This framework document describes the strategy used by the Center for International Reproductive Health Training at the University of Michigan (UM-CIRHT) to integrate preservice family planning and comprehensive abortion care training into health professional schools' curricula. The program is designed to ensure acquisition of requisite competencies so that partner schools can graduate competent health professionals able to deliver high-quality, comprehensive reproductive health services to women.
The framework is intended to provide guidance on how the programmatic and operational strategies for family planning and comprehensive abortion care could be extended in countries or institutions that seek to replicate the UM-CIRHT model in their settings. It may be adapted to the local context of individual countries and institutions.
This framework document is produced by UM-CIRHT with funding from an anonymous donor.
Written for nonexperts, this is a brisk, engaging history of American healthcare from the advent of Medicare and Medicaid in the 1960s to the impact of the Affordable Care Act in the 2010s. Step by step, Jonathan Engel shows how we arrived at our present convoluted situation, where generic drugs prices can jump 1,000 percent in a day and primary care physicians can lose 20 percent of their income at the stroke of a Congressional pen.
Unaffordable covers, in a conversational style punctuated by apt examples, topics ranging from health insurance, pharmaceutical pricing, and physician training to health maintenance organizations and hospital networks. Along the way, Engel introduces approaches that other nations have taken in organizing and paying for healthcare and offers insights on ethical quandaries around end-of-life decisions, neonatal care, life-sustaining treatments, and the limits of our ability to define death. While describing the political origins of many of the federal and state laws that govern our healthcare system today, he never loses sight of the impact that healthcare delivery has on our wallets and on the balance sheets of hospitals, doctors' offices, government agencies, and private companies.
Eric Michaels Duke University Press, 1997 Library of Congress RC607.A26M53 1997 | Dewey Decimal 362.19697920092
In 1982, the American-born anthropologist Eric Michaels went to Australia to research the impact of television on remote aboriginal communities. Over the next five years, until his death, he became a major intellectual presence in Australia. Unbecoming is Michaels’s gritty, provocative, and intellectually powerful account of living with AIDS—a chronicle of the last year of his life as he became increasingly ill. Michaels’s diary offers a forceful and ironic rumination on the cultural phenomenon of AIDS, how it relates to his concerns as both an anthropologist and a gay man, and the failure of medical and governmental institutions to come to terms with the disease. Like the AIDS testimony of artist David Wojnarowicz and filmmaker Derek Jarman, Unbecoming provides a view of the AIDS epidemic from a distinctly new vantage point.
This volume revisits the Nobel Prize-winning economist Kenneth Arrow’s classic 1963 essay “Uncertainty and the Welfare Economics of Medical Care” in light of the many changes in American health care since its publication. Arrow’s groundbreaking piece, reprinted in full here, argued that while medicine was subject to the same models of competition and profit maximization as other industries, concepts of trust and morals also played key roles in understanding medicine as an economic institution and in balancing the asymmetrical relationship between medical providers and their patients. His conclusions about the medical profession’s failures to “insure against uncertainties” helped initiate the reevaluation of insurance as a public and private good.
Coming from diverse backgrounds—economics, law, political science, and the health care industry itself—the contributors use Arrow’s article to address a range of present-day health-policy questions. They examine everything from health insurance and technological innovation to the roles of charity, nonprofit institutions, and self-regulation in addressing medical needs. The collection concludes with a new essay by Arrow, in which he reflects on the health care markets of the new millennium. At a time when medical costs continue to rise, the ranks of the uninsured grow, and uncertainty reigns even among those with health insurance, this volume looks back at a seminal work of scholarship to provide critical guidance for the years ahead.
Contributors Linda H. Aiken Kenneth J. Arrow Gloria J. Bazzoli M. Gregg Bloche Lawrence Casalino Michael Chernew Richard A. Cooper Victor R. Fuchs Annetine C. Gelijns Sherry A. Glied Deborah Haas-Wilson Mark A. Hall Peter J. Hammer Clark C. Havighurst Peter D. Jacobson Richard Kronick Michael L. Millenson Jack Needleman Richard R. Nelson Mark V. Pauly Mark A. Peterson Uwe E. Reinhardt James C. Robinson William M. Sage J. B. Silvers Frank A. Sloan Joshua Graff Zivin
Undead Science examines the story of cold fusion, one of the most publicized scientific controversies of the late twentieth century. In 1989 two Utah-based “discoverers” claimed to have developed an electrochemical process that produced more energy than was required to initiate the process. Finding no other explanation, the researchers described their findings as some kind of nuclear reaction. If they were correct, an important new energy source would have been found. Objections surfaced quickly, and in the year that followed, hundreds of scientists worldwide attempted to reproduce these results. Most, though not all, failed, and the controversy became increasingly antagonistic. By 1990, general scientific opinion favored the skeptics and experimental work went into a steep decline. Nevertheless, many scientists continue to do research in what Bart Simon calls this “undead science.”
