• Title/Summary/Keyword: Medical Narrative

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The Design of Convergence Curriculum, the Historical Case of Medical Mission and the Research Initiative Outcome of Medicine and Theology (의학과 신학의 융합 교육과정 개발, 의료선교의 역사적 사례, 연구개발 성과에 관한 연구)

  • Son, Moon
    • Journal of Christian Education in Korea
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    • v.65
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    • pp.133-161
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    • 2021
  • This study focuses on the vulnerability of our society and environment under the Covid-19 pandemic. The medical descriptions about severe acute respiratory syndrome coronavirus disease 2019 provide the serious manifestation of the SARS-CoV-2 virus and a new resilient hope of its vaccination. Moreover, with the perspective of feminist practical theology, the author explores a resilient possibility to reconstitute an ecological relationship between our society and environment. In addition, many people's depression in the time of Covid-19 is understood in the meaningful narrative of the relationship between integrity and despair to be stressed by Erikson in the perspective of Loder. Especially, this study focuses on the main stream of designing the convergence curriculum of medicine and theology to move toward the life wellbeing of community members, overcoming their difficult circumstances such as Covid-19.

Hepatic encephalopathy on magnetic resonance imaging and its uncertain differential diagnoses: a narrative review

  • Chun Geun Lim;Myong Hun Hahm;Hui Joong Lee
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.136-145
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    • 2023
  • Hepatic encephalopathy (HE) is a severe neuropsychiatric abnormality in patients with either acute or chronic liver failure. Typical brain magnetic resonance imaging findings of HE are bilateral basal ganglia high signal intensities due to manganese deposition in chronic liver disease and hyperintensity in T2, fluid-attenuated inversion recovery, or diffusion-weighted imaging (DWI) with hemispheric white matter changes including the corticospinal tract. Low values on apparent diffusion coefficient mapping of the affected area on DWI, indicating cytotoxic edema, can be observed in acute HE. However, neuropsychological impairment in HE ranges from mild deficits in psychomotor abilities affecting quality of life to stupor or coma with higher grades of hepatic dysfunction. In particular, the long-lasting compensatory mechanisms for the altered metabolism in chronic liver disease make HE imaging results variable. Therefore, the clinical relevance of imaging findings is uncertain and differentiating HE from other metabolic diseases can be difficult. The recent introduction of concepts such as "acute-on-chronic liver failure (ACLF)," a new clinical entity, has led to a change in the clinical view of HE. Accordingly, there is a need to establish a corresponding concept in the field of neuroimaging diagnosis. Herein, we review HE from a historical and etiological perspective to increase understanding of brain imaging and help establish an imaging approach for advanced new concepts such as ACLF. The purpose of this manuscript is to provide an understanding of HE by reviewing neuroimaging findings based on pathological and clinical concepts of HE, thereby assisting in neuroimaging interpretation.

Generating Radiology Reports via Multi-feature Optimization Transformer

  • Rui Wang;Rong Hua
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.17 no.10
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    • pp.2768-2787
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    • 2023
  • As an important research direction of the application of computer science in the medical field, the automatic generation technology of radiology report has attracted wide attention in the academic community. Because the proportion of normal regions in radiology images is much larger than that of abnormal regions, words describing diseases are often masked by other words, resulting in significant feature loss during the calculation process, which affects the quality of generated reports. In addition, the huge difference between visual features and semantic features causes traditional multi-modal fusion method to fail to generate long narrative structures consisting of multiple sentences, which are required for medical reports. To address these challenges, we propose a multi-feature optimization Transformer (MFOT) for generating radiology reports. In detail, a multi-dimensional mapping attention (MDMA) module is designed to encode the visual grid features from different dimensions to reduce the loss of primary features in the encoding process; a feature pre-fusion (FP) module is constructed to enhance the interaction ability between multi-modal features, so as to generate a reasonably structured radiology report; a detail enhanced attention (DEA) module is proposed to enhance the extraction and utilization of key features and reduce the loss of key features. In conclusion, we evaluate the performance of our proposed model against prevailing mainstream models by utilizing widely-recognized radiology report datasets, namely IU X-Ray and MIMIC-CXR. The experimental outcomes demonstrate that our model achieves SOTA performance on both datasets, compared with the base model, the average improvement of six key indicators is 19.9% and 18.0% respectively. These findings substantiate the efficacy of our model in the domain of automated radiology report generation.

