Many children with medical conditions fail to improve despite physicians' best efforts. Sometimes, we ascribe this failure to lack of adherence to therapy or to the severity of the condition. What we often fail to appreciate, however is that sometimes the lack of improvement can be explained by the patients' psychological states. The first section of Functional Symptoms in Pediatric Disease: A Clinical Guide teaches children's health care providers to recognize functional symptoms that can complicate organic disease as well as symptoms that are believed to be purely functional in origin. Literature reviews, case studies and quizzes are provided in each chapter, with video demonstrations included in some of the chapters. The second section of the book will help clinicians differentiate the patients for whom referral to a mental health provider is mandatory from those for whom other approaches may be useful. For the latter group, the book teaches clinicians to empower themselves by learning how to incorporate various therapies for functional disorders into their practice, including biofeedback, basic cognitive behavioral therapy techniques, hypnosis, acupressure, yoga and meditation. Practical strategies for obtaining training in these modalities are provided in the appendix. Useful for practicing clinicians including pediatricians, family practitioners, pediatric subspecialists, child psychiatrists, psychologists, other mental health care providers and practitioners of alternative and complementary medicine, Functional Symptoms in Pediatric Disease: A Clinical Guide is an important new book that will help children's health care providers consider the possible impact of functional contributions to the clinical presentation of their patients.

A Fateful Meeting A year and a half ago, I was sitting at a conference listening to Ed Noffsinger speak, and suddenly had the most profound ''Aha'' moment of my professional career. Here was someone presenting a practical and tested solution to some of the most challenging problems currently plaguing the US healthcare system, problems such as poor access to primary and specialty care; the uncontainable and rising costs of healthcare; our nation's relatively poor quality outcomes; and finally, the sense of frustration, disempowerment, loneliness, and disenfranchisement that patients and their families too often experience. Dr. Noffsinger's solution seemed deceptively simple-shared medical appointments (SMAs) that afford the highest quality healthcare to be delivered in the highest quality care experience-a group setting. Experience collected over a decade and involving more than 100,000 patient visits throughout the United States, Canada, and parts of Europe has demonstrated that SMAs, when used in primary care as well as in the medical and surgical subspecialties, lead to increased access to care, enhanced quality of care, and improved patient satisfaction. For physicians, the efficiency gains and team support from their participation in SMAs translate into much needed relief and improved career satisfaction.

Stroke Essentials for Primary Care: A Practical Guide is a must-have resource, offering the essential, practical knowledge required to evaluate and treat stroke patients. While an indispensable guide for primary care clinicians, including family practitioners and medical internists who often assume the care of stroke patients without the aid of a neurologist (primarily in underserved areas), the information contained herein is also an invaluable resource to all physicians in training, especially residents and fellows in neurology, cardiology, and surgery, among others. Stroke Essentials for Primary Care: A Practical Guide provides the latest diagnostic and treatment information that allows for greater clinical confidence. Designed to allow easy access to essential information, most chapters include a quick summary of their content and conclusions. Chapters review information on such topics as distinguishing features of presentation, rapid determination of stroke type, prevention strategies, long-term complications, and special topics that may apply to specific populations. Targeted and easy to read, Stroke Essentials for Primary Care: A Practical Guide is an essential resource for all practitioners in primary care medicine and specialty physicians in training.

Rewritten with the new primary care environment in mind, this greatly expanded and updated edition of Child Mental Health in Primary Care extends the structured approach of the first edition to adoelscent mental health. As in the first edition, Primary Child and Adolescent Mental Health covers each problem in a uniform way, offering definitions, assessment outlines, detailed management options and indications for referral. Numerous case examples further illuminate aspects of many conditions. Comprehensive and practical, the forty-eight chapters of Primary Child and Adolescent Mental Health cover the full range of difficulties and disabilities affecting the mental health of children and young people. The book is divided into three volumes, and can either be read from cover to cover or used as a resource to be consulted for guidance on specific problems. This book is vital for all healthcare professionals including general practitioners, health visitors and other staff working in primary care to assess, manage and refer children and adolescents with mental health problems. School medical officers, social workers and educational psychologists, many of whom are in the front line of mental health provision for children and young people, will also find it extremely useful. Reviews of the first edition: 'This very comprehensive and detailed book provides the tools for primary care health professionals not only to assess a child's needs but in many cases also to implement an initial package of care.' JUST FOR NURSES 'I have no reservation in recommending the book to all people working with children and families in any capacity. An important training text for a variety of professions. A very effective text to be used in daily practice for quick reference.' CHILD AND ADOLESCENT MENTAL HEALTH 'This book is well produced and clearly written. A useful book for anyone interested or involved with children.' FAMILY PRACTICE 'I looked through the book again and again but could not find anything missing.' NURSING TIMES

