• 제목/요약/키워드: stepwise regression analysis

검색결과 1,501건 처리시간 0.03초

미숙아에서 초기 스트레스성 고혈당과 예후 사이의 연관성 (Early stress hyperglycemia as independent predictor of increased mortality in preterm infants)

  • 위영선;안계현;유은경;임인숙;이규형
    • Clinical and Experimental Pediatrics
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    • 제51권5호
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    • pp.474-480
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    • 2008
  • 목 적 : 스트레스성 고혈당은 중환자의 급성 질병기에 흔히 동반되며, 이는 여러 질환의 유병율과 사망률을 증가시킨다. 이 연구는 미숙아에서 생후 48시간 이내에 나타나는 스트레스성 고혈당이 예후에 어떤 영향을 미치는지 알아보고자 하였다. 방 법 : 재태 주령 30주 이하의 신생아 141명을 대상으로, 생후 48시간동안 혈당이 한번이라도 150 mg/dL 이상이었던 고혈당군(n=61)과 모두 150 mg/dL 미만이었던 비고혈당군(n=80)으로 분류하였다. 두 군의 분만력 상의 특징, CRIB score를 이용한 임상적 중증도, 임상 경과, 예후 및 사망률에 대해 비교하였다. 결 과 : 두 군의 재태 주령은 차이가 없었으나, 고혈당군에서 비고혈당군에 비해 출생체중은 더 작았고(P<0.001), CRIB 점수는 더 높았다(P<0.001). 임상적으로 패혈증이 의심된 경우와 파종성 혈관내응고증은 고혈당군에서 더 많았으며(P=0.046, P< 0.001), 사망률은 고혈당군이 41.0%, 비고혈당군이 11.3%로 고혈당군에서 월등히 높았다(P<0.001). 단계적 로지스틱 회귀분석 결과, 고혈당(OR 3.787; 95% CI 1.324 to 10.829)은 CRIB score (OR 1.252; 95% CI 1.047 to 1.496), 출생체중(OR 0.997; 95% CI 0.994 to 1.000)과 함께 사망률에 독립적으로 의미 있는 영향을 미쳤다. 결 론 : 30주 이하의 미숙아에서 생후 48시간 이내에 나타나는 스트레스성 고혈당은 임상 경과의 악화 및 사망률의 증가와 독립적인 연관성을 보였다.

산업장의 소음폭로수준과 근로자의 스트레스 증상간의 관련성 (The Relationship between Noise Exposure Level in Worksite and Workers' Stress Symptoms)

  • 박경옥;이명선
    • Journal of Preventive Medicine and Public Health
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    • 제29권2호
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    • pp.239-254
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    • 1996
  • Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

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난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구 (GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH))

  • 김미란;송인옥;연혜정;최범채;백은찬;궁미경;손일표;이진우;강인수
    • Clinical and Experimental Reproductive Medicine
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    • 제26권2호
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    • pp.163-170
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    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

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중년여성의 삶의 의미와 영향요인 (Factors Influencing the Meaning of Life for Middle-aged Women)