Simon argues that in spite of widespread skepticism in the scientific community, there has been a continued effort to make sense of the controversial phenomenon. Researchers in well-respected laboratories continue to produce new and rigorous work. In this manner, cold fusion research continues to exist long after the controversy has subsided, even though the existence of cold fusion is circumscribed by the widespread belief that the phenomenon is not real.
The survival of cold fusion signals the need for a more complex understanding of the social dynamics of scientific knowledge making, the boundaries between experts, intermediaries, and the lay public, and the conceptualization of failure in the history of science and technology.
Under Quarantine is the riveting story of Shaar Ha’aliya, a central immigrant processing camp opened shortly after Israel became an independent state. This historic gateway for Jewish migration was surrounded by a controversial barbed wire fence. The camp administrators defended this imposing barrier as a necessary quarantine measure - even as detained immigrants regularly defied it by crawling out of the camp and returning at will. Focusing on the conflicts and complications surrounding the medical quarantine, this book brings the history of this place and the remarkable experiences of the immigrants who went through it to life. Evocative and bold, Under Quarantine shows that we cannot fully understand Israel until we understand Shaar Ha’aliya. The gate of arrival for nearly half a million immigrants - a space of homecoming, conflict, exclusion and welcoming - here was the country’s crucible.
Most women who elect to have cosmetic surgery want a “natural” outcome—a discrete alteration of the body that appears unaltered. Under the Knife examines this theme in light of a cultural paradox. Whereas women are encouraged to improve their appearance, there is also a stigma associated with those who do so via surgery.
Samantha Kwan and Jennifer Graves reveal how women negotiate their “unnatural”—but hopefully (in their view) natural-looking—surgically-altered bodies. Based on in-depth interviews with 46 women who underwent cosmetic surgery to enhance their appearance, the authors investigate motivations for surgery as well as women’s thoughts about looking natural after the procedures. Under the Knife dissects the psychological and physical strategies these women use to manage the expectations, challenges, and disappointments of cosmetic surgery while also addressing issues of agency and empowerment. It shows how different cultural intersections can produce varied goals and values around body improvement.
Under the Knife highlights the role of deep-seated yet contradictory gendered meanings about women’s bodies, passing, and boundary work. The authors also consider traditional notions of femininity and normalcy that trouble women’s struggle to preserve an authentic moral self.
Every year, about forty million Americans require surgery. Few truly understand what happens to them during the procedure-especially what the anesthesiologist does to ensure their survival and well being. An anesthesiologist disarms your entire nervous system with the most effective drugs for your body chemistry; keeps you alive while you're subjected to manipulations that would otherwise kill you; and ensures your safe return to consciousness. Yet despite their crucial role, anesthesiologists are often the unseen doctors. Under the Mask, written by a compassionate practitioner, demystifies the surgical process with detailed information that will make you a better-informed consumer.
Part One describes the development and current scope of anesthesiology, the medications and techniques used, and what the anesthesiologist does both in and outside the operating room. It explains your-the patient's- rights and advises you how to use the preoperative consultation with the anesthesiologist to your best advantage, specifying what information you need provide and what questions you should ask.
Part Two details the most common surgical and diagnostic procedures requiring anesthesia or conscious sedation. Using clear language, it explains each procedure, the possible risks, and the choices to make if there is more than one option. It also covers the anesthesiologist's crucial role in controlling pain caused by chronic conditions. The last chapter describes the newest anesthetic and pain control techniques available.
The author also helps you understand anesthesiology within the managed care system and explains what you can expect and what to do if you aren't getting what you need. This book enables you to make informed decisions regarding surgical anesthesia and subsequent pain control within the managed care system to protect your well-being and hasten your recovery.
