• CELLMED
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• v.6 no.3
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• pp.15.1-15.4
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• 2016

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.285-317
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• 2008

To accept the doctor's professional negligence in the medical malpractice, the mistakes, by which the doctor did not foresee the production of the results in spite of the possibility of foresight and did not avoid the production of the results in spite of the possibility of avoidance, must be considered, and to decide the presence of the doctor's professional negligence, the standard must be the attention standard of general-common doctor engaged in the same business and the same function, and the medical enviornments, the conditions, the extraordinary nature of medical behavior, and etc should be considered by the general level of medical science at the time of accident. This principlel must be applied to the medical malpractice case occurred being on duty without exception. But, because of the extraordinary nature of duty work, it is difficult for any doctor to do one's best technical practice by making all diagnosis, medical treatment with all the equipment on the same plane as the ordinary times. That cannot be also expected for any doctor to do one's best technical practice in the terms of a social idea. From this point of view looking into The Precedent case related to Medical-service person being on duty sentenced by The Supreme Court, unlike the general medical malpractice case, the presence of the professional negligence in the medical malpractice occurred being on duty seems to be decided with more consideration on the general level of medical science, the medical enviornments and the conditions, particularities of medical practice at the time of accident. Especially, the extraordinary nature of medical behavior of the medical service person being on duty in the emergency room seems to be admitted compared to that of the medical service person being on duty in ward.

• Korean Journal of Agricultural Science
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• v.37 no.3
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• pp.435-449
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• 2010

Soils in the sloping uplands in Korea are subject to intensive land use with high input of agrochemicals and are vulnerable to soil erosion. Development of the environmentally sound land management strategy is essential for a sustainable production system in the sloping upland. This report addresses the status of upland agriculture and the best management practices for the uplands toward the sustainable agriculture. More than 60% of Korean lands are forest and only 21% are cultivating paddy and upland. Uplands are about 7% of the total lands and about 62% of the uplands are in the slopes higher than 7%. Due to the site-specificity of the upland, many managerial and environmental problems are occurring, such as severe erosion, shallow surface soils with rocky fragments, and loadings of non-point source (NPS) contaminants into the watershed. Based on the field trials, most of the sloping uplands were classified as Suitability Class III-V and the major limiting factor was slope and rock fragments. Due to this, soils were over-applied with N fertilizer, even though N rate was the recommendation. This resulted in decreases in yield, degradation of soil quality and increases in N loading to the leachate. Various case studies drew management practices toward sustainable production systems. The suggested BMP on the managerial, vegetative, and structural options were to practice buffer strips along the edges of fields and streams, winter cover crop, contour and mulching farming, detention weir, diversion drains, grassed waterway, and slope arrangement. With these options, conservation effects such as reductions in raindrop impact, flow velocity, runoff and sediment loss, and rill and gully erosion were observed. The proper management practice is a key element of the conservation of the soil and water in the sloping upland.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.312-319
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• 2013

Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

• Proceedings of the Korea Water Resources Association Conference
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• 2012.05a
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• pp.781-781
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• 2012

본 연구에서는 수문-수질 모의가 가능한 SWAT (Soil and Water Assessment Tool) 모형을 이용하여 경안천 상류의 별미천 유역($1.21km^2$)을 대상으로 최적관리기법(Best Management Practice, BMP) 적용에 따른 비점오염원 저감효과를 분석하고자 한다. 이를 위해, 별미천 유역내 논($0.049km^2$)과 밭($0.018km^2$) 지역에 대한 BMP 시나리오를 작성하였다. 먼저, 논에서는 계단식(Terrace) 재배 방법을 적용하였으며, 밭에서는 등고선(Contour farming) 재배 방법과 볏짚지표피복 시나리오를 적용하였다. 여기서, 볏짚지표피복 시나리오는 현재 $1276.6m^2$, 경사도 약 3.2%의 콩 재배가 이루어지고 있는 시험포장에서 수행된 결과를 이용하여 SWAT 모형의 지표유출관련 매개 변수를 조정하였다. SWAT 모형의 적용성 평가를 위해, 1:5,000 수치지도로부터 2m DEM(Digital Elevation Model) 및 QuickBird(2006.05.01) 위성영상으로부터 스크린 디지타이징기법(On-Screen Digitizing Method)을 이용하여 총 21개 토지이용항목의 1:5,000급 정밀토지이용도를 작성하고, 농촌진흥청에서 제공하는 1:25,000 정밀토양도를 구축하였다. 또한, 유역출구점에서 자동수위 및 강우량 계측기, 수질측정을 위한 오토샘플러를 설치하여 시간당 수위(유량), 강우 자료와 강우발생에 따른 수질자료(Sediment, Total Nitrogen, Total Phosphorus)를 이용하여 모형의 검보정(2011.06.08 ~ 2011.10.31)을 실시하였다. 모형의 검보정 후, 논에서의 Terrace 및 밭에서의 Contour farming, 밭 시험포장에서의 저감효과가 분석된 지표피복시나리오의 적용을 위한 SWAT 모형의 관련 매개변수를 정의하고, 각 BMP 시나리오별 비점오염원 저감효과를 분석하였다.