Rewritten with the new primary care environment in mind, this greatly expanded and updated edition of Child Mental Health in Primary Care extends the structured approach of the first edition to adoelscent mental health. As in the first edition, Primary Child and Adolescent Mental Health covers each problem in a uniform way, offering definitions, assessment outlines, detailed management options and indications for referral. Numerous case examples further illuminate aspects of many conditions. Comprehensive and practical, the forty-eight chapters of Primary Child and Adolescent Mental Health cover the full range of difficulties and disabilities affecting the mental health of children and young people. The book is divided into three volumes, and can either be read from cover to cover or used as a resource to be consulted for guidance on specific problems. This book is vital for all healthcare professionals including general practitioners, health visitors and other staff working in primary care to assess, manage and refer children and adolescents with mental health problems. School medical officers, social workers and educational psychologists, many of whom are in the front line of mental health provision for children and young people, will also find it extremely useful. Reviews of the first edition: 'This very comprehensive and detailed book provides the tools for primary care health professionals not only to assess a child's needs but in many cases also to implement an initial package of care.' JUST FOR NURSES 'I have no reservation in recommending the book to all people working with children and families in any capacity. An important training text for a variety of professions. A very effective text to be used in daily practice for quick reference.' CHILD AND ADOLESCENT MENTAL HEALTH 'This book is well produced and clearly written. A useful book for anyone interested or involved with children.' FAMILY PRACTICE 'I looked through the book again and again but could not find anything missing.' NURSING TIMES

People age 65 and older are the fastest growing segment of the U.S. population. In the 2010 census 16% of the population, 50 million people, were age 65 and older. That number is projected to increase to 66 million by the year 2050. Life expectancy has also increased, with recent CDC reports indicating life expectancy at 77.9 years. Age-adjusted death rates have decreased significantly with the largest changes occurring in older patients. Despite these trends, the 10 leading causes of death include several pulmonary etiologies including lung cancer, chronic respiratory diseases, influenza and pneumonia.

Aging and Lung Disease: A Clinical Guide is devoted to understanding the impact of respiratory diseases in older patients. It includes reviews of physiology of the aging lung, allergy and immunology of the aging, as well as sleep changes over the life cycle. There are also comprehensive reviews on specific disease topics including chronic obstructive lung disease, lung cancer, atypical mycobacteria, interstitial lung disease, pulmonary hypertension, pulmonary embolism, obstructive sleep apnea, sleep disorders in older patients. Two chapters focus on unique issues in older patients; HIV and lung transplant. Included also are important chapters on assessing functional and cognitive status and end-of-life issues in older patients with lung disease. In addition to outlining the current state of knowledge, each chapter focuses on special considerations when caring for older patients. Of particular interest to pulmonologists, internists, and gerontologists, other readers, such as pulmonary and geriatric nurse practitioners, as well as clinical researchers interested in both pulmonary and aging issues, will find Aging and Lung Disease: A Clinical Guideto be a vital resource for improving their care of older patients with lung disorders.

