양극성 장애 환자에서 불안이 질병 경과에 미치는 영향 : 전향적 추적관찰에 대한 중간분석

김수정,김소정,송혜현,이원혜,전명욱,남윤영,박동연,Kim, Soojeong,Kim, So Jeong,Song, Hye Hyun,Lee, Wonhye,Chon, Myong-Wuk,Nam, Yoon Young,Park, Dong Yeon 대한생물정신의학회 2021 생물정신의학 Vol.28 No.1

Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

저작·연하 용이 소불고기 노인식 개발

김수정,주나미,Kim, Soojeong,Joo, Nami 한국식품영양학회 2014 韓國食品營養學會誌 Vol.27 No.6

This study was conducted to develop for the elderly food that is safe, well-shaped, and easy to chew and swallow, using gelification. Gelatin, which has low adhesiveness, thereby lowering the possibility of being swallowed wrongly into the respiratory track, was used as a viscosity agent for the gelification. Water and gelatin amounts were adjusted to facilitate breaking the food with the tongue. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. Sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in appearance (p<0.05), saltiness (p<0.05), sweetness (p<0.01), and overall quality (p<0.05). The optimum formulation of the Korean barbecue beef calculated by numerical and graphical method was 3.71 g of sugar and 19.53 g of soy sauce. Moisture content, hardness and adhesiveness of the Korean barbecue beef were 78.85%, 2.40, -1.87, respectively. The result shows that food for the elderly, which is easy to chew and swallow, using gelification will have sufficient competitiveness in terms of safety, taste, and preference. The development of food for the elderly that take into account the difficulties in chewing and swallowing among the elderly, reflects their preference, and has sufficient nutrients, is important to enable the elderly to enjoy their meals. Also, as the Korean society is getting older, it remains one of the biggest social challenges.

가자미 구이 저작·연하 용이 노인식 개발

김수정,주나미,Kim, Soojeong,Joo, Nami 한국식품영양학회 2015 韓國食品營養學會誌 Vol.28 No.1

This study was conducted to develop food for the elderly, which are well-shaped and easy to chew and swallow. The amounts of water and gelatin were adjusted to facilitate breaking down of the food with the tongue. In the aging society, it is necessary to support the development of a variety of products that can ease the intake functions of swallowing and chewing, while complementing with the essential nutrients supplements; such products can be actively commercialized in the elderly industry. Various types of food, for elderly with difficulties in chewing and swallowing, were used for sensory assessment. Sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in the appearance (p<0.01), saltiness (p<0.01) and overall quality (p<0.01). The optimum formulation of pan fried flat fish, calculated by numerical and graphical method, was 8.54 g of salt and 6.34 g of olive oil. Moisture content, hardness, and adhesiveness of pan fried flat fish were 84.77%, 250, and -1.20, respectively. The result showed that easily chewable and swallowable pan fried flat fish for the elderly will have sufficient competitiveness, considering its safety, taste, and preference. This study may provide the basic materials for the development of easily chewable and swallowable foods for elderly.

고추장 제육볶음 및 시금치나물 저작·연하 용이 노인식 개발

김수정,주나미,Kim, Soojeong,Joo, Nami 한국식품영양학회 2016 韓國食品營養學會誌 Vol.29 No.4

This study was conducted to develop food for the elderly, which is easier to chew and swallow, using gelification. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. The sensory panel consisted of 10 dieticians (10 women) working in nursing care facilities. The sensory optimal composite recipes were determined by the central composite design (CCD). The optimum formulation of hot pepper paste stir fried pork calculated by the numerical and graphical method was 1.48 g of sugar and 18.97 g of hot pepper paste. The optimum formulation of seasoned spinach was 8.0 g of sesame oil and 5.41 g of soy sauce. Moisture content, hardness, and adhesiveness of hot pepper paste stir fried pork was 76.49%, 2.50, and -1.20, respectively. Moisture content, hardness, and adhesiveness of seasoned spinach was 83.48%, 2.27, and -1.17, respectively. This study provides the basic materials for the development of easily chewable and swallowable foods for the elderly, which can reduce the risk of food going down the wrong pipe, and the preference can be improved by eating solid food instead of porridge or liquid food. The development of food for the elderly, which takes the difficulties in chewing and swallowing among the elderly into consideration and reflects their preference and has sufficient amount of nutrients, is important to enable the elderly to enjoy their meals and it is one of the biggest challenges in Korea, as Korean society is aging rapidly.

