델파이 방법을 이용한 노인전문치과위생사 핵심역량 도출

이선미,원영순,김형미,심선주,이정화,문상은,김창희,Lee, Sun-Mi,Won, Young-Soon,Kim, Hyeong-Mi,Sim, Seon-Ju,Lee, Jung-Hwa,Moon, Sang-Eun,Kim, Chang-Hee 한국치위생학회 2022 한국치위생학회지 Vol.22 No.5

Objectives: This study derived the core competencies for developing a curriculum for advanced practice dental hygienists in the elderly. Methods: A Delphi survey was conducted thrice times with 12 subjects engaged in dental hygiene-related activities for the elderly. Results: The item with the highest average in each domain was 'understanding the elderly (mean=5.00)' in basic qualities and attitude competency, 'understanding the oral health characteristics of the elderly (mean=5.00)' in the job competency, and 'development and evaluation of oral health programs for the elderly (mean=4.75)' in job support competency. Conclusions: The core competencies of dental hygienists specializing in the elderly are divided into 3 'basic qualifications and attitude competencies', 'job competencies', and 'job support competencies' 27 sub-competencies are presented.

치위생학교육평가·인증체계 정립을 위한 학습성과기반 치위생 핵심역량에 관한 조사

이선미,장경애,이정화,Lee, Sun-Mi,Jang, Kyeung-Ae,Lee, Jung-Hwa 한국융합학회 2020 한국융합학회논문지 Vol.11 No.9

치위생학교육평가·인증체계 정립을 위한 학습성과기반 치위생 핵심역량을 파악하고자 치위생(학)과 전임교수 207명을 대상으로 설문 조사를 실시하였다. 핵심역량별 세부영역에서 전문가적 행동 및 윤리적 의사결정 능력(1영역)과 과학적이고 전문적인 임상치위생과 임상치과업무의 지식과 기술을 적용할 수 있는 능력(2영역)의 전체 점수가 가장 높게 나타났고, 의사소통 능력 정도(3영역)는 4.48점, 근거중심의 통합적 사고와 문제해결 능력 정도(5영역)는 4.35점으로 나타났다. 핵심역량 세부영역들은 강한 상관관계가 있는 것을 확인하여 보건의료서비스 직종간의 핵심역량 파악과 임상 실무현장에 근무하고 있는 치과위생사들의 핵심역량에 대한 질적 연구가 필요하다고 사료된다. This study conducted to investigate the core competency of dental hygiene based on learning outcomes for establishing an educational evaluation and certification system for dental hygiene. The sub-categories of core competencies, the overall score of professional behavior and ethical decision-making ability (category 1) and the ability to apply scientific and professional clinical hygiene and knowledge and skills of clinical dental work (category 2) was highest. and the level of communication skills (category 3) was 4.48 points, and the level of evidence-based integrated thinking and problem solving skills (category 5) was 4.35 points. Furthermore, there was a strong correlation between the core competency sub-categories, and it is necessary to identify the core competency between health care service occupations and to qualitatively study the core competency of dental hygienists working in clinical practice.

MCF-7 cell에서 all-trans retinoic acid에 의한 insulin-like growth factor-I와 insulin-like growth factor binding protein-3 분비조절에 있어서 PKC-δ의 역할

이선미,김상훈,최광수,강창원,Lee, Sun-Mi,Kim, Sang-Hoon,Choi, Kwang-Soo,Kang, Chang-Won 대한수의학회 2006 大韓獸醫學會誌 Vol.46 No.2

