Mutation Profile of Well-Differentiated Thyroid Cancer in Asians

송영신,임정아,박영주 대한내분비학회 2015 Endocrinology and metabolism Vol.30 No.3

Recent advances in molecular diagnostics have led to significant insights into the genetic basis of thyroid tumorigenesis. Among the mutations commonly seen in thyroid cancers, the vast majority are associated with the mitogen-activated protein kinase pathway. B-Raf proto-oncogene (BRAF) mutations are the most common mutations observed in papillary thyroid cancers (PTCs), followed by RET/PTC rearrangements and RAS mutations, while follicular thyroid cancers are more likely to harbor RAS mutations or PAX8/peroxisome proliferator-activated receptor γ (PPARγ) rearrangements. Beyond these more common mutations, alterations in the telomerase reverse transcriptase (TERT) promoter have recently been associated with clinicopathologic features, disease prognosis, and tumorigenesis in thyroid cancer. While the mutations underlying thyroid tumorigenesis are well known, the frequency of these mutations is strongly associated with geography, with clear differences reported between Asian and Western countries. Of particular interest is the prevalence of BRAF mutations, with Korean patients exhibiting the highest rate of BRAF-associated thyroid cancers in the world. Here, we review the prevalence of each of the most common mutations in Asian and Western countries, and identify the characteristics of well-differentiated thyroid cancer in Asians.

병원간호사가 지각하는 성장욕구와 조직분위기가 조직사회화에 미치는 영향

송영신,이미영 병원간호사회 2010 임상간호연구 Vol.16 No.3

Purpose: The purpose of this study was to determine the effect of needs for professional development and organizational climate on organizational socialization of clinical nurses. A cross?]sectional analysis were performed to assess the factors affecting organizational socialization. Methods: The data used in this study were obtained from clinical nurses who were employed in a hospital (N=606). Using multiple regression, we tested variables to assess their effects on organizational socialization in this sample. The data were analyzed using descriptive test, t?]test, ANOVA, Pearson correlation coefficiency and stepwise multivariate regression. SPSS 17.0 program was utilized for data analysis. Results: The mean scores of organizational socialization, needs for professional development and organizational climate were statistically differed by career ladder, educational level and position. Organizational socialization had significant positive correlations with the needs for professional development (r=.332, p<.01) and organizational climate (r=.523, p<.01). Those variables including career ladder explained 33.4% of organizational socialization. Conclusion: Our findings indicate that organizational socialization of clinical nurses could be enhanced by meeting the needs for professional development and organizational climate. Developing innovative educations for encouraging clinical nurses' carrier development and creating a positive organizational climate are mandated for clinical nurses to have constructive organizational socialization.

Psychometric Evaluation of Hill-Bone Medication Adherence Subscale

송영신,Hae-Ra Han,Hee-Jung Song,Soohyun Nam,Tam Nguyen,Miyong T. Kim 한국간호과학회 2011 Asian Nursing Research Vol.5 No.3

Purpose: Medication adherence is an essential part of the management and control of high blood pressure (HBP). Although the Hill-Bone Medication Adherence (HBMA) scale is one of the most frequently used instruments for measuring HBP medication adherence, the psychometric properties of the scale have never been tested among Korean Americans, a population that experiences a disproportionately high prevalence of HBP. Therefore, the objective of this study is to validate a Korean version of the HBMA subscale (HBMA-K). Method: We used two, independent samples of Korean Americans (KAs) (combined n ¼ 525) who participated in community-based intervention trials for HBP control. To develop the HBMA-K, the original scale was translated into Korean and then back translated into English. Reliability was assessed by calculating the Cronbach’s alpha. Exploratory factor analysis (EFA) was done to assess construct validity. We also calculated the Pearson’s correlation coefficients between the scale and theoretically driven variables such as blood pressure, knowledge, and HBP belief to test concurrent validity. Results: The EFA revealed a one-factor solution with eight items, explaining 35.4% of the variance. Cronbach’s alpha was .80. The 8-item HBMA-K scale was significantly associated with systolic blood pressure (BP) (r ¼ .18, p < .01), diastolic BP (r ¼ .24, p < .01), HBP knowledge (r ¼ .13, p < .01), and HBP belief score (r ¼ .18, p < .05). Conclusions: The 8-item HBMA-K scale is a valid and reliable instrument for measuring medication adherence among KAs with HBP. It can be easily administered at community and clinical settings to screen hypertensive patients with low medication adherence.

