This is the third book in a new international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. There are few more distressing problems for patients and families than the development of a primary or secondary brain tumor. Treatment is often palliative, though intensive, from the start. Little firm evidence exists to guide the physician in caring for patients with seizures refractory to standard treatment. Most of the work is based on case reports or personal experience. This book draws the information together in an easily accessible form so that the book can be read and referred to on the ward, or before a domiciliary visit.
Specialists in palliative care and oncology settings, working in the acute sector and in hospices, will find this book invaluable. It will also appeal to consultants as well as specialist registrars, clinical nurse specialists and nurse practitioners in palliative care, oncology and neurology.

Based upon a tried and tested framework of intervention, Health Behavior Change, third edition, brings together the field of communication, the study of motivation and how people change, and insights derived from listening to and observing patients over many years, to provide a helpful source of advice on how to encourage individuals to embrace behaviour change and then maintain it. This popular paperback is written in a friendly and accessible writing style, and contains an abundance of 'real-life' clinical cases, sample interviews, and the latest evidence-base regarding best practice. The book also contains information on learning the necessary techniques, overcoming personal barriers to success, and how to use the techniques in a wide variety of settings. Learning aids include 'Useful Questions' boxes, to help learners structure consultations, 'Key Points' boxes, to summarise the crucial 'take home' message, and 'What to Avoid' boxes, which give the benefit of extensive experience. The new edition now comes with an EVOLVE (c) website which contains a helpful video demonstration of a successful interview, an explanatory transcript of which is given within the book, and downloadable Patient Worksheets. Suitable for a wide-ranging readership ranging from primary care physicians and nurses to physiotherapists and sports therapists, this book will be perfect for use in the primary care setting, inpatient or outpatient departments, community health projects, the A&E department, leisure facilities and occupational health clinics. Perfect for brief consultations in the healthcare and sports setting Abundance of practical examples - showing both good and bad practice - illustrate how the techniques can be used to optimum effect even with patients who are 'difficult to reach' Useful 'dialogue' between practitioner and patient illustrate points of theory Contains a chapter on how to learn the technique, including potential barriers to success Discusses the frustrations encountered in practice and provides practical tips on how to control emotion Ideal for use in the primary care setting, inpatient or outpatient departments, community health projects, the A&E department, leisure facilities or occupational health clinics Fully updated throughout with the latest research and evidence base for best practice Updated clinical examples reflect recent developments in public health Now available with an EVOLVE (c) website containing a helpful video demonstration of the techniques being used and downloadable Patient Worksheets

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 editions preserve the original texts of these important books while presenting them in durable paperback and hardcover 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.

Mit zunehmender Lebenserwartung steigt auch die Anzahl alterer Patienten, die nicht mehr in der Lage sind, Entscheidungen zu treffen und ihre hauslichen Aufgaben selbst zu erledigen. Der behandelnde Arzt benoetigt aber fur seine Entscheidungen eine rechtsverbindliche Einwilligung des Patienten. In einer solchen Situation muss eine dritte Person stellvertretend fur den Patienten zusammen mit dem Arzt die erforderliche Therapieentscheidung treffen.

There is increasing ethnic diversity in our society posing challenges for health professionals and health care. Existing texts on ethnicity and health are often esoteric and academic in focus, accessible to researchers and policy analysts rather than health practitioners. Other texts consider a single health topic or cultural group.

Ethnicity, Health and Primary Care is a new book, intended as a broad but concise and practical introduction to ethnicity and health care for a wide range of health professionals - general practitioners, GP registrars, practice and community nurses, bilingual workers, medical students and other health practitioners in training. Although focusing on primary care, the book's general principles and its clinical coverage will be highly relevant to other health and social care practitioners, in addition to those developing and commissioning health services.

Chapters have been written to enable busy practitioners and students to grasp the essentials quickly and easily. The book aims to stimulate readers to learn about and develop an effective approach to ethnic diversity in health care.

Rather than be an encyclopaedia of different ethnic groups and cultural practices, this book emphasises the need for practitioners to respond to people as individuals within a broader understanding of the diverse needs of communities. It thus promotes generic principles for good practice wherever diversity has an impact. Having underlined these principles the book considers major clinical topics and groups arguably of particular concern for the health of diverse ethnic communities.

