The possibility that nutrition in early life could influence propensity to adult disease is of great concern to public health. Extensive research carried out in pregnant women, in breastfeeding women and in infants strongly suggests that nutrition in early life has major effects on long-term health and well-being. Health problems such as hypertension, tendency to diabetes, obesity, blood lipids, vascular disease, bone health, behaviour and learning and longevity may be a ~imprinteda (TM) during early life. This process is defined as a ~programminga (TM) whereby a nutritional stimulus operating at a critical, sensitive period of pre and postnatal life imprints permanent effects on the structure, physiology and metabolism.

For this reason, academics and industry set-up the EC supported Scientific Workshop -Early Nutrition and its Later Consequences: New Opportunities. The prime objective of the Workshop was to generate a sound exchange of the latest scientific developments within the field of early nutrition to look for opportunities for new preventive health concepts. Further, a closer look was taken at the development of food applications which could provide (future) mothers and infants with improved nutrition that will ultimately lead to better future health. The Workshop was organised by the Dept. of Pediatrics, University of Munich, Germany in collaboration with the Danone Institutes and the Infant Nutrition Cluster, a collaboration of three large research projects funded by the EU.

Many of the contributors have important roles to play in a new EC supported integrated project: Early nutrition programming of adult health (EARNEST) which will take place between 2005 and2010 and will involve more than 40 research centres. Further Workshops on the same theme are planned as part of this project.

This volume addresses the overlapping aspects of the fields of genomics, obesity and (non-) medical ethics. It is unique in its examination of the implications of genomics for obesity from an ethical perspective. Genomics covers the sciences and technologies involved in the pathways that DNA takes until the organism is completely built and sustained: the range of genes (DNA), transcriptor factors, enhancers, promoters, RNA (copy of DNA), proteins, metabolism of cell, cellular interactions, organisms. Genomics offers a holistic approach, which, when applied to obesity, can have surprising and disturbing implications for the existing networks tackling this phenomenon. The ethical concerns and consideration presented are inspired by the interaction between the procedural perspective emphasizing the necessity of consultative and participatory organizational relationships in the new gray zones between medicine and food, and the substantive perspective that both cherishes individual autonomy and embeds it in socio-cultural contexts.

This volume explores issues connected with quality, planning of services and access concerns especially as linked with providers of care, health care institutions, and patients. Changes have continued to occur within the field but have been led by overall marketplace trends. Papers in this volume are presented in four parts covering changing models of health care. In Part I topics come from a broad perspective to include: development of newer models of care, more traditional areas such as the medical profession and the patient or the hospital and the patient, the changes that alternative medicine brings to issues of quality of care and access and planning, and of citizen participation in health planning. Part II deals with federal programs such as Medicare and Medicaid and access and quality issues within those programs. Part III covers the challenges of planning for long-term care needs and services. And Part IV explores other aspects of the changing health care delivery system: changes in nursing, midwifery, and rural health care and provides linkages to quality, access, and planning issues. This excellent work helps the reader to think more carefully and more creatively about issues of quality of care, access to care, and planning for services.

The editors of Stress, Trauma, and Substance Use have gathered a collection of innovative chapters written by cutting edge researchers that depict both the breadth of the relationships between stress, trauma, and substance use, as well as how closely these phenomena are all too often linked. Individually, the chapters in this volume present innovative conceptual models, original research findings, and recommendations to service providers that are applicable to a diverse body of individuals affected by a wide variety of stressful and/or traumatic experiences, such as HIV/AIDS, incarceration, homelessness, sexual assault, and other forms of trauma and violence in addition to substance use. Taken as a whole, the content of this text provides a window into the true nature of the multi-layered and interconnected relationship between stress, trauma, and substance use. The untangling of these relationships holds great promise for continued research that develops a better understanding of these phenomena and ultimately improves the lives of individuals touched by these experiences. This book was previously published as a special issue of Stress, Trauma, and Crisis: An International Journal.

Research in Community and Mental Health

A study of social assumptions, specific events, medical categories, distinct groups and ideas of control in health research. This book examines presumptions about gender, race and age with particular reference to the "biological clock" and notions of "civilized countries" and "primitive races." The volume is divided into three sections. The first section spells out the author's new theory of medicalism - a co-emergent process of health care which puts health-care consumers on an equal causal footing with health-care providers. The second section takes up each of the issues of age, sex and race in turn and looks at the particular consequences of these assumptions for specific health events. With age, fertility is the focus. With sex and race, the focus is on cancer. The third section deals with action both in terms of doing better research and making informed choices about health care.

