Based on long-term medical anthropological research in northern Ghana, the author analyses issues of health and healing, of gender, and of the control and use of money in a changing rural African setting. He describes the culture of medical pluralism, so typical for neo-colonial states, and people's choices of "traditional" (local) medicine (plants and sacrifices), Islamic medicine (charms and various written solutions) and "modern" therapy (biomedicine, in particular western pharmaceuticals). He concludes that the rural-urban divide is a fiction, that demarcations between these areas are frequently blurred, linked by a postcolonial, capitalist discourse of local markets, regional economies and national structures, which frequently emerge in local African settings but often originate in global and multinational markets.

Non-governmental organizations (NGOs) are increasingly recognised as playing a significant role in the health sector in developing countries. This book examines the background to the growth both in the sector and interest in it, the strengths and weaknesses of NGOs and the arguments for and against their use for different aspects of the health sector. It focuses particularly on the relationship between the State and non-governmental organizations and the issues critical to the development of policies towards the sector.

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This book engages theoretically and empirically with the unprecedented wave of public management reforms in public hospitals in Europe in the past 25 years. It provides a useful overview of these reforms and studies the way in which they have influenced the ability of national policy-making institutions to co-ordinate the system of public hospitals as a whole. Using a comparative structure, as well as original empirical data collected by the author, the book examines case studies on which little has so far been published for an international audience in English.

Intelligent Technologies for Bridging the Grey Digital Divide offers high-quality research with both industry- and practice-related articles in the broad area of intelligent technologies for seniors. The main focus of the book is to provide insights into current innovation, issues to be resolved, and approaches for widespread adoption so that seniors, their families, and their caregivers are able to enjoy their promised benefits.

In the previous two volumes of this series, we presented classic problems in internal medicine as illustrated by actual cases cared for in our institution. It has been gratifying for us to see the interest that these volumes have generated with students and trainees. We remain committed to the case method of instruction, and believe that there is no better method to learn medicine than to have an individual patient problem as the basis for study of pathophysiology, natural history, diagnosis and management. We hope that our readers find this third volume as enjoyable and instructive as the editors found it. Juan M. Bowen, MD Ernest L. Mazzaferri, MD, FACP xiii Acknowledgement The editors are grateful to Jeff Smith and Jenny Riegler for their unflagging professionalism and patience. xiv Contents Case 1 Mitral Regurgitation - Chronic Versus Acute: Implications for Timing of Surgery * . * * * . . * . . . . . * . . . . . . . . . . . 1 Harisios Boudoulas, MD Charles F. Wooley, MD Advances and diagnostic imaging in a surgical technique have changed the approach to mitral valve regurgitation. This chapter provides an expert's perspective. Case 2 Cystic Fibrosis in Adults .. * ************ 36 Andrew Libertin, MD John S. Heintz, MD As children with cystic fibrosis grow into adulthood, the internist assumes a greater role in their care. Case 3 Thrombotic Thrombocytopenic Purpura . . . . . . . . . . 51 . . . Donald E. Thornton, MD Earl N. Metz, MD, FACP Patients with ITP continue to present difficulties in diagnosis and management. Two experts discuss the current approach to ITP.

As adoption of Electronic Health Record Systems (EHR-Ss) shifts from early adopters to mainstream, an increasingly large group of decision makers must assess what they want from EHR-Ss and how to go about making their choices. The purpose of this book is to inform that decision. This book explains typical needs of a variety of stakeholders, describes current and imminent technologies, and assesses the available evidence regarding issues in implementing and using EHR-Ss.

Divided into four important sections--Needs, Current State, Technology, and Going Forward--the book provides the background and general notions regarding the EHRS and lays out the framework; delves into the historical review; presents a high-level view of EHR systems, focused on the needs of different stakeholders in the health care and the health enterprise; offers practical views of existing systems and current (and short-term future) issues in specifying a EHR system and deciding how to approach the institution of such a system; deals with technology issues, from front- to back-end; and describes where we are and where we should be going with EHR systems.

