Coronary heart disease remains the leading cause of death in both men and women in most industrialized countries. Yet it is largely preventable, and health care providers can acquire the skills to help their patients reduce their risks substantially. Traditional risk factors such as cigarette smoking, hypercholesterolimia, hypertension, sedentary lifestyle, obesity and glucose intolerance explain a major proportion of coronary events. Recent evidence also suggests important adjunctive roles for hormone replacement therapy in postmenopausal women, and aspirin prophlaxis in individuals at high risk of a first myocardial infarction. Emerging evidence indicates an important role for diet in the prevention of heart disease. Although the importance of lifestyle and behavioral modifications may well be known among physicians and other health-care providers, the implementation of this knowledge has been limited. One reason is that the information supporting the value, feasibility and cost-effectiveness of risk-reduction strategies has not been previously synthesized and made widely available to health-care providers in office and community settings.
Prevention of Myocardial Infarction fills these critical gaps by providing a state-of-the-art compendium of the scientific evidence on the efficacy of coronary disease prevention, while focusing on helping clinicians develop intervention skills to utilize available knowledge. Chapters by leading authorities in cardiovascular epidemiology, clinical cardiology, cost-effectiveness analysis, and public health translate the theory of preventive cardiology into feasible implementation. The counseling and other intervention strategies described in thistextbook have documented clinical efficacy and cost-effectiveness, and they require little time to learn or implement. The book is written mainly for primary care providers, including general internists and family physicians, but will also be of interest to medical subspecialties such as cardiologists and endocrinologists, as well as medical students, dietitians, psychologists, epidemiologists, and students, practitioners, and researchers in public health.

Safe and effective prescribing is one of the pillars of medical practice but is much more complicated than it seems. Many new prescribers find prescribing extremely challenging, and a plethora of independent, multidisciplinary prescribers are also seeking guidance. However, pharmacology textbooks are rarely practical. They warn to 'take care when prescribing erythromycin to a patient on warfarin, as the INR may rise'. But what should the prescriber actually do? Surviving Prescribing fulfils an important need by offering practical advice for real-world prescribing problems. The book complements existing educational resources but adds a new perspective. Written by experienced contributors from a variety of professional backgrounds, the content speaks directly to the problems routinely seen in hospital prescribing. And all in one, pocket-sized volume. Whether revising for the national Prescribing Safety Assessment, preparing for starting on the wards, or looking for a quick reference guide, this book is an essential companion.

Which developments can be expected to take place in the dental health of the Dutch population in the decades to come, and what are the influential factors? What effects might the changing supply of dental professionals, the additional substitution of responsibilities from dentists to dental hygienists and the possible reforms in health care insurance have on the nation's oral status? These are some of the central questions discussed in this report by the Scenario Committee and the research group. For this purpose, the Committee developed a computer simulation model of dental health care which was used to analyze future scenarios. The future scenarios described in this report clearly show that a number of crucial decisions must be taken if dental health care is to remain accessible and available for all sections of the population in the future.

The first STG report to embody scenarios on population aging, health and care appeared in 1985. This report describes developments since 1985, reviewing the current position and setting out updated scenarios. The 1985 report set out three scenarios, in which the central focus was on the developing future pattern of demand for care by the elderly. The present report too sets out three scenarios, centring on the demand for care, in which account is taken of a variety of factors; it also details four strategic scenarios whose central focus is on the developing supply of care and which set supply and demand one against the other. Three of the strategic scenarios -- emphasizing respectively intramural, extramural and informal care -- suppose the demand for care to be met in full; the fourth scenario, which rolls current policies on the care of the elderly forward into the future, pinpoints discrepancies between the need for care and the extent to which that need is likely to be met, making clear in so doing that a review of long-term policy for the elderly is urgently needed.

Effective communication with patients suffering from cancer and their relatives is essential for providing the best possible standards of care. This practical guide will help you to improve your ability to recognize and respond to the physical, psychological, and spiritual problems which cancer patients experience. For the first time in one volume, practical guidelines which have proven efficiency over years in clinical practice are presented. Real dialogues illustrate a clear model of eliciting, assessing, and responding to patients' needs and concerns with an emphasis primarily on the skills and strategies needed for effective communication between health professionals and patients trying to adapt to a fear-provoking diagnosis and an uncertain future. The book also provides invaluable guidance on how to deal with your own emotional responses to the challenges faced in working with seriously ill people. Everyone who cares for cancer patients will benefit from the sympathetic yet practical advice offered in this book.