• Journal of Korean society of Dental Hygiene
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• v.9 no.2
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• pp.73-88
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• 2009

The purpose of the study was to provide the basic for the prevention of infection control by analyzing the level of recognition and practice of dental hygiene students. It is important for dental clinic staffs to know and practice infection control measures in favor of effective infection control. Thus, this study conducted an one-month questionnaire survey (during October 2008) for dental hygiene students who ever experienced in 16-week clinical practice, and analyzed total 206 questionnaire forms as collected from them, so that it could determine potential associations between their recognition and practice of infection control and thereby suggest an efficient solution for infection control in dental hygiene. 1. It was found that our students' recognition about infection control averaged $4.49{\pm}.58$ points on the whole, and they were best aware of instrumental disinfection and sterilization among other measures, which was followed by hand washing, extirpation control, post-sterilization management, personal protective outfit and instrumental surface maintenance respectively. 2. It was found that our students' practice of infection control averaged $3.85{\pm}.57$ points on the whole, and they practiced hand washing most actively among other measures, which was followed by extirpation control, post-sterilization management, instrumental disinfection and sterilization, personal protective outfit and instrumental surface maintenance respectively. 3. It was found that our students scored higher mean points in recognition about every measure of infection control than those in practice (t=15.676, p=0.000). Particularly, it was notable that there were significant differences between their mean points in recognition and practice of some infection control measures, such as instrumental surface maintenance (t=15.361, p=0.000), personal protective outfit (t=15.245, p=0.000) and instrumental disinfection and sterilization (t=11.169, p=0.000). But there was least significant difference between mean points in recognition and practice of hand washing (t=5.460, p=0.000). 4. For potential associations between recognition and practice of infection control, it was found that higher recognition was in significantly positive associations with higher practice in every measure of infection control (r=.478, p=.000), such as extirpation control (r=.630, p=.000), instrumental disinfection and sterilization (r=.477, p=.000) and post-sterilization management (r=.433, p=.000). 5. It was found that there were differences in our students' recognition depending upon availability of infection control guideline (t=4.587, p=.011), and there were significant differences in practice depending on necessity of infection control education on a statistical basis (t=2.229, p=.027). Overall, it is found that our dental hygiene students are very likely to practice hand washing and extirpation control, because both of these measures are relatively easy to practice or are considered legally binding.

• Journal of Construction Engineering and Project Management
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• v.3 no.1
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• pp.35-38
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• 2013

No single project is identical to one another in the construction industry. Furthermore, many construction projects are suffering from tighter budget, shortened schedule and higher client satisfaction level. To overcome these, project managers and engineers are willing to apply various best management practices to their projects. However, it is non-trivial to select the most appropriate practices for their projects. In many cases, it is much more important to find the appropriateness of the management practices than just to use the practices. Although many researchers are focusing on the development of new management practices, there is little research on matching between the circumstances of projects and the developed management practices. The objective of this study is to provide a structured process to suggest the best management practices for individual construction projects by developing a computerized system where an individual project is matched with the most optimal management practices to increase the value of the project. At this stage of writing, the authors have developed a computerized system to effectively find out the best suitable management practices for individual projects. By maximizing the usages of this system, it would facilitate the application of the best management practices in the industry.

• International conference on construction engineering and project management
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• 2013.01a
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• pp.624-627
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• 2013

No single project is identical to one another in the construction industry. Furthermore, many construction projects are suffering from tighter budget, shortened schedule and higher client satisfaction level. To overcome these, project managers and engineers are willing to apply various best management practices to their projects. However, it is non-trivial to select the most appropriate practices for their projects. In many cases, it is much more important to find the appropriateness of the management practices than just to use the practices. Although many researchers are focusing on the development of new management practices, there is little research on matching between the circumstances of projects and the developed management practices. The objective of this study is to provide a structured process to suggest the best management practices for individual construction projects by developing a computerized system where an individual project is matched with the most optimal management practices to increase the value of the project. At this stage of writing, the authors have developed a computerized system to effectively find out the best suitable management practices for individual projects. By maximizing the usages of this system, it would facilitate the application of the best management practices in the industry.

• Information Systems Review
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• v.11 no.2
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• pp.131-145
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• 2009

Knowledge management is systematic management of vital knowledge resources and its associated processes of creating, gathering, organizing, diffusion, use and exploitation. A key challenge emerging for such organizations is how to encourage knowledge sharing within organization because knowledge is the organization's intellectual capital, of increasing importance in promoting competitive advantages. Isolated initiatives for promoting knowledge sharing and team collaboration, without taking consideration of the knowledge sharing limitations and constraints can defeat further development of KM culture. This article investigates knowledge sharing bottlenecks and proposes the use of community of practice as an effective instrument for knowledge sharing. The article demonstrates the opportunity for overcoming barriers of knowledge sharing through the application of communities of practice. The article introduces a steel company case as the best practice of communities of practice. Then, the paper empirically analyzes the case study to provide evidence for the feasibility and effectiveness of the proposed approach.

• PNF and Movement
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• v.14 no.3
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• pp.157-176
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• 2016

Purpose: The purpose of this study was to share an experience about processes and lessons learned to execute evidence-based practice (EBP) in neurological physical therapy. Methods: The most important thing in applying EBP to practice is to search, find, and appraise the existing evidence. Many evidence databases are available, such as CENTRAL, PEDro, PUBMED, and EMBASE. However, the knowledge represented in these databases is not always perfect. The practice model is a set of processes to resolve client problems. Therapists should make hypothesis-focused decisions through EBP. Integrating clinical reasoning and evidence is most important when it comes to the execution of EBP. Results: The process of EBP consisted of following: coming up with clinical questions, followed by searching for, appraising, evaluating, and integrating evidence. To integrate EBP into practice, it is necessary to consider clinical expertise, patient value and preferences, as well as research wth the best evidence. We provided an example of a clinical case with a stroke patient to show how this process and framework concerning clinical reasoning through evidences can be integrateds. During this process, we also utilized information technology to improve EBP ability. Conclusion: We should recognize what manner of information is needed to resolve eash patient's problem, and we should search for this information efficiently. Then, we should judge the value of the information obtained as it applies, to the clinical setting.