• Title/Summary/Keyword: 교육.연구

Search Result 41,777, Processing Time 0.069 seconds

Case study of Music & Imagery for Woman with Depression (우울한 내담자를 위한 MI(Music & Imagery) 치료사례)

  • Song, In Ryeong
    • Journal of Music and Human Behavior
    • /
    • v.5 no.1
    • /
    • pp.67-90
    • /
    • 2008
  • This case used MI techniques that give an imagery experience to depressed client's mental resource, and that makes in to verbalism. Also those images are supportive level therapy examples that apply to positive variation. MI is simple word of 'Music and Imagery' with one of psychology cure called GIM(Guided Imagery and Music). It makes client can through to the inner world and search, confront, discern and solve with suitable music. Supportive Level MI is only used from safety level music. Introduction of private session can associate specification feeling, subject, word or image. And those images are guide to positive experience. The First session step of MI program is a prelude that makes concrete goal like first interview. The Second step is a transition that can concretely express about client's story. The third step is induction and music listening. And it helps to associate imagery more easily by used tension relaxation. Also it can search and associate about various imagery from the music. The last step is process that process drawing imagery, talking about personal imagery experience in common with therapist that bring the power by expansion the positive experience. Client A case targets rapport forming(empathy, understanding and support), searching positive recourse(child hood, family), client's emotion and positive support. Music must be used simple tone, repetition melody, steady rhythm and organized by harmony music of what therapist and client's preference. The client used defense mechanism and couldn't control emotion by depression in 1 & 2 sessions. But the result was client A could experience about support and understanding after 3 sessions. After session 4 the client had stable, changed to positive emotion from the negative emotion and found her spontaneous. Therefore, at the session 6, the client recognized that she will have step of positive time at the future. About client B, she established rapport forming(empathy, understanding and support) and searching issues and positive recognition(child hood, family), expression and insight(present, future). The music was comfortable, organizational at the session 1 & 2, but after session 3, its development was getting bigger and the main melody changed variation with high and low of tune. Also it used the classic and romantic music. The client avoids bad personal relations to religious relationship. But at the session 1 & 2, client had supportive experience and empathy because of her favorite, supportive music. After session 3, client B recognized and face to face the present issue. But she had avoidance and face to face of ambivalence. The client B had a experience about emotion change according depression and face to face client's issues After session 4. At the session 5 & 6, client tried to have will power of healthy life and fairly attitude, train mental power and solution attitude in the future. On this wise, MI program had actuality and clients' issues solution more than GIM program. MI can solute the issue by client's based issue without approach to unconsciousness like GIM. Especially it can use variety music and listening time is shorter than GIM and structuralize. Also can express client's emotion very well. So it can use corrective and complement MI program to children, adolescent and adult.

  • PDF

A Survey on the Oral Health Conditions according to Dental Health Behaviors of Elderly People in Community (일부 지역사회 노인들의 구강보건행동에 따른 구강건강상태)

