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      • 가상현실 기반 양측성 상지훈련이 편마비 아동의 상지 운동기능에 미치는 영향

        도지혜 연세대학교 대학원 2015 국내석사

        RANK : 247631

        The purpose of this study was to examine the impact of virtual reality-based bilateral arm training on the motor skills of children with hemiplegic cerebral palsy, in terms of their upper limb motor skills on the affected side, as well as their bilateral coordination ability. The research subjects were three children who were diagnosed with hemiplegic cerebral palsy. The research followed an ABA design, which was a single-subject experimental design. The procedure consisted of a total of 20 sessions, including four during the baseline period (A1), 12 during the intervention period (B), and four during the baseline regression period (A2), For the independent variable bilateral arm training based on virtual reality, Nintendo Wii game was played for 30 minutes in each of the 12 sessions. For the dependent variables of upper limb motor skills on the affected side and bilateral coordination ability, a Wolf Motor Function Test (WMFT) was carried out for each session and the Pediatric Motor Activity Log (PMAL) was measured before and after the intervention, as well as after the baseline regression period. To test bilateral coordination ability, shooting baskets in basketball with both hands and moving large light boxes were carried out under operational definitions, with the number of shots and time needed to move boxes measured. The results were presented using visual graphs and bar graphs. The study’ s results indicated that after virtual reality-based bilateral arm training, improvement occurred in upper limb motor skills on the affected sides, and in bilateral coordination ability, for all of the research subjects. Measurements of the effects of sustained therapy after completion of the intervention, during the baseline regression period, revealed that upper limb motor skills on the affected side and bilateral coordination ability were better than in the baseline period for all subjects. This study confirmed that for children with hemiplegic with cerebral palsy, bilateral arm training based on virtual reality can be an effective intervention method for enhancing the upper limb motor skills on the affected side, as well as bilateral coordination ability. 본 연구의 목적은 가상현실 기반의 양측성 상지훈련이 편마비형 뇌성마비 아동의 환측 상지 운동기능과 양손협응 능력 향상에 효과가 있는지 검증하기 위함이었다. 연구 대상은 3명의 편마비형 뇌성마비로 진단받은 아동이었고, 연구 설계는 개별사례 실험연구(single subject experimental design) 중 ABA 설계를 사용하였다. 연구 과정은 기초선 기간(A1) 4회, 중재기간(B) 12회, 기초선 회귀기간(A2) 4회로 총 20회기로 이루어졌다. 독립변수인 가상현실 기반 양측성 상지운동은 닌텐도 Wii 게임에 양측성 상지 운동을 적용하여 매회 30분씩 12회기 동안 시행되었다. 종속변수는 환측 상지 운동기능과 양손협응 능력으로 환측 상지 운동기능은 매 회기 울프운동기능 검사(Wolf Motor Function Test : WMFT)를 측정하였고, 소아용 운동활동 척도 검사(Pediatric Motor Activity Log: PMAL)를 중재 전과 후, 그리고 기초선 회귀 기간 후에 각 1회씩 측정하였다. 양손협응 능력은 조작적 정의를 통해 양손으로 골대에 농구공을 넣은 개수와 양손으로 크고 가벼운 상자 옮기기 활동의 수행시간을 측정하였다. 결과는 시각적 그래프 또는 막대 그래프를 통해 제시하였다. 연구 결과 가상현실 기반 양측성 상지훈련 후 모든 대상자의 환측 상지 운동기능과 양손협응 능력이 향상되었다. 기초선 회귀 기간에는 중재를 제거한 뒤 치료유지 효과를 측정한 결과 모든 대상자의 환측 상지 운동기능과 양손협응 능력은 기초선 기간보다 높게 유지되었다. 본 연구를 통해 가상현실 기반 양측성 상지훈련이 편마비형 뇌성마비 아동의 환측 상지 운동기능과 양손협응 능력 향상에 효과적인 중재임을 알 수 있었다.