Documenting the daily efforts of African Americans to protect their community against highly oppressive conditions, this ground-breaking volume chronicles the unique experiences of black women that place them at higher risk for morbidity and mortality - especially during pregnancy. Stress and Resilience: The Social Context of Reproduction in Central Harlem examines the processes through which economic circumstances, environmental issues, and social conditions create situations that expose African American women to stress and chronic strain. Detailing the individual and community assets and strategies used to address these conditions, this volume provides a model methodology for translating research into public health and social action. Based on interactive community partnered research, Stress and Resilience: The Social Context of Reproduction in Central Harlem Facilitates more exact hypotheses about the relationship between risk factors, protective factors and reproductive health; Furnishes a better understanding of chronic disease patterns and suggests more effective interventions to reduce rates of infant mortality; Incorporates the voices of the community and of women themselves through their own words and actions; Sheds light on epidemiologic research and intervention protocols; Examines the social context in which reproductive behaviors are practiced; Provides a holistic framework in which to understand infant mortality; And more. Filling a large gap in the literature on the social context of reproduction this important monograph offers indispensable information for public health researchers, program planners, anthropologists, sociologists, urban planners, medical providers, policy makers, and private funders.

This wide-ranging study reviews the state of public health worldwide and presents informed recommendations for real-world solutions. Identifying the most urgent challenges in the field, from better understanding the causes of acute diseases and chronic conditions to reducing health inequities, it reports on cost-effective, science-based, ethically sound interventions. Chapters demonstrate bedrock skills essential to developing best practices, including flexible thinking for entrenched problems, conducting health impact assessments, and working with decision-makers. From these current findings come long-term practice and policy goals for preventing disease, promoting health, and improving quality of life, both locally and globally. A sampling of the topics covered: * Health trends of communicable diseases. * Epidemiology of cancer and principles of prevention. * Respiratory diseases and health disorders related to indoor and outdoor air pollution. * Public health gerontology and active aging. * Migrant and ethnic minority health. * Public health genomics. A Systematic Review of Key Issues in Public Health offers graduate students in the discipline a firm grasp on the field as it presently stands, and a clear set of directions for its potential future.

This book provides an account of the emergence, nature and impact of armed youth gangs in an East London Borough over the last decade. It describes the challenges these armed young men and women pose to their communities, those charged with preventing crime and those struggling to vouchsafe 'community safety'. While the focus of the book is 'local', the processes it outlines and the effects it chronicles have both a national and international relevance. It argues that the main reason behind the emergence of the armed youth gang has been the coalesence of two previously discreet socially deviant groups; the rowdy, episodically criminal, adolescent peer group on the one hand and the locally-based organized criminal network on the other. The book analyses the impact of the globalisation of the drugs trade and the consequent shift in the focus of local organized crime from the 'blag' to the 'business'. It also discusses how socio-economic and cultural factors, as well as family and neighbourhood histories and loyalties and localized racial antagonisms all play their part in the emergence of the armed youth gang.

In most European countries there is a growing imbalance between the supply and demand of medical manpower. Though many national gov ernments, international organizations and scientific institutes, and also, with a view from a different angle, doctors associations recognize this problem, it appears to be very difficult to bring all people concerned with this problem together in order to find a solution. On this occasion, the initiative to arrange an international meeting was taken by the junior-doctors associations of The Netherlands and Sweden with the organizational support of the Faculty of Medicine of University Limburg, Maastricht, The Netherlands, and under the auspices of the Permanent Working Group of European Junior Hospital Doctors. The symposium should be considered as a step in a series of continuing activities within the field of health manpower planning. The Organization for Economic Cooperation and Development (OECD) organized a working symposium on Long-Range Forecasting and Planning in 1968 (8ellaglio, Italy), followed by the Expert Committee ofthe OECD which produced the 'New Directives in Education for Changing Health Care System' (OECD CERI report, Paris 1975). The Dutch ministries of Education and Sciences and of Health and Environmental Protection organized a seminar on 'Cooperation of Health Care and Education at Regional Level, Responsibilities and Cost Alloca tion' (1978, Noordwijkerhout, The Netherlands). Following this, the Dutch Association of Junior Hospital Doctors (LVAG) organized a national con ference 'Today a consultant in training, tomorrow an unemployed special ist?' (1980, Utrecht, The Netherlands)."