  • 박금자
    • 여성건강간호학회지
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    • 제8권2호
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    • pp.232-243
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    • 2002
  • The purpose of this study was to examine factors influencing the meaning of life for middle-aged women. The subjects for the study were 190 middle-aged women who live in Busan. Data were collected from May 25 to June 20, 1999. The instruments for this study were as follows : the meaning of life scale developed by Jung D. R(1978) ; the self-esteem scale developed by Ro, E. Y, Kwon, J. H.(1997) ; the volunteer activity scale developed by Park G. J.(1999), the marital satisfaction scale developed by Choi G. Y.(1999) ; and the health status scale developed by Kim S. Y. (1991). SPSS PC+ was utilized for data analysis. Data were analysed according to frequency and percentage, mean and standard deviation, t-test, ANOVA, Sheffe' s test and Pearson' s correlation coefficients and stepwise multiple regression. The reliability of the tools was tested by Cronbach's $\alpha$ : and it showed reliability scores of 0.88(for the meaning of life tool), 0.81(for the self-esteem tool), 0.94(for the marital satisfaction tool) and 0.78(for the health status tool). The results were as follows: 1) The scores showed that middle-aged women had a moderate level of meaning of life, with a mean of 30.31 and standard deviation of 6.24 (with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate levels of self-esteem, with a mean of 28.92 and standard deviation of 4.67 (with values ranging from 10.00 to 40.00). The scores showed that middle-aged women had a very low level of volunteer activity, with a mean of 0.87 and standard deviation of 0.93(with values ranging from 0.00 to 1.00). The scores showed that middle-aged women had a moderate level of satisfaction in their marriages, with a mean of 31.99 and standard deviation of 7.84(with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate level of health status, with a mean of 6.63 and standard deviation of 1.57(with values ranging from 3.00 to 9.00). 2) There was a statistically significant difference of the meaning of life of middle-aged women according to their religion(F=8.930, p=.000), christian ($31.94{\pm}5.96$) had more meaning th life than buddhists ($28.40{\pm}6.23$). 3) There was a statistically significant correlations between the subject' s self-esteem and the her meaning of life(r=0.477, p=0.000), the subject' s level of volunteer activity and meaning of life(r=.428, p=.000), her level of marital satisfaction and meaning of life(r=.417, p=.000), and her level of health status and meaning of life(r=.261, p=.000) among these middle-aged women. 4) Self- esteem was the highest factor influencing the level of meaning of life in middle-aged women. 40.0% of the total variance of levels of meaning of life by was dependent on self-esteem, volunteer activity, marital satisfaction and health status. In conclusion, the higher the self-esteem and levels of volunteer activity, marital satisfaction, and health status of middle-aged women, the higher the meaning of life for them. Therefore, it is necessary to elevate levels of the self-esteem and volunteer activity, marital satisfaction and health status in order to help middle-aged women have more meaning of life.

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암환자의 희망 예측요인 (Predictive Factors of Hope in Patients with Cancer)

  • 이화진;손수경
    • 성인간호학회지
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    • 제12권2호
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    • pp.184-195
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    • 2000
  • It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

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Cone-beam CT를 이용한 안면비대칭자에서 이부편위에 따른 치성보상의 양상분석 (Correlation between menton deviation and dental compensation in facial asymmetry using cone-beam CT)

  • 박수병;박정희;정연화;조봉혜;김용일
    • 대한치과교정학회지
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    • 제39권5호
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    • pp.300-309
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    • 2009
  • 본 연구는 Cone-beam CT의 MPR이미지상에서 하악골 평면에 대한 하악 제1대구치와 견치의 편위측과 비편위측의 높이와 각도차이 그리고 FH 평면에 대한 상악 제1대구치와 견치의 편위측과 비편위측의 높이와 각도차이를 계측함으로써 안면비대칭자에서 이부편위에 따른 편위측과 비편위측의 제1대구치와 견치의 높이와 협설측 경사도를 CBCT를 이용하여 분석하고 그 관련성을 알아보는 데 있다. 연구대상은 하악골의 이부편위를 동반한 안면비대칭 환자 50명(여자 29명, 남자 21명, 평균나이 24세 4개월)으로 하였다. 대조군으로 평균나이 25세 7개월인 20명(남자 11명, 여자 9명)을 분석하였다. 결과는 이부편위에 대해 FH 평면에 대한 상악 제1대구치의 편위측과 비편위측의 길이 및 각도 차이(편위측 - 비편위측)는 대조군에 대해 통계적으로 유의한 차이가 존재하였다 (p < 0.01). 비대칭군에서 상악 제1대구치 각도는 편위측이 비편위측보다 평균 $8.62\;{\pm}\;5.95^{\circ}$ 컸다 (p < 0.01). 상악 견치의 경우에도 편위측과 비편위측의 각도차이가 평균 $4.48\;{\pm}\;5.05^{\circ}$로 통계적으로 유의한 차이가 존재하였다 (p < 0.01). 하악골 평면에 대한 하악 제1대구치의 수직 길이와 각도는 편위측과 비편위측에서 통계적으로 유의할 만한 차이가 존재하였다 (p < 0.01). 각도의 차이는 평균 $-11.92\;{\pm}\;5.79^{\circ}$로 나타났다. 이부편위에 대한 상하악 제1대구치와 견치의 수직거리 및 각도의 Pearson 상관분석 및 회귀분석 결과, FH 평면에 대한 상악 제1대구치의 편위측과 비편위측의 각도차이(${\Delta\angle}UM6$-FH plane (dev.-ndev.))는 통계적으로 유의한 양의 상관관계를 나타내었고, 하악골 평면에 대한 하악 제1대구치의 편위측과 비편위측의 각도차이(${\Delta\angle}LM6$-Mn plane (dev.-ndev.))는 통계적으로 유의한 음의 상관관계를 나타내었다. 이상의 결과에서 이부편위를 동반한 하악골 비대칭이 존재하는 경우, 이부가 편위되는 방향으로 상하악 제1대구치의 치아장축의 각도가 변화되는 것으로 나타났다.

