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[The environment, knowledge and preventive medicine. 3. The radical approach of conservative medicine--preventive environmental medicine as the physician's responsibility].

To develop a strategy of environmental medicine it is necessary to harmonize the scientific and the holistic ways of thinking. On the basis of a holistic philosophy it is possible to set up a constructive system of values that looks ahead and the assessment of anthropogenic pollutions of the environment. It is imperative to change the way of thinking.

Environmental Pollutants↗

Curative medicine, preventive medicine and health status: the influence of politics on health status in a rural Mexican village.

This paper examines a recent program which purports to address the health concerns of millions of poor rural Mexicans whose constitutional guarantees of health have been largely ignored. This new program asserts the importance of preventive medicine, but makes little effort to implement preventive measures. The curative medicine it does emphasize in practice may alleviate pain and suffering for a time, but ignores critical factors that contribute to the persistence of disease. This paper examines why underdeveloped countries are more likely to implement curative than preventive services for poor people, even while proclaiming the importance of preventive measures. In dependent capitalist economies, the rural penetration of state-directed health services perpetuates the privileged position of the political and economic elite. Based on research conducted in a highland Chinantec village in Oaxaca, this paper concludes that the recent health services program addresses symptoms rather than causes of disease and is not likely to significantly improve the health status of the people who are most in need of such assistance.

Delivery of Health Care↗

Medicalization as a moral problem for preventative medicine.

Preventive medicine is sometimes criticised as it contributes to medicalization of normal life. The concept 'medicalization' has been introduced by Zola to refer to processes in which the labels 'health' and 'ill' are made relevant for more and more aspects of human life. If preventive medicine contributes to medicalization, would that be morally problematic? My thesis is that such a contribution is indeed morally problematic. The concept is sometimes used to express moral intuitions regarding the practice of prevention and health promotion. Through analysis of these intuitions as well as some other moral concerns, I give an explication of the moral problems of medicalization within the context of preventive medicine.

Altruism↗

From atabrine in World War II to mefloquine in Somalia: the role of education in preventive medicine.

Preventive medicine requires an understanding not only of the disease to be prevented, but a complete understanding of conditions affecting the disease transmission, human nature, and the historic situation of the target group. An analysis of a new drug introduction (Atabrine) during World War II is viewed from multiple perspectives and is compared with the introduction of mefloquine during the mission to Somalia 50 years later. Common themes of educational failure at the end-user and policy-marker levels are shown as barriers to effective preventive medicine efforts.

Antimalarials↗

[Veterinary medicine and preventive medicine].

Veterinary medicine concentrates its main activities onto the curative practice for animals but also onto the field of health protection for men since a very long time. But as late as in the year 1900 the first regulation by law within the modern world was edited in Germany. It was initiated by the well-known pathologist Virchow in Berlin and elaborated, besides other veterinarians, by the first food hygienist at the Veterinary School of Berlin, Robert von Ostertag. At that time, the protection of men from the classical infections caused by bacteria was the target, e.g. tuberculosis and the so-called food poisoning. Also, parasitoses like trichinellosis or hydatidosis were the most fought enemies. Nearly 100 years after the application of this regulation by law new types of zoonoses or zooanthroponoses get importance in the view of preventive medicine fulfilled by veterinarians. That are infections which can not be recognized visually and clinically in the new breeding and fattening ways for animals. Such latent infections are the main targets in the present goals and objectives of food hygiene. An undefined and unsolved problem seems to be the occurrence of the BSE of cattle in Great Britain. It may be regarded as a new and intermediate form of a latent and apparent disease of animals which may be dangerous by an unknown way also for men. Since the seventies of this century, the interest of veterinary medicine was focussed also onto residue levels within the products from food animals. These are caused by "substances with pharmacological efficacy", illegally handled by agronoms or veterinarians or by "poisons from the contaminated environment" provoked by industrial emission or manipulations by men. A classical task of food hygiene within the veterinary medicine is to protect the consumer from being taken advantage of through the sale of products containing substantial disregulatory structures of animal tissues.

Animal Diseases↗

Practicing preventive medicine: a national survey of general preventive medicine residency graduates--United States, 1991.

We conducted a national survey of all physicians who graduated from preventive medicine residency (PMR) programs between 1979 and 1989. We mailed a self-administered questionnaire to all PMR graduates of the 43 U.S. programs in General Preventive Medicine and Public Health, requesting information on their current professional activities. Out of 1,070 PMR graduates, 797 (75%) responded to the survey. Overall, graduates were distinguished from other physicians by both work setting and work activities. PMR graduates worked predominantly in institutional settings: in federal or state health agencies, academia, or hospitals/clinics. In addition to maintaining their involvement in clinical medicine, PMR graduates were heavily involved in epidemiologic research and program management. This unique blend of organizational skills, expertise in population-based research, and clinical experience makes PMR graduates an increasingly important human resource as health care reform increases the population of patients being cared for in a managed care setting.

Female↗