The Experts below are selected from a list of 174 Experts worldwide ranked by ideXlab platform
Nicolas Treich - One of the best experts on this subject based on the ideXlab platform.
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scientific progress and irreversibility an economic interpretation of the precautionary principle
Journal of Public Economics, 2000Co-Authors: Christian Gollier, Bruno Jullien, Nicolas TreichAbstract:We consider the problem of the optimal use of a good whose consumption can produce damages in the future. Scientific progress is made over time that provides information on the distribution of the intensity of damages. We show that this progress induces earlier Prevention Effort only if prudence is larger than twice absolute risk aversion. This paper thus identifies the class of quite restrictive but plausible conditions such that scientific uncertainties justify an immediate reduction of the consumption of a potentially toxic substance.
Petra Steinorth - One of the best experts on this subject based on the ideXlab platform.
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impact of health savings accounts on precautionary savings demand for health insurance and Prevention Effort
Journal of Health Economics, 2011Co-Authors: Petra SteinorthAbstract:The paper examines the influence of health savings accounts (HSAs) on optimal savings, insurance demand and Prevention Effort over the course of a lifetime. This paper adds to the literature by investigating HSAs as both a form of insurance and as saving vehicle in an expected utility framework. Assuming no regulatory constraints on the deductible, we show that individuals voluntarily choose a positive deductible and increase their savings with HSAs. If the government-imposed minimum deductible becomes too great, however, individuals may instead choose to remain in traditional insurance. We determine the effect of HSAs on Prevention Effort. We find that an increased tax subsidy may worsen moral hazard issues. Assuming partial risk aversion to be less than or equal to one, individuals will either invest less in the health preservation Effort and more money in the HSA or vice versa. However, they will never increase both Effort and savings simultaneously as was intended when HSAs were introduced.
Barbara Stanley - One of the best experts on this subject based on the ideXlab platform.
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treatment engagement a neglected aspect in the psychiatric care of suicidal patients
Psychiatric Services, 2010Co-Authors: Dana Lizardi, Barbara StanleyAbstract:Objective: Suicide remains a serious health problem in the United States and worldwide. Despite changing distributions in sex, race-ethnicity, and age and considerable Efforts to reduce the incidence rate, the number of suicides has remained relatively stable. The transition from emergency services to outpatient services is a crucial but often neglected step in treating suicidal individuals. Up to 50% of attempters refuse recommended treatment, and up to 60% drop out after only one session. This point of intervention is crucial for patients at elevated risk of suicide to reduce imminent danger and to increase the chances that patients will follow up on recommended treatment. Methods: PubMed, MEDLINE, and PsycINFO databases were searched for empirical investigations of treatment engagement of suicide attempters. Keywords searched included treatment, intervention, engagement, adherence, compliance, utilization, participation, and suicide attempt. Mapped terms were also included. Thirteen articles were selected. Results: Studies that have examined the effectiveness of postdischarge contact with suicide attempters (phone, letter, and in-person visits) to increase treatment adherence have found some immediate effects after substantial contact that were not sustained. Simple referrals to outpatient care were not effective. Family group interventions for adolescents have improved adherence, as have brief interventions in the emergency department. Conclusions: Despite greater public awareness of suicide, heightened Prevention Effort, and increased efficacy of treatment interventions, success in reducing suicidal behavior has been limited. Developing brief interventions for use in emergency settings that can reduce suicide risk and enhance treatment follow-up has been a neglected aspect of suicide Prevention and may help to reduce suicidal behavior. (Psychiatric Services 61:1183–1191, 2010)
Juberg Anne - One of the best experts on this subject based on the ideXlab platform.