Expanding the Supply of Home Health Nurses : Post-Master's Program and Certification Examination (가정전문간호사 공급 확대를 위한 방안: 석사후과정과 자격시험)

  • Baek, Heechong;Lee, Kayoung;Song, Chong Rye
    • Journal of Home Health Care Nursing
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    • v.31 no.1
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    • pp.5-15
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    • 2024
  • Purpose: The study aim was to examine the home healthcare system and relevant education, as well as the special certification examination, and propose a plan to increase the supply of home health nurses. Methods: A narrative literature review was conducted using data from research articles, Korean and U.S. educational institutes and organizations, Korean national statistical data, government press releases, and related medical legislation. Results: Between 2005 and 2006, 763 home health nurses were certified through the special qualification examination; however, in the 16 years from 2007 to 2023 (after the graduate-level program was established), a total of 555 home health nurses were certified, with an average of approximately 35 per year. Currently, 790 home health nurses are working at 194 medical institutions nationwide. Relatively few institutions exist in rural areas, and the supply of home health nurses is low. Only seven educational institutions offer home health nurse certification programs, with a total of 77 designated students. In contrast to Korea, post-master's certification courses are offered in the U.S.. Conclusion: To expand the supply of home health nurses, we recommend revising the rules for the special qualification examination and introducing a post-master's certification program for home health nurses. Future studies should provide additional education for applicants from other specialties in post-master's certification programs.

Analysis of Serious Game Elements of the Contents for Smart Device Based First-Aid Education (스마트 기기 기반 응급 처치 교육 콘텐츠의 기능성 게임 요소 분석 연구)

  • Suh, Dong-hee
    • Cartoon and Animation Studies
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    • s.47
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    • pp.273-294
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    • 2017
  • Korea has suffered numerous casualties due to a lot of accidents caused by safety insufficiency in recent years. Therefore, safety education is more important than ever before, and 'how to educate with what contents' is an important subject. Especially, experience education is effective rather than theoretical education because of the nature of safety education. However, it is not easy to design and develop these safety education programs. There is not much opportunity to access first-aid training, which is a part of safety education, unless it is compulsory to learn through public institutions. As a result, program utilization on safety education in Korea is still insufficient to what it should be. With that taken into account, this study proposed an effective serious game with fun and immersion for medical first-aid education. To do this, we analyzed five medical games through 20 cases of first-aid applications and elicited five factors that enhance the usability of serious games. With an analysis of five medical games, we selected one game to borrow the game rules, and applied the elicited five elements in the forms of level-up structure, iterative learning, compensation outcomes, competition system, and information transfer. The proposed medical education functional games should have 1) a character that plays a role of a patient, 2) a narrative flow that shows the situation, 3) the user should judge the situation and induce first aid. 4) compensation, levels, and simple repetition should be designed, and 5) information should be shared with the others in the given community. The results of this study is believed to contribute to enhance the medical emergency education in Korea.

Narrative Review of Clinical Trial on Scolopendrid Pharmacopuncture in Korean Literature (국내 데이터 베이스 검색을 통한 오공 약침 시술에 대한 임상 논문고찰)

  • Jo, Dong-Chan;Lee, Jin-Hyun;Kim, Chang-Gon;Jung, Woo-Seok;Moon, Su-Jeong;Park, Tae-Yong;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.73-82
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    • 2013
  • Objectives The purpose of this review is to investigate studies of Scolopendrid pharmacopuncture and the evidence of it's effects in order to suggest a better research method in the future. Methods We retrieved numbers of clinical studies about Scolopendrid pharmacopuncture from 7 Korean web databases, using key words such as 'Scolopendrid', 'Scolopendrid AND Pharmacopuncture'. This study had been conducted from 1st May 2013 to 31th July 2013. Controlled studies and case studies were only used for this study. Clinical studies that we picked from the databases were classified according to the diseases that those studies are about, and from these clinical studies, we are to research what has to be improved generally in clinical researches. Results 18 case studies, 4 controlled studies had been under research. Scolopendrid pharmacopuncture has a therapeutic effect mainly in musculoskeletal and neurological diseases such as herniated intervertebral disc, carpal tunnel syndrome, swollen leg, feeling of cold on legs, wrist ganglion, lateral epicondylitis, radial nerve palsy, cervical myelopathy, cauda equina syndrome, postauricular pain; as an early symptom of Bell's palsy, pain of popliteal part, gout, plantar fasciitis, cellulitis, frozen shoulder, pain of hip adductors. However objectivity and reliability of the Scolopendrid pharmacopuncture studies still remains controversial. Conclusions It has been suggested that there are positive effects of Scolopendrid pharmacopuncture therapy in treating specific diseases (especially neuromusculoskeletal diseases). However, this narrative review can't conclude and prove that the Scolopendrid pharmacopuncture has positive effectiveness on these diseases unlike systematic review. So, in order to put Scolopendrid pharmacopuncture therapy to use for many kinds of diseases in more reasonable ways, it is essential to build well-designed clinical research tools. In the future, abundant case studies, more follow-up trials and randomized controlled trials based on the korean medicine should be done to use Scolopendrid pharmacopuncture for a clinical purpose.