  • Kang, Hyeong-Ku;Yoon, Hyun-Suk;Cho, Young-Chae
    • Journal of agricultural medicine and community health
    • /
    • v.30 no.3
    • /
    • pp.263-277
    • /
    • 2005
  • Objectives: This study aimed to reveal the oral health conditions based on the dental health behaviors of a community-dwelling elderly. Methods: The subjects included 206 rural dwellers(100 men & 106 women) aged over 65 years old, who received dental health check-ups in the local public health center and its branches attached to 6 respective Myons of Chunchongnamdo Province, during the 2-month period from Jan. 1st to Feb. 28th, 2005. They were examined by dentists and given self-administered questionnaires asking about their dental heaith behaviors and subjective symptoms of gingival bleeding. Results: The oral health conditions based on dental health behavior showed that those who have not taken dental health service a year were found to have significantly greater number of missing teeth(p=0.002), DMFT(p=0.002) and CPITN(p=0.018), and those who have not observed intra-oral conditions a week to have significantly less number of filled teeth(p=0.002) and significantly greater number of missing teeth(p=0.000) and CPITN (p=0.000) than their respective counterparts. In terms of brushing, those who brushed their teeth below "3 times/day" were found to have significantly greater number of decayed teeth(p=0.000), missing teeth(p=0.000), DMFT(p=0.000) and CPITN(p=0.000) than their counterparts. In terms of time spent in brushing, those who spends "below 3 minutes" had significantly greater number of missing teeth(p=0.002) and DMFT(p=0.041), and significantly less number of filled teeth(p=0.036). According to the use of aid tools for cleaning teeth, the group who don't use them had significantly greater number of DMFT(p=0.041) and CPITN(p=0.018) than its counterpart. Classified by smoking habits, smoking groups had significantly greater number of decayed teeth(p=0.035) and CPITN(p=0.001) than non-smoking groups. Multiple regression analysis of the study data revealed that the significant factors influencing number of decayed teeth were number of brushing, sex and intra-oral observation (explanatory power of 14.2%). The significant factors for number of filled teeth were sex, intra-oral observation, use of aid tools, frequency of brushing, subjective health conditions and drinking of sweet beverages(explanatory power of 18.2%), those for number of missing teeth, number of brushing and age(explanatory power of 13.9%) those for DMFT, number of brushing, sex, use of dental service, age(explanatory power: 13.5%), and those for CPITN included smoking habits, use of dental service, use of aid tools (explanatory power: 10.8%). Conclusions: The study results revealed that the dental health behavior of the elderly population is in poor conditions and their consequent intra-oral health conditions are not good. To improve their oral conditions, public campaign and education will be needed to modify unhealthy dental health behaviors.

  • PDF

The Content of Minerals and Vitamins in Commercial Beverages and Liquid Teas (유통음료 및 액상차 중의 비타민과 미네랄 함량)

  • Shin, Young;Kim, Sung-Dan;Kim, Bog-Soon;Yun, Eun-Sun;Chang, Min-Su;Jung, Sun-Ok;Lee, Yong-Cheol;Kim, Jung-Hun;Chae, Young-Zoo
    • Journal of Food Hygiene and Safety
    • /
    • v.26 no.4
    • /
    • pp.322-329
    • /
    • 2011
  • This study was done to analyze the contents of minerals and vitamins to compare the measured values of minerals, vitamins with labeled values of them in food labeling and to investigate the ratio of measured values to labeled values in 437 specimen with minerals and vitamins - fortified commercial beverages and liquid teas. Content of calcium and sodium in samples after microwave digestion was analyzed with an ICP-OES (Inductively Coupled Plasma Optical Emission Spectrometer) and vitamins were determined using by HPLC (High Performance Liquid Chromatography). The measured values of calcium were ranged 80.3~142.6% of the labeled values in 21 samples composed calcium - fortified commercial beverages and liquid teas. In case of sodium, measured values were investigated 33.9~48.5% of the labeled values in 21 sports beverages. The measured values of vitamin C, vitamin $B_2$ and niacin were ranged 99.7~2003.6, 81.1~336.7, 90.7~393.2% of the labeled values in vitamins - fortified commercial beverages and liquid teas, 57, 12, 11 samples. To support achievement of the accurate nutrition label, there must be program and initiatives for better understanding and guidances on food labelling and nutrition for food manufacture.

Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage (한 대학병원에서 조사된 재택산소요법을 받고 있는 환자의 특성과 재택산소요법 처방에 대한 순응도: 건강보험급여전환 후 조사)

  • Koo, Ho-Seok;Song, Young Jin;Lee, Seung Heon;Lee, Young Min;Kim, Hyun Gook;Park, I-Nae;Jung, Hoon;Choi, Sang Bong;Lee, Sung-Soon;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Lee, Hyun-Kyung
    • Tuberculosis and Respiratory Diseases
    • /
    • v.66 no.3
    • /
    • pp.192-197
    • /
    • 2009
  • Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

Utilization Pattern of Complementary Therapy in Hypertension, Diabetes and Chronic Arthritis Patients Visited to Local Health Center (일개 보건소를 방문하는 고혈압, 당뇨 및 관절염환자의 보완요법 이용실태)