      • 지체장애 근로자의 직무만족도 변화궤적과 예측요인 분석 : 잠재성장모형을 이용한 종단연구

        도지혜 연세대학교 대학원 2021 국내박사

        RANK : 247631

        본 연구는 지체장애 근로자의 직무만족도가 시간이 지남에 따라 어떠한 양상으로 변화하는지 변화궤적을 밝혀내고, 직무만족도 변화궤적에 영향을 미치는 예측요인을 규명하고자 하였다. 이를 위해 장애인고용패널조사 2차 웨이브 1차(2016년)부터 3차(2018년)까지 3년간 데이터를 잠재성장모형을 활용하여 직무만족도의 변화궤적에 유의미한 개인차이가 있는지 검증하고, 인구사회학적 요인과 직업능력요인, 근로환경 요인, 직업재활 및 직무요인, 심리사회적 요인 변수를 투입하여 변화궤적에 미치는 영향을 규명하였다. 본 연구에는 2016년부터 2018년까지 3년간 취업 상태를 유지한 지체장애 임금근로자 693명의 조사 자료를 분석하였으며, 잠재성장모형 분석을 위해 AMOS 25.0을 사용하였다. 잠재성장모형 분석 첫 단계인 무조건모형분석 결과, 지체장애 근로자의 직무만족도는 시간이 흐름에 따라 지속적으로 증가하는 양상을 보였고, 직무만족도 초기치와 변화율에 유의한 개인차이가 존재하는 것으로 나타났다. 또한 직무만족도 초기치가 높을 경우 시간이 지남에 따라 변화율이 완만하게 증가하고, 직무만족도 초기치가 낮을 경우 시간이 지남에 따라 변화율이 급격하게 증가하는 것으로 나타났다. 잠재성장모형 분석 두 번째 단계인 조건모형분석 결과, 인구사회학적 요인에서는 지체장애 근로자의 성별이 여자이고 중증장애일 경우 직무만족도가 높았고, 연령에 따른 차이는 나타나지 않았다. 직업능력요인에서는 학력이 높고 컴퓨터 활용능력과 대인관계·조직적응능력이 뛰어날수록 직무만족도가 높게 나타났다. 근로환경요인인 장애인 편의시설도 직무만족도를 높이는 요인이었으나 편의제공은 영향을 미치지 않았다. 직업재활 및 직무요인에서는 취업지원 서비스를 받은 경우 직무만족도 초기치가 낮았고, 직무적합성이 높으면 직무만족도가 높아졌다. 반면, 일반 직업교육은 직무만족도에 영향을 미치지 않았다. 심리사회적 요인인 장애수용도와 자아존중감이 높은 지체장애 근로자의 직무만족도가 높은 것을 알 수 있었다. 그리고 차별경험은 많을수록 직무만족도를 낮추는 부정적인 요인으로 작용했다. 직무만족도 변화율에 영향을 미치는 요인은 장애정도와 컴퓨터 활용능력, 취업지원 서비스, 차별경험이었다. 장애정도가 중증이고 컴퓨터 활용능력이 뛰어날 경우 직무만족도 변화율이 완만하게 증가했고, 취업지원 서비스를 제공받고 직장에서 차별경험이 많은 지체장애 근로자의 직무만족도 변화율이 급격하게 증가하는 것으로 나타났다. 본 연구는 지체장애 근로자의 직무만족도의 변화양상과 이에 영향을 미치는 예측요인을 종단적으로 분석하였고, 연구대상자를 지체장애인으로 특정함으로써 지체장애 근로자의 장애특성을 반영한 직무만족도 분석이 이루어졌다는데 의의가 있다. 따라서 본 연구 결과는 지체장애 근로자의 직무만족도 향상을 위한 작업치료사의 직업재활 중재 계획에 기초자료로 활용 가능할 것으로 기대된다. The purpose of this study was to find out how the job satisfaction of workers with physical disabilities changes over time and to identify the predictive factors that influence the change trajectory of job satisfaction. This study verifies whether there are significant individual differences in the trajectory of change in job satisfaction by analyzing data for three years from Wave 1 (2016) to Wave 3 (2018) of the 2nd wave of the Employment panel survey for the disabled, using a Latent growth model. Demographic factors, vocational competence factors, working environment factors, vocational rehabilitation and job factors, and psychosocial factors were input to investigate the effect on the trajectory of change. In this study, data from a survey of 693 wage workers with physical disabilities who maintained their employment status for 3 years from 2016 to 2018 were analyzed, and AMOS 25.0 was used to analyze the Latent growth model. As a result of the unconditional model analysis, the first stage of the analysis of the latent growth model, the job satisfaction of workers with physical disabilities showed a pattern that continuously increased over time, and there was a significant individual difference in the initial value of job satisfaction and the rate of change. In addition, when the initial value of job satisfaction is high, the rate of change gradually increases over time, and when the initial value of job satisfaction is low, the rate of change increases rapidly over time. In the second stage of the analysis of the latent growth model, the conditional model analysis was analyzed by putting predictive factors into the optimal model. As a result of the analysis, among the demographic and sociological factors, when the sex of a worker with a physical disability was female and severely disabled, job satisfaction was high, and there was no difference according to age. In the case of vocational competency factors, the higher the academic background, the better the computer use ability and the interpersonal relationship/organizational adaptation ability, the higher the job satisfaction. In terms of working environment factors, convenience facilities for the disabled were a factor that increased job satisfaction, but providing convenience did not affect job satisfaction. Among the vocational rehabilitation and job factors, the initial value of job satisfaction was low when job support services were received, and job satisfaction increased when job suitability was high. On the other hand, general vocational education did not affect job satisfaction. In psychosocial factors, job satisfaction was higher as disability acceptance and self-esteem increased. In addition, the more experiences of discrimination, the more negative the job satisfaction was. Factors influencing the rate of change in job satisfaction were the degree of disability, computer use ability, employment support service, and discrimination experience. When the degree of disability was severe and the ability to use computers was excellent, the rate of change in job satisfaction increased gradually, and when there was a lot of discrimination experience at work after receiving a job support service, the rate of change in job satisfaction increased rapidly. This study is meaningful in that it has longitudinally analyzed the patterns of change in job satisfaction of workers with physical disabilities and predictive factors affecting them. It is significant that the job satisfaction analysis reflecting the disability characteristics of workers with physical disabilities was conducted by specifying the subjects of the study as persons with physical disabilities. Therefore, the results of this study are expected to be used as basic data for occupational therapists' vocational rehabilitation intervention plans to improve job satisfaction of workers with physical disabilities.

