Social Relationships and Survival: Limits and Next Steps
토플 꼴 학술 지문 모음 2 · 에머슨 · 소로 · 다윈 · 제임스 · 듀이 · 공개 연구 논문과 보고서(발췌)
고전 교양서와 최근 연구 논문 · 보고서에서 뽑은 어려운 학술 글 80편입니다. 글마다 문장 분석과 낱말 풀이, 문항이 붙어 있습니다.
출처 Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social Relationships and Mortality Risk: A Meta-analytic Review. PLOS Medicine, 7(7), e1000316. https://doi.org/10.1371/journal.pmed.1000316 — Discussion · 라이선스 CC BY 4.0 · 원문
문장을 누르면 해석과 끊어 읽기가 아래에 열립니다. 밑줄 친 문장은 글의 뜻을 정하는 핵심 문장입니다.
Other possible limitations of this review should be acknowledged. Statistical controls (e.g., age, sex, physical condition, etc.) employed by many of the studies rule out a number of potentially confounding variables that might account for the association between social relationships and mortality. However, studies used an inconsistent variety of controlling variables, and some reports involved raw data (Table 1). Although effect size magnitude was diminished by the inclusion of statistical controls only within the data obtained by measures of structural social relationships (but not functional or combined measures), future research can better specify which variables are most likely to impact the overall association. It must also be acknowledged that existing data primarily represent research conducted in North America and Western Europe. Although we found no differences across world region, future reviews inclusive of research written in all languages (not only English) with participants better representing other world regions may yield better estimates across populations.
Approximately two decades after the review by House and colleagues, a generation of empirical research validates their initial premise: Social relationships exert an independent influence on risk for mortality comparable with well established risk factors for mortality (Figure 6). Although limited by the state of current investigations and possible omission of pertinent reports, this meta-analysis provides empirical evidence (nearly 30 times the number of studies previously reported) to support the criteria for considering insufficient social relationships a risk factor of mortality (i.e., strength and consistency of association across a wide range of studies, temporal ordering, and gradient of response). The magnitude of the association between social relationships and mortality has now been established, and this meta-analysis provides much-needed clarification regarding the social relationship factor(s) most predictive of mortality. Future research can shift to more nuanced questions aimed at (a) understanding the causal pathways by which social participation promotes health, (b) refining conceptual models, and (c) developing effective intervention and prevention models that explicitly account for social relations.
Some steps have already been taken identifying the psychological, behavioral, and physiological pathways linking social relationships to health. Social relationships are linked to better health practices and to psychological processes, such as stress and depression, that influence health outcomes in their own right; however, the influence of social relationships on health cannot be completely explained by these processes, as social relationships exert an independent effect. Reviews of such findings suggest that there are multiple biologic pathways involved (physiologic regulatory mechanisms, themselves intertwined) that in turn influence a number of disease endpoints. For instance, a number of studies indicate that social support is linked to better immune functioning – and to immune-mediated inflammatory processes. Thus interdisciplinary work and perspective will be important in future studies given the complexity of the phenomenon.
Perhaps the most important challenge posed by these findings is how to effectively utilize social relationships to reduce mortality risk. Preliminary investigations have demonstrated some risk reduction through formalized social interventions. While the evidence is mixed, it should be noted that most social support interventions evaluated in the literature thus far are based on support provided from strangers; in contrast, evidence provided in this meta-analysis is based almost entirely on naturally occurring social relationships. Moreover, our analyses suggest that received support is less predictive of mortality than social integration (Table 4). Therefore, facilitating patient use of naturally occurring social relations and community-based interventions may be more successful than providing social support through hired personnel, except in cases in which patient social relations appear to be detrimental or absent. Multifaceted community-based interventions may have a number of advantages because such interventions are socially grounded and include a broad cross-section of the public. Public policy initiatives need not be limited to those deemed “high risk” or those who have already developed a health condition but could potentially include low- and moderate-risk individuals earlier in the risk trajectory. Overall, given the significant increase in rate of survival (not to mention quality of life factors), the results of this meta-analysis are sufficiently compelling to promote further research aimed at designing and evaluating interventions that explicitly account for social relationship factors across levels of health care (prevention, evaluation, treatment compliance, rehabilitation, etc.).
이 장의 낱말
- association 관련 association between A and B: A 와 B 사이의 관련.
- exert (영향을) 미치다 exert an influence on N: ~에 영향을 미치다.
- integration 통합 social integration: 사회적 통합(관계망에 얼마나 들어가 있는가).
- intervention 개입(치료 · 예방 조치) social interventions: 사회적 개입.
- mortality 사망, 사망률 mortality risk: 사망 위험.
- pathway 경로 pathways linking A to B: A 와 B 를 잇는 경로.
- acknowledge 인정하다 should be acknowledged: 인정해야 한다.
- approximately 약, 대략 approximately two decades: 약 20년.
- behavioral 행동의 behavioral pathways: 행동 경로.
- biologic 생물학적인 biological 과 같은 말.
- causal 인과의 causal pathways: 원인과 결과를 잇는 경로. casual(가벼운)과 구별합니다.
- clarification 설명, 분명히 함 clarify 의 명사.
- combined 결합된 combined measures: 둘을 합친 척도.
- comparable 견줄 만한 comparable with N: ~에 견줄 만한.
- compelling 설득력 있는 compel(강제하다)에서 왔지만 여기서는 '수긍하게 만드는'.
- compliance 순응, 지시대로 따름 treatment compliance: 치료 순응(처방을 잘 따름).
- conceptual 개념의 conceptual models: 개념 모형.
- confound 교란하다, 뒤섞다 confounding variables: 교란 변수(진짜 관련을 흐리는 다른 변수).
- consistency 일관성 consistency of association: 관련의 일관성.
