• Title/Summary/Keyword: Multi-Level Logistic Regression

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Fasting Serum Glucose Level and Gastric Cancer Risk in a Nested Case-control Study (공복 혈당과 위암 발생 위험에 관한 코호트 내 환자-대조군 연구)

  • Jun, Jae-Kwan;Gwack, Jin;Park, Sue-Kyung;Choi, Yun-Hee;Kim, Yeon-Ju;Shin, Ae-Sun;Chang, Soung-Hoon;Shin, Hai-Rim;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.493-498
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    • 2006
  • Objectives : Diabetes has been reported as a risk factor for several cancers. However, the association between diabetes and gastric cancer has been inconsistent. The aim of this study was to evaluate the association between the fasting serum glucose level and gastric cancer risk in Korea. Methods : Among the members of the Korean Multi-Center Cancer Cohort (KMCC) from 1993 to 2004, a total of 100 incident gastric cancer cases were ascertained until December 31, 2002 and 400 controls were matched according to age, sex, and year and area of enrollment. Of the eligible subjects, those without fasting serum glucose level information were excluded, with a total of 64 cases and 236 controls finally selected. On enrollment, all subjects completed a baseline demographic and lifestyle characteristics questionnaire, and had their fasting serum glucose level measured. The Helicobacter pylori infection status was determined by an immunoblot assay using long-term stored serum. The odds ratios (ORs) were estimated using conditional and unconditional logistic regression models adjusted for the H. pylori infection status, smoking, drinking, education, follow-up period and matching variables. Results : The ORs for risk of gastric cancer according to the serum glucose level were 1.33 [95% CI=0.50-3.53] and 1.66 [95% CI=0.55-5.02] for the categories of 100-125 and 126 mg/dL or greater, respectively, compared to the category of less than 100 mg/dL. No increased risk of gastric cancer according to the serum glucose level was found (p-trend=0.337). Conclusions : This study provides no evidence for an association of the serum glucose level with gastric cancer.

Awareness regarding Safe Abortion among Adolescent Girls in Rural area of Mahottari district of Nepal

  • Singh, Jitendra Kumar;Sah, Poonam Kumari;Kushwaha, Shambhu Prasad;Bajgain, Bishnu Bahadur;Chaudhary, Sanjay
    • Journal of agricultural medicine and community health
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    • v.44 no.2
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    • pp.73-81
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    • 2019
  • This study aimed to assess the level of awareness on safe abortion among adolescent girls in rural area of Mahottari district of Nepal. A community based cross-sectional study was conducted in rural areas of Mahottari district of Southern Nepal between January and March 2019.A sample of 412 adolescent girls was selected using multi-stage cluster sampling. Multivariable logistic regression model was adapted to explore level of awareness among adolescent girls. This study found that 45.6% of adolescent girls had high awareness regarding safe abortion. The odds of awareness among the married adolescents was higher (AOR=2.16; 95% CI: 1.01-4.87) than unmarried adolescent whereas the odds of awareness among the adolescents who had education of secondary level and more had higher (AOR=2.21; 95%CI: 1.13-3.04) than those who had primary or lower secondary level of education. Similarly, the adolescents who had monthly family income of Nepalese Rupees (NRs.), 10,000-20,000 and more than NRs. 20,000 were respectively, 2.33 times (AOR = 2.33; 95% CI: 1.07-3.55) and 3.17 times (AOR = 3.17; 95% CI: 2.19-8.94) more likelihood to have high awareness regarding safe abortion than those their counterparts. The study showed that overall level of knowledge towards safe abortion was found low. Socio-demographic factors like marital status, level of education, and family income were the factors independently associated with level of awareness on safe abortion. Therefore, efforts should be exerted towards arising and improving the awareness of abortion care which may reduce unwanted pregnancy, abortion and other complications related to abortion.

Characters and Factors Affecting the Life Satisfaction of the Older Adults with Disabilities: A Comparison of one-person and multi-person households (고령장애인 실태와 생활만족도 영향 요인: 1인가구와 다인가구 비교)

  • Park, Ju-Young
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.272-280
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    • 2018
  • The purpose of this study was to analyze characters and determinant factors of the life satisfaction of the older adults with disabilities so as to provide suggestion for improving the quality of life. I used the data on 8th Panel Survey of Employment for the Disabled(PSED). The total number of respondents was 452, 126 respondents of one-person households and 326 respondents of multi-person households. The data was analyzed using SPSS Win 24.0 program and utilizing $x^2$test, ANOVA, logistic regression analysis. First, The characteristics of older adults with disabilities was man, married, mild disorder, physical external disorder, non-basis living security recipient, unemployment and the level of life satisfaction was 3.27. Second, The one-person households group showed female, non-married, severe disorder, lower acceptance of disability, lower health status, higher help daily living activity, higher discrimination experience, unemployment, lower income, basis living security recipient, lower position than multi-person group. Third, acceptance of disability, health status, social activity, religion were found to have a significant effect on the life satisfaction of one-person households. And acceptance of disability, health status, position were found to have a significant effect on the life satisfaction of multi-person households. Base on the results of this study, suggested for improving the quality of life of the older adults with disabilities.

