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In recent years, there has been an explosion of research focused on using technology in healthcare, including Web and mobile health assessment and intervention tools, as well as smartphone sensors and smart environments for monitoring and promoting health behavior. This work has shown that technology-based therapeutic tools offer considerable promise for monitoring and responding to individuals’ health behavior in real time. They may extend the reach of clinicians or serve as stand-alone tools, may be cost-effective and offer countless opportunities for tailoring behavioral interventions that are optimally responsive to individuals’ needs and preferences. Technology may enable entirely new models of healthcare both within and outside of formal systems of care. This book defines the state of scientific research related to the development, experimental evaluation, and effective dissemination of technology-based therapeutic tools targeting behavioral health. It provides an overview of evidence-based approaches to harnessing technology in areas of substance use, mental health, diet and exercise, medication adherence, and chronic disease management. The book also defines the state of implementation research examining models for integrating technology-based behavioral healthcare systems to increase the quality and reach of evidence-based and cost-effective behavioral healthcare, and discusses public health and policy implications of this work. This book consists of contributions from an interdisciplinary group of authors who are leaders in fields of paramount importance to the arena of technology and behavioral health, including the science of behavior change, emerging technologies, health economics, novel methodologies and analytics, implementation science, regulation, privacy and security, and public policy.Less

Medical innovation as it stands today is fundamentally unsustainable. There is a widening gap between what biomedical research promises and its current impact in terms of patient benefit and health system improvement. This book highlights the global problem, analyses underlying causes, and provides powerful prescriptions for change to close the gap.It contrasts progress in biomedicine with other areas of science and technology, such as information technology, in which there are faster, more reliable returns for society from scientific advance. It questions whether society is right to expect so much from biomedicine and why we have become accustomed to such poor returns.It focuses on four specific ‘gaps in translation’ between bioscience breakthroughs and ultimate patient benefit, and explains how unhelpful mental models and differing perceptions of value, risk, and uncertainty contribute to stifling progress.Specific examples are examined, in which these bottlenecks have prevented promised progress (e.g. antibiotic-resistant infections), and others in which these barriers have been overcome, as a result of patient pressure (e.g. HIV treatment) or a sense of impending crisis (e.g. pandemic influenza).Less

Although urban living has accounted for being the lifestyle for more than half of the global population since 2010, nearly half are still living in a rural context. As pointed out by the United Nations as a backdrop of the Sustainable Development Goals (SDGs) (2016–2030), at least 1.8 billion people across the world still consumed faecally contaminated drinking water by 2015, 2.4 million lacked access to basic sanitation services such as toilets or latrines, and nearly 1,000 children died every day of preventable water and sanitation-related diarrhoeal diseases. Rural areas fare far worse: children are about 1.7 times more likely to die before their fifth birthday as those in urban areas. About 16% of the rural population do not use improved drinking water sources, compared to 4% of the urban population. About 50% of people living in rural areas lack improved sanitation facilities, compared to only 18% of people in urban regions. Far too many one-off rural on-site public health knowledge transfer projects fail to deliver long-term results. Theoretical understanding may be strengthened among non-governmental organization (NGO) practitioners and volunteers to support project planning, monitoring, and evaluation. Based on public health theories and illustrated by relevant examples, as well as the insights gained from the long-established CCOUC Ethnic Minority Health Project in China, this book introduces how health, emergency, and disaster preparedness education programmes could be organized in remote rural Asia, which could become a useful reference for organizers and volunteers of rural development projects.Less

