Journal of urban health : bulletin of the New York Academy of Medicine
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Building on decades of Academy activities related to substance use, this report emphasizes three guiding principles: 1. Drug treatment should be accessible to all drug users seeking care, including those who are incarcerated. Because turning users away when programs are operating at or above capacity represents lost opportunities for care, programs should be prepared to commence treatment at the time users request it. 2. ⋯ Steps need to be taken to reduce the health-related harms associated with injection drug use, including the transmission of human immunodeficiency virus (HIV), hepatitis B and C, and other blood-borne pathogens. Harm reduction incorporates many modalities, such as HIV prevention education, including condom use and safer sex counseling and education; referrals for drug treatment and other health care and social services; interim methadone maintenance; and syringe and needle availability and exchange programs. Each of these interventions represents important medical and public health strategies that may decrease some of the secondary medical consequences of injection drug use.
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Insights into the evolution of virulence may aid efforts to control or even prevent emerging diseases. Specifically, dangerous pathogens can be distinguished from those that pose relatively little threat by identifying characteristics that favor intense exploitation of hosts by pathogens, hence causing high virulence. ⋯ These insights may improve the return on investments in disease control by directing effort and resources to the most-dangerous emerging pathogens. The approach also should help us to identify those control measures that will guard against the future emergence of dangerous pathogens, even those that have not yet been identified.
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Overwhelming evidence indicates the strong adverse health impact of several personal behaviors, including smoking, immoderate use of alcohol, too little physical exercise, and excessive caloric consumption. These behaviors have arisen on a mass scale in the industrialized nations during the 20th century, thus generating the epidemics of our time. ⋯ To advance health, particularly in inner cities of America, a systematic approach to dealing with these major forces on health-related behavior is necessary. Such an approach is briefly outlined.
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Developmental screening scores among preschool-aged children: the roles of poverty and child health.
To investigate, using a nationally representative sample of preschool-aged children, the relationship among poverty history, child health, and risk of an abnormal developmental screening score. ⋯ Poverty is the largest single predictor of an abnormal developmental screening score. The implications of inadequate medical care among poor children for the interpretation of individual screening scores and for amelioration of problems are also discussed.