[Diet & constitution of various classes of citizens of a Calabrese commune].
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A wide variety of prevention approaches that reduce substance use and associated problems have been developed and tested. But successes have been limited in promoting the use of these scientific advances by the policy makers, practitioners, and concerned citizens. The Center for Substance Abuse Prevention's six regional Centers for the Application of Prevention Technologies (CSAP's CAPTs) are a major mechanism by which CSAP brings research to practice. This article synthesizes the issues that the CAPTs have faced, the solutions they have developed, and conclusions concerning the work that still needs to be done to increase the application of science-based approaches to prevention. These discussions highlight the particular importance of addressing issues related to the larger systems in which prevention programs and strategies operate.
Since the late 1970s, grass-roots community groups, consumer advocates, and national (and international) environmental organizations have made two main contributions to public discussions, and public policies, affecting the production, use, and disposal of toxic materials. With the advent of e-mail, listservs, and the World Wide Web, such groups formed global "early warning" networks that have (1) alerted people to many uses of toxic materials and their effects on wildlife and humans, and (2) advocated new prevention-based public policies, including: assessment of available alternatives as a means of supplementing risk assessments; clean production as a way of avoiding the use of toxic materials; the substitution principle as a way of systematically reducing the use of toxic materials as time passes; the precautionary principle as a policy response to uncertainties in toxicological science; and zero discharge of persistent or bioaccumulative substances. We describe and discuss numerous important digital resources (web sites, discussion lists, and databases) created and maintained by and for citizen groups.
CONCLUSION: Genetic knowledge is now in the public domain and its interpretation by the media and the citizens brings the issues into the public forum of discussion for the necessary ethical, legal and socio-cultural evaluation of its application. Science is being perceived by some as dangerous and as requiring international regulation. Others feel that genetic knowledge will be the breakthrough that will permit medical progress and individual autonomy with regards to personal health and lifestyle choices. The mapping of the human genome has already yielded valuable information on an increasing number of diseases and their variants. Prevailing popular and journalistic archetypes ("imaginaires") used in the media are perceived by the producers as slowing down the possible application of genetic knowledge. The answers to these dilemmas are not readily apparent nor are they prescribed by classical philosophy of medicine. Since genetic knowledge eventually resides with the individual who carries the genes of disease and/or susceptibility, a logical approach to integration of this knowledge at a societal level would seem to reside with individual education and decision-making. The politics of the ensuing social debate could transform the current social contract since an individual's interests need to be balanced against those of his or her immediate family in the sharing of information. The ethical foundations of such a contract requires the genetic education of "Everyone" as a matter of urgent priority. Genetic education should not serve ideological power struggles between the medical establishment and the ethical-legal alliance. Instead, it should ensure the transfer of knowledge to physicians, to patients, to users, to planners, to social science and humanities researchers and to politicians, so that they may make "informed" and free decisions....
Medical science and practice can no longer ignore the phenomenon of jogging, but should support it as the expression of an instinct of the citizen. Here also understatement and exaggeration are often found, so that the doctor, as the citizen's adviser must be informed about kinesitherapy. In four-dimensional therapy (environmental awareness: psychological conduct, movement, dietetics, physical measures), in primary, secondary and tertiary prevention and in sports for the handicapped, jogging is almost always involved and is very often the central point. Every century has its diseases and lesions and every century must evolve for itself the laws on prevention, healing and restoration and incorporate them into everyday life.
Historically, unpleasant odors have been considered warning signs or indicators of potential risks to human health but not necessarily direct triggers of health effects. However, citizen complaints to public health agencies suggest that odors may not simply serve as a warning of potential risks but that odor sensations themselves may cause health symptoms. Mal-odors emitted from large animal production facilities and wastewater treatment plants, for example, elicit complaints of eye, nose, and throat irritation, headache, nausea, diarrhea, hoarseness, sore throat, cough, chest tightness, nasal congestion, palpitations, shortness of breath, stress, drowsiness, and alterations in mood. There are at least three mechanisms by which ambient odors may produce health symptoms. First, symptoms can be induced by exposure to odorants (compounds with odor properties) at levels that also cause irritation or other toxicological effects. That is, irritation--rather than the odor--is the cause of the health symptoms, and odor (the sensation) simply serves as an exposure marker. Second, health symptoms from odorants at non-irritant concentrations can be due to innate (genetically coded) or learned aversions. Third, symptoms may be due to a co-pollutant (such as endotoxin) that is part of an odorant mixture. Objective biomarkers of health symptoms must be obtained, however, to determine if health complaints constitute health effects. One industry that is receiving much attention, worldwide, related to this subject is concentrated animal production agriculture. Sustainability of this industry will likely necessitate the development of new technologies to mitigate odorous aerial emissions. Examples of such "environmentally superior technologies" (EST) developed under the initiative sponsored through agreements between the Attorney General of North Carolina and Smithfield Foods and Premium Standard Farms are described.