Expert public psychiatrists use case studies to share best practice strategies in this clinically oriented introduction to community mental health. Today, the majority of psychiatrists work with people who suffer not only from mental illness but also from poverty, trauma, social isolation, and discrimination. Psychiatrists cannot do this work alone but, instead, are part of teams of behavioral health workers navigating larger health care and social service systems. In an increasingly complex health care environment, mental health clinicians need to master systems-based practice in order to provide optimal care to their patients. The rapid development of public psychiatry training programs is a response to the learning needs of psychiatrists in an evolving system. This book begins with seven foundational principles of public psychiatry—recovery, trauma-informed care, integrated care, cultural humility, harm reduction, systems of care, and financing care—using cases to bring these concepts to life. Then, using a population health framework, cases are used to explore the typical needs of different age groups or vulnerable populations and to illustrate evidence-based/best practices that have been employed to meet these needs. Common to all of the chapters is a focus on the potential of each person, regardless of illness, to achieve personal goals, supported by a clinician who is also an advocate, activist, and leader.Less

It is every health professional’s responsibility to be able to identify and respond to child abuse. This book equips health professionals working with children with the knowledge to recognize at-risk children or those already suffering abuse. Child protection work is challenging both emotionally and strategically, and so practical advice on how to navigate the multidisciplinary processes involved is provided using many challenging cases and exercises. The realistic fictional cases aim to immerse readers in the scenario and challenge them on how to take action to safeguard the children involved. Real cases in which children suffered actual harm are also presented, and readers are taken through the learning points, recommendations, and subsequent changes in legislation. New challenges in child protection from trafficking, child sexual exploitation, gang violence, radicalization, and internet bullying and abuse are defined, and abuse resulting from cultural practices such as female genital mutilation, witchcraft and spirit possession, honour-based violence, and forced marriage is also covered. Advice is provided for those undertaking work in low-resource settings with non-government organizations and charities. Practical advice is offered on accurate documentation, writing police and court reports, talking to parents, and answering frequently asked questions. New gender-specific anatomically positioned body maps of infants, toddlers, young children, and teenagers are included to help improve medical record-keeping. The complicated safeguarding process is broken down into palatable and stimulating chunks that can be read in a few sittings or just dipped into for advice.Less

This unique collection of interactive case studies covers diverse topics at the intersection of public health and business, including direct-to-consumer genetic testing, programs to impact prescription adherence, the marketing of e-cigarettes and marijuana, workplace safety in Bangladesh, and cancer screening in Japan. Teaching notes for all cases are available to instructors adopting the text.Less

This book presents a system of critical appraisal applicable to clinical, epidemiological and public health studies and to many other fields. It assumes no prior knowledge. The methods are relevant to students, practitioners and policymakers. The book shows how to assess if the results of one study or of many studies show a causal effect. The book discusses study designs: randomised and non-randomised trials, cohort studies, case-control studies, and surveys, showing the presentation of results including person-time and survival analysis, and issues in the selection of subjects. The system shows how to describe a study, how to detect and assess selection biases, observation bias, confounding, and chance variation, and how to assess internal validity and external validity (generalisability). Statistical methods are presented assuming no previous knowledge, and showing applications to each study design. Positive features of causation including strength, dose-response, and consistency are discussed. The book shows how to do systematic reviews and meta-analyses, and discusses publication bias. Systems of assessing all evidence are shown, leading to a general method of critical appraisal based on 20 key questions in five groups, which can be applied to any type of study or any topic. Six chapters show the application of this method to randomised trials, prospective and retrospective cohort studies, and case-control studies. An appendix summarises key statistical methods, each with a worked example. Each main chapter has self-test questions, with answers provided.Less

