The book is the first one published exclusively on the field of nutritional epidemiology of breast cancer. It summarizes the currently existing knowledge, with an updated and comprehensive international bibliography (~ 1.000 references). The authors also performed a review on the epidemiological studies on nutrition and breast cancer carried out in Uruguay between 1994 and 2011, which allowed exploring and identifying the main risk and protective factors for the disease in this high-risk country. Epidemiologists, Nutritionists, Public Health managers and breast specialists -from the prevention to the treatment fields - will find in this book a unique source of technical information, which will contribute in expanding their knowledge and view of the disease.

A clear and thorough introduction to meta-analysis, the process of synthesizing data from a series of separate studies. The first edition of this text was widely acclaimed for the clarity of the presentation, and quickly established itself as the definitive text in this field. The fully updated second edition includes new and expanded content on avoiding common mistakes in meta-analysis, understanding heterogeneity in effects, publication bias, and more. Several brand-new chapters provide a systematic "how to" approach to performing and reporting a meta-analysis from start to finish. Written by four of the world's foremost authorities on all aspects of meta-analysis, the new edition: Outlines the role of meta-analysis in the research process Shows how to compute effects sizes and treatment effects Explains the fixed-effect and random-effects models for synthesizing data Demonstrates how to assess and interpret variation in effect size across studies Explains how to avoid common mistakes in meta-analysis Discusses controversies in meta-analysis Includes access to a companion website containing videos, spreadsheets, data files, free software for prediction intervals, and step-by-step instructions for performing analyses using Comprehensive Meta-Analysis (CMA)(TM) Download videos, class materials, and worked examples at www.Introduction-to-Meta-Analysis.com This book offers the reader a unified framework for thinking about meta-analysis, and then discusses all elements of the analysis within that framework. The authors address a series of common mistakes and explain how to avoid them. As the editor-in-chief of the American Psychologist and former editor of Psychological Bulletin, I can say without hesitation that the quality of manuscript submissions reporting meta-analyses would be vastly better if researchers read this book. Harris Cooper, Hugo L. Blomquist Distinguished Professor Emeritus of Psychology and Neuroscience, Editor-in-chief of the American Psychologist, former editor of Psychological Bulletin A superb combination of lucid prose and informative graphics, the authors provide a refreshing departure from cookbook approaches with their clear explanations of the what and why of meta-analysis. The book is ideal as a course textbook or for self-study. My students raved about the clarity of the explanations and examples. David Rindskopf, Distinguished Professor of Educational Psychology, City University of New York, Graduate School and University Center, & Editor of the Journal of Educational and Behavioral Statistics. The approach taken by Introduction to Meta-analysis is intended to be primarily conceptual, and it is amazingly successful at achieving that goal. The reader can comfortably skip the formulas and still understand their application and underlying motivation. For the more statistically sophisticated reader, the relevant formulas and worked examples provide a superb practical guide to performing a meta-analysis. The book provides an eclectic mix of examples from education, social science, biomedical studies, and even ecology. For anyone considering leading a course in meta-analysis, or pursuing self-directed study, Introduction to Meta-analysis would be a clear first choice. Jesse A. Berlin, ScD This book offers the reader a unified framework for thinking about meta-analysis, and then discusses all elements of the analysis within that framework. The authors address a series of common mistakes and explain how to avoid them. As the editor-in-chief of the American Psychologist and former editor of Psychological Bulletin, I can say without hesitation that the quality of manuscript submissions reporting meta-analyses would be vastly better if researchers read this book. Harris Cooper, Hugo L. Blomquist Distinguished Professor Emeritus of Psychology and Neuroscience, Editor-in-chief of the American Psychologist, former editor of Psychological Bulletin A superb combination of lucid prose and informative graphics, the authors provide a refreshing departure from cookbook approaches with their clear explanations of the what and why of meta-analysis. The book is ideal as a course textbook or for self-study. My students raved about the clarity of the explanations and examples. David Rindskopf, Distinguished Professor of Educational Psychology, City University of New York, Graduate School and University Center, & Editor of the Journal of Educational and Behavioral Statistics. The approach taken by Introduction to Meta-analysis is intended to be primarily conceptual, and it is amazingly successful at achieving that goal. The reader can comfortably skip the formulas and still understand their application and underlying motivation. For the more statistically sophisticated reader, the relevant formulas and worked examples provide a superb practical guide to performing a meta-analysis. The book provides an eclectic mix of examples from education, social science, biomedical studies, and even ecology. For anyone considering leading a course in meta-analysis, or pursuing self-directed study, Introduction to Meta-analysis would be a clear first choice. Jesse A. Berl