A Biographical Study of Social Exclusion Experiences - Focused on the Physical and Cerebral Palsy Disabled - (장애인의 사회적 배제 경험에 대한 생애사 연구 -지체와 뇌병변 장애인 중심으로-)

  • Shin, Yu-Ri
    • Korean Journal of Social Welfare
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    • v.64 no.2
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    • pp.299-323
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    • 2012
  • The purpose of this study is to understand social exclusion experiences with the disabled through a biographical study. It is analysed the interview date conducting an interview about 10 focused on the physical and cerebral palsy disabled with social exclusion experiences. The results show that it is multi-social exclusion including the inequality of approach opportunity of education, labor, education, medical, social participation, information, social service, space, health etc. It shows their life neglected and marginalized resulted from not providing social right as citizenship. And their social relationship is isolated by social exclusion and Other-directed identity is to be shaped in accordance to the method to define as regulated social ideals. Also, there is their painful and heavy life bound with double risky factors of disability and poverty. They share common historical experiences and social events impacted on their recognition and value among participants generation in biographical narrative. On the other hand, their life is reconstructed according to each their resource and standard to interpreter and evaluate on it. It suggests political and clinical implications in order to overcome the disabled's social exclusion, which is based on practical and vivid experiential dates from the participants.

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Visualization of unstructured personal narratives of perterm birth using text network analysis (텍스트 네트워크 분석을 이용한 조산 경험 이야기의 시각화)

  • Kim, Jeung-Im
    • Women's Health Nursing
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    • v.26 no.3
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    • pp.205-212
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    • 2020
  • Purpose: This study aimed to identify the components of preterm birth (PTB) through women's personal narratives and to visualize clinical symptom expressions (CSEs). Methods: The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). Results: The participants' mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical condition, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. "Stress" was ranked first in terms of frequency and "uterine contraction" had individual attributes. Conclusion: The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included for developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women's health nursing practicum.

The Meanings of Hands among Clinical Nurses in a Tertiary Hospital (간호사가 생각하는 손의 의미)

  • Yoo, Hye Jin;Suh, Eunyoung E.;Shin, Yeon Hee;Choi, Jung Sun;Park, Kwang Hee;Kim, Jung Yoon;Kim, Hyunsun;Kang, Jiyoung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.3
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    • pp.50-60
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    • 2019
  • Purpose : The purpose of this study was to explore and describe the meanings of hands among clinical nurses. Methods : A descriptive qualitative study design was used. Participants were 1,048 nurses working in a tertiary hospital in G city. From April to May 2018, an open-ended survey on how nurses felt about their hands and what their hands meant to them was conducted. The collected data were analyzed using MAXQDA 2018 version as well as content analysis. Results : A total of 1,048 pieces of data were analyzed, and 2,094 units of analysis were categorized based on their attributes, resulting in physical, emotional, and social domains. The data in the social domain were reported in a narrative format; thus, they were analyzed using content analysis. Three themes and eight sub-themes were elicited. The three themes included "meaning as an instrument," "meaning of infection control," and "meaning of caring." Conclusion : Nurses imbue essential meanings of caring on their hands even though they face negative skin symptoms. Furthermore, nurses understand the importance of hand hygiene on infection control. The findings of this study provide an in-depth look into nurses' perceptions of their hands.

Analysis of Bystander Cardiopulmonary Resuscitation and Public Access Defibrillation Utilization -Convergence Study based on the Data of Daegu - (목격자에 의해 시행된 심폐소생술 및 자동심장충격기 시행률 분석 -대구광역시 자료기반 법률 및 지침 고찰을 통한 융합연구-)

  • Park, Si-Eun
    • Journal of the Korea Convergence Society
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    • v.13 no.3
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    • pp.265-274
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    • 2022
  • This study was conducted on 3,418 cases of cardiopulmonary arrest patients' detailed status table (2020, raw data) collected in 2020. Also, it is a retrospective narrative research that investigates and examines related laws and guidelines. The main findings are as follows. First, the implementation rate of 'bystander CPR' was 30.66% (1047 cases) and it was a remarkable result. It can be inferred the quality of the relevant laws and guidelines. Second, 'Public access defibrillation (shock)' accounted for only 0.10%(5 cases). it is considered that the relevant laws and guidelines are weighted towards 'stock and obligation.' Strategic differentiation of response by region is needed. Third, out-of-hospital cardiac arrest occurred at house was 71.97%(2,640 cases). To operate the 'special ambulance team' efficiently, it is necessary to analyze regional data more closely and develop an efficient strategy in the future.