• 제목/요약/키워드: Risk Adjustment

검색결과 386건 처리시간 0.025초

Association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome in Korean women with type 2 diabetes mellitus

  • Oh, Ji Soo;Kim, Hyesook;Vijayakumar, Aswathy;Kwon, Oran;Choi, Young Ju;Huh, Kap Bum;Chang, Namsoo
    • Nutrition Research and Practice
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    • 제10권1호
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    • pp.67-73
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    • 2016
  • BACKGROUND/OBJECTIVES: This study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database. RESULTS: In the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (${\geq}0.74$) was significantly low in the $4^{th}$ quartile compared to that in the $1^{st}$ quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group. CONCLUSIONS: Dietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.

어머니의 골밀도와 생활습관이 소아청소년의 골밀도에 미치는 영향 (Maternal and lifestyle effect on bone mineral density in Korean children and adolescents aged 8-19)

  • 이병국;이용현;이혜림;박선민
    • Journal of Nutrition and Health
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    • 제46권2호
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    • pp.147-155
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    • 2013
  • Higher bone mineral density (BMD) at a young age, calcium intake, and exercise are important for prevention of osteoporosis later in life. We examined familial effects of BMD between mothers and children and adolescents aged 8-19 in Cheonan, Korea and the relationships between BMD and lifestyle parameters, including: food and nutrient intake and exercise. For daughters and sons, significant differences in BMD were observed at the three bone sites (total femur, femur neck, and lumbar spine) according to age, gender, body mass index, exercise, and milk consumption, compared to the reference value for each classification category. Mean differences in children's BMD were observed according to maternal BMD. Energy and calcium intake were lower in both children and mothers in comparison to the estimated daily energy requirement; however, their protein intake was much greater than the daily recommended intake. After adjusting for age and gender and for mother's age, body mass index, and total calorie intake, results of the food frequency test showed an association of a higher intake of meat, meat products, milk and milk products with greater BMD of total femur, femur neck, and lumbar spine of children. In addition, exercise was positively associated with higher BMD. Regression analysis showed a positive association of BMD with age, male gender, exercise, and mother's BMD. In conclusion, after adjustment for environmental parameters, maternal BMD had a positive influence on BMD in daughters and sons. This finding suggests that parents need to check their BMD in order to determine whether their children are at increased risk of low BMD.

비부비동염과 혈압의 상관관계 (Relationship between Chronic Rhinosinusitis and Blood Pressure)

  • 서윤태;김덕수;길부관;신승헌;예미경
    • 임상이비인후과
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    • 제29권2호
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    • pp.182-189
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    • 2018
  • Background and Objectives : There were few literatures about the relationship between upper airway disorders and cardiovascular risk factors such as hypertension, although an association between impaired lower respiratory function and cardiovascular alterations was often reported. Our purpose was to assess the relationships between chronic sinusitis and hypertension. Materials and Methods : Three hundred subjects with bilateral chronic sinusitis who underwent functional endoscopic sinus surgery between 2015and 2017 were evaluated. Six hundred forty subjects without any nasal diseases were enrolled as a control group. Blood pressure and body mass index (BMI) were measured using a standardized method, and subjects were asked about current use of any antihypertensive medication, history of diabetes, smoking and alcohol drinking habits.Sinusitis group was assessed by nasal endoscopic examination, paranasal sinus CT scan and allergy test. Results : Average systolic and diastolic blood pressures were statistically significantly higher in subjects with sinusitis than control group. Chronic rhinosinusitis was associated with a 1.415-fold (95% confidence interval 1.053-1.930) increased hazard of hypertension after multivariate adjustment. Conclusions : These results suggest that sinusitis is associated with high blood pressure. Therefore patients with sinusitis may need special attention for blood pressure control. Further studies need to be performed to elucidate the pathogenesis behind such associations.

Seismic pounding effects on the adjacent symmetric buildings with eccentric alignment

  • Abdel Raheem, Shehata E.;Fooly, Mohamed Y.M.;Omar, Mohamed;Abdel Zaher, Ahmed K.
    • Earthquakes and Structures
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    • 제16권6호
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    • pp.715-726
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    • 2019
  • Several municipal seismic vulnerability investigations have been identified pounding of adjacent structures as one of the main hazards due to the constrained separation distance between adjacent buildings. Consequently, an assessment of the seismic pounding risk of buildings is superficial in future adjustment of design code provisions for buildings. The seismic lateral oscillation of adjacent buildings with eccentric alignment is partly restrained, and therefore a torsional response demand is induced in the building under earthquake excitation due to eccentric pounding. In this paper, the influence of the eccentric seismic pounding on the design demands for adjacent symmetric buildings with eccentric alignment is presented. A mathematical simulation is formulated to evaluate the eccentric pounding effects on the seismic design demands of adjacent buildings, where the seismic response analysis of adjacent buildings in series during collisions is investigated for various design parameters that include number of stories; in-plan alignment configurations, and then compared with that for no-pounding case. According to the herein outcomes, the effects of seismic pounding severity is mainly depending on characteristics of vibrations of the adjacent buildings and on the characteristics of input ground motions as well. The position of the building wherever exterior or interior alignment also, influences the seismic pounding severity as the effect of exposed direction from one or two sides. The response of acceleration and the shear force demands appear to be greater in case of adjacent buildings as seismic pounding at different levels of stories, than that in case of no-pounding buildings. The results confirm that torsional oscillations due to eccentric pounding play a significant role in the overall pounding-involved response of symmetric buildings under earthquake excitation due to horizontal eccentric alignment.

