• 제목/요약/키워드: Integrative Review

검색결과 369건 처리시간 0.024초

텍스트네트워크 분석을 활용한 국내 의사 직무역량 연구동향 분석 (Research Trends on Doctor's Job Competencies in Korea Using Text Network Analysis)

  • 김영전;이제욱;윤소정
    • 의학교육논단
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    • 제24권2호
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    • pp.93-102
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    • 2022
  • We use the concept of the "doctor's role" as a guideline for developing medical education programs for medical students, residents, and doctors. Therefore, we should regularly reflect on the times and social needs to develop a clear sense of that role. The objective of the present study was to understand the knowledge structure related to doctor's job competencies in Korea. We analyzed research trends related to doctor's job competencies in Korea Citation Index journals using text network analysis through an integrative approach focusing on identifying social issues. We finally selected 1,354 research papers related to doctor's job competencies from 2011 to 2020, and we analyzed 2,627 words through data pre-processing with the NetMiner ver. 4.2 program (Cyram Inc., Seongnam, Korea). We conducted keyword centrality analysis, topic modeling, frequency analysis, and linear regression analysis using NetMiner ver. 4.2 (Cyram Inc.) and IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA). As a result of the study, words such as "family," "revision," and "rejection" appeared frequently. In topic modeling, we extracted five potential topics: "topic 1: Life and death in medical situations," "topic 2: Medical practice under the Medical Act," "topic 3: Medical malpractice and litigation," "topic 4: Medical professionalism," and "topic 5: Competency development education for medical students." Although there were no statistically significant changes in the research trends for each topic over time, it is nonetheless known that social changes could affect the demand for doctor's job competencies.

두드러기의 한의치료 임상-국내 증례연구 분석 (Korean Medicine Treatment for Urticaria -Analysis of Case Studies)

  • 하재운;황윤경;윤영주
    • 대한예방한의학회지
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    • 제27권1호
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    • pp.1-16
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    • 2023
  • Objective : To investigate syndrome identification, herbal prescriptions, acupuncture point and other treatment, this study systematically reviewed case studies on Korean medicine (KM) treatment for urticaria. Method : Literature searches were performed on four Korean database; OASIS, RISS, KTKP and NDSL. Studies published before December 2022 were categorized and analyzed according to the herbal prescriptions. Results : Thirty-three studies including 16 case series and 17 single case reports were included in our review and the total number of patients was 523. Ancient prescriptions (古方) were used in 7 studies and prescriptions of Sasang constitutions were used in 8 studies and 18 studies used prescriptions of posterity (後世方). Wind-Heat (風熱) and syndrome identifications associated with digestive function were used frequently. Nineteen studies used acupuncture combined with herbal medicine and mainly used acupoints were ST36 (足三里), LI4 (合谷), LI11 (曲池), LR3 (太衝), SP6 (三陰交), CV12 (中脘), SP10 (血海). External herbal medicine was used in only 3 studies. Conclusion : To increase the cure rate of KM, various prescriptions should be used according to the symptom and stage of urticaria. Diversification of herbal formulations and the development of new external medicines are also necessary to conduct additional clinical studies with a high level of evidence.

부인과 질환에 대한 추나 요법: 체계적 문헌 고찰 및 메타분석 (Chuna Manual Therapy on Gynecologic Disease: A Systematic Review and Meta-analysis)

  • 이연우;설재욱;이진현;조동찬;송윤경;황만석
    • 척추신경추나의학회지
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    • 제17권2호
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    • pp.27-37
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    • 2022
  • Objectives This study aimed to investigate the clinical trial trends of Chuna manual therapy (CMT) on gynecologic disease and suggest the effectiveness and safety evidence for further study. Methods We searched nine electronic databases (CENTRAL, CiNii, CNKI, EMBASE, KMbase, KISS, MEDLINE PubMed, NDSL, and OASIS) using the search terms "Chuna" and "Tuina" and identified relevant literature that investigated the CMT as an intervention for gynecologic disease. All relevant papers were extracted and selected to be analyzed. Results Among the 1456 studies that were searched and screened, 18 randomized controlled trials (RCTs) satisfied the designated criteria. A meta-analysis showed that CMT had a curative effect on patients with primary dysmenorrhea, postpartum hypogalactia, breast hyperplasia, postpartum urinary retention, and pelvic pain. Conclusions Based on this study, CMT should be comprehensively considered for gynecologic disease. The treatment response was significantly enhanced after treatment; however, there were some limitations in the study. More well-designed RCTs are needed to ensure that all gynecologic patients have a safe and effective therapy.