- criterion 기준 복수 criteria. the criteria for considering A B: A 를 B 로 볼 기준.
- cross-section (여러 층을 두루 담은) 대표 집단 a broad cross-section of the public: 폭넓은 대중.
- datum 자료(data 의 단수) data 는 복수라 동사도 복수(data represent).
- deem 여기다, 분류하다 those deemed high risk: 고위험으로 여겨진 사람들.
- detrimental 해로운 detrimental to N: ~에 해로운.
- diminish 줄이다, 작아지게 하다 was diminished by: …로 줄었다.
- empirical 경험적인, 실제 자료에 바탕을 둔 empirical research: 경험 연구.
- endpoint 결과 지표, 종착점 disease endpoints: 질병의 결과(발병 · 사망 등).
- establish 확립하다 well established risk factors: 잘 확립된 위험 요인.
- evaluate 평가하다 designing and evaluating interventions: 개입을 설계하고 평가하기.
- explicitly 명시적으로 explicitly account for: 명시적으로 고려하다.
- facilitate 쉽게 하다, 돕다 facilitating patient use: 환자가 쓰도록 돕기.
- formalize 공식화하다 formalized interventions: 정해진 틀로 만든 개입.
- functional 기능적인 functional measures: 관계가 하는 기능(지지)을 잰 것.
- gradient 기울기 gradient of response: 관계가 많을수록 효과가 커지는 기울기.
- grounded 뿌리내린, 바탕을 둔 socially grounded: 사회에 뿌리내린.
- immune 면역의 immune functioning: 면역 기능.
- impact 영향을 주다 여기서는 동사. impact the association: 관련에 영향을 주다.
- inclusion 포함, 넣음 include 의 명사.
- inclusive 포함하는 inclusive of N: ~을 포함하는.
- inconsistent 일관되지 않은 in- + consistent.
- inflammatory 염증의 inflammation(염증)의 형용사.
- initiative (정책) 사업, 계획 public policy initiatives: 공공 정책 사업.
- insufficient 불충분한 in- + sufficient.
- interdisciplinary 학제 간의, 여러 학문에 걸친 inter-(사이) + discipline(학문).
- intertwine 얽히다 themselves intertwined: 그 자체가 서로 얽힌.
- limitation 한계 limit(한정하다)의 명사. limitations of this review: 이 종설의 한계.
- literature (연구) 문헌 여기서는 문학이 아니고 그 분야의 연구 논문 전체.
- magnitude 크기 effect size magnitude: 효과 크기.
- mechanism 기제, 작동 원리 physiologic regulatory mechanisms: 생리 조절 기제.
- mediate 매개하다 immune-mediated: 면역이 매개하는.
- meta (meta-analysis) 메타 분석 여러 연구 결과를 모아 다시 분석하는 방법.
- multifaceted 여러 측면의 multi-(여러) + facet(면).
- nuanced 섬세한, 미묘한 차이를 담은 more nuanced questions: 더 섬세한 물음.
- obtain 얻다 data obtained by measures: 척도로 얻은 자료.
- omission 누락, 빠뜨림 omit(빠뜨리다)의 명사.
- ordering 순서 order 의 명사 꼴.
- participation 참여 social participation: 사회 참여.
- personnel 인력, 직원 hired personnel: 고용된 인력. personal(개인의)과 구별합니다.
- pertinent 관련 있는 pertinent reports: 관련 보고.
- phenomenon 현상 복수는 phenomena.
- physiologic 생리적인 physiological 과 같은 말.
- physiological 생리적인 physiological pathways: 몸의 작동에 관한 경로.
- population 인구 집단 across populations: 여러 인구 집단에 걸쳐.
- potentially 잠재적으로, …할 수도 있게 potential(잠재적인) + -ly.
- predictive 예측하는 predictive of N: ~을 예측하는.
- preliminary 예비의, 앞선 단계의 preliminary investigations: 예비 연구.
- premise 전제 initial premise: 처음의 전제.
- primarily 주로 primary(주된) + -ly.
- promote 높이다, 촉진하다 promotes health: 건강을 높이다.
- psychological 심리적인 psychological pathways: 심리적 경로.
- refining 다듬기 refine(다듬다)의 ~ing.
- regard (regarding) ~에 관하여 regarding N: ~에 관해.
- regulatory 조절하는 regulatory mechanisms: 조절 기제.
- rehabilitation 재활 병이나 다친 뒤 기능을 되찾는 치료.
- specify 가려내다, 분명히 밝히다 specify which variables: 어떤 변수인지 가려내다.
- statistical 통계적인 statistics(통계)의 형용사. statistical controls: 통계적 통제.
- structural 구조적인 structural social relationships: 관계의 구조(크기 · 수)를 잰 것.
- sufficiently 충분히 sufficiently compelling to []: …하기에 충분히 설득력 있는.
- survival 생존 rate of survival: 생존율.
- temporal 시간의 temporal ordering: 시간 순서(원인이 결과보다 앞섬).
- trajectory 경로, 궤적 risk trajectory: 위험이 커져 가는 경로.
- utilize 활용하다 use 의 격식 낱말.
- validate 입증하다 validates their premise: 그들의 전제를 입증하다.
- variable 변수 여기서는 명사. 형용사로는 '변하기 쉬운'.
- yield 내놓다 yield better estimates: 더 나은 추정치를 내놓다.
이해 확인 18문항. 읽은 글로 푸는 문제입니다. 결과는 프라이빗 코치의 독해 실력에 기록됩니다.
이해 확인 풀기이 글은 위 출처의 공개 글을 그 라이선스에 따라 옮겼습니다. 해석 · 끊어 읽기 · 낱말 풀이와 이해 확인 문항은 따로 덧붙인 것입니다.