• 제목/요약/키워드: Generalized linear mixed model

검색결과 57건 처리시간 0.028초

Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • 제18권2호
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    • pp.128-135
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    • 2015
  • 목적: 2006년부터 가정산소치료 서비스에 대해 보장을 시작함에 따라, 기준에 부합하는 사람들은 가정산소 서비스이용에 대해 20%의 본인부담만을 지출하게 되었다. 이 같은 제도의 도입은 환자의 가정산소치료 서비스에 대한 부담을 경감시키게 됨에 따라 주요 이용자인 만성 폐쇄성 폐질환 환자들에게 긍정적인 효과를 미쳤을 것으로 예상된다. 하지만, 제도 도입 후 가정산소치료 서비스 제도의 효과에 대한 연구가 많지 않았고, 실증적 근거자료 또한 부족한 실정이다. 따라서, 본 연구는 제도 도입 후, 가정산소치료 서비스가 만성 폐쇄성 폐질환 환자들의 상태에 긍정적 영향을 미쳤는지를 알아보고자 한다. 방법: 만성폐쇄성 폐질환으로 2007년부터 2012년까지 병원을 방문한 사람(N=10,798)의 청구데이터를 분석에 이용하였으며, 가정산소치료 서비스 제도 적용의 기준인 호흡기장애등급에 따라 분포의 차이를 설명하기 위해 ${\chi}^2$ test을 하였다. 또한, 가정산소치료 서비스 이용에 대한 요인을 알아보고자 Multiple Logistic Regression Analysis을 하였으며, 가정산소치료 서비스 이용이 호흡기장애등급의 변화에 어떠한 영향을 주었는지 알아보고자 Generalized Linear Mixed Model 분석을 하였다. 결과: 분석대상 중 호흡기장애등급 1등급에 속하는 대상은 2,490명이었으며, 2/3등급에 속하는 대상은 8,308명이었다. 가정산소치료 서비스 이용에 대해서는 호흡기 장애등급 3등급이 1 또는 2등급에 비해 적게 이용하였다(OR: 0.33, 95% CI: 0.30~0.37). 또한, 가정산소치료를 이용함에 따라 환자의 상태의 변화에 대해 분석한 결과, 가정산소치료 이용자는 미이용자에 비해 상태의 완화 또는 유지에 대해 높은 값을 보였다(OR: 1.41, 95% CI: 1.23~1.61). 결론: 가정산소치료 서비스 이용은 만성 폐쇄성 폐질환 환자의 상태 악화방지에 대해서 긍정적인 영향을 준다.

뇌혈관질환의 예측인자로서의 악력 (Grip Strength as a Predictor of Cerebrovascular Disease)

  • 정석환;김재현
    • 보건행정학회지
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    • 제29권3호
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    • pp.303-311
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    • 2019
  • Background: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. Methods: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. Results: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963-0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342-0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. Conclusion: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

인지기능에 비만 역설은 존재하는가?: 고령화연구패널자료(2006-2016)를 이용하여 (Does the Obesity Paradox Exist in Cognitive Function?: Evidence from the Korean Longitudinal Study of Ageing, 2006-2016)

  • 강경식;이용재;박소희;김희진;정우진
    • 보건행정학회지
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    • 제30권4호
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    • pp.493-504
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    • 2020
  • Background: There have been many studies on the associations between body mass index (BMI) and cognitive function. However, no study has ever compared the associations across the methods of categorizing BMI. In this study, we aimed to fill the gap in the previous studies and examine whether the obesity paradox is valid in the risk of cognitive function. Methods: Of the 10,254 people aged 45 and older from the Korean Longitudinal Study of Ageing from 2006 to 2016, 8,970 people were finalized as the study population. The dependent variable was whether a person has a normal cognitive function or not, and the independent variables of interest were BMI categorized by the World Health Organization Western Pacific Regional Office (WHO-WPRO) method, the WHO method, and a 10-group method. Covariates included sociodemographic factors, health behavior factors, and health status factors. A generalized linear mixed model analysis with a logit link was used. Results: In the adjusted model with all covariates, first, in the case of BMI categories of the WHO-WPRO method, underweight (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.15-1.17), overweight (OR, 1.36; 95% CI, 1.35-1.36), and obese (OR, 1.34; 95% CI, 1.33-1.34) groups were more likely to have a normal cognitive function than a normal-weight group. Next, in the case of BMI categories of the WHO method, compared to a normal-weight group, underweight (OR, 1.15; 95% CI, 1.14-1.16) and overweight (OR, 1.06; 95% CI, 1.06-1.07) groups were more likely to have a normal cognitive function; however, obese (OR, 0.62; 95% CI, 0.61-0.63) group was less likely to have it. Lastly, in the case of the 10-group method, as BMI increased, the likelihood to have a normal cognitive function changed like a wave, reaching a global top at group-7 (26.5 kg/㎡ ≤ BMI <28.0 kg/㎡). Conclusion: The associations between BMI and cognitive function differed according to how BMI was categorized among people aged 45 and older in Korea, which suggests that cognitive function may be positively associated with BMI in some categories of BMI but negatively in its other categories. Health policies to reduce cognitive impairment need to consider this association between BMI and cognitive function.