Impact of Insulin Resistance on Acetylcholine-Induced Coronary Artery Spasm in Non-Diabetic Patients

  • Kang, Kwan Woo;Choi, Byoung Geol;Rha, Seung-Woon
    • Yonsei Medical Journal
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    • 제59권9호
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    • pp.1057-1063
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    • 2018
  • Purpose: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. Materials and Methods: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; $1.35{\leq}HOMA-IR<1.93$), 3Q (n=83; $1.93{\leq}HOMA-IR<2.73$), and 4Q (n=83; $HOMA-IR{\geq}2.73$). Results: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. Conclusion: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.

안전리더십, 안전준수, 안전교육, 안전문화 간의 구조적 관계 - K 사 사례연구 - (Structural Relations Between Safety Leadership, Safety Observance, Safety Education, and Safety Culture - K Company Case Study -)

  • 위국환;방원석;김선화;장성록
    • 한국안전학회지
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    • 제36권1호
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    • pp.36-43
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    • 2021
  • Effective leadership in safety performance, such as safety leadership, has received attention as a factor that greatly affects safety performance in various high-risk industrial environments. Based on prior research, this study aims to analyze the impact relationship between safety leadership, safety observance, safety education, and safety culture to reveal the effectiveness of safety leadership. In addition, this study will examine the effects of safety leadership on safety observance and safety education to identify the effects of safety understanding. For this purpose, a survey was conducted with employees of an aviation manufacturing company in Gyeongnam. For verification, a positive factor analysis, correlation analysis, and structural equation analysis were conducted using the AMOS 21.0 program. This study's findings show that, first, safety leadership has a positive and significant impact on safety observance and safety education. Second, safety leadership was found to have a direct impact on organizations' safety culture. Third, although safety observance has significant positive effects on safety culture, safety education has often been rejected. Finally, after verifying the control effect of safety understanding, this study uncovered the presence of an adjustment effect in the effect of safety leadership on safety observance. Therefore, based on the results of this study, theoretical and practical implications suggest that through the exercise of safety leadership, managers can improve their organizations' safety culture by increasing organizations' compliance with safety observance and/or acceptance of safety education.

Factors influencing prenatal and postpartum depression in Korea: a prospective cohort study

  • Yoo, Hyeji;Ahn, Sukhee;Park, Seyeon;Kim, Jisoon;Oh, Jiwon;Koh, Minseon
    • 여성건강간호학회지
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    • 제27권4호
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    • pp.326-336
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    • 2021
  • Purpose: This study explored the prevalence of prenatal and postpartum depression in Korea and its influencing factors from 20 weeks of pregnancy to 12 weeks postpartum. Methods: Using a prospective cohort study design, data on women's depression and its influencing factors were collected at 20, 28, and 36 weeks of pregnancy and at 2, 6, and 12 weeks postpartum. The participants were 219 women and 181 spouses during pregnancy; and 183 mothers and 130 spouses after childbirth. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale and influencing factors were measured by the Postpartum Depression Predictors Inventory-Revised, parity, and spousal depression. Results: The prevalence of maternal depression was 10.5% to 21.5% before birth, and it was 22.4% to 32.8% postpartum. The prevalence slightly decreased during the prenatal period but peaked at 2 weeks postpartum. Antenatal depression was influenced by low socioeconomic status, lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, a previous history of depression, lower social support, lower marital satisfaction, and higher life stress. The factors influencing postpartum depression were lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, lower social support, lower marital satisfaction, and higher life stress, as well as infant temperament and maternal blues. Parity and spousal depression had no impacts. Conclusion: The prevalence and influencing factors of maternal depression changed over time. Nurses need to screen women accordingly during the perinatal period and should provide education or counseling to prevent depression and promote adjustment to parenthood.