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When not too far gone: A pragmatic - reflexive approachto substance and crimePrevention in consumer societytowards indicated 16-18-yearold adolescents
NTNU, 2014Co-Authors: Juberg AnneAbstract:Når de ikke har kommet “for langt”: En pragmatisk- refleksiv tilnærming til rus og kriminalitetsforebygging i konsumentsamfunnet rettet mot utvalgte 16- 18- åringer Avhandlingen bygger på en fokusgruppestudie der 17 ungdommer deltok. Ungdommene hadde det til felles at de hadde fremvist en type atferd i tilknytning til rusmiddelbruk og omgang med lover og regler som vekket bekymring for framtida deres blant voksne som brydde seg om dem. Hensikten med studien var for det første å få innblikk i ungdommenes perspektiver og praksiser når det gjaldt sentrale livsstils- og livsførselstemaer og hvordan de forholdt seg til temaene når de snakket om dem i fokusgruppene. Analysen av dataene var ment å bidra til en forståelse av rus- og kriminalitets-forebygging som var i pakt med de endringene konsumentsamfunnet har brakt med seg. Analysen antyder at ungdommene som deltok i studien i stor grad ga tilslutning til fellesnormer i samfunnet og gjorde grep for å holde mer avvikende livsstils - alternativer på avstand. De var gjennomgående opptatt av det risikofylte i andres atferd. Likevel var tentativitet i forhold til livsstils - og livsførselstemaene et sentralt trekk i ungdommenes væremåte. Tentativiteten innebar at flere og delvis motstridende livsstilsalternativer kunne se attraktive ut for ungdommene på samme tid, uten at de stoppet opp og reflekterte over hva de ulike alternativene innebar. Livet manglet derfor gjennomgående en retning. Ungdommene uttalte i liten grad frykt for egen helse eller risikoen for å bli utstøtt av «det gode selskap» for egen del. I den grad slik frykt forekom, hadde den mer indirekte uttrykk. Ulike perspektiv på disse tendensene medfører ulike typer faglige tilnærminger. Konvensjonell forebyggingstankegang bygger på ideen om at folk er like og at kunnskap om konsekvenser i framtida må være retningsgivende for nåværende atferd. Ikke minst fordi denne type rasjonalitet krever et tydelig retningsvalg vil tentativitet i et slikt lys framstå som en uakseptabel væremåte. Når data derimot blir sett i lys av de problemene med å spå om framtida som preger nåtida generelt og ungdomslivet spesielt, fremstår tentativiteten annerledes. Da kan den betraktes som et forsøk på å tross alt imøtekomme de kravene til reflektert selvdannelse som gjelder i nåtidssamfunnet, men som en i kraft av å være ungdom og mangle holdepunkter for hva framtida vil bringe ikke alltid har umiddelbare forutsetninger for å imøtekomme. En vet kanskje hva en ikke vil, men ikke hvor en vil og hvordan en skal komme dit. En målsetting i tidsriktig forebyggingsinnsats blir i lys av denne innsikten å i første omgang akseptere retningsløsheten som en «plattform» for mer bevisst refleksjon omkring retning i livet. I neste omgang blir målsettingen å fremme slik refleksjon gjennom å ta tak i temaer som de aktuelle ungdommene rent umiddelbart er opptatt av. Forskningsprosjektet har utspring i politiske målsettinger fra omkring tusenårsskiftet om å gi rusrelatert problematikk større plass på området barn og unges psykiske helse. Prosjektet er også motivert ut fra nasjonale målsettinger om å styrke bruker-medvirkning og forebygging innenfor dette innsatsområdet. Forebyggingsinnsats overfor ungdom som har framvist bekymringsfull rusatferd eller som omgås loven på bekymringsfull måte er dessuten et relativt u-utforsket felt. Fokusgruppe ble i det aktuelle prosjektet ansett som den beste metoden for å stimulere til artikulasjon av halvbevisste og ofte uartikulerte synspunkter omkring ungdommenes egne handlemåter, aspirasjoner og livsprosjekter. Utvelgelsen av deltakere og gruppesammensetning skjedde i nært samarbeid med fagfolk som fra ulike ståsted hadde forhåndskontakt med ungdommene. Den analytiske rammen for utforsking av dataene bygget på elementer både fra seinmoderne teori om selvdannelse og seinmoderne teori om sosial makt.The thesis sheds light on the life shaping challenges of youths who occupy the indeterminable landscape between shared norms for use of substances and abidance of the law on the one hand, and more deviant life arrangements on the other hand. The concept of life shaping has been derived within theory on late modernity (see Giddens 1991). It refers to the capacity to exert judgment around the socially appropriate and the capacity to shift direction on short notice. By emphasizing life shaping, the thesis is meant to contribute to a timely conceptual framework for professional Effort aimed at hindering that incipient problems with substance use as well as rule breaking / delinquency develop and become persistent. The data material consists of transcripts from focus group interviews with a total of 17 youths, 11 boys and 6 girls, 16-18 years of age from Trondheim, Norway and some other municipalities. The youths corresponded on a group level to those risk factors that are statistically associated with persistent delinquency and persistent problems with substances later in life. Additionally, the youths had been exhibiting involvement in risk activities