BACKGROUND: Evidence is available in support of the policies for a population-wide approach to shifting risk factor distribution; on the other side, setting up enduring projects of primary prevention is difficult, as well as gathering the right experts. METHODS: In 1999 the Piedmont Region's Administration set up a multi-year intervention with the aim at reducing risk factors and increasing protective factors of oncologic and cardiovascular diseases in the general population, particularly in disadvantage groups. The cardiologists played a primary role by supporting the project of evidence-based guidelines, producing bibliographic reviews and spreading coronary risk maps. A main group of trainers was set up in each Local Health Service to promote a system of counseling lifestyles, with the central reference of the general practitioner activity. As a second step, a mass-media campaign has been set up using health advertisements on newspapers, television, public transports, notice-boards on the following subjects: nutrition, hypertension, tobacco, physical activity, stress; warehouses, food markets, trains and squares were involved. Moreover, a newsletter review has been published since January 2000, to produce basic models, most effective interventions and recommendations for their implementation. RESULTS: A new care for the primary prevention and counseling arguments as well as the need for continuous training to promote preventive actions were shown to general practitioners. A system to identify the best channels, communication ways and the most effective messages for healthy lifestyles was settled. A model of monitoring risk factor changes and protective behaviors in the population, describing social differences, was established to better plan and assess effective interventions. CONCLUSIONS: After more than half a century of productive public health science, there is an urgent need that Government Administrations steer their health policies towards determinants of health and create the best conditions to make citizens to improve their lifestyle.
Regulatory science is, broadly speaking, the effort to insure that the products of our advanced technological civilization are developed in harmony with human needs. More specifically, regulatory science can be described as the science of evaluating the safety, efficacy and quality of these products. An unbiased assessment of these aspects is necessary for proper regulation of food, drugs, the environment, agricultural chemicals as well as the countless new materials available to the public every year. Evaluation does not interfere with product development; indeed, it often hastens the appearance of beneficial products in the public sector. Evaluation criteria should be established through consensus between industry, academia, and government and only after a thorough scientific discussion grounded in the basic principle of protecting the welfare of society's citizens. Even more important than broad-ranging knowledge is the need to develop new evaluation strategies and methodologies. Numerous problems confronting the world today can surely benefit from the evaluative techniques of regulatory science. Since research in the academic sphere often fails to address many of these issues, I want to reiterate the need for our National Institute to play a more prominent role in coordinating regulatory policy and pursuing these issues based on my firm belief that such activity is indispensable for human survival.
I. G. Savchenko is an outstanding scientist-pathologist, microbiologist and immunologist. He dedicated all his life to the cause of protecting and promoting the health of the people and combating the infectious diseases. He made a valuable contribution to the development of medical science. He displayed selflessness having carried out an experiment in himself to confirm observations on building up artificial immunity to cholera. He was an organizer of the bacteriological institutes of Kazan and Krasnodar, chairs of pathology and microbiology at the Krasnodar Medical Institute. He founded scientific schools in Krasnodar and Kazan. In spite of his immense services to science and the population he was subjected to repression in 1932. 60 years have passed since his decease but the scientist-innovator, physician and citizen will always be held in remembrance.
Environmental threats are one of the highest concerns of communities seeking to improve public health. University researchers seek to assist communities with these concerns by providing technical expertise. But these community-science collaborations are often frustrating to both parties. Communities often find that the scientific studies have not proven what they believe the problem to be, while scientists often feel at least pestered, if not manipulated, by the dirty politics of the community. This paper investigates the proposition that environmental scientists must learn to combine their quantitative studies with qualitative views on the community and its health, if their studies are to be useful and indeed even fully accurate. The goal of the presentation is to explore changes in the methods of one particular field, environmental epidemiology, that might make it more relevant to current environmental debates. After a brief history of the field, limitations in the current practice of epidemiology are presented. These can be grouped under two headings: an over-emphasis on quantitative results, and an underestimation of uncertainties in study results. Some suggestions are given for changes that might address these problems, and make epidemiology more useful for citizens and policy-makers. These are: 1. nest quantitative results in qualitative descriptions of study populations; 2. fit two different kinds of statistical models one very simple, the other quite complex; 3. conduct sensitivity analyses; and 4. use precautionary guidelines for causal inference. It is concluded that environmental epidemiology serves a particular societal function; which is to inform citizens and policy makers about environmental hazards that, perhaps, should be the subject of legal and economic interventions. For this reason, methods could be changed to improve the fit of the science to this function. There remains, however, much to be done to revise and refine this perspective, and to make the suggestions sufficiently specific that they can be put into practice.
