• Title/Summary/Keyword: Nutrition therapy

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Development of Job Standards for Clinical Dietitians Administering Clinical Nutrition Therapy to Diabetic Patients in Hospitals (당뇨병 환자의 임상영양치료를 위한 임상영양사의 직무표준 개발)

  • Gwon, Su-Jin;Woo, Mi-Hye;Ju, Dal Lae;Kim, Eun Mi;Park, Mi-Sun;Sohn, Cheongmin;Wie, Gyung-Ah;Lee, Song-Mi;Cha, Jin-A;Seo, Jung-Sook
    • Journal of the Korean Dietetic Association
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    • v.21 no.1
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    • pp.37-56
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    • 2015
  • This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

Effects of Nutrition Counseling on Diabetes Management in Type 2 Diabetes Mellitus Patients (영양상담이 제2형 당뇨병 환자의 혈당과 식사요법에 대한 지식과 실천에 미치는 영향)

  • Lee, Seung-Lim
    • Journal of the Korean Dietetic Association
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    • v.15 no.2
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    • pp.188-196
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    • 2009
  • The purpose of this study was to investigate the effects of nutrition counseling on diabetes management by determining changes in anthropometry and blood components as well as knowledge and practice of diet therapy and nutrient intake in 34 (male 11, female 23) type 2 diabetes patients. The knowledge and the practice of diet therapy, drinking, smoking and exercise were analyzed by questionnaires. Dietary nutrient intake were obtained from the patients by the 1 day 24-hr recall. Blood glucose level and blood pressure were measured before and 3 months after the treatment. The results are summarized as follows: Average weight (p<0.05) and body mass index (p<0.05) were significantly lower post-counseling. Fasting blood glucose levels (p<0.01) and postprandial-2hour blood glucose levels (p<0.01) were also significantly lower post-counseling. In lifestyle changes for self-management the patients showed significantly higher exercise habits post-counseling (p<0.01). Regarding their level of diet knowledge, they showed significantly higher levels post-counseling in six items such as importance of diet therapy for diabetes (p<0.001), principles of diet therapy (p<0.001), nutrient composition of foods (p<0.01), carbohydrate composition of foods (p<0.001), the prescribed calories (p<0.001) understanding food item and exchange units of cereals, grains (p<0.001) and fruits, juices (p<0.001). Regarding their diet practices, the patients showed significantly higher levels of practice post-counseling in keeping within permitted meal size (p<0.001), using food exchange lists (p<0.001), keeping exact meal times (p<0.01), and controling sweet foods (p<0.001). Protein (p<0.05), animal lipid (p<0.05), and vitamin C (p<0.05) intakes were significantly higher post-counseling.

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A Study on Eating Habits, Life Styles and Nutrition Care of Diabetic Outpatients

  • Chang, Kyung-Ja;Nam, Moon-Suk
    • Journal of Community Nutrition
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    • v.1 no.2
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    • pp.133-139
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    • 1999
  • The purpose of this survey was to investigate eating habits, life styles and nutritional care of diabetic outpatients and to provide basic data for developing individualized nutritional care and diabetic education programs. This survey was carried out by nutritional counseling with a questionnaire and checking medical record. Information about the general characteristics of the subjects, eating habits, health-related life styles and attitude and perception of subjects to diet therapy was gathered from 200 randomly-sampled diabetic outpatients at a University Hospital located in Inchon. All data were analyzed by Statistical Analysis System(SAS) software. The results are summarized as follows : Female subjects were 63.5% of total subjects and 65.5% of total subjects were 50 years or more. The average Body Mas Index(BMI) of male and female subjects were 23.06kg/㎡ and 25.02kg/㎡ respectively and 44% of all subjects wee obese. Among subjects, type II diabetic patients were 81.0% and 82.5% of subjects had suffered from diabetes for more than one year. Also 41% subjects had diabetic history in their family. More than half of the subjects had nutrition education concerning diabetes. Also 75.5% of them thought that nutrition education was effective. The most important guideline in diet therapy was to eat cooked rice with dietary fiber-rich grains. Therefore, it might be necessary to develop nutrition education program adjusted according to diabetic patient's needs and life styles, which may increase feasibility of self-care and implementation of management guidelines.

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Development of computer programs for Nutrition Counseling (영양상담을 위한 전산화 프로그램 개발연구)

  • 홍순명
    • Journal of Nutrition and Health
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    • v.22 no.4
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    • pp.275-289
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    • 1989
  • The purpose of this study is to develop a computer system with data file and computerized programs for nutrition counseling. In this research, a 16 / XT personal computer (word : COBOL) compatible with IBM-PC/XT was used. Computer system developed for this study was as follows: Data files(food composition list, food exchange list, nutrition management comment, special diet therapy) were used for analysis the nutritional status and the ntrition education comment. (1) Programs for the nutritional status assessment 1) General information a) Name, age, sex, higher, weight, activity, disease and special diet b) Ideal body weight and Obesity assessment(Kaup index and Broca index) c) Rest and athletics status d) Biochemical data comparision with standard 2) Food Intakes 3) Nutrient Intakes a) Comparison of the amounts intaked with the recommended dietary allowances for present weight. b) Comparison of the energy composition rate intaked with the recommended dietary allowances for present weight. b) Comparison of the energy composition rate intaked with the recommended for present weight and ideal weight. c) Nutrient analysis by each meal and snack. 4) Food intakes from each food group and comparison with recommended 5) Special nutrient analysis. (2) Programs for the nutrition education based on nutritional status assessment. 1) Suggestion of number of food exchange group 2) Nutritional assessment and advise comments 3) Nutritional management comments 4) Special diet therapy In the study, the nutritioal status and nutrition education comments are based on individual data from nutrition counseling.

