A ground-breaking new volume and the first of its kind to concisely outline and explicate the emerging field of whole person care process, Whole Person Care: A New Paradigm for the 21st Century organizes the disparate strains of literature on the topic. It does so by clarifying the concept of 'whole person' and also by outlining the challenges and opportunities that death anxiety poses to the practice of whole person care. Whole person care seeks to study, understand and promote the role of health care in relieving suffering and promoting healing in acute and chronic illness as a complement to the disease focus of biomedicine. The focus is on the whole person -- physical, emotional, social, and spiritual. Using concise, easy-to-read language, the early chapters offer practitioners a thorough understanding of the concepts, skills and tools necessary for the practice of whole person care from a clinician-patient interaction standpoint, while the last two chapters review the myriad implications of whole person care for medical practice. An invaluable resource for all areas of medical practice and for practitioners at all stages of development, from medical students to physicians and allied health providers with many years of experience, Whole Person Care: A New Paradigm for the 21st Century will have a profound impact on western medical practice in North America and elsewhere.

Healthcare Changes Reach Main Street: A Call to Action for Physicians provides guidance, examples, and information on processes and time lines for physicians based on the implementation of The Affordable Care Act (ACA) that was established in 2010. This volume focuses on how geriatricians and other healthcare professionals can be engaged in responding to the roll-out of the ACA in their communities, and through this engagement assume leadership roles in local hospitals, healthcare organizations, and medical societies to advance quality improvement and new models of care for older adults. In-depth chapters provide an update on quality improvement efforts at the state level, as well as changes in Medicaid financing and the significant impact this will have for older adults, particularly dual-eligibles. Many elements of the ACA are yet to be rolled out and many healthcare decisions are yet to be made. Healthcare Changes Reach Main Street: A Call to Action for Physicians will guide healthcare decision makers and help them to play a leadership role in advancing quality care for older adults in our changing healthcare environment.

Orthostatische Hypotonie.- Orthostatic hypotension in the elderly: the Honolulu Heart Program.- Campher, ein festes atherisches OEl.- Klinische Pharmakologie von D-Campher.- Toxikologie von D-Campher.- Leichte bis mittelschwere Depressionen.- Haufigkeit und klinische Relevanz der Interaktionen und Nebenwirkungen von Hypericumpraparaten.- Arzneimittelinteraktionen mit Johanniskrautextrakt.- Untersuchung zur Alltagssicherheit des Johanniskrautextraktes Ze 117.- Mechanismen der Interaktionen mit Johanniskrautextrakten.- Johanniskrautextrakt Ze 117 - Klinische Wirksamkeit und Vertraglichkeit.- Chronische Schmerzleiden.- Wirksamkeit eines Harpagophytum-Extrakts bei Patienten mit Ruckenschmerzen.- Wirkmechanismen von Harpagophytum-procumbens-Extrakt LI 174 bei der Behandlung von unspezifischen Ruckenschmerzen.- Placebokontrollierte, randomisierte und doppelblinde Studien zur Analyse der Wirksamkeit und Vertraglichkeit von Oleum-menthae-piperitae-Loesung LI 170 bei Kopfschmerz vom Spannungstyp und Migrane.- Zur Pharmakokinetik und zum Einfluss von Harpagophytumextrakten auf den Arachidonsaurestoffwechsel.- Immunmodulation zur Infektvorbeugung und bei malignen Tumoren.- Pflanzliche Immunstimulanzien aus padiatrischer Sicht.- Sport und Infekte der oberen Atemwege - Epidemiologie, Immunologie und Einflussfaktoren unter besonderer Berucksichtigung der Infektvorbeugung durch Echinacin.- Pharmakodynamik der Arzneimittelkombination aus Echinaceae (purp. et pall.) radix, Baptisiae tinctoriae radix und Thujae occidentalis herba (Esberitox(R) N). Wirksamkeit und Arzneimittelsicherheit bei akuten viralen Infekten.- Misteltherapie - ihr aktueller Stellenwert bei der Behandlung von Tumorerkrankungen.- Reizmagen- und Reizdarmsyndrom.- Symptomatologie, klinische Pathophysiologie und therapeutische Aspekte des Reizdarm-Syndroms.- Therapie von Reizmagen- und Reizdarmsyndrom aus klinischer Sicht.- Stellenwert von Iberogast(R) beim Reizmagen- und Reizdarmsyndrom.- Fixe Kombination aus Pfefferminzoel und Kummeloel - UEbersicht zur Pharmakologie und Klinik.- Pharmazeutische Qualitat und Vorschlage zu Transparenzkriterien ausgewahlter Phytopharmaka beim Reizmagen- und Reizdarmsyndrom.- Phytotherapie des Colon irritabile. Ein systematischer Review.- Weitere Indikationen.- Der Pestwurz-Extrakt Ze 339 - Wirkungsprinzipien und klinische Pharmakologie.- Therapie klimakterischer Beschwerden mit Cimicifuga racemosa - Daten zur Wirkung und Wirksamkeit aus einer randomisierten kontrollierten Doppelblindstudie.- Tradition reicht nicht mehr aus.- Phytopharmaka aus Sicht der gesetzlichen Krankenversicherung (GKV).- Japanische Phytotherapie (Kampo) - Klinische Relevanz und Qualitatssicherung in der modernen Medizin.