The number of individuals who are obese or overweight has dramatically increased over recent years and is now becoming epidemic. These individuals are more likely to suffer cardiovascular diseases and therfore physicians, specialists, and trainees increasingly need to deal with these issues on the ward and in clinic. As a result, the need for appropriate knowledge of up-to-date clinical management of obesity and its associated cardiovascular problems is essential for any practicing physician.
Obesity and Cardiovascular Disease is a readily assimilated pocket guide to obesity and cardiovascular disease. It is intended to be used "on-the-go" and is compact enough to be on hand while in consultation with patients. It provides a clear and succinct overview of contemporary clinical management of cardiovascular risk stratification, and fully covers the diagnosis and treatment of cardiovascular in obese patients and individuals with increased visceral adiposity, translating up-to-date clinical research findings into clinical practice. Particular emphasis is placed on recent updates in practical care in obesity and cardiovascular disease, such as new diagnostic techniques and novel pharmacological and surgical approaches, as well as cardiac visceral fact, ethnic differences in adiposity-related cardiovascular risk, and metabolically healthy, but obese subjects. Topics are presented in an easily accessible format with numerous illustrations, photographs, tables, diagnostic and therapeutic algorithms while highlight boxes summarize the main concepts discussed in each chapter.

General Practice is undergoing the most major series of changes since the introduction of the National Health Service in 1948. They concern both concepts of care and practical details of the way care is delivered. In spite of the hostility generated by the changes most of the broad general concepts have been accepted. The principle of patients having more choice is widely sup ported, the inclusion of preventive medicine and antici patory care in the responsibilities of practice has few opponents, the introduction of audit as a way of im proving performance has been generally welcomed. Even the idea of putting GPs in better financial management of patients and drug budgets has had supporters in prin ciple. The antipathy has generally related to the method of introduction of these changes. One important con cern has been the time requirements of the New Con tract and the feeling that these will erode the real nature of our work: the close personal relationship with pa tients. If we improve the quality of our management this is less likely to happen. We shall be able to work within the New Contract and retain the quality of service we pro vide. If we improve the understanding of our staff of what we are trying to achieve we are more likely to reach the targets that we set whilst keeping people happy. vii This book sets out to explain the New Contract."

General Practice is undergoing the most major series of changes since the introduction of the National Health Service in 1948. They concern both concepts of care and practical details of the way care is delivered. In spite of the hostility generated by the changes most of the broad general concepts have been accepted. The principle of patients having more choice is widely sup ported, the inclusion of preventive medicine and antici patory care in the responsibilities of practice has few opponents, the introduction of audit as a way of im proving performance has been generally welcomed. Even the idea of putting GPs in better financial management of patients and drug budgets has had supporters in prin ciple. The antipathy has generally related to the method of introduction of these changes. One important con cern has been the time requirements of the New Con tract and the feeling that these will erode the real nature of our work: the close personal relationship with pa tients. If we improve the quality of our management this is less likely to happen. We shall be able to work within the New Contract and retain the quality of service we pro vide. If we improve the understanding of our staff of what we are trying to achieve we are more likely to reach the targets that we set whilst keeping people happy. vii This book sets out to explain the New Contract."

Einfuhrung zur psychosomatischen Frauenheilkunde; Zur Arzt-Patient-Beziehung in der Frauenheilkunde; Aspekte der psychosomatischen Geburtshilfe; Symptome in der Schwangerschaft mit einer moeglichen Psychogenese; Psychosomatische Aspekte der Geburt; Psychosomatische Aspekte des Wochenbetts; Psychosomatische Gynakologie; Symptome und Krankheitsbilder in der Psychosomatischen Gynakologie; Psychosomatische Aspekte kritischer Zeitabschnitte; Askekte der angwandten psychsomatischen Frauenheilkunde; Entwicklungen und Zukunftstendenzen in der psychosomatischen Geburtshilfe und Gynakologie

