Patients who are confident of physicians' intellectual and technical abilities are sometimes not convinced of their professional behavior. Systemic and anecdotal cases of physician misconduct, conflict of interest, and self-interest abound. Many have even come to mistrust physicians as patient advocates. How can patients trust the intellectual and technical aspects of medical care, but not the professional? In order to enhance and promote professionalism in medicine, one should expect it, encourage it, and evaluate it. By measuring their own professional behavior, physicians can provide the kind of transparency with which they can regain the trust of patients and society.
Not only patients, but also institutions which accredit organizations have demanded accountability of physicians in their professional behavior. While there has been much lament and a few strong proposals for improving professionalism, no single reliable and valid measure of the success of these proposals exists. This book is a theory-to-practice text focused on ways to evaluate professional behavior written by leaders in the field of medical education and assessment.

This volume is a call to re-examine assumptions about what care is and how it be practised. Rather than another demand for radical reform, it makes the case for thinking clearly and critically. It urges people living with HIV to become full partners in designing and implementing their own care and for caregivers to accept them in this role.

Quantified Societal Risk and Policy Making is the result of an international workshop on societal risk organized by the Dutch Ministry for Transport, Public Works and Water Management with additional financial support from the Directorate for Transportation (DG VII) of the European Union. Managing risks, whether there is a strong man-made or natural component, basically means assessing alternative options under uncertainty. The possibility of multiple fatalities is one of the factors that can vary between options. This volume is concerned with one particular type of risk - the risk of death of a number of people in one accident - and with one particular tool - probabilistic risk analysis - as they are developing in various domains of society nowadays. Generally, this risk is labelled societal risk. This book shows how such comparisons are shaped at present in various hazard domains, such as: flood protection location and physical planning of industry transportation of chemicals, and prevention of aircraft accidents. It examines how to represent aggregate risks from major hazards in ways that can be handled by policy-makers. The purpose of the book is to increase the awareness of societal risk, disseminate available knowledge of existing approaches, and exchange information on applications from various domains. Quantified Societal Risk and Policy Making should be of interest to all those professionally concerned with defining the optimal separation between hazardous activities and equally desirable developments nearby.

An engaging history of the role that George Washington, Thomas Jefferson, and Benjamin Franklin played in the origins of public health in America Before the advent of modern antibiotics, one's life could be abruptly shattered by contagion and death, and debility from infectious diseases and epidemics was commonplace for early Americans, regardless of social status. Concerns over health affected the founding fathers and their families as it did slaves, merchants, immigrants, and everyone else in North America. As both victims of illness and national leaders, the Founders occupied a unique position regarding the development of public health in America. Revolutionary Medicine refocuses the study of the lives of George and Martha Washington, Benjamin Franklin, Thomas Jefferson, John and Abigail Adams, and James and Dolley Madison away from the usual lens of politics to the unique perspective of sickness, health, and medicine in their era. For the founders, republican ideals fostered a reciprocal connection between individual health and the "health" of the nation. Studying the encounters of these American founders with illness and disease, as well as their viewpoints about good health, not only provides us with a richer and more nuanced insight into their lives, but also opens a window into the practice of medicine in the eighteenth century, which is at once intimate, personal, and first hand. Perhaps most importantly, today's American public health initiatives have their roots in the work of America's founders, for they recognized early on that government had compelling reasons to shoulder some new responsibilities with respect to ensuring the health and well-being of its citizenry. The state of medicine and public healthcare today is still a work in progress, but these founders played a significant role in beginning the conversation that shaped the contours of its development.