Here, Erich H. Loewy expands on his earlier book Textbook of Medical Ethics (1989) offering healthcare workers and students a new perspective on ethical practice. Textbook of Healthcare Ethics focuses on the social conditions in which medical practice occurs and how ethical healthcare decisions involves nurses, social workers, psychologists, technicians, and patients as well as physicians. This thoroughly revised and expanded edition addresses historical and theoretical underpinnings and practical concerns. A series of case studies serve as a guideline for further discussion. The text examines provocative issues such as organ donation, care of the terminally ill, abortion, HIV-positive healthcare professionals, physician-assisted suicide, and experimentation with fetal tissue. This is an ideal book for all members of the healthcare team as well as students and residents in any discipline of medicine.

This new book provides a unified, in-depth, readable introduction to the multipredictor regression methods most widely used in biostatistics: linear models for continuous outcomes, logistic models for binary outcomes, the Cox model for right-censored survival times, repeated-measures models for longitudinal and hierarchical outcomes, and generalized linear models for counts and other outcomes.

Treating these topics together takes advantage of all they have in common. The authors point out the many-shared elements in the methods they present for selecting, estimating, checking, and interpreting each of these models. They also show that these regression methods deal with confounding, mediation, and interaction of causal effects in essentially the same way.

The examples, analyzed using Stata, are drawn from the biomedical context but generalize to other areas of application. While a first course in statistics is assumed, a chapter reviewing basic statistical methods is included. Some advanced topics are covered but the presentation remains intuitive. A brief introduction to regression analysis of complex surveys and notes for further reading are provided. For many students and researchers learning to use these methods, this one book may be all they need to conduct and interpret multipredictor regression analyses.

The authors are on the faculty in the Division of Biostatistics, Department of Epidemiology and Biostatistics, University of California, San Francisco, and are authors or co-authors of more than 200 methodological as well as applied papers in the biological and biomedical sciences. The senior author, Charles E. McCulloch, is head of the Division and author of Generalized Linear Mixed Models (2003), Generalized, Linear, and Mixed Models (2000), and Variance Components (1992).

From the reviews:

"This book provides a unified introduction to the regression methods listed in the title...The methods are well illustrated by data drawn from medical studies...A real strength of this book is the careful discussion of issues common to all of the multipredictor methods covered." Journal of Biopharmaceutical Statistics, 2005

"This book is not just for biostatisticians. It is, in fact, a very good, and relatively nonmathematical, overview of multipredictor regression models. Although the examples are biologically oriented, they are generally easy to understand and follow...I heartily recommend the book" Technometrics, February 2006

"Overall, the text provides an overview of regression methods that is particularly strong in its breadth of coverage and emphasis on insight in place of mathematical detail. As intended, this well-unified approach should appeal to students who learn conceptually and verbally." Journal of the American Statistical Association, March 2006