to an extent that made adults be more than averagely worried about their future. All the same, the youths had not developed problems of the most serious kind. Moreover, they represented a wide range of situations and personalities. It seems to be general consensus among researchers that it is difficult to distinguish the normal from the deviant in adolescence. Approaches based on the assumption that youth in the indeterminable landscape without further consideration are problem youths with life shaping ideals that deviate from the mainstream population therefore appear as inappropriate in a perspective of Prevention. The fact that we deal with youths in constant development as well as the fact that contemporary society has become highly changeable and unpredictable seems to have reinforced the need for new principles for Prevention. The capacity to change direction on short notice and to exert judgment around the socially appropriate is, for instance, as appreciated in today`s world as the capacity for long term planning and risk calculation. This constitutes a principle for life shaping that often is described as “reflexivity”. A result of the development in recent decades is also that the focus on individual responsibility for one’s own welfare is increasing at the same time as the knowledge about risk-prone phenomena has become commonly shared. Behavior that puts health at risk against the actors` better judgment is regarded as a threat against the common good. Life shaping or self-shaping therefore appears as a fruitful concept within substance and crime Prevention in late modern consumer society; even though much literature on life shaping may be criticized for ignoring social inequality. Without the capacity of reflexive life shaping exclusion from respectable society may become the result. A basic assumption in this thesis is therefore that a focus on reflexive individual life shaping in the future should be viewed as a major basis for substance and crime Prevention. Despite the increasing emphasis on the role of individual life shaping for avoidance of problems in the future, research with a focus on such principles is scarce within the realm of Prevention. A reason why may be that the “risk zone” is a landscape which is difficult to conceptualize in the conventional scientific way. It may also be that the very topic of life shaping is regarded as a theme beyond the academic mandate. Yet, the lack of timelier research may not at least be due to the fact that Prevention in the described area is still predominated by a mind-set that fits in a less complex and therefore more predictable society, but which is no longer really appropriate in consumer society. Knowledge based on self-experience, agency and curiosity towards the indeterminable has poor conditions within this tradition. A premise for most Prevention Effort has, for instance, been that there are relatively sharp boundaries between risk-prone behavior and safe behavior and between “at risk” youths and “ordinary” youths. Moreover, risk in this perspective is not likely to be treated as mere future potentiality, but as something that already has happened. In this way, the phenomena appear as determinable in normative space that is relatively indeterminate. The analysis of the current data indicates that everyday experience after all may be as an important basis for Prevention and self-shaping processes as the more universal conceptualizations and solutions that have been developed by experts. This should be the main rule even when the projects may seem indeterminate and directionless in the first place. Expert solutions are mostly derived from a conceptualization of risk as calculable and predictable. The assumption that there is a tension in contemporary society between contingency (everybody may become anybody they wish) on the one hand and social constraint on the other, shaped the groundwork for the current data analysis. The analysis suggested that the youths both acknowledged and drew on both tendencies. They made many attempts at keeping more deviant life style at an arm’s length, although often in a non-reflected manner. All the same, many of them seemed to lack a determined direction in life. Besides, in the latter perspective it proved easier to become aware that the youths had problems with arriving at a more conscious position in their own life. There was a tendency to operate in quite evasive ways and participants generally tended to see more easily the risk prone aspects of their peers’ activities than the risk prone aspects implied in own modes of operating. Much is dependent on the perspective by means of which the described tendencies are regarded. If the analysis had been carried out in the light of conventional risk discourse, the evasive maneuvers and the ignorance of own risk could be mistakenly viewed as deviant acts. Moreover, the youths could be ascribed characteristics as morally deviant. This may entail unintended stigma and blocked communication. When viewed in the light of prevailing currents in contemporary society, however, it also becomes clearer that the uncertain and directionless way in which the youths are operating may even be viewed as a resource to draw on in the interaction with the