"

Rewritten with the new primary care environment in mind, this greatly expanded and updated edition of Child Mental Health in Primary Care extends the structured approach of the first edition to adoelscent mental health. As in the first edition, Primary Child and Adolescent Mental Health covers each problem in a uniform way, offering definitions, assessment outlines, detailed management options and indications for referral. Numerous case examples further illuminate aspects of many conditions. Comprehensive and practical, the forty-eight chapters of Primary Child and Adolescent Mental Health cover the full range of difficulties and disabilities affecting the mental health of children and young people. The book is divided into three volumes, and can either be read from cover to cover or used as a resource to be consulted for guidance on specific problems. This book is vital for all healthcare professionals including general practitioners, health visitors and other staff working in primary care to assess, manage and refer children and adolescents with mental health problems. School medical officers, social workers and educational psychologists, many of whom are in the front line of mental health provision for children and young people, will also find it extremely useful. Reviews of the first edition: 'This very comprehensive and detailed book provides the tools for primary care health professionals not only to assess a child's needs but in many cases also to implement an initial package of care.' JUST FOR NURSES 'I have no reservation in recommending the book to all people working with children and families in any capacity. An important training text for a variety of professions. A very effective text to be used in daily practice for quick reference.' CHILD AND ADOLESCENT MENTAL HEALTH 'This book is well produced and clearly written. A useful book for anyone interested or involved with children.' FAMILY PRACTICE 'I looked through the book again and again but could not find anything missing.' NURSING TIMES

This book has been written with general practitioners primarily in view, describing common paediatric conditions that present in the outpatient clinics and those that require admission to hospital. The book is neither a textbook of paediatrics nor a handbook but is aimed to provide guidelines for the more commonplace conditions. Some aspects therefore, have been dealt with in detail, where felt relevant, while others are omitted on grounds of probable rare encounter. It is hoped that this volume will provide the family practitioner with an insight in the paediatrician's approach to many of the common problems in chifdren and to help him decide on the best course of action to follow. The care of children constitutes a significant and important part of a family doctor's work and practitioners are keen to promote optional care in all circumstances. It is hoped that the endeavours of this book will go in some small way to help put across the practitioner's approach.

Polycyclic hydrocarbons are of interest in many fields of science: theoretical chemistry, physical chemistry, organic chemistry, dyestuff chemistry and biology. With regard to the latter, I am indebted to Dr. Regina Schoental of the Medical Research Council for the review in this present work of carcinogenesis by polycyclic hydrocarbons. This book is designed to present the facts in a simple and clear order and to derive empirical rules from them, but it does not present a com prehensive theory about polycyclic hydrocarbons. An attempt is made instead to extend classical symbolism into modern structural chemistry. Thus extensive use is made of Robinson's aromatic sextet, which is applied in an uncompromising and strict way. This quasi-classical attempt is encouraged further by such completely unexpected dis coveries as those of Dewar benzene and of the electronic asymmetry of formally symmetric hydrocarbons. How difficult it is to break away from any established way of thinking has been admirably expressed by Kekule ("Organische Chemie," 1861, Part 1, page 4, translated from the German): "All our ideas are based, to an extent much greater than we ordinarily believe, on those of our predecessors. Our accumulated experience, the notions of which our training has accustomed us to, of whatever kind they have been, influence the course of our thoughts far more than we are willing to admit; only too frequently the following of our regularly used, well trodden way of thinking leads us to overlook the simplest of correlations."

Often, information in review books can raise as many questions as it answers. This interferes with the study process, because the learner must either look up additional information or skip ahead without truly comprehending what he or she has read. As an alternative, Pediatric Infectious Disease: A Practically Painless Review presents bite-size chunks of information that can be read and processed rapidly, helping learners to stay active while studying and to pick up new information the first time they read it. This book's question and answer format allows for self-testing or study with a partner or a group. The format also facilitates dipping into the book during a few minutes of downtime at the hospital or office. Pediatric Infectious Disease: A Practically Painless Review is a quick and easy way to master tricky infectious disease topics and is suitable for those studying for the pediatric board exam, practicing physicians brushing up their skills, and any busy clinician who wants to learn more about this topic while on the go.