멸치볶음 저작·연하 용이 노인식 개발

김수정,주나미,Kim, Soojeong,Joo, Nami 한국식품영양학회 2015 韓國食品營養學會誌 Vol.28 No.2

Failure of the functions involved in ingestion leads to, not only loss of enjoyment of eating, but also protein-energy malnutrition. Dysmasesis and difficulty of swallowing occurs in various diseases, but aging is a major cause. In the aging society, the proportion of elderly people with dysmasesis and difficulty of swallowing is expected to increase rapidly. Developing foods for the elderly that are easy to chew and swallow is thus required. This study was conducted to develop easily chewable and swallowable foods for the elderly who can crush foods and ingest with their own tongues, but occasionally have difficulty in drinking fluids such as water and tea. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. The sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in saltiness (p<0.05), sweetness (p<0.05), and overall quality (p<0.05). The optimum formulation of stir fried anchovy calculated by numerical and graphical methods was 3.74 g of soy sauces and 30.17 g of oligo-saccharides. Stir fried anchovy had a moisture content, hardness and adhesiveness of 76.52%, 2.10, and -1.57, respectively.

반응표면분석법을 이용한 천년초 분말 첨가 머핀 제조 조건의 최적화

김수정,정복미,주나미,Kim, Soojeong,Jung, Bok-Mi,Joo, Nami 한국식품영양학회 2012 韓國食品營養學會誌 Vol.25 No.4

The objective of this study was to determine the optimum mixing ratio of Opuntia humifusa powder and sugar in the preparation of muffin. The optimal sensory composite recipe was determined by following the central composites for muffin with different levels of Opuntia humifusa powder (A) and sugar (B). The analysis was performed using the response surface methodology, and the sensory evaluation was performed with the data. Ten experimental recipes, including two with reference points in the composition, were selected. The compositional and functional properties were measured, and the physical and sensory values were applied to the mathematical models. Perturbation plots showed the effects of each ingredient on the final product. Measurements showed significant values in lightness (p<0.05), sweetness (p<0.05), hardness (p<0.05), gumminess (p<0.05) and cohesiveness (p<0.01). The sensory measurements showed significant values in color (p<0.05), flavor (p<0.05), appearance (p<0.05), softness (p<0.05) and overall quality (p<0.05). Based on the numerical and graphical methods, the optimal formulation was determined to be 6.10 g of Opuntia humifusa powder and 82.61 g of sugar.

독일 원격의료 합법화와 법개정 논의

김수정,Kim, SooJeong 대한의료법학회 2020 의료법학 Vol.21 No.2

원격의료가 이미 허용되어 상당히 진행된 국가도 있는 반면, 원격의료가 법률해석상 금지되는 국가들도 있다. 최근까지 한국과 독일은 모두 후자에 속하였다. 독일에서 원격의료가 금지되는 가장 주요한 근거는 독일연방의사협회가 마련한 표준의사직업규정 제7조 제4항이 "상담을 전적으로 인쇄 및 통신매체를 통해 수행해서는 안 된다. 원격의료절차에서도, 의사가 환자를 직접 진료하는 것이 보장되어야 한다."고 규정하고 있었고 각 주(州)의 의사직업규정이 이를 그대로 수용하였기 때문이다. 그렇지만 독일 내에서도 전적인 원격의료가 허용되어야 한다는 논의 및 전자의료(E-Health) 활성화를 위한 인프라와 그를 규제하는 법을 마련해야 한다는 논의가 상당히 오래 전부터 있어 왔다. 2018년 표준의사직업규정이 변경되었고 대부분의 주(州)의사협회가 의사직업규정을 개정하였으므로 이제 독일에서는 원격의료가 대부분 허용된다고 할 수 있다. 아직 우리나라는 원격의료를 허용하지는 않으나, 우리와 같은 입장이었던 독일이 어떤 준비 하에 원격의료 허용 쪽으로 선회하였는지 살펴보는 것은 우리법이 개정될 경우를 대비하여 여전히 중요한 작업이라 할 것이다. Until recently the German and the South Korean medical associations reacted cautiously to the introduction of telemedicine between doctor and patient which is exclusively on the platform conducted. But the General Assembly of German Physicians voted to lift the ban on remote treatment with the amendment to Section 7 (4) MBO-Ä(Medical Association's Professional Code of Conduct) in 2018 and the situation has been fundamentally changed in Germany. From then until now 16 of 17 rural medical associations have changed their professional code to allow telemedicine. In addition the legislature started to prepare the basis for the introduction of the electronic health card (eGK) and the telematics infrastructure. So far, various laws such as Medicinal Products Act, Drug Advertisement Act and Social Code have been changed to support legalization of telemedicine and digitalization of health care. Unlike in Germany, the social circumstances such as excessive centralization of the big hospitals in Seoul and the resulting concern of small medical practices for profitability are the main obstacles to the introduction of telemedicine. However the German approach how to legalise the telemedicine and to prepare for legal and technical infrastructure is also interesting in South Korea. The discussions for and against the changes in the law and the telematics infrastructure attempted by the German government for several years indicate that not only lifting the ban on remote treatment, but also harmonization of all the related legal system could guarantee successful implementation of telemedicine.