youths. There certainly are some things they do not want for their future and life styles they do not want to be identified with. The maneuvering in the morally indeterminable space that the youths tended to occupy has in this thesis been described by means of the term “tentativeness”. In contrast to the concept “practical reason” which is oriented towards the normative and commonly acknowledged, the concept of tentativeness is implying both thoughtless and directionless maneuvering. The data suggest that the leap needs not be far from a predominantly unconscious to a more conscious tentativeness. The professional challenge is above all to take this seriously without oversteering the interest in the youths towards becoming more active in their life projects. The precondition for this leap is to accept that not all life shaping is calculable. Moreover, one must accommodate the ambiguous and indeterminable and support the single youth`s capacity to get further in life. Not least, it is a crucial point to facilitate the youths’ participation in meaningful activity and that they attend work life. Principles that have been particularly addressed are accept of non-calculability as a part of being, the need to allow for ambiguity and indeterminability, promotion of “nudging” or “scaffolding” practices and the necessity of assisting youth in getting involved in meaningful activity. Both theoretically and with regard to content the term tentativeness resembles terms derived from cultural criminology. The novel way in which the concept of tentativeness is employed in this thesis is above all that it is related to crime and substance Prevention on a so-called indicated level and that it clarifies why life-shaping projects should be emphasized more in substance and crime Prevention with teenagers
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When not too far gone: A pragmatic - reflexive approachto substance and crimePrevention in consumer societytowards indicated 16-18-yearold adolescents
2014Co-Authors: Juberg AnneAbstract:Når de ikke har kommet “for langt”: En pragmatisk- refleksiv tilnærming til rus og kriminalitetsforebygging i konsumentsamfunnet rettet mot utvalgte 16- 18- åringerAvhandlingen bygger på en fokusgruppestudie der 17 ungdommer deltok. Ungdommene hadde det til felles at de hadde fremvist en type atferd i tilknytning til rusmiddelbruk og omgang med lover og regler som vekket bekymring for framtida deres blant voksne som brydde seg om dem. Hensikten med studien var for det første å få innblikk i ungdommenes perspektiver og praksiser når det gjaldt sentrale livsstils- og livsførselstemaer og hvordan de forholdt seg til temaene når de snakket om dem i fokusgruppene.Analysen av dataene var ment å bidra til en forståelse av rus- og kriminalitets-forebygging som var i pakt med de endringene konsumentsamfunnet har brakt med seg. Analysen antyder at ungdommene som deltok i studien i stor grad ga tilslutning til fellesnormer i samfunnet og gjorde grep for å holde mer avvikende livsstils - alternativer på avstand. De var gjennomgående opptatt av det risikofylte i andres atferd. Likevel var tentativitet i forhold til livsstils - og livsførselstemaene et sentralt trekk i ungdommenes væremåte. Tentativiteten innebar at flere og delvis motstridende livsstilsalternativer kunne se attraktive ut for ungdommene på samme tid, uten at de stoppet opp og reflekterte over hva de ulike alternativene innebar. Livet manglet derfor gjennomgående en retning. Ungdommene uttalte i liten grad frykt for egen helse eller risikoen for å bli utstøtt av «det gode selskap» for egen del. I den grad slik frykt forekom, hadde den mer indirekte uttrykk.Ulike perspektiv på disse tendensene medfører ulike typer faglige tilnærminger. Konvensjonell forebyggingstankegang bygger på ideen om at folk er like og at kunnskap om konsekvenser i framtida må være retningsgivende for nåværende atferd. Ikke minst fordi denne type rasjonalitet krever et tydelig retningsvalg vil tentativitet i et slikt lys framstå som en uakseptabel væremåte. Når data derimot blir sett i lys av de problemene med å spå om framtida som preger nåtida generelt og ungdomslivet spesielt, fremstår tentativiteten annerledes. Da kan den betraktes som et forsøk på å tross alt imøtekomme de kravene til reflektert selvdannelse som gjelder i nåtidssamfunnet, men som en i kraft av å være ungdom og mangle holdepunkter for hva framtida vil bringe ikke alltid har umiddelbare forutsetninger for å imøtekomme. En vet kanskje hva en ikke vil, men ikke hvor en vil og hvordan en skal komme dit. En målsetting i tidsriktig forebyggingsinnsats blir i lys av denne innsikten å i første omgang akseptere retningsløsheten som en «plattform» for mer bevisst refleksjon omkring retning i livet. I neste omgang blir målsettingen å fremme slik refleksjon gjennom å ta tak i temaer som de aktuelle ungdommene rent umiddelbart er opptatt av.Forskningsprosjektet har utspring i politiske målsettinger fra omkring tusenårsskiftet om å gi rusrelatert problematikk større plass på området barn og unges psykiske helse. Prosjektet er også motivert ut fra nasjonale målsettinger om å styrke bruker-medvirkning og forebygging innenfor dette innsatsområdet. Forebyggingsinnsats overfor ungdom som