Challenging Cases in Allergic and Immunologic Diseases of the Skin offers clinicians a wide range of challenging cases that are certain to provide hours of thoughtful and instructive review. Using a case study format and including excellent quality color images, Challenging Cases in Allergic and Immunologic Diseases of the Skin consists of five parts and 20 chapters. The chapters cover such areas as allergic rhinitis, allergic diseases of the eye, drug-induced urticaria, cosmetic allergy, drug allergy, latex allergy, atopic dermatitis, vasculitis, and a range of other commonly seen disorders of the skin. Each chapter comprises at least two cases that are followed by a differential diagnosis, discussion, and five multiple choice questions for thoughtful stimulation and excellent value as a teaching tool. Comprehensive, concise, and well-designed in presentation, Challenging Cases in Allergic and Immunologic Diseases of the Skin is a one-of-a-kind resource that will become a standard resource for all clinicians who care for patients with allergic and immunologic diseases of the skin.

There is ample opportunity and scope for gynaecology in prim ary care in general practice. Many conditions and problems can be managed successfully in this context without referral to hos pital and specialist care. The first aim of this book is to deal with common problems that are referred for consultant opinion and specialist management to the average District General Hospital by analysing problems of presentation and diagnosis on a symptom-orientated basis. Selection for primary care management as opposed to hospital referral is then considered, following which the wide range of available treatment is evaluated with particular emphasis on the maximum use of up-to-date but proven regimes. The full use of the expertise of the practitioner is highlighted throughout. The second aim is to encourage the practice of primary care gynaecology and to help those doctors who have a special in terest in the subject, while hopefully stimulating others to de velop a similar one. With this in mind, the approach to the problems is realistic and often dogmatic while opportunities for individual management and for practical procedures are kept to the forefront.

DDDDDDDDDDDD Effective management logically follows accurate diagnosis. Such logic often is difficult to apply in practice. Absolute diagnostic accuracy may not be possible, particularly in the field of primary care, when management has to be on analysis of symptoms and on knowledge of the individual patient and family. This series follows that on Problems in Practice which was con cerned more with diagnosis in the widest sense and this series deals more definitively with general care and specific treatment of symp toms and diseases. Good management must include knowledge of the nature, course and outcome of the conditions, as well as prominent clinical features and assessment and investigations, but the emphasis is on what to do best for the patient. Family medical practitioners have particular difficulties and advantages in their work. Because they often work in professional isolation in the community and deal with relatively small numbers of near-normal patients their experience with the more serious and more rare conditions is restricted. They find it difficult to remain up-to-date with medical advances and even more difficult to decide on the suitability and application of new and relatively untried methods compared with those that are 'old' and well proven. IX Their advantages are that because of long-term continuous care for their patients they have come to know them and their families well and are able to become familiar with the more common and less serious diseases of their communities.

This is a book about primary care clinicians and the "clinical uncertainty" endemic to their work. Even when seemingly straightforward, each patient raises unique questions regarding how best to listen to their complaints, empathize with their suffering, or respond to their silences.

This book is also about "addressing" uncertainty in primary care practice and "engaging" it. Engagement requires knowledge, explicit and tacit, placed in the service of a single patient s problem. It also requires carefully managed communication, facilitating dialogue with the patient and encouraging shared problem-solving.

