• Title/Summary/Keyword: Multivariate Assessment

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Assessment of Community Capacity Building Ability of Health Promotion Workers in Public Health Centers

  • Kim, Jung-Min;Koh, Kwang-Wook;Yu, Byeng-Chul;Jeon, Man-Joong;Kim, Yoon-Ji;Kim, Yun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.283-292
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    • 2009
  • Objectives : This study was performed to assess the community capacity building ability of health promotion workers of public health centers and to identify influential factors to the ability. Methods : The subjects were 43 public officers from 16 public health centers in Busan Metropolitan City. Questionnaire was developed based on 'Community Capacity Building Tool' of Public Health Agency of Canada which consists of 9 feathers. Each feather of capacity was assessed in 4 point rating scale. Univariate analysis by characteristics of subjects and multivariate analysis by multiple regression was done. Results : The mean score of the 9 features were 2.35. Among the 9 feathers, 'Obtaining resources' scored 3.0 point which was the highest but Community structure scored 2.1 which was the lowest. The mean score of the feathers was relatively lower than that of Canadian data. The significant influential factors affecting community capacity building ability were 'Service length', 'Heath promotion skill level', 'Existence of an executive department', and 'Cooperative partnership for health promotion'. According to the result of multiple linear regression, the 'Existence of an executive department' had significant influence. Conclusions : Community capacity building ability of subjects showed relatively lower scores in general. Building and activating an executive department and cooperative partnerships for health promotion may be helpful to achieve community capacity building ability.

Associated Factors of Impaired Fasting Glucose in Some Korean Rural Adults (농촌지역 주민의 공복혈당장애와 관련요인)

  • Yun, Hye-Eun;Han, Mi-Ah;Kim, Ki-Soon;Park, Jong;Kang, Myeng-Guen;Ryu, So-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.4
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    • pp.309-318
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    • 2010
  • Objective: This study was performed to investigate the prevalence of impaired fasting glucose (IFG) and its related characteristics among healthy adults in some Korean rural areas. Methods: We conducted a cross-sectional study using the data from 1352 adults who were over the age 40 and under the age 70 and who were free of diabetes mellitus (DM), cardiovascular diseases and other diseases and who participated in a survey conducted as part of the Korean Rural Genomic Cohort Study. IFG was defined as a serum fasting glucose level between 100 and 125 mg/dL. Results: The prevalence of IFG was 20.4% in men, 15.5% in women and 12.7% overall. Multivariate logistic regression analysis demonstrated that the independent risk factors for IFG were male gender, having a family history of DM, the quartiles of gamma glutamyltransferase and high sensitive C-reactive protein and the waist circumference. The homeostatis model assessment for insulin resistance was very strongly associated with IFG. The prevalence of metabolic syndrome (MS) and MS components was higher in the subjects with IFG then in those with normal fasting glucose (NFG). Conclusions: The result of study could supply evidence to find the high risk population and to determine a strategy for treating IFG. Further research is needed to explain the causal relationship and mechanisms of IFG.

Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

  • Zeglinski-Spinney, Amy;Wai, Denise C.;Phan, Philippe;Tsai, Eve C.;Stratton, Alexandra;Kingwell, Stephen P.;Roffey, Darren M.;Wai, Eugene K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.227-233
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    • 2018
  • Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

Probabilistic Strength Assessment of Ice Specimen considering Spatial Variation of Material Properties (물성치의 공간분포를 고려한 빙 시험편의 확률론적 강도평가)

  • Kim, Hojoon;Kim, Yooil
    • Journal of the Society of Naval Architects of Korea
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    • v.57 no.2
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    • pp.80-87
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    • 2020
  • As the Arctic sea ice decreases due to various reasons such as global warming, the demand for ships and offshore structures operating in the Arctic region is steadily increasing. In the case of sea ice, the anisotropy is caused by the uncertainty inside the material. For most of the research, nevertheless, estimating the ice load has been treated deterministically. With regard to this, in this paper, a four-point bending strength analysis of an ice specimen was attempted using a stochastic finite element method. First, spatial distribution of the material properties used in the yield criterion was assumed to be a multivariate Gaussian random field. After that, a direct method, which is a sort of stochastic finite element method, and a sensitivity method using the sensitivity of response for random variables were proposed for calculating the probabilistic distribution of ice specimen strength. A parametric study was conducted with different mean vectors and correlation lengths for each material property used in the above procedure. The calculation time was about ten seconds for the direct method and about three minutes for the sensitivity methods. As the cohesion and correlation length increased, the mean value of the critical load and the standard deviation increased. On the contrary, they decreased as the friction angle increased. Also, in all cases, the direct and sensitivity methods yielded very similar results.