Patient participation and user involvement are central to current thinking about the effective delivery of desired healthcare outcomes. Working with the person who lies behind every patient is core to palliative care. A voice can only become significant when it is listened to and acted upon. With palliative care increasingly addressing the needs of people with a variety of conditions in a range of settings, as well as with advances in research, technology, and information, the challenge to be 'a voice for the voiceless' is greater than ever.

This book addresses key aspects in the provision of patient-centred palliative care and tracks significant developments in user involvement. It sets the philosophy within the cultural, social and political context of modern healthcare, particularly addressing issues of quality, standards, education and bereavement. A key component in the delivery of high quality palliative care is the multi-professional team. Following a discussion of teamwork, five core professions present a critical analysis of their working practices. The book concludes with a commentary from a palliative care user and a bereaved carer.

It is often somewhat glibly asserted that the patient is, or should be, at the centre of care. There have been few attempts to examine how to keep him or her there without professional needs and protocols crowding him or her out. This book asks how we listen and why we listen. The book focuses on the challenges of how professionals can keep the needs of the patient central in clinical care and how the patient can influence the direction of that care.

This concise text delivers a basic introduction to neurology and is designed for use by medical students during their rotation in neurology and related disciplines. Updated and expanded, this second edition follows the same order as the first, starting with how to approach a patient with a neurologic problem followed by the latest information on the phenomenology, pathophysiology and symptoms of common adult and pediatric neurologic diseases. Supplementing the learning experience are clinical cases that begin each chapter and videos of examples ranging from how to perform the normal neurologic exam to abnormal exam findings. Easy-to-read and richly illustrated, Fundamentals of Neurologic Disease, 2nd Edition is an invaluable resource for anyone seeking to learn the fundamentals of neurology.

In our society, the overwhelming majority of people die in later life. They typically die slowly of chronic diseases, with multiple co-existing problems over long periods of time. They spend the majority of their final years at home, but many will die in hospitals or care homes. This book explores the possibilities for improving the care of older people dying in residential care and nursing homes. It argues that there are aspects of palliative care that, given the right circumstances, are transferable to dying people in settings that are not domestic or hospice based.

End of Life in Care Homes describes what happens in nursing and residential care homes when a resident is dying, how carers cope, and the practical, health and emotional challenges that carers face on top of their day-to-day work. Based on detailed research from both the UK and US, the book shows how the situation can be improved.

In line with major changes in medical education over the last decade, Health and Illness in the Community stresses the importance of the community and the health of the population which play an integral part in becoming a good doctor. Through the use of case histories, summary panels, bullet lists the book looks at the context within which illness is experienced, health is sought and medicine is practised. It explains to the reader how the determinants of health and illness are much wider than the influence of medicine, or indeed healthcare. It is generally recognised that the effectiveness of clinical decisions made for each patient is increased if the doctor takes account of the patient's family and community setting. Equally the impact of these decisions is mediated through the environmental, economic and political conditions of the day.

This concise multi-disciplinary textbook for medical students takes a practical approach to the subject, integrating the subjects that are being taught within the community. Taking health and normality as a starting point, the book considers the environmental and social factors which influence the health of a community, discussing the nature, distribution and determinants of illness. Students need a solid understanding of medicine in the community encompassing elements of public health, general practice, child health, geriatrics, mental health, psychology and sociology and this book provides the material required.

The Consultation, published almost 20 years ago by the same authors, has been completely rewritten. The New Consultation will be an essential aid for all doctors and their educators to increase the effectiveness of their consultations and to help to make them more patient-centred. It includes theoretical background as well as practical help for both consulters and teachers.

The consultation is 'the central act of medicine': the meeting between the patient and the doctor. The first part of the book takes the reader from the context of the consultation in society and with the medical profession, to the intimacy of the consulting room, and then delves into its processes. The reader is invited to share the individual perspectives of doctor and patient and to consider what will lead to positive outcomes. The last chapter of the first section puts all these factors together and provides a coherent, evidence-based description of the processes needed for an effective consultation for the patient, the doctor, and society.

The second part of the book takes the reader into the practicalities of learning and teaching effective consultations. It starts with a brief description of the evidence for effective teaching and outlines the authors' experience of teaching in this way with over 1,000 doctors. Realizing that many doctors organize their own self-directed learning, the authors have included a chapter that enables individuals to develop their own consulting technique. Help is offered for teachers of the consultation in both undergraduate and postgraduate settings. The consultation is now assessed by a number of the royal medical colleges to measure competence and there is a chapter on these issues. The last chapter discusses the difficulties that many doctors still have in conducting patient-centred consultations and makes some suggestions for effective implementation of skills.