Development of a Quality Assessment Tool for Hypertension Management by Public Healthcare Providers: A Cross-Sectional Survey

송영신,서가원 기본간호학회 2023 기본간호학회지 Vol.30 No.4

Purpose: This study aimed to develop and assess the validity of a quality assessment tool for hypertensionmanagement (QAT-HTN), to evaluate the quality of hypertension management by public healthcare providersworking in community healthcare centers. Methods: The QAT-HTN was distributed to 528 patients with HTN. Theconstruct validity (exploratory and confirmatory factor analyses), internal consistency reliability, and concurrentvalidity of the QAT-HTN were evaluated. Results: A six-subscale measurement model of the QAT-HTN involvingblood pressure (BP) control, regular checkups and medicine education, complication prevention and assessment,BP measurement, and lifestyle management was validated using exploratory and confirmatory factor analyses. Concurrent validity was evaluated based on correlations with HTN self-care behavior. The Cronbach’s ⍺coefficient for internal consistency was .92. Conclusion: The QAT-HTN was found to be a reliable and validmeasure of the quality of HTN management in Korean community healthcare centers.

더불어, 함께, 바로 이곳에서!

송영신 한국자치학회 2017 월간 공공정책 Vol.140 No.-

Application of the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline to the Korean National Health and Nutrition Examination Surveys from 1998 to 2012

송영신,오태정,김경민,문재훈,최성희,장학철,박경수,임수 대한당뇨병학회 2017 Diabetes and Metabolism Journal Vol.41 No.1

Background: The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline for the treatment of blood cholesterol recommends statin therapy for individuals at high risk of atherosclerotic cardiovascular disease (ASCVD). The aim of this study was to investigate serial trends in the percentages of Korean adults considered eligible for statin therapy according to the new ACC/AHA cholesterol guideline. Methods: Data from the Korean National Health and Nutrition Examination Survey (KNHANES) I (1998, n=7,698), II (2001, n=5,654), III (2005, n=5,269), IV (2007 to 2009, n=15,727), and V (2010 to 2012, n=16,304), which used a stratified, multistage, probability sampling design, were used as representative of the entire Korean population. Results: The percentage of adults eligible for statin therapy according to the ACC/AHA cholesterol guideline increased with time: 17.0%, 19.0%, 20.8%, 20.2%, and 22.0% in KNHANES I, II, III, IV, and V, respectively (P=0.022). The prevalence of ASCVD was 1.4% in KNHANES I and increased to 3.3% in KNHANES V. The percentage of diabetic patients aged 40 to 75 years with a low density lipoprotein cholesterol levels of 70 to 189 mg/dL increased from 4.8% in KNHANES I to 6.1% in KNHANES V. People with an estimated 10-year ASCVD risk ≥7.5% and aged 40 to 75 years accounted for the largest percentage among the four statin benefit groups: 9.1% in KNHANES I and 11.0% in KNHANES V. Conclusion: Application of the 2013 ACC/AHA guideline has found that the percentage of Korean adults in the statin benefit groups has increased over the past 15 years.

간호사의 시간관리 행동 유형, 직무만족 및 직무몰입

송영신,안은경,심희숙 한국디지털정책학회 2014 디지털융복합연구 Vol.12 No.5

[외국정책사례] ‘코로나 시대’의 독일의 공동체 지키기

송영신 한국자치학회 2020 월간 공공정책 Vol.177 No.-

Cu(3-amino-1-propanol)X_2 (X=C1, Br)의 분광학 및 자기적 성질

송영신,박윤창 성균관대학교 기초과학연구소 1988 論文集 Vol.39 No.1

The Spectral and magnetic properties of [Cu(3-amino-1-propanol)X]_2 where X=Cl and Br have been studied and are compared with those of dimeric copper (Ⅱ) acetate monohydrate. The exchange interaction parameter J of [Cu(3-amino-1-propanol)Cl]_2 is estimated to be 391cm^-1, the zero field splitting parameters are D=0.438cm^-1 and E=0cm^-1. On the other hand the magnetic parameters of [Cu(3-amino-1-propanol)Br]_2 can not be obtained because its EPR spectrum shows only one absorption line that is broad and superimposed with the line due to monomer. The calculated Cu-Cu distance is 2.81Å. The super exchange interaction through alkoxo bridge is considered to be dominant rather than the direct exchange interaction through copper-copper. The visible, infrared and far-infrared spectra of these compounds are also discussed.