Health communication research examines the role of communication in health professional/client relationships and in promoting patient adherence, the flow of information within and between health organizations, the design and effectiveness of health information for various audiences and the planning and evaluation of health care policy. Other important areas treated in this book are cultural and social factors influencing health communication, ethical issues effecting communication, and education in communication within medical schools. Medical students, physicians, policy makers, students and faculty in communications and sociology, as well as social services professionals should find this reference an important tool.

This volume of "Research in Community and Mental Health" is divided into two main sections: social networks within and between organizations and social networks and interpersonal relationships.

"The 60% Solution should be required reading for political and industry leaders focused on healthcare reform. Timely, insightful and comprehensible." - Eric Affeldt Chairman, Vail Health The 60% Solution offers a bold new vision of how to radically improve the availability and affordability of healthcare by focusing on five critical components: Emphasizing primary care, Clarifying pricing Standardizing accounting and IT Modifying Health Savings Accounts Changing governance #1 Bestselling author Todd Furniss, an industry insider, offers clear and practical solutions to the complexity of healthcare while examining the historical missteps that landed us facing ongoing systemic dysfunction. The book takes on the task of solving the impersonality of healthcare as well as creating an industry that embraces and manifests a compassionate delivery model, putting the power of choice in the center of the relationship of doctor/care-giver and patient. The 60% Solution makes activists out of the 60% of Americans with private healthcare insurance. Our current system is far too costly, ineffectual, and cold; it violates the ideological and moral tenets of a caring nation. High insurance premiums and insurmountably large bills have left countless citizens under mounds of debt or rolling the dice with their lives. This book is about the actionable measures we as individuals can take to become financially capable, educated, and engaged enough to demand the far-reaching reform necessary. It is an inspiring call to action to have all see the benefit of true healthcare reform that focuses on driving consumerism while vastly improving personal choice and access to affordable care.

Environmental Chemistry is a relatively young science. Interest in this subject, however, is growing very rapidly and, although no agreement has been reached as yet about the exact content and limits of this interdisciplinary discipline, there appears to be increasing interest in seeing environmental topics which are based on chemistry embodied in this subject. One of the first objectives of Environ mental Chemistry must be the study of the environment and of natural chemical processes which occur in the environment. A major purpose of this series on Environmental Chemistry, therefore, is to present a reasonably uniform view of various aspects of the chemistry of the environment and chemical reactions occurring in the environment. The industrial activities of man have given a new dimension to Environ mental Chemistry. We have now synthesized and described over five million chemical compounds and chemical industry produces about hundred and fifty million tons of synthetic chemicals annually. We ship billions of tons of oil per year and through mining operations and other geophysical modifications, large quantities of inorganic and organic materials are released from their natural deposits. Cities and metropolitan areas of up to 15 million inhabitants produce large quantities of waste in relatively small and confined areas. Much of the chemical products and waste products of modern society are released into the environment either during production, storage, transport, use or ultimate disposal. These released materials participate in natural cycles and reactions and frequently lead to interference and disturbance of natural systems.

A thoroughly revised and updated fourth edition of a text that has become an international standard for curriculum development in health professional education. Intended for faculty and other content experts who have an interest or responsibility as educators in their discipline, Curriculum Development for Medical Education has extended its vision to better serve a diverse professional and international audience. Building on the time-honored, practical, and user-friendly approach of the six-step model of curriculum development, this edition is richly detailed, with numerous examples of innovations that challenge traditional teaching models. In addition, the fourth edition presents * updates in our understanding of how humans learn; * a new chapter on curricula that address community needs and health equity; and * an increased emphasis throughout on health systems science, population health, equity, educational technology in health professions education, and interprofessional education. This new edition remains a cutting-edge tool and practical guidebook for faculty members and administrators responsible for the educational experiences of health professional students, residents, fellows, and practitioners. It includes chapters on each of the steps of curriculum development, with updated examples and questions to guide the application of the timeless principles. Subsequent chapters cover curriculum maintenance and enhancement, dissemination, and curriculum development for larger programs. Appendixes present examples of full curricula designed using the six-step approach, which is widely recognized as the current standard for publication and dissemination of new curricula and provides a basis for meaningful educational interventions, scholarship, and career advancement for the health professional educator. The book also provides curricular, faculty development, and funding resources. Contributors: Chadia N. Abras, Belinda Y. Chen, Heidi L. Gullett, Mark T. Hughes, David E. Kern, Brenessa M. Lindeman, Pamela A. Lipsett, Mary L. O'Connor Leppert, Amit K. Pahwa, Deanna Saylor, Mamta K. Singh, Sean A. Tackett, Patricia A. Thomas

