• 대한한방내과학회지
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• 제33권4호
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• 대한간호학회지
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• 제25권1호
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• pp.17-29
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• 1995

This study was done to analysis data on breastfeeding mothers. This stud was conducted using data from telephone counseling in one metropolitan area. The subjects who had received consultation about breastfeeding were 100 breastfeeding mothers. The period of consultation was from Mar. 9, 1994 to August 23, 1994. Consultants were referred from UNICEF, hospitals, TV, newspapers or magazines. Analysis of the problem patterns resulted in 11 classifications. These were physio -anatomical factors(11 cases) , psychological factors(15 cases), breastfeeding methods(21 cases), breastfeeding intervals and frequency(19 cases) , disease in the breastfeeding mothers(13 cases), disease in the babies (12 cases), lack of support (4 cases), food and drugs while breastfeeding(5 cases), weaning(11 cases), others(27 cases). The highest frequency was for breastfeeding methods (21 cases). When the contents of the counselling were analyzed for the 100 cases, 36 problem patterns were identified. Patterns with over 10 responses were diarrhea, insufficient milk supply, sore and cracked nipples, weaning, inverted nipples and jaundice. The age of infants when mothers were telephoned was as below : 1 week(28 cases), 2 weeks(12 cases), 3-4 weeks(18 cases), 5-8 weeks(7 cases), 9 weeks-3 menths(4 cases), 4 menths-6 months(12 cases), over 6 months(2 cases), and the number of pregnant women was 12. The nursing diagnosis were classified according to problem patterns and each diagnosis was assigned an appropriate Problem Pattern The total number of nursing diagnoses was 22. When clients are referred for counselling nurses need guidelines about problems, possible causes and nursing. In this study, the example of guidelines for sore nipples is suggested. The recommendations based on the telephone counseling results are as follows : Prenatal education about the advantages of breastfeeding and breast care, and home visits after delivery for counseling related to breastfeeding. During the hospital stay, nursing intervention such as education on breastfeeding methods using slides, audio-visual tapes, pamphlets are needed as well as an initial trial of breastfeeding. Further research is indicated on the perceived lack of breast milk and on the effectiveness of nursing interventions to pro-mote breastfeeding.

• 한국환경복원기술학회지
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• 제21권1호
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• pp.145-155
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• 2018

Problems and improvement plan in ecological pathways created by Environmental Impact Assessment(EIA) were found based on 504 expost environmental impact survey reports submitted to the National Institute of Ecology in 2016. A total of five improvement plans have been proposed. First, the concept and composition principle of ecological pathways should be unified. Second, Guidelines for consultation on the EIA should be provided for each stage to be applied on-site. Third, if ecological pathway is constructed differently than the consultation, the punishment clauses should be applied to prevent formal composition of ecological pathways. Fourth, We need to prepare measures to strengthen basic research for the installation of ecological pathways. Fifth, We need to strengthen the expost inspection function to compensate for the poorly created of ecological pathways. It is believed that the problems of ecological pathways created by consultation on environmental impact assessment could be corrected in the future. And it is deemed possible to systematically manage ecological pathways.

• 대한영양사협회학술지
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• 제19권2호
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• pp.112-123
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• 2013

HbA1c was recently adopted as a reliable indicator for screening diabetes. This study investigated the ability of nutrition consultation to prevent diabetes in overweight women (BMI 23 $kg/m^2$ or more) using HbA1c as an indicator. Twenty overweight and obese women (with $HbA1c{\geq}5.7$%) completed the 12-week nutritional study, with individual and personalized nutrition counseling performed every 2 weeks. The main study guidelines involved the following: 1) reducing the intake of high fat foods and alcohol, 2) consuming a large amount of vegetables, 3) reducing the intake of simple sugars and empty-calorie foods, and 4) increasing physical activity to ${\geq}30$ min/day. Anthropometric (height, weight, BMI, body muscle (kg), body fat (%), waist and hip circumference, blood pressure) and biochemical parameters (fasting blood sugar (FBS), HbA1c, lipid profiles, hs-CRP) were measured before and after the nutrition consultation. After 12 weeks, the HbA1c<5.7% group had significant decreases in BMI, WC, HC, WHR, HbA1c, hs-CRP and also dietary intake of energy (P<0.01), carbohydrates, lipids (P<0.01), proteins (P<0.01) and cholesterol was significantly decreased (P<0.05). In the HbA1c ${\geq}5.7$% group, HbA1c, TC, LDL, NON-HDL, hs-CRP and dietary intake of energy, carbohydrate, lipid, protein, and cholesterol significantly decreased (P<0.05). These results suggest that nutrition consultation effectively helps to prevent diabetes in overweight and obese women after applying HbA1c standards. Overall, the improvement in all markers measured suggest that HbA1c is a good indicator for blood glucose regulation, helping to prevent diabetes.

• 성인간호학회지
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• 제28권5호
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• pp.546-558
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• 2016

Purpose: This study aimed at the effectiveness to investigate the performance of evidence-based pain assessment and management guidelines. Methods: Participants were 140 nurses at the med-surgical units. Data were collected in early July, 2014 using Registered Nurses Association of Ontario (RNAO) guideline (2007) revised and validated by Hong and Lee (2012) and analyzed by descriptive statistics, t-test, ANOVA using SPSS/WIN18.0. Results: The score of performance of pain assessment guideline was higher than the score of pain management. Categories with high score were pain screening, parameter of pain assessment, documentation, assessment of opioids side-effects, and record of pain caused intervention. Categories with low score were comprehensive pain assessment, multidisciplinary communication, establishing a plan for pain management, consultation and education for patients and their families, and education for nurse. Non-pharmacological management was the lowest one. Conclusion: Assessing and managing pain is a complex phenomenon. It might be useful if institutions host training programs to ensure that nurse are better able to understand and implement pain assessment and management. Since non-pharmacological management is less likely to be used by nurses it may be helpful to include these methods in a training program.