  • Park, Ae-Ju;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
    • /
    • v.28 no.2
    • /
    • pp.107-122
    • /
    • 2003
  • Objectives: The objective of this study is to investigate the use rate and some aspect of complementary therapies used by patients with chronic illness(hypertension, diabetic mellitus and chronic arthritis). Methods: 600 patients visiting the health center for one month(Jan. 2001) were interviewed on their complementary therapies used by the subjects for the previous year. Results: About fourteen-eight percent of the respondents used therapies; 35% of patients with hypertension, 44.6% of patients with diabetic mellitus and 62.9% of patients with chronic arthritis, which shows the highest rate among patients with three chronic disease. The use rate of complementary therapies indicates few meaningful differences according to the general characteristics of the interviewees. Hypertension patients used herb medication(31.0%) acupuncture(29.6%) and most of all the other therapies. Diabetic patients used dietary therapy(57.5%) and herb medication(35.1%). Chronic arthritis patients used acupuncture(85%) and herb medication(34.7%). 36.8% of all the patients who used complementary therapies tried more than two therapies. 18.3% of hypertension patients, 24.1% of diabetic patients and 55.9% of chronic arthritis patients used more than two therapies. Acupuncture(47%) was used most frequently, followed by herb medications(26.3%), health assistance utensils(21.8%). oriental therapy(21.8%), physical therapy(9.5%), health assistance food(8.4%), herb(7.7%), Korea hand acupuncture(3.2%), abdomen respiration(1.1%), and pore therapy(0.7%) Oriental clinic was visited most frequently(42.8%), which was used to cure diseases(61.8%), and to relieve symptoms(26.0%). (p<0.001) The cost spent on complementary therapies last year was 90,000 won(40.3%) and there are some cases of more than 500,000 won(31.2%). Most of the patients(56.1%) were satisfied with the complementary therapies, with 6% of them having side effects. 74% of the patients used complementary therapies answered that they would continue them and 56.1% of them also answered that they would continue them and 56.1% of them also answered that they would advise other patients to do them. Advantages(compared with those of orthodox medical treatment) are psychological comfort(28.1%), body protection(26.0%), effectiveness(20.0%). 34% of the patients using complementary therapies wanted to have informational orientation on complementary therapies. These findings reveal that a considerable number of patients with chronic illness(47.5%) tried a variety of complementary therapies. Though 6% of the patients using therapies had side effects, most of the subjects seemed satisfied with them and they are supposed to continue them. Conclusions: In conclusion, health center personnels and medical doctors should pay more attention to the complementary therapies used by patients with chronic illness. They also have to try their best to advise more scientific and informative complementary programs with less side effects and more help to improve their conditions.

  • PDF

A Survey on Physical Complaints Related with Farmers' Syndrome of Vinylhouse and Non-vinylhouse Farmers (비닐하우스 재배농민과 일반농민의 농부증 관련 신체증상 호소율 조사)