This article describes work from an allied health project grant that resulted in an interdisciplinary geriatric educational experience for health professions faculty and students (health information administration, occupational therapy, physical therapy, and health professions education) at an academic health sciences center. The educational experience centered on the process of designing, administering, and analyzing the results of a comprehensive needs assessment for clients attending a senior citizen center. This process enabled faculty and students to integrate education, service, and research activities into their curricula, and to work as an interdisciplinary team in assessing the health care needs of elderly adults in the community.
This essay uses an approach borrowed from environmental history to investigate the interaction of science and nature in a late twentieth-century controversy. This debate, over the proper response to fire ants that had been imported into the American South accidentally and then spread across the region, pitted Rachel Carson and loosely federated groups of conservationists, scientists, and citizens against the U.S. Department of Agriculture. The analysis falls into three sections: an examination of the natural history of the ants; an examination of the views of the competing factions; and an examination of how those views, transformed into action, affected the natural world. Both sides saw the ants in terms of a constellation of beliefs about the relationship between nature, science, and democracy. As various ideas were put into play, they interacted with the natural history of the insects in unexpected ways--and with consequences for the cultural authority of the antagonists. Combining insights from the history of science and environmental history helps explain how scientists gain and lose cultural authority and, more fundamentally, allows for an examination of how nature can be integrated into the history of science.
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As a rural state, Ohio has a vital interest in addressing rural health and information needs. NetWellness is a Web-based consumer health information service that focuses on the needs of the residents of Ohio. Health sciences faculty from the state's three Carnegie Research I universities--University of Cincinnati, Case Western Reserve University, and The Ohio State University--create and evaluate content and provide Ask an Expert service to all visitors. Through partnerships at the state and local levels, involving public, private, commercial, and noncommercial organizations, NetWellness has grown from a regional demonstration project in 1995 to a key statewide service. Collaboration with public libraries, complemented by alliances with kindergarten through twelfth grade agencies, makes NetWellness Ohio's essential health information resource.
As part of the restructuring of the electricity industry in many states, public benefits funding has emerged as a primary mechanism for supporting social benefits such as energy efficiency and research and development (RD). In California, a Public Interest Energy Research (PIER) Program was established to "conduct public interest energy research that seeks to improve the quality of life for California"s citizens by providing environmentally sound, safe, reliable, and affordable energy services and products. PIER includes the full range of research, development, and demonstration activities that will advance science or technology not adequately provided by competitive and regulated markets." The PIER Program is comprised of six PIER Program funding areas, including the Energy-Related Environmental Research. The overall mission of the Energy-Related Environmental Research is to "Develop cost-effective approaches to evaluating and resolving environmental effects of energy production, delivery, and use in California, and explore how new energy applications and products can solve environmental problems." This paper describes the process used in developing these approaches and identifies a set of environmental issues that the State plans to evaluate.
The increase in individuals over 60 years of age in America must cause professionals from the fields of nutrition, food science, food systems management and the food industry to consider the determinants of food choices and the effects on the overall health and well-being of elderly citizens and those soon to be in their mature years. Income, household composition, food preferences, time, technology, education, good health, attitudes, physiological changes in vision, hearing, taste and smell, psychological and sociological factors all affect the food choices of the elderly.
An examination of the way in which the Environmental Protection Agency, Occupational Safety and Health Administration, and Consumer Product Safety Commission each responded to evidence of formaldehyde's carcinogenicity in animal systems reveals the interplay between politics and science policy in regulatory determinations. In some cases there were significant and unjustified departures from reasoned decision-making. Agency decisions not to take action deserve special attention by citizens, the Congress, and the judiciary to ensure that federal regulatory agencies take the necessary steps to protect the public from significant health, safety, and environmental risks.
In the transition out of socialism to market capitalism, bodies, populations, and categories of citizenship have been reordered. The rational-technical management of group affected by the Chernobyl disaster in Ukraine is a window into this contested process. Chernobyl exemplifies a moment when scientific knowability collapsed and new maps and categories of entitlement emerged. Older models of welfare rely on precise definitions situating citizens and their attributes on a cross-mesh of known categories upon which claims rights are based. Here one observes how ambiguities related to categorizing suffering created a political field in which a state, forms of citizenship, and informal economies were remade.