Most importantly, this book is about "collaborative engagement with case-based uncertainty in the setting of small groups of clinicians. "Sommers and Launer contend that the medical profession s tradition of working independently should be augmented with an explicitly shared, collegial one of jointly creating wisdom through practice-based learning.

An international panel of expert clinicians and educators provides: Perspectives on clinical uncertainty in the medical literatureA taxonomy of clinical uncertainty with patient examplesAnalysis of the educator role to support clinicians in engaginguncertainty A compendium of small group methods for collaborative engagement with clinical scenariosAnalysis of the special challenges ofcollaborative engagement

A mind-opening manifesto, "Clinical Uncertainty in Primary Care" will equip primary care clinicians, educators, public health and behavioral health professionals with resources for infusing practice with meaning through collegial collaboration.

From the Foreword: Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which, and the extent to which it is intrinsic to medicine and they present a cogent case for itsspecial relationship to primary care practice Clinical Uncertainty in Primary Care not only presents amodel of collegialcollaboration and support, it also implicitly legitimatesit. Renee Fox. "

Acute Care for Elders (ACE) is a model of care designed to improve functional outcomes and to improve the processes for the care of older patients. This model includes: an environment of care designed to promote improved function for older patients; an interdisciplinary team that works together to identify/address the vulnerabilities of the older patients; nursing care plans for prevention of disability; early planning to help prepare the patient to return home; and a review of medical care to prevent iatrogenic illness. Acute Care for Elders: A Model for Interdisciplinary Care is an essential new resource aimed at assisting providers in developing and sustaining an ACE program. The interdisciplinary approach provides an introduction to the key vulnerabilities of older adults and defines the lessons learned from the Acute Care for Elders model. Expertly written chapters describe critical aspects of ACE: the interdisciplinary approach and the focus on function. The fundamental principles of ACE described in this book will further assist hospital leaders to develop, implement, sustain and disseminate the Acute Care for Elders model of care. Acute Care for Elders: A Model for Interdisciplinary Care is of great value to geriatricians, hospitalists, advance practice nurses, social workers and all others who provide high quality care to older patients.

Over the past decade, significant advances in research methodology have stimulated dramatic progress in the field of child psychiatry in general, and in pediatric anxiety disorders, more specifically. Pediatric Anxiety Disorders: A Clinical Guide is a comprehensive and vital addition to the literature at an exciting time in the field of psychiatry. This state-of-the-art reference aims to bridge the most up-to-date research findings with relevant clinical perspectives, making it a unique and essential resource for established clinicians and researchers, as well as for students and trainees. The book is organized into four sections, each of which includes chapters on a specific area of interest. The first section reviews the current research regarding etiological mechanisms of pediatric anxiety. The second section provides in-depth descriptions of the anxiety disorders that affect children and adolescents. The third section summarizes the literature on empirically supported assessment tools and evidence based cognitive-behavioral and pharmacological interventions. Of special practical note, the authors of these chapters have included comprehensive summary tables that can serve as quick reference tools. The final section of the text is dedicated to understanding how anxiety manifests in two special populations, children with chronic medical illnesses and those with autism spectrum disorders. Pediatric Anxiety Disorders: A Clinical Guide is an authoritative new volume developed by a renowned collection of clinicians and researchers in the field of childhood anxiety disorders.

Medical care of the elderly today challenges the practitioner to break away from narrow diagnostic labelling and view the whole picture of disease in old age. In an excellent problem-oriented approach, Geriatric Medicine offers a complete overview for practitioners. The main portion of the text deals with the common diseases of old age; important aspects such as physiology, demography, and health care delivery are discussed in separate chapters. Social and legal aspects in the major English-speaking countries receive adequate attention. All of the contributors have at some time been connected with the University Department of Geriatric Medicine in Cardiff and attest to a positive and dynamic approach in geriatric medicine, an approach that has international validity and relevance.

Primary Liver Cancer: Surveillance, Diagnosis and Treatment focuses on the many therapies rapidly evolving to assist with controlling hepatocellular carcinoma as well as emerging technologies to assist in early diagnosis as well as prevention. All chapters are written by experts in their fields and include the most up to date information for diagnosis, treatment, surveillance, epidemiology, staging, recurrence and prevention. This volume will serve as a useful resource for clinical gastroenterologists, hepatologists, oncologists, pathologists, and physicians who treat patients with chronic liver disease and hepatocellular carcinoma.