All-trans retinoic acid (AtRA) induces growth inhibition and apoptosis in a variety of tumer cells, including MCF-7 cells. Insulin-like growth factors (IGFs) system has been reported to be associated with the development of cancer. Although MCF-7 cell with AtRA is to be the major stimulus for the cell growth and apoptosis, the mechanism of insulin-like growth factor-I (IGF-I)/insulin-like growth factor binding protein-3 (IGFBP-3) system remains to be elucidated. Thus, this study was conducted to the effect of AtRA on the gene expression and level of IGF-I and IGFBP-3. In addition, we investigated the involvement of PKC-${\delta}$ on the IGF-I and IGFBP-3 secretion in MCF-7 cell. AtRA(${\geq}10^{-7}M$) decreased the IGF-1 secretion and mRNA expressions, but increased IGFBP-3 secretion and mRNA expressions in MCF-7 cells. Especially, the treatment of AtRA at 72 hours caused a significant reduction in the IGF-I secretion and mRNA expressions but increment in IGFBP-3 secretion and mRNA expressions (p < 0.05). $10^{-7}M$ AtRA activated PKC-${\delta}$ that is one among PKC-$\iota$, ${\alpha}$, ${\lambda}$ and ${\delta}$ in MCF-7 cell. Rotllerin, a PKC-${\delta}$ inhibitor, blocked AtRA-induced inhibition of the IGF-I and mRNA expressions, and increase of lGFBP-3 and mRNA expressions in MCF-7 cell. Together, AtRA inhibited the IGF-I secretion and mRNA expressions, but increased IGFBP-3 secretion and mRNA expressions in MCF-7 cell. Furthermore, AtRA-induced alteration of IGF-I, IGFBP-3 secretion, and the gene expressions were mediated via PKC-${\delta}$ activity.

흰쥐의 배양된 간세포에서 ethanol에 의해 유도된 p42/44 MAPkinase가 IGF system에 미치는 효과

이선미,김종훈,강창원,Lee, Sun-Mi,Kim, Jong-Hoon,Kang, Chang-Won 대한수의학회 2006 大韓獸醫學會誌 Vol.46 No.4

Ethanol abuse is associated with liver injury, neurotoxicity, modulation of immune responses, and increased risk for cancer, whereas moderate ethanol consumption exerts protective effects against liver injury. However, the underlying signal transduction mechanisms of insulin-like growth factors (IGFs) which play an important regulatory role in various metabolism mechanisms are not well understood. We investigated the effects of ethanol-induced p42/44 activity on IGF-I secretion, IGF-I receptor and IGFBP-1 secretion using radioimmunoassay and western blotting in primary cultured rat hepatocytes. The p42/44 activity, IGF-I secretion and IGF-I receptor activity significantly accelerated compared to control at 10 and 30 min after 200 mM ethanol treatment, but then it became suppressed at 180 min. In contrast, IGFBP-1 secretion was inhibited compared to control at 30 min after 200 mM ethanol treatment, but increased at 180 min. The IGF-I secretion, IGF-I receptor and p42/44 activity at 30 min after 200 mM ethanol treatment accelerated with increasing ethanol concentration but IGFBP-1 secretion inhibited (p<0.05). The increased IGF-I secretion, inhibited IGFBP-1 secretion and IGF-IR activity by ethanol-induced temporal p42/44 activity at 30 min after ethanol treatment was blocked by treatment with PD98059. Alcohol dehydrogenase (ADH) inhibitor, 4-methylpyramazole blocked the changes of IGF-I secretion, IGFBP-1 secretion, and IGF-IR activity by ethanol-induced p42/44 activity at 30 and 180 min. Taken together, these results suggest that ethanol is involved in the modulation of IGF-I and IGFBP-1 secretion and IGF-IR activity by p42/44 activity in primary cultured rat hepatocytes. In addition, changing of p42/44 activity by ethanol was caused with ADH.