The Relationship between the Soil Seed Bank and Above-ground Vegetation in a Sandy Floodplain, South Korea

  • Cho, Hyung-Jin;Jin, Seung-Nam;Lee, Hyohyemi;Marrs, Rob H.;Cho, Kang-Hyun
    • Ecology and Resilient Infrastructure
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    • v.5 no.3
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    • pp.145-155
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    • 2018
  • In a monsoonal climate, the soil seed bank can play an important role in plant regeneration after the severe annual floods that disturb above-ground vegetation within the riparian zone. To investigate the relationship between the soil seed bank and vegetation, we measured the species composition of the soil seed bank and the extant above-ground vegetation in six major plant communities (Artemisia selengensis, Miscanthus sacchariflorus, Persicaria nodosa, Phalaris arundinacea, Phragmites japonica, and Rorippa palustris) in the Cheongmicheon Stream, Korea. A total of 21 species germinated from the floodplain soil seed banks. The most diverse seed bank (21 species) was found in the A. selengensis community, wheres the lowest number of species was found in the R. palustris community (2 species). Most soil seed banks were composed of annuals (90%), exceptions being Rumex crispus and Artemisia princeps, which are perennial ruderals. The similarity of species composition between the soil seed bank and above-ground vegetation was low with Sorensen's similarity indices averaging 29% (range 12 - 42%). Crucially, existing dominant perennials of the extant vegetation including A. selengensis, M. sacchariflorus, P. japonica and P. arundinacea were absent from the soil seed bank. In conclusion, the soil seed banks of the floodplains of the Cheongmicheon Stream were mainly composed of viable seeds of ruderal plants, which could germinate rapidly after severe flood disturbance. The soil seed bank may, therefore, be useful for the restoration of the early succession stages of riparian vegetation after flood disturbances.

Objective and Subjective Socioeconomic Position and Current Smoking Among Korean Adolescents

  • Ko, Min Jung;Lee, Eun Young;Kim, Kirang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8877-8881
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    • 2014
  • Background: Despite social gradients in adult smoking, the effects of socioeconomic position (SEP) on adolescent smoking is not well understood. This study examined effects of subjective SEP as well as the objective SEP on smoking among Korean adolescents. Materials and Methods: Data were obtained from the 2012 Korea Youth Risk Behavior Web-based Survey, a nationally representative sample of middle and high school students (38,221 boys; 35,965 girls). SEP was assessed by the Family Affluence Scale (FAS) and the self-rated household economic status. Relationships between SEP and smoking were analyzed by multivariate logistic regression. Results: The low perceived SEP for either the high or low FAS grade was related to an elevated likelihood of smoking in both genders. A significantly higher risk of smoking was found in boys of low perceived SEP in middle school (odds ratio [OR] 1.50; 95% confidence interval [CI] 1.28-1.77 for high FAS, OR 1.55; 95% CI 1.21-1.98 for low FAS), and of low perceived SEP and high FAS in high school (OR 1.13; 95% CI 1.02-1.26). Among girls, an elevated risk of smoking was observed in middle school group with low perceived SEP and low FAS (OR 2.01; 95% CI 1.44-2.79) and in the high school group of low perceived SEP, regardless of FAS level (OR 1.34; 95% CI 1.14-1.57 for high FAS, OR 1.31; 95% CI 1.04-1.65 for low FAS). Conclusions: The relationship of subjectively perceived SEP with smoking is as important as objective SEP and more significant in Korean high school adolescents.

Relationship Between Prognosis and Neutrophil: Lymphocyte and Platelet:Lymphocyte Ratios in Patients with Malignant Pleural Mesotheliomas

  • Cihan, Yasemin Benderli;Ozturk, Ahmet;Mutlu, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2061-2067
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    • 2014
  • Background: It has been demonstrated that neutrophil:lymphocyte (NLR) and platelet:lymphocyte (PLR) ratios are associated with prognosis in cancer patients. The aim of this study was to investigate whether pretreatment white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, basophil and eosinophil counts, LDH level, NLR and PLR are associated with prognosis in patients with malignant pleural mesothelioma (MPM). Materials and Methods: We retrospectively reviewed files of 50 patients who were managed with a diagnosis of MPM between 2005 and 2010. Demographic and clinical characteristics, treatments, response to treatment and prognostic factors were evaluated, along with relationships between pretreatment blood parameters and prognosis. Results: Overall, 38 men and 12 women were included to the study. Mean age was $61.5{\pm}9.4$ years (range: 39-83 years). There was advanced disease in 86% (n=43) and the histological type was epithelial mesothelioma in the majority (82%). Of the cases, 17 (34%) received radiotherapy, while 42 cases underwent first- and second-line chemotherapy, with cisplatin plus pemetrexed as the most commonly used regimen. In the assessment after therapy, it was found that there was complete response in 4 cases (8%), partial response in 10 cases (20%), stable disease in 17 cases (34%) and progression in 19 cases (38%). Median follow-up was 10 months (range: 10 day-30 months). Median overall survival was found to be 20.7 months while median progression-free survival as 10 months. In univariate and multivariate analyses, it was found that factors significantly affecting overall survival included stage (p=0.030), response to treatment (p=0.026) and monocyte count (p=0.004), while factors affecting disease-free survival included NLR (p=0.018), response to treatment (p=0.001), and PLR score (p=0.003). Conclusions: Overall and disease-free survival was found to be better in cases with a WBC count<8.000, platelet count<300,000, and low NLR and PLR scores in malignant pleural mesothelioma.

Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

  • Wang, Zheng;Ma, Li;Zhang, Xing-Mao;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5371-5375
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    • 2014
  • Background: An accurate assessment of potential lymph node metastasis is important for the appropriate treatment of early gastric cancers. Therefore, this study analyzed predictive factors associated with lymph node metastasis and identified differences between mucosal and submucosal gastric cancers. Materials and Methods: A total of 518 early gastric cancer patients who underwent radical gastrectomy were reviewed in this study. Clinicopathological features were analyzed to identify predictive factors for lymph node metastasis. Results: The rate of lymph node metastasis in early gastric cancer was 15.3% overall, 3.3% for mucosal cancer, and 23.5% for submucosal cancer. Using univariate analysis, risk factors for lymph node metastasis were identified as tumor location, tumor size, depth of tumor invasion, histological type and lymphovascular invasion. Multivariate analysis revealed that tumor size >2 cm, submucosal invasion, undifferentiated tumors and lymphovascular invasion were independent risk factors for lymph node metastasis. When the carcinomas were confined to the mucosal layer, tumor size showed a significant correlation with lymph node metastasis. On the other hand, histological type and lymphovascular invasion were associated with lymph node metastasis in submucosal carcinomas. Conclusions: Tumor size >2 cm, submucosal tumor, undifferentiated tumor and lymphovascular invasion are predictive factors for lymph node metastasis in early gastric cancer. Risk factors are quite different depending on depth of tumor invasion. Endoscopic treatment might be possible in highly selective cases.

I Do Not Even Say "It" - a Mixed Methods Study on Breast Cancer Awareness of Omani Women

  • Alkhasawneh, Esra;Siddiqui, Saad T;Leocadio, Michael;Seshan, Vidya;Al-Farsi, Yahya;Al-Moundhri, Mansour S
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2247-2254
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    • 2016
  • Background: The incidence of breast cancer is rising in Oman, and the disease is diagnosed at late stages, when treatment success is limited. Omani women might benefit from better awareness, so that breast cancer can be detected early and treated. This study was conducted to assess Omani women's levels of breast cancer awareness and early detection practice, and explore factors which might influence these levels. Materials and Methods: A mixed methods study was conducted in 2014, including a quantitative survey of 1,372 and a qualitative assessment of 19 Omani women, aged ${\geq}20years$ from five Omani governorates using convenient sampling. Demographic information and scores for awareness levels were used in a multivariate regression model to investigate factors associated with awareness. Thematic analysis and interpretive description were used to analyse the qualitative data. Results: The overall means for early detection and general awareness scores were 0.58 (SD 0.24) and 0.46 (SD 0.21), respectively. General awareness was significantly associated with age, education, income and familiarity with cancer patients (p<0.05), while early detection was significantly associated with age, marital status and education. A majority of women (59.5%) agreed with a belief in 'evil eye' or envy as a risk factor for breast cancer. Women discussed various factors which may empower or inhibit awareness, including the cultural-religion-fatalistic system, personal-familial-environmental system, and healthcare-political-social system. Conclusions: The overall low scores for awareness and early detection, and the survey of local beliefs highlight a severe necessity for a contextually-tailored breast cancer awareness intervention programme in Oman.

The Influence of Comorbidities on Reoperations Following Primary Surgery of Lumbar Degenerative Diseases : A Nationwide Population-Based Retrospective Cohort Study from 2009-2016

  • Park, Hyung-Ki;Park, Su-Yeon;Lee, Poong-Hhoon;Park, Hye-Ran;Park, Sukh-Que;Cho, Sung-Jin;Chang, Jae-Chil
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.730-737
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    • 2020
  • Objective : Spinal degeneration is a progressive disease, worsening over time. Lumbar degenerative disease (LDD) is a major spinal disease in elderly patients. Surgical treatment is considered for medically intractable patients with LDD and reoperation after primary surgery is not uncommon. The surgical outcome is occasionally unpredictable because of comorbidities. In the present study, the relationship between comorbidities and the incidence of reoperation for LDD over time was determined. Methods : The claims data of the health insurance national database were used to identify a cohort of patients who underwent spinal surgery for LDD in 2009. The patients were followed up until 2016. Medical comorbidity was assessed according to the Charlson comorbidity index (CCI). Cox proportional hazard regression modeling was used to identify significant differences in sex, surgery, age, causative disease, and comorbidity. Results : The study cohort included 78241 patients; 10328 patients (13.2%) underwent reoperation during the observation period. The reoperation rate was statistically higher (p<0.01) in males, patients 55-74 years and 65-74 years of age, and patients with decompression or discectomy. Significant association was found between increasing reoperation rate and CCI score (p<0.01). Based on multivariate analysis of comorbidities, the significantly higher reoperation rates were observed in patients with peripheral vascular disease, pulmonary lung disease, peptic ulcer, diabetes, and diabetes complications (p<0.01). Conclusion : The study results indicate the reoperation rate for LDD is associated with patient comorbidities. The comorbidities identified in this study could be helpful in future LDD studies.