Ramos B세포의 아포토시스 과정에서 이상 발현되는 Zinc Finger 유전자의 규명

신민선,김수영,동승명,나은영,이석형,박원상,이정용,유남진,신민선 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.12

병원 표준화 사망비 평가 개선 방안

신민선,심보람,이유진 건강보험심사평가원 심사평가연구소 2020 연구보고서 Vol.2019 No.0

코로나19 유행 시기의 사망과 의료 이용 변화에 대한 탐색적 연구

신민선,이풍훈,장원모 건강보험심사평가원 심사평가연구소 2021 연구보고서 Vol.2021 No.0

From January to September 2020, Korea experienced the first and second waves of COVID-19 cluster infection in Daegu and North Gyeongsang province (February to March) and Seoul Metropolitan area (August to September). However, there was not enough evidence for policy measures due to lack of systematic analysis on the impact of COVID-19 to public health. This study aims to identify the magnitude of excess deaths and deprived utilization of health care. Based on data from 2010 to 2019, the gaps between estimated and actual deaths and utilization of health care in 2020 were calculated. In order to understand excess deaths and deprived utilization of health care, Quasi-poisson regression model was built in consideration of year, season, and other factors. Deaths and utilization of health care data during severe outbreak period were identified by total, gender, age, and region. According to the result, there was no excess deaths from January to September 2020. When compared against the model design, there was a reduction of 1,638 in death, but it was not statistically significant. There was no excess deaths by gender, but those between 20 to 34 showed 15.4% of excess deaths compared against estimation. In Daegu and North Gyeongsang province, there were excess deaths in March and August, and COVID-19 related deaths were concentrated around March and April. In regards to utilization of health care, reduction was detected between February to September in all areas of health care utilization compared against estimation. The greatest fall was observed in emergency room visit (28.0%), followed by inpatients (17.6%), outpatient (15.4%), and ICU admission (9.8%). While the level of fall differed upon service type (inpatient, outpatient, emergency room, ICU), the biggest gaps between estimation and actual were observed in March and September 2020. Gender gap was not significant across all service types, and reduction rate was higher among age 19 and younger and Daegu and North Gyeongsang province region. There is a need for more accurate and faster measurement methodology for excess deaths as it is an important indicator in understanding impact of infectious disease outbreak. Going forward, it is required to build an automated healthcare data infrastructure that can check and predict excess deaths and decreased health care utilization on a real-time basis in case of similar healthcare crisis.

소아암 환아와 가족에 대한 이해

신민선,Sin, Min-Seon 한국호스피스협회 2006 호스피스 학술지 Vol.6 No.2

In this thesis, Chapter I Introduction suggested the necessity of this research and defined related terms, and Chapter II defined hospice for children and examined the symptoms of pediatric cancers as well as the general characteristics of pediatric cancer patients. In particular, we surveyed the physical condition, psychological and emotional condition, financial condition, environmental aspect, educational aspect and spiritual aspect of pediatric cancer patients’ families, investigated pediatric cancer patients’ parents and siblings with regard to their understanding of the pediatric cancer patients’ death, and lastly considered spiritual care. Chapter III presented summaries and conclusions. In their developmental stage, pediatric cancer patients lack abilities to express themselves and are highly dependent on their parents, so parents who take care of cancer children have to make hard decisions and cancer children’s families are heavily burdened by the situation of preparing their children’s death and sending them away while denying their death, and for this reason they need help from specialists. That is, for pediatric cancer patients, we need highly experienced pediatricians or nurses skilful in managing young terminal patients as well as hospice counseling and family counselors for consulting on family crises. In particular, there is a keen need of child life support specialists. In addition, clergymen’s help is critical for spiritual care to ease the fear and terror of the unknown world, fear of death, etc. Moreover, in order to prevent cancer children from failing to adjust themselves to school life or peer relation after recovery, hospice service should provide cancer children with opportunities to learn school curriculums and associate with friends.