A staple of family medicine training for 30 years, Essentials of Family Medicine offers a comprehensive introduction to this specialty designed just for clerkship students. Covering principles of family medicine, preventive care, and a full range of common ambulatory care problems, it provides all the guidance you need to succeed on a clinical rotation in family medicine. This 7th Edition features many significant changes, including a new, stronger focus on the hands-on "how-tos" of family medicine...a great deal of new coverage related to direct care, the context of care, and community medicine...input from a new Student Advisory Board to ensure the practicality and utility of the content... and many other key updates to keep Essentials of Family Medicine as relevant as possible for today's practice. You'll appreciate its user-friendly writing style, focus on common clinical problems, and use of case studies to illustrate practical applications of key concepts. Meet the challenges of contemporary practice with many brand-new chapters and updates throughout. Effectively navigate the challenges you'll face in your clerkship thanks to a new emphasis on how to approach specific situations. Enjoy content that's optimized for your needs through input from an advisory team of 4th-year medical students. See how concepts apply to practice with chapter-opening case studies, and build your clinical skills with clinical questions and case discussions that simulate the patient encounter.

A patient's job is to tell the physician what hurts, and the physician's job is to fix it. But how does the physician know what is wrong? What becomes of the patient's story when the patient becomes a case? Addressing readers on both sides of the patient-physician encounter, Kathryn Hunter looks at medicine as an art that relies heavily on telling and interpreting a story--the patient's story of illness and its symptoms.

The well-loved Oxford Handbook of General Practice is a lifeline for busy GPs, medical students, and healthcare professionals. With hands-on advice from experienced practitioners, this essential handbook covers the entire breadth and depth of general practice in small sections that can be located, read, and digested in seconds. Now in its fifth edition, the Handbook has been fully revised to reflect the major new developments shaping general practice today. Fully updated with the latest guidelines and protocols, this edition offers even more full colour diagrams and tables, and colour-coded chapters on general practice (green), clinical topics (purple), and emergencies (red). Covering the whole of general practice from practice management to hands-on advice dealing with acute medical emergencies, this comprehensive, rapid-reference text will ensure that everything you need to know is only a fingertip away.

This book is about four ways of using the consultation in primary health care. One ofthem is very familiar, the other three a little less so. But they should all be as much a part of the repertoire of doctor or nurse as examining some system of the body or relieving pain and discomfort. If each is not used when appropriate, the full potential of the consultation is not achieved. This is the practical message of the book. Simultaneously it is concerned with the more theoretical problems of clarifying the role of the generalist in contemporary medicine and of relating it to the wider world of people's day-to-day lives and decisions and to their interest in seeking health for their children and themselves. Is primary care too broad and general to be manageable? Is it a pot-pourri derived from other disciplines or is it distinct? If distinct, exactly how does it differ and can its principles be stated in a clear and practical way? How can it respond effectively to people's wants and needs? The same four uses of the consultation, presented in a diagram which can be easily remembered, serve as a simple map for outlining the role of the doctor or nurse in primary care. The details of the map are filled in with clinical anecdotes and copious reference to studies from all over the world.

Psychosomatic Medicine (PM) is a rapidly developing subspecialty of psychiatry focusing on psychiatric care of patients with other medical disorders. PM specialists diagnose and manage psychiatric symptoms in a variety of medical settings, optimize their patients' medical care, and expand understanding regarding the role of psychological factors in health and disease. Dr. Kurt Ackerman and Dr. Andrea DiMartini presernt Psychosomatic Medicine , portable handbook geared to helping psychiatric and other medical practitioners and trainees to stay current in their understanding of the practice of psychosomatic medicine. Drawing practical techniques and wisdom from their team of contributors, Psychosomatic Medicine provides readers with historical background, key clinical information and guidelines, readily accessible charts and tables, exercises to aid in self-assestment, and suggestions for further reading to spark additional learning in this rapidly developing field of psychiatry.

Designed for quick reference, Algorithmic Diagnosis of Symptoms and Signs: A Cost-Effective Approach equips you to effectively interpret more than 230 of the most common symptoms and signs. The ideal aid for the busy clinician, this handy, portable resource promotes a cost-effective patient workup, explaining which diagnostic tests are most appropriate (and when such tests are not indicated). Comprehensive updates throughout put the very latest diagnostic approaches at your fingertips. Features: Evaluate patients efficiently using clear, step-by-step algorithms that spell out what to look for, what tests to order, what differentials to consider, and when to refer to a specialist. Master essential clinical skills with a new section on "Getting the most out of your history and physical examination." Effectively evaluate more conditions through new algorithms for various symptoms and laboratory tests, including algorithms representing diseases that are symptoms of other diseases. Recognize diagnostic alternatives at a glance thanks to differential diagnostic tables. Your book purchase includes a complimentary download of the enhanced eBook for iOS, Android, PC & Mac. Take advantage of these practical features that will improve your eBook experience: The ability to download the eBook on multiple devices at one time - providing a seamless reading experience online or offline Powerful search tools and smart navigation cross-links that allow you to search within this book, or across your entire library of VitalSource eBooks Multiple viewing options that enable you to scale images and text to any size without losing page clarity as well as responsive design The ability to highlight text and add notes with one click