This book focuses on the risks that climate change poses for the health sector. It discusses the current vulnerabilities to climate-sensitive diseases, the resultant mortality and morbidity in human populations, the projected risks in connection with increasing global warming, and the options for tackling the adverse impacts of climate change. Adapting to climate change so as to effectively address the risks for and adverse impacts on the health sector requires an in-depth understanding of current deficits in health sector preparedness for climate-sensitive illnesses, as well as future plans and programs for increasing adaptive capacity and building resilience. The book situates climate and health adaptation concerns in the broader context of developing countries, providing insights that can be useful for other countries as well, helping them further their health adaptation efforts. In India, poverty and inadequate access to basic water, health and sanitation services combine with climate-related events to adversely impact health outcomes. Three case studies on the occurrence of heat stress, flooding, and extreme cyclonic events in India are presented along with a critical assessment of the level of preparedness and capacity of healthcare facilities to respond to the threats posed by climate change. The book presents the key challenges faced in reducing the risks posed to the health sector by climatic factors, and highlights the most important opportunities for promoting resilience and adaptation to achieve sustainable development. Dr. Dasgupta's excellent book reviews the health risks of climate change, outlines an operational framework for health adaptation, and describes the socioeconomic context for adaptation in India. - Kristie L. EbiProfessor, Departments of Global Health, and Environmental and Occupational Health Sciences, University of Washington, USA This pioneering work contributes to an the understanding of the preparedness in India to manage health risks from such (climate) change on the basis of detailed data analysis, both from large national surveys and contextualized field based surveys.- Kanchan ChopraFormer Director and Professor, Institute of Economic Growth, New Delhi, India

The last time Clancy Martin tried to kill himself was in his basement with a dog leash. He didn’t write a note. How Not to Kill Yourself is an affirmation of life by someone who has tried to end it multiple times. It’s about standing in your bathroom every morning, gearing yourself up to die. It’s about choosing to go on living anyway. In an unflinching account of his darkest moments, Clancy Martin makes the case against suicide, drawing on the work of philosophers from Seneca to Jean Améry. Through critical inquiry and practical steps, we might yet answer our existential despair more freely – and with a little more creativity.

This comprehensive review provides a systematic, unbiased analysis, critique and summary of the available literature and generates novel clinical decision-making algorithms which can aid clinicians and scientists in practice management and research development. Potential mechanisms for the identified drug interactions are deduced from available preclinical and in vitro data which are interpreted in the context of the in vivo findings. Current limitations and gaps in the literature are summarized, and potential future research directions / experimentations are also suggested. In addition to the main objective to review the available clinical pharmacokinetic and pharmacodynamic drug interactions associated with WHO-recommended antimalarial drugs on the market today (i.e. chloroquine, amodiaquine, sulfadoxine, pyrimethamine, mefloquine, artemisinin, artemether, artesunate, dihydroartemisinin, artemotil, lumefantrine, primaquine, atovaquone, proguanil, piperaquine and quinine), this book also provides succinct chapter summaries on the epidemiology of malaria infection, diagnosis and therapeutics, in vivo pharmacology and chemistry, preclinical pharmacology, in vitro pharmacodynamics, in vitro reaction phenotyping, and in vitro drug-drug interaction data associated with the identified antimalarial drugs.

-Rick Thomas brings his 30 years experience in the field to the text making it very applied and accessible.

-Lots of boxed material.

-"Recommended" purchase for all librarians as reviewed in the June 2004 issue of CHOICE.

People-centred public health examines how members of the public can be involved in delivering health improvement, primarily as volunteers or lay health workers. With a foreword by Professor Sir Michael Marmot and Dr Mike Grady, this timely book draws on a major study of lay engagement in public health, using case studies and real life examples to provide a comprehensive and accessible overview of policy, practice and research in this area. In an economic and political climate where there is renewed interest in the role of the citizen, the authors challenge old orthodoxies in public health and build a coherent argument for radical change in the way public agencies support lay action. The book is aimed at readers with an academic or professional interest in public health and/or community involvement, including practitioners and managers within public services and the voluntary sector, and post-graduate and undergraduate students studying public health, health promotion, public sector management, social policy and community work.

The brief, successful Gulf War resulted in few casualties, but there were still recognizable "pockets of trauma." This study examines the Mental Health Services available in the theater of operations, the preparations made to train the soldiers for the stress of combat, and details of how they coped with the experience of combat. It assesses the Gulf War in terms of mental health. Some attention is also given to the phenomenon named "Gulf War Syndrome." The authors conclude that United States Military Forces were not prepared for the mental health requirements of combat.