여성 노인 1인 가구의 실태 및 정책적 개선방안

송영신 이화여자대학교 젠더법학연구소 2015 이화젠더법학 Vol.7 No.2

급속한 1인 가구의 증가 및 고령화의 진행에 따라 우리 사회의 노인 1인 가구의 증가율은 가파른 상승곡선을 그려 2014년 기준 전체 노인인구 중 23%를 차지한다. 그 중 여성 노인 1인 가구는 약 104만 명으로 전체 노인 1인 가구의 3/4을 차지하는 것으로 추산할 수 있다. 그런데, 여성 노인 1인 가구는 여성, 노인, 독거라는 사회적 약자로서의 인자를 모두 갖춘 계층으로, 특히 혼자 사는 데 있어서 아플 때 간호문제, 경제적 불안감, 심리적 불안감・외로움을 가장 힘든 점으로 들고 있다. 이것은 각 건강 영역, 경제 영역, 사회 영역으로 대별되는데, 본 연구의 목적은 이와 같이 각 영역별로 나타난 구체적 현황과 문제점을 살펴보고 그 정책적 개선방안을 찾는데 있다. 먼저 건강 영역에서, 주로 치매 등 정신적 제약으로 인해 의사능력이 결여 내지 부족한 경우의 수발자 문제이다. 정부지원정책의 주요 골자는 치매 검진사업, 치매 치료관리비 지원사업, 노인장기요양보험제도를 통한 치매노인의 생활안정 등 대부분 의료・생활지원의 범주에 속한다. 하지만, 양질의 의료・생활지원서비스라도 이를 이용하고 관리할 능력이 부족하다면 무용지물이 될 수 있기 때문에, 그 효과를 극대화하기 위해서는 법률지원이 병행되어야 한다. 이를 위해, 성년후견제도를 활용할 수 있도록 법적・사회적 연계시스템이 뒷받침되어야 한다. 즉, 치매여성 노인 1인 가구의 대상자 발굴 및 연계, 절차구조, 공공후견서비스 제공이 이루어져야 하고, 공공후견인 양성 교육 및 인프라 구축, 예산편성과 기금 조성 등이 뒷받침되어야 한다. 그리고 치매노인의 생활안정에 긍정적 효과를 거두고 있는 노인장기요양보험제도에서도 성별・가구형태별・질환유형별로 장기요양급여 및 돌봄서비스의 양과 질에 차이 둔 다각적인 지원시스템을 마련하여 여성 노인 1인 가구에 적합하도록 조정이 이루어져야 한다. 다음으로, 경제 영역에서 여성 노인 1인 가구는 남성보다 2배가량 더 경제적 불안감을 호소한다. 실제 여성노인의 빈곤율은 41.2%로 남성노인의 빈곤율 31.2%보다 10%p 높다. 소득원천을 비교해도, 남성노인은 근로활동에 의한 소득이 1순위인 반면, 여성노인은 남성노인 근로활동소득의 절반에도 못 미치고 사적 이전소득에 많이 의존하고 있기 때문에 경제적 독립성이 낮고 재정적으로 불안정한 구조이다. 이를 공적 이전소득으로 보완해야 할 터인데, 대표적인 공적연금제도인 국민연금제도는 본질적으로 연금가입자의 과거 직업력과 소득력(job and earning history)에 근거하기에 여성 노인 1인 가구는 수급 혜택의 범위가 제한적일 수밖에 없다. 즉, 수급자 수가 적고, 급여수준도 낮은 중첩적 취약성을 보인다. 따라서 독자적 수급권 확보를 위해, 현재 및 장래 여성 노인 1인 가구의 국민연금 가입률을 높여야 하고, 그 전제로 여성의 노동시장 진입이 용이해야 하며, 여성노동의 특성에 맞춰 임금수준이 현실화되어야 한다. 뿐만 아니라, 남성보다 1.8배 많은 여성노인의 기초연금 수급현황에서 볼 수 있듯이, 여성 노인 1인 가구의 노후소득보장제도로서 기능하고 있는 기초연금제도에 대하여도 보완이 필요하다. 즉, 현재 국민기초생활보장 생계급여 산정을 할 때 기초연금을 개인별 소득인정액에 포함시키고 있는 것은 「국민기초생활보장법」과 「기초연금법」의 입법취지를 희석시킬 위험이 있으므로, 그 포함 여부 및 범위에 대한 조속한 조치가 필요하다. 무엇보다 가장 중요한 것은, 저소득 여성 노인 1인 가구에게 괜찮은 거처를 마련해주는 ‘Housing First’ 정책의 수립이다. 이는 소득빈곤을 해소함에 있어 가장 효과적인 사회복지 지원책으로 평가되고 있다. 그리고 이러한 정책은 모두 여성 노인 1인 가구를 위한 노인 일자리 우선지원 정책을 병행해야 그 효과를 극대화할 수 있다. 끝으로, 사회 영역에서의 심리적 불안감 내지 외로움의 문제이다. 노인 1인 가구는 남녀를 불문하고 ‘심리적 불안감 또는 외로움’을 공통적으로 토로하는데, 그 영향요인에는 상당한 차이가 있다. 즉, 남성 고령자는 직장유무, 경제수준이 주된 요인이지만, 여성 고령자의 경우 사회적 관계로부터 소외되는 것이 가장 중요한 영향요인이다. 여성 노인 1인 가구는 동거하는 가족 없이 혼자 생활을 하고 있기 때문에, 사회적 관계로부터 소외・단절될 가능성이 높아 심리적・정서적 불안감 내지 외로움을 경험할 확률이 매우 높고, 이러한 사회적 고립의 문제 ‘고독사’ 또는 ‘자살’ 등 매우 극단적인 사회문제로 악화될 수 있다. 따라서 이를 극복하기 위해서 ‘사회적 가족’이라는 새로운 사회적 관계망 모델을 제시한다. 정부차원의 지원정책이 있으나, 민간부문에서의 자발적인 시도와 노력이 그 효과를 배가시킬 수 있다. 한 예로, 사단법인 시니어희망공동체의 조부모세대, 부모세대, 형제자매세대 등 4인 이상 3세대로 구성된 ‘소셜팸(Social Family, 사회적 가족)운동’이 있다. 또한, 다양한 형태의 공동생활가정, 즉 코하우징(Co-Housing)도 추진해야 한다. 이는 여성 노인 1인 가구의 안전과 더불어 안정적인 사회적 관계망을 형성・유지할 수 있는 방안이기에 정부와 지자체, NGO, 협동조합 등을 중심으로 민・관이 협력할 필요성이 크다. 위의 각 영역별 정책적 개선방안은, 상호간에 유기적으로 영향을 미치는 관계에 있다. 예컨대, 성년후견제도는 여성 노인 1인 가구에게 치매발병시 수발자 기능을 할 뿐만 아니라, 그로 하여금 장기요양보험・기초연금 등 사회복지서비스를 이용할 수 있도록 하여 공적 노후소득보장에 기여하는 순기능을 한다. 따라서 각 영역별 현황에 따른 정책을 수립・시행하는 데 있어, 상호 유기적 관련성 및 연관효과 등에 대한 분석이 선행되어야 한다. Korean society has witnessed rapid increase in population of elderly forming one-person household(hereinafter referred to as “single-household elderly”) amid an increase in single-person household and aging. In 2014, the number of single-household elderly comprised 23% of entire elderly population. Among them, the number of single-household female elderly stands at 1.04 million which accounts for 3/4 of whole single-household elderly population. Single-household female elderly represent the class with whole elements of socially-disadvantaged, including elements of women, elderly, and solitary life, and encounter the greatest difficulty in connection with nursing care