At the end of the Second World War, a diagnosis of cancer was a death sentence. Sixty years later, it is considered a chronic disease rather than one that is invariably fatal. Although survival rates have improved, the very word continues to evoke a special terror and guilt, inspiring scientists and politicians to wage war against it.
In Under the Radar, Ellen Leopold shows how nearly every aspect of our understanding and discussion of cancer bears the imprint of its Cold War entanglement. The current biases toward individual rather than corporate responsibility for rising incidence rates, research that promotes treatment rather than prevention, and therapies that can be patented and marketed all reflect a largely hidden history shaped by the Cold War. Even the language we use to describe the disease, such as the guiding metaphor for treatment, "fight fire with fire," can be traced back to the middle of the twentieth century.
Writing in a lucid style, Leopold documents the military, governmental, industrial, and medical views of radiation and atomic energy to examine the postwar response to cancer through the prism of the Cold War. She explores the role of radiation in cancer therapies today, using case studies and mammogram screening, in particular, to highlight the surprising parallels. Taking into account a wide array of disciplines, this book challenges our understanding of cancer and how we approach its treatment.
Examines the postwar response to cancer through the prism of the Cold War
Goes beyond medical science to look at the influence of Cold War policies on the way we think about cancer today
Links the experience of postwar cancer patients with the broader evolution of what have become cancer industries
Traces the history of human-made radiation as a state-sponsored environmental toxin
Assisted suicide remains one of the most emotionally charged and controversial topics—and the issue isn’t going away any time soon. As the baby boomer generation ages, many of us will watch as our parents—and ourselves—grow older, and wonder at the decisions that lie ahead.
Understanding Assisted Suicide provides both a fresh take on this important topic and the framework for intelligent participation in the discussion. Uniquely, the author frames the issue using his own experience watching both his parents die, which led him to ask fundamental questions about death, dying, religion, and the role of medicine and technology in alleviating human suffering.
In concerns about assisted suicide, each person’s “big picture” has largely been created out of picking and choosing from nine separate snapshot albums.
Understanding this offers a perspective for quickly determining the sources of another’s opinion on assisted suicide, as well as the issues they are not considering. Most importantly, Understanding Assisted Suicide offers a clear, easy-to-traverse landscape over which those who are sincerely looking for their own answers can navigate. The “nine-issue structure” allows both careful exploration of separate issues and a view of the full spectrum of ideas involved.
Understanding Brain Disease is as much for the specialist as it is for the lay person interested in finding out where we are today in the scientific attempts to understand and control such conditions as stroke, Alzheimer’s, Parkinson’s, and BSE.
The book will help build bridges between medical practitioners and researchers and the general public.
One has only to take stock of Canadian statistics to realize the immense, and world-wide, significance of this research and the need for information --
•Stroke is the fourth leading cause of death in Canada.
•Each year, about 16,000 Canadians die from stroke.
•Each year, more women than men die from stroke.
•There are between 40,000 and 50,000 strokes in Canada each year.
•For every 10,000 Canadian children under the age of 19, there are 6.7 strokes.
•About 300,000 Canadians are living with the effects of stroke.
•After age 55, the risk of stroke doubles every 10 years.
•A stroke survivor has a 20% chance of having another stroke within 2 years.
•Of every 100 people who have a stroke 15 die (15%)
•10 recover completely (10%)
•25 recover with a minor impairment or disability (25%)
•40 are left with a moderate to severe impairment (40%)
•10 are so severely disabled they require long-term care (10%)
•Stroke costs the Canadian economy $2.7 billion a year.
•The average acute care costs is about $27,500 per stroke.
•Canadians spend a total of 3 million days in hospital because of stroke.
Self-help groups have encountered fierce criticism as places where individuals join to share personal problems and to engage in therapeutic intervention without the aid of skilled professionals. These groups have flourished since the 1970s and continue to serve more people than professional therapy.
Yet these groups have been criticized as fostering a culture of whiners and victims, and not using professional help as needed. Thomasina Jo Borkman debunks this commonly held assessment, and also examines the reasons for these groups’ enduring popularity since the 1960s—more people attend these meetings (word?) than see professional therapists. What accounts for their success and popularity?
Understanding Self-Help / Mutual-Aid Groups is the first book to describe three stages of individual and group evolution that is part of this organization’s very structure; it also reconceptualizes participants’ interactions with professionals. The group as a whole, Borkman posits, draws on the life experiences of its membes to foster nurturing, support, and transformation through a “circle of sharing.” Groups create more positive and less stigmatizing “meaning perspectives” of the members’ problems than is available from professionals or lay folk culture.
