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Abstract: A US Department of Health and Human Services (DHHS) report for health professionals charts and catalogs a host of US Federal activities that are directed at improving health promotion, health protection, and disease prevention in the general population. The 4 text chapters cover: health protection highlights; health status trends; innorations of DHHS and of other Federal agencies; and DHHS prevention inventories, covering fiscal allocations for 14 DHHS health-related areas, and for agency cross-cutting programs. The section on health status trends includes 28 graphs. (wz).
Recognizing that favorable clinical outcomes are associated with earlier initiation of treatment -- and even more ideally with prevention -- this volume addresses the current status of early intervention in, and prevention of, major mental and substance use disorders. A team of distinguished participants addresses this problem at many levels -- from the DNA molecule to public policy -- in order to show how prevention efforts should be informed by a better understanding of etiology and by a knowledge of indicators of vulnerability. In considering the current standing of etiological knowledge, Recognition and Prevention of Major Mental and Substance Use Disorders addresses issues that are critical precursors to the prevention of mental disorders and offers an understanding of factors that contribute to the disorders' development. The contributors review genetic methodologies and current findings in mental disorders, with an emphasis on schizophrenia, and then show how biological and psychosocial environmental variables may affect vulnerability. Chapters devoted specifically to lessons in prevention drawn from recent research into schizophrenia discuss the implications of prodromal studies and relationships between stress, critical periods, and the development of the disorder. The book includes contributions from NIH representatives on how basic scientific understanding of mental disorders can be translated into public policy. It also features chapters that describe cutting-edge projects in prevention research for Alzheimer's disease, drug dependence, antisocial behavior, and posttraumatic stress disorder -- each providing compelling accounts of how existing knowledge can be adapted to promising prevention efforts. Among the volume's contributions: New data on the role of substance abuse -- particularly marijuana and psychostimulants -- in increasing vulnerability to schizophrenia Review of vulnerability factors for several relevant disorders, examining stress and its concomitant psychobiological responses and the contribution of cognitive factors to vulnerability to depression Intriguing approach for translating successful treatment methods for schizophrenia into efforts to prevent the transition from the prodrome of the disorder to the full-blown illness Program for prevention of antisocial behavior that can be implemented as early as the first grade Secondary prevention efforts for posttraumatic stress disorder, with a focus on pharmacological interventions Each chapter reviews clinical implications of the research presented, contributing to a volume that will benefit clinicians and researchers who share the goal of preventing these debilitating conditions. This multidimensional, interdisciplinary work represents a major step toward cutting the social costs of these disorders -- and, more important, their untold cost in human suffering.
The purpose of this book is to present a focused approach to the pathophysiology, diagnosis, and management of the most common autonomic disorders that may present to the clinical neurologist. Autonomic Neurology is divided into 3 sections. The first section includes 5 chapters reviewing the anatomical and biochemical mechanisms of central and peripheral nervous system control of autonomic function, principles of autonomic pharmacology, and a clinical and laboratory approach to the diagnosis of autonomic disorders. The second section focuses on the pathophysiology and management of orthostatic hypotension, postural tachycardia, baroreflex failure; syncope, disorders of sweating, neurogenic bladder and sexual dysfunction, gastrointestinal dysmotility, and autonomic hyperactivity. The final section is devoted to specific autonomic disorders, including central neurodegenerative disorders; common peripheral neuropathies with prominent autonomic failure; painful small fiber neuropathies; autoimmune autonomic ganglionopathies and neuropathies; focal brain disorders; focal spinal cord disorders; and chronic pain disorders with autonomic manifestations. This book is the product of the extensive experience of its contributors in the evaluation and management of the many patients with autonomic symptoms who are referred for neurologic consultation at Mayo Clinic in Rochester, Minnesota. Autonomic Neurology focuses on clinical scenarios and presentation of clinical cases and includes several figures showing the results of normal and abnormal autonomic testing in typical conditions. Its abundance of tables summarizing the differential diagnosis, testing, and management of autonomic disorders also help set this book apart from other books focused on the autonomic nervous system.