Outcomes of Urgent Interhospital Transportation for Extracorporeal Membrane Oxygenation Patients

  • Jun Tae, Yang;Hyoung Soo, Kim;Kun Il, Kim;Ho Hyun, Ko;Jung Hyun, Lim;Hong Kyu, Lee;Yong Joon, Ra
    • Journal of Chest Surgery
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    • 제55권6호
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    • pp.452-461
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    • 2022
  • Background: Extracorporeal membrane oxygenation (ECMO) can be used in patients with refractory cardiogenic shock or respiratory failure. In South Korea, the need for transporting ECMO patients is increasing. Nonetheless, information on urgent transportation and its outcomes is scant. Methods: In this retrospective review of 5 years of experience in ECMO transportation at a single center, the clinical outcomes of transported patients were compared with those of in-hospital patients. The effects of transportation and the relationship between insertion-departure time and survival were also analyzed. Results: There were 323 cases of in-hospital ECMO (in-hospital group) and 29 cases transferred to Hallym University Sacred Heart Hospital without adverse events (mobile group). The median transportation time was 95 minutes (interquartile range [IQR], 36.5-119.5 minutes), whereas the median transportation distance was 115 km (IQR, 15-115 km). Transportation itself was not an independent risk factor for 28-day mortality (odds ratio [OR], 0.818; IQR, 0.381-1.755; p=0.605), long-term mortality (OR, 1.099; IQR, 0.680-1.777; p=0.700), and failure of ECMO weaning (OR, 1.003; IQR, 0.467-2.152; p=0.995) or survival to discharge (OR, 0.732; IQR, 0.337-1.586; p=0.429). After adjustment for covariates, no significant difference in the ECMO insertion-departure time was found between the survival and mortality groups (p=0.435). Conclusion: The outcomes of urgent transportation, with active involvement of the ECMO center before ECMO insertion and adherence to the transport protocol, were comparable to those of in-hospital ECMO patients.

시그모이드 함수를 이용한 가스안전사업 효과의 발현시점 추정과 조정 (Estimation and Adjustment of Time Point in Manifestation of Gas Safety Project Effects using Sigmoid Functions)

  • 임현교;박건영
    • 한국안전학회지
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    • 제38권1호
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    • pp.70-77
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    • 2023
  • Gas has replaced coal or petroleum as primary fuel because of its convenience. However, gas has risk of fire, explosion, or poisoning. To reduce gas-related accidents, many strategic projects have been being carried based on 'Gas Safety Management Basic Plans' on a domestic scale. In spite of those projects, the gas-related accident rate did not decrease over past decades. Thus, this study was conducted to analyze the effectiveness of ongoing projects, and to find out ways to make improvements. Conventional statistical analyses on accident data published by gas-related institutions were not useful to determine meaningful attributes to predict future. Whereas, accident case analyses adopted in the present study discovered differences in the type of people and their unsafe acts for each gas type. Meanwhile, the overall average priority of projects was not high in the aspect of System Safety Precedence. If the current trend is maintained, with sigmoid functions, it can be estimated that mean annual accident rate will decrease by only 2.0% in the next two decades. To improve the current trend, the present study made conclusions as followings: (1) safety projects should be designed with careful consideration of accident traits including gas type, unsafe acts, and persons involved and (2) alternative strategies should include system considerations such as minimum hazard design and safety devices prior to mere education or training. To summarize briefly, the present state related with gas accidents highlights the necessity of a system-based multidisciplinary approach.

Association of periodontitis with menopause and hormone replacement therapy: a hospital cohort study using a common data model

  • Ki-Yeol Park ;Min-Ho Kim;Seong-Ho Choi;Eun-Kyoung Pang
    • Journal of Periodontal and Implant Science
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    • 제53권3호
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    • pp.184-193
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    • 2023
  • Purpose: The present study was designed to compare the incidence of periodontitis according to menopausal status and to investigate the possible effect of hormone replacement therapy (HRT) on periodontitis in postmenopausal women using a common data model (CDM) at a single institution. Methods: This study involved retrospective cohort data of 950,751 patients from a 20-year database (2001 to 2020) of Ewha Womans University Mokdong Hospital converted to the Observational Medical Outcomes Partnership CDM. One-way analysis of variance models and the χ2 test were used to analyze the statistical differences in patient characteristics among groups. A time-dependent Cox regression analysis was used to calculate hazard ratios and 95% confidence intervals, and P values less than 0.05 were considered to indicate statistical significance. Results: Of the 29,729 patients, 1,307 patients were diagnosed with periodontitis and 28,422 patients were not. Periodontitis was significantly more common among postmenopausal patients regardless of HRT status than among the non-menopausal group (P<0.05). Time-dependent Cox regression analysis showed that the postmenopausal patients had a significantly higher chance of having periodontitis than non-menopausal patients (P<0.05), but after adjustment for age, body mass index, and smoking status, the difference between the non-menopausal and post-menopausal HRT-treated groups was insignificant (P=0.140). Conclusions: Postmenopausal women had a significantly greater risk of periodontitis than non-menopausal women. Additionally, the use of HRT in postmenopausal women could reduce the incidence of periodontitis.