har framvist bekymringsfull rusatferd eller som omgås loven på bekymringsfull måte er dessuten et relativt u-utforsket felt. Fokusgruppe ble i det aktuelle prosjektet ansett som den beste metoden for å stimulere til artikulasjon av halvbevisste og ofte uartikulerte synspunkter omkring ungdommenes egne handlemåter, aspirasjoner og livsprosjekter. Utvelgelsen av deltakere og gruppesammensetning skjedde i nært samarbeid med fagfolk som fra ulike ståsted hadde forhåndskontakt med ungdommene. Den analytiske rammen for utforsking av dataene bygget på elementer både fra seinmoderne teori om selvdannelse og seinmoderne teori om sosial makt.The thesis sheds light on the life shaping challenges of youths who occupy the indeterminable landscape between shared norms for use of substances and abidance of the law on the one hand, and more deviant life arrangements on the other hand.The concept of life shaping has been derived within theory on late modernity (see Giddens 1991). It refers to the capacity to exert judgment around the socially appropriate and the capacity to shift direction on short notice.By emphasizing life shaping, the thesis is meant to contribute to a timely conceptual framework for professional Effort aimed at hindering that incipient problems with substance use as well as rule breaking / delinquency develop and become persistent.The data material consists of transcripts from focus group interviews with a total of 17 youths, 11 boys and 6 girls, 16-18 years of age from Trondheim, Norway and some other municipalities.The youths corresponded on a group level to those risk factors that are statistically associated with persistent delinquency and persistent problems with substances later in life. Additionally, the youths had been exhibiting involvement in risk activities to an extent that made adults be more than averagely worried about their future. All the same, the youths had not developed problems of the most serious kind. Moreover, they represented a wide range of situations and personalities.It seems to be general consensus among researchers that it is difficult to distinguish the normal from the deviant in adolescence. Approaches based on the assumption that youth in the indeterminable landscape without further consideration are problem youths with life shaping ideals that deviate from the mainstream population therefore appear as inappropriate in a perspective of Prevention.The fact that we deal with youths in constant development as well as the fact that contemporary society has become highly changeable and unpredictable seems to have reinforced the need for new principles for Prevention. The capacity to change direction on short notice and to exert judgment around the socially appropriate is, for instance, as appreciated in today`s world as the capacity for long term planning and risk calculation. This constitutes a principle for life shaping that often is described as “reflexivity”.A result of the development in recent decades is also that the focus on individual responsibility for one’s own welfare is increasing at the same time as the knowledge about risk-prone phenomena has become commonly shared. Behavior that puts health at risk against the actors` better judgment is regarded as a threat against the common good. Life shaping or self-shaping therefore appears as a fruitful concept within substance and crime Prevention in late modern consumer society; even though much literature on life shaping may be criticized for ignoring social inequality. Without the capacity of reflexive life shaping exclusion from respectable society may become the result. A basic assumption in this thesis is therefore that a focus on reflexive individual life shaping in the future should be viewed as a major basis for substance and crime Prevention.Despite the increasing emphasis on the role of individual life shaping for avoidance of problems in the future, research with a focus on such principles is scarce within the realm of Prevention. A reason why may be that the “risk zone” is a landscape which is difficult to conceptualize in the conventional scientific way. It may also be that the very topic of life shaping is regarded as a theme beyond the academic mandate.Yet, the lack of timelier research may not at least be due to the fact that Prevention in the described area is still predominated by a mind-set that fits in a less complex and therefore more predictable society, but which is no longer really appropriate in consumer society. Knowledge based on self-experience, agency and curiosity towards the indeterminable has poor conditions within this tradition. A premise for most Prevention Effort has, for instance, been that there are relatively sharp boundaries between risk-prone behavior and safe behavior and between “at risk” youths and “ordinary” youths. Moreover, risk in this perspective is not likely to be treated as mere future potentiality, but as something that already has happened. In this way, the phenomena appear as determinable in normative space that is relatively indeterminate.The analysis of the current data indicates that everyday experience after all may be as an important basis for Prevention and self-shaping processes as the more universal conceptualizations and solutions