for illness, economic insecurity, and psychological anxiety/loneliness. Such issues are considered to fall under health realm, financial realm, and social realm. The objective of this study was to examine specific conditions and problems which were manifested in each realm and to explore measures for mitigating such problems at policy level. In the health realm, there are problems of benefit recipients who have little or inadequate communication ability primarily due to mental constraints such as dementia(Alzheimer’s disease). Government’s supportive policy mostly relates to medical and livelihood support, such as dementia examination project, dementia treatment & management support project, livelihood support project including long-term recuperation insurance system designed to help stabilize lives of elderly with dementia, etc. However, such supportive policy of government needs to be pushed forward in tandem with legal support in order to maximize desired effect, considering that even excellent medical and livelihood support services may become useless if the ability to use and manage such services is inadequate. For that, legal and social inter-connective system needs to be buttressed to ensure that adult guardianship system can be fully leveraged. In other words, it is deemed necessary to identify and connect to eligible single-household female elderly with dementia, establish procedural structure, and provide public guardian service, and furthermore, the support needs to be provided to underpin education for development of public guardians, establishment of infrastructures, budget preparation and fund-raising process, etc. In addition, even elderly long-term recuperation insurance system, which has positive effect in stabilizing the lives of elderly with dementia, needs to map out multi-faceted supportive system differentiated in terms of quality of care service and long-term recuperation allowance based on gender, type of household, and type of disease, thus ensuring adjustment tailored to situations of single-household female elderly. Meanwhile, single-household female elderly experience financial instability twice as much as their male counterparts in economic realm. In fact, poverty rate of female elderly stands at 41.2% which is 10%p higher than that of male elderly who are reported to have poverty rate of 31.2%. Female elderly has higher reliance on private transfer income with their labor income level remaining below half that of male elderly, which results in low economic independence and high financial instability of female elderly, in stark contrast to male elderly who earn the largest portion of their income from labor income. Such problem needs to be addressed by public transfer income. National pension plan system, the most typical public pension system, has unavoidably limited scope of pension benefit disbursements to single-household female elderly because such benefit disbursements are based on past job and earning history of pension holders. In short, the system has double vulnerability which means small number of recipients and low level of allowance such as recuperation allowance. Therefore, it is considered necessary to increase the ratio of present and future single-household female elderly covered by national pension plan in order to ensure that pensionable right can be secured independently. Based on that, the access of women to labor market should be made easy, and the wage level should be aligned with reality in light of characteristic of labor