온라인 플랫폼의 이용후기 - 허위의 온라인 이용후기를 둘러싼 법적 쟁점 -

金水晶 ( Soojeong Kim ) 법조협회 2021 法曹 Vol.70 No.6

온라인플랫폼을 통해 재화나 서비스의 구매가 늘어나고 정보교환이 활발해지면서 온라인플랫폼상의 소비자 이용후기는, 소비자들의 구매선호도에 막대한 영향을 미치게 되었다. 즉 이용후기의 내용은 후기 대상이 된 업체의 매출에 직접적인 영향을 미친다. 또한 이용후기는 소비자들의 정보비대칭을 해소하는 수단으로 작용하며, 소비자들이 특정 플랫폼에 게시된 이용후기를 신뢰하게 될수록 그 플랫폼의 이용도가 증가할 것이므로 플랫폼 운영자 입장에서도 이용후기의 신뢰도를 확보하는 것은 매우 중요하다. 이용후기의 진실성을 확보하기 위해, 허위의 이용후기를 삭제하고 방지할 필요가 있다. 우리나라에서는 이용후기 문제가 정보통신망 이용촉진법에 관련해서 형사사건으로 다루어진 사례가 몇 건 있을 뿐이고, 민사적으로는 이 쟁점이 크게 주목받지 못하고 있으나, 온라인 이용후기가 갖는 사회적 영향력이 늘어날수록 민사적 분쟁에 대비할 필요가 있다. 허위의 이용후기 중에서도, 특히 이용후기가 부정적인 경우에는 그 이용후기의 대상인 영업의 영업주가, 이용후기가 긍정적인 경우에는 그 이용후기의 대상인 영업의 경쟁자와 소비자들이 피해를 보게 된다. 전자의 경우 피해가 구체적이므로 이용후기 대상 영업주가 이용후기를 작성한 소비자 또는 해당 플랫폼에 대해 손해배상청구나 금지청구를 제기하는 형태의 분쟁이 많다. 후자의 경우 소비자이용후기 자체가 일종의 은밀한 광고처럼 작용하게 된다는 점에서 광고 규제에 관한 법리가 적용될 여지가 많다. 그러나 긍정적 이용후기에 대해서도 영업주와 플랫폼 사이에 분쟁이 발생하는 경우가 종종 있다. 플랫폼 입장에서는 허위인 이용후기를 제거해야 플랫폼 이용후기의 신뢰도가 제고되고 이로 인해 더 많은 소비자들을 유인할 수 있기 때문에, 허위인 것으로 의심되는 이용후기를 게시하지 않거나 평점 계산에서 제외하는 경우가 있는데, 이에 대해 그 긍정적 이용후기의 대상인 영업주가 소를 제기하는 것이다. 이처럼 이용후기를 둘러싼 여러 민사법적 분쟁 유형에서 소비자와 영업주, 온라인플랫폼 제공자의 충돌하는 이해관계를 어떻게 공정하게 해결할 것인지 모색하도록 한다. The proliferation of consumer review sites unquestionably provide easily searchable information on products and services. The explosion of consumer review can be very beneficial for consumers and businesses alike. Consumers can find out what they need to know before the decide to procure the products or services, while businesses get publicity that consumers can easily find. For the success of consumer review sites the reliability of consumer reviews is decisive. Of course fake consumer reviews harm to the reliability of consumer reviews and should be prohibited. The practice of posting fake reviews appears in two ways: fake positive reviews and fake negative reviews. The former is regarded as a form of covert advertising. It tends to be regulated within the scope of competitive law. On the other hand significant litigation has arisen over false or misleading negative reviews that business owners claim to be defamatory. The business owners want legal recourse against an individual reviewer or the consumer review sites. Legal recourse for claims of defamation against an online reviewer is generally futile because reviewers post comments anonymously. Therefore plaintiffs want unmasking the identify of an anonymous reviewer which is a circular battle with state procedures that require a business to prove the statement is false. Comparative law studies show that the problem of negative reviews is focused primarily on proving the reviewer as a real consumer. In any case the importance of freedom of free speech and protection of business reputation should be balanced.