There is growing awareness of the crucial relationship between health and development. But while the importance of this relationship may be obvious, scholars are still debating about the nature of it, and different assumptions on this crucial relationship have an impact on the developmental agenda of international organizations and their modus operandi at country level. Is good health a consequence or a pre-requisite of country development? How does the long term impact of different diseases affect economic development?" Health and Developmen"t will address these and other questions, bringing the reader to a closer understanding of the role of international organizations in the health arena.

What is the relationship between social science research and public health policy, particularly in the developing world? This question is at the heart of this collection of essays drawn from Rockefeller Foundation-sponsored conferences at Harvard University. The book examines the theoretical impact of social science research as well as specific case studies of successful applied research.

Beginning with a section on broad issues and the conceptualization of behavioral change, the volume then examines the anti-smoking movement in the United States; measures to prevent and control HIV infection in the United Kingdom, Sweden, and the United States; anti-malaria measures; and the application of dietary management and lot quality assurance sampling to public health issues in Peru. The volume concludes with a section re-examining ways social science research can have an impact on improving public health. Scholars and researchers as well as policy makers involved with health research and international development will find this collection particularly valuable.

Cogent, concise, and up-to-date, this comprehensive and multidisciplinary one-volume encyclopedia written by experts from many fields covers all the major aspects of home health care for the elderly in America today. Patients, health care providers, and concerned family members, as well as students, teachers, practitioners, and policymakers in the fields of medicine, nursing, health care, social work, psychology and psychiatry, therapy and rehabilitation, sociology, public policy, and public administration will find this information important to their work in caring for the elderly. The clearly written articles discuss common problems, home care measures, trends, key issues, groups, and agencies. The entries point to sources for further reading. An appendix linking related topics, descriptions of 37 key organizations with addresses, a lengthy bibliography, and a full index make this basic reference easily accessible for broad audiences of readers.

In the early 1980s the transtheoretical model of change was still in its infancy. Seminal publications were just appearing, but the model already seemed to hold such promise that we made it the organizing theme for the Third International Conference on Treatment of Addictive Behaviors (ICTAB-3), which convened in Scotland in 1984. That meeting gave rise to the first edition of this volume (Miller & Heather, 1986), which focused on processes involved in moving people from one stage to the next. With the volume still in print more than a decade later, we were approached by Plenum Press with the idea of preparing this second edition. We were, obvi ously, persuaded that there was merit to the idea. Since 1986 the work of Pro chaska and DiClemente has grown exponentially in popularity and influence. In Britain and the Americas, it is now unusual to find an addiction professional who has not at least heard about the stages of change, and more sophisticated applica tions of the transtheoretical model are spreading through health care systems and well beyond. The model has influenced professional training, health care delivery, and the design of many studies including a number of large clinical trials."

Future Risks and Risk Management provides a broad perspective on risk, including basic philosophical issues concerned with values, psychological issues, such as the perception of risk, the factors that generate risks in current and future technological and social systems, including both technical and organizational factors. No other volume adopts this broad perspective. Future Risks and Risk Management will be useful in a variety of contexts, both for teaching and as a source book for the risk professional needing to be informed of the broader issues in the field.

