• Title/Summary/Keyword: Evidence-developing

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미국의 최신 건강중심 체육교육수업의 소개 - Sports, Play, Active Recreation for Kids(SPARK) 체육프로그램 개발배경 및 사례보고 - (Introduction to a Health-related Physical Education Curriculum Model in the United States : Sports, Play, and Active Recreation for Kids (SPARK))

  • 유수진
    • 한국학교ㆍ지역보건교육학회지
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    • 제12권3호
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    • pp.101-109
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    • 2011
  • The purpose of this article is to introduce the Sports, Play, and Active Recreation for Kids (SPARK) physical education curriculum. SPARK is a model for health-related, research-based and evidence-based physical education programs in the United States. The outcome of school physical education can relate to public health, but there exists few evidence-based physical education programs reporting health-related variables. School physical education can provide more opportunities for children and adolescents to be physically active and to learn more about healthy lifestyles. However, physical education programs have been cut and eliminated due to lack of funding in the U.S. as in South Korea. Although facing these problems, SPARK programs have been implemented in over 50% of schools, after school programs and coordinated school health programs in the U.S. This article reviewed: (a) background information of the SPARK program, (b) examples of effective interventions, and (c) methods of dissemination to schools nationally in the U.S. The methods showed in SPARK may use as a model for researching, developing and implementing new physical education(PE) program and after school programs in Korea.

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기분부전장애와 비전형우울증의 약물치료 (Pharmacological Treatments for Dysthymic Disorder and Atypical Depression)

  • 임세원;오강섭
    • 생물정신의학
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    • 제14권1호
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    • pp.14-20
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    • 2007
  • Objectives : The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. Methods : Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. Results : For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors( SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. Conclusions : The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.

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Evidence-based Screening, Early Diagnosis and Treatment Strategy of Cervical Cancer for National Policy in Low-resource countries: Example of India

  • Saxena, Upma;Sauvaget, Catherine;Sankaranarayanan, Rengaswamy
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1699-1703
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    • 2012
  • Cervical cancer remains the most frequent cancer in women from the developing world. More than 88% of deaths occur in low-income countries, and it is predicted to climb to 91.5% by 2030. Although Pap-based screening programmes have shown to be effective in reducing the disease burden in high-resource countries, implementation and sustention of cytology-based programmes is quite challenging in low-resource settings. The present paper reviews evidence-based alternatives of screening methods, triaging algorithm, treatment of cervical precancerous lesions, and age-group at screening appropriate for low-income countries. Evidence shows that visual inspection methods using diluted acid acetic or Lugol's iodine, and HPV-DNA testing are more sensitive tests than the Pap-smear screening test. Visual inspection allows an immediate result and, when appropriate, may be immediately followed by cryotherapy, the so called "screen-and-treat" approach, achieved in a single visit, by trained nurses and midwives. Examples of cervical cancer prevention programmes in India and selected low-income countries are given.

감각처리 장애에 대한 신경생리학적 증거들 (Neurophysiological Evidence for Sensory Processing Disorder)

  • 김은영
    • 재활치료과학
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    • 제1권1호
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    • pp.5-16
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    • 2012
  • 감각통합은 이론에서 출발하여 현재 치료사들이 아동의 문제를 찾고 중재하는데 유용한 틀을 제공한다. 이전까지 대부분의 감각통합 연구들은 감각처리 장애아동들이 나타내는 행동을 측정하는 경험적 증거들을 보고하였다. 최근에 감각처리 장애 진단에 대한 객관적 증거 마련을 위해서 신경생리학적 연구 결과가 축적되기 시작하였다. 감각처리 장애에 대한 신경생리학적 근거를 찾는 연구들은 전기피부 활동, 미주신경 톤, 뇌파를 사용하여 감각처리 장애아동과 전형적으로 발달하는 또래 아동들 간 신경생리학적 반응이 다르다는 결과를 보고하였을 뿐만 아니라 감각처리 어려움과 관련한 행동 특징이 신경생리학적 지표에서도 반영됨을 발견하였다. 앞으로 연구에서는 감각통합 치료 효과를 지지하는 신경생리학적 증거도 얻을 수 있을 것이라 기대해 본다.

컴퓨터 포렌식을 위한 디지털 저작권 보호시스템 개발 (Development of a Copyright Protection System for Computer Forensics)

  • 이월영;황철
    • 한국멀티미디어학회논문지
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    • 제10권3호
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    • pp.365-372
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    • 2007
  • 세계에서 생성되는 정보의 대부분은 디지털 데이터로 만들어지고 있다. 이러한 디지털 저작물들은 불법 사용이 손쉽기 때문에 법적인 보호 장치나 기법이 꼭 필요하다. 그래서 지금까지 많은 연구가들은 다양한 기법들을 개발하고 있다. 지금까지 대부분의 기법들은 디지털 저작물 침해에 관한 법적인 증거 자료 확보를 위해 디스크 검증과 같은 물리적 또는 화학적인 방법 개발에 초점을 두고 있다. 본 논문에서는 사용자가 부적당하게 저작물을 사용할 때 이를 인지하고 법적 위배 사항을 통지해 주도록 하는 컴퓨터 포렌식 기반 디지털 저작물 보호 시스템을 개발하였다. 또한 계속적으로 침해 사실이 진행된다면 이런 일련의 위배 행위를 지적재산권법 매핑에 의하여 법적 증거 자료로 사용할 수 있도록 시스템에 저장하도록 한다. 이 기법은 디지털 증거 조작이나 증거 인멸의 문제로부터 데이터를 보호할 수 있다.

