• 제목/요약/키워드: Integrated Care

검색결과 639건 처리시간 0.028초

Efficacy and Safety of ClearCutTM Knife H-type in Endoscopic Submucosal Dissection for Gastric Neoplasms: A Multicenter, Randomized Trial

  • Eun Jeong Gong;Hyun Lim;Sang Jin Lee;Do Hoon Kim
    • Journal of Gastric Cancer
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    • 제23권3호
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    • pp.451-461
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    • 2023
  • Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCutTM Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCutTM Knife H-type) or IT-knife (conventional IT knife) groups. Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4-47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2-137.7 minutes) in the IT-knife group (P=0.209). Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions: The newly developed hybrid device, the ClearCutTM Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.

의료시스템과학의 개념과 교육 필요성 고찰 (The Concept of Health Systems Science and Educational Needs in the Korean Context)

  • 양은배;이단비;이종태
    • 의학교육논단
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    • 제25권3호
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    • pp.192-197
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    • 2023
  • Physicians should be able to address health-related issues of patients and populations from a multidimensional perspective. Therefore, medical schools have a social responsibility to develop and implement curricula that enable trainees to acquire the competencies needed to improve all aspects of patient care and healthcare delivery. This study explored the concept of health systems science concept as the third pillar of medical education (the other two are basic science and clinical medicine) in the Korean context, as well as related educational needs. The theoretical foundation of health systems science is the biopsychosocial conceptual model, which emphasizes the biological, psychological, and social factors surrounding patients. We concluded that the three domains (core functional, foundational, linking) and 12 subcategories of health systems science proposed by the Association of American Medical Colleges could be applied to Korean medical education. Health systems science education must be emphasized to solve the various healthcare problems facing Korea today and to train physicians to provide medical services in line with society's needs. Introducing a health systems science curriculum will be challenging in the Korean medical environment, which has traditionally emphasized basic science and clinical medical education. Health systems science education should begin in the basic medical education phase, where physicians' professional identity is formed, and continue through graduate medical education. It is essential to understand related educational needs, develop curricular content, conduct faculty development programs, and provide financial resources for the development of an integrated curriculum.

청소년 임신에 대한 연구 동향 분석: 텍스트 네트워크 분석과 토픽 모델링 (A study on research trends for pregnancy in adolescence: Focusing on text network analysis and topic modeling)

  • 박승미;곽은주;박혜옥;홍정은
    • 한국간호교육학회지
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    • 제30권2호
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    • pp.149-159
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    • 2024
  • Purpose: The aim of this study was to identify core keywords and topic groups in the "adolescent pregnancy" field of research for a better understanding of research trends in the past 10 years. Methods: Topics related to adolescent pregnancy were extracted from 3,819 articles that were published in journals between January 2013 and July 2023. Abstracts were retrieved from five databases (MEDLINE, CINAHL, Embase, RISS, and KISS). Keywords were extracted from the abstracts and cleaned using semantic morphemes. Text network analysis and topic modeling were performed using NetMiner 4.3.3. Results: The most important keywords were "health," "woman," "risk," "group," "girl," "school," "service," "family," "program," and "contraception." Five topic groups were identified through topic modeling. Through the topic modeling analysis, five themes were derived: "health service," "community program for school girls," "risks for adult women," "relationship risks," and "sexual contraceptive knowledge." Conclusion: This study utilized text network analysis and topic modeling to analyze keywords from abstracts of research conducted over the past decade on adolescent pregnancy. Given that adolescent pregnancy leads to physical, mental, social, and economic issues, it is imperative to provide integrated intervention programs, including prenatal/postnatal care, psychological services, proper contraception methods, and sex education, through school and community partnerships, as well as related research studies. Nurses can play a vital role by actively engaging in prevention efforts and directly supporting and educating socially disadvantaged adolescent mothers, which could significantly contribute to improving their quality of life.

랜덤 포레스트 모델을 활용한 국내 청소년 성경험 영향요인 분석 연구: 2019~2021년 청소년건강행태조사 데이터 (Factors Influencing Sexual Experiences in Adolescents Using a Random Forest Model: Secondary Data Analysis of the 2019~2021 Korea Youth Risk Behavior Web-based Survey Data)

  • 양윤석;권주원;양영란
    • 대한간호학회지
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    • 제54권2호
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    • pp.193-210
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    • 2024
  • Purpose: The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance." Methods: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ2 tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix. Results: The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol. Conclusion: Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.

