Music therapists' perceptions on professionalism

The purpose of this study was to investigate how music therapists perceive the professionalism. The 37-item questionnaire was constructed and distributed to 210 credentialed music therapists to examine the current status of clinical practices and their perceived professionalism. A total of 98 music therapists completed the online survey with a 46.7% of a response rate and a total of 78 responses were included in the analysis after excluding incomplete responses. The results of this study demonstrated that music therapists show a high level of perceptions on music therapy professionalism in general. With regard to subcategory of perceived professionalism, participants perceived a relatively low level of professionalism in relation to the social aspect that indicates the perception on whether the profession contributes to addressing needs of the society. Particularly, participants showed the lowest rating with the item on recognition of their occupation as a social service. In addition, the results showed that there were significant differences in perceived professionalism depending on the length of clinical practice and the level of education. The correlation of ratings on the perceived professionalism with the length of clinical practice also reached statistical significance. With regard to self-evaluation, the majority of the respondents rated the level of their professionalism as high (M=7.24). They tended to identify individual competency as the most important aspect of professionalism. The results of study indicate that the quality of training in the controlled education system may contribute to a high level of perception on professionalism. Meanwhile, the observed lower levels of system-related and social aspects of the professionalism compared to individual aspects imply the needs for continuing education for broadening the understanding of professionalism. In consideration of the importance of professionalism in enhancing the quality of the care for clients and expanding the profession, this study also suggests future studies investigating the music therapy professionalism in multifaceted dimensions and presenting strategies for maintaining and/or reeducating the professionalism of music therapists.;본 연구는 음악치료사의 직업전문성에 대한 인식수준에 대해 알아보기 위해 시행되었다. 이를 위해 설문 참여에 동의한 전체 210부의 온라인 설문지를 배포한 후 98부를 회수 하였고, 이 중 미완성된 응답을 제외한 78부의 설문지를 분석하였다. 설문 문항은 음악치료사의 기본 정보 10문항, 전문성 인식 27문항으로 전체 37문항으로 구성되었다. 설문 결과, 음악치료사들은 직업전문성에 대해 높은 인식 수준을 가지고 있는 것으로 나타났으나 직업전문성의 측면 중 사회적 측면에서 상대적으로 점수가 낮은 결과가 나타났다. 직업전문성 인식 점수를 교육정도에 따른 집단 간 비교 시 직업전문성 점수에 차이가 있었다. 직업전문성 인식 점수와 경력의 상관관계는, 통계적으로 유의미한 결과가 나타났다. 또한 음악치료사 전문성에 대한 자기평가는 대체적으로 높게 인식하는 것으로 나타나는 결과를 보였다. 마지막으로 음악치료사가 전문성과 관련하여 가장 중요하게 생각하는 것은 개인적 측면과 관련한 답변이 가장 많았다. 본 결과를 통해 음악치료사의 직업전문성 인식이 개인적 측면에 치중되어있어 여러 측면에서의 중요성에 대한 지속적 교육의 필요성이 요구됨을 알 수 있다. 전반적으로 음악치료사는 교육과정 내에서 높은 수준의 교육이 이루어짐으로 이점이 높은 인식 수준에 반영이 되었다고 할 수 있다. 결론적으로 본 연구에서 음악치료사들의 전문성 인식을 알아봄으로 음악치료사의 지속적인 전문성 강화 방향과 전문성 관리를 위한 재교육의 필요성의 중요함을 알 수 있다.Ⅰ. 서론 1 A. 연구의 필요성 1 B. 연구 문제 4 Ⅱ. 이론적 배경 5 A. 직업전문성 5 1. 직업전문성의 개념과 이해 5 2. 직업전문성의 중요성 6 B. 음악치료사의 전문성 7 1. 음악치료사 7 2. 음악치료 분야 내 전문성 10 3. 음악치료사 자격증 12 C. 치료분야 전문성 연구 고찰 13 1. 음악치료사의 전문성 연구 13 2. 관련 치료분야 전문성 연구 14 Ⅲ. 연구 방법 16 A. 연구 참여자 15 B. 조사도구 17 C. 연구 절차 20 1. 설문문항 내용평가 20 2. 본 조사 21 3. 자료처리 21 D. 윤리적 고려사항 22 Ⅳ. 결과 및 논의 23 A. 결과 23 1. 연구 참여자 사항 23 2. 현재 활동하는 치료현장 관련 27 B. 직업전문성 인식 30 1. 직업전문성 인식 수준 30 2. 경력에 따른 직업전문성 인식 33 3. 교육정도에 따른 직업전문성 인식 33 C. 음악치료사 직업전문성 자기 평가 33 D. 직업전문성에 대한 음악치료사의 의견 36 E. 논의 38 Ⅴ. 결론 및 제언 40 A. 결론 40 B. 제언 41 참고문헌 43 부록1. 설문지 49 ABSTRACT 5