Proportion of Non-Medical Opioid Use of Prescription Opioids among Cancer Patients in Korea

  • Se-Il, Go;Jung Hye Kwon;Sung Woo Park;Gyeong-Won Lee;Jung Hun Kang;Eduardo, Bruera
    • Journal of Hospice and Palliative Care
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    • 제26권4호
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    • pp.185-189
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    • 2023
  • Purpose: Limited research has been conducted on the prevalence of non-medical opioid use (NMOU) in Korean cancer patients who have received prescription opioids (PO). This study aimed to identify the potential proportion of NMOU in cancer patients who had been prescribed opioids in Korea. Methods: A retrospective cohort analysis was conducted on 14,728 patients who underwent cancer-related treatment between January 2009 and December 2019, using electronically collected data from a tertiary hospital in Korea. Information regarding the type and duration of opioid use was gathered. A detailed review of medical charts was carried out, focusing on patients who had been prescribed opioids for over 60 days beyond a 12-month period following the completion of their cancer treatment (long-term PO users). Results: Out of the 5,587 patients who were prescribed PO and followed up for at least 12 months, 13 cases of NMOU were identified, representing 0.23% of the patient population. Among the 204 long-term PO users, the rate was 6.37% (13/204). The most commonly misused opioids were oxycodone and fentanyl. For the group confirmed to have NMOU, the median duration of prescription was 1,327 days in total. Of the 13 patients diagnosed with NMOU, 9 reported withdrawal symptoms, 3 exhibited craving behavior for opioids, and 1 experienced both symptoms. Conclusion: This study found that 0.23% of cancer patients who had been prescribed opioids in Korea demonstrated NMOU. Despite this relatively low rate, careful monitoring is necessary to minimize the risk of NMOU in this population, especially among long-term PO users.

운동몰입의 경험과 내적동기 저하에 관한 고찰 (Integrative Literature Review of Flow Experience and Intrinsic Motivation Decrease)

  • 손정민;하민성;이민철
    • 한국응용과학기술학회지
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    • 제40권5호
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    • pp.1001-1009
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    • 2023
  • 몰입은 내적동기와 관련성이 큰 개념으로 스포츠심리학에서 스포츠 수행에 있어 긍정적인 요소로 여겨진다. 몰입과 중독의 상관관계에 대한 연구들이 선행되었지만, Flow와 Commitment의 개념이 혼동돼 사용되었다. 또한 몰입이 장기적으로 미치는 영향에 대해서는 충분한 연구가 이루어지지 않았다. 따라서 본 연구는 선행연구들을 통해 몰입의 중독성을 확인하였으며, 기존의 연구들과 다르게 장기적으로 몰입이 내적동기를 저하시킬 수 있다는 새로운 가설을 제시하고자 한다. 적응수준 이론과 한계효용체감의 법칙의 관점에서는 몰입을 통해 얻는 만족감이 지속적으로 감소하게 된다. 어느 시점에서 이러한 개인의 발전은 한계를 느끼게 되며, 몰입을 경험하지 못하는 시점에 도달하게 된다. 하지만 개인은 몰입을 다시 경험하고자 하는 욕구가 존재하므로 지속적으로 노력할 것이다. 그러나 몰입 경험의 실패로 이어질 때 반복적인 실패는 슬픔으로 작용하여 내적동기를 약화시키게 된다. 따라서, 본 연구를 통해서 몰입의 부정적인 요소와 장기적인 관점에서 미치는 영향에 대한 연구들이 필요하다고 사료된다.

반하백출천마탕을 사용한 국내 임상연구 분석 (Usage of Korean Herbal Medicine Banhabaekchulcheonmatang-Analysis of Korean Clinical Studies)

  • 김녹원;배민정;윤영주
    • 대한예방한의학회지
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    • 제28권1호
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    • pp.89-107
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    • 2024
  • Objectives : To investigate the clinical usage of Banhabaekchulcheonmatang (BBCT), this study reviewed clinical studies conducted in Korea. Method : Literature search was performed on four Korean database; OASIS, RISS, KTKP and NDSL. Studies published before July 2023 were categorized and analyzed according to the target disease. Results : Fifty-four studies including 36 single case reports and 18 case series were included in this review and the total number of case patients was 79. There were 24 patients with peripheral vertigo such as benign paraoxysmal positional vertigo and Meniere's disease, 17 with central vertigo such as cerebellar infarction, 15 with vertigo accompanied by digestive symptoms, 13 with headache, and 10 with other diseases. Vertigo treatment accounted for more than 70% of the total case and there was no cases of hypertension and dementia. The BBCT formulation used was decoction in 69 patients (87.3%), powder in 7 patients (8.9%), and combination of decoction and powder in 3 patients (3.8%). Conclusion : Clinical research should be accumulated to expand the use of BBCT in the treatment of hypertension and dementia. In order to increase the use of insurance-covered extract preparation, it is necessary to make an effort to include the various diseases actually treated with BBCT in the indications.