퍼블리시티권과 표현의 자유의 형량

김수정(SooJeong Kim) 한국비교사법학회 2017 비교사법 Vol.24 No.1

Although the Korean Supreme Court has not yet acknowledge the Right of Publicity, lots of cases are accrued at the level of lower courts. However even the lower courts has not yet discussed the problem of balancing the right of publicity against freedom of expression. In this respect the recent development of case law of Germany and Japan could give some useful tips for us. Traditionally the German jurisprudence considered that a picture of contemporary public figure can be published without his consent only if the commercial use of the picture serves the public interest of information. Even if this condition is fulfilled the publication of the picture should not be allowed if the use violates legitimate interest of the public figure concerned. Also an unauthorized use of the right to one s name, which is not derived from § 12 BGB but based on the constitutionally protected right of personality, constitutes a violation of this right, if the use aims only to gain the economic interest of the usurper. In these cases the personality right becomes dominant over freedom of expression, even if the picture of name of the public figure concern the public interest of information. But this opinion got changed after the Federal Constitutional Court stated that the constitutionally protected freedom of expression embraces also commercial expression and advertisement. Especially after the “Rücktritt des Finanzministers” case in 2006 the Federal Supreme Court held the opinion that the unauthorized use of the picture of former German Finance Minister in a commercial advertisement was discharged from liability if the picture was used within a satiric advertisement and it gave political expression about the current affairs concerned. This decision caused dispute because the criterion suggested by the Federal Court could lead to the result that advertisers put a satirical element into the advertisement using the identities of celebrities without his or her consent with the purpose to avoid being sued for violation of the right of publicity. On the other hand the German jurisprudence gives due consideration in order to make the right of publicity not be undervalued against the freedom of expression. For example “Wer wird Millionär?”- and “Playboy am Sonntag”-case made the point that the unpermitted use of pictures of the celebrities made no special contribution for the formation of public opinion and held that the advertiser should pay compensation. The advertisement concerned showed no satirical elements, so it s not certain whether the Federal Supreme Court dismissed the claims even if the advertisement would have been significantly satirical. But “Playboy am Sonntag”-case is still remarkable in that the Court understood the article in the editorial section as an advertisement and awarded not non-economic damages for pain and suffering the right-holder has undergone, but economic damage, i.e. payment of reasonable royalties. While the German Federal Supreme Court from the start found the ground of the right of one s picture and the right to one s name in the constitutionally protected fundamental right of Human Dignity and of Personal Freedom, the Japanese Supreme Court made reference to the Personality Right as the ground of the right of publicity very recently. In comparison with the german case law and literature the japanese ones focus on developing a concrete criteria balancing the right of publicity and the freedom of expression rather than defining the relationship between the constitutionally protected personality right and the freedom of expression. Attention should be paid to that the japanese cases concerning this topic were concentrated on the photo reports, which is considered to belong to the traditional area of the freedom of press. Though in the leading case of 2 February 2012 the Japanese Supreme Court denied claims and royalties because the article using the pictures of the claimants with 퍼블리시티권을 둘러싼 논의가 다양하게 이루어지고 있지만, 퍼블리시티권과 표현의 자유의 충돌 문제는 아직 큰 주목을 받지 못하고 있다. 그렇지만 이는, 우리보다 먼저 퍼블리시티권 내지 인격권의 재산적 이익을 판례로 확립한 독일과 일본의 최근 판례에서 가장 빈번하게 나타나는 문제이다. 유명인의 사진이나 성명을 이용한 광고나 출판물은 대부분 이용자의 이익 증대로 이어지지만, 그렇다고 해서 이들을 항상 퍼블리시티권 침해로 인정하면 표현의 자유가 위축될 수 있다. 표현의 자유가 부당하게 위축되지 않으면서도 퍼블리시티 가치가 부당하게무단으로 이용되지 않도록 독일과 일본의 법원은 구체적인 형량 기준을 발달시켜 왔다. 독일에서는 주로 광고에서, 일본에서는 주로 출판물에서 퍼블리시티권과 표현의 자유가 충돌하는 양상을 보인다. 독일 연방헌법재판소가 헌법상 보장되는 표현의 자유에 상업적 표현의 자유를 포함시킨 이후로, 연방대법원은, 타인의 인격표지를 무단으로 사용한 광고라도 그것이 의견형성적 내용을 포함하고 있다면 그 광고가 허용된다는 입장을 유지하고 있으나, 이 태도에 대해서는 비판의 여지가 있다. 한편 일본 판례는 초상 등 그 자체를 독립한 감상의 대상이 되는 경우 퍼블리시티권 침해가 된다고 하는데, 여기에는 사진기사도 포함된다. 기사는 전형적인 표현의 자유에 속하는 영역이므로, 이로 인해 표현의 자유가 지나치게 제약되지 않도록 일본법원은 출판물의 내용이 공공의 정보이익에 얼마나 기여하는지 실질적인 내용은 판단하지 않고, 사진이 전체 잡지에서 어느 정도의 비중을 차지하는지, 함께 게재된 문장이 사진과 얼마나 관련성이 있는지와 같은 형식적 판단을 기준으로 한다. 이러한 형량기준들은 앞으로 우리 법원이 퍼블리시티권과 표현의 자유가 충돌하는 사안을 해결할 때 유용한 참조가 될 것이다.

