• Title/Summary/Keyword: self-associated curve

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Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study

  • Yi, Sang-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.3
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    • pp.176-182
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    • 2016
  • Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001). The unadjusted hazard ratios (HRs) in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001) than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001). The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64). Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

Geriatric Dwelling Depression Measurement Based on Projective Image Analysis Modeling

  • Lee, Yewon;Park, Chongwook;Woo, Sungju
    • International Journal of Advanced Culture Technology
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    • v.6 no.4
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    • pp.323-330
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    • 2018
  • The growth of the older population is expected to further increase social problems associated with population aging, such as isolation, poverty, and depression. The emerging issues associated with the older population are also expected to provide further momentum on studies about the dwelling environment as factors that ensure the health of older people as well as improve their quality of life. Therefore, approaches for explaining the issues of the older age group should be diversified using a variety of factors and appropriate analytic tools. Studies on measuring depression have principally focused on assessing an objective self-report questionnaire, usually in a highly structured, textual form which may not reflect the cognitive impairment of older adults. The aim of this study was to define and measure dwelling depression among older adults in Korea. There are two specific hypotheses in this study as follows: (a) there will be statistically significant relationships with dwelling dissatisfaction and depression, and (b) dwelling depression tools containing text and images will be, respectively, assessment tools that have a good construct with content validity and reliability. In the first experiment, to define and measure dwelling depression, 301 people over 65 years old living in single and two-person households were surveyed using a text-based dwelling depression questionnaires from September 1-30, 2017. In the second experiment, to examine whether the projective image questionnaire could serve as a suitable replacement for the text-based questionnaires, the same participants were surveyed from January 22 to February 2, 2018. The results show that depression has a close correlation with dwelling dissatisfaction. In addition, the geriatric dwelling depression index (GDDI) based on the projective image was refined. Additionally, the projective image questionnaire has a close correlation with the text-based questionnaire. Finally, through ROC curve analysis, it was found that the projective image questionnaire can accurately predict a depression group. To this end, this preliminary study examined the validity of the projective image questionnaire in older adults to make this instrument feasible for older populations and to contribute to a profound understanding of geriatric depression due to the living environment. We hope they will provide a basis for further research on psychological diagnoses using projective images.

Identification of shear layer at river confluence using (RGB) aerial imagery (RGB 항공 영상을 이용한 하천 합류부 전단층 추출법)

  • Noh, Hyoseob;Park, Yong Sung
    • Journal of Korea Water Resources Association
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    • v.54 no.8
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    • pp.553-566
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    • 2021
  • River confluence is often characterized by shear layer and the associated strong mixing. In natural rivers, the main channel and its tributary can be separated by the shear layer using contrasting colors. The shear layer can be easily observed using aerial images from satellite or unmanned aerial vehicles. This study proposes a low-cost identification method extracting geographic features of the shear layer using RGB aerial image. The method consists of three stages. At first, in order to identify the shear layer, it performs image segmentation using a Gaussian mixture model and extracts the water bodies of the main channel and tributary. Next, the self-organizing map simplifies the flow line of the water bodies into the 1-dimensional curve grid. After that, the curvilinear coordinate transformation is performed using the water body pixels and the curve grid. As a result, the shear layer identification method was successfully applied to the confluence between Nakdong River and Nam River to extract geometric shear layer features (confluence angle, upstream- and downstream- channel widths, shear layer length, maximum shear layer thickness).

Trajectories of Drinking problems of the elderly: A Longitudinal Multi-level Growth Curve Model for Change (노인의 음주문제 발달궤적의 예측요인 : 다수준 성장곡선 모형의 적용)

  • Ahn, Jun Hee;Jang, Soo Mi
    • Korean Journal of Social Welfare Studies
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    • v.43 no.1
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    • pp.389-411
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    • 2012
  • A new era of research has focused on examining the growth of change in drinking problems among the elderly. Thus, the purpose of the present study was two fold: (1) to investigate trajectories of drinking problems(CAGE) among the Korean elderly(age$${\geq_-}65$$); and (2) to identify the predicting factors for the intercept and the slope of alcohol problems using multi-level growth curve model. Data come from three waves(1st wave(2006)~3rd wave(2008) of the Korea Welfare Panel(KWP) study. The results indicated that the levels of drinking problems decreased over time and that age, gender, marital status, religion, poverty, self-rated health, and social relationship satisfaction were associated with the baseline CAGE. Further analysis showed that social relationship satisfaction affected the declining slope of drinking problems over time. Specifically, among those who satisfied social relationship, there was a sharp decline of CAGE over time. Overall findings highlight the importance of developing and implementing effective alcohol prevention programs for the elderly in the community settings to mitigate the harmful effects of various psycho-social stressors. Especially, programs to maintain and form healthy social support network are suggested as critical interventions for prevention as well as recovery of alcohol problems in late life.