This timely professional reference and educational resource applies current concepts of pediatric adherence to medical treatment to create a model for a family-centered, collaborative approach to managing chronic illness. At its core are the latest findings on adherence: the factors that encourage it, the barriers that derail it, and the most effective interventions for its improvement. The book's developmental lens highlights how adherence waxes and wanes across different stages of childhood and adolescence, and specialized chapters analyze social realities exacerbating adherence problems. And its end product is a framework for how patients, parents/caregivers, and providers can work together effectively for improved adherence and optimum outcomes. Included in the coverage: The scope and impact of nonadherence. Poverty, stress, and chronic illness management. Racial/ethnic health disparities and adherence. Reconsidering the idea of self-management. * Screening for nonadherence in pediatric patients. * A comprehensive behavioral health system for identifying and treating nonadherence. Healthcare Partnerships for Pediatric Adherence offers relevant contemporary perspective for pediatricians looking for new ways to reduce treatment failure, improve support to patients and their families, and promote patient involvement in their own care.

Violence within the family, whether directed against children, partners or elders, profoundly disturbs our notions of what the relationship between the family and the discipline of general practice should be. GPs are doctors to whole families and yet their relationships with patients are individual ones, drawing their strength from the principles of confidentiality, mutual trust and positive regard. Violence and abuse within families necessarily challenges all of these, creating a profusion of ethical, interpersonal and practical difficulties and dilemmas. At the same time the nature of general practice confers unique opportunities to deal effectively with family violence.

GPs and GP registrars will find this book an invaluable and empowering resource. It brings together a broad range of expertise and opinion from relevant specialities and disciplines and sets family violence in its historical, epidemiological and societal context. It describes in separate sections, child abuse, domestic violence and elder abuse, its presentations, diagnosis and treatment; and suggests ways forward for its prevention and early detection. It draws throughout on the experience of GPs, health visitors and social workers, providing practical safe and workable guidelines.

Family violence can present to any member of the primary care team and there is much here that will be of relevance and interest to them all.

This book deals with child abuse and neglect as it presents itself in primary care. All health professionals, including those who work in primary care, have an important role to play in the child protection process. Inappropriate management of suspected instances of child abuse may result in serious implications for the child, family and involved professionals. Primary health care teams have specific and unmet training needs in this area and many general practitioners express anxiety regarding their involvement in child protection work. The overall aim of this book is to enable members of the primary health care team to fulfil their responsibilities in the protection of children from the threat of abuse or neglect. Readers are made aware of the skills required both to protect children and to subsequently maintain relationships with families. The contents have been extended to include child protection issues in our multi-cultural society along with comparison of different systems across Europe. The book is primarily aimed at GPs and their teams; social workers and health care managers will also benefit from its unique treatment of child protection issues in a primary care setting.

'This book addresses these issues with sagacity and imagination. The reader (all primary care team members would benefit from it) is offered facts, skills, attitudes and insights to help in this difficult area. We can all do child protection better - let us use this book to achieve that aim.'

From the foreword by Professor Michael Pringle, Immediate Past Chairman, Council of Royal College of General Practitioners

Mental Health has finally come home to primary care, where 90% of all patients with psychological difficulties are diagnosed and treated, and where Governments increasingly see the bulk of mental health commissioning and practice as belonging. This book, whose contributors uniquely include leading figures from the world of both primary care and psychiatry, brings together the best of contemporary psychiatry with a deep understanding of the realities, challenges and opportunities of general practice. The book is divided into four parts. The reader is taken from the first-hand experience of the encounter with the psychiatric patient in the GP consulting room, through the stresses and strains of such work, to the wider primary care mental health team of counselling, family therapy and group dynamics, and finally to specific disorders such as psychosis, eating disorders, depression, suicide, and trauma as they present in the primary care setting. The book ends with practical guidance in the use of psychotropic drugs and psychological treatments in primary care.