Association Between Socio-economic Factors and Practices of Postnatal Care Among Women of Childbearing Age in Northwestern Cambodia

김수정(Soojeong Kim),김상균(Sang Gyeun Kim),찌어 초반(Chhea Chhorvann),신수진(Soojin Shin),오창석(Chang Seok Oh),배경의(Kyungeui Bae),김성민(Seongmin Kim) 국제개발협력학회 2021 국제개발협력연구 Vol.13 No.2

연구목적: 캄보디아 서북부의 바탐방, 뽀삿, 파일린 지역은 사회기반시설이 부족하고 지역간 큰 격차가 존재한다. 또한 양질의 의료서비스 공급 부족으로 모성보건지표도 낮다. 본 연구는 한국국제보건의료재단(KOFIH)이 수행하 는 캄보디아 모자보건 사업의 대상인 3개 지역에서의 산후조리실천에 영향을 미치는 요인을 파악하고자 하였다. 연구의 중요성: 본 연구는 캄보디아 서북부지역의 가임기 여성의 사회경제적 특성과 산후 건강관리의 관련성을 이해하기 위한 의미 있는 연구이다. 연구방법론: 최근 2년 내 임신 경험이 있는 가임기 여성 705명을 대상으로 조사를 실시하였다. 사회인구학적 특성과 산후 건강관리와 관련된 변수의 연관성 파악을 위해 카이제곱 분석을 실시하였다. 산후 건강관리 실천에 영향을 미치는 요인을 파악하기 위해 다중 로지스틱 회귀분석을 적용하였다. 연구결과: 세 지역 모두 10~29세의 비율이 가장 높았다. 사회경제적 특성에 따른 산후 건강관리 실천은 지역, 연령, 남편의 직업, 교통수단, 주거여건에 따라 차이가 있었다. 다중 로지스틱 회귀분석 결과, 파일린 지역의 산후 건강관리 실천율은 바탐방보다 2.12배 높았고(p=0.004), 주거여건이 좋은 여성은 열악한 여성보다 산후 건강관리 실천율이 1.61배 높았다(p=0.003). 결론 및 시사점: 캄보디아 서북부 지역의 산후 건강관리 실천율 개선을 위해서 보건의료 접근성 확대를 위한 물리적 인프라 지원, 사회적 자본 확충, 산후 건강관리 중요성에 대한 교육 기회 확대 등 지역간 격차를 줄이는 노력이 필요할 것으로 생각된다. Purpose: Lack of social infrastructure and large regional gaps exist in Cambodia and in particular, Battambang, Pursat, and Pailin in the northwest area. Maternal and Child Health indicators are also low due to insufficient supply of quality health care services. The purpose of this study is to identify factors affecting postnatal care (PNC) practice in three target provinces of the Cambodian 2nd Integrated Maternal and Child Healthcare Project supported by Korea Foundation for International Healthcare (KOFIH). Originality: This is a valuable study to understand the relevance of PNC practice to socio-economic levels of childbearing aged women in Northwestern Cambodia. Methodology: A comprehensive survey was conducted on 705 women of childbearing age in the project area who had experience in pregnancy within the last two years. Chi-square analyses were performed to identify the relationships between socio-economic characteristics and variables related to PNC. Multiple logistic regression analyses were conducted to identify factors affecting PNC practice. Result: The proportion of 10-29 years old was the highest in all three regions. The behavior of PNC according to socio-economic characteristics was significantly different by region, age, husband’s job, transportation like motorcycles, and residential conditions like water pump, electricity. In the results of multiple logistic regression analyses, the PNC practice rate in Pailin was 2.12 times higher than that of Battambang (p=0.004), and women with good residential conditions had 1.61 times higher practice than that of women with poor residential conditions for PNC (p=0.003). Conclusions and Implication: PNC is the care necessary for the mother and her newborn baby after delivery. We found that women have the different practice rates of PNC according to their regions and living conditions. Therefore, in order to improve PNC practice rates, the government should make efforts to reduce the gap between regions such as supporting physical infrastructure to expand accessibility, increasing social capital, and expanding educational opportunities for the importance of PNC.