Impact of Community Health Care Resources on the Place of Death of Older Persons with Dementia in South Korea Using Public Administrative Big Data (공공 빅데이터를 이용한 치매 노인 사망장소의 결정요인: 지역보건의료자원의 영향)

  • Lim, Eunok;Kim, Hongsoo
    • Health Policy and Management
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    • v.27 no.2
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    • pp.167-176
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    • 2017
  • Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

Type of Alcoholic Beverage and High Risk Drinking for Acute Harm (음주 주종과 급성 위해 유발 음주 위험도)

  • Yoo, Tai-Woo;Lee, Sun-Mi;Chung, Woo-Jin
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.383-389
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    • 2003
  • Objective : Studies have suggested that beer is associated with a high risk of mortality and morbidity. The purpose of this study was to investigate how types of alcoholic beverage are related to high risk acute harm. Methods : Data from the 1997 Korea's Behavioral Risk Factor Surveillance System Survey, collected through telephone questionings, were analyzed based on multi-stage stratified random sampling(N=1,045). Among those who had drunk at least one type of alcoholic beverage in the last month, one episode where the drinker had consumed the highest level of ethanol was selected, and the alcohol consumption per drinking day categorized into four risk levels of short-term, 'acute' harm, according to the WHO guidelines. Employing ordered logistic regression analyses, as the explanatory variables, types of alcoholic beverage, with and without socioeconomic characteristics, were considered. Results : Spirits and soju were more than ten and three times, respectively, more likely than beer, while makkolli and wine were almost as likely as beer, to involve high risk drinking, irrespective of controlling for the socioeconomic characteristics. Conclusions : Unlike most Western countries, in Korea, beer, rather than spirits or soju, is generally less likely to be associated with high risk drinking for acute harm, The influence of beverage types on high risk drinking for acute harm appears to vary between countries.

The Relationship between E-Cigarette Experience and Smoking Cessation Behavior among Current Smokers (우리나라 성인 흡연자의 전자담배 이용경험과 금연행태의 관련성)

  • Lee, Yoon Noh;Kim, Bokmi;Min, In Soon;Hahm, Myung-Il
    • Health Policy and Management
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    • v.27 no.4
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    • pp.276-283
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    • 2017
  • Background: Electronic cigarette (e-cigarette) has rapidly increased. Even though e-cigarettes are actually not smoking cessation alternative supplies, some people perceive them as smoking cessation alternative supplies. The purpose of this study is to identify the relationship between e-cigarette experiences and smoking cessation behaviors among Korean adults. Methods: Cross-sectional data was collected from 7,550 participants of Korea National Health and Nutrition Examination Survey in 2014. A total of 867 participants who were current smokers were enrolled in this study. Multi-variable logistic regression analysis were performed to identify the relationship between the smoking cessation behavior and the e-cigarette experience. Results: The e-cigarette experience rate of current smokers was 22.1%. The e-cigarette experience rate was higher in groups with the higher income, the higher education level, and the white collar jobs. Smokers with experience of smoking cessation (odds ratio [OR], 3.03; 95% confidence interval [CI], 1.67 to 5.76) and with intention to smoking cessation in the future (OR, 1.59; 95% CI, 1.05 to 2.43) were more likely to experience the e-cigarette. Especially, smokers who used smoking cessation alternative supplies were more likely to experience the e-cigarette than smokers who did not use it (OR, 2.87; 95% CI, 1.59 to 5.18). Conclusion: We confirmed that e-cigarette experiences were associated with smoking cessation experience, smoking cessation plan, and use of smoking cessation aid among smokers in Korea. Additional studies should be continued to confirm whether e-cigarette are continuously influencing the smoking cessation of current smokers in South Korea as one of the smoking cessation alternative supplies.

Impact of Menopausal Status, Metabolic Syndrome and its Risk Factors on Impaired Quality of Life above Middle-aged Women (중년 이후 여성에서 삶의 질 저하에 영향을 미치는 요인: 폐경 형태와 대사증후군 위험요인을 중심으로)

  • Kim, Jisoon;Ahn, Sukhee
    • Women's Health Nursing
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    • v.22 no.4
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    • pp.275-286
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    • 2016
  • Purpose: This study explored influencing factors on quality of life (QoL) above middle-aged women in relation to demographic factors, health-related factors, menopausal status, metabolic syndrome (MS) and its risk factors. Methods: This study was secondary data analysis from the Sixth Korea National Health and Nutrition Examination Survey 2013~2015 that utilized a complex, multi-stage probability sample design. Study sample of 2,310 was inclusive of (28.8%) of women who were over 40. To evaluate the factors that would influence an impaired quality of life, $x^2$ test, GLM, and logistic regression analysis were done. Results: Level of quality of life was lower in women with late post-menopause(over 10 years since menopause) than women with pre-menopause. Factors influencing impaired QoL were as follows: graduated middle school and elementary school or less (OR=2.43, 4.42, respectively, p<.05), no job (OR=1.92, p<.001), stress (OR=1.92, p=.001), depression (OR=1.93, p=.001), insufficient sleep (OR=1.64, p=.003), late post-menopause (OR=2.61, p=.044) and over 85cm of waist circumference (OR=1.76, p=.01). Conclusion: These results suggest that late post-menopause may be an independent factor influencing an impaired QoL. To promote post-menopausal womens' health, a nursing strategy is required to teach women how to manage levels of stress, depression, insufficient sleep, and abdominal obesity through health education, nutritional counselling, and physical activity program.