논 생태계 서식 수서생물 채집 도구 개발: 유인제를 사용한 수중트랩 (The Development of a Sampling Instrument for Aquatic Organisms in Rice Paddy Fields: Submerged Funnel Traps with Attractants)

  • 윤성수;김명현;최순군;어진우;권순익;송영주
    • 환경생물
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    • 제35권4호
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    • pp.640-647
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    • 2017
  • 생물다양성 측면에서 논 생태계의 중요성이 대두되면서 수서생물을 효율적으로 채집하는 방법이 요구되고 있다. 본 연구는 논 생태계 내에서 수서생물을 객관적이고 정량적으로 쉽게 채집하기 위해 두 가지 유인제(어분, 캐미라이트)를 활용한 수중트랩을 고안하였다. 고안된 트랩으로 채집된 수서생물의 유인제 선호도는 일반화선형혼합모형을 통해 분석되었다. 또한 선행연구의 데이터를 활용하여 방형구와 수중트랩으로 채집된 수서 무척추동물의 군집 조성을 비계량형다차원척도법을 통해 비교 분석하였다. 그 결과, 수중트랩에 의해 채집된 65분류군의 수서생물 중 18분류군이 유인제에 의해 채집효율이 달라지는 것을 확인하였다. 18분류군 중왕우렁이, 수정또아리물달팽이, 애기물달팽이, 돌거머리, 패충류, 풍년새우, 꼬마줄물방개, 애기물방개, 깔따구류, 참개구리, 미꾸리류 등 12분류군은 어분을 선호하였고, 아시아실잠자리, 실잠자리류, 깃동잠자리, 방물벌레, 검정배물벌레, 애물땡땡이 등 6종은 캐미라이트를 선호하였다. 또한 수중트랩은 방형구법에 비해 생물다양성의 측정도구로서의 활용도는 낮지만 특정 분류군의 선택적인 채집에는 효과적이었다. 본 연구에서 간단하고 정량적인 방법으로 수서생물을 채집할 수 있도록 고안된 트랩은 장기적이고 광범위한 논 수서생물 생태 조사에 유용하게 활용될 수 있을 것으로 판단된다.

Cone-beam computed tomographic analysis of the alveolar ridge profile and virtual implant placement for the anterior maxilla

  • Lim, Hyun-Chang;Kang, Do-Uk;Baek, Hyehyeon;Hong, Ji-Youn;Shin, Seung-Yun;Chung, Jong-Hyuk;Herr, Yeek;Shin, Seung-Il
    • Journal of Periodontal and Implant Science
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    • 제49권5호
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    • pp.299-309
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    • 2019
  • Purpose: To analyze the ridge profile of the anterior maxilla using cone-beam computed tomography and to assess the clinical significance of the ridge profile by performing virtual implant placement. Methods: Thirty-two cone-beam computed tomography scans of anterior maxillae were included. For each tooth, a vertical line was made along the longitudinal axis, and 3 horizontal lines at 1-, 3-, and 5-mm levels below the labial bone crest were drawn perpendicularly to the vertical reference. At these levels, the thickness of the alveolar ridge (RT), and the labial (LT) and palatal bone plate (PT) were measured. Then, virtual implant placement using standard and tapered implants was performed. A generalized linear mixed model was used for statistical analysis. Results: The teeth were located labially based on the proportion of LT and PT with respect to RT. At the 1-mm level, the value of LT was between $1.0{\pm}0.4mm$ for central incisors and $1.3{\pm}0.6mm$ for canines. A large number of teeth had area(s) with less than 1-mm-thick labial bone between the 1- and 5-mm levels below the crest. The mean PT was generally thicker than the LT in all tooth types. The greatest mean value of labial concavity was observed for canines, compared to other tooth types. Men had a greater RT than did women, but had a comparable LT. Less apical fenestration was observed when tapered implants were used. Conclusions: Most teeth in the anterior maxilla had a thin labial bone plate, with no significant difference between sexes. Tapered implants may be advantageous for the anterior maxilla.

우리나라 고혈압 환자의 병원급 의료기관 외래이용 관련 요인: 한국의료패널자료(2010-2016)를 이용하여 (Factors Associated with the Use of Medical Care at Hospitals among Outpatients with Hypertension: A Study of the Korea Health Panel Study Dataset (2010-2016))

  • 이수미;박소희;김희진;이용재;정우진
    • 보건행정학회지
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    • 제30권4호
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    • pp.479-492
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    • 2020
  • Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

필리핀 결혼이민여성의 한식 섭취실태 및 한식 섭취율에 따른 사회경제학적 요인 (Consumption of Han-sik and its Association with Socioeconomic Status among Filipino Immigrant Women: the Filipino Women's Diet and Health Study (FiLWHEL))

  • 김나연;강민지;그레이스 아브리스;쉘린 메이 프로비도;정효지;홍상모;유성훈;이창범;이정은
    • 대한지역사회영양학회지
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    • 제23권6호
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    • pp.475-487
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    • 2018
  • Objectives: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). Methods: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. Results: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18-4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. Conclusions: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.