• Journal of Preventive Medicine and Public Health
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• 제55권1호
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• pp.37-48
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• 2022

Objectives: Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis. Methods: PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I² statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias. Results: Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I² = 87%). Conclusions: Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• 한국엔터테인먼트산업학회논문지
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• 제14권5호
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• pp.159-170
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• 2020

유아를 평가하는 과정에서 교사의 역할이 매우 중요함에도 불구하고, 교직 입문 과정에서 초임 유아교사들은 충분한 배경지식이나 실제적 지도능력을 갖추지 못하고 있어 상당한 어려움을 겪고 있다. 본 연구에서는 협력적 실행연구를 통하여 한 초임 유아교사가 '유아관찰평가'에 대한 신념과 실제를 반성적으로 바라보고 실천적으로 개선해나갈 수 있도록 지원하고자 한다. 실행연구의 순환과정을 통해 참여교사는 유아관찰평가에 대한 자신의 신념과 접근방식을 반성적으로 들여다봄으로 스스로를 성장시키는 계기가 될 것이다. 본 연구결과를 바탕으로 초임 유아교사의 교직 입문을 지원할 수 있는 하나의 방안으로 협력적 실행 연구의 적용을 제안하고자 한다.

• 한국수학교육학회지시리즈C:초등수학교육
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• 제25권1호
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• pp.43-55
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• 2022

수학을 지도하고 배우는 방법에 관하여 교사 교육 프로그램을 통해서 교사들의 신념이 변화하는지 조사하는 것은 중요하다. 이런 의미에서 이 연구는 초등 예비교사들의 신념 변화를 알기 위해 이를 측정하는 도구를 개발하는데 목적이 있다. 수학교육 전문가들과 함께 검사 문항들을 생성하고 검토한 후, 연구자들은 이 도구의 구조 타당도를 평가하기 위해 수학과 교재연구 및 지도법 강좌를 수강한 166명의 예비교사들로부터 설문자료를 수집하였다. 검사도구 개발을 위해 평행 분석과 탐색적 요인분석을 차례로 적용하여 타당도와 신뢰도를 검토하였다. 연구 결과로 개발된 도구는 초등 예비교사의 교사 중심, 학습자 중심 교육 신념을 측정하는데 이용할 수 있다. 그리고 개발 도구를 적용해서 얻는 점수를 적절히 해석하는 방법을 제안한다.

• 한방재활의학과학회지
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• 제32권4호
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• pp.73-82
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• 2022

Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2^nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권6호
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• pp.331-341
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• 2022

This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.

• 한국지진공학회논문집
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• 제27권5호
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• pp.203-211
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• 2023

For fast-built and safe precast concrete (PC) construction, the dry mechanical splicing method is a critical technique that enables a self-sustaining system (SSS) during construction with no temporary support and minimizes onsite jobs. However, due to limited experimental evidence, traditional wet splicing methods are still dominantly adopted in the domestic precast industry. For PC beam-column connections, the current design code requires achieving emulative connection performances and corresponding structural integrity to be comparable with typical reinforced concrete (RC) systems with monolithic connections. To this end, this study conducted the standard material tests on mechanical splices to check their satisfactory performance as the Type 2 mechanical splice specified in the ACI 318 code. Two PC beam-column connection specimens with dry mechanical splices and an RC control specimen as the special moment frame were subsequently fabricated and tested under lateral reversed cyclic loadings. Test results showed that the seismic performances of all the PC specimens were fully comparable to the RC specimen in terms of strength, stiffness, energy dissipation, drift capacity, and failure mode, and their hysteresis responses showed a mitigated pinching effect compared to the control RC specimen. The seismic performances of the PC and RC specimens were evaluated quantitatively based on the ACI 374 report, and it appeared that all the test specimens fully satisfied the seismic performance criteria as a code-compliant special moment frame system.