Determinants of Participation in a Breast Cancer Screening Trial in Trivandrum District, India

  • Frie, Kirstin Grosse;Ramadas, Kunnambath;Anju, Gopan;Mathew, Beela Sara;Muwonge, Richard;Sauvaget, Catherine;Thara, Somanathan;Sankaranarayanan, Rengaswamy
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7301-7307
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    • 2013
  • Background: Conspicuous differences in participation rates for breast self-examination (BSE), clinical breast examination (CBE), and referral for further investigations have been observed indicating involvement of a number of different factors. This study analysed determinants for participation in different levels of the breast cancer screening process in Indian females. Materials and Methods: An intervention group of 52,011 women was interviewed in a breast cancer screening trial in Trivandrum district, India. In order to assess demographic, socio-economic, reproductive, and cancer-related determinants of participation in BSE, CBE, and referral, uni- and multi-variate logistic regression was employed. Results: Of the interviewed women, 23.2% reported practicing BSE, 96.8% had attended CBE, and 49.1% of 2,880 screen-positives attended referral. Results showed an influence of various determinants on participation; women who were currently not married or who had no family history of cancer were significantly less likely to attend the screening process at any level. Conclusions: Increasing awareness about breast cancer, early detection methods, and the advantages of early diagnoses among women, and their families, as well as health care workers offering social support, could help to increase participation over the entire screening process in India.

Effectiveness of an Intervention Program on Knowledge of Oral Cancer among the Youth of Jazan, Saudi Arabia

  • Quadri, Mir Faeq Ali;Saleh, Sanaa Mahmoud;Alsanosy, Rashad;Abdelwahab, Siddig Ibrahim;Tobaigy, Faisal Mohamed;Maryoud, Mohamed;Al-Hebshi, Nezar
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.1913-1918
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    • 2014
  • Background: The study is the first of its kind to be conducted in Saudi Arabia (KSA), aiming to analyze the effectiveness of an intervention program in improving the knowledge of oral cancer among the youth. Materials and Methods: A total of 1,051 young Saudis (57% males and 43% females with a mean age of $20.4{\pm}1.98$) were selected using multi-stage cluster sampling. Knowledge assessment was accomplished using a closed-ended questionnaire which was subjected to reliability tests. Prevalence of risk factors in relation to gender was analyzed using the chi-squared test. Effectiveness was calculated by comparing the pre- and post-intervention means, using the two-tailed paired t-test. Multiple logistic regression was employed in order to determine factors associated with awareness of risk habits, signs/symptoms and prevention of oral cancer. The significance level in this study was set at 0.05. Results: Females were seen to be more into the habit of sheesha smoking (3.3% rather than the use of other forms of risk factors. Prevalence of diverse risk factors such as cigarette smoking (20%), sheesha (15.3%), khat (27%) and shamma (9%) was seen among males. Gender and the use of modifiable risk factors among the study sample were significantly (p<0.001) associated with effectiveness of the intervention. The intervention program was highly effective (p<0.001) in improving the knowledge of oral cancer among the youth in Jazan, KSA. Multivariate analysis revealed that age and gender are the most significant factors affecting knowledge. Conclusions: The study gives a direction for further public health initiatives in this oral cancer prone region.

Complex Sample Analysis of the Effect of Alcohol Drinking and Smoking Period on Bone Mineral Densities in Korean Men Aged 50 Years and Over (50세 이상 한국 남성의 알코올과 흡연력이 골밀도에 미치는 영향에 대한 복합표본 분석)

  • Kim, Moon Ja;Lee, Eun Nam
    • Journal of muscle and joint health
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    • v.25 no.2
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    • pp.157-166
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    • 2018
  • Purpose: This study aimed to identify the effect of the level of alcohol drinking and smoking period on the occurrence of lumbar and femoral neck osteoporosis in men aged 50 years and over. Methods: This study analyzed the data of 1,410 men based on results of a National Survey on Nutritional Health for the period 2010-2012. Complex sample multi-variate logistic regression analysis was conducted to determine whether alcohol drinking and smoking period were associated with osteoporosis in men aged 50 years older. Results: The risk of osteoporosis in the femoral neck was 3.43 times (95% confidence interval [CI]=1.15~10.29) higher in men who consumed less alcohol and smoked for a long time compared to men who smoked more than 40 years and consumed much alcohol at once. The risk of osteoporosis in the lumbar spine was 3.45 times (95% confidence interval [CI]=1.69~7.04) higher respectively. Men who consumed much alcohol at a time and smoked less than 40 years were 1.54 (1/0.65) times (95% confidence interval [CI]=0.45~0.93) more likely to be classified as normal than the men who consumed much alcohol and had a long smoking period. Conclusion: The interaction of excessive drinking and smoking has a more detrimental effect on bone mineral density.