that have been developed by experts. This should be the main rule even when the projects may seem indeterminate and directionless in the first place.Expert solutions are mostly derived from a conceptualization of risk as calculable and predictable.The assumption that there is a tension in contemporary society between contingency (everybody may become anybody they wish) on the one hand and social constraint on the other, shaped the groundwork for the current data analysis. The analysis suggested that the youths both acknowledged and drew on both tendencies. They made many attempts at keeping more deviant life style at an arm’s length, although often in a non-reflected manner. All the same, many of them seemed to lack a determined direction in life. Besides, in the latter perspective it proved easier to become aware that the youths had problems with arriving at a more conscious position in their own life. There was a tendency to operate in quite evasive ways and participants generally tended to see more easily the risk prone aspects of their peers’ activities than the risk prone aspects implied in own modes of operating.Much is dependent on the perspective by means of which the described tendencies are regarded. If the analysis had been carried out in the light of conventional risk discourse, the evasive maneuvers and the ignorance of own risk could be mistakenly viewed as deviant acts. Moreover, the youths could be ascribed characteristics as morally deviant. This may entail unintended stigma and blocked communication.When viewed in the light of prevailing currents in contemporary society, however, it also becomes clearer that the uncertain and directionless way in which the youths are operating may even be viewed as a resource to draw on in the interaction with the youths. There certainly are some things they do not want for their future and life styles they do not want to be identified with.The maneuvering in the morally indeterminable space that the youths tended to occupy has in this thesis been described by means of the term “tentativeness”. In contrast to the concept “practical reason” which is oriented towards the normative and commonly acknowledged, the concept of tentativeness is implying both thoughtless and directionless maneuvering. The data suggest that the leap needs not be far from a predominantly unconscious to a more conscious tentativeness. The professional challenge is above all to take this seriously without oversteering the interest in the youths towards becoming more active in their life projects.The precondition for this leap is to accept that not all life shaping is calculable. Moreover, one must accommodate the ambiguous and indeterminable and support the single youth`s capacity to get further in life. Not least, it is a crucial point to facilitate the youths’ participation in meaningful activity and that they attend work life. Principles that have been particularly addressed are accept of non-calculability as a part of being, the need to allow for ambiguity and indeterminability, promotion of “nudging” or “scaffolding” practices and the necessity of assisting youth in getting involved in meaningful activity.Both theoretically and with regard to content the term tentativeness resembles terms derived from cultural criminology. The novel way in which the concept of tentativeness is employed in this thesis is above all that it is related to crime and substance Prevention on a so-called indicated level and that it clarifies why life-shaping projects should be emphasized more in substance and crime Prevention with teenagers.PhD i helsevitenskapPhD in Health Scienc
Sandra Hassink - One of the best experts on this subject based on the ideXlab platform.
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the role of the pediatrician in primary Prevention of obesity
Pediatrics, 2015Co-Authors: Stephen R Daniels, Sandra HassinkAbstract:The adoption of healthful lifestyles by individuals and families can result in a reduction in many chronic diseases and conditions of which obesity is the most prevalent. Obesity Prevention, in addition to treatment, is an important public health priority. This clinical report describes the rationale for pediatricians to be an integral part of the obesity-Prevention Effort. In addition, the 2012 Institute of Medicine report "Accelerating Progress in Obesity Prevention" includes health care providers as a crucial component of successful weight control. Research on obesity Prevention in the pediatric care setting as well as evidence-informed practical approaches and targets for Prevention are reviewed. Pediatricians should use a longitudinal, developmentally appropriate life-course approach to help identify children early on the path to obesity and base Prevention Efforts on family dynamics and reduction in high-risk dietary and activity behaviors. They should promote a diet free of sugar-sweetened beverages, of fewer foods with high caloric density, and of increased intake of fruits and vegetables. It is also important to promote a lifestyle with reduced sedentary behavior and with 60 minutes of daily moderate to vigorous physical activity. This report also identifies important gaps in evidence that need to be filled by future research.