List of Contributors xviii An Aging Humankind: New Realities E. Dicgalusy Does Menopause Increase the Risk of Coronary Heart Disease? M.V. Huisrnan Chronic Low-Grade Metabolic Acidosis in Normal Adult Humans: Pathophysiology and Consequences L. Frassetto, R.C. Morris, Jr., K. Todd, and A. Sebastian The Menopause, Sex Hormones, and Rheumatic Disease G. Hall Novel Mechanisms of Estrogen Action J.-A. Gustafsson The Action of Ovarian Steroid Hormones on Tissues and Organs M.J. Legato Nongenomic Mechanisms of Sex Hormones J.H.H. Thijssen Action of Specific Estrogens on Vascular Cells C.S. Wingrove and J.C. Stevenson Direct Actions of Estrogen on Vascular Cells Ameliorates Response to hjury D. W. Losordo ix Newer Progestogens G. Samsioe IV. 11. Cardiovascular Disease: Risk Factors Related to Thrombosis G. de Gaetano, M.B. Donati, and L. Iacoviello Estrogen Effect upon Coronary Vasculature G.M.C. Rosano, F. Leonardo, and G. Panina Estrogen and Endothelial Function A. Virdis, L. Ghiadoni, I. Sudano, S. Pinto, S. Taddei, and A. Salvetti Action of Specific Estrogens on the Coronary Artery: Effects on Lipoproteins, Coagulation, and Fibrinolysis J.M. Sullivan Coronary Heart Disease in Women: Status 1998 N. K. Wenger Introduction to Osteoporosis C. Christiansen Genetics of Osteoporosis L. Masi, L. Gennari, A. Falchetti, and M.L. Brandi The Clinical Management of Osteoporosis S.E. Papapou los VI.

From the President of the Research Society on Alcoholism In the last decade research concerning the causes and consequences of alcohol abuse and alcoholism has come of age. We have witnessed a plethora of sci entific findings that have shed light on some of the actions of alcohol at the molecular level. Interesting new data have been forthcoming on the complexi ties of the development of tolerance to alcohol. It is becoming increasingly appropriate to consider that tolerance to alcohol involves biological as well as psychological factors. New scientific insights have been gained concerning the treatment of with drawal as well as the presence of persistent withdrawal signs that may possibly be involved with relapse. More recently, new and compelling data indicating that alcoholism is a common familial disorder have appeared. Clinical studies indicate that alcoholism is a heterogeneous disorder with multiformity in clin ical symptomatology and genetic heterogeneity. The heterogeneity of the clin ical features and the heritability of the predisposing factors of alcoholism are currently under vigorous scientific investigation. In the past several years sophisticated psychosocial studies have provided fundamental information on subjects at high risk for alcoholism. Psychosocial and biological studies of families including alcoholics and subjects at high risk are likely to bring new insights to our understanding of etiological factors. Moreover, as a result of these studies we stand to develop better prevention initiatives and treatment approaches.

Classic biostatistics, a branch of statistical science, has as its main focus the applications of statistics in public health, the life sciences, and the pharmaceutical industry. Modern biostatistics, beyond just a simple application of statistics, is a confluence of statistics and knowledge of multiple intertwined fields. The application demands, the advancements in computer technology, and the rapid growth of life science data (e.g., genomics data) have promoted the formation of modern biostatistics. There are at least three characteristics of modern biostatistics: (1) in-depth engagement in the application fields that require penetration of knowledge across several fields, (2) high-level complexity of data because they are longitudinal, incomplete, or latent because they are heterogeneous due to a mixture of data or experiment types, because of high-dimensionality, which may make meaningful reduction impossible, or because of extremely small or large size; and (3) dynamics, the speed of development in methodology and analyses, has to match the fast growth of data with a constantly changing face. This book is written for researchers, biostatisticians/statisticians, and scientists who are interested in quantitative analyses. The goal is to introduce modern methods in biostatistics and help researchers and students quickly grasp key concepts and methods. Many methods can solve the same problem and many problems can be solved by the same method, which becomes apparent when those topics are discussed in this single volume.

To date, much of the empirical work in social epidemiology has demonstrated the existence of health inequalities along a number of axes of social differentiation. However, this research, in isolation, will not inform effective solutions to health inequalities. Rethinking Social Epidemiology provides an expanded vision of social epidemiology as a science of change, one that seeks to better address key questions related to both the causes of social inequalities in health (problem-focused research) as well as the implementation of interventions to alleviate conditions of marginalization and poverty (solution-focused research). This book is ideally suited for emerging and practicing social epidemiologists as well as graduate students and health professionals in related disciplines.