Although distant metastases are the most dreaded situation in the evolution of cancer of every organ, the medical literature has surprisingly given little attention to the anatomical relationship between the primary tumor and metastasic sites. Only risk factors, treatment possibilities, and survival results are extensively examined.
Stimulated by the occurrence in his practice of some puzzling and unexpected metastases, the author reviewed more than 12,000 references. He looked for anatomical relationships highlighting the relation between the location of the primary tumors and the particular patterns of metastasis observed. It would seem that the pathways and flows' are apparently a more decisive factor in the implantation of the metastases than the seed and soil' properties of the cancer cells and the metastatic site.
Aided by his colleague Dr. T. Geukens, M.D., the author includes original anatomical drawings, illustrating the sometimes unexpected pathways the cancer cells follow in order to reach the organs where they will become lodged and give rise to metastatic tumors. The subject has apparently not been exhausted in the literature and several ideas are given for further research.

There is a world-wide epidemic on obesity. This epidemic is driving the immense proportions of Type 2 diabetes across the globe. While there are numerous therapies for treating Type 2 diabetes, the most effective therapy is prevention. Prevention of Type 2 diabetes can be achieved properly by simultaneous prevention of obesity. Prediabetes, or metabolic syndrome, is the period between simple obesity and diabetes, and this critical period needs to be identified in a more consistent and systematic manner by clinicians worldwide. Clinical trials have indicated that diabetes prevention can be achieved by lifestyle changes and also by certain medications, though none are yet approved for use in prevention. On the other hand, there are funding agencies such as the NIH, CDC, and State Institutions that are interested in studying the prevention paradigms in different communities and ethnic minorities who are most prone to this epidemic. For these reasons, this title by renowned physician-scientist Derek LeRoith is both timely and vitally important for academic physicians, practitioners, allied health care providers, analysts, community activists, and all others interested in this increasing epidemic. This book provides a unique and comprehensive synthesis of the prevention and early diagnosis of Type 2 Diabetes, focusing on identifying risk factors and then moving into topics that address how to prevent their progression to full-blown diabetes. The difficult task of changing patients' behavior is given special emphasis. The chapters in this practical volume are written by a wide range of international experts, reflecting the editor's distinguished, internationally renowned career. The volume is organized in eight sections: an introduction to the overall issue of prevention, definitions of values based on ADA guidelines, pathophysiology, discussion of a range of interventional trials regarding prevention, and an overview of state-of-the-art clinical management approaches. Comprehensive and timely, Prevention of Type 2 Diabetes: From Science to Therapy is an essential reference for those treating and researching Type 2 Diabetes.

Sexually Transmitted Diseases: A Guide for Primary Care, second edition, covers the diagnosis and treatment of STDs and other information critical to patient care and reflects the last five years of significant changes in information about STDs. Updated to reflect the 2010 Center for Disease Control Guidelines on the Treatment of STDs, this book also contains new information about: -the epidemiology of herpes virus infections -expedited partner therapy -changes in recommendations for HPV vaccination for men -changes in resistance patterns for antimicrobial therapy for gonorrhea and chlamydia -treatment recommendations for bacterial vaginosis -treatment recommendations for genital warts In order to better meet clinician needs, the book has been streamlined to quickly convey critical, evidence-based information. Whether seeking information about particular conditions (including HPV, herpes, syphilis, trichomoniasis, HIV and AIDS, and others) or related patient issues (such as STD exposure evaluation and evaluation of sexual assault), Sexually Transmitted Diseases, second edition, contains the knowledge doctors need in a friendly, to-the-point format.

Amytrophic Lateral Sclerosis (ALS or motor neurone disease) is a progressive neurodegenerative disease that can cause profound suffering for both the patient and their family. Whilst new treatments for ALS are being developed, these are not curative and offer only the potential to slow its progression. Palliative care must therefore be integral to the clinical approach to the disease. Palliative Care in Amyotrophic Lateral Sclerosis: From diagnosis to bereavement reflects the wide scope of this care; it must cover not just the terminal phase, but support the patient and their family from the onset of the disease. Both the multidisciplinary palliative care team and the neurology team are essential in providing a high standard of care and allowing quality of life (both patient and carer) to be maintained. Clear guidelines are provided to address care throughout the disease process. Control of symptoms is covered alongside the psychosocial care of patients and their families. Case studies are used to emphasise the complexity of the care needs and involvement of the patient and family, culminating in discussion of bereavement. Different models of care are explored, and this new edition utilizes the increase in both the evidence-base and available literature on the subject. New topics discussed include complementary therapies, personal and family experiences of ALS, new genetics research, and updated guidelines for patient care, to ensure this new edition remains the essential guide to palliative care in ALS.