This book, designed for professionals, introduces a psychobiological model for understanding the paths that lead people to illness and provides recommendations for alterations of maladaptive pathways so that health is regained. Research findings are incorporated to identify causal variables for illness that can be targets for change. Evidence based recommendations for healthy behaviors and therapies are described. Throughout the book, the authors emphasize recognition of turning points on the path to illness that, through informed decision making and implementation of behavioral change, can be re-directed to pathways to health. This book presents case material to illustrate the directions that lead people to illness or to health. The pathways metaphor provides an organizing force, both in addressing variables contributing to illness onset, and in identifying interventions to restore health. This approach will guide the clinician to understanding how people become ill and the types of interventions that are appropriate for stress related illnesses. The clinician will also become better informed about ways to help clients make better decisions, mobilize clients' survival skills, and implement an interactive model of care. The book includes chapters on stress-related illnesses with high prevalence in today's society. For each illness, the genetic-psychobiological etiology is explored with enough detail so that the clinician understands the best method of patient assessment and treatment. One of the strengths of the book is the step-wise system of interventions that are applied to the stress-related illnesses. Beginning with re-establishment of normal daily psychobiological rhythms and continuing to evidence based state of the art interventions, the professional is presented with detailed intervention plans. For example, the section on "Applications to common illnesses: metabolic disorders of behavior: diabetes, hypertension, and hyperlipidemia" considers the confluence of genetics, behavior, and maladaptive mind body interactions to produce the metabolic syndrome. Then the personal and professional assessments are described to establish the baseline for recommending treatment while fully engaging the patient. Finally, multilevel interventions are formulated for these disorders. The plan begins with clinician guided self care recommendations to re-establish the normal rhythm of appetite and satiety. The next level of interventions consists of skill building techniques, such as relaxation and imagery. Lastly, psychotherapy and advanced applied psychophysiological interventions are detailed. Case examples are used throughout to illustrate the pathways to illness, the turning points, and the pathways to health. From the patients' viewpoints, the pathways metaphor is a motivator. The patient is guided to understand the paths that led to illness. Subsequently, the patient becomes empowered by the pathways framework to begin to make choices that lead to health.

This history of the medical profession in pre-Revolutionary Russia examines an influential segment of the educated elite. The author shows how Russian physicians differed in social origin, careers, and professionalization from their counterparts in other lands.

Originally published in 1982.

The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

Selected as a Doody's Core Title for 2022! Perfect for primary care physicians, nurse practitioners, and PAs, who are routinely confronted with behavioral health disorders among patients in a primary care setting, the second edition of this unique multimedia handbook-now affiliated with the Association of Medicine and Psychiatry-sits at the intersection of primary care and psychiatry. You'll find much that is new: updated fundamentals on depression, anxiety, psychosis, substance, and eating disorders, as well as overviews on CBT, motivational therapy, and common pharmacological therapies. With contributors from the worlds of both psychiatry and primary care, you have a perfect package on how to integrate the two in order to deliver better mental health care for your patients. Ebook now features 30-minute educational videos, instructional PowerPoint slides, and a 15-question multiple-choice assessment for every chapter. Includes tips on navigating the psychiatric interview and updated DSM-5 diagnostic criteria. Disorder-specific chapters follow a handy templated format: clinical highlights, diagnosis, treatment, medications, practice tips, and more. True-to-life case studies and patient scenarios illuminate key concepts in psychiatry. Guidance on navigating the Collaborative Care Model and applying the primary care psychiatry assessment. Packed with easy-to-read figures and tables that helps make information easy to digest and implement. Enhance Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

