Depression has become the most frequently diagnosed chronic mental illness, and is a disability encountered almost daily by mental health professionals of all trades. "Major Depression" is a medical disease, which some would argue has reached epidemic proportions in contemporary society, and it affects our bodies and brains just like any other disease. Why, this book asks, has the incidence of depression been on such an increase in the last 50 years, if our basic biology hasn't changed as rapidly? To find answers, Dr. Blazer looks at the social forces, cultural and environmental upheavals, and other external, group factors that have undergone significant change. In so doing, the author revives the tenets of social psychiatry, the process of looking at social trends, environmental factors, and correlations among groups in efforts to understand psychiatric disorders.

Depression has become the most frequently diagnosed chronic mental illness, and is a disability encountered almost daily by mental health professionals of all trades. Major depression is a medical disease, which some would argue has reached epidemic proportions in contemporary society, and it affects our bodies and brains just like any other disease. The Age of Melancholy asks why the incidence of depression has been on such an increase in the last 50 years, if our basic biology hasn't changed as rapidly. To find answers, Dr. Blazer looks at the social forces, cultural and environmental upheavals, and other external, group factors that have undergone significant change. In so doing, the author revives the tenets of social psychiatry, the process of looking at social trends, environmental factors, and correlations among groups in efforts to understand psychiatric disorders. The biomedical model of psychiatry that has dominated the field for the past half-century has faced minimal scrutiny, due in part to the apparent advances made in the treatment of mental health issues during that time. But, Dr. to complement and complete the model, and he points to two concurrent trends for support: during the same 50-year period that saw the death of social psychiatry, the rate of occurrence and increasing medicalization of depression as a secluded individual's issue have brought us to the Prozac era. In making the case for the connection of these two trends (both the products themselves of larger social and cultural movements), the author proposes a return of a new, more mature social psychiatry, to complete - not replace - the biomedical and clinical research models in place today. This book is eminently readable, and should appeal to a broader audience than the psychiatrists, clinicians, and researchers who will make up the primary audience. While replete with the standard mental health references, sound research, and authored by a recognized and respected professional, the ease of language and range of examples make this text accessible to a lay reader. This book should have cross-over appeal in sociology as well as social work and psychology.

Contemporary Surgical Management of Liver, Biliary Tract, and Pancreatic Diseases presents an excellent resource for surgical residents, hepatobiliary fellows and practicing surgeons interested in hepatobiliary surgery. This textbook offers a readable, concise and practical alternative. It is divided into three sections: liver, biliary tract, and pancreatic diseases. Each section covers the spectrum of benign and malignant disease. In addition, several chapters in each section are devoted to surgical techniques. This textbook should ultimately serve as an essential source for the rapidly evolving field of hepatobiliary surgery and its practitioners.

The loss of hearing - be it gradual or acute, mild or severe, present since birth or acquired in older age - can have significant effects on one's communication abilities, quality of life, social participation, and health. Despite this, many people with hearing loss do not seek or receive hearing health care. The reasons are numerous, complex, and often interconnected. For some, hearing health care is not affordable. For others, the appropriate services are difficult to access, or individuals do not know how or where to access them. Others may not want to deal with the stigma that they and society may associate with needing hearing health care and obtaining that care. Still others do not recognize they need hearing health care, as hearing loss is an invisible health condition that often worsens gradually over time. In the United States, an estimated 30 million individuals (12.7 percent of Americans ages 12 years or older) have hearing loss. Globally, hearing loss has been identified as the fifth leading cause of years lived with disability. Successful hearing health care enables individuals with hearing loss to have the freedom to communicate in their environments in ways that are culturally appropriate and that preserve their dignity and function. Hearing Health Care for Adults focuses on improving the accessibility and affordability of hearing health care for adults of all ages. This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages. Table of Contents Front Matter Summary 1 Introduction 2 Hearing Loss: Extent, Impact, and Research Needs 3 Hearing Health Care Services: Improving Access and Quality 4 Hearing Technologies: Expanding Options 5 Improving Affordability of Services and Technologies 6 Engaging a Wider Community: Awareness, Education, and Support 7 Opportunities for Action Appendix A: Meeting Agendas Appendix B: Committee Biographies