The first edition of Infection Prevention reviewed evolving areas in infection prevention on topics including contact precautions, technology implementation, specific infections, and care in various settings. It summarized the current data on infection prevention, presents controversies on the various topics, and includes recommendations for patient safety. Addressing hot topics such as MRSA, C. difficile vaccination, mandatory flu vaccines, and CLABSI, this is the only text to include prevention and control overviews across a range of infection issues. Written by experts in the field, this successor edition will update current chapters on the most cutting-edge models of care on emerging and evolving topics in infectious diseases. It will also include new material and chapters on high-level disinfection, diagnostic test stewardship, unique pathogens units, outpatient antibiotic stewardship, outpatient antibiotic therapy, as well as a chapter on infection prevention metrics: how much can we prevent healthcare associated infections and how hard should we try. The second edition of Infection Prevention: New Perspectives and Controversies is a valuable resource for infection prevention professionals, healthcare quality and safety professionals, caring for patients in in- and outpatient settings.

Featuring more than 85 vibrant, fully annotated charts-19 new to this edition-this updated fourth edition of Diseases and Disorders: The World's Best Anatomical Charts is a perfect quick reference for medical and nursing students and an ideal visual aid for patient education. Printed on oversized, cardstock pages and compiled in a convenient, 10" x 12" spiral-bound volume with a laminated cover, these full-color charts created by some of the world's best medical illustrators illustrate and explain common diseases and disorders of the brain; heart; GI tract; eye and ear; endocrine, muscular, skeletal, reproductive, and respiratory systems; dental diseases; infectious diseases; healthy lifestyle issues; and cancer. Nineteen new charts cover Schizophrenia, Ovarian Cancer, Multiple Myeloma, Liver Cancer, Pancreatic Cancer, Prostate Cancer, Heart Failure, Peripheral Artery Disease, UC/Crohn's Disease, Irritable Bowel Syndrome, Age-Related Macular Degeneration, and more. All charts have been reviewed and updated. Medical terminology and easy-to-understand supporting text are printed directly on each chart. Every chart depicts an aspect of human anatomy, physiology, and disease presented in a clear, visual presentation. The book is ideal as a review resource or quick reference for studying human anatomy or for patient consultation and education.

A large number of doctors take the MRCP examination every year; unfortunately the highest percentage of failure occurs in the Part II examination, particularly in the clinical part. The candidates are expected to elicit the clinical features correctly and quickly; they are closely scrutinized by the examiners and therefore there is a certain amount of stress involved on the part of the candidates. In addition, they are also expected to identify features shown in the illustrations correctly and within the limited time, which causes additional stress. Therefore continued practice is the only way to improve clinical acumen and confidence to enhance the chance of success. The book is designed for these candidates bearing in mind their particular requirements. Considerable information is gathered not only from the doctors who have already passed this examination but also from those who have been currently sitting the examination. The author has been taking part in teaching junior doctors for the last 22 years; most of his registrars passed the examination while working for him. The book contains a large number of clinical photographs, X-rays (including CT scans), ECGs, haematology and histology slides which the candidates are likely to encounter in the examination. Every effort has been made to fulfil most of the requirements of the MRCP examination but at the same time the book has been kept to a reasonable size.

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. vii 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."

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. vii 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.

