미충족의료와 소득의 상호작용이 주관적 건강수준에 미치는 효과: 한국의료패널 2009-2014년도 자료의 분석

박유경,김창엽,황승식 한국보건사회학회 2018 보건과 사회과학 Vol.0 No.47

Unmet healthcare needs index is widely used as an indicator to measure the performance of health care system and inequality of healthcare. It needs to be paid more attention since recent studies report that unmet healthcare needs have a negative effect on health outcome. There are little knowledge and research on how unmet healthcare needs affect health although it is essential for the policy effectiveness. This study explored the relationship between unmet healthcare needs and subjective health status by analyzing the interaction effect of income level, which is an important factor both for healthcare utilization and health. We estimated the modification effect of the income level to the health effects of unmet healthcare needs. The generalized estimation equation (GEE) was applied include 1-year time-lagged effect. A 6-year(from 2009 to 2014) data of Korea Health Panel was analyzed. It has confirmed that unhealthy influence of unmet healthcare needs is more effective in the low-income group than the high-income group. The additive interaction effect size of EQ-VAS was 2.29, and 0.48 in self-rated health. Interaction effects were prominent in the unmet needs experiences due to user's resource shortage. The trend of unhealthy effects of both income and unmet healthcare needs was increasing, but the slope which means the additive interaction effect was gradually decreasing. The presence of additional interactions means that there are other complex influence factors thatare not accounted for by income alone. To address unmet healthcare needs aimed at improving health, other factors besides financial issues for healthcare use should be considered, and efforts should be made to identify pathways and mechanisms between experiencing unmet healthcare needs and health. 미충족의료는 보건의료제도의 성과와 의료이용 불평등을 측정하기 위한 지표로 널리 쓰인다. 특히건강 수준에도 좋지 않은 영향을 미친다는 연구가 발표되면서 더욱 주목해야 할 문제가 되었다. 미충족의료 경험과 건강 수준은 상호관련성이 있음에도 그 기전이 명확하게 밝혀지지 않았고 연구도 부족하다. 이 연구는 의료이용의 미충족과 건강수준에 모두 중요한 요인인 소득의 상호작용 효과를 분석함으로써 미충족의료가 건강에 미치는 복잡한 과정의 일부를 설명하고자 하였다. 2009년도부터2014년도까지 6개년도의 의료패널 자료에 일반화추정방정식(GEE)을 적용한 상호작용 분석으로 미충족의료 경험의 건강 영향에서 소득수준으로 인한 조절 효과의 크기를 추정했다. 연구 결과, 저소득군에서 미충족의료 경험을 할 때 소득과 미충족의료 경험으로 인한 개별 건강 영향의 합보다 더 크게건강이 악화되는 상호작용 효과를 확인했다(EQ-VAS의 덧셈 상호작용 효과: 2.29, 주관적 불건강 응답률의 덧셈 상호작용 효과: 0.48). 상호작용 효과는 이용자의 자원 문제로 발생하는 미충족 경험에서 두드러졌고 연도에 따라 소득과 미충족 경험의 건강 영향은 점차 커지고 있으나 그 증가폭은 조금씩 줄어들었다. 덧셈 상호작용이 있다는 것은 소득이 의료이용과 건강 영향에서 중요한 요인이기는하나 소득만으로는 설명되지 않는 다른 복잡한 영향요인들이 존재함을 의미한다. 건강 향상을 목표로미충족의료 정책을 펴려면 단지 의료이용을 위한 재정적 문제 외에 다른 요인도 고려해야 하며, 미충족의료 경험이 건강에 영향을 주는 경로와 기제를 파악하기 위해 힘써야 할 것이다.

소음인 태음증으로 진단한 소뇌성 운동실조 환자 1례

박유경,이미숙,배나영,Park, Yu-Gyeong,Lee, Mi-Suk,Bae, Na-Young 사상체질의학회 2014 사상체질의학회지 Vol.26 No.2

Objectives The aim of this study was to examine significant improvement of gait ataxia, vertigo and tremor after treatment with Sipyimigwanjung-tang, Hyangsayangwi-tang in a Soeumin Greater Yin Symptomatology patient Diagnosed as Cerebellar ataxia. Methods The patient was diagnosed with Soeumin Greater Yin Symptomatology and treated with Soeumin's constitutional medications and acupuncture. The primary outcome measures for this study were the Unified Multiple System Atrophy Rating Scale(UMSARS) and Cerebellar function test to assess the overall function of patient. Secondary outcome assessment included Global Assessment Scale(GAS), change of patient's sleep, stool and digestion. Results The symptoms of gait ataxia, vertigo and tremor decreased from GAS 100 to GAS 0~40 after treatment, and the UMSARS score decreased in Part I, II. Conclusions This case showed that Sasang Constitutional medicine treatment can be effective treatment method for cerebellar ataxia. We consider that consistent treatment can contribute to improve the patient's quality of life.

