As health care costs soar there is increasing interest in examining what society and, particularly, patients receive in return for these expenditures. Optimizing Health brings together the best thinking from both sides of the Atlantic to explore these issues. It employs disciplinary perspectives from economics, ethics, philosophy, psychology, clinical practice, and epidemiology to explore various ways that value for patients have and can be determined. It concludes with a discussion of changes required in practice, research, and health care systems to maximize the outcomes received from the provision of medical care services from the patient's perspective.
The first section of the book provides theoretical perspectives from economics and systems thinking that help us to focus on how one might determine the value of medical care for patients. The next section considers the ethical and philosophical dilemmas that face developed countries in distributing medical care. How is justice served and evidence-based medicine employed to increase the value of medical care for patients?
The section on psychology deals with measuring outcomes from the patient's perspective and involving patients in medical decision making. Measuring quality of life and gaining valid quality of life information when patients cannot respond for themselves are important topics covered by these chapters. Other chapters consider ways that patients can become more involved in medical decision making with the expectation that this will increase the value of medical care for patients.
A major section of the book about clinical practice discusses problems that can reduce the value to patients of medical care. These include overdiagnosis, aggressive treatments that do not result in better patient outcomes, findings that earlier diagnosis does not always result in better outcomes, and the extent of medical error in treatment.
The final sections deal with cost-effectiveness analyses and applications of clinical epidemiology. The chapters include a number of original investigations and applications of new methodologies. All-in-all, the volume is must reading for practitioners, policy makers, and researchers who want to find in one place the state-of-the-art thinking and future directions of valuing medical care from the patient's perspective.
Wasserman Professor Emeritus of the Departments of Health Services and Sociology at the University of California School of Public Health in Los Angeles
This book represents the first comprehensive, gold standard reader on research integrity in the biomedical sciences. Now more than ever, the responsible conduct of research (RCR) has become critically important as new technologies affect research practices in both positive and negative ways. Since learning to do science and practicing it brings researchers into contact with a vast array of ethical issues, it is critical to know the standards and how they are evolving. Indeed, research integrity requires scientists at all levels to operate ethically in a system that supports ethical practice. This unique, foundational text covers all the relevant areas -- subject protection, research misconduct and conflict of interest as well as newly quantified concerns about research bias and non-reproducibility, as well as other unique issues. Developed by renowned experts, this compelling title discusses the full range of practices and policies that should support research that is honestly produced and disseminated. It also specifically incorporates topics noted by the National Institutes of Health as essential and required for training in RCR. Getting to Good - Research Integrity in the Biomedical Sciences is a major contribution to the literature on bioethics and will serve as an invaluable resource for all researchers, students, administrators and professionals interested in research ethics and integrity.
This volume is about understanding the relationship between deviance and selected correlates of deviance in one generation and deviance and its selected correlates in the next generation. By examining the significance of these constructs in the parental generation as part of the explanation for the same constructs in the child's generation, we contribute to an und- standing of the phenomena. This contribution, however, is quite limited in the sense that we are examining in essence bivariate relationships-the association between first-generation and second-generation phenomena- while ignoring all of the other influences on the second-generation p- nomena that do not stem from or account for the intergenerational relationship. Nevertheless, the study of intergenerational parallelism of deviance and its correlates justifiably has excited attention and resulted in a vo- minous literature greater than might have been expected for any parti- lar bivariate relationships because of the mystique surrounding ideas-cycle of violence, reproduction of culture, to name but a few-that are evoked by consideration of the association between such phenomena in one generation and the same phenomena in a successive generation.
Careful evaluation of the placenta can often give much insight into disorders of pregnancy in the mother and fetus. The techniques of gross placental examination are not difficult, but a systematic approach is necessary to be complete. Color Atlas of Gross Placental Pathology, Second Edition is designed to aid in the careful and thorough gross examination of the placenta by providing an illustrated manual of examination that includes normal variations, abnormal findings, as well as unusual pathology.
"...this atlas contains a wealth of important information for pathologists examining the placenta and provides superb illustrations. This atlas is highly recommended for all those engaged in pathologic examination of the placenta."
Archives of Pathology & Laboratory Medicine
"The quality of any atlas depends on clear and appropriate illustrations and concise text in a format that allows for rapid identification of specific entities. This atlas has both. The quality of the illustrations is top rate."
American Journal of Surgical Pathology