on self-efficacy, depression, and posttraumatic growth among survivors with breast cancer. Methods: This pilot study utilized a longitudinal design. Participants were 14 women with breast cancer who participated in the breast cancer prevention educational program The data were collated between February and August in 2013. Self-report questionnaires were used to measure the self-efficacy for self-management of breast cancer, depression, and posttraumatic growth at pre-education(T0), 1 month(T1), 3 months(T2), and 6 months(T1) post-education. A generalized estimating equation regression model was used to identify the effects. Results: The scores of self-efficacy increased significantly at T1(${\chi}^2$=5.56, p=.0l8) and D(${\chi}^2$=4.56, p=.033) compared with T0. Depression and posttraumatic growth remained stable with fairly good levels throughout the 6-month period. Conclusion: The results of this study suggest that breast cancer prevention volunteering in survivors with breast cancer can be effective for enhancing their self-efficacy and maintaining psychological well-bang. Also the study showed that such volunteering activity could be a useful program not only for the general public but also for breast cancer survivors.

Change of Psychological Characteristics after Joining the Army According to Internet Addiction Tendency in Young Male Army Recruits (군 병사들에서 인터넷 중독 경향에 따른 입대 후 심리특성 변화)

  • Kang, Hyun Mook;Kim, Hyun Soo;Cho, Hyun Sang;An, Suk Kyoon;Oh, Byoung Hoon;Lee, Kang Soo;Hong, Chang Hyung;Bae, Hwallip;Kook, So Dahm;Son, Sang Joon
    • Korean Journal of Biological Psychiatry
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    • v.20 no.3
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    • pp.86-90
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    • 2013
  • Objectives The aim of this study was to find out the psychological changes associated with internet addiction between before and after the military drill among the young male army recruits. Methods All 1091 participants were army recruits aged from 19 to 22 years who participated in the 5-week military drill. They were assessed with some self-reported questionnaires [Sociodemographic questionnaires, Young's Internet Addiction Scale (IAS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), the Barratt Impulsiveness Scale (BIS), the Attention-Deficit/Hyperactivity Disorder Self-Rated Scale (ASRS)]. They were divided into two groups, One is the internet addiction tendency group and the other is non-addiction group according to the IAS score. And the severity of the internet addiction tendency, depression, anxiety and impulsiveness were evaluated by the IAS, the STAI, the BDI, the BIS, the ASRS before and after military drill. Results The result of the paired t-test shows that the IAS, the STAI, the BDI, the BIS, the ASRS scores decreased after military drill in both non-addiction group and internet addiction tendency group. The result of the repeated measures ANOVA shows that there is an interaction effect between the changes of ASRS-hyperactivity (F = 23.437, p < 0.001), ASRS-impulsiveness (F = 4.896, p = 0.027), BIS-total (F = 4.057, p = 0.044), BIS-motor impulsiveness (F = 13.609, p < 0.001) scores and groups. The result of the generalized estimating equation shows that internet addiction tendency is associated with ASRS-inattention (${\beta}=0.075$, p < 0.001), ASRS-hyperactivity (${\beta}=0.092$, p = 0.002), STAI-trait anxiety (${\beta}=0.046$, p < 0.001), BIS-motor impulsiveness (${\beta}=0.119$, p = 0.028). Conclusions The results show that psychopathologies such as internet addiction tendency, depression, anxiety, impulsiveness may improve after military drill regardless of the groups. Internet addiction tendency may be related to the ASRS-inattention, ASRS-hyperactivity, STAI-trait anxiety, motor-impulsiveness. So these findings may be considered in the treatment of internet addiction in terms of the impulsiveness control.