Serial changes of CT findings in patients with chronic hypersensitivity pneumonitis: imaging trajectories and predictors of fibrotic progression and acute exacerbation

Objectives: To evaluate the longitudinal changes of chest CT findings in patients with chronic hypersensitivity pneumonitis (HP) and identify risk factors for fibrotic progression and acute exacerbation (AE). Methods: This retrospective study included patients with chronic HP with follow-up CT. Baseline and serial follow-up CT were evaluated semi-quantitatively. Fibrosis score was defined as the sum of the area with reticulation and honeycombing. The modified CT pattern of Fleischner Society idiopathic pulmonary fibrosis diagnostic guidelines was evaluated. Cox proportional hazards regression was performed to determine significant variables associated with fibrotic progression and AEs. Results: Of 91 patients, mean age was 59.1 years and 61.5% were women. The median follow-up period was 4.9 years. Seventy-nine patients (86.8%) showed fibrotic progression with persistent areas of mosaic attenuation, finally replaced by fibrosis, and 20 (22.0%) developed AE. Baseline fibrosis score and CT pattern of usual interstitial pneumonia (UIP)/probable UIP were independent risk factors for predicting fibrotic progression (hazard ratio [HR] = 1.05, 95% confidence interval [CI] = 1.02?1.09, p < 0.001, for fibrosis score; HR = 2.50, CI = 1.50?4.16, p < 0.001, for CT pattern) and AEs (HR = 1.07, CI = 1.01?1.13, p = 0.019, for fibrosis score; HR = 5.47, CI = 1.23?24.45, p = 0.026, for CT pattern) after adjusting clinical covariables. Conclusion: Fibrotic progression and AE were identified in 86.8% and 22.0% of patients with chronic HP. Fibrosis score and CT pattern of UIP/probable UIP on baseline chest CT may predict fibrotic progression and AE. Key Points: ? Most patients (87%) showed fibrotic progression on long-term follow-up with persistent areas of mosaic attenuation that were finally replaced by fibrosis at a later stage. ? One-fifth of patients (22%) experienced acute exacerbation associated with worse prognosis. ? Fibrosis score (sum of reticulation and honeycombing) and CT pattern of UIP/probable UIP on baseline CT were independent predictors for predicting fibrotic progression and acute exacerbation

CT radiomics-based prediction of anaplastic lymphoma kinase and epidermal growth factor receptor mutations in lung adenocarcinoma

Purpose: To develop and validate a CT-based radiomic model to simultaneously diagnose anaplastic lymphoma kinase (ALK) rearrangements and epidermal growth factor receptor (EGFR) mutation status of lung adenocarcinoma and to assess whether peritumoural radiomic features add value in the prediction of mutation status. Methods: 503 patients with pathologically proven lung adenocarcinoma containing information on the mutation status were retrospectively included. Intratumoural and peritumoural radiomic features of the primary lesion were extracted from CT. We proposed two-level stepwise binary radiomics-based classification models to diagnose ALK (step1) and EGFR mutation status (step2). The performance of proposed models and added value of peritumoural radiomic features were evaluated by using the areas under receiver operating characteristic curves (AUC) and Obuchowski index in the development and validation sets. Results: Regarding the prediction of ALK rearrangement, the diagnostic performance of the intratumoural radiomic model showed the AUC of 0.77 and 0.68 for the development and validation sets, respectively. As for EGFR mutation, the diagnostic performance of the intratumoural radiomic model showed the AUCs of 0.64 and 0.62 for the development and validation sets, respectively. The radiomics added value to the model based on clinical features (development set [radiomics + clinical model vs. clinical model]: Obuchowski index, 0.76 vs. 0.66, p < 0.001; validation set: 0.69 vs. 0.61, p = 0.075). Adding peritumoural features resulted in no improvement in terms of model performance. Conclusion: The CT radiomics-based model allowed the simultaneous prediction of the presence of ALK and EGFR mutations while adding value to the clinical features