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.

"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.

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.

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

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.

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.

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.

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.

Carefully selected to reflect the latest research at the interface between public health and criminal justice in the US, these contributions each focus on an aspect of the relationship. How, for example, might a person's criminal activity adversely affect their health or their risk of exposure to HIV infection? The issues addressed in this volume are at the heart of policy in both public health and criminal justice. The authors track a four-fold connection between the two fields, exploring the mental and physical health of incarcerated populations; the health consequences of crime, substance abuse, violence and risky sexual behaviors; the extent to which high crime rates are linked to poor health outcomes in the same neighborhood; and the results of public health interventions among traditional criminal justice populations.

As well as exploring these urgent issues, this anthology features a wealth of remarkable interdisciplinary contributions that see public health researchers focusing on crime, while criminologists attend to public health issues. The papers provide empirical data tracking, for example, the repercussions on public health of a fear of crime among residents of high-crime neighborhoods, and the correlations between HIV status and outcomes, and an individual's history of criminal activity. Providing social scientists and policy makers with vital pointers on how the criminal justice and public health sectors might work together on the problems common to both, this collection breaks new ground by combining the varying perspectives of a number of key disciplines.

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Coordination of risk assessments and risk communication strategies requires information sharing and establishing networks of working relationships between groups and agencies. Establishing these relationships necessitates overcoming - stitutional, cultural, and political boundaries. Signi?cant barriers exist between r- ulatory agencies and industry groups. Traditionally, these groups have mistrusted one another, and cooperation and collaboration, including sharing information, c- respondingly has been limited. The adoption of radio frequency identi?cation te- nology for tracking livestock, for example, has been met with signi?cant resistance due in part to mistrust between regulatory agencies and producers (Veil, 2006). In the food industry, the need for coordination has been enhanced by industry in- gration and globalization of both markets and production. In the case of GM foods discussed earlier, disagreements between U. S. , European Union, and Canadian r- ulatory agencies fueled the debate over the safety of GM crops. Overcoming institutional and cultural barriers, and mistrust is necessary to create consistency in risk messages. Open communication and information sharing can help clarify where risk perceptions diverge and identify points of convergence. The outcome may not be universal agreement about risks, but convergence around the general parameters of risk. Summary These best practice strategies of risk communication are not designed to function as distinct steps or isolated approaches. Rather than being mutually exclusive, they serve to complement one another and create a coherent approach to confronting risk communication problems.

By chronicling the transformations of hospitals from houses of mercy to tools for confinement, from dwellings of rehabilitation to spaces for clinical teaching and research, from rooms for birthing and dying to institutions of science and technology, this book provides a historical approach to understanding of today's hospitals. The story is told in a dozen episodes which illustrate hospitals in particular times and places, covering important themes and developments in the history of medicine and therapeutics, from ancient Greece to the era of AIDS. This book furnishes a unique insight into the world of meanings and emotions associated with hospital life and patienthood by including narratives by both patients and care givers. By conceiving of hospitals as houses of order capable of taming the chaos associated with suffering, illness, and death, we can better understand the significance of their ritualized routines and rules. From their beginnings, hospitals were places of spiritual and physical recovery. They should continue to respond to all human needs. As traditional testimonials to human empathy and benevolence, hospitals must endure as spaces of healing.

The US political system has come to depend upon money too much. The US health care industry spends the most on political lobbying among all the 13 industrial sectors in the US economy. The government regulatory agencies at both federal and state levels have been "captured" by the health industry interest groups meaning that the regulatory agencies respond to the interests of the industry but not those of citizens. This book employs a broad theoretical framework of crony capitalism to understand US health care system dysfunction. This framework has not been applied before in any serious manner to understand the shortcomings in the US health care system. Specifically, the book examines the role of seven key players using this framework - politicians/interest groups, pharmaceutical companies, private health insurers, hospitals/hospital networks, physicians, medical device manufacturers, and the American public. Crony capitalism is a destructive force and is rampant in US health care system, causing much waste, inefficiencies, and malaise in the system. Current efforts and initiatives, such as patient-centered medical homes and precision medicine, for improving/reforming the system are of mere academic interest and tantamount to taking aspirin to treat cancer. They do not even pretend to address the root cause of the problem, namely, crony capitalism. Offering prescriptions to fix the U.S. health care system based on a comprehensive diagnosis of the dysfunction, this book will be of interest to researchers, academics, policymakers, and students in the fields of health care management, public and non-profit management, health policy, administration, and economics, and political science.

AIDS is the fourth leading cause of death among women of childbearing age and is increasing by about 8% a year in this group. * And yet, our understanding of the impact of HIV and AIDS on women's lives remains fragmented and incomplete. After a decade of struggling with mounting surveys of risk behavior, clinical trials, and behavioral interventions that were based primarily on experience with gay communities in large cities and, subsequently, on the needs of injection drug users, we have not given programs for women the attention they require if they are to be meaningful, effective, and gender appropriate. This book will introduce the reader to the range of complex issues of HIV and AIDS in women's lives. Ann O'Leary and Loretta Sweet Jemmott have assembled an impres sive list of authors who have contributed chapters from different disciplinary viewpoints. The reader will find information on prevention programs that have been effective for adolescent girls, on culturally specific strategies for African American and Latina women, and on the multiple issues of sub stance use and HIV that need to be faced by any outreach and intervention programs for drug-using women."