A Study On The Economic Value Of Firm's Big Data Technologies Introduction Using Real Option Approach - Based On YUYU Pharmaceuticals Case - (실물옵션 기법을 이용한 기업의 빅데이터 기술 도입의 경제적 가치 분석 - 유유제약 사례를 중심으로 -)

  • Jang, Hyuk Soo;Lee, Bong Gyou
    • Journal of Internet Computing and Services
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    • v.15 no.6
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    • pp.15-26
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    • 2014
  • This study focus on a economic value of the Big Data technologies by real options model using big data technology company's stock price to determine the price of the economic value of incremental assessed value. For estimating stochastic process of company's stock price by big data technology to extract the incremental shares, Generalized Moments Method (GMM) are used. Option value for Black-Scholes partial differential equation was derived, in which finite difference numerical methods to obtain the Big Data technology was introduced to estimate the economic value. As a result, a option value of big data technology investment is 38.5 billion under assumption which investment cost is 50 million won and time value is a about 1 million, respectively. Thus, introduction of big data technology to create a substantial effect on corporate profits, is valuable and there are an effects on the additional time value. Sensitivity analysis of lower underlying asset value appear decreased options value and the lower investment cost showed increased options value. A volatility are not sensitive on the option value due to the big data technological characteristics which are low stock volatility and introduction periods.

Impact of Changes in Medical Aid Status on Health Care Utilization

  • Kim, Woorim;Nam, Chung Mo;Lee, Sang Gyu;Park, Sohee;Kim, Tae Hyun;Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.4
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    • pp.513-522
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    • 2019
  • Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

Smoking Patterns, Oral Health Behavior and Perception of the South Korean Army (육군의 복무 상황에 따른 흡연 양상과 구강보건행태 및 인식)

  • Jang, Sun-Ok;Kim, Yoon-Hee;Kang, Jung-Yun;Ko, Min-Seo;Kim, Bo-Yon;Park, Ji-Hae;Shim, Seo-Youn;Kim, Sang-Hoon;Chung, Won-Gyun
    • Journal of dental hygiene science
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    • v.10 no.3
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    • pp.131-139
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    • 2010
  • The purpose of this study was to evaluate smoking patterns, oral health behavior and perception of dental healthcare of military personnel in the South Korea Army. All 367 subjects were surveyed by the structured questionnaires with convenience sampling method. The questionnaires were consisting of 22 items. Depending on the conditions of military training, the distribution and differences of smoking patterns and oral behaviors were evaluated by frequency test, Weighted Kappa, Paired t-test and ANOVA. The differences of oral health perception on smoking were demonstrated by Mantel-Haenszel Chi-square test. In addition, Generalized Estimating Equation (GEE) was used to estimate the effects of oral behavior for the conditions of military training and smoking. The number of cigarette during military training period was similar to that during non-military training (p=0.109). The perception of smokers such as smoking effect on oral health, oral health and systemic health, and need of education for smoking cessation was significantly lower than non-smokers (p=0.0095, p=0.0007, and p<0.0001). The probability that toothbrush frequency per day was only one was associated with higher during military training period than non-military training (OR=9.29, 95% CI 5.05-17.07). Moreover, the probability that hours of toothbrush were less than one minute was associated with higher during military training than non-military training (OR=2.19, 95% CI 1.78-2.71). To improve knowledge, attitude, and behavior of oral health for the members, the army needs to develop oral health education and tobacco cessation programs. In particular, motivation and practice for oral health care are required to improve poor oral health behavior during the military training.

The Effects of Evaluation Attributes of Cultural Tourism Festivals on Satisfaction and Behavioral Intention (문화관광축제 방문객의 평가속성 만족과 행동의도에 관한 연구 - 2006 광주김치대축제를 중심으로 -)