This volume covers the myriad of functional and motility gastrointestinal disorders in a comprehensive manner. The book is divided into seven major sections, with each section beginning with a brief case presentation highlighting the specific disorder to be reviewed. Appropriate criteria is highlighted, followed by a brief review on the epidemiology, etiology, pathophysiology, diagnosis and treatment of each specific disorder. 2-3 key teaching "pearls", test questions and key references are also provided for each chapter. The book is organized so that each chapter can stand on its own and be used as a quick reference source in the clinic. Alternatively, it can be read cover to cover as an authoritative textbook on gastrointestinal functional and motility disorders. Written by international experts in the field of motility disorders, Functional and Motility Disorders of the Gastrointestinal Tract: A Case Study Approach is an invaluable resource for experienced physicians, students, residents, fellows, nurse practitioners and physician assistants.

Often considered the prototypic autoimmune disease, Lupus is characterized by protean manifestations and affects a wide range of organ systems. Despite widespread availability of anti nuclear antibody testing and other technological diagnostic advances, the diagnosis of lupus can be elusive, difficult, and inexact. Treatment of the disease can also be challenging. Advances in immunology and biotechnology have led to a burgeoning world of new therapies in development that offer patients the real possibility of new therapies and physicians and scientists novel insights into the pathogenesis of this complicated immunological disease. Lupus Erythematosus: Clinical Evaluation and Treatment summarizes the clinical aspects of lupus facing the general clinician in the 21st century. In this invaluable, practical book, the reader will find introductory chapters regarding general diagnostic and treatment principles, followed by chapters addressing the lupus-specific organ manifestations. Special topics regarding pregnancy and comorbidities are also presented. Written by highly experienced physicians with special expertise in lupus, Lupus Erythematosus: Clinical Evaluation and Treatment is an indispensable reference for the common and not so common problems affecting patients with lupus.

Whereas during the past decade endoscopy has become established as the leading means of diagnosis and management of diseases affecting the esophagus, starnach and large bowel, radiology has retained its pre-eminence for the clinical study and evaluation of the small bowel. This book provides unique coverage of all current radiological techniques used to study the small bowel, including not only barium studies and angiography but also cross-sectional methods such as uhrasound and computer tomography as well as nuclear medicine. Ernerging techniques such as magnetic resonance imaging are given close consideration, and interventional procedures are dealt with fully. Following an introduction on anatomy, physiology, and pathology pertinent to radiol ogy, the book describes in great detail common and less common congenital and development anomalies, trauma, infectious and infl.ammatory conditions, and tumors. The radiological accounts are illustrated by unique color photographs of pathological specimens. It is important for all professionals involved in the management of patients with small-bowel disease tobe critically informed about the specific advantages as well as the limitations of the various modern imaging techniques now employed for the in vivo morphological evaluation of the small bowel. This comprehensive book provides a timely update of our knowledge in this field and is a welcome addition to our series "Medical Radiology;' which aims to provide exhaustive coverage of modern diagnostic radiology. It will be of great interest for general and abdominal radiologists, gastroen terologists, and abdominal surgeons.

This book is about a new surgical procedure, surgical hysteroscopy, for out-patients. It is both a diagnostic approach and a surgical procedure. As a simple and non-aggresive technique, it is a "patient-friendly" procedure with a little surgical trauma as it avoids hysterectomy or laparotomy procedures thus preserving the genital tract. It is the leading procedure in the treatment of uterine bleeding. It has also proved to be an essential investigation technique of in the assessment of infertility. This book is the result of surgical practice and teaching experience in the field of hysteroscopic procedures.