  • Lee, Ju-Young;Park, Jung-Han;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
    • /
    • v.27 no.2 s.46
    • /
    • pp.258-273
    • /
    • 1994
  • To compare the physical complaints of vinylhouse farmers with those of non-vinylhouse farmers, a personal interviews on 250 vinylhouse and 142 non-vinylhouse farmers were conducted in Sungjoo county in Kyungpook province selected by a random sampling from July 5 to July 10, 1993. Blood pressure of the subjects was also measured. Vinylhouse farmers had a higher average age, larger family size, shorter experience of farming, more working hours per day and working days per year and higher annual income than the non-vinylhouse farmers. The frequency of pesticide spray of the vinylhouse farmers was 3.4 times on the average in June 1993 as compared with 2.0 times of non-vinylhouse farmers, and 16.7 times for the vinylhouse farmers during the last one year while it was 8.3 times for the non-vinylhouse farmers in the same period. While 39.6% of vinylhouse farmers experienced pesticide intoxication symptoms such as headache, nausea, vomiting, dizziness, itching, and skin irritation, etc. during the month of June, 25.4% of non-vinylhouse farmers experienced such symptoms. The most frequent symptoms among eight symptoms that constitute the farmers' syndrome were lumbago, numbness of hand or foot, shoulder pain and dizziness regardless of sex and type of farming. Prevalence of the farmers' syndrome in male and female among vinylhouse farmers were 22.1%, 43.4%, respectively, and the prevalence in non-vinylhouse farmers was 23.2% for male and 50.7% for female. There was no statistically significant difference in the prevalence of farmers' syndrome between vinylhouse and non-vinylhouse farmers. However, the prevalence in female was about 2 times higher than that of male. When the effects of other factors were adjusted by multiple logistic regression for farmers' syndrome, the prevalence in female was 3.0 times higher than that of male. The prevalence of farmers' syndrome was increased as the age of farmers increased in both vinylhouse and non-vinylhouse farmers, and adjusted odds ratio of farmers' syndrome increased by 3% as the age increased by 1 year. Adjusted odds ratio for Farmers' syndrome in farmers who experienced pesticide intoxication during the month of June was 3.1 times higher than that of farmers who did not have such experience. While the prevalence of hypertension in male and female non-vinylhouse farmers were 22.4%, 13.7%, respectively, the prevalence in vinylhouse farmers were 13.5% for male and 12.0% for female. However, there was no association between farmers' syndrome and hypertension. It was found in this study that the vinylhouse farmers are at a high risk of pesticide intoxication, which is associated with tile common physical complaints. To reduce such risk it is necessary to develop farming methods which do not require the pesticide or may use less pesticide, a safer method of pesticide spraying, and the protective equipments which can be worn at a high temperature and have a better protective effect. Also education of farmers for the correct methods of ventilation after pesticide spraying in the vinylhouse and wearing the protective equipments may be considered as a supportive method. Since inappropriate posture at work and intensive labor may cause farmers' syndrome, it is recommended to develop farming tools which reduce physical burden and take a rest and exercise periodically during work. It is necessary to strengthen the hypertension management program of the Kyungpook province, because the prevalence of hypertension was as high as about 15%.

  • PDF

Activities of Daily Living and Instrumental Activities of Daily Living of Elderlies in Chollabuk-Do Area (일부 전북지역 노인들의 일상생활동작능력과 수단적 일상생활동작능력)

  • Lee, Ki-Nam;Jeung, Jae-Yeal;Jahng, Doo-Sub;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
    • /
    • v.25 no.1
    • /
    • pp.65-83
    • /
    • 2000
  • To know the relationship of general characteristics with activities of daily living(ADL) and instrumental activities of daily living(IADL), we carried out the study on the elderies living in Chollabuk-Do area during 6 months, from June to December in 1999. Study subjects were 281, women and men were 195(69.6%) and 85(30.4%) respectively. Mean ages of women and men were 71.9 and 70.8 respectively. 81.1% elderies has disease and 18.9% were disease free. Disease prevalences of movement joint disease, others, circulatory disease, digestive disease, dental disease, respiratory disease were 50.1%, 25.0%, 10.5%, 9.4%, 8.5%, and 6.3% respectively. The percentages to the use of medical institution in recent were 40.0% for hospital, 16.8% for oriental hospital, 14.5% for public health center, 10.9% for drug store, 10.0% for others, and 7.8% for dental service. The percentages to the improvement of symptom after the use of medical institution were 62.3% for normal, 19.4% for improvement, and 18.2% for non-improvement. The percentages to the health situation were 37.1% for bad, 35.7% for good, and 27.1% for normal. Activities of daily living were 67.1% for 6 scores, 27.9% for 5 scores, 2.1% for 4 scores and ADL of women was lower than the men's. Instrumental activities of daily living were 50.4% for 5 scores, 19.3% for 3 scores, 12.1% for 4 scores and IADL of women was lower than the men's. Frequencies of disability in ADL were 28.9% for incontinence, 6.1% for bathing, 2.9% for meal, 2.5% for walking around house, 1.8% for toilet use, 1.4% for dressing and disability frequencies of women in 6 items of ADL were higher than the men's. The percentages of high, intermediate, low ADL in activities of daily living were 67.1%, 32.5%, 0.4% respectively and decrease of high ADL, increase of intermediate ADL were found with the increasing of age. Frequencies of disability in IADL were 42.9% for payment in and out, 31.8% for payment of written claim, 21.1% for shopping, 16.4% for preparation of meal, and 11.8% for use of bus. All items of women in IADL was higher than the men's but preparation of meal. The percentages of high, intermediate, low IADL in instrumental activities of daily living were 50.4%, 42.5%, 7.1% and decrease of high IADL, increase of intermediate IADL were found with the increasing of age. Mean of ADL with the general characteristics was 5.56 and 2 variables of level of education, health situation were statistically significant. Mean of IADL with the general characteristics was 3.76 and 8 variables of age, sex, level of education, occupation, presence of spouse, duty of living cost, health situation, category of ADL were statistically significant. With the result of stepwise regression, ADL was statistically related with religion, health situation and ADL was statistically related with level of education, living together with family, duty of living cost, health situation.