  • Kim, Jung-Hoon
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.2
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    • pp.55-73
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    • 2007
  • Festivals are an indispensable feature of cultural tourism(Formica & Uysal, 1998). Cultural tourism festivals are increasingly being used as instruments promoting tourism and boosting the regional economy. So much research related to festivals is undertaken from a variety of perspectives. Plans to revisit a particular festival have been viewed as an important research topic both in academia and the tourism industry. Therefore festivals have frequently been leveled as cultural events. Cultural tourism festivals have become a crucial component in constituting the attractiveness of tourism destinations(Prentice, 2001). As a result, a considerable number of tourist studies have been carried out in diverse cultural tourism festivals(Backman et al., 1995; Crompton & Mckay, 1997; Park, 1998; Clawson & Knetch, 1996). Much of previous literature empirically shows the close linkage between tourist satisfaction and behavioral intention in festivals. The main objective of this study is to investigate the effects of evaluation attributes of cultural tourism festivals on satisfaction and behavioral intention. accomplish the research objective, to find out evaluation items of cultural tourism festivals through the literature study an empirical study. Using a varimax rotation with Kaiser normalization, the research obtained four factors in the 18 evaluation attributes of cultural tourism festivals. Some empirical studies have examined the relationship between behavioral intention and actual behavior. To understand between tourist satisfaction and behavioral intention, this study suggests five hypotheses and hypothesized model. In this study, the analysis is based on primary data collected from visitors who participated in '2006 Gwangju Kimchi Festival'. In total, 700 self-administered questionnaires were distributed and 561 usable questionnaires were obtained. Respondents were presented with the 18 satisfactions item on a scale from 1(strongly disagree) to 7(strongly agree). Dimensionality and stability of the scale were evaluated by a factor analysis with varimax rotation. Four factors emerged with eigenvalues greater than 1, which explained 66.40% of the total variance and Cronbach' alpha raging from 0.876 to 0.774. And four factors named: advertisement and guides, programs, food and souvenirs, and convenient facilities. To test and estimate the hypothesized model, a two-step approach with an initial measurement model and a subsequent structural model for Structural Equation Modeling was used. The AMOS 4.0 analysis package was used to conduct the analysis. In estimating the model, the maximum likelihood procedure was used.In this study Chi-square test is used, which is the most common model goodness-of-fit test. In addition, considering the literature about the Structural Equation Modeling, this study used, besides Chi-square test, more model fit indexes to determine the tangibility of the suggested model: goodness-of-fit index(GFI) and root mean square error of approximation(RMSEA) as absolute fit indexes; normed-fit index(NFI) and non-normed-fit index(NNFI) as incremental fit indexes. The results of T-test and ANOVAs revealed significant differences(0.05 level), therefore H1(Tourist Satisfaction level should be different from Demographic traits) are supported. According to the multiple Regressions analysis and AMOS, H2(Tourist Satisfaction positively influences on revisit intention), H3(Tourist Satisfaction positively influences on word of mouth), H4(Evaluation Attributes of cultural tourism festivals influences on Tourist Satisfaction), and H5(Tourist Satisfaction positively influences on Behavioral Intention) are also supported. As the conclusion of this study are as following: First, there were differences in satisfaction levels in accordance with the demographic information of visitors. Not all visitors had the same degree of satisfaction with their cultural tourism festival experience. Therefore it is necessary to understand the satisfaction of tourists if the experiences that are provided are to meet their expectations. So, in making festival plans, the organizer should consider the demographic variables in explaining and segmenting visitors to cultural tourism festival. Second, satisfaction with attributes of evaluation cultural tourism festivals had a significant direct impact on visitors' intention to revisit such festivals and the word of mouth publicity they shared. The results indicated that visitor satisfaction is a significant antecedent of their intention to revisit such festivals. Festival organizers should strive to forge long-term relationships with the visitors. In addition, it is also necessary to understand how the intention to revisit a festival changes over time and identify the critical satisfaction factors. Third, it is confirmed that behavioral intention was enhanced by satisfaction. The strong link between satisfaction and behavioral intentions of visitors areensured by high quality advertisement and guides, programs, food and souvenirs, and convenient facilities. Thus, examining revisit intention from a time viewpoint may be of a great significance for both practical and theoretical reasons. Additionally, festival organizers should give special attention to visitor satisfaction, as satisfied visitors are more likely to return sooner. The findings of this research have several practical implications for the festivals managers. The promotion of cultural festivals should be based on the understanding of tourist satisfaction for the long- term success of tourism. And this study can help managers carry out this task in a more informed and strategic manner by examining the effects of demographic traits on the level of tourist satisfaction and the behavioral intention. In other words, differentiated marketing strategies should be stressed and executed by relevant parties. The limitations of this study are as follows; the results of this study cannot be generalized to other cultural tourism festivals because we have not explored the many different kinds of festivals. A future study should be a comparative analysis of other festivals of different visitor segments. Also, further efforts should be directed toward developing more comprehensive temporal models that can explain behavioral intentions of tourists.

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