일부 치과 종사자의 치과 건강보험의 지식수준에 미치는 요인에 대한 융합연구

이선미,손화경,Lee, Sun-Mi,Son, Hwa-Kyung 한국융합학회 2021 한국융합학회논문지 Vol.12 No.10

The purpose of this study is to analyze the factors affecting the education experience, education needs, and knowledge level of calculation criteria for dental workers. It was conducted on dental workers in Daegu and Gyeongbuk province and an online survey was conducted using Google Survey. We used frequency analysis, crossover analysis, and ANOVA analysis method to find out general characteristic, education experience, education needs, and knowledge level according to education experience and education needs of candidates. As a result of in the knowledge level survey of dental health insurance, there were high rates of incorrect answers to the calculation criteria when the claim program automatically processes it or notifies you through an error window. The level of knowledge of candidates who are experienced, on a claim, and with experience in dental insurance training in the last six months was high. In conclusion, it seems that accurate and correct insurance claims are possible when the dental workers are familiar with the calculation criteria changed through regular dental health insurance education. We look forward to this study providing basic data in preparation of education system for professional dental insurance claims for dental workers. 이 연구는 치과 종사자들의 치과 건강보험 교육경험 및 교육요구도와 산정기준에 대한 지식수준에 미치는 요인을 분석하는 것을 목적으로 한다. 대구·경북 지역의 치과 종사자들을 연구대상으로 하였으며, 구글 설문지를 활용한 온라인 조사를 실시하였다. 연구대상자의 일반적 특성, 교육 경험, 교육 경험 및 교육요구도에 따른 지식수준을 알아보기 위하여 빈도분석과 교차분석 및 ANOVA분석을 사용하였다. 분석 결과, 치과 건강보험에 대한 지식수준 조사에서 청구 프로그램에서 자동으로 처리를 해주거나 오류창으로 알려주는 경우의 산정기준에 대한 오답률이 높았다. 근무경력이 많고 치과에서 보험청구를 하고 있거나 최근 6개월 동안 치과보험 교육 경험이 있는 대상자들에서 산정기준에 대한 지식수준이 높았다. 결론적으로, 정기적인 치과 건강보험 교육을 통해 변경되는 산정기준을 숙지하도록 해야만 정확하고 올바른 보험청구가 가능하다고 보여진다. 이 연구는 치과 종사자들의 전문적인 치과 보험청구를 위한 교육체계 마련에 기초자료를 제공할 것으로 기대한다.

소아 촬영 시 선량감소 및 화질 향상을 위해 고안된 차폐가운 사용에 따른 유용성 평가

이선미(Sun-Mi Lee),심지나(Ji-na Shim),정지상(Ji-sang Jung),이용수(Yong-Su Lee),진덕은,강성호(Sung-Ho Gang),임재식(Jea-Sik Lim) 대한영상의학기술학회 2014 대한영상의학기술학회 논문지 Vol.2014 No.1

목 적 : 본 연구는 성인에 비해 방사선감수성이 높은 소아의 일반 x선 촬영 시 환자가 받는 유효선량을 감소시키고 화질 향상에 도움을 줄 수 있는 자체제작 차폐가운의 유용성에 대해 검토하고자 하였다. 대상 및 방법 : 실험에 사용된 장비는 GE사의 Definium 8000과 직경 15cm, 높이 20cm의 CTDI 원통형 아크릴팬텀, 자체 제작한 차폐가운을 사용하였다. 차폐가운은 Pb 0.25mm apron 소재를 사용하여 가로 45cm, 세로 55cm, 폭 15cm의 ‘ㅁ’형태로 제 작하였다. 밸크로를 이용하여 ROI 크기를 변경할 수 있도록 고안되었다. 실험은 대조군(차폐가운 비사용 시)과 실험군(차폐가운을 사용 시)으로 나누어 장비에 표시된 mAs, DAP값을 기록하였고, 각 촬영은 10회씩 시행하여 평균값을 구하였고 ‘SPSS’ program을 통 해 Wilcoxon 부호순위 검정을 시행하여 유의성을 검증하였다. <실험1> Manual mode(65kVp, 8mAs)로 장비의 collimator를 이용하여 40cm*40cm, 35cm*35cm, 30cm*30cm, 25cm*25cm, 20cm*20cm으로 ROI 크기를 변화하여 촬영하였다. <실험2> AEC(Auto exposure control) mode(관전압 65kVp)에서 <실험1>과 동일한 방법으로 촬영하였다. <실험3> 65kVp, 8mAs의 조사조건으로 collimation은 최대로 설정하고 차폐 가운을 이용하여 <실 험1>과 동일하게 ROI 크기를 변화하여 촬영하였다. <실험4> AEC mode(관전압 65kVp)에서 <실험3>와 동일한 방법으로 촬영하였다.  ‘PCXMC2.0’ program을 통해 DAP값을 이용하여 유효선량을 계산하였고, ‘ImageJ’ program을 이 용하여 영상의 SNR을 구하여 화질평가를 시행하였다. 결 과 : AEC mode에서 실험군이 대조군에 비해 mAs가 평균 5%낮게 조사되었다. 유효선량도 AEC mode에서 실험군이 대조군에 평균 9.7% 낮았다. 하지만 SNR은 Manual mode 와 AEC mode에서 모두 평균 7% 향상 되었다. p value가 0.05미만 일 때 실험군과 대조군의 차이가 유의함이 증명되었다. 결 론 : 자체 제작한 차폐 가운의 사용으로 기존의 AEC mode에서 소아 촬영 시 발생했던 문제점을 보완하여 ROI영역 내 유효선량을 감소시키고 ROI영역 밖의 후방산란을 제거하여 화질향상에 도움을 줄 수 있었다. 또한 ROI영역 밖의 부위를 차폐하여 불필요한 피폭을 방지하고 소아를 고정시키는 검사자와 검사보조자의 손을 X선으로부터 보호할 수 있게 되었다. Purpose : This study examine the usefulness of newly digined protector for pediatric patients who highly sensitive to radiation than adults to reduce the effective dose and improve the quality of image. Materials and Methods : The experiments was performed with GE Definium 8000, cylindrical CTDI acrylic   phantom(diameter 15cm, height 20cm) and newly designed protector. Protector made by  Pb 0.25mm , width 45cm, height 55cm, It was constructed by ㅁ form. Using Velcro been designed to change the size of the ROI. Divided the control experiment (non-use protector) and experimental (protector was used). The valuse of mAs, DAP shown the equipment were recorded for each exmaination. Through SPSS program  the Wilcoxon signed rank test was performed to verify the significance. <Experiment 1> With Manual mode (65kVp, 8mAs), using the collimator of equipment the size of the ROI varied 40cm * 40cm, 35cm * 35cm, 30cm * 30cm, 25cm * 25cm, 20cm * 20cm. <Experiment 2> With AEC (Auto exposure control) mode (65kVp), take same method  as <experiment 1>. <Experiment 3> With Manual mode (65kVp, 8mAs), using the protector the size of the ROI varied. <Experiment 4> With AEC (Auto exposure control) mode (65kVp), take same method  as <experiment 3>.  PCXMC2.0 program through the DAP values were calculated by using the effective dose, ImageJ program to obtain the SNR of the image quality assessment was performed. Result : The values of mAs were lower 5% in the experimental group compared with the control group with AEC mode. Also, The values of effective dose were lower 9.7% in the experimental group compared with the control group with AEC mode. But, The values of SNR were improved 7% with AEC mode and Manual mode. When the p value was less than 0.05 the difference between the experimental group and the control group was demonstrated significance. Conclusion : By using of newly digned protector for pediatic, some problems are supplied in AEC mode, effective dosed in ROI area was reduced. And image quality was improved by removing the backscattering X ray, outside of ROI area was protected from X-ray

