从高血压防治论医学从临床走向预防

高血压防治中出现的“三高”、“三低”和“三个误区”,反映了我国在高血压防治方面医学知识的普及和全民宣教的滞后,在加强诊治的同时全民预防的滞后。为此,我国政府加大了高血压病防治工作的力度,使其逐步实现由医疗、科研为主向群众预防为主的方向转化。这是高血压防治“战线”前移,从医院移到社会,从临床移到预防的过程。     

Oppression and empowerment: perceptions of violence among urban youth

Youth violence in the United States has emerged as a major concern for communities, policymakers and community researchers. This paper reports on the efforts of a child mental health clinic to build a community consensus around addressing violence that affects youth and all members of the community. We describe and give case examples regarding our approach to acquiring the perspectives of the community, particularly that of youth, discuss key themes and implications that emerged from our work, and offer preliminary recommendations for designing a youth violence prevention initiative in a disenfranchised community. Copyright © 2007 John Wiley & Sons, Ltd.     

Privacy Rights,Crime Prevention,CCTV, and the Life of Mrs Aremac

Over the past decade the use of closed circuit television (CCTV) as a means of crime prevention has reached unprecedented levels. Though critics of this development do not speak with one voice and have pointed to a number of different problems in the use of CCTV, one argument has played a dominant role in the debate, namely, that CCTV constitutes an unacceptable violation of people’s right to privacy. The purpose of this paper is to examine this argument critically. It is suggested that the argument is hard to sustain.     

Prenatal Diagnosis for Inherited Deafness—What is the Potential Demand?

Genetic testing for inherited deafness is now available within some genetics centres. This study used a structured questionnaire to assess the potential uptake of prenatal diagnosis (PND) for inherited deafness, and document the opinions of deaf and hearing individuals toward PND and termination of pregnancy (TOP) for hearing status. Participants were self-selected from the whole of the UK, of whom 644 were deaf, 143 were hard of hearing or deafened, and 527 were hearing individuals who had either a deaf parent or child. The results showed that 21% of deaf, 39% of hard of hearing and deafened, and 49% of hearing participants said they would consider PND for deafness. Six percent of deaf, 11% of hard of hearing and deafened, and 16% of hearing participants said they would consider a TOP if the fetus was found to be deaf. Two percent of deaf participants said they would prefer to have deaf children and would consider a TOP if the fetus was found to be hearing.     

Church-based health behavior programs: Using social cognitive theory to formulate interventions for at-risk populations

Epidemiological analyses conclude that the major contributors to all-cause premature mortality and morbidity are smoking, alcohol abuse, inappropriate diet, and a sedentary lifestyle. Efforts to modify these health behaviors in populations with community and worksite interventions, although initially promising, have had difficulty in sustaining health-behavior changes. More intensive, theoretically based interventions targeted to at-risk groups and delivered in smaller social units, such as churches and other religious organizations, have been recommended. An intervention based on social cognitive theory that entails integrating self-regulatory procedures with social and environmental supports in rural churches serving people from lower socioeconomic groups is described in detail.     

Stimuli previously associated with reinforcement mitigate resurgence

Resurgence refers to the recurrence of an extinguished target behavior following subsequent suspension of alternative reinforcement. Delivery of reinforcers during extinction of alternative behavior has been shown to mitigate resurgence. The present experiment aimed to determine whether delivering stimuli associated with reinforcers during resurgence testing similarly mitigates resurgence. Three groups of rats pressed target levers for food according to variable‐interval 15‐s schedules during Phase 1. In Phase 2, lever pressing was extinguished, and an alternative nose‐poke response produced alternative reinforcement according to a variable‐interval 15‐s schedule. Food reinforcement was always associated with illumination of the food aperture and an audible click from the pellet dispenser during Phases 1 and 2. Phase 3 treatments differed between groups. For one group, nose poking continued to produce food and food‐correlated stimuli. Both of these consequences were suspended for a second group. Finally, nose poking produced food‐correlated stimuli but not food for a third group. Target‐lever pressing resurged in the group that received no consequences and in the group that received only food‐correlated stimuli for nose poking. Resurgence, however, was smaller for the group that received food‐correlated stimuli than for the group that received no consequences for nose poking. Target‐lever pressing did not increase between phases in the group that continued to receive food and associated stimuli. Thus, delivery of stimuli associated with food reinforcement after suspension of food reduced but did not eliminate resurgence of extinguished lever pressing. These findings contribute to potential methodologies for preventing relapse of extinguished problem behavior in clinical settings.     

Valuing Our Communities: Ethical Considerations for Economic Evaluation of Community‐Based Prevention

Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large‐scale community‐based intervention. Principles for valuing community members’ time and conducting economic evaluations of community programs are discussed.     

Housing and Child Welfare: Emerging Evidence and Implications for Scaling up Services

Inadequate housing threatens family stability in communities across the United States. This study reviews emerging evidence on housing interventions in the context of scale‐up for the child welfare system. In child welfare, scale‐up refers to the extent to which fully implemented interventions sustainably alleviate family separations associated with housing instability. It incorporates multiple aspects beyond traditional measures of effectiveness including costs, potential reach, local capacities for implementation, and fit within broader social services. The framework further encompasses everyday circumstances faced by service providers, program administrators, and policymakers who allocate resources under conditions of scarcity and uncertainty. The review of current housing interventions reveals a number of systemic constraints for scale‐up in child welfare. Reliance on rental assistance programs limits capacity to address demand, while current practices that target the most vulnerable families may inadvertently diminish effectiveness of the intervention and increase overall demand. Alternative approaches that focus on homelessness prevention and early intervention must be tested in conjunction with community initiatives to increase accessibility of affordable housing. By examining system performance over time, the scalability framework provides an opportunity for more efficient coordination of housing services within and outside of the child welfare system.     

Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief

Background: Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA’s negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study’s objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG.

Design: An online, retrospective survey was conducted with 161 women.

Methods: Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses.

Results: Moderate levels of PTG were observed for “relating to others,” “personal strengths” and “appreciation of life.” “Positive reframing” was a significant predictor of PTG. Despite using mainly “adaptive” coping strategies, women’s grief levels were high.

Conclusions: “Adaptive” coping strategies such as, “positive reframing” are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women’s experience, may be beneficial.