Rose's Prevention Paradox

Geoffrey Rose's ‘prevention paradox’ occurs when a population‐based preventative health measure that brings large benefits to the community – such as compulsory seatbelts, a ‘fat tax’, or mass immunisation – offers little to each participating individual. Although the prevention paradox is not obviously a paradox in the sense in which philosophers understand the term, it does raise important normative questions. In particular, should we implement population‐based preventative health measures when the typical individual is not expected to gain from them? After canvassing other attempts to address the paradox, I argue that what is significant about the prevention paradox is that it involves intra‐personal trade‐offs; the costs and benefits of the choice to implement or not implement a preventative health measure fall on the same individuals. The intra‐personal nature of these trade‐offs has two implications. First, the solutions to the paradox proposed by other authors are deficient. Second, the policy choice to not implement some preventative health measures can be normatively justified.     

Teaching Violence Prevention

Summary

This paper defines violence from a Public Health perspective. It offers recommendations for creating a curriculum to teach health professionals about the critical issues involved in establishing a more peaceful society. Specific learning objectives, teaching methods, and examples of group discussion activities are presented, as well as an extensive bibliography. The intention is to make available to health professionals information that promotes an understanding of the overall impact of violence in our society, and specific skills in the recognition and management of victims of violence. Because of the importance of domestic violence as the center of the web of violence in our culture, emphasis is placed on understanding the dynamics and effects of this specific form of violent behavior. Teaching violence prevention occupies a critical role for medical education.     

Primary Prevention and Assessment

Prevention is related to the need for a comprehensive assessment technology. The failure of training programs to prepare counselors for assessment is viewed as one of the major problems.     

Prevention of Mental Disorders

Given the high prevalence and enormous burden of mental disorders and the efficacy of CBT in reducing symptom severity of a number of acute disorders, it is reasonable to use these same CBT strategies at an earlier stage to prevent the full expression of emotional problems. In comparison to treatment outcome research, work in prevention of mental disorders is in its infancy. Ongoing and recent prevention trials for 4 Axis I problems are introduced and the challenges of doing this work will be addressed. The goal within each one of the articles is to provide concrete guidelines and examples of the clinical work done in each trial to facilitate therapeutic efforts for individual practitioners.     

Substance Abuse Prevention:

Components of a successful substance abuse prevention program are discussed. Substance use and abuse trends in school-aged populations are briefly reviewed. Prevention program strategies deemed desirable through recent research efforts are incorporated in describing a model program. Educational approaches and substance abuse intervention strategies are differentiated. Program planning guideliens are presented and discussed. These guidelines are designed to establish and maintain school and community support for prevention programs.     

Homicide Prevention and Intervention

ABSTRACT: Homicide is defined a major public health problem, as well as a criminal justice problem. The direct implications of suicidology theory for the understanding and prevention of homicide are discussed. Specifically mentioned are the concepts of prevention-intervention-postvention; clues; lethality; the identification of high risk groups; and the psychological autopsy. The need for homicide-prevention education is explored at levels ranging from a better informed public to more knowledgeable professionals.     

Developing Effective Prevention Services for the Real World: A Prevention Service Development Model

A Prevention Service Development Model (PSDM) is presented as an approach to develop prevention programs that are both effective and that are readily adopted for implementation in community settings. The model is an integration of concepts and methods from two fields, prevention research and marketing research as applied to new service development. Questions that are posed at each stage of the PSDM are described. Studies from the development of two preventive interventions are presented to illustrate research at several of the stages of the model.     

An Overview of Primary Prevention

The historical antecedents of primary prevention are found in the methods of public health, counseling, and psychotherapy. Primary prevention is defined as being proactive and is aimed predominantly at high-risk groups not yet affected by the condition to be prevented. Its success is measured in a decline in the incidence of a condition that is compared with controls. Only through prevention can we reduce incidence, and it seems that it is the only feasible way to deal with the unbridgeable gap between the enormous number of individuals at risk for emotional disturbance and the limited availability of treatment resources.     

School-Based Substance Abuse Prevention Programs

Substance abuse has been identified as a significant problem among adolescents. Personal and social coping skills training programs implemented in school settings have shown evidence of effectiveness as a primary prevention approach. Early intervention programs for students most at risk are also needed, however, few have been adequately evaluated. Special services providers possess training and skills that are well suited for planning and implementing school-based programs that address the substance abuse issue.     

甲状腺术后甲状旁腺功能低下的相关因素分析及对策

探讨甲状腺术后引起甲状旁腺功能低下的发生原因和防治方法.用统计学方法对我院1 975例甲状腺手术患者进行回顾性分析.甲状腺术后甲状旁腺功能低下的发生与手术切除范围、手术次数及手术技术操作有关.甲状腺术中应注意精细操作、术后近期应检测血清钙值并适当补钙以防低钙血症的发生.