불필요한 재입원 비용 추정에 관한 연구

신민선,이원재 한국융합학회 2017 한국융합학회논문지 Vol.8 No.12

Unnecessary readmissions could be the result of the inadequate and unnecessary treatments. Adequate quality indicators for readmission are important because they can identify inadequate spending by inpatients as well as quality screening. This study attempted to estimate the cost incurred by unnecessary readmissions. The Health Insurance Claims Data of 18 years or older who were admitted in the tertiary hospitals in 2014 were analyzed. Admissions and readmissions were sorted and readmissions were classified into planned and unplanned readmissions. We adopted 28 days as a criteria for the classification of the readmission. Proportion of the patients were higher in readmissions among cancer, accompanied diseases, and special rehabilitation patients. Cost of the readmissions were 50% of the total cost of the admission among the patients of same diseases, same departments, and same hospitals. Almost 1,000billion Won were used by the unnecessary readmissions. We need to reduce the readmissions in regions, departments, and diseases studying the pattern of the readmissions. National level efforts are required to improve quality of care and reduce cost by the unnecessary readmissions. 입원기간동안 적절하지 않거나 불필요한 처치로 발생될 수 있는 재입원관련 질지표는 질스크리닝 뿐만 아니라 입원환자의 적절하지 못한 지출을 파악할 수 있어서 중요하다. 이 연구는 예방할 수 있는 재입원으로 인해 발생되는 진료비 규모를 파악하고자 한다. 건강보험심사평가원의 2014년도 청구 데이터를 활용하여 종합병원이상 의료기관에 입원한 18세 이상 성인을 대상으로 분석하였다. 입원 유형을 1회 입원군과 재입원군으로 분류하였고, 재입원군은 다시 계획된 재입원과 계획되지 않은 재입원으로 분류하였다. 재입원 간격은 28일 이내로 설정하였다. 암질환, 동반질환, 전문재활 환자의 경우 1회 입원군보다 재입원군의 분포가 더 많았다. 계획되지 않은 재입원 유형 중 동일 기관, 동일 진료과목, 동일 질병군 입원의 경우 재입원에 지출된 총 진료비가 전체 재입원 진료비의 50%가량을 차지하였다. 불필요한 재입원으로 인해 발생되는 진료비는 2014년 1년간 9,990억원 정도였다. 재입원이 잦은 지역, 진료과목, 질병군 등의 패턴을 활용하여 재입원을 줄이려는 노력이 필요하다.

호스피스와 종교적 죽음이해

신민선,김문수,Sin, Min-Seon,Kim, Mun-Su 한국호스피스협회 2006 호스피스 학술지 Vol.6 No.1

There are various understandings how to define death. In the context of medicine, death is defined as the irreversible change of the tissue according to the cessation of circulation and respiration. According to the psychologists, a person need to accept the finiteness as a human being and remain conscious that the death is not avoidable. And they say if a person doesn't regard death as unavoidable reality of life he or she will not confront the humanistic death and after all will die like animals. In philosophy, death is viewed as an unwelcome reality in the end of the journey of life. Sociologists usually understand that the society is the organization composed with living persons and human beings which construct and transmit the culture from generation to generation between the both ends of life and death. In society, the generation is changed, maintained, and developed through the phenomenon of death. Although death of human being is natural event in society, the death of a specific person brings a sense of loss, crisis, and anxiety to the communities like family, regional society, nation, and the world. In this context, death is not confined to personal dimension and it can be regarded as a social problem. It is valuable to summarize the religious perspectives on the meaning of death for the better hospice care. In shamanism, there are basic idea that although the flesh of human being disappears, soul never die. If human dies, the flesh of human being disappears but soul never disappear and come back to the origin of soul as it is called chaos. So in shamanism, it is said that shaman can solve the mortified feeling, restore the broken harmony, send the soul to comfortable space- the origin, and guarantee the blessing of descendents. Buddhists regard the death as an essential component through the cycles of life. Through this cycle, human being exits as an endlessly transmigrating being and the death is just a restoration to the original status. In Confucianism, the view on the death based on the philosophy of the "Yin and Yang" and "Five elements". In Buddhist tradition, many believers said the philosophy of "Death is the same as life". Unlike usual thoughts that a god governs "life and death" and "fortune and misfortune", Confucianists deny the governance of a god and emphasize the natural orders in which every phenomenon in the world moves according to the principle. Confucianists understand the death as a natural order with this principle. In Confucianists' belief, the essence of human being remains in their own descendent's lives after the death of ancestor, so in Confucianism there is no concept of immortality of the soul. In the history of Christianity, death has been defined generally as the separation of the immortal soul from the mortal body. In the earlier days of Old Testament, the death is regarded as a disappearance of just a flesh and human never disappear and always live in the relationship with God. Later days in Old Testament, we can find the growing concern for the life after the death because of the entrance of the theodicy. In the New Testament, the death is not regarded as the normal process of the human life and regarded as the abnormal status in which death come to human because of sin as a decisive factor and it should be conquered. In fact, the most of us afraid death because not of the fear of death itself but of the sense of the emptiness and regrets. so many people often make the monument hoping to live forever. But Christian usually regard this behavior as a sinful act because human being usually think themselves as a master of their life and attempt to become immortal in this kind of trial mortal. But if we live with God, we cannot confront such a condition because we aware limits as a mortal human being and entrust everything on Him and want to live according to His guidance. Therefore, in the Christian tradition, the death is regarded as accomplishment of life, fruits of life, invitation to