  • PDF

Korea's Street Processions and Traditional Performing Arts (한국의 가두행렬(街頭行列)과 전통연희)

  • Jeon, KyungWook
    • (The) Research of the performance art and culture
    • /
    • no.18
    • /
    • pp.513-557
    • /
    • 2009
  • The procession depicted in Goguryeo's ancient tomb mural consists of guards, honor guards, music band, and performing artists. Since this coincides with the royal processions of Goryeo and Joseon Dynasties, the relationship of its impact can be examined. The performing arts appearing in such street procession were mostly sanakbaekhui. During the Goryeo Dynasty, the king visited Bongeunsa templ when the lotus lantern festival was celebrated. At such time, on the left and right sides of the road travelled by the king were installed mountains made of lanterns and trees made of lanterns. The procession was quite large in scale and was accompanied by colorful music and performances. In the narye ceremony of the Goryeo Dynasty, as in China, street procession and performing arts took place. The jisinbarbgi performed by a peasant band in early January is a custom of narye. A new character appears in the royal narye during the first half of the Joseon period. Therefore the features of narye transforming according to the changes of the times can be examined. In the Joseon Dynasty's procession of a king returning to the palace, the royal band in front and behind the carriage of the king played marching music, and led by a sanbung this street procession headed toward the palace. Various performances also took place during this time. The samilyuga and munhuiyeon were festivals of the yangban class(nobility). Those who passed the state examination hired musicians and performers and paraded around town in Seoul for three days to celebrate the auspicious outcome for their family and to show off their family's power. In the Joseon's dongje and eupchijeui ceremonies, street processions were carried out with a shrine deity image or symbolic flag at the head. The dongje in a Korean village, combined with jisinbarbgi, incorporated a procession with the flags ymbolizing the guardian deity of the village at the head, and this went from house to house. The procession of suyeongyaru had the publicity impact of a mask play performance, and by creating a sense of unity among the participants, heightened the celebratory atmosphere. At the core of the bukcheonggun toseongri gwanweonnori was as treet procession imitating the traveling of high government officials. The toseong gwanweonnori has the folk religion function of praying for safe human living and abundance of grains for the village, the entertainment function of having fun and joy through street processions and various performances, and the social function of creating unity and harmony among the residents. In all the aforementioned events, the street procession had a large role in creating a celebratory atmosphere, and the performance of traditional performing arts in the middle of the procession or after the procession enabled the participants to feel united. The participants of the street procession felt cultural pride and self-confidence through the various events and they were able to have the opportunity to show off and proudly display their abilities.