Mood Phrase and Adjunct Clause Modification

박유경 사단법인 한국언어학회 2015 한국언어학회 학술대회지 Vol.2015 No.12

[P7-14] 대전지역 학교급식을 통한 당류의 섭취실태 연구

박유경,이은미,선남규,김창수,엄준호,변정아,이진하 한국식품영양과학회 2008 한국식품영양과학회 학술대회발표집 Vol.2008 No.10

각질세포의 TLR3 활성화에 의한 Autophagy 유전자 발현

박유경,서가연,서혁일,노승준,김민지,김수아,김동원 한국생물공학회 2022 KSBB Journal Vol.37 No.4

Autophagy is a cellular process that degrades and recycles cytoplasmic organelles and macromolecules, which plays critical roles in cell survival and maintenance. Indeed, accumulating studies have shown that inactivation of autophagy genes generates defects in embryogenesis and tissue regeneration. The genome wide analysis showed many genes required for autophagy are highly upregulated in human keratinocytes stimulated by Poly (I:C). Using TLR3-siRNA, we found expression of autophagy-related genes is regulated by TLR3-mediated signaling pathway. Importantly, inhibition of autophagy using the class III PI3K inhibitor 3-methyladenine significantly decreases TLR3-induced genes including TLR3 and WNT7b. In particular, ATG5 specific inhibition blocks WNT7b expression in human keratinocytes in response to Poly (I:C). Thus, we suggest that autophagy is essential to regulate TLR3-mediated regeneration.

사회적경제 조직에서 일하는 성인 발달장애인의 근로경험과 삶의 변화에 대한 탐색적 연구

박유경,서홍란 한국발달장애학회 2023 발달장애연구 Vol.27 No.4

본 연구는 사회적경제 조직에서 일하는 성인 발달장애인의 근로 경험과 이에 따른 삶의 변화를 심층적으로조명하기 위해 수행되었다. 이를 위해 본 연구는 성인 발달장애인 5명과 이들과 짝을 이룬 부모 5명 그리고상사 5명을 대상으로 심층 인터뷰를 수행하였다. 연구참여자 모집은 의도적 표집과 눈덩이 표집을 병행하여 이루어졌으며, 자료수집은 2023년 2월 초순부터 3월 중순까지 약 6주간 진행되었다. 자료 분석 결과, 4개의 주제와 14개의 하위주제가 도출되었다. 근로 경험과 관련하여 ‘다양한 지원을 받으며 직장생활을 유지하고 성장발전함’, ‘직장인’이라는 새로운 정체성을 가지로 근면 성실하게 일함’, ‘복지혜택과 근로자의 권리를 누릴 수있는 여유와 능력이 생김’이라는 주제가 도출되었다. 직장생활을 통한 삶의 변화는 ‘자립역량이 강화되고 미래에 대한 꿈과 희망을 갖게 됨’으로 확인되었다. 주제가 도출되었다. 직장생활을 통한 삶의 변화는 ‘자립역량이강화되고 미래에 대한 꿈과 희망을 가지게 됨’으로 확인되었다. 본 연구에 참여한 성인 발달장애인 근로자, 그들의 부모와 상사는 근로 경험에 대해 전반적으로 유사한 견해를 가지고 있었으나, 직장 유지와 관련된 의견에는 일부 차이가 났다. 이러한 분석 결과를 토대로 본 연구는 성인 발달장애인의 욕구와 특성을 반영한 일자리창출과 고용 안정을 위한 방안을 제시하였다. This study was conducted to shed light on the work experiences of adults with developmental disabilities employed in social economy organizations and the impact of employment on their lives. To achieve this, in-depth interviews were conducted with five adult individuals with developmental disabilities, five of their parents and five supervisors. A combination of purposive and snowball sampling was applied to recruit research participants. Data collection took place approximately six weeks from early February to mid-March 2023. Thematic analysis revealed 4 main themes and 14 subthemes. Regarding work experiences, the emerging themes included “sustaining the job and growing in the workplace with diverse support,” “developing a new identity as an employee and diligently working,” and “gaining the ability and flexibility to utilize welfare benefits.” The study also affirmed that employment brings about changes in life, such as fostering “self-sufficiency and instilling dreams and hope for the future.” While adults with developmental disabilities, their parents, and supervisors generally shared similar perspectives on work experiences, some differences in their views on job retention were noted. Based on these findings, the study offers measures for job creation and employment stability that reflect the needs and characteristics of adults with developmental disabilities.