• 한국BIM학회 논문집
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• 제11권4호
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• pp.10-19
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• 2021

In the evaluation for ordering BIM-based projects (Design Build) of Korean National Railway, criteria of BIM-based smart construction technology are assessed. Unlike the existing assessment criteria, performance resources and detailed assessment guidelines have been added by this research. The purpose of this study is to propose qualification assessment standards according to specific guidelines when evaluating on the phase of bidding for BIM-based projects. In the study, an improved evaluation standard (draft) was arranged based on two consultation meetings and surveys of related companies, applied to existing projects with the companies that won the bid, and validated. As more specific and added criteria compared to the existing standards, it could reduce the difficulty of evaluation for BIM capability and lay the foundation for railway BIM-based project management.

• 한국환경복원기술학회지
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• 제15권2호
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• pp.163-175
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• 2012

In spite of the ecological value of the DMZ, there have not been established guidelines for sustainable conservation and use on the DMZ and adjacent area. In this study we suggested a method about zoning the conservation and utilization area considering environmental data and the characteristic of the DMZ region, and we make the guideline for conservation of the DMZ region based on the zone. Using 10 legal protection areas, the Environmental Conservation Value Assessment Map (ECVAM) and the boundaries of the DMZ region, we evaluated this region into conservation areas, management areas, and utilization areas. The results showed that as much as 91.8% of the DMZ region was evaluated as conservation areas, 6.9% as management areas, and 1.3% as utilization areas. After consultation with experts we suggested management principles, the direction, and the guideline based on the planning process considering the evaluation map. The study suggests principles and guidelines for management, and the guidelines could be a effective tool for the sustainable conservation and management strategy of DMZ region.

• 한국물환경학회지
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• 제31권5호
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• pp.576-582
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• 2015

In recently, the Korea government is concerning on non-point source pollution management to improve water quality. The objective of this paper is to investigate the improvement measurement for management of livestock wastes. As a result, we find that the National Pollution Source Survey is necessary to establish the unified database system with the Korea Statistics(KOSAT) in order to minimize the difference between relevant data. The investigation for environmental impact of livestock manure should be supported the designation of control areas and establishment of the technical guidelines including target material, monitoring site, standard method, etc. In addition, it should be followed by appropriate nutrient recycling and proper fertilizer usage based on social consultation and cost-benefit analysis.

• 환경영향평가
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• 제28권3호
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• pp.312-331
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• 2019

해상최종처리장은 육상에서의 폐기물 처리 공간 부족 문제 해소와 친환경적인 해양공간 조성 및 개발을 목적으로 육 해상 폐기물 소각재 등 안정화된 무기성 고형 폐기물을 해상에서 최종 매립하는 폐기물 처리장을 의미한다. 본 연구의 목적은 현재까지 국내 조성 사례가 없는 해상최종처리장의 건설 시 해양환경에 어떠한 영향을 미치는지를 조사 예측 평가하고 환경영향에 대한 저감과 피해를 최소화하여, 사업 초기단계에서부터 충분한 환경적 고려가 반영된 해상최종처리장 건설 환경영향평가 가이드라인을 마련하고자 한다. 이를 위하여 국내 외 유사사례 환경영향평가서 및 기존 환경영향평가 가이드라인 사례 분석과 포럼 운영을 통한 전문가 검토 및 합의과정을 거쳐 해상최종처리장 건설에 특화된 가이드라인을 도출하였다. 국내 유사사례 환경영향평가서 검토를 위해서 총 17건의 준설토 투기장 및 발전소 회처리장 조성사업 환경영향평가서(2005~2016년)를 대상으로 해양 동 식물 및 해양수질 및 해양저질, 해양물리 항목의 조사현황을 분석하고 문제점과 개선안을 도출하였다. 본 가이드라인을 통해 과학적이고 체계적인 절차에 따라 환경영향평가가 수행될 수 있도록 지원함으로써 해양환경 피해를 최소화하고, 사업과 관련한 협의기간 단축 및 사회적 갈등 해소와 제반 경제적 비용 절감 등에 기여하고자 하였다.

• 대한치과의사협회지
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• 제48권7호
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• pp.538-546
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• 2010

Dental surgical procedures are potentially stress-inducing to not only patients but clinicians especially in case of medically compromised patients. The body response to dental stress involves the cardiovascular, respiratory and the endocrine system. To minimize the stress to the medically compromised patients, the stress reduction protocols should be established. The protocols include (1) Recognize the patient's degree of medical risk (2) Medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Intra-venous sedation during surgical procedures (6) Adequate pain control during therapy (7) Short length of appointment time (8) Contact the patients on the same day. Two cases of Bisphosphonate-related osteonecrosis of the jaws were analyzed. There were 2 women, and the mean age was 70 years (range, 64~74 years). both are medically compromised, with steroids. Both patients were taking an oral bisphosphonate for several years. BRONJ is defined as an area of exposed bone of more than 8 weeks - duration in a patient taking a bisphosphonate for bone disease. Bisphosphonates have been widely prescribed over the last decade for a range of bone diseases, mainly intravenously for bone cancers and orally for osteoporosis. Although it is still controversial as to precisely how the bisphosphonates work, generally it is accepted that they prevent osteoclast action, with consequent cessation of osteoblast activity, so that the bone turnover is markedly reduced or ceased. The aim of this study is to informed the clinicians how to prepare and recognize in case of the BRONJ with medically compromised patients.