By 1977 it was clear that the thermophilic campylobacters were a major cause of acute bacterial enteritis. In response to that observation an international workshop was convened in Reading, England, and attracted over 130 participants. Many of these individuals resolutely returned for the eighth in the series of biennial international workshops, this time held in Win chester, England, in July 1995. All were surprised at the continued, and even expanding, re search effort in this narrow microbiological field. Such a lasting interest is undoubtedly a reflection of a consistent rise in the incidence of infection, the growing number of closely re lated organisms and disease associations, and an ever-increasing awareness by the public and government agencies of public health and food safety issues. The second workshop in Brussels in 1983 was a forum that demonstrated the growing awareness in the campylobacter community of the existence of campylobacter-like organisms and provided the platform for presentations describing the association of these organisms, now classified in the genus Helicobacter. with gastroduodenal disease. The clinical aspects of the research into helicobacters is now thoroughly covered in several other meetings, and the remit of the international workshop has been expanded to provide a forum for the presentation of the basic microbiological research carried out on these bacteria. In a continuation of this ap proach the remit of the workshop has been further extended to other related organisms, reflect ing that there are many other campylobacter-like organisms still to identify and characterize."

The book presents a basic introduction to epidemiology from the perspective of economics, using economic modeling to better understand and describe how infectious disease spreads. Three main elements are introduced: epidemiology, social network analysis, and the economics needed to model the behavior of individuals in the presence of infectious disease. The book aims to provide a starting point for discussion between medical professionals, social scientists and public health officials, the three groups interested in the spread of disease.

In spite of progress in biomedical research, we know little about the causes, prevention, and treatment of the numerous mental and neurological disorders that afflict up to 15% of all individuals. In the last decade, great advances have been made in the physiopathology of mental and neurological disorders, leading to at least a partial control of Parkinson's disease, epilepsy, certain psychoses, and anxiety syndromes. Despite the fact that an underlying specific neurotransmitter deficiency has been demonstrated in Alzheimer's and Parkinson's diseases, the immune dysfunction and viral hypotheses continue to be attractive for investigators dealing with these degenerative diseases of the aging brain, which afflict 10% of senior citizens. A retrospective epidemiologic study suggests that the encephalitis lethargica and parkinsonism were almost certainly caused by the 1918 influenza virus pandemics. It must be stressed that the etiopathogenesis of many mental disorders is not known, and this ignorance has led to several untenable neurophysiological and biochemical hypotheses. Epidemiologic investigations show a high prevalence of functional psychoses and organic mental disorders. Although many of them are conceptualized as biopsychosocial disorders, recent data indicate that the biological component appears more and more as a major etiologic factor. Among the various biological hypotheses, the viral and im munologic concept has become a significant one. In view of recent discoveries in virology and immunity, it becomes clear that viral and immunologic hypotheses should be inves tigated more systematically concerning the mechanisms of numerous mental and neu rological disorders."

This book is based on an international meeting organized by the University of Tokyo and the University of Rochester, and is published as one belonging to the series of Rochester International Conferences in Environmental Toxicity. The meeting on "Advances in Mercury Toxicology" was held at the University of Tokyo on August 1 to 3, 1990. The invited papers are published in this book along with an "Overview" chapter that was written by the editors at a meeting held at the University of Rochester on August 1 to 2, 1991. The purpose of the meeting was to assemble leading scientists to discuss their most recent findings on the toxicology of mercury. The time was opportune. Considerable progress has been made on the environmental fate and toxicology of mercury. Recent findings have given new insight into the global model for mercury. Transport in the atmosphere extends great distances resulting in pollution of lakes and rivers far distant from the source of mercury release. The process of methylation leads to accumulation of methylmercury in fish and thus in the human diet. New evidence indicates that acid rain and the impoundment of water for hydroelectric purposes affects the methylation and bioaccumulation processes resulting in higher levels of methylmercury in fish.