Exploring preventive factors against insufficient antibody positivity rate for foot-and-mouth disease in pig farms in South Korea: a preliminary ecological study

  • Dongwoon Han;Byeongwoo Ahn;Kyung-Duk Min
    • Journal of Veterinary Science
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    • 제25권1호
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    • pp.13.1-13.9
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    • 2024
  • Background: Foot-and-mouth disease (FMD) is a highly contagious viral disease in livestock that has tremendous economic impact nationally. After multiple FMD outbreaks, the South Korean government implemented a vaccination policy for efficient disease control. However, during active surveillance by quarantine authorities, pig farms have reported an insufficient antibody positivity rate to FMD. Objective: In this study, the spatial and temporal trends of insufficiency among pig farms were analyzed, and the effect of the number of government veterinary officers was explored as a potential preventive factor. Methods: Various data were acquired, including national-level surveillance data for antibody insufficiency from the Korea Animal Health Integrated System, the number of veterinary officers, and the number of local pig farms. Temporal and geographical descriptive analyses were conducted to overview spatial and temporal trends. Additionally, logistic regression models were employed to investigate the association between the number of officers per pig farm with antibody insufficiency. Spatial cluster analysis was conducted to detect spatial clusters. Results: The results showed that the incidence of insufficiency tended to decrease in recent years (odds ratio [OR], 0.803; 95% confidence interval [95% CIs], 0.721-0.893), and regions with a higher density of governmental veterinary officers (OR, 0.942; 95% CIs, 0.918-0.965) were associated with a lower incidence. Conclusions: This study implies that previously conducted national interventions would be effective, and the quality of government-provided veterinary care could play an important role in addressing the insufficient positivity rate of antibodies.

산림재난 대응 플랫폼 설계를 위한 기초연구 (A Study for Designing a Forest Disaster Response Platform)

  • 전계원;장창덕;강배동
    • 한국방재안전학회논문집
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    • 제17권1호
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    • pp.17-25
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    • 2024
  • 최근 기후 변화로 인한 산림재난(산불, 산사태) 발생 확률이 상승하고 있으나, 산림재난 대응을 위한 정보 제공 시스템은 통합된 접근을 제공하지 못하고 있다. 따라서 본 연구에서는 신속한 대응을 위해 필수적인 재난정보를 일원화된 시스템으로 제공하고자 기초적인 설계안을 제시하고자 하였다. 이를 위해 산림재난 플랫폼 설계를 위한 필수 구성요소를 조사하고, 사례검토를 통해 신속한 대응과 정보 제공이 가능한 플랫폼 가시화 방법 및 자료구축 방법 등을 연구하고 결과를 제시하였다. 이에 국내외 산림재난 대응 플랫폼은 공간 정보를 활용하여 대상지역의 위치별 정보를 제공하는 것으로 확인되었으며, 산림재난 대응 플랫폼을 설계하기 위한 구성요소로는 대상지역에 대한 기후정보를 포함한 산림재난 빅데이터 구축, 재난 단계별 산림재난 통합진단 요소 기술, 그리고 재난지역 맞춤형 안전 케어 서비스 설계가 필요하다는 결론을 도출하였다.

Exploring dietitians' views on digital nutrition educational tools in Malaysia: a qualitative study

  • Zahara Abdul Manaf;Mohd Hafiz Mohd Rosli;Norhayati Mohd Noor;Nor Aini Jamil;Fatin Hanani Mazri;Suzana Shahar
    • Nutrition Research and Practice
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    • 제18권2호
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    • pp.294-307
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    • 2024
  • BACKGROUND/OBJECTIVES: Dietitians frequently use nutrition education tools to facilitate dietary counselling sessions. Nevertheless, these tools may require adaptation to keep pace with technological advancements. This study had a 2-fold purpose: first, to identify the types of nutrition education tools currently in use, identify their limitations, and explore dietitians' perspectives on the importance of these tools; second, to investigate the features that dietitians prefer in digital nutrition education tools. SUBJECTS/METHODS: A semi-structured face-to-face interview was conducted among 15 dietitians from selected public hospitals, primary care clinics, and teaching hospitals in Malaysia. Inductive thematic analysis of the responses was conducted using NVivo version 12 software. RESULTS: Most dietitians used physical education tools including the healthy plate model, pamphlets, food models, and flip charts. These tools were perceived as important as they facilitate the nutrition assessment process, deliver nutrition intervention, and are time efficient. However, dietitians described the current educational tools as impersonal, outdated, limited in availability due to financial constraints, unhandy, and difficult to visualise. Alternatively, they strongly favoured digital education tools that provided instant feedback, utilised an automated system, included a local food database, were user-friendly, developed by experts in the field, and seamlessly integrated into the healthcare system. CONCLUSION: Presently, although dietitians have a preference for digital educational tools, they heavily rely on physical nutrition education tools due to their availability despite the perception that these tools are outdated, impersonal, and inconvenient. Transitioning to digital dietary education tools could potentially address these issues.