provided by women. Furthermore, an improvement is needed for basic pension system that functions as Old-Age Income Security System for single-household female elderly as witnessed by the supply-demand status of basic pension for female elderly whose population is 1.8 times larger than that of their male counterparts. In other words, legislative purpose of National Basic Livelihood Security Act and Basic Pension Act can be attenuated if basic pension is included in individual countable income when the livelihood benefit under National Basic Livelihood Security Act is estimated. Actions need to be taken swiftly with respect to such inclusion or exclusion and related scope. Above all, the priority is to map out ‘Housing First’ policy that provides good housing first to low-income single-household female elderly. That is deemed to be the policy that underpins social welfare most effectively in helping address low-income poverty. Moreover, such policy can produce the greatest impact when it is accompanied by policies designed to bolster job creation for the elderly, particularly single-household female elderly. Finally, it relates to issues of psychological anxiety or loneliness in social realm. Single-household elderly commonly express psychological anxiety or loneliness, whether they are men or women, and related influential factors differ significantly. In other words, employment status and financial conditions are most influential factors for men of advanced age while disconnection from social relationship is the most influential factor for women of advanced age. Single-household female elderly tend to experience alienation and disconnection from society because they are living alone without any co-habitating family member. Consequently, single-household female elderly are very likely to encounter psychological or emotional anxiety or loneliness, and such social isolation may lead to very serious social problems such as lonely death, suicide, etc. Thus, a new social relational network model, called ‘social family’, is presented to overcome such problems. Despite supportive policies of government, spontaneous attempts and efforts of private sector may redouble the effects. For instance, Senior Hope Community has proceeded with a movement called Social Fam(Social Family) consisting of more than 4 persons from 3 generations such as grandparent generation, parent generation, and sibling generation. In addition, various types of community life households, i.e., co-housing, needs to be pushed forward. Co-housing represents a measure that can help form and maintain stable social relationship and networking among single-household female elderly, along with their safety, and therefore, there is an increasing need for cooperation between government and private sector, spearheaded by central government, local governments, NGOs(Non-Governmental Organizations), cooperatives, etc. Aforesaid measures, which are designed to achieve improvement for each realm at policy level, have inter-relational systematic effect. For example, adult guardianship system helps provide single-household female elderly with access to social welfare services such as long-term recuperation insurance/basic pension, etc., as well as medical treatment, when they have dementia, thus contributing to guaranteeing public old-age income security. Thus, analysis of systematic interrelationship and related effect, etc., needs to take precedence in establishing and enforcing policies associated with conditions of each realm.