From the President of the Research Society on Alcoholism In recent years, increasingly convincing evidence in support of a biobehavioral conceptual model of the etiology of alcoholism has emerged. In this model, the disorder is perceived as arising from the interaction of geneticlbiological vulnerability and psychosocial risk. Drinking, or alcohol-seeking, is a metric trait. Alcoholism, which is a state of abnormally intense alcohol-seeking be havior that, over time, leads to the alcohol dependence syndrome, lies at the extreme, high end of this quantitative measure. Metric traits are influenced by multiple genes; the extent of genetic loading of biological risk for alcoholism would be different in different individuals. Added to this kind of variability is the wide range of options for exposure to the psychosocial risk factors of heavy drinking provided by modern society. Further, environmental prov ocation also changes when life events change. It is not surprising, therefore, from the combination of the kinds of genetic and environmental variability described above that there is a wide array of patterns of expression of the disorder alcoholism, referred to by some as "alcoholisms. " In the search for understanding of underlying mechanisms and rational bases for potential therapy, it is important to focus our attention on the final common pathway of this disorder, alcohol-seeking behavior. This series, ever since its beginning in 1983, has been sensitive to the complexities of the interaction between biological and psychosocial risk factors in alcoholism.

From the President of the American Society of Addiction Medicine Recent Developments in Alcoholism (Volume 10) is a major contribution to the literature of addiction medicine. This volume, 'ru.cohol and Cocaine: Similarities and Differences," contains an impressive collection of chapters from the basic research, epidemiological, and clinical research perspectives, as well as articles that address the relative policy issues and clinical application and patient care concerns. It also sends a message to those who would still distinguish between alcohol and drugs, or legal and illegal drugs. In the research laboratory, in the intentions and behavior of the user, and by the clinician, such distinctions have never been upheld. The first section, "Clinical Pathology," includes chapters on the role of alcohol in cocaine dependence, dual-diagnosis empirical and developmental humanistic approaches, and on neuroendocrine and catecholamine levels in humans during administration and withdrawal of cocaine and alcohol, emer gency room evaluation of cocaine-associated neuropsychiatric disorders, and clinical and pharmacological interactions of alcohol and cocaine. These chap ters, written by authors who are preeminent in their fields, offer a broad perspective to both the researcher and the clinician on relevant issues in clinical pathology. .

The incidence of insulin-dependent diabetes mellitus (100M) varies dramatically across racial groups and countries, with annual age-adjusted rates of approximately 40/100,000 per year in Finland, but only 0.51100,000 per year in China. Although reasons for these marked geographic differences are unknown, it is likely that genetic variations across populations play a m or role. To determine the contribution of genetic factors to the global patterns of 100M incidence, international comparative studies are now being undertaken as part of the WHO Multinational Project for Childhood Oiabetes, known as the DIAMOND Project. It is, therefore, necessary to develop and implement epidemiologic standards for these investigations which can be applied across populations. This will ensure that comparable data are obtained in all countries, and that relevant scientific questions can be properly addressed. The development of standards for molecular epidemiologic studies of 100M is the of the NATO Advanced Research Workshop. During this meeting at the objective University of Pittsburgh, scientists from across the world convened to discuss issues relating to the standardization of: 1. the collection of family history data to assess the risk of 100M in first degree relatives, 2. case-control molecular epidemiology studies of 100M susceptibility, 3. HLA family studies, 4. laboratory methods and ONA technology transfer for genetic marker evaluations.

This book attempts to set communicable diseases and the efforts to control them in a social and historical context. The primary focus is on England with its particular history, culture and traditions. The timescale covered is extensive and ambitious, and the many strands that came together in the nineteenth century to form the English public health service are clearly highlighted. However the main emphasis of the narrative is on developments from the Second World War onwards, in some of which the author has had a degree of personal involvement as a schoolchild, medical student, hospital doctor, Army doctor and public health physician. The work as a whole reveals the persisting nature of communicable diseases throughout history and strongly argues that, although the relevant importance of individual infections may vary over time, man's struggle against the microbiological world can never be relaxed. How England has been affected is described in detail and evidence is put forward to suggest that complacency (or at least misjudgement) concerning the ever-present risks of emerging and re-emerging infections, led unwisely to the dismantling in 1974 of its established arrangements for their control, along with the subsequent need, frequently repeated, to create new structures for this purpose. This book will appeal strongly to all students and practitioners of public health along with those interested in English social history.