민담 <내 복에 산다>의 분석심리학적 해석 (A Psychological Interpretation of a Korean Fairy Tale "I live on my Fortune" - From the Perspective of Analytical Psychology -)

  • 박영선
    • 심성연구
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    • 제25권2호
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    • pp.163-193
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    • 2010
  • 한국민담 <내 복에 산다>를 분석심리학적 관점에서 고찰하고 해석하였다. <내 복에 산다>는 한국에서 광범위하게 채집되는 민담으로서 삼공본풀이, 무왕설화 등 여러 이야기에서 공통된 주제들이 발견된다. 누구 복에 사는가 묻는 아버지의 질문에 내 복에 산다고 대답한 셋째 딸은 쫓겨나 숯구이 총각과 결혼하게 되고 산중에서 금을 발견하여 부자가 된 후 아버지를 다시 만나 잘 모시게 된다. 분석심리학에서는 민담을 무의식의 원형적 작용이 상징적으로 표현된 것으로서 이해한다. 따라서 일방적인 집단의식을 보상하여 전체성을 이루려는 목적을 향해 이야기가 진행된다. 본 민담은 부성의 지배에서 벗어나, 세속적인 기준으로 볼 때 열등한 것과 결합하는 고통의 체험과 무의식적 세계에 대한 헌신을 통해 전 인격적 실현을 이뤄가는 한 여성의 자기실현의 이야기인 동시에 경직된 집단의식이 무의식의 작용으로 변화되고 통합되는 과정을 보여주는 이야기로 해석될 수 있다.

보호관찰 중인 정신장애자의 심리상담 경험에 관한 연구 (A Study on the Psychological Counseling Experience of Mental Impaired Persons Under Probation)

  • 홍미연;유주숙
    • 보건의료생명과학 논문지
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    • 제10권1호
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    • pp.137-149
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    • 2022
  • 본 연구의 목적은 정신질환자 관리방안인 보호관찰을 받는 대상자의 심리상담 경험을 이해하기 위한 것이다. 이러한 목적을 달성하기 위하여 4명의 심리상담을 받는 대상자들의 심층 인터뷰와 상담 기록지를 중심으로 자료를 수집하였으며, 수집된 자료를 사례연구 방법으로 분석하였다. 분석된 결과는 연구참여자들의 경험을 통합한 주제분석 결과로 제시하였다. 통합 분석 결과 보호관찰 대상자들의 심리상담 경험과 관련하여 17개의 하위범주와 5개의 주제가 도출되었다. 5개의 주제는 '겉도는 삶', '세상 사람들의 눈이 두려움', '혼자서 감당하기 버거움', '기대고 싶은 의지처', '절망에서 희망으로'다. 이러한 연구 결과를 바탕으로 보호관찰 대상자들의 재범을 예방하고 관리할 수 있도록 실천 방안을 제시하였다.

Common Mental Disorders and Associated Factors During Pregnancy and the Postpartum Period in Indonesia: An Analysis of Data From the 2018 Basic Health Research

  • Arum Ariasih;Besral;Meiwita Budiharsana;Sudarto Ronoatmodjo
    • Journal of Preventive Medicine and Public Health
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    • 제57권4호
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    • pp.388-398
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    • 2024
  • Objectives: A substantial proportion of women experience mental health challenges during pregnancy or the postpartum period. Common mental disorders (CMDs), including depression, anxiety, and obsessive-compulsive disorder, are prevalent. Identifying causes and associated risk factors is imperative for early intervention and the prevention of mental health issues. Methods: This study utilized data from the 2018 Basic Health Research, which was conducted nationwide in Indonesia, using a cross-sectional approach. We focused on women aged 13-49 years who were currently or previously married, and had experienced pregnancy, including 8889 pregnant women and 77 012 women who had delivered between January 1, 2013 and August 31, 2018. The Self-Reporting Questionnaire-20 was employed to assess CMDs. Multivariate logistic regression was performed. Results: The prevalence of CMDs in pregnant women was 12.6%, while postpartum mothers exhibited a prevalence of 10.1%. Poor health status displayed the strongest impact on CMDs during both pregnancy (adjusted odds ratio [aOR], 12.23; 95% confidence interval [CI], 9.01 to 16.60) and the postpartum period (aOR, 16.72; 95% CI, 14.85 to 18.82). Additional significant factors for both group include young maternal age, lack of education, unemployment, history of hypertension, and smoking status. Among pregnant women, CMDs was also associated with first-trimester pregnancy, previous pregnancy complications, and small upper arm circumference. For postpartum mothers, significant factors include living in rural areas, history of abortion, unwanted pregnancy, pregnancy complications, lack of antenatal care, spontaneous delivery, postpartum complications and contraceptive use. Conclusions: CMDs can impact in pregnant and postpartum women. Early diagnosis and management must be seamlessly integrated into primary healthcare practices.