This volume focuses on blocking disease transmission and the ecological perspective of pathogens and pathogenic processes. The chapters on blocking transmission cover the environmental safety of space flight, biocides and biocide resistance, as well as infection control in healthcare facilities. The book also offers insights into the ecological aspects of infectious disease, introducing the reader to the role of indigenous gut microbiota in maintaining human health and current discussions on environmentally encountered bacterial and fungal pathogens including species that variously cause the necrotizing skin disease Buruli ulcer and coccidioidomycosis. Further, it explores the influenza A virus as an example for understanding zoonosis. It is a valuable resource for microbiologists and biomedical scientists alike.

A groundbreaking prescription for health care reform-from a legendary leader in innovation Our health care system is in critical condition. Each year, fewer Americans are able to afford health care and fewer businesses are able to provide it. We need a cure, and we need it now. Lead author Clayton M. Christensen is the foremost expert in the field of disruptive innovation. In this thought-provoking book, Christensen and his coauthors, health care pioneers Jerome Grossman, MD, and Jason Hwang, MD, present a comprehensive analysis of the strategies needed to improve health care. They examine a range of symptoms and offer proven solutions. You'll learn how disruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors work.

How a community in Cairo, Egypt, has adapted the many systems required for clean water. Who is responsible for ensuring access to clean potable water? In an urbanizing planet beset by climate change, cities are facing increasingly arid conditions and a precarious water future. In Well Connected, anthropologist Tessa Farmer details how one community in Cairo, Egypt, has worked collaboratively to adapt the many systems required to facilitate clean water in their homes and neighborhoods. As a community that was originally not included in Cairo's municipal systems, the residents of Ezbet Khairallah built their own potable water and wastewater infrastructure. But when the city initiated a piped sewage removal system, local residents soon found themselves with little to no power over their own water supply or wastewater removal. Throughout this transition, residents worked together to collect water at the right times to drink, bathe, do laundry, cook, and clean homes. These everyday practices had deep implications for the health of community members, as they struggled to remain hydrated, rid their children of endemic intestinal worms, avoid consuming water contaminated with sewage, and mediate the impact of fluctuating water quality. Farmer examines how the people of Cairo interact with one another, with the government, and with social structures in order to navigate the water systems (and lack thereof) that affect their day-to-day lives. Farmer's extensive ethnographic fieldwork during the implementation of the Governorate of Cairo's septic system shines through in the compelling stories of community members. Well Connected taps into the inherent sociality of water through social contacts, moral ideology, interpersonal relationships, domestic rhythms, and the everyday labor of connecting.

This volume is unique to the existing literature in the Peptide Nucleic Acid field, in that it focuses on comparing and contrasting PNA with other available oligonucleotide homologues and considers areas in which these biomolecules could be profitably applied to clinical and diagnostic applications. Part I of the book addresses comparative strengths and weaknesses of various nucleoside homologues. Part II of the book addresses specific translational or clinical applications for PNA and related antisense biomolecules. The editors have succeeded in presenting a balanced yet broad view of the methods available for gene targeting and modification.

From a new perspective, namely focusing on the interaction of selenium and mercury, this thesis provides new insights into traditional research on biogeochemical cycles of mercury in soil-plant interaction and associated human exposure and risks. The subject of this thesis is both valuable and timely, providing essential information not only on selenium-mercury interaction in the soil-plant system but also on how to assess the combined benefits and risk of co-exposure to mercury and selenium. This work also sheds light on future aspects regarding prevention, remediation and risk management for environmental mercury contamination. Presenting high-quality papers published in leading international SCI journals such as Environmental Health Perspectives and Environmental Science & Technology and having been recognized with the Special Award of Presidential Scholarship Award and Excellent Doctoral Dissertations Prize of the Chinese Academy of Sciences (CAS), this thesis offers a valuable resource for scientific communities, policy-makers and non-experts who are interested in this field.

Dr. Hua Zhang works at the Norwegian Institute for Water Research (NIVA), Oslo, Norway.