      • (The) role of Epac2 on dorsal striatal neurons and neuromodulation in vitro

        도지혜 서울대학교 대학원 2013 국내석사

        RANK : 247631

        Cholinergic interneurons that are scattered scarcely throughout the dorsal striatum exhibit spontaneous activity which is autonomous in nature (Bennett et al. 2000). These tonically active neurons recorded in awake-behaving monkeys showed correlated pause of firing in response to a primary reward and to the sensory stimuli that becomes associated with the reward (Crutcher and DeLong 1984; Kimura et al. 1984; Aosaki et al. 1994; Apicella et al. 1997) . Studies to this day have reached a general conclusion that the pause is triggered by dopamine that mainly activates D2 receptors (most abundantly expressed on cholinergic interneurons) and down-regulates activity of channels that maintain autonomous firing (Yan et al. 1997; Maurice et al. 2004; Deng et al. 2007). One of the mechanisms is the D2 receptor mediated Ih current inhibition which was shown to be cAMP-dependent but PKA independent (Deng et al. 2007). However, the downstream molecular target that underlies Ih current inhibition is unknown. In this study, I focused on investigating the involvement of Epac2, a cAMP-activated guanine nucleotide exchange factor (GEF), in mediating the D2 receptor downstream that results in Ih inhibition. First, the expression of Epac2 mRNA in cholinergic inter-neurons was identified by scRT-PCR. Then, I employed a pharmacological approach in a whole-cell configuration to measure total Ih currents through HCN channels. In the presence of an Epac activator, 8CPT-2Me-cAMP, there was no effect on total Ih currents. Interestingly, activation of D2 receptors by quinpirole had no inhibiting effects on total Ih currents as previous study has shown, and more surprisingly, 8CPT-2Me-cAMP increased total Ih currents when D2 receptors were activated. Lastly, I investigated the effect of Epac2 deletion which itself had no effect on total Ih currents, but dramatically increased total Ih currents upon D2 receptor activation. These results suggest that Epac2 function may be tightly regulated by D2 receptors in a complex manner through mechanisms that recruit distinct sets of signaling cascades but result in enhancement of total Ih currents. In other words, either Epac2 activation or deletion may abolish the dopamine mediated pause response by enhancing Ih currents in cholinergic interneurons through distinct sets of GPCR signaling cascades yet to be determined.

      • Isolation of full-length complementary DNA encoding caffeic acid O-methyltransferase from yellow poplar (Liriodendron tulipifera)

        도지혜 고려대학교 대학원 2013 국내석사

        RANK : 247615

        Among the phenylpropanoid pathway genes, caffeic acid O-methyltransferase (COMT) catalyzes key steps in the biosynthesis of monoligniols. COMT cataylzes the O-methylation of caffeic acid and hydroxyferulic acid in monolignol biosynthesis and plays a role in determining the monomer composition of lignin. In order to understand the functions of COMT-related genes from yellow poplar, the six of COMT-related genes were isolated from the EST database. However, one (TW3-1a-T3_G01) of the COMT-related genes was partial sequence. Then, using 5′ - RACE-PCR, the full sequences of six COMT-related genes were obtained. Using the full sequences of six COMT-related genes, the results of domain region search had two conserved domains, dimerisation and methyltransferase domain, except for CL83Contig1. The CL83Contig1 had partial domain of methyltreansferase superfamily, and then was excluded from further experiments. All of the five COMT proteins showed a high degree of sequence similarity, especially S-adenosyl-L-methionine (SAM) binding site was highly conserved. Also, CL83Contig2, CL145Contig, CL570Contig1 and TW3-1a-T3_G01 were closely related to known other typical COMT proteins, while TW12-4a-T3_H18 was phylogenetically distant from their proteins. From these results, TW12-4a-T3_H18 was guessed other enzymes (such as FOMT and CCoAOMT) transferred a methyl group. To investigate tissue-specific expression pattern of COMT-related genes, I extracted total RNA from leaves, young stem, and mature stem. RT-PCR analysis showed that all of the five COMT-related genes were highly expressed in the stem. In particular, the expression of CL83Contig2 was higher in the mature stem than in the leaf and young stem. To find out that each of the COMT enzymes affected reactions within enzyme-substrate complexes, COMT-related genes were transformed into E.coli. Then, COMT proteins were heterologously expressed in the E.coli and partially purified. In addition, in order to understand the mechanism of transcription at the molecular level, I performed the promoter analysis of COMT-related genes. The promoter of CL570Contig1 was isolated and obtained -1.8 kb upstream containing two CAAT-box and one TATA-box. Continually, its GFP::GUS fusion construct will be transformed into Arabidopsis. Furthermore, overexpression constructs for COMT-related genes will be transformed into Arabidopsis and poplar for their functional characterization at molecular level.

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