The 1989 Annual Meeting of the Society for Risk Analysis dramatically demonstrated one of the most important reasons for having the Society - to bring together people with highly diverse backgrounds and disciplines to assess the common problems of societal and individual risks. The physical scientists emphasized the analytical tools for assessing environmental effects and for modeling risks from engineered systems and other human activities. The health scientists presented numerous methods of analyzing health effects, including the subject of dose-response relationships, especially at low exposure levels - never an easy analysis. The social and political scientists concentrated on issues of risk perception, communication, acceptability, and human touch. Others discussed such issues as cost-benefit analysis and the risk-based approach to decision analysis. Use of risk assessment methods for risk management continued to be a matter of strong opinion and debate. The impacts of state and federal regulations, existing and planned, were assessed in sessions and in luncheon speeches. These impacts show that risk analysis practitioners will have an increasingly important role in the future. They will be challenged to provide clear, easily understood evaluations of risk that are responsive to society's concern for risk, as evidenced in laws and regulations. Of course, the various risk analysis specialties overlapped in domains of interest.

Psychological vulnerabilities and environment influences are the most powerful forces shaping the behavior and choices of students to use harmful substances. This book employs computer-assisted Associative Group Analysis technology of comparative imaging and cognitive mapping to identify these factors and offers new perspectives for more comprehensive risk assessments and effective prevention.

Converting Data into Evidence: A Statistics Primer for the Medical Practitioner provides a thorough introduction to the key statistical techniques that medical practitioners encounter throughout their professional careers. These techniques play an important part in evidence-based medicine or EBM. Adherence to EBM requires medical practitioners to keep abreast of the results of medical research as reported in their general and specialty journals. At the heart of this research is the science of statistics. It is through statistical techniques that researchers are able to discern the patterns in the data that tell a clinical story worth reporting. The authors begin by discussing samples and populations, issues involved in causality and causal inference, and ways of describing data. They then proceed through the major inferential techniques of hypothesis testing and estimation, providing examples of univariate and bivariate tests. The coverage then moves to statistical modeling, including linear and logistic regression and survival analysis. In a final chapter, a user-friendly introduction to some newer, cutting-edge, regression techniques will be included, such as fixed-effects regression and growth-curve modeling. A unique feature of the work is the extensive presentation of statistical applications from recent medical literature. Over 30 different articles are explicated herein, taken from such journals. With the aid of this primer, the medical researcher will also find it easier to communicate with the statisticians on his or her research team. The book includes a glossary of statistical terms for easy access. This is an important reference work for the shelves of physicians, nurses, nurse practitioners, physician's assistants, medical students, and residents.

Oscar Harkavy offers a unique insider's view of the fascinating world of population politics. Chapters trace the growth of the movement as well as the various foundations, governments, and intergovernmental organizations which were an integral part of it from its beginning in the 1950s, through its growth during the 60s and 70s, to the present. Topics include the role of social science in understanding the causes and effects of population growth; reproductive research and contraceptive development; and the politics of family planning, sex education, and abortion in the United States.

The disorders induced by iodine deficiency affect at least one billion people. Because ofits effects on brain development, iodinedeficiency is the single most preventable cause of mental retardation in the world. Therefore, the United Nations and the Heads of State of almost all the world's countries represented at the Summit for Children in 1990 adopted resolutions to eradicate the disorders induced by iodine deficiency (IDD) by the year 2000. For geological and socio-economic reasons, most of the populations affected by iodine deficiency disorders live in isolated and usually mountainous areas, in pre industrialized parts ofthe world. The problem of iodine deficiency in Europe has been greatly underestimated in the last decades. After the remarkable studies on the effects of iodine deficiency and their prevention and correction in Switzerland, IDD was generally considered no longer a significant public health problem in Europe. However, surveys carried out in the early 1980's under the auspices of the European Thyroid Association, clearly demonstrated the persistence of moderately or even severely affected areas. These surveys also highlighted the lack ofinformation about large parts ofEurope, especially its eastern part. It is only quite recently, following major changes in international relations and thanks to the support of UNICEF, WHO, the International Council for the Control of Iodine Deficiency Disorders and the European Thyroid Association, that more extensive surveys have been conducted in several parts of Europe hitherto almost unexplored. These surveys showed that most European countries were iodine deficient."