Addressing the major advances in biomedical, psychological, social, and environmental sciences over the past decade, Developmental-Behavioral Pediatrics, 5th Edition, remains the reference of choice for professionals in a wide range of fields, including medicine and health care, education, social service, advocacy, and public policy. This foundational, pioneering resource emphasizes children's assets and liabilities, not just categorical labels. Comprehensive in scope, it offers information and guidance on normal development and behavior, psychosocial, and biologic influences on development, developmental disorders, neurodevelopmental disabilities, and mental health conditions. It also discusses tools and strategies for diagnosis and management, including new assessments that can be used in telehealth encounters. Offers a highly practical focus, emphasizing clinical approaches to evaluation, counseling, treatment, and ongoing care. Provides new or expanded information on theoretical foundations of human development and behavior; trauma, adverse childhood events, and resilience across the life span; mechanisms of genetic, epigenetic, and neurological conditions; and principles of psychological assessment, including a broad array of evaluation approaches. Discusses management and treatment for developmental and behavioral conditions, spanning common factors, cognitive behavior therapies, rehabilitative services, integrative medicine, and psychopharmacology. Contains up-to-date chapters on celebrating socio-cultural diversity and addressing racism and bias, acute stress and post-traumatic stress disorder in youth, sexuality and variation, and alternatives to restrictive guardianship. Begins each chapter with a colorful vignette that demonstrates the importance of the human dimensions of developmental-behavioral pediatrics. Offers viewpoints from an interdisciplinary team of editors and contributors, representing developmental-behavioral pediatrics, general pediatrics, psychiatry, psychology, occupational and physical therapy, speech-language pathology, and law. Provides the latest drug information in the updated and revised chapters on psychopharmacology. Includes key points boxes, tables, pictures, and diagrams to clarify and enhance the text. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

The past few years have witnessed the emergence of steroid hormones as the wonder molecules which generate as much discussion in the scientific literature as they do in a typical living room. This transition has been a result of the tremendous public and scientific interest in the normal functioning of the hor mones as well their suggested involvement in several clinical conditions. In the recent past, notable scientific and technological advances have been made in the areas of contraception and regulation of fertility. Steroid receptors are the indis pensable mediators of hormonal responses and are complex protein molecules which appear to exist in association with other, yet undefined, proteins and/or factors. Receptors for vitamin D, retinoic acid and the thyroid hormones share structural similarities with steroid receptors, and the roster of this superfamily is still expanding. While our knowledge of the diversity and magnitude of steroid effects has advanced, the precise mode of steroid hormone action has alluded investigators. This volume brings together an international team of prominent investigators who discuss their most recent work on the basic and clinical aspects of steroid/nuclear receptors. The contributions represent updated versions of the invited presentations made at The Second Meadow Brook Conference on Steroid Receptors in Health and Disease. I am grateful to my colleagues on the Scientific Committee: Etienne Baulieu, Jack Gorski, Benita Katzenellenbogen, David Toft and James WittJiff, who provided the vision and guidance in formulating an out standing program."

'Health practice has always been many things, with many constraints and pressures. These things have changed over time and still vary from place to place. Being a practitioner here and now is, from one perspective, no different to the way it has always been. It involves integration. It involves weaving together many threads into one whole tapestry. It involves taking a constrained and limited palate and painting freely. It may be a science, it may be technical, it may be psychological, it may be spiritual, but it is always an art, because it integrates everything in order to create. And what we create is better health.' Justin Amery This extraordinary new series fills a void in practitioner development and well-being. The books take a reflective step back from the tick-box, target-driven and increasingly regulated world of 21st century health practice; and invite us to revisit what health and health practice actually are. Building carefully on the science and philosophy of health, each book addresses the messy, complex and often chaotic world of real-life health practice and offers an ancient but now almost revolutionary understanding for students and experienced practitioners alike: that health practice is a fundamentally creative and compassionate activity. The series as a whole helps practitioners to redefine and recreate their daily practice in ways that are healthier for both patients and practitioners. The books provide a welcome antidote to demoralisation and burn-out amongst practitioners, reversing cynicism and reviving our feeling of pride in, and our understanding of, health practice. By observing practice life through different lenses, they encourage the development of efficiency, effectiveness and, above all, satisfaction. The fourth book in the series, The Integrated Practitioner: Integrating Everything, considers the 'we', the 'me' and the 'other' perspectives of books 1-3 and integrates everything into 'health practice' as a single entity. It recognises the multifaceted nature of healthcare, its different constraints and varied pressures, but also views it from a new perspective, fostering a happier, healthier and more skilful whole within the real-life, complex and often messy world of health practice. Brilliantly written, practitioners, students and trainees and GP trainers will find the enlightening, witty, conversational style a joy to read.