Designed for use by chief information officers, chief medical informatics officers, medical liaisons to hospital systems, private practitioners, and business managers at academic and non-academic hospitals, care management organizations, and practices. The book could be used in any medical or health informatics course, at any level (undergrad, fellowship, MBA).

Some goods and services are normally left to the market mechanism. Health care is often described as an exception to the rule. Society wants care to be allocated equitably; it wants the financial burden to be kept within bounds; it wants treatments to be both medically effective and economically efficient. These shared concerns lead to a demand for State intervention which this book seeks impartially to appraise and evaluate.

The purpose of this book is to be the premier resource for behavioural health clinicians who are considering adopting technology into their practice. Written by experts and policy makers in the field this book will be recognized as the gold standard. Other books currently in this field are extremely technical and are geared primarily to policy makers, researchers and informaticians. While this book will be a useful adjunct to that audience, it is primarily designed for the over .5 million behavioural health clinicians in the U.S. and the millions others around the world. Adoption of technology is slow in behavioural healthcare, and this book will enhance the adoption and utilization of various technologies in practice. I.T. vendors may also purchase this book for their customers.

This innovative volume introduces Trajectory Analysis, a new systems-based approach to measuring nonlinear dynamics in continuous change, to public health and epidemiology. It synthesizes influential strands of statistical and probability science (including chaos theory and catastrophe theory) to complement existing methods and models used in the health fields. The computational framework featured here pinpoints complex cause-and-effect processes in behavioral change as individuals and populations adjust to health interventions, with examples from neuroscience and cardiology. But this is no mere academic exercise, as the author illustrates how these methods can be harnessed toward finding real-world answers to longstanding public health problems, starting with treatment recidivism. Included in the coverage: * The universality of physical principles in the analysis of health and disease * The problem of recidivism in healthcare intervention studies * Stability and reversibility/irreversibility of health conditions * Chaos theory and sensitive dependence on initial conditions * Applications in health monitoring and geographic systems * Simulations, applications, and the challenge for public health A stimulating new take on statistics with powerful implications for future study, practice, and policy, Trajectory Analysis in Health Care should interest public health epidemiologists, researchers, clinicians, and policymakers.

The United States health care system is broken. Critics and commentators point to the staggering costs of health care, the shrinking insurance coverage, and the diminishing access that many U.S. citizens have to essential services and treatments. These problems are compounded by a growing realization that the quality of care across the country is uneven at best, with the goal of finding the appropriate kind and level of care proving elusive. High Stakes enters into the health care debates at a critical time, offering an analysis that homes in on factors that account for many of the inefficiencies and shortcomings of our unsystematic system, and putting forth recommendations that are ideologically blind.
Using real-world examples to illustrate the fragile state of health care today, Drs. Shore and Kupferberg enlist a powerful analytic frame to bear on these conflicts: stakeholder management. That involves addressing the present system of conflicts, in which key groups in the field pursue their own interests at the risk of the system at large. Insurance providers want to reduce their payments, hospitals want higher reimbursements, patients want access to unlimited services, and no one wants to work together. The fights are constant and financially disastrous, for every dollar earned by one group is one less dollar earned by another. For health care to succeed as an enterprise, key stakeholder groups must come to appreciate their dependence on other groups. More importantly, they must find ways to align their interests and move beyond entrenched behaviors. As the authors point out, all constituency groups must begin by acknowledging that where people stand on an issue depends on where they sit, and that greater stakeholder alignment and engagement are prerequisites for more effective and efficient health care. Drawing equally from both scholarly studies and real world examples, High Stakes offers health care leaders the necessary tools to both map their current stakeholder relationships and fashion concrete steps to produce greater stakeholder engagement, collaboration, and cooperative competition.

This NIH-supported study of HIV's physical and psychosocial impacts offers both practical and inspiring accounts of how individuals living with HIV respond and cope with the disease and its progressive stages and impacts. The longitudinal approach of the research and the rich resources offered by extensive interviews with the persons with HIV and those closest to them avail the reader of insights and responses that should improve others' coping and caring abilities.

