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- しょうぶ わたぬき
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1 Japan Perspectives in Public Health
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4 (RCT) 21 Plan-Do-See iii
5 BSE (quality of life. QOL) 21 iv
6 Japan Perspectives in Public Health EBMevidence-based medicine invisible PDS v
7 21 vi
8 Japan Perspectives in Public Health vii
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10 6) attractive ix
11 18 Japan Perspective
12 hostenvironment homeostasis host-environment relationship
13 multiple causation theory of disease. host factors intrinsic factors.
14 . environmental factors extrinsic factors
15 VDT 20 X Y Y X X Y rate Graunt J 1662 Natural and Political Observations Mentioned in a Following Index and Made upon the Bills of Mortality 1603 Graunt London Hampshire
16 1837 General Register OfficeFarr W 1839 Farr (illiteracy) 19 population at risk attributable risk Farr X
17 21 Total Health Promotion Plan evaluation 21 EBMevidence-based medicine EBM randomized controlled trial, RCT RCT meta-analysis EBM invisible 80
18 80 (visible) invisible A B A B A B 20 PDS PDS Plan-Do-See evaluation dietphysical activity
19 (convincing) 160mmHg 100mmHg risk analysisrisk assessmentrisk management risk communication 2001 BSE 18 BSE stakeholder
20 1953 Leavell HR Clark EG specific preventionhealth promotion early diagnosis and prompt treatment disability limitationrehabilitation RCT quality of life, QOL SNPs SNPs
21 2003 ( 15 )
22 21 21
23 % 21.1% 14.4% %26.4%8.8% 50.2%40.3%9.9% 55.3%30.1%25.1% 63.9%39.1%24.8% 74.3%52.0%22.3% Andersen E
24 18 20% primary health care NIHNational Institute of HealthNational Center for Complementary and Alternative Medicine orthomolecular medicinefeldenkrais 50%
25 postgraduate course School of Public Health 30 School of Public Health
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28 Japan Perspectives in Public Health
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38 EBMEvidence Based Medicine gray zone 10
39 Randomized Clinical Trial, RCT RCT RCT EBM NNTB(number needed to treat for benefit) RCT RCT SNPs physician-scientist TR GCPgood clinical practice 21 11
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66 intractable diseases SMONsubacute myelo-optic neuropathy QOL QOL 38
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68 Akamizu T, et al. Prevalence and clinico-epidemiology of familiar Graves' disease in Japan based on nationwide epidemiologic survey in Endocrine J 2003;50: SSPE Kobashi G, et al. High body mass index after age 20 and diabetes mellitus are independent risk factors for ossification of the posterior longitudinal ligament of the spine in Japanese subjects: A case-control study in multiple hospitals. Spine 2004; 29: Nakamura Y, et al. Incidence rate of Creutzfeldt-Jakob disease in Japan. Int J Epidemiol 1999;28:
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78 1. Marmot, M. & et al:alcohol and cardiovascular disease: The status of the U-shaped curve. Brit Med J 303: , Howard, AA. & et al:effect of alcohol consumption on diabetes mellitus. Ann Int Med, 140( ), Criqui. MH.: Alcohol and coronary heart disease risk:implications for public policy. J Stud Alcohol, 58: , Bearer,CF.: Markers to detect drinking during pregnancy. Alcohol Research & Health, 25: , Edenberg, HJ.: The collaborative study on genetics of alcoholism: An update. Alcohol Research & Health, 26: ,
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