리튬이차전지용 음극활물질로서 Micro sized Silicon/CNT/Carbon 복합입자의 전기화학적 특성

신민선,이태민,이성만,Shin, Min-Seon,Lee, Tae-Min,Lee, Sung-Man 한국전기화학회 2019 한국전기화학회지 Vol.22 No.3

본 연구에서는 마이크로 크기의 실리콘 입자와 탄소나노튜브를 활용하여 고용량을 갖는 실리콘/탄소나노튜브/탄소 복합입자를 제조하여 리튬이차전지용 음극활물질로서의 적용가능성을 확인하고자 하였다. 실리콘/탄소나노튜브/탄소 복합입자 제조를 위해 분무건조 방식을 이용하여 실리콘입자가 탄소나노튜브에 의해 균일하게 분산되어 비정질탄소로 결합된 구조를 갖는 구형의 복합입자를 제조하였다. 제조한 복합입자는 실리콘 입자 주변에 탄소나노튜브의 네트워크 구조를 형성하며 비정질 탄소에 의해 실리콘 입자와 탄소나노튜브의 입자들이 결합한 상태를 유지하는 구조로 이루어진다. 이러한 복합입자의 구조적인 특성으로 인해 계속적인 충방전 과정에서 실리콘의 부피팽창이 효과적으로 완충되고 이에 따라 전기적 접촉 손실 및 SEI 막 형성에 따른 비가역 반응이 제어되어 우수한 수명 특성 및 충전출력 특성을 갖는 것으로 나타난다. In this study, silicon / carbon nanotube / carbon composite particles with high capacity were fabricated by using micro-sized silicon particles and carbon nanotubes as an anode material for lithium ion batteries. The silicon / carbon nanotube / carbon composite particles were prepared by spray drying method to prepare spherical composite particles. The composite particles have the network structure of the carbon nanotubes around the silicon particles, in which the silicon particles and the carbon nanotubes are bonded by amorphous carbon. It appears that the volume expansion of silicon is effectively buffered and the electrical contact is maintained in the network structure of the composite particles during charge-discharge cycles.

무위당 장일순의 생애와 교육사상 - 평생교육에의 함의

신민선 한국평생교육학회 2023 평생교육학연구 Vol.29 No.2

삶의 터전을 교육의 장으로 만들고 변화를 이끈 지도자의 삶을 평생교육과 연결 지어 그 가치를 탐색하는 연구는 중요한 의미를 갖는다. 이 연구는 한국 현대사에서 일관된 자세로 평생 야인으로 살아온 무위당 장일순의 생애와 교육사상을 고찰함으로 평생교육에의 함의를 밝히고자 하였다. 구체적으로 그의 생애에서 가르침의 의미와 평생교육 원리가 무엇이며 더 나아가 장일순의 교육사상이 오늘날 평생학습사회에 주는 시사점은 무엇인지 살펴보았다. 연구 방법은 장일순에 관한 역사적 사료 및 문헌 분석 고찰 등 해석적 연구를 위한 질적 연구를 활용했다. 연구 결과로 장일순의 가르침은 ‘개문류하’, ‘일인일기’, ‘교학상장’, ‘교자채신’이 제시되었다. 장일순 교육사상에서 나타난 평생교육 원리는 ‘평등의 원리’, ‘실천의 원리’, ‘공생의 원리’, ‘해방의 원리’로 유형화되었다. 장일순의 교육사상이 평생학습사회에 주는 시사점은 ‘동등한 평생교육 기회 제공’, ‘실천 지향적 교육활동과 사회변혁’, ‘배움공동체 의미와 가치 구현’, ‘교수자의 비판적 성찰과 행동’ 등이 제시되었다. 교육자이자 동시에 학습자였던 장일순의 교육사상은 교수자 지식 전달 중심의 평생교육 현실과 민간 차원의 교육 운동과 실천가들의 교육활동에 평생교육 함의를 부여하며 평생학습사회 구현에 시사점을 제시했다.

공교육의 문제점과 해결 방안

신민선 한국교정복지학회 2007 교정복지연구 Vol.- No.8

교회에서의 가족자원봉사활동

신민선,변호순 한국인권사회복지학회 2009 인권복지연구 Vol.- No.5