A RAND study, the first to examine care received by a census of active-duty service members diagnosed with mild traumatic brain injury in the Military Health System, assessed the number and characteristics of these patients (including deployment history and history of traumatic brain injury), their care settings, the treatments they received, co-occurring conditions, the duration of treatment, and the risk factors for requiring long-term care.
UnitaryCaring Science: The Philosophy and Praxis of Nursing takes a profound look at conscious, intentional, reverential caring-healing as sacred practice/praxis and as a necessary turn for survival. Jean Watson posits Unitary Caring Science for the evolved Caritas-conscious practitioner and scholar. A detailed historical discussion of the evolution from Caring Science toward Unitary Caring Science reflects the maturing of the discipline, locating the nursing phenomena of wholeness within the unitary field paradigm. An exploration of praxis as informed moral practice results in an expanded development of the ten Caritas processes, resulting in a comprehensive value-guide to critical Caritas literacy and ontological Caritas praxis.
Watson writes for the Caritas Conscious Nurse™ or the Caritas Conscious Scholar/Practitioner/Educator on the journey toward the deeper caring-healing dimensions of life. Unitary Caring Science offers a personal-professional path of authenticity, bringing universals of Love, Energy, Spirit, Infinity of Purpose, and Meaning back into nurses lives and their life’s work. Unitary Caring Science serves as a continuing, evolving message to the next generation of nurse scholars and healing-health practitioners committed to a praxis informed by mature disciplinary consciousness.
Each book comes with a set of Caritas cards, and individual customers will also receive a secure link to select copyrighted teaching videos and meditations on www.watsoncaringscience.org.
As millions of baby boomers retire and age in the coming years, more American families will confront difficult choices about the long-term care of their loved ones. The swelling ranks of the disabled and elderly who need such care—including home care, adult day care, or a nursing home stay—are faced with a strained, inequitable and expensive system. How will American society and policy adapt to this demographic transition? In Universal Coverage of Long-Term Care in the United States, editors Nancy Folbre and Douglas Wolf and an expert group of care researchers assess the current U.S. long-term care policies and exercise what can be learned from other countries facing similar care demands. After the high-profile suspension of the Obama Administration’s public long-term insurance program in 2011, Robert Hudson and Howard Gleckman provide concrete suggestions for lowering the cost and improving the quality of long-term care coverage in America. In a deeply personal and empirically rigorous analysis, family care expert Carol Levine draws crucial lessons from her experience as a caregiver for her ailing husband. She sheds light on the often fraught interactions that occur between the formal care system and family caregivers and analyzes how public policy can best support long-term family care. The volume next examines recent reforms in other developed countries and finds valuable lessons for American policy-makers. Contributors David Bell and Alison Bowes discuss the provision of personal care services in Scotland, which have been publicly financed since 2002. Their analysis shows that the new program reduced costs improved efficiency and allowed more recipients to receive care. The volume assesses the political and institutional prospects for moving towards a truly universal long-term care system in the United States. Robyn Stone provides a sobering overview of the formal, paid long-term care workforce in America, which is in crisis due to increasing demand and a shortage of qualified workers. Economist Leonard Burman focuses on public finances of the long-term care system, which will come under increasing strain as more Americans rely on Medicaid to pay for their long-term care. In the volume’s concluding chapter, Folbre and Wolf summarize criticisms of existing long-term care policies and outline particular reforms that can move the United States toward a universal system of long-term care insurance. Universal Coverage of Long-Term Care in the United States provides an essential resource on how to improve the long-term care sector in America and helps advance the national debate on this pressing topic. This volume is available for free download on the Foundation’s website, as are the volume’s individual chapters.
Since the defeat of the Nazi Third Reich and the end of its horrific eugenics policies, battles over the politics of life, sex, and death have continued and evolved. Dagmar Herzog documents how reproductive rights and disability rights, both latecomers to the postwar human rights canon, came to be seen as competing—with unexpected consequences.