벼 유수분화기 생장 및 질소영양상태에 따른 수량의 수비질소 반응 (Yield Response to Nitrogen Topdress Rate at Panicle Initiation Stage under Different Growth and Nitrogen Nutrition Status of Rice Plant)

  • 김민호;부금동;이변우
    • 한국작물학회지
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    • 제51권7호
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    • pp.571-583
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    • 2006
  • 안정적인 고품질 쌀의 생산을 위한 수비처방을 하기 위해서는 유수형성기 생육상태와 질소영양상태별 질소시비량에 따른 수량반응에 대한 이해가 있어야만 한다. 따라서 본 연구는 기비와 분얼비 시용량을 달리하여 유수분화기에 다양하게 조성된 벼 생육 및 질소영양상태별로 수비 질소 시용량을 달리하였을 때의 수량반응을 질소시비량과 질소흡수량으로 살펴봄으로써 수비처방에 필요한 기초 자료를 얻고자 하였다. 1. 기비 + 분얼비와 수비 시용량 간에는 유의한 상호작용이 없어 수비 시용량에 관계없이 기비 + 분얼비가 증가할수록 그리고 기비 + 분얼비 시용량에 관계없이 수비 시용량이 증가할수록 수량은 증가하는 경향이었다. 2. 영양생장기 시비량(기비 + 분얼비)이 $10{\sim}12\;kgN/10a$까지 생식생장기 시비량(수비)이 6 kgN/10a까지 증가할수록, 그리고 영양생장기 질소흡수량이 $6{\sim}7\;kgN/10a$까지 생식생장기 질소흡수량이 $5{\sim}6\;kgN/10a$까지 수량은 직선적으로 유의하게 증가하는 경향이었으나 그 이상일 경우 수량 증가폭은 점차 줄어들었는데, 이는 등숙률과 천립중이 크게 감소하기 때문이었다. 3. 단위질소흡수량당(kgN/10a) 총영화수($/m^{2}$) 증가는 영양생장기가 약 1900여개, 생식생장기가 $1400{\sim}1500$여개였지만 단위질소흡수량당 수량증가(kg/10a)는 영양생장기가 $30{\sim}50$, 생식생장기가 $40{\sim}80$ 정도였다. 4. 총영화수는 출수기 질소흡수량과 직선적인 관계를 보이고 수량은 시기별 질소흡수량의 다과에 상관없이 이들의 총합인 수확기 질소함량과 2차 곡선관계($R^2$>0.88)를 보였는데, 이는 어느 시기에 질소를 흡수하느냐보다는 생육기간의 총질소흡수량에 의해 수량이 좌우되는 것으로 볼 수 있다. 또한 질소흡수량이 같더라도 총영화수와 수량은 연차간에 차이를 보였다.

고혈압 환자에서 혈장 고분자량 아디포넥틴 농도와 심장-대사위험인자와의 관련성 연구 (Plasma Levels of High Molecular Weight Adiponectin are Associated with Cardiometabolic Risks in Patients with Hypertension)