The Korean Prediction Model for Adolescents’ Future Smoking Intentions

  • Lee, Sung-Kyu;Yun, Ji-Eun;Lee, Ja-Kyoung;Kim, Il- Soon;Jee, Sun-Ha
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.4
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    • pp.283-291
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    • 2010
  • Objectives: The purpose of this study was to develop a prediction model for future smoking intention among Korean adolescents aged 13 to 15 in order to identify the high risk group exposed to future smoking. Methods: The data was collected from a total of 5940 students who participated in a self-administrated questionnaire of a cross-sectional school-based survey, the 2004 Korea Global Youth Tobacco Survey. Chi-square tests and logistic regression analyses were carried out to identify the relevant determinants associated with intentions of adolescents’ future smoking. Receiver Operation Characteristic (ROC) assessment was applied to evaluate the explanation level of the developed prediction model. Results: 8.4% of male and 7.2% of female participants show their intentions of future smoking. Among non-smoking adolescents; who have past smoking experience [odds ratio (OR) 2.73; 95% confidence interval (CI) 1.92- 3.88]; who have intentions of smoking when close friends offer a cigarette (OR 31.47; 95% CI = 21.50 - 46.05); and who have friends that are mostly smokers (OR 5.27; 95% CI = 2.85 - 9.74) are more likely to be smokers in the future. The prediction model developed from this study consists of five determinants; past smoking experience; parents smoking status; friends smoking status; ownership of a product with a cigarette brand logo; and intentions of smoking from close friends’ cigarette offer. The area under the ROC curve was 0.8744 (95% CI=0.85 - 0.90) for current non-smokers. Conclusions: For efficiency, school-based smoking prevention programs need to be designed to target the high risk group exposed to future smoking through the prediction model developed by the study, instead of implementing the programs for all the students.

A Systematic Review of Evidence for Education and Training Interventions in Microsurgery

  • Ghanem, Ali M.;Hachach-Haram, Nadine;Leung, Clement Chi Ming;Myers, Simon Richard
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.312-319
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    • 2013
  • Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

Determinants of Opioid Efficiency in Cancer Pain: a Comprehensive Multivariate Analysis from a Tertiary Cancer Centre

  • Goksu, Sema Sezgin;Bozcuk, Hakan;Uysal, Mukremin;Ulukal, Ece;Ay, Seren;Karasu, Gaye;Soydas, Turker;Coskun, Hasan Senol;Ozdogan, Mustafa;Savas, Burhan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9301-9305
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    • 2014
  • Background: Pain is one of the most terrifying symptoms for cancer patients. Although most patients with cancer pain need opioids, complete relief of pain is hard to achieve. This study investigated the factors influencing persistent pain-free survival (PPFS) and opioid efficiency. Materials and Methods: A prospective study was conducted on 100 patients with cancer pain, hospitalized at the medical oncology clinic of Akdeniz University. Patient records were collected including patient demographics, the disease, treatment characteristics, and details of opioid usage. Pain intensity was measured using a patient self-reported visual analogue scale (VAS). The area under the curve (AUC) reflecting the pain load was calculated from daily VAS tables. PPFS, the primary measure of opioid efficacy, was described as the duration for which a patient reported a greater than or equal to two-point decline in their VAS for pain. Predictors of opioid efficacy were analysed using a multivariate analysis. Results: In the multivariate analysis, PPFS was associated with the AUC for pain (Exp (B)=0.39 (0.23-0.67), P=0.001), the cumulative opioid dosage used during hospitalisation (Exp (B)=1.00(0.99-1.00), P=0.003) and changes in the opioid dosage (Exp (B)=1.01 (1.00-1.01), P=0.016). The change in VAS score over the standard dosage of opioids was strongly associated with current cancer treatment (chemotherapy vs. others) (${\beta}=-0.31$, T=-2.81, P=0.007) and the VAS for pain at the time of hospitalisation (${\beta}=-0.34$, T=-3.07, P= 0.003). Conclusions: The pain load, opioid dosage, concurrent usage of chemotherapy and initial pain intensity correlate with the benefit received from opioids in cancer patients.