For most Americans, staying "mentally sharp" as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. Cognitive Aging assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. Cognitive Aging offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors. Table of Contents Front Matter Summary 1 Introduction 2 Characterizing and Assessing Cognitive Aging 3 Population-Based Information About Cognitive Aging 4A Risk and Protective Factors and Interventions: Lifestyle and Physical Environment 4B Risk and Protective Factors and Interventions: Health and Medical Factors 4C Risk and Protective Factors and Interventions: General Cognitive Aging Interventions and Next Steps 5 Health Care Response to Cognitive Aging 6 Community Action: Health, Financial Management, Driving, Technology, and Consumer Decisions 7 Public Education and Key Messages 8 Opportunities for Action Appendix A: Meeting Agendas Appendix B: U.S. Surveys and Studies That Include One or More Items to Measure Cognition Appendix C: Committee Biographies

Over the past century, we have made great strides in reducing rates of disease and enhancing people's general health. Public health measures such as sanitation, improved hygiene, and vaccines; reduced hazards in the workplace; new drugs and clinical procedures; and, more recently, a growing understanding of the human genome have each played a role in extending the duration and raising the quality of human life. But research conducted over the past few decades shows us that this progress, much of which was based on investigating one causative factor at a time&#8212often, through a single discipline or by a narrow range of practitioners&#8212can only go so far. Genes, Behavior, and the Social Environment examines a number of well-described gene-environment interactions, reviews the state of the science in researching such interactions, and recommends priorities not only for research itself but also for its workforce, resource, and infrastructural needs. Table of Contents Front Matter Summary 1 Introduction 2 The Impact of Social and Cultural Environment on Health 3 Genetics and Health 4 Genetic, Environmental, and Personality Determinants of Health Risk Behaviors 5 Sex/Gender, Race/Ethnicity, and Health 6 Embedded Relationships Among Social, Behavioral, and Genetic Factors 7 Animal Models 8 Study Design and Analysis for Assessment of Interactions 9 Infrastructure 10 Ethical, Legal, and Social Implications 11 Conclusion Appendix A Methodology: Data Collection and Analysis Appendix B Recommendation from the National Academy of Sciences Report, Facilitating Interdisciplinary Research Appendix C Social Environmental and Genetic Influences on Obesity and Obesity-Promoting Behaviors Appendix D The Interaction of Social, Behavioral, and Genetic Factors in Sickle-Cell Disease Appendix E Modern Epidemiologic Approaches to Interaction: Applications to the Study of Genetic Interactions Appendix F Acronyms Appendix G Biographical Sketches Index

Popular culture often equates testosterone with virility, strength, and the macho male physique. Viewed by some as an a /antiaging tonic,a testosteronea (TM)s reputation and increased use by men of all ages in the United States have outpaced the scientific evidence about its potential benefits and risks. In particular there has been growing concern about an increase in the number of middle-aged and older men using testosterone and the lack of scientific data on the effect it may have on aging males. Studies of testosterone replacement therapy in older men have generally been of short duration, involving small numbers of participants and often lacking adequate controls. Testosterone and Aging weighs the options of future research directions, examines the risks and benefits of testosterone replacement therapy, assesses the potential public health impact of such therapy in the United States, and considers ethical issues related to the conduct of clinical trials. Testosterone therapy remains an attractive option to many men even as speculation abounds regarding its potential.

The evaluation of psychiatric disorders and the delivery of mental health services is grounded in clinical research. Findings from published studies in scientific journals are translated by clinicians into changes in daily practice. Psychiatrists and other mental health professionals read original research reports and case studies in journals, and often attend scientific meetings where the latest research findings are presented. Yet despite their extensive education and experience, most psychiatrists do not have sufficient training in clinical research methods to evaluate critically the latest findings.
Blazer and Hays have written this primer to acquaint practitioners and residents with the basic methodology of study design. The book covers single-subject studies, description studies (such as case registers and population-based surveys), community surveys, cohort and case-control studies, longitudinal studies, population genetic studies and clinical trials. The focus is on clinical research in which the patient is the unit of analysis. The two authors write in clear style, uncluttered by technical jargon, so that their book will be accessible to readers with little or no grounding in clinical research methods. The theoretical presentation is illustrated with examples from published studies which highlight the problems typically encountered by clinicians involved in patient-oriented research in psychiatry.
Introduction to Clinical Research in Psychiatry employs an interactive, problem-based approach to introducing epidemiologic methods, which has been successfully tested in a course the authors taught at the Duke University School of Medicine. The book is designed primarily for mental health care professionals with little experience in research methods, including psychiatrists, psychologists, social workers, nurses, and others working in mental health centers, hospitals, and psychiatric ambulatory care centers.