Accepting that there is no one-size-fits-all approach to controlling drinking, the latest edition of this bestselling book will help you assess your drinking and determine whether moderation or abstinence is the best path for you. For decades, the standard treatment for people struggling with alcohol consumption has focused on convincing them to admit that they are an alcoholic, to stop drinking entirely, and to enter into a program, most commonly Alcoholics Anonymous. But in his more than thirty-five-year career as an addiction specialist working with people who want to change their drinking habits, Michael S. Levy has found that the routes to behavioral change actually vary. And although abstinence is the successful route for many people, others can moderate their drinking on their own or with professional help. In this practical, effective, and compassionate book, Levy helps people take control of their alcohol problem by teaching them how to think about and address their drinking habits. Beginning with a set of self-assessments that reveal whether the reader's use of alcohol is creating problems, Levy explains the causes of problem drinking, discusses the growing recognition of the various ways an alcohol use disorder can show itself, and talks about why it is so difficult to change. Offering advice for choosing between moderating your drinking or abstaining altogether, he also touches on coping with slipups, fighting helplessness and the fear of failure, and knowing when moderation is not achievable. The book is unique in that instead of telling people what they need to do, it meets people at their stage of change and level of readiness to change and helps them decide for themselves what they need to do. Drawing on the latest scientific evidence, this new edition includes * a chapter on the concept of self-medication-a useful but at times overused idea; * a chapter on the concurrent use of drugs (particularly cannabis) during recovery; * an exploration of modern strategies for dealing with drinking, including technology (apps that count drinks, for example) and medications that curb alcohol consumption; * reflections on the use of stigma; * communication strategies for individuals seeking to share their struggle with others; * an exploration of common triggers; * additional worksheets and tips to achieve success; * further material about self-help programs; and * insights about the dark side of addiction treatment. Ultimately, Take Control of Your Drinking empowers people to tackle their drinking problem and gives them the freedom to do so in a way that fits with their own lifestyle and values. This book is useful for anyone who may find that they are drinking too much, for the loved ones of such people, and for clinicians who want to broaden their skills when working with people who struggle with alcohol.

To have a clear picture of developments in public financial management, a multidimensional perspective of the field is needed, since governments--unlike for-profit organizations-- serve multiple and often conflicting interests. This book provides this dynamic approach by integrating insights from economics, business, and political science. Written by some of the leading scholars in the field, this collection presents eleven chapters that run the gamut of public financial management issues. Topics include: Transaction costs in contractual relationships; Uncertain conditions and probability assessment in the bond market; Rational choice and the institutional framework in public investment decision; E-Government financial management models; Budget balance as the building block of public financial strategy. Together the contributors present a robust framework for understanding and analyzing financial decision making in the public sector.

The motivation and inspiration for this book come directly from expe- ences with clients during the years that I practiced HIV-related law at the Legal Aid Society of San Diego, Inc. The issues discussed in this work reflect issues that arose on a recurring basis with clients participating in HIV research studies, with investigators calling for guidance on the legal implications of particular aspects of their proposed studies, and with research institutions and health care facilities struggling to make sense of legal maneuvers aimed at obtaining the records of their HIV-infected patients. It is impossible to thank each of these persons individually for their provocative questions and their insights. The discussion of ethical and legal issues relating to the design of clinical trials reflects questions raised during discussions with Donald J. Slymen, Ph.D. Don was one of the first researchers, in my realm of experience, to pay close attention to ethical concerns, and I am greatly appreciative of his contribution to both my professional growth and the development of various scenarios discussed in this text. The portions of this text dealing with confidentiality are the result of many hours of thoughtful discussion and analysis with Penn Lerblance, J.D., now deceased and still missed. Penn and I often participated together as presenters of in-service training programs for health prof- sionals. Penn addressed discrimination, and I focused on confidentiality.

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

Sickle cell and thalassaemia are among the world's most common genetic conditions. They are especially common in Africa, Brazil, the Caribbean, the Middle East and Asia. They affect all ethnic groups but they particularly impact on minority ethnic groups in North America, Europe and Australasia. Much research has focused on clinical, laboratory and genetic studies of these conditions. Through a wide-ranging selection of readings based on social scientific research into sickle cell and thalassaemia, this book seeks to redress this imbalance. This is important as, through an examination of the different social, economic and cultural contexts of the lives of people living with sickle cell or thalassaemia, the contributors demonstrate that people are more than the sum of their genes and that their life experiences are rarely derived solely from the clinical severity of their condition but depend on the social context of their lives. Genetics and Global Public Health presents a new concluding chapter which highlights the critical nature of social science research for sickle cell and thalassaemia communities, providing key insights into the social contexts of human behaviour and analysing how societal arrangements could change to assist people living with either condition. It will be of great interest to postgraduate and research students as well as professionals working in the field of public health. This book was originally published as a special issue of the journal Ethnicity and Health.