중,고등학교 급식의 대표메뉴 선정 및 표준조리법 개발

이선미 ( Sun Mi Lee ),정현아 ( Hyeon A Jung ),박상현 ( Sang Hyun Park ),주나미 ( Na Mi Joo ) 대한영양사협회 2005 대한영양사협회 학술지 Vol.11 No.1

수돗물불소농도조정사업에 대한 제주시 서부지역 주민의 인식과 사업지지에 미치는 요인

이선미 ( Sun Mi Lee ),강승훈 ( Sung Hoon Kang ),이은경 ( Eun Kyoung Lee ),박순희 ( Soon Hee Park ),배광학 ( Kwang Hak Bae ),김진범 ( Jin Bom Kim ) 대한예방치과·구강보건학회 2010 大韓口腔保健學會誌 Vol.34 No.3

Objectives. The study sought to identify factors among residents in the western area of Jeju, Korea that would increase support for an adjusted water fluoridation program. Methods. Questionnaires were distributed to the parents of schoolchildren in the western area of Jeju in 2005. Responses were collected from 1,381 residents. The questionnaire items were related to the water used for drinking and for cooking, knowledge of the issue, caries prevention effect and safety of fluoridated water and approval of water fluoridation. All collected data were analyzed using the SPSS 14.0 program. Results. Of the residents, 55.1% used public tap water for drinking and 88.2% for cooking. The majority of the residents (73.7%) were aware of the caries prevention goal of the fluoridation program with the 65.4% recognizing the safety of the program. 67.3% of residents approved the program`s implementation. The approval rate of residents being aware of the program`s implementation was 2.4 times compared to residents being unaware of the program`s implementation. The approval rate of residents recognizing the caries preventive effect of the program was 9.9 times compared to residents misunderstanding the caries preventive effect of the program. The approval rate of residents recognizing the safety of the program was 2.7 times compared to residents misunderstanding the safety of the program. Conclusions. In order to secure residents` approval for the continuation of an adjusted water fluoridation program, the education for the benefits of water fluoridation on caries prevention and the safety of fluoridation should be reinforced.