ISM에 의한 어린이보호구역의 잠재위험 요인 구조화모형 구축

박유경,정현정,김영지,금기정 한국도로학회 2012 한국도로학회논문집 Vol.14 No.6

PURPOSES : This study is to develop ISM for potential risk factor in School Zone. METHODS : Based on the literature review, the Analytic Hierarchy Process (AHP) has been used most widely. However, it is difficult to apply in practice because the AHP results have the characteristics of the independence between each element and the interlayer can not explain the interrelationship. The Network Analysis Process (ANP) is possible to analyze the relationship between the elements and the network through the feedback. But, the reliability of the analysis fall because of complicated pair of comparison, also it is difficult to solve the super matrix. In this study, the complicated relationship between each element is inquired through the Interpretive Structural Modeling (ISM). RESULTS : The methodology of ISM is developed to remove the children’s potential risk factors in school zone. CONCLUSIONS : It is possible to remove the children’s potential risk factors from low level to high level step by step and improve safety. Through this, risk factors can be removed from the low-level, and upper-level will automatically improve.

만성 폐쇄성 폐질환 환자에서 Roflumilast 약물 사용 평가

박유경,위완주,한영현,한옥연,나현오 한국병원약사회 2015 病院藥師會誌 Vol.32 No.4

Background : Roflumilast is a selective phosphodiesterase (PDE)-4 inhibitor approved for treatment of severe chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis and patients with a history of exacerbation. It improves lung function and reduces the frequency of exacerbation in patients with severe COPD. However, high rates of adverse events such as diarrhea and nausea have been reported in clinical trials. The purpose of this study was to investigate the pattern of roflumilast usage, tolerability, and adverse events in clinical practice. Methods : We retrospectively analyzed the medical records of patients who received roflumilast between December 2012 and September 2013. Results : Roflumilast was prescribed for 88 COPD patients. Initially, 49 patients (55.7%) received 500 mcg and 39 patients (44.3%) received 250 mcg once daily. For 64 patients, roflumilast was prescribed for maintenance of severe COPD (post-bronchodilation forced expiratory volume (FEV1) ≤50%), which is associated with chronic bronchitis in adult patients with a history of exacerbations as an add-on to bronchodilator treatment. Roflumilast-related adverse events were observed in 47.73% (40/88) of the overall population (62 cases). The most common adverse events were gastrointestinal issues, including diarrhea, nausea, GI trouble, and decrease in appetite. Other adverse events included weight loss, skin reactions, headaches, and insomnia. Only 38 patients (43.18%) completed 1 year of roflumilast therapy and treatment discontinuation occurred in 50 patients (56.82%). Adverse events are the leading cause of treatment discontinuation. Conclusions : Roflumilast, in conjunction with standard therapy, caused more adverse events than has previously been reported. The long-term safety and efficacy of roflumilast has not been evaluated fully, and serious adverse events should be closely monitored.

Growth and Cut Flower Yield of Roses as Affected by Age of Rooted Cuttings

박유경,정병룡 한국화훼학회 2011 화훼연구 Vol.19 No.1

This study was conducted to investigate the effect of age of transplants, propagated by cutting,of two cut rose (Rosa hybrida Hort.) cultivars on their subsequent growth and yield in an effort to develop an efficient cutting propagation method for domestic rose cultivars. Two cultivars used in this study were a standard type ‘Pink Aurora’ and a spray type ‘Yellow King’. Cuttings were prepared as single node cuttings each with a five-leaflet leaf and were stuck in rockwool cubes (5 cm × 5 cm × 5 cm, UR, Korea) at two different dates. Cuttings rooted for either 30 (stuck on Jan. 20, 2009) or 48 days (stuck on Jan. 2, 2009) were transplanted into a rockwool slabs (10 cm × 15 cm × 100 cm, UR, Korea) on the same date, 18 Feb. 2009. Plant growth and cut flower quality were investigated for two successive harvests during the period of Jan. to July in 2009. In both cultivars, 48 days old plants showed some growth of the shoot and root before transplanting. However,in the case of 30 days old plants before transplanting no noticeable growth of the shoot and root was obserable in ‘Pink Aurora’, while only shoot growth, but not root growth to the bottom of the rooting medium, was observed in ‘Yellow King’. This suggested cultivar-specific responses that in this experiment a spray type ‘Yellow King’ showed greater growth rate during the rooting stage than a standard type ‘Pink Aurora’. In the measurement of growth and cut flower yield after transplanting, the 48 days old standard type ‘Pink Aurora’ produced greater number of cut flowers per plant than 30 days old plants, whereas their mean stem fresh weight was recorded smaller than that of the 30 days old plants. For ‘Yellow King’, 30 days old plants showed greater stem length, flower width, number of five-leaflet leaves per stem, stem fresh weight, and number of cut flowers per plant than 48 days old plants. Therefore, growth and yield were significantly affected by cultivar and age of the rooted cutting, and additional research is needed on the effect of age of rooted cuttings in more cultivars.

Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis

박유경,김창엽,유명순,이군세,박은영 대한예방의학회 2014 Journal of Preventive Medicine and Public Health Vol.47 No.6

Objectives: To assess the current public participation in-local health policy and its implications through the analysis of policy networksin health center programs. Methods: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts (‘gu’s) of Seoul. Participants of the policy network were selected by the snowballingmethod and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. Results: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementationprocess, the program was led by the health center, while other actors participated passively. Conclusions: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders,including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.