This book is intended as a relatively nontechnica1 introduction to eurrent demographie methods. It has been several years in preparation, beginning from occasional class handouts I wrote to elaborate on essential points of demographie methodology. Its growth from scattered notes to an integrated text was a natural process, if a gradual one. The eontent of the book addresses three objectives. first, I have tried to avoid demographie methods that are now dated. In some ehapters, that has meant eoncentrating on formulas most demographers recognize. In the ehap ters on life tables, it meant testing competing formulas on a variety of real and synthetie data se.ts, and dropping or relegating to footnotes those that were least accurate. Second, I have attempted to give readers a sense of the limits of different formulas and methods. I am a terse writer, however, and for the reader that means most sentences carry weight. Chapters should be read attentively, with careful regard to commentary as weIl as to formulas and examples. Finally, I have tried to make the principal methodologies of the book accessible, by offering explanations for formulas that are not obvious, by keeping examples to the forefront, and by placing relatively specialized topics in ehapter appendices.

Responding to the Homeless: Policy and Practice is largely a product of a unique collaboration between Russell K. Schutt and Gerald R. Garrett and their Boston community. As such, it offers a rich perspective on the problem of homelessness that is derived from the authors' shared experience with researchers, academics, students, providers, policymakers, and homeless persons themselves. Schutt and Garrett take the reader into the shelters and acquaint him or her with the philosophical and practical dilemmas facing line workers as well as policymakers. They also take the reader into the community to better understand the housing market and the dysfunctional continuities among shelter, housing, treatment, and social supports. There are sensitive discussions of the salient health problems that too commonly touch the lives of homeless individuals, such as substance abuse and AIDS. The volume also includes clear descriptions of the sometimes elusive processes of counseling and case management for homeless individuals. The sidebars of "what to do" and "what not to do" contain useful information that will both inform and empower individuals who are working on the front lines, and inspire and prepare future caregivers. While the eminently readable organization and style of the book are sugges tive of a highly practical handbook on the basics of homelessness, the authors and their contributors have also produced a scholarly volume that is replete with current research findings, programs descriptions, case studies, and vignettes."

Public health has a legacy of neglect regarding social and behavioral research. Too often, prompted by technical and scientific progress, we have ignored even marginalized-the vital "human element" in health thinking and prac tice. Thus, for example, while family planning programs focused on providing a choice among safe and effective contraceptive methods (a supremely worthy goal), the central issue of sexuality and sexual behavior was generally neglected. Similarly, the enormous and important efforts to develop rapid and reliable diagnostic and treatment methods for sexually transmitted diseases helped divert attention away from the crucial issues of sexual practice. In short, we seem to have difficulty addressing the fundamental behaviors-including sex, drug taking and other intoxications, and violence-that are central to the major causes of preventable morbidity, disability, and premature mortality in the world today. Our collective reluctance to examine and understand ourselves is also expressed in the oft-repeated pipedream that scientific progress will "take care of" the HIV / AIDS pandemic by delivering a preventive vaccine, an effective cure, or both. Yet even a cursory glance at the relationship between scientific/ technical progress and health shows that meeting the scientific challenges is only one step toward effective application of the vaccine or drug. It is typical, not atypical, that hepatitis B vaccine is only now becoming relatively freely available to large populations in the developing world, more than a decade after the vaccine's licensure.

If resources for HIV prevention efforts were truly unlimited, then this book would be en tirely unnecessary. In a world with limitless support for HIV prevention activities, one would simply implement all effective (or potentially effective) programs without regard to expense. We would do everything useful to prevent the further spread of the virus that has already claimed hundreds of thousands of lives in the United States and millions of lives worldwide. Unfortunately, funding for HIV prevention programs is limited. Even though the amount of available funding may seem quite large (especially in the United States), it is still fixed and not sufficient to meet all needs for such programs. This was very well illustrated in the summer of 1997 when over 500 community-based organizations applied for a combined total of $18 million of HIV prevention funding from the U.S. Centers for Disease Control and Prevention (CDC). Less than one-fifth ofthese organizations received support via this funding mechanism. Hence, although $18 million may seem like a large amount of money at first blush, it is not enough to meet all of the prevention needs that could be addressed by these community-based organizations.