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A Case of Esophageal Candidiasis in an Adolescent Who Had Frequently Received Budesonide Nebulizing Therapy

  • Kang, Hae Ryong;Kwon, Yong Hoon;Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.3
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    • pp.185-189
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    • 2013
  • Corticosteroid (budesonide) nebulizer therapy is commonly performed. Its side effects have been considered as being safe or ignorable. The authors present a case of esophageal candidiasis in a healthy female adolescent who was treated with budesonide nebulizer therapy a few times for a cough during the previous winter season. This child presented with dysphagia and epigastric pain for 1 month. Esophageal endoscopy showed a whitish creamy pseudomembrane and erosions on the esophageal mucosa. Pathologic findings showed numerous candidal hyphae. She did not show any evidence of immunodeficiency, clinically and historically. The esophageal lesion did not resolve naturally. The esophageal lesion completely improved with the antifungal therapy for 2 weeks; the symptoms disappeared, and the patient returned to normal health. It is important that frequent esophageal exposure to topical corticosteroids application can cause unexpected side effects.

Medical-Nutrition-Therapy for Obese Patients with Type 2 Diabetes Mellitus Undergoing Metabolic Surgery (제2형 당뇨비만환자의 수술요법 시 임상영양치료 프로토콜 설정)

  • Kim, Hye-Jin;NamGung, Sin-A;Hong, Jeong-Im;Mok, Hee-Jung
    • Journal of the Korean Dietetic Association
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    • v.17 no.2
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    • pp.206-215
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    • 2011
  • Currently, metabolic surgery (Laparoscopic Roux-en-Y gastric bypass, LRYGB) has an important role and should be recommended as an intervention in the management of obese patients with type 2 diabetes mellitus (T2DM). A successful outcome of surgery requires medical nutrition therapy. Therefore, we performed a retrospective study on 25 patients with T2DM who underwent LRYGB at Yeouido St. Mary's Hospital from October 2008 to May 2010. The patients were followed up for an average of 6 months after surgery (range: 2~19 months). Diabetes was resolved in 80% of the patients. Percentage of excess weight loss was (%EWL) was 56.2%. After surgery, fasting blood sugar (FBS) and HbA1c were significantly reduced (123 mg/dl, A1c 6.7%, P<0.001) and triglyceride was also significantly reduced to 107.6 mg/dl (P<0.05). As diets of the patients progressed from liquid to soft to regular diet, energy, carbohydrates, and fat intakes increased significantly (P<0.001). But protein intake did not change significantly. Nutrient intake of the patients after the surgery was significantly lower than the recommended diet for the non-surgery group. Patients experienced side-effects related to the diets after surgery, including hair-loss (76%), smelly gas (52%), vomiting (48%), etc. A significantly positive correlation was observed between vomiting and FBS (P<0.001). There was a significant relationship between side effects and the amount of nutrient intakes. Therefore, guide patients to a diet progression with treatment to minimize side effects, especially vomiting. And monitor their dietary life to be healthy and not to regain weight until remission of T2DM.

A Review of the Medical Nutrition Therapy (MNT) of the U.S. Medicare System (미국 임상영양치료(MNT)의 법제화 과정 및 수가 체계)

  • 박은철;김현아;이해영;이영은;양일선
    • Korean Journal of Community Nutrition
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    • v.7 no.6
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    • pp.852-862
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    • 2002
  • The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

The Case Study of the Nutrition Services for Patients as a Result of the Changes in Food Services Management (병원급식의 위탁 운영에 따른 영양서비스 변화에 대한 사례연구)

  • 이승림;장유경
    • Korean Journal of Community Nutrition
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    • v.8 no.1
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    • pp.83-90
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    • 2003
  • The purpose of this study was to investigate the relationship between changes in the Department of Nutrition and patient satisfaction, following the changes in Food Services Management. Statistical data analyses were completed using the SAS/Win 6.12 program. The results can be summarized as follows. The working environment for dietitians and cooking and meal serving assistants was improved following to a change catering of food service management. The number of dietitians who worked in medical nutritional therapy and food services was increased from one to four, and the number of dietary consultations and meal rounds were increased 2.5-fold and 5-fold, respectively after the change services were implemented. Among the 10 items included in the patient satisfaction questionnaire, "Taste of meals" (p< 0.01) and "Satisfaction of offered menus" (p < 0.01) showed significantly higher scores before the catering. "Kindness of meal sewing assistant" this increase was not statistically significant, showed increased satisfaction after the catering, however.n after the catering, however.

Case Study of a Wart Patient Using Ortho-cellular Nutritional Therapy (OCNT) (세포교정영양요법(OCNT)을 이용한 사마귀 환자 사례 연구)

  • Shimi Min
    • CELLMED
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    • v.13 no.7
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    • pp.26.1-26.3
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    • 2023
  • Objective: A case report of wart patient treated with Ortho-cellular Nutritional Therapy. Methods: A 95-year-old Korean male with a large wart measuring more than 1cm in diameter, experiencing no pain but discomfort in daily life. Results: After 50 days of applying nutritional therapy, the wart completely disappeared. Conclusion: The application of nutritional therapy can soften the hardened tissue of warts and aid in the treatment process.