구조방정식을 이용한 치과위생사의 전문직업성, 자기효능감이 직무만족에 미치는 영향

이선미 ( Sun Mi Lee ),김수화 ( Soo Hwa Kim ) 한국치위생과학회 2012 치위생과학회지 Vol.12 No.3

This study aims to figure out the effects of dental hygienists`` professionalism and self-efficacy on job satisfaction using structural equations. This research conducted a survey to 616 study subjects. According to the analysis using SPSSWIN 18.0 and AMOS 20, the results are as follows : 1. It was shown that the dental hygienists`` professionalism gained 3.34 points, self-efficacy was 3.76 points, and job satisfaction received 3.36 points. 2. It was found that as their age was higher, educational degree was higher, they were married, and working experience was more, their professionalism, self-efficacy, and job satisfaction were higher, which showed statistically significant difference. 3. Regarding the study model, there was positive effect as the correlation coefficient of professionalism and self-efficacy was .69, that of professionalism and job satisfaction was .33, that of self-efficacy and job satisfaction was .59. In other words, there was correlation between professionalism and self-efficacy. When self-efficacy was higher than professionalism, job satisfaction also increased. Job satisfaction is affected by various environments within an organization and each individual``s internal factors. The reason why job satisfaction is important is that along with the medical service quality and productivity, it is also associated with dental hygienists`` individual life quality. In order to cope with this changeful time, it is needed for an organization to make efforts for change to enhance dental hygienists`` job satisfaction, and also it is necessary to make endeavors so that dental hygienists can have confidence in their job and their professionalism and self-efficacy can be improved.

새로운부양지표, 실질총부양비(Effective TDR)의제안과적용

이선미(Lee, Sun-Mi),송해련(Song, Hae-Ryeon) 한국인구학회 2018 한국인구학 Vol.41 No.2

본 연구는 기존의 부양지표가 갖는 한계점을 보완한 새로운 부양지표, 실질 총부양비의 개념을 정의한다. 출산율, 이주자 유입, 정년연장의 세 요인이 실질 총부양비에 미치는 영향을 분석함으로서 본 지표의 적극적인 활용제안을 목적으로 한다. 실질 총부양비는 고령층의 경제활동상태와 고령층 개념의 재정립, 경제적 관점에서의 부양비 개념과 유소년 인구 개념의 확대를 고려하여 정의되며, 20세~69세 취업자 100명당 일하지 않는 사람의 부양비를 파악한다. 그 결과 기존 총부양비와는 달리 실질 총부양비는 훨씬 크게 나타났다. 주요 요인의 적용이 실질 총부양비 변화에 미치는 영향을 파악하기 위한 시나리오 분석을 통해 각 요인별 특징을 발견하였다. 출산율 제고는 장기에 그 효과가 나타나며, 목표출산율에 따라 실질 총부양비의 차이는 크게 나타났다. 이주자 유입의 경우 단기 및 중기에 걸쳐 영향을 미치고 이는 이주자의 고령화 현상과 이주자 유입 가정자체의 특성에 기인하는 것으로 판단된다. 정년을 연장할 경우 전 기간에 걸쳐 실질 총부양비가 낮추지만 그 정도는 미미한 것으로 밝혀졌다. 모든 요인을 동시에 고려한 경우, 전 기간에 걸쳐 실질 총부양비를 낮추는 것으로 확인되며, 특히 각 요인에 따른 기간별 효과가 달리 나타남에 따라 차이가 나타난다. 이상의 분석을 통해 본 연구는 저출산과 인구 고령화에 대한 대응과 예측, 그리고 측정에 있어서 새로운 부양지표로서 실질 총부양비가 다양한 분석에서 적용되고 활용될 수 있음을 확인하였다. In this study, we define the Effective Total Dependency Ratio and suggest its use and application by analyzing three major factors. The effective TDR considers some aspects that are labor force participation, redefinition of terms on the elderly, an economic approach regarding the dependency ratio, and the youth of working age. The major findings are as follows. First, the effective TDR is much larger than the general TDR, which indicates imposing a huge burden on the workers in the 20-69 age group. Second, it is required to consider each factor depending on the timing. Third, in the case of considering all three factors, we find a decreasing and slow trend over the whole period on the effective TDR. With these analysis, we find two interesting points, one is related to the applicability of the effective TDR as an alternative and useful social dependency ratio indicator, the other is associated with importance of seeking for timely political measures to overcome low fertility and population ageing.