Preventive medical interventions—and even non-medicalized public health programmes that implicitly promise health benefits in the future, from actions taken now—all carry a strong ethical requirement: primum non nocere (‘first, do no harm.’) This is especially true nowadays, when new preventive advice and interventions are being promoted on a daily basis, sometimes by scientifically ill-informed special interest groups. This slim volume provides a set of ‘critical appraisal’ tools to help those considering a preventive action to be sure that it is effective (does more good than harm), efficient (is a competitive use of scarce resources), and equitable in its impact across society. Throughout the book worked examples are provided and ‘case-studies’, illustrating the risks and benefits (and in some cases the costs per unit of health benefit) of specific preventive interventions, both laudable, and not so laudable. The nine chapters focus on the following aspects of prevention: the hierarchy of preventive options; the assessment of causation; finding and appraising scientific evidence; prevention directed at entire populations (as opposed to individuals); the scientific perils underlying ‘healthy nutrition’ advice; measuring chronic disease risk factors and medically managing them, e.g. statin treatment of high cholesterol; PSA screening for prostate cancer: more harm than good?; genetic screening for future disease risk; and assessing the health equity implications of prevention. This book is aimed at front-line primary care and public health professionals, to help them better inform, and serve, their patients and communities.Less

This resource examines the current trends in increased air/water pollution and energy consumption, and the depletion of natural resources, and the disproportionate impact on the poor and the economically viable solutions that can serve to remedy them — solutions that simultaneously address environmental and economic problems. This gap in previous research, evidence, and writing has left low-income countries often unwilling to take on major environmental problems and many poor communities believing they faced impossible choices between improving the environment in which they live and increasing the jobs and income available. Bringing together evidence-based recommendations and in-depth case studies of successful policies and programs around the world, this resource examines innovative solutions to this crucial challenge. In doing so, it addresses a comprehensive range of environmental sustainability challenges affecting low-, middle-, and high-income countries.Less

This book provides a broad, in-depth primer on chemicals in the total environment, covering the atmosphere, hydrosphere, lithosphere and biosphere. It defines the terminology used in environmental health science related to chemicals, describes the sources of chemical agents in the environment, how they disperse and transform as they travel throughout the environment, their effects on environmental quality and human health, how levels and exposures are monitored and quantified, the technology for control of chemical pollutants, how environmental standards and guidelines are developed, and procedures for human health risk assessment and risk management. It can serve as a textbook for courses taken by advanced undergraduate or graduate university students and may also be a useful reference for practitioners working in environmental and public health areas.Less

Coronary heart disease (CHD) and stroke, collectively cardiovascular disease (CVD), are caused by narrowing and blockage of the arteries supplying the heart and brain, respectively. In type 2 diabetes (DM₂) insulin is insufficient to maintain normal blood glucose. South Asians have high susceptibility to these diseases. Drawing upon the scientific literature and discussions with 22 internationally recognized scholars, this book focuses on causal explanations and their implications for prevention and research. Genetically based hypotheses are considered together with the developmental origins of health and disease (DOHAD) family of hypotheses. The book then considers how CHD, stroke, and DM₂ are closely linked to rising affluence and the accompanying changes in life-expectancy and lifestyles. The established causal factors are shown to be insufficient, though necessary, parts of a convincing explanation for the excess of DM₂ and CVD in South Asians. In identifying new explanations, this book emphasizes glycation of tissues, possibly leading to arterial stiffness and microcirculatory damage. In addition to endothelial pathways to atherosclerosis an external (adventitial) one is proposed, i.e. microcirculatory damage to the network of arterioles that nourish the coronary arteries. In addition to the ectopic fat in their liver and pancreas as the cause of beta cell dysfunction leading to DM₂, additional ideas are proposed, i.e. microcirculatory damage. The high risk of CVD and DM₂ in urbanizing South Asians is not inevitable, innate or genetic, or acquired in early life and programmed in a fixed way. Rather, exposure to risk factors in childhood, adolescence, and most particularly in adulthood is the key. The challenge to produce focused, low cost, effective actions, underpinned by clear, simple, and accurate explanations of the causes of the phenomenon is addressed.Less