• 한양메디칼리뷰
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• 제33권1호
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• pp.10-16
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• 2013

Follicular helper T cells (Tfh) play a significant role in providing T cell help to B cells during the germinal center reaction, where somatic hypermutation, affinity maturation, isotype class switching, and the differentiation of memory B cells and long-lived plasma cells occur. Antigen-specific T cells with IL-6 and IL-21 upregulate CXCR5, which is required for the migration of T cells into B cell follicles, where these T cells mature into Tfh. The surface markers including PD-1, ICOS, and CD40L play a significant role in providing T cell help to B cells. The upregulation of transcription factor Bcl-6 induces the expression of CXCR5, which is an important factor for Tfh differentiation, by inhibiting the expression of other lineage-specific transcription factors such as T-bet, GATA3, and RORγt. Surprisingly, recent evidence suggests that CD4 T cells already committed to Th1, Th2, and Th17 cells obtain flexibility in their differentiation programs by downregulating T-bet, GATA3, and RORγt, upregulating Bcl-6 and thus convert into Tfh. Limiting the numbers of Tfh within germinal centers is important in the regulation of the autoantibody production that is central to autoimmune diseases. Recently, it was revealed that the germinal center reaction and the size of the Tfh population are also regulated by thymus-derived follicular regulatory T cells (Tfr) expressing CXCR5 and Foxp3. Dysregulation of Tfh appears to be a pathogenic cause of autoimmune disease suggesting that tight regulation of Tfh and germinal center reaction by Tfr is essential for maintaining immune tolerance. Therefore, the balance between Tfh and Tfr appears to be a critical peripheral tolerance mechanism that can inhibit autoimmune disorders.

• 임상간호연구
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• 제29권1호
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• pp.95-106
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• 2023

Purpose: This study is descriptive survey research on the analysis of nurses' perception of the 4th industrial revolution and the importance and performance of future core nursing competencies in a tertiary hospital located in Seoul. Methods: Data were collected from 149 nurses with more than a year of work experience and analyzed using descriptive statistics, t-test, one-way ANOVA, and Importance Performance Analysis(IPA) with the IBM SPSS/WIN 25.0 program. Results: The nurses' perception of the 4th industrial revolution was 3.23±0.71 out of 5 points. The importance of future core nursing competencies was 4.31±0.48, and the performance of it was 3.47±0.54. The analysis results of IPA showed that A (area of continuous maintenance) included critical thinking, problem-solving skills, teamwork and collaboration, evidence-based practice, communication, quality improvement and safety, professionalism, self-regulation and self-management, and personal literacy. The specific competencies were not included in B (area of priority improvement). Creativity, informatics, healthcare policy, leadership, research ability, and continuing education were included in C (area of progressive improvement). Knowledge and patient-centered care, ability to manage resources as well as professional, legal, and ethical responsibility were included in D (area of overinvestment). Conclusion: The nurses seemed not to be fully prepared for the 4th industrial revolution. However, they were well aware of the importance of the future core nursing competencies. Therefore, if nurses increase the performance of core competencies in order of priority according to the IPA results, they will be able to independently lead the changing nursing field.

• 대한청각학회지
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• 제23권1호
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• pp.1-7
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• 2019

Self-reported difficulties in speech-in-noise (SiN) recognition are common among tinnitus patients. Whereas hearing impairment that usually co-occurs with tinnitus can explain such difficulties, recent studies suggest that tinnitus patients with normal hearing sensitivity still show decreased SiN understanding, indicating that SiN difficulties cannot be solely attributed to changes in hearing sensitivity. In fact, cognitive control, which refers to a variety of top-down processes that human beings use to complete their daily tasks, has been shown to be critical for SiN recognition, as well as the key to understand cognitive inefficiencies caused by tinnitus. In this article, we review studies investigating the association between tinnitus and cognitive control using behavioral and brain imaging assessments, as well as those examining the effect of tinnitus on SiN recognition. In addition, three factors that can affect cognitive control in tinnitus patients, including hearing sensitivity, age, and severity of tinnitus, are discussed to elucidate the association among tinnitus, cognitive control, and SiN recognition. Although a possible central or cognitive involvement has always been postulated in the observed SiN impairments in tinnitus patients, there is as yet no direct evidence to underpin this assumption, as few studies have addressed both SiN performance and cognitive control in one tinnitus cohort. Future studies should aim at incorporating SiN tests with various subjective and objective methods that evaluate cognitive performance to better understand the relationship between SiN difficulties and cognitive control in tinnitus patients.