요추 추간판 탈출증 환자의 의·한의 협진 의료이용 현황 분석: 건강보험심사평가원 환자표본 데이터를 이용하여 (Analysis of Lumbar Herniated Intervertebral Disc Patients' Healthcare Utilization of Western-Korean Collaborative Treatment: Using Health Insurance Review & Assessment Service's Patients Sample Data)

  • 고준혁;유지웅;서상우;서준원;강준혁;김태오;조휘성;서연호;안종현;이우주;김보형;최만규;김승범;김형석;김고운;조재흥;송미연;정원석
    • 한방재활의학과학회지
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    • 제31권4호
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    • pp.105-116
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    • 2021
  • Objectives Lumbar herniated intervertebral disc (L-HIVD) is common disease in which Western-Korean collaborative treatment is performed in Korea. This study aimed to analyze Western-Korean collaborative treatment utilization of Korean patients with L-HIVD using Health Insurance Review & Assessment Service's Patients Sample Data. Methods This study used the Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) in 2018. Claim data of L-HIVD patients were extracted. The claim data were rebuilt with the operational concept of 'episode of care' and divided into Korean medicine episode group (KM), Western medicine episode group (WM) and collaborative treatment episode group (CT). General characteristics, medical expenses and healthcare utilization were analyzed. In addition, the difference of average visit day and average medical expenses between non-collaborative group (KM plus WM) and CT were analyzed by the propensity score matching method. Results A Total of 64,333 patients and 365,745 claims were extracted. The number of episodes of WM, KM and CT was 69,383 (92.97%), 3,903 (5.23%), and 1,341 (1.80%) respectively. The frequency of collaborative treatment episode was higher in women and the age of 50s. The most frequently described treatment in CT was acupuncture therapy. As a result of the propensity score matching, the number of visit days and medical expenses in the collaborative treatment group was higher than in the non-collaborative group. Conclusions The analysis of healthcare utilization of Korean-Western collaborative treatment may be used as basic data for establishing medical policies and systematic collaborative treatment model in the future.

부르디외와 사진 : 사진행위에 대한 부르디외의 분석이 갖는 의의와 한계 (Bourdieu and Photography -A Critical Review of Bourdieu's Works in the Sociology of Photography-)

  • 주형일
    • 한국언론정보학보
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    • 제17권
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    • pp.145-178
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    • 2001
  • 사진과 사진행위에 대한 부르디외의 사회학적인 분석은 $\ll$중간예술$\gg$$\ll$구별짓기$\gg$를 통해 발표되었다. 여러 문화적 산물들 중 사진은 사회과학에서 소홀히 다루어져 왔기 때문에 사진에 대한 부르디외의 연구는 주목할 만한 가치가 있다. 특히 $\ll$중간예술$\gg$은 거의 모든 사진 장르들을 다루면서 사회적 계급들이 사진에 대해 적용하는 규범 체계들, 사진행위의 유형들, 여러 분야의 전문 사진사들이 자신들의 직업에 대해 가지고 있는 생각들과 그들이 참조하는 미학들을 분석하고 있고 최종적으로는 그러한 분석을 바탕으로 사진에 대한 정신분석학적 분석도 시도함으로써 사진과 사진행위에 대해 체계적이고 명료하게 인식할 수 있는 기회를 제공했다는 점에서 대단히 의미가 있는 작업이라 할 수 있다. 그러나 주요 분석 대상인 사진이 급속한 기술적 변화를 겪고 있는 매체이며 경제적이고 문화적인 요인들의 변화에 따른 위상의 변화를 보이고 있는 매체라는 점에서 부르디외의 분석은 오늘날 몇 가지 수정되어야 할 부분들을 가지게 되었다. 우선 부르디외가 강조한 사진의 사회적 기능이 무척 약화되었다. 반면에 사진의 예술적 지위는 대단히 상승했다. 이에 따라, 사진과 사진행위를 둘러싼 사회적 계급간의 관계들도 변했을 것이라 가정할 수 있다. 물론 이러한 계급간의 관계의 변화는 이후의 연구들을 통해 입증되어야 할 것이지만 적어도 오늘날, 부르디외가 연구를 진행했던 시기처럼 단호하게 사진을 중간예술이라고 규정하는 것은 무리가 있어 보인다. 따라서 부르디외의 작업을 현재의 상황에 무비판적으로 적용하기 전에 그 작업을 1960년대의 프랑스라는 사회적이고 역사적인 특수성 안에 위치시키고 사회학, 심리학, 미학, 기호학이 충돌하는 지식의 장 속에서 부르디외의 역할을 살펴봄으로써 그의 연구가 갖는 특성과 한계에 대해 명확히 인식할 필요가 있다.