The Influence of Organizational Commitment, Job Commitment and Job Satisfaction on Professionalism Perceived by Radiotechnologists Working in the Department of Radiation Oncology (방사선종양학과에 근무하는 방사선사의 조직몰입, 직무몰입, 직무만족이 전문 직업성에 미치는 영향)

  • Gim, Yang-Soo;Lee, Sun-Young;Lee, Joon-Seong;Gwak, Geun-Tak;Pak, Ju-Gyeong;Lee, Seung-Hoon;Hwang, Ho-In;Cha, Seok-Yong
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.24 no.2
    • /
    • pp.67-75
    • /
    • 2012
  • Purpose: The study is to check the specialty of radiotherapists working in the department of radiation oncology and find job satisfaction, organizational commitment and job commitment having an effect on professional parts. After making analysis of the mutual relation, it is to provide radiotechnologists with making progress in the future. Materials and Methods: From March 2 to March 30, we had carried out a survey with email. It is possible to have 272 questionnaires answered in the survey. We make use of SPSS 13.0 for Windows to analyze the data collected for study. Frequency and a percentage are meant to show general characteristics, and t-test and ANOVA to do the difference between general properties and professionalism. Pearson's correlation coefficient also is meant to do the correlation of professionalism, organizational job commitment and job satisfaction, and multiple regression analysis to do the factor for a relevant variable to affect professionalism. Results: There are subdivisions in the professionalism informing us of the self-regulation $17.74{\pm}2.32/3.55{\pm}.46$, a sense of calling $17.58{\pm}2.63/3.52{\pm}.53$, reference of the professional $17.14{\pm}2.39/3.43{\pm}.48$, service to the public $15.97{\pm}2.48/3.19{\pm}50$, and autonomy $15.68{\pm}2.28/3.14{\pm}46$. Grand mean turns out to be $83.89{\pm}7.63$(Summation of items)/$3.37{\pm}0.49$ (Numbers of items). When it comes to a statistical relation between general characteristics and professionalism, the statistics have it that these come within age (P<.001), period of employment (P<.001), education status (P<.05), a monthly income (P<.001), radiotherapists who get a special license (P<.001), the position (P<.001), and an opportunity for developing (P<.001). As a result of organizational commitment, job commitment, and job satisfaction, grand mean in organizational commitment proves to be $80.10{\pm}8.15/3.34{\pm}.34$. There are subvisions showing affective commitment $28.64{\pm}4.61$/3.58, continuance commitment $27.54{\pm}4.22/3.44{\pm}.53$, and normative commitment $23.95{\pm}2.94/2.99{\pm}.37$ in order of precedence. The average grade in job commitment is $32.47{\pm}5.77/3.30{\pm}.60$ and that in job satisfaction is $63.39{\pm}10.16/3.17{\pm}.51$, respectively. We find the positive relationship between professionalism and organizational commitment (r=.522, P<.05), between professionalism and job commitment (r=.444, P<.05), and between professionalism and job satisfaction (r=.507, P<.05). And we also get the positive relationship between organizational commitment and job commitment (r=.549, P<.05), between organizational commitment and job satisfaction (r=.433, P<.05), and between job commitment and job satisfaction (r=.462, P<.05). To catch the factors influencing the professionalism of radiotherapists, we used multiple regression analysis. According to the final model, it appears affective commitment (B=.755, P<.05), normative commitment (B=.305, P<.05), job satisfaction (B=.092, P<.05), an opportunity for developing (B=-1.505, P<.05), and the position (B=-1.155, P<.05) in order of precedence. It seems that explaining influece on $R^2$ is 0.504. Conclusion: The results of the factors that influence professionalism working as radiotherapists in the department of radiation oncology have it that the more affective commitment, normative commitment, and job satisfaction we feel, the more professionalism we recognize. We think that the focus of professionalism is increased if getting the chances for radiotherapists to have little to do with developing opportunities given.

  • PDF

Comparisons of Unicortical and Bicortical Lateral Mass Screws in the Cervical Spine : Safety vs Strength (경추부의 후관절 나사못 고정술에서 단피질삽입법과 양피질 삽입법 간의 특성에 관한 비교)

  • Park, Choon-Keun;Hwang, Jang-Hoe;Ji, Chul;Lee, Jae Un;Sung, Jae Hoon;Choi, Seung-Jin;Lee, Sang-Won;Seybold, Eric;Park, Sung-Chan;Cho, Kyung-Suok;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.10
    • /
    • pp.1210-1219
    • /
    • 2001
  • Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

  • PDF