Bringing together the latest findings in Holocaust studies, the history of religion, and the history of sexuality in postwar—and now also postcommunist—Europe, Unlearning Eugenics shows how central the controversies over sexuality, reproduction, and disability have been to broader processes of secularization and religious renewal. Herzog also restores to the historical record a revelatory array of activists: from Catholic and Protestant theologians who defended abortion rights in the 1960s–70s to historians in the 1980s–90s who uncovered the long-suppressed connections between the mass murder of the disabled and the Holocaust of European Jewry; from feminists involved in the militant "cripple movement" of the 1980s to lawyers working for right-wing NGOs in the 2000s; and from a handful of pioneers in the 1940s–60s committed to living in intentional community with individuals with cognitive disability to present-day disability self-advocates.
Unstable Frontiers was first published in 1994. Minnesota Archive Editions uses digital technology to make long-unavailable books once again accessible, and are published unaltered from the original University of Minnesota Press editions.
"John Erni's heartfelt and insightful book is a valuable contribution to the study of the cultural politics of AIDS."–Jeff Nunokawa Princeton University
The "cure" for AIDS: The search goes on, keeping pace with our belief that AIDS is incurable. How such a seeming paradox works-and how it may well work against the proper treatment of the disease-is the subject of Unstable Frontiers, a probing, critical look at the cultural politics behind the quest for a cure for AIDS.
This massive commercial and scientific project, John Erni suggests, actually hinges on our contradictory definitions of the disease as curable and incurable at the same time. Drawing on diverse sources, from popular media to medical literature to cultural theory, he shows how the dual discourse of curability/incurability frames the way we think about and act on issues of medical treatment for AIDS. His work makes a major advance in our understanding of—and, perhaps, humane response to—a national crisis.
In his critique of the logic and fantasies underlying the double definition of AIDS, Erni explores a broad range of issues: the scientific paradigm used to develop AZT; the politics of alternative treatment practices, of clinical drug trials, and of AIDS activism; and the notions of time and temporality operating in AIDS treatment science. He also addresses the problematic popular themes, such as "AIDS is invariably fatal" and "Knowledge = Cure."
Unique in its approach to a social and political issue still in the making, the book reveals how AIDS has challenged technomedicine's historical position of authority-and in doing so, recasts this challenge in a powerful and ultimately hopeful way.
John Nguyet Erni is assistant professor of communication at the University of New Hampshire. He has published essays on AIDS and is currently working on a book about AIDS in Thailand.
This book describes the emergence of a small but essential medical specialty, urology, at one of the first American public institutions of higher education, the University of Michigan. Urology at Michigan: The Origin Story, a microcosm of the modern world of healthcare specialization, entwines many stories beginning with its earliest roots, diagnostic uroscopy and the primitive interventions of catheterization and lithotomy. The Hippocratic Oath forbade its generalist healers from only three practices – abortion, euthanasia, and lithotomy, relegating the last to specialists “in that art,” namely itinerant lithotomists of whom little record remains. Over two and a half millennia since Hippocrates, catheterization, lithotomy, and genitourinary surgery in general advanced only modestly until products of the industrial revolution and scientific inquiry provided the tools and knowledge that accelerated the ancient genitourinary work into a new discipline of urology around the fin de siècle of the 19th century, just as the University of Michigan concurrently was joining the top rank of higher education.
The University of Michigan in the early 20th century was nearly a century old and contained a medical school and wholly-owned University Hospital, the first of that genre. Ann Arbor was a propitious place for modern urology to take hold when Hugh Cabot brought not just the new terminology, but also the complete triple mission with urologic education and research embedded in a milieu of world-class clinical care. Cabot arrived in Ann Arbor from Boston in the autumn of 1919, imbued with more than two years’ service in WWI with the British Expeditionary Forces on the Western Front, and he became Dean of the Medical School in 1921. Cabot expanded the full-time salary model in the medical school, supervised construction of Ann Arbor’s 4th iteration of the University Hospital, but its first state-of the art facility. He created a multi-specialty academic group practice and assembled a great faculty with future leaders in surgery including Frederick Coller, Max Peet, Carl Badgley, and John Alexander. Cabot’s first trainees to become urologists were Charles Huggins, a future Nobel Laureate, and Reed Nesbit who rose to the top ranks of academic and organizational urology and made Ann Arbor an international clinical and educational destination. This book tells the story of urology at Michigan amidst the larger stories of the roots of genitourinary surgery, the formation of the University of Michigan and its Medical School, and the inevitable tensions of balancing the triple mission of medical academia: education and investigation within a milieu of the essential transaction of excellent clinical care.