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Regulation of Prolactin Secretion: Dopamine is the Prolactin-release Inhibiting Factor (PIF), but also Plays a Role as a Releasing Factor (PRF)

  • Shin, Seon H.;Song, Jin-Hyang;Ross, Gregory M.
    • Animal cells and systems
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    • 제3권2호
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    • pp.103-113
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    • 1999
  • Many in-depth reviews related to regulations of prolactin secretion are available. We will, therefore, focus on controversial aspects using personal opinion in this review. The neuroendocrine control of prolactin secretion from the anterior pituitary gland involves multiple factors including prolactin-release inhibiting factor (PIF) and prolactin releasing factor (PRF). The PIF exerts a tonic inhibitory control in the physiological conditions. The PIF should be able to effectively inhibit prolactin release or a lifetime, but the inhibitory action of dopamine cannot be sustained for a long period of time. Perifusion of a high concentration of dopamine (l ,000 nM) could not sustain inhibitory action on prolactin release but when a small amount of ascorbic acid (0.1 mM) is added in a low concentration of dopamine (3 nM) solution, prolactin release was inhibited for a long period. Ascorbate is essential for dopamine action to inhibit prolactin release. We have, therefore, concluded that the PIF is dopamine plus ascorbate. The major transduction system for dopamine to inhibit prolactin release is the adenylyl cyclase system. Dopamine decreases cyclic AMP concentration by inhibiting adenylyl cyclase, and cyclic AMP stimulates prolactin release. However, the inhibitory mechanism of dopamine on prolactin release is much more complex than simple inhibition of CAMP production. The dopamine not only inhibits cyclic AMP synthesis but also inhibits prolactin release by acting on a link(s) after the CAMP event in a chain reaction for inhibiting prolactin release. Low concentrations of dopamine stimulate prolactin release. Lactotropes are made of several different subtypes of cells and several different dopamine receptors are found in pituitary. The inhibitory and stimulatory actions induced by dopamine can be generated by different subtype of receptors. The GH$_4$ZR$_7$ cells express only the short isoform (D$_{2s}$) of the dopamine receptor, as a result of transfecting the D$_{2s}$ receptors into GH$_4$C$_1$ cells which do not express any dopamine receptors. When dopamine stimulates or inhibits prolactin release in GH$_4$ZR$_7$ cells, it is clear that the dopamine should act on dopamine D$_{2s}$ receptors since there is no other dopamine receptor in the GH$_4$ZR$_7$. Dopamine is able to stimulate prolactin release in a relatively low concentration while it inhibits in a high concentration in GH$_4$ZR$_7$. These observations indicate that the dopamine D$_2$ receptor can activate stimulatory and/or inhibitory transduction system depending upon dopamine concentrations.

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Surgical Treatment for Early Esophageal Squamous Cell Carcinoma

  • Chen, Shao-Bin;Weng, Hong-Rui;Wang, Geng;Yang, Jie-Sheng;Yang, Wei-Ping;Liu, Di-Tian;Chen, Yu-Ping;Zhang, Hao
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3825-3830
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    • 2013
  • More studies are needed to clarify treatments and prognosis of early esophageal squamous cell carcinoma (ESCC). This retrospective study was designed to review the outcome of surgical treatment for early ESCC, evaluate the results of a left thoracotomy for selected patients with early ESCC, and identify factors affecting lymph node metastases and survival. The clinicopathological data of 228 patients with early ESCC who underwent transthoracic esophagectomy with lymphadenectomy without preoperative adjuvant treatment were reviewed. The ${\chi}^2$ test or Fisher's exact test were used to detect factors related to lymph node metastasis. Univariate and multivariate analyses were performed to identify prognostic factors. There were 152 males and 76 females with a median age of 55 years. Two hundred and eight patients underwent a left thoracotomy, and the remaining 20 patients with lymph nodes in the upper mediastinum more than 5 mm in short-axis diameter by computed tomography scan underwent a right thoracotomy. No lymph node metastasis was found in the 18 patients with carcinoma in situ, while lymph node metastases were detected in 1.6% (1/62) of patients with mucosal tumours and 18.2% (27/148) of patients with submucosal tumours. Only 7 patients showed upper mediastinal lymph node metastases in the follow-up. The 5- and 10-year overall survival rates were 81.4% and 70.1%, respectively. Only histologic grade (P<0.001) and pT category (P=0.001) significantly correlated with the presence of lymph node metastases. In multivariate analysis, only histologic grade (P=0.026) and pT category (P=0.008) were independent prognostic factors. A left thoracotomy is acceptable for selected patients with early ESCC. Histologic grade and pT category affected the presence of lymph node metastases and were independent prognostic factors for early ESCC.