Diagnostic radiology is a medical specialty that is primarily devoted to the diagnostic process, centered on the interpretation of medical images. This book reviews the high level of uncertainty inherent to radiological interpretation and the overlap that exists between the uncertainty of the process and what might be considered “error.” There is also a great deal of variability inherent in the physical and technological aspects of the imaging process itself. The information in diagnostic images is subtly encoded, with a broad range of “normal” that usually overlaps the even broader range of “abnormal.” Image interpretation thus blends technology, medical science, and human intuition. To develop their skillset, radiologists train intensively for years, and most develop a remarkable level of expertise. But radiology itself remains a fallible human endeavor, one involving complex neurophysiological and cognitive processes employed under a range of conditions and generally performed under time pressure. This book highlights the human experience of error. A taxonomy of error is presented, along with a theoretical classification of error types based on the underlying causes and an extensive discussion of potential error-reduction strategies. The relevant perceptual science, cognitive science, and imaging science are reviewed. A chapter addresses the issue of accountability for error, including peer review, regulatory oversight/accreditation, and malpractice litigation. The potential impact of artificial intelligence, including the use of machine learning and deep-learning algorithms, to reduce human error and improve radiologists’ efficiency is also explored.Less

Assessing and addressing the risks of chemical hazards requires a sound knowledge of toxicology, environmental epidemiology, environmental science, health risk assessment, and public health principles. Essentials of Environmental Public Health Science provides practical guidance on the technical aspects of environmental and public health investigations. Written by leaders in the field, the authors provide practical, expert advice on a range of topics from key concepts and framework for investigation to contaminated land and waste management. Case studies are used to aid learning and understand of the topics discussed. Produced by Public Health England, this resource offers a comprehensive and structured approach to understanding environmental public health issues.Less

Fitness for Work gathers together specialist advice on the medical aspects of employment, covering the majority of medical conditions that are likely to be encountered in the working population. The aim is to inform the best occupational health advice to employers, managers, and others about the impact of a patient’s health on work and how they can be supported to gain or remain in work. The book also emphasizes the benefits to health and well-being from work. A main objective of the book is to reduce inappropriate barriers to work for those who have overcome injury and disease or who live with chronic conditions. The first half of the book deals with the general principles applying to fitness to work and occupational health practice. This includes legal aspects, ethical principles, health promotion, health surveillance, and general principles of rehabilitation. There are also chapters dealing with sickness absence, ill health retirement, medication, transport, vibration, and travel. The second half of the book is arranged in chapters according to clinical specialty or topic, written jointly by two specialists, one of whom is an occupational physician. Each specialty chapter outlines the conditions covered, including their prevalence and impact, discusses the clinical aspects including treatment that affects work capacity, notes rehabilitation requirements or special needs in the workplace, discusses problems that may arise at work and necessary work restrictions, and includes any current advisory or statutory medical standards. The recommendations are evidence based and make use of the National Institute for Health and Care Excellence guidelines and recent and relevant systematic reviews where available.Less

The emergence of the discipline of global mental health as one of the most dynamic fields of global health underscores the need for this resource, which covers two major aspects of the field: its scientific foundations and its practice. It opens with an original account charting the history of the field from antiquity to its most recent developments. The language and content is geared towards a wide audience of practitioners and students of global mental health, including those who do not have any previous training in a clinical mental health specialty. Edited by four of the field's most widely acknowledged champions, this resource features 20 chapters authored by over 30 global leaders of the field from diverse institutions and countries, is aimed to be the definitive text of this dynamic new discipline.Less

Amid ongoing shifts world economic and political systems, the promise for future public health is more tenuous than ever. We must query if today's economic systems sustain tomorrow's health, and if future generations will inherit fair access to health and health care. The best hope for the health of future generations is the establishment of a well-grounded, global public health system for today. To that end, Global Public Health: Ecological Foundations addresses both the challenges and cooperative solutions of contemporary public health, all within a framework of social justice, environmental sustainability, and global cooperation. With an emphasis upon ecological foundations, this resource approaches public health principles-history, foundations, topics, and applications-with a community-first perspective. By achieving global reach through cooperative, local interventions, this resource illustrates that through the practice of public health we can also maintain the health of our world.Less