The author's professional experience and extensive research informs the work throughout and fashions a remarkable and moving synthesis of the themes that will help those living with AIDS as well as all who relate to them. From the first awareness of infection to coping with bereavement, this book honestly, sensitively, and substantively addresses the essential concerns that any and all who are touched by the HIV pandemic must reflect on.

Climate change is increasing the severity of disasters and adverse weather conditions worldwide, with particularly devastating effects on developing countries and on individuals with lower resources. Climate change is likely to impact mental health and psychosocial well-being via multiple pathways, leading to new challenges. Direct effects such as gradual environmental changes, higher temperatures, and natural disasters, are likely to lead to more indirect consequences such as social and economic stressors, population displacement, and conflict.

Climate change, largely the product of industrialized nations, is projected to magnify existing inequalities and to impact the most vulnerable, including those with low resources, individuals living in developing countries and specific populations such as women, children and those with pre-existing disabilities. This book outlines areas of impact on human well being, consider specific populations, and shed light on mitigating the impact of climate change. Recommendations discuss ways of strengthening community resilience, building on local capacities, responding to humanitarian crises, as well as conducting research and evaluation projects in diverse settings.

Drawing on insights from international organization and securitization theory, the author investigates the World Health Organization and how its approach to global health security has changed and adapted since its creation in 1948. He also examines the organization's prospects for managing global health security now and into the future.

The Future of Mental Health drills to the heart of the current mental health crisis, where hundreds of millions of individuals worldwide receive unwarranted "mental disorder diagnoses." It paints a picture of how mental health providers can improve their practices to better serve individuals in distress and outlines necessary steps for a mental health revolution. Eric Maisel's goal is to inject more human interaction into the therapeutic process. Maisel powerfully deconstructs the "mental disorder" paradigm that is the foundation of current mental health practices. The author presents a revolutionary alternative, a "human experience" paradigm. He sheds a bright light on the differences between so-called "psychiatric medication" and mere chemicals with powerful effects, explains why the DSM-5 is silent on causes, silent on treatment, and wedded to illegitimate "symptom pictures." Maisel describes powerful helping alternatives like communities of care, and explains why one day "human experience specialists" may replace current mental health professionals. An important book for both service providers and service users, The Future of Mental Health brilliantly unmasks current mental health practices and goes an important step further: it describes what we are obliged to do in order to secure better mental health services-and better mental health-for everyone.

Eat for your mental health and learn the fascinating science behind nutrition with this "must-read" guide from an expert psychiatrist (Amy Myers, MD).

Did you know that blueberries can help you cope with the aftereffects of trauma? That salami can cause depression, or that boosting Vitamin D intake can help treat anxiety?

When it comes to diet, most people's concerns involve weight loss, fitness, cardiac health, and longevity. But what we eat affects more than our bodies; it also affects our brains. And recent studies have shown that diet can have a profound impact on mental health conditions, including:

• ADHD
• Depression
• Anxiety
• Sleep disorders
• OCD
• Dementia
• And beyond

Numerous studies suggest that people with a variety of health concerns are increasingly turning to online networks for social support. As a result, the number of online support communities has risen over the past two decades. Global Perspectives on Health Communication in the Age of Social Media is a critical scholarly resource that examines the illness and pain-and-suffering narrative of health communication. Featuring coverage on a broad range of topics, such as social networks, patient empowerment, and e-health, this book is geared towards professionals and researchers in health informatics as well as students, practitioners, clinicians, and academics.