A riveting expose of child abuse in America and how the newest breed of pediatricians determines what happened, why, and at whose hands. Although more than one million children are abused each year in the United States, child abuse often remains a secret to family members, professionals, and politicians who neither see nor understand it. Child abuse pediatricians are the newest breed of pediatricians, specialized in exposing abuse. With detective-like acumen, child abuse pediatricians deduce through careful medical analysis who has abused and who has been abused. Describing the most compelling cases among the thousands that they have evaluated, author Lawrence Ricci reveals the trauma, pain, disability, and sometimes death that abused children experience at the hands of trusted adults. This gripping look at the dark side of American families is about good parents and poor ones, perpetrators and victims, and collateral victims such as innocent family members. It is also about the professionals who have made it their career to expose child abuse and to treat children who have suffered from it. The conclusion calls for systematic changes that could help to stem the tide of child abuse. Explains how signs of abuse can be missed by professionals, community members, and even family members Includes interviews and insights from more than two dozen child abuse pediatricians Addresses physical, sexual, and emotional abuse, including abuse by neglect and abuse due to Munchausen syndrome by proxy Details how cases can go wrong in court rooms when confuscation by defense attorneys overpowers evidence brought to court by child abuse pediatricians Offers ideas for stemming the tide of child abuse

Written for virtually every professional and leader in the health care field, as well as students who are preparing for careers in health services delivery, this book presents a framework for developing a patient safety program, shows how best to examine events that do occur, and reveals how to ensure that appropriate corrective and preventative actions are reviewed for effectiveness. The book covers a comprehensive selection of topics including * The link between patient safety and legal and regulatory compliance * The role of accreditation and standard-setting organizations in patient safety * Failure modes and effect analysis * Voluntary and regulatory oversight of medical error * Evidence-based outcomes and standards of care * Creation and preservation of reports, data, and device evidence in medical error situations * Claims management when dealing with patient safety events * Full disclosure * Patient safety in human research * Managing confidentiality in the face of litigation * Managing patient safety compliance through accountability-based credentialing for health care professionals * Planning for the future

Nocturia: Causes, Consequences and Clinical Approaches is the first volume exclusively on the topic of nocturia and is designed to be a comprehensive treatise on the subject. The volume is organized into 11 chapters first introducing and defining nocturia and its impact to patients and society, followed by chapters dealing with predictors and risk factors; relationship to sleep disorders; overactive bladder; and water homeostasis. Therapeutic areas addressing nocturia are covered in specific chapters and include pharmacotherapy affecting the bladder, prostate and kidneys as well as behavioral therapy and surgical intervention. Separate chapters are devoted to alternative therapies as well as the impact of nocturia in the elderly. The volume closes with a chapter presenting avenues for future investigation into the etiology and management of nocturia. Clinical case scenarios inclusive of figures and tables illuminate the evaluation and management of patients with nocturia. Nocturia: Causes, Consequences and Clinical Approaches will give physicians and related healthcare providers the background to understand the conditions causing nocturia, how nocturia affects society and the basis for its rational treatment. It will be used as a state of the art reference by urologists, urogynecologists, internists, nephrologists, pulmonologists, endocrinologists and sleep medicine specialists.

This book and CD-ROM package integrates the use of STELLA software into the teaching of health, nutrition and physiology, and may be used on its own in nutrition and physiology courses, or can serve as a supplement to introduce the role that simulation modelling can play. The author presents key subjects ranging from the theory of metabolic control, through weight regulation to bone metabolism, and gives readers the tools to simulate these using the STELLA software. Topics include methods for simulation of gene expression, a multi-stage model of tumour development, theories of ageing, circadian rhythms and physiological time, as well as a model for managing weight loss and preventing obesity.

For over 30 years, the stepped care approach has been used in the management and treatment of hypertension. This approach advocates the use of initial monotherapy to reach the desired blood pressure, and the subsequent use of additional drugs with complementary modes of action, until the target BP is achieved. However, current control rates for hypertension suggest that such an approach may be outdated and no longer effective in the management of hypertension. Clinical trials have shown that more than 50% of patients require a combination of drug therapies to achieve their target BP. Some proponents of combination therapy have argued that the risk of adverse side effects and non-compliance will be lower than that compared to monotherapy, which initially requires higher doses to be administered to be effective. Consequently, there have been increasing calls of the necessity for a much more combined approach in the treatment of hypertension. Adding to this, Combination Therapy in Hypertension will cover current control rates of blood pressure worldwide, the benefits of monotherapy and combination therapy, examine the effectiveness, risk of adverse effects, compliance, and cost of the available therapies and will also include information on relevant outcome studies.