This book is an accessible and practical core text on the three domains of health protection: Communicable Disease Control, Emergency Preparedness Resilience and Response (EPRR), and protection of the public from environmental hazards (Environmental Public Health). The editors have attempted to develop an “all hazards approach” to dealing with health protection situations. Most health protection books confine themselves to one of the three domains, whereas this book presents a practical and all hazards approach, with some account of the overarching principles of health protection on which day-to-day practice rests. The target audience is health protection practitioners, students, doctors, nurses and other non-medical professionals who may encounter health protection issues in their daily practice. From a clear introduction to the essential principles of health protection work, the book guides readers through how to manage real health protection incidents using a combination of case studies and quick reference action checklists. Each case study provides a common health protection scenario which develops in stages, in the same way as a real-life case or incident. As the story unfolds, the reader will learn about the nature and significance of the specific threat to population health, the practical steps and issues involved in an effective public health response and the health protection principles underpinning that response. Other chapters outline the general principles of health protection, providing a deeper understanding of key tools and mechanisms, as well as insights into new and emerging health protection issues. A series of individual checklists dealing with a broad range of commonly-faced diseases, hazards and incidents complete the book. These give concise and practically-focused information that can be used even by non-specialists in time-pressured situations. In particular, the variety of chapters covered throughout the book, on Communicable Diseases, Emergency Preparedness Resilience and Response, and Environmental Public Health, offer a unique perspective borne out of practical experience, not easily accessible elsewhere.Less

The majority of errors, litigation, and complaints in the health service are due to 'human factors', yet the term is still not widely understood and is sometimes used interchangeably to refer to team training or communication skills. Although it includes these, the definition of 'human factor' goes beyond to look at systems, environmental influences, and interactions with equipment, in addition to self-awareness and human interaction. All of these aspects are captured in Human Factors in Healthcare and are built into a new framework: the SHEEP model, which breaks down into five key areas: Systems, Human Interaction, Environment, Equipment, and Personal, providing a structured way to focus on adopting 'safety-positive' behaviours. Through the use of relevant real world healthcare examples and exercises, this resource encourages interaction and thinking, as well as illustrating how mistakes can be avoided. It also sets out ways on how to improve the experience of patients and staff across healthcare, in particular focusing on how to improve patient safety. Less

Illness narratives, patients’ stories about their experiences of illness, have gained a reputation as a scientific domain in medicine in the last thirty years. Patients’ stories about living with an illness, diagnostic procedures and treatments, encounters with medical institutions and its impact on their private and social life have been considered as an important access to their meaning-making and coping endeavours. They also play an important role in doctor-patient communication and the development of a healing relationship. This book aims at sensitizing professionals who use illness narratives in the field of medicine for their problems, challenges, and chances. In what ways should scholars of narratives respond to such uses? We argue that the use of narratives in applied contexts raises many questions about what kind of tools they are and what epistemological foundations, communicational properties and pragmatic effects they comprise when they are shifted from research material to clinical or educational and instructive instruments in various domains. This raises ethical concern and reflections. The book brings together scholars from various disciplines across clinical and theoretical fields. They give impressive examples how illness narratives can be used in many practical domains, and reflect on the chances as well as on the methodological or epistemological assumptions and challenges which are inevitably connected with the use of narratives as clinical, educational, or informative tools.Less

Health Impact Assessment (HIA) is a policy-support instrument and approach that seeks to assess the health impacts of projects, programmes and policies on population health. The ultimate goal of HIA is to systematically predict health impacts and subsequently inform the intersectoral decision- and policy-making processes of these impacts. This resource examines how the process of integrating HIA with policy can take place. Introductory chapters outline the HIA process and provide a conceptual foundation for the book. Then, drawing from experiences of HIA practice and research globally, country-specific experiences are presented to examine HIA's relationship with the policy process. Throughout, checklists and learning points are provided to assist in the understanding of the concepts and examples discussed.Less