The tone throughout is influenced by the editors' background , one a GP, the other a psychiatrist, in psychotherapy and 'Balint' groups, which places the doctor's own feelings and aspirations centre stage, no less than those of the patient. The book offers new ideas in two ways. First, in that it looks at how cutting edge psychiatry can be applied and practised in the primary care setting, away from psychiatric institutions, and adapted to the realities of primary care, where distress does not easily fit into predetermined categories derived from secondary care. Second, because the editors, possibly unfashionably, believe that, faced with an ever-expanding, protocol-driven, standardised medical culture, the concepts and ideas of group dynamics and counter-transference need to be rediscovered if primary care is to be effective.

In sum, this book is an essential vade-mecum for all primary care mental health workers, whether GPs, psychologists, nurses, psychiatrists, psychotherapists or counsellors. It contains practical guidance and holds onto the vision that GP, patient, family and practice team must work together.

This book is a comprehensive and easy-to-read guide to obstetrics and gynecology in developing countries. Although significant progress has been made towards the reduction of maternal mortality and morbidity globally, they are still unacceptably high in developing countries. This can be directly or indirectly tied to poor quality maternal health care and lack of access to cost-effective, comprehensive healthcare. Health practitioners in developing countries also contend with trying to keep abreast of recent developments in obstetrics and gynecology while dealing with lack of time, resources, and access to relevant information. This textbook was thus created by experts in obstetrics and gynecology with extensive experience in African clinical settings and consultants in developed countries to teach proper and accurate diagnosis, treatment and management of gynecologic and obstetric health issues within the context of developing countries. This second edition has been fully updated throughout with an added 25+ chapters that cover topics such as reproductive health, gynecological cancers and research methods. The book is divided into six sections: Women's Reproductive Health; Obstetrics; Medical and Surgical Disorders in Pregnancy; General Gynecology; Gynecological Malignancies; Health Systems Organization, Research Methodology and Biostatistics. These section topics have been carefully covered by expert authors with the use of valid scientific data, policy instruments, and adapted to the cultural and social context of developing countries, with particular in depth coverage of conditions that have greater prevalence and incidence in developing countries. Each chapter also focuses on filling gaps in knowledge with a distinct pedagogical approach, starting with a set of learning objectives and ending with key takeaways for the chapter. This is an ideal guide for residents, medical students, practitioners of obstetrics and gynecology, midwives, general practitioners, and pediatricians, particularly those working in developing companies.

This book will be an invaluable resource for GPs, counsellors, managers and others in primary care who seek to understand the debates about counselling and play a part in its future as part of health care. Its authors discuss the nature of counselling in this setting and the contribution it can make in improving the care of patients with a variety of health problems. The authors include practitioners and academics, service providers and counselling clients, supporters and sceptics. Overall they offer a comprehensive and thought provoking guide to those responsible for commissioning, working with and providing counselling services in a health service that seeks to be increasingly primary care led and evidence based.

This book discusses the establishment and evaluation of counselling services in primary care and the need to consider the most appropriate forms of service for different groups. It describes the specialist counselling services that are available to back up what can be provided as part of primary care and the variety of organisations that can be approached for information and advice, and assesses the research evidence on the efficacy and cost effectiveness of counselling.

A GP writes: 'If ever there was a subject guaranteed to generate debate, often heated, it's counselling. Does it work? Who's it for? What does it cost? How can we set up a service? Well, this book has the answers. And not just the positive ones - in the spirit of true balance, it even gives the sceptical view. A bit like turkeys voting for Christmas you might think? Nothing of the kind. The chapters cover just about everything GPs or Primary Care Organisations (PCO) might want to know about counselling in a primary care setting. In amongst the practical pointers on how to deal with thorny clinical counselling problems in specific situations, it even covers cost-effectiveness. Even the most sceptic, hard-hearted PCO clinical director will find the arguments in this book persuasive. The chapters on managed counselling, services for young people, substance misuse, trauma and sexual abuse could easily stand alone. But they don't. They are all in this little gem of a book. If not one for your doctor's bag, it's definitely one for your shelf!'