  • 정혜경;신민정
    • Journal of Nutrition and Health
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    • 제41권8호
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    • pp.733-741
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    • 2008
  • 고혈압 환자 110명을 대상으로 혈장 고분자량 아디포넥틴과 총 아디포넥틴 농도를 측정하고 심장-대사위험인자와의 관련성을 비교 평가한 연구 결과를 요약하면 다음과 같다. 1) 비만군과 비비만군으로 나누어 비교한 결과, 고분자량 아디포넥틴 농도는 비만군에서 유의적으로 낮았으나 총 아디포넥틴 농도는 두군간 유의적인 차이를 보이지 않았다. 2) 비만도를 나타내는 BMI 및 허리둘레의 경우 고분자량 아디포넥틴과 음의 상관관계를 보였으나 혈장 아디포넥틴과는 유의적인 상관관계를 보이지 않았다. 3) 혈액 지질 수준과의 상관성 평가시, 고분자량 아디포넥틴은 중성지방과 음의 상관관계를, 고밀도 콜레스테롤과는 양의 상관관계를 보였으며 혈장 아디포넥틴의 경우 단지고밀도 콜레스테롤과 유의적인 양의 상관관계를 보였다. 4) 인슐린 저항성 지표인 HOMA-IR의 경우 고분자량 아디포넥틴 및 혈장 아디포넥틴 모두와 음의 상관관계를 보였다. 5) 염증지표와의 상관성 분석 시, 고분자량 아디포넥틴은 C-반응성 단백질, IL-6과 강한 음의 상관 관계를 TNF-${\alpha}$, ICAM-1과 음의 경향을 보였으나 혈장 아디포넥틴은 C-반응성 단백질외에는 상관관계를 보이지 않았다. 또한 회귀분석 결과, 혈장 고분자량 아디포넥틴 농도는 C-반응성 단백질 수준을 예측하는 독립적 인자였다. 위의 결과로 보아 고분자량 아디포넥틴은 혈장 아디포넥틴보다 전반적으로 심장-대사위험인자와 더 많은 상관성을 보여주었다. 따라서 심혈관 질환 및 대사성증후군을 예측하고 반영하는 데 혈장 고분자량 아디포넥틴 수준이 총 아디포넥틴 수준보다 민감하고 정확한 지표로 활용될 수 있을 것이다.

산업장 여성근로자의 근무형태에 따른 건강증진행위 비교 (The Comparative Study on Health Promoting Behaviors by Shift Pattern of Duties of Women Workers in workplace)

  • 장희정;박경민
    • 한국직업건강간호학회지
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    • 제8권1호
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    • pp.22-41
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    • 1999
  • This study intended to analyze the health promoting behaviors, compare their factors according to the shift pattern of duties of women workers who were working in the industrial workplace and present basic data in planning systematic and effective programs of health promotion for three-shift system and day-duty. Using Quota Sampling, 219 women workers were selected as subjects from 5 workshops which had 50 settled workers up to 300 and 10 factories which had more than 300 located in Taegu and Kyung-Book Province. Data were collected by means of questionnaire from September 12 to September 30, 1998. As the instruments of the study were used Health Promotion Lifestyle Profile(HPLP) which was adapted and adjusted by Seo, Y. O. for health promoting behavior, the one developed by Moon, J. S. (1990) for health-belief, the one developed by Sherer et al.(1982) and then adapted by Oh, H. S. for self-efficacy, and the one developed by Park, J. W. (1985) for social support. The analysis of data were performed with Cronbach's ${\chi}^2$-test, t-test, ANCOVA, Kendal tau, Pearson correlation, Stepwise Multiple Regression test using SPSS program. The results of the study are as follows : 1. There was a significant difference in age(${\chi}^2=32.46$, p=0.000), career (${\chi}^2=18.47$, p=0.000), working day(t=-3.18, p=0.000) by the shift pattern of duties in terms of socio-demographic characteristics. 2. There was a statistically significant difference between the two groups on the health promoting behaviors (t=2,52, p=0.012). The score of three-shift group on health promoting behaviors was 2.27, showing that it was lower by .13 than that of day-duty group(2.40). 3. ANCOVA involving age, career and working day as covariables, which had revealed significant difference before, showed that health promoting behaviors by the shift patterns of duties was significantly different(F=4.88, p=0.028). 4. In consideration of variables that have an influence on health promoting behavior by the shift pattern of duties, social support occupied 19.4% of health promoting behavior in the three-shift group and 22.5% including the sense of self-efficacy. In the day-duty group, social support occupied 34.4% of health promoting behavior. 5. The score of three-shift group(2.94) was significantly lower than that of day-duty group(3.12) in the perceived benefit of health-belief(t= -3.29, p=0.001), while the score of three-shift group (2.48) was significantly higher than that of day-duty group(2.24) in the perceived barrier (t=4.22, p=0.000). In the sense of self-efficacy(t=-4.20, p=0.000), the score of three-shift group(3.24) was significantly lower than that of day-duty group(3.53) while in social support(t=-4.56, p=0.000) the one of three-shift group(2.64) was significantly lower than that of day-duty group(2.88). The suggestions are as follows on the basis of the results of this study : 1. It is required to develop health promoting program that takes the shift pattern of duties of women workers into consideration. In addition, there are special demands on developing nursing strategies for health promoting behavior of three-shift workers. 2. It is required to develop specific strategies for social support which is the most significant factor to the health promoting behavior for women workers. 3. It is necessary to develop some programs for improving the sense of self-efficacy, social support, and health-belief of three-shift workers. To achieve these tasks, industrial nurses should play an active role and improve the ability of self-health care of women workers.