This book covers a wide range of disorders such as atrial fibrillation, artificial heart valves, deep vein thrombosis, pulmonary embolism and stroke. Handbook of Oral Anticoagulation aims to provide an accessible overview of the exciting new developments in this field. Incorporating numerous quick-reference tables and figures and fully referenced throughout to key papers and the latest reviews, it will be a useful resource for all healthcare professionals involved in thromboprophylaxis.

Gastroparesis is an increasingly recognized disorder. Treatment can be difficult due to the several mechanisms for symptom production. Gastroparesis: Pathophysiology, Presentation and Treatment serves as a concise reference on this disorder that allows clinicians to quickly access and evaluate the necessary information for treating and managing patients with gastroparesis. Each chapter is written byexperts in their respective area. The volume will enable the reader to better understand all aspects of this disorder. The book presents current concepts in a variety of areas opening with the epidemiology, clinical presentation and pathophysiology of gastroparesis. The natural history of patients is explored as well as evaluation of patients with suspected gastroparesis. This section includes chapters on Wireless Capsule Motility, Electrogastrography and Antroduodenal Manometry. This important resource concludes with a full section on treatment including dietary, prokinetic, antiemetic, sensory, electric stimulation, and surgical methods. New developments include the use of gastric electric stimulation for treatment, the use of SmartPill for diagnosis, and a number of new agents in development for this disorder. Gastroparesis: Pathophysiology, Presentation and Treatment is the ideal reference for gastroenterologists, and also for surgeons, endocrinologists, primary care physicians and nutritionists looking to keep pace with the latest information treatment options for their patients. "

Cardiovascular disease is a leading cause of death throughout the world. Chronic negative emotions such as depression and anxiety place cardiac patients at greater risk for death and recurrence of cardiovascular disease. In 2008 the editor published a book related to this topic, titled Psychotherapy with Cardiac Patients: Behavioral Cardiology in Practice (American Psychological Association). Aside from that book, there are very few resources specifically written for clinicians who treat psychologically distressed cardiac patients. Unlike other medical specialty areas such as oncology, the field of cardiology has been slow to integrate behavioral treatments into the delivery of service. Perhaps because the field has been largely defined and dominated by researchers, mental health clinicians are only starting to recognize behavioral cardiology as a viable arena in which to practice. There is a large void in the practitioner literature on behavioral cardiology. In a review of Psychotherapy with Cardiac Patients, Paul Efthim, Ph.D. wrote, "Her new book goes well beyond previous works by giving specific and detailed guidance about how to tailor psychological interventions with this variegated population." He added, "It would benefit from even more details about treatment approaches." This proposed volume goes beyond the editor's previous volume by providing in-depth descriptions of behavioral treatments for distressed cardiac patients written by eminent leaders in behavioral cardiology. This book describes a wide range of behavioral treatments for the common psychologically based problems encountered by clinicians who treat cardiac patients. The book is organized as follows: Part I focuses on the most psychologically challenging and common presentations of cardiac diagnosis; coronary artery disease, arrhythmia, and heart failure. This section also includes a chapter on heart transplantation, which is a treatment, not a diagnosis, but a treatment that incurs profound psychological impact for the individual. In Part II, behavioral interventions for the general cardiac population are described. Mainstream therapies such as stress management, cognitive-behavioral therapy, and medical family therapy are described, along with approaches that have less empirical support but considerable practical significance such as personality-guided therapy and interventions aimed at altering type D personality traits. The literature in behavioral cardiology has a rich history of investigating maladaptive personality traits and thus it is important to include behavioral approaches that target personality in this volume. Part III focuses on common behavioral problems encountered by clinicians who work with this patient population. Most patients who seek psychological help do so because they perceive themselves to be stressed due to their job or overextended in all areas of their life. Other people with heart disease present with sleep problems and/or an inability to motivate themselves to exercise or quit smoking. There are many practical behavioral approaches that can be helpful for patients with these difficulties and these are detailed in this section of the book. The conclusion of the book focuses on how to integrate the behavioral treatments described in the preceding chapters into a comprehensive treatment model.

In the last decade there has been no major clinical mono- graph on this increasingly common and difficult malignancy which is a killer of young people. The gap in the literature is now filled by this authoritative volumewhich will be essential reading for any body involved in the study or management of melanoma.