'For patients, good quality primary healthcare is of fundamental importance. In order to provide quality care education and training is paramount to professionals in primary care. Yvonne Carter and Neil Jackson have brought together a group of well-known practitioners to help them give an up to date and comprehensive overview of education and training in primary care. Readers will find much here which will help them chart the way forward in their own practice teams in ways which should lead to good results for patients and that enhanced professionalism in practitioners so crucial to their satisfaction and morals.' from the foreword by Sir Donald Irvine

With the advent of PCGs/PCTs and a huge government programme of primary care development comes a great need to understand the education and training system, and its relation to other systems in the NHS, ie. service provision and research and development - a 'three systems approach'.The book encourages and facilitates strategic thinking and planning in relation to education and training at various levels including organisation, team and individual healthcare professional. The Handbook of Education and Training in Primary Care contains up to date information on educational concepts and practice for the benefit of all healthcare professionals in primary care and the wider NHS.

The handbook covers a range of issues paramount to education and training including clinical governance, quality and audit, research methods, clinical effectiveness and evidence-based primary care. A chapter devoted to learning from patients and coverarge of the interface between primary and secondary care make this handbook a unique and valuable resource for all in primary care.

About the Editors

Professor Yvonne Carter is Professor of General Practice and Primary Care and Head of Department at Barts and the London, Queen Mary's School of Medicine and Dentistry, University of London. She is editor of many books and is committed to increasing the research capacity in primary care and is particularly interested in the accreditation of research practices and the development of primary care research networks.

Dr Neil Jackson is Dean of Postgraduate General Practice London Deanery, University of London. He is currently advising the Governments of Georgia and Uzbekistan to develop systems of Primary Care, a network of GP trainers and Family medicine Training programme in collaboration with the Department for International Development and Imperial College, London.

In der arztlichen Praxis ist umfangreiches Arzneimittelwissen gefragt, das permanent aktualisiert und neu bewertet werden muss. Das Fachbuch vermittelt den neuesten Wissensstand mit direktem Bezug zur Praxis. Die Neuauflage ist vollstandig uberarbeitet und aktualisiert, erscheint jetzt im grossem Format und ubersichtlichen zweifarbigen Layout. Indikation und Therapie stehen noch starker im Vordergrund. Damit bietet das Buch AErzten kompetente Hilfestellung bei der indikationsbewussten, evidenzbasierten Arzneitherapie.

Every branch of healthcare has its own particular experience of violence, from direct physical or verbal aggression aimed at members of staff, to dealing with the victims of a crime perpetrated elsewhere. Since the first edition of this book was published in 1994, there have been huge developments in understanding and managing violence in the healthcare setting. Violence prevention is now not just the concern of the frontline healthcare team, but also of architects, service managers, psychologists, governments, health and safety managers, human resources managers, and members of the emergency services. This fully revised and updated new edition will equip all members of these teams with the information required to understand the range of factors involved, and enable them not just to develop strategies to tackle the issues but also to deal with violence when it arises in both hospital and community settings. Coverage includes the causes and nature of violence, including domestic violence, the effects on, and care of, the victims, as well as describing opportunities to limit the potential for violence through good design. This book is essential reading for all those working in, or in association with, health services and related agencies. It is also an essential resource for anyone seeking to understand, prevent or survive violence. From reviews of the 1^st edition: 'this short and affordable guide to the recognition, avoidance and aftermath of violence will prepare you for the event' John Bignall, The Lancet 1994. 344:180 'Many health care staff will look for a practical guide to coping and will find this book an excellent place to start ... Those spurred into action could usefully rely on this book to aid the process of effective management and staff support' Arden Tomison, Fromeside Clinic, Bristol, British Journal of Psychiatry , August 1995 'There are no obvious gaps in an eminently readable and well-unified text.' Patrick Hoyte, MDU Nurse, February 1995 '... the book effectively addresses a pressing problem for health care workers: how to cope with aggressive behavior' Ellen H Taliaferro, University of Texas Southwestern Medical School, Annals of Emergency Medicine, October 1995 'It would be important reading for those undertaking further study of the prevention and management of violence and aggression ...' John Rawlinson, Lecturer in Mental Health Nursing, Professional Nurse, July 1996

Mit Beitragen zahlreicher Fachwissenschaftler. Stand: Marz 2002"

This book's focus is on the decisions taken in consultations between health care patients and professionals. Clinician- patient partnerships in health care decisions are increasingly advocated. Evidence- based patient choice describes a model of health care in which the evidence-based approach can integrate with the promotion of consumer choice. The book examines the traditional approach and the changing experience and expectations of consumers. It describes with many clinical examples and patient narratives how to practice evidence-based patient choice, and explores the ethical, sociological and economic issues raised. It also addresses the future modifications to professional training and organisational change which are required if evidence-based patient choice is to become the norm and speculates about what is likely to be achieved in the next few years. The book provides a summary of current perspectives in this area, which will be of interest to consumers, their representative groups, and to professionals in practice and training alike. From the foreword by Richard Grol: 'An enormous challenge lies before us. In this new and challenging field Evidence-based patient choice is manna from heaven. It summarises the current state of knowledge about these new patient involvement approaches. It is by far the most comprehensive account of scientific and ethical thinking about patient choice at this moment. And, it manages to show us the way to a potential future: health care provision where patients and professionals operate as real partners with shared goals...'