Often, information in review books can raise as many questions as it answers. This interferes with the study process, because the learner must either look up additional information or skip ahead without truly comprehending what he or she has read. As an alternative, "Pediatric Development and Neonatology: A Practically Painless Review" presents bite-sized chunks of information that can be read and processed rapidly, helping learners to stay active while studying tounderstand and processnew information the first time they read it. This book's question and answer format allows for self-testing or study with a partner or a group. The format also facilitates dipping into the book during a few minutes of downtime at the hospital or office. "Pediatric Development and Neonatology: A Practically Painless Review" is a quick and easy way to master these tricky topics and is suitable for those studying for the pediatric board exam, practicing physicians brushing up on their skills, medical students and pediatric residents doing rotations, and any busy clinician who wants to learn more about these topics while on the go. "

Motility is a fundamental property of living systems, from the cytoplasmic streaming of unicellular organisms to the most highly differentiated and de veloped contractile system of higher organisms, striated muscle. Although of motility have a long and in scientific investigations into the mechanisms teresting history, the knowledge of molecular processes, especially in the area of regulation of control of motility, has been developing at an ever more rapid pace with the utilization of multidisciplinary approaches from physiology, cell biology, genetics, biochemistry, pharmacology, and biophysics. In Volume 3, Cell and Muscle Motility continues the same philosophy as that of the preceding volumes. The essays are meant to focus on topics of current interest, to be critical rather than exhaustive, and to indicate the current trends of research efforts. The series is intended to foster an in terchange of concepts among various workers in a variety of disciplines and to serve as a reference for students and workers who wish to familiarize them selves with the most current progress in motility. Robert M. Dowben Jerry W. Shay Dallas vii Contents Chapter 1 Intermediate Filaments in Striated Muscle: A Review of Structural Studies in Embryonic and Adult Skelttal and Cardiac Muscle Maureen C. Price and Joseph W. Sanger 1. Introduction ................................................ ."

Acupuncture for Pain Management is intended as the premier resource for learning the fundamentals of the art of medical acupuncture. Edited by top pain medicine specialists at Harvard and UCLA, and based on their popular annual workshop at the American Society for Anesthesiologists, the book is the perfect synthesis of Western and Chinese medicine. Anesthesiologists, pain medicine specialists, primary care physicians, osteopaths, neurologists, psychiatrists, physical medicine and rehabilitation specialists, and other health professionals looking to add acupuncture to their repertoire will benefit from the concise and practical approach of the book. Features: Each individual meridian discussed in detail Acupuncture for 25 clinical conditions, including headache, menstrual pain, low back pain, insomnia, and more Aimed at acupuncturists as well as practitioners who want to add acupuncture to their clinical armamentarium

The US healthcare system faces numerous difficulties: uncontrolled increases in costs; major access problems; doctor shortages; closing practices; inefficiencies; decreasing revenues; shrinking bottom lines; large numbers of uninsured and underinsured patients; and the upcoming increased demands in service posed by the Affordable Care Act. As a result, many physicians and health care organications are turning to group visits to address these problems. While Dr. Noffsinger's textbook Running Group Visits In Your Practice is the cornerstone reference on designing, implementing and running shared medical appointments (SMAs) in one's practice, it lacks the simplicity and practicality that clinicians are looking for to start their own SMA programs. The ABCs of Group Visits is a practical, streamlined and step-by-step guide focused on the implementation aspects of group visits.Healthcare professionals at every level are looking for alternate ways to deliver high quality care at lower cost, and it is clear to many that group visits provide a care delivery model that will address many of today's critical challenges. The ABCs of Group Visits quickly provides a solution for your busy practice."

Changes in health care are at a breakneck pace. Regardless of the many changes we have collectively experienced, delivering health care has been, is, and will continue to be an enormously information-intensive process. Whether caring for a patient or a population, whether managing a clinic or a continuum, we are in a knowledge exchange business. A major task for our industry, and the task for chief information officers (CIOs), is to find and apply improved strategies and technologies for managing healthcare information. In a fiercely competitive healthcare marketplace, the pressures to suc ceed in this undertaking-and the rewards associated with success-are enormous. While the task is still daunting, we can all be encouraged by progress being made in information management. There are documented successes throughout health care, and there is growing recognition by healthcare chief executive officers and boards that information strategies, and their deployment, are essential to organizational efficiency, quite pos sibly organizational survival.