It is a tragic paradox of American health care: a system renowned for world-class doctors, the latest medical technologies, and miraculous treatments has shocking inadequacies when it comes to the health of the urban poor. Urban Health Knowledge Management outlines bold, workable strategies for addressing this disparity and eliminating the "knowledge islands" that so often disrupt effective service delivery. The book offers a wide-reaching global framework for organizational competence leading to improved care quality and outcomes for traditionally underserved clients in diverse, challenging settings. Its contributors understand the issues fluently, imparting both macro and micro concepts of KM with clear rationales and real-world examples as they: * Analyze key aspects of KM and explains their applicability to urban health. * Introduce the KM tools and technologies most relevant to health care delivery. * Offer evidence of the role of KM in improving clinical efficacy and executive decision-making. * Provide extended case examples of KM-based programs used in Washington, D.C. (child health), South Africa (HIV/AIDS), and Australia (health inequities). * Apply KM principles to urban health needs in developing countries. * Discuss new approaches to managing, evaluating, and improving delivery systems in the book's "Measures and Metrics" section. Urban health professionals, as well as health care executives and administrators, will find Urban Health Knowledge Management a significant resource for bringing service delivery up to speed at a time of great advancement and change.

'Incredible. One of those rare books that should be dispensed on prescription to every household.' - Lucy Easthope, author of When the Dust Settles 'Hilarious, bitter, poignant and profound . . . like an existential soap opera - only with more laughs.' - Philip Hoare, author of Leviathan It was the kind of phone call we all dread. Your elderly father has been admitted to hospital. Your even older mum is now at home alone. The answer? Simple. Drop everything, go back and help. The reality? Not so straightforward. Suddenly, you're a kid again, stranded in the overheated house you grew up in. Soon they need you 24/7. And you want to help, of course you do. But now your own life starts to unravel almost as quickly as their health. And then there is nowhere else to go. In between bouts of washing, feeding, cooking and fighting there are times that test you, days where everything goes wrong and moments when everyone, miraculously rises to the occasion. And amidst all of that, this strange second childhood offers up a shot at redemption - if you can just stop everyone from falling down. Irresistibly funny, unflinching and deeply moving, this is a love letter to family and friends, to carers and to anyone who has ever packed a small bag intent on staying for just a few days. This is a true story of what it really means to be a carer, and of the ties that bind even tighter when you least expect it. This is The Reluctant Carer.

The purpose of the series is to explore the central and unique role of organizational ethics in creating and sustaining a pluralistic, free enterprise economy. The primary goal of the research studies published here is to examine how profit seeking and not for profit organizations can be conceived and designed to satisfy legitimate human needs in an ethical and meaningful way.

Religious, political, social, and health reform earmarked the Progressive Era. The era's health reform movement--like today's clean living movement--saw campaigns against alcohol, tobacco, drugs, and sexuality. It included crusades for exercise, vegetarian diets, and alternative health care and concerns about eugenics and new diseases. Covering the years leading up to the Progressive Era through the 1920s, this book provides entries on the central figures, events, crusades, legislation, publications and terms of the health reform movements, while a detailed timeline ties health reform to political, social, and religious movements. A valuable resource for scholars, students, and laymen interested in earlier health reform movements.

A growing, aging population; the rise to epidemic proportions of various chronic diseases; competing, often overlapping medical technologies; and of course, skyrocketing costs compounded by waste and inefficiency - these are just a few of the multifarious challenges currently facing healthcare delivery. An

unexpected source of solutions is being imported from the manufacturing sector: lean thinking.

"Lean Principles for Healthcare" presents a conceptual framework, management principles, and practical tools for professionals tasked with designing and implementing modern, streamlined healthcare systems or overhauling faulty ones. Focusing on core components such as knowledge management, e-health, patient-centeredness, and collaborative care, chapters illustrate lean concepts in action across specialties (as diverse as nursing, urology, and emergency care) and around the globe. Extended case examples show health systems responding to consumer needs and provider realities with equal efficiency and effectiveness, and improved quality and patient outcomes. Further, contributors tackle the gamut of technological, medical, cultural, and business issues, among them:

Initiatives of service-oriented architecture towards performance improvementAdapted lean thinking for emergency departmentsLean thinking in dementia care through smart assistive technologySupporting preventive healthcare with persuasive servicesValue stream mapping for lean healthcareA technology mediated solution to reduce healthcare disparities

Geared toward both how lean ideas can be carried out and how they are being used successfully in the real world, "Lean Principles for Healthcare" not only brings expert knowledge to healthcare managers and health services researchers but to all who have an interest in superior healthcare delivery."