Krankenhaus-und Praxishygiene ist Praventiv-Medizin mit der Aufgabe Kranken- haus-bzw. Praxisinfektionen zu verhindem. Infektioser sowie nichtinfektioser Hos- pitalismus als Komplikation des Heilungsverlaufes sind seit dem Bestehen von Krankenhausem bekannt. Prototypen des klassischen infektiosen Hospitalismus in der vorbakteriologischen Ara waren der Gasbrand, das Kindbettfieber, die Wund- rose und der Wundstarrkrampf. Durch die Entdeckung der Erreger, ihrer Ubertra- gungsweise und der Erkennung von Kreuzinfektionen sowie den sich daraus entwik- kelnden Methoden der Hygiene sind seit jener Zeit entscheidende Erfolge erzielt worden. Die Art der Krankenhausinfektionen und das Keimspektrum haben sich al- lerdings verlagert. Der eigentliche Beginn des modemen infektiosen Hospitalismus fallt mit dem Zeitpunkt zusammen, der auch als Beginn der Antibiotika-Ara bezeich- net wird. Das Vertrauen in die umfassende Wirksamkeit dieser Mittel war so groB, daB die bis dahin mit Selbstverstandlichkeit angewandten Methoden der Hygiene vemachlassigt wurden. Die Folgen dieser Fehleinschatzung, die inkonsequente An- wendung von Antibiotika, war die Heranziichtung von antibiotikaresistenten Kei- men, den sogenannten Problemkeimen im Krankenhaus. Damit hat sich in den letzten lahrzehnten das Erregerspektrum von Krankenhaus- z. T. erheblich gewandelt. Zunehmend werden schwerste Infektionen von infektionen Keimen verursacht, die friiher als apathogen galten. Neben dem Erregerwechsel sind "neue" Keime als Erreger von Krankenhausinfektionen aufgetreten. Griinde fUr die- se Veranderung sind neben der Selektion durch Antibiotika eingreifendere und lan- gerdauemde medikotechnische MaBnahmen auch bei immunsupprimierten Patien- ten. Uberhaupt spielt der Risikopatient, dessen lokale und allgemeine Infektions- abwehr durch Alter, Grundleiden oder Therapiefolgen eingeschrankt sind, sowie die Risikobereiche im Krankenhaus, in denen ihre Behandlung erfolgt, eine zunehmend groBe Rolle.

Primary Care for Older People is a contemporary reference work on health problems in later life written exclusively by primary care professionals for primary care professionals that: integrates nursing and medical perspectives on clinical practice and service organisation. understands that well-intentioned changes in practice and service provision can have harmful effects on patients, professionals and the health service is still able to offer positive guidance to individual practitioners, practices and Primary Care Groups, about best practice and innovative multi-disciplinary care for an ageing population. It is aimed at doctors, nurses, health visitors and social workers who are trying to combine care of individuals with an understanding of the needs of whole communities. Its themes are relevant to teachers in different professional disciplines, to members of Primary Care Group and Trust Boards, to planners and managers of primary care services, as well as to practitioners. The authors bring to this book their experience in general practice and community nursing, their expertise in service development and management, and their awareness of primary care research. Dr. Steve Iliffe has been an inner-city general practitioner in London since 1978, and is Reader in General Practice at the Royal Free and University College Medical School, where he is co-director of the Centre for Ageing Population Studies (CAPS) and manages the Primary Care for Older People research and development programme. He can be contacted at [email protected]. Vari Drennan has been a community health service manager , specialist health visitor for older people and health visitor since 1980 and is currently a senior lecturer in primary care nursing in the Department of Primary Care & Population Sciences at the Royal Free and University College Medical School. She can be contacted at [email protected],