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한국형 우울증 임상진료지침 개발(II) (Korean Clinical Practice Guideline for the Treatment of Depressive Disorder(II))

  • 강이헌;김수영;이민수
    • 생물정신의학
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    • 제13권4호
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    • pp.219-225
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    • 2006
  • Depression has been causing huge direct and indirect losses to people's health because of its high prevalence, various clinical patterns, drug reaction and diverse courses different among individuals, but its treatment has not been systematic but dependent on individual clinicians' experience and knowledge. To correct this problem, it has been highly necessary to develop clinical guidelines defined as "systematically developed statements to assist practitioners' and patients' decisions about appropriate healthcare for specific clinical circumstances." Currently, countries throughout the world are making efforts to establish evidence-based guidelines among different levels of guidelines and to evaluate and test them. Although such efforts have been unsatisfactory in Korea because of several constraints including lack of high-quality RCT, the Korean Depression Clinical Practice Guideline has started to develop evidence-based guidelines, which are established through strictly designed processes. Thus, the present study purposed to review methods adopted in the development processes and to present the processes of developing the evidence-based guidelines clearly and transparently.

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Pharmacologic Considerations for Youth with Posttraumatic Stress Disorder

  • Keeshin, Brooks;Strawn, Jeffrey R.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권1호
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    • pp.14-19
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    • 2017
  • Children exposed to potentially traumatic events are at risk of developing posttraumatic stress disorder (PTSD). However, the subsequent developmental course of posttraumatic stress symptoms appears to vary considerably. In this regard, some PTSD symptoms resolve without significant interventions, while for many children and adolescents, they persist until the patient receives appropriate treatment specifically designed to address PTSD and other trauma related symptoms. Evidence-based psychotherapies represent the standard of care for children with PTSD and, while psychopharmacologic interventions are utilized for many youth with posttraumatic stress symptoms and PTSD, there is little data available to guide the use of these medications in this population. However, given the structural challenges involved in disseminating and delivering evidence-based psychotherapies in all settings, prescribing clinicians should be aware of the medications whose use in children with pediatric PTSD has been studied. Herein, we review the PTSD assessment modalities, as well as the use of pharmacologic interventions in PTSD, including antiadrenergic agents, selective serotonin reuptake inhibitors and other medications.

The Impact of Tax Treaties on Foreign Direct Investment: The Evidence Reconsidered

  • LEE, SIWOOK;KIM, DAEYONG
    • KDI Journal of Economic Policy
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    • 제44권3호
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    • pp.27-48
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    • 2022
  • This paper reconsiders the empirical evidence of the relationship between tax treaties and FDI using U.S. outbound FDI to 78 countries over the period of 2007-2018. Unlike previous studies, we explicitly consider differences in the tax environments of recipient economies, including their tax-haven status, transfer pricing rules, CFC rules and anti-avoidance regulations, in our estimations. Our results confirm the importance of controlling for country-specific tax environments, especially the tax-haven status and transfer pricing rules. We find that tax treaties positively contribute to FDI inflows in developing countries, while they have no statistically significant impacts on OECD countries. Recently signed tax treaties still foster FDI but less than older ones do. Finally, our results indicate, all other things being equal, that the weaker the transfer pricing regulations, the greater the amount of U.S. direct investment into a non-OECD economy.

일반외과 영역 다빈도 수술률의 소규모 지역간 변이 (Small Area Variation in Rates of Common Surgery in General Surgery Department)

  • 김윤미;양봉민
    • 보건행정학회지
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    • 제14권2호
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    • pp.138-162
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    • 2004
  • This study was performed to investigate small area variation in rates of three common surgeries in general surgery department across 156 small areas. Three surgery rates were analyzed; Anal and/or stomal procedures, inguinal and/or femoral hernia procedures, appendectomy. Methods: We used health insurance claims data and the number of patients were 13,845, 2,154 and 7,151 persons respectively. Surgery rates were directly standardized with age and sex and logistic regression was used to analyze surgery rates. Results: Mapping of the surgery rates, there was small area variation in anal and/or stomal procedures. The clinic which was located in more competitive market and chose DRG payment system tends to do more anal and/or stomal procedures. There was no factor except DRG bed rates had effect on rate of inguinal and/or femoral hernia procedures. Conclusions: Findings of this study will contribute to developing investigation method on small area variation and policy to reduce the variation such as developing evidence based medical practice guideline.

Environmental tobacco smoke and childhood asthma

  • Song, Dae Jin
    • Clinical and Experimental Pediatrics
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    • 제53권2호
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    • pp.121-128
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    • 2010
  • In recent years, environmental tobacco smoke (ETS) has become an important worldwide public health issue. Children are particularly vulnerable to ETS because they are still developing. ETS exposure causes a wide range of adverse health effects on childhood asthma. There is convincing evidence that ETS exposure is causally associated with an increased prevalence of asthma, increased severity of asthma and worsening asthma control in children who already have the disease, even though a causal relationship with asthma onset is not yet established for asthma incidence. Mechanisms underlying these adverse effects of ETS are not clearly elucidated but e studies on this issue suggest that genetic susceptibility, impaired lung function, and augmented airway inflammation and remodeling may be involved. Children with asthma are just as likely to be exposed to ETS as children in general and there is no risk-free level of exposure. Therefore, providing a smoke-free environment may be of particular importance to the asthmatic children exposed to ETS who have adverse asthma outcomes, as well as to children with genetic susceptibility who are at increased risk of developing asthma upon exposure to ETS in early childhood.