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남자 만성폐쇄성폐질환 환자들의 골밀도에 대한 예비연구 (A Pilot Study of Bone Mineral Density in Men with Chronic Obstructive Pulmonary Disease)

  • 배윤오;한민수;이성규;김정념;김정식;김진호;이양덕;조용선
    • Tuberculosis and Respiratory Diseases
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    • 제54권4호
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    • pp.395-402
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    • 2003
  • 연구배경 : 만성폐쇄성폐질환 환자들은 여러 요인들에 의해 골다공증의 발생이 증가하는 것으로 알려져 있으며 골다공증으로 인한 척추골절은 폐기능 및 신체적 활동을 더욱 감소시키고 사망률을 증가시키는 것으로 알려져 있다. 이에 연구자들은 극히 제한된 환자들이지만 남자 만성폐쇄성폐질환 환자들의 골다공증 및 골밀도에 관련이 있는 요인들을 알아보기 위해 본 예비연구를 시행하였다. 방 법 : 2002년 1월부터 8월까지 을지대학병원 호흡기내과에 내원한 남자 만성폐쇄성폐질환 환자 44명을 대상으로 골밀도를 측정하였다. 환자들은 폐기능에 따라 세 군으로 나누어 $FEV_1$ 예측치의 65%이상, 예측치의 50-64%, 예측치의 49%이하로 세분하여 나이, 흡연, 음주, 운동, 스테로이드사용 누적량, 신체질량지수, 골밀도 등을 비교하여 보았다. 결 과 : 총 44명의 환자 중 골다공증 환자는 17명(61.4%)이었고, 골감소증 환자는 27명(38.6%)이었으며, 정상 골밀도를 보이는 환자는 한 명도 없었다. 평균 나이는 $69{\pm}9$세, 신체질량지수는 $21{\pm}3kg/m^2$, $FEV_1$$50{\pm}18%$, L1-4 T-score는 $-3.0{\pm}1.2$, L1-4 Z-score $-2.0({\pm}1.2)$, L1-4의 골밀도는 $0.76{\pm}0.13g/cm^2$ 이었다. 대상 환자들에서 $FEV_1$과 골밀도는 연관성이 없었다. $FEV_1$에 따른 세 군 간에 흡연, 음주, 운동, 스테로이드사용 누적 사용량, 신체질량지수, 골밀도가 유의한 차이가 없었다. 골다공증 군과 골감소증 군 간에 나이, 흡연, 음주, 운동, 스테로이드사용 누적 사용량, $FEV_1$은 차이가 없었고, 신체질량지수만이 골다공증 군에서 더 낮았다. 다 변량 분석시 골밀도와는 신체질량지수와 운동량이 관련이 있었다. 결 론 : 남자 만성폐쇄성폐질환 환자에서 골밀도의 감소는 뚜렷하였으나 폐기능과 골밀도 간에 직접적인 관련이 없었다. 향후 보다 많은 환자를 대상으로 만성폐쇄성폐질환 환자에서 골밀도 감소에 영향을 미치는 요인 및 골다공증 치료에 대한 전향적인 연구가 필요할 것으로 생각된다.