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Bodies, Politics, and African Healing

The Matter of Maladies in Tanzania

Stacey A. Langwick

This subtle and powerful ethnography examines African healing and its relationship to medical science. Stacey A. Langwick investigates the practices of healers in Tanzania who confront the most intractable illnesses in the region, including AIDS and malaria. She reveals how healers generate new therapies and shape the bodies of their patients as they address devils and parasites, anti-witchcraft medicine, and child immunization. Transcending the dualisms between tradition and science, culture and nature, belief and knowledge, Langwick tells a new story about the materiality of healing and postcolonial politics. This important work bridges postcolonial theory, science, public health, and anthropology.

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Broken Hearts

The Tangled History of Cardiac Care

David S. Jones

Still the leading cause of death worldwide, heart disease challenges researchers, clinicians, and patients alike. Each day, thousands of patients and their doctors make decisions about coronary angioplasty and bypass surgery. In Broken Hearts David S. Jones sheds light on the nature and quality of those decisions. He describes the debates over what causes heart attacks and the efforts to understand such unforeseen complications of cardiac surgery as depression, mental fog, and stroke. Why do doctors and patients overestimate the effectiveness and underestimate the dangers of medical interventions, especially when doing so may lead to the overuse of medical therapies? To answer this question, Jones explores the history of cardiology and cardiac surgery in the United States and probes the ambiguities and inconsistencies in medical decision making. Based on extensive reviews of medical literature and archives, this historical perspective on medical decision making and risk highlights personal, professional, and community outcomes.

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Building Healthy Communities through Medical-Religious Partnerships

Richard G. Bennett, M.D., and W. Daniel Hale, Ph.D.

Because health care works best when patients assume greater responsibility for their own health, community outreach and patient education have taken on increased importance. Building Healthy Communities through Medical-Religious Partnerships describes an innovative approach to the development of community-based health education and patient advocacy programs targeted at the prevention and management of disease. Partnerships between health systems and religious congregations, the authors show, can be remarkably successful at bringing appropriate care to people who are often difficult to serve. The book offers valuable guidance for religious and medical leaders interested in developing programs in their congregations and communities. It includes practical and accessible information for establishing health education programs, identifies additional resources that can be obtained from local and national organizations, and discusses a range of medical topics. It also outlines how to train volunteers to assist others in navigating our complex health system. This revised and expanded edition of Building Healthy Communities through Medical-Religious Partnerships includes several new chapters along with descriptions of five medical-religious partnership models. Special attention is given to the challenges and opportunities presented by our aging and increasingly diverse population.

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The Burdens of Disease

Epidemics and Human Response in Western History, Revised Edition

J.N. Hays

In this updated edition of The Burdens of Disease, with revisions and additions to the original content, including the evolution of drug-resistant diseases and expanded coverage of HIV/AIDS, along with recent data on mortality figures and other relevant statistics, J. N. Hays chronicles perceptions and responses to plague and pestilence over two thousand years of western history. Disease is framed as a multidimensional construct, situated at the intersection of history, politics, culture, and medicine, and rooted in mentalities and social relations as much as in biological conditions of pathology.

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Cancer Screening in the Developing World

Case Studies and Strategies from the Field

Madelon L. Finkel, PhD

Worldwide, cancer is responsible for one in eight deaths—more than AIDS, tuberculosis, and malaria combined. This global burden starkly illustrates the inequality between the developed and the developing world. While the majority of people living in developed countries receive timely treatment, those living in developing countries are not as fortunate and their survival rates are much lower—not only due to delays in diagnosis, but also to a lack of personnel, a paucity of treatment facilities, and the unavailability of many medications. Routine screening—a mainstay in the developed world—could greatly increase the likelihood of identifying individuals with early stage cancers and thus reduce the number of people who present with advanced disease.

This book represents a critical addition to the literature of global health studies. Focusing on cervical, breast, and oral cancers, these case studies highlight innovative strategies in cancer screening in a diverse array of developing countries. The authors discuss common issues and share how obstacles—medical, economic, legal, social, and psychological—were addressed or overcome in specific settings. Each chapter offers an empirical discussion of the nature and scope of a screening program, the methodology used, and its findings, along with a candid discussion of challenges and limitations and suggestions for future efforts.

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Catastrophic Diseases

Who Decides What?

People do not choose to suffer from catastrophic illnesses, but considerable human choice is involved in the ways in which the participants in the process treat and conduct research on these diseases.

Catastrophic Diseases draws a powerful and humane portrait of the patients who suffer from these illnesses as well as of the physician-investigators who treat them, and describes the major pressures, conflicts, and decisions which confront all of them. By integrating a discussion of "facts" and "values," the authors highlight the forces which affect new developments in medicine—such as kidney and heart transplants—and the controversial issues they generate.

Katz and Capron explore these issues through the use of dual conceptual perspectives. Their study first examines and evaluates the authority which should be vested in each of the chief participants in the catastrophic disease process—the physician-investigator, the patient-subject and his relatives, the professionals, and the state. Challenging questions are raised concerning medical education, informed consent, and professional responsibility. The authors next explore how the roles and capacities of the participants vary not only according to the basic issues they face but also according to the point in decision-making at which these issues arise. The process of investigating and treating catastrophic diseases, the authors believe, can thus usefully be divided into three decision-making stages—the formulation of policy, the administration of research and therapy, and the review of the decisions and their consequences.

In conclusion, Katz and Capron demonstrate the need for a variety of individuals and groups with diverse values to be involved in decision-making in a manner which will not unnecessarily impede the scientific investigation of these diseases.

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Child Health in America

Making a Difference through Advocacy

Judith S. Palfrey, M.D.

Who will speak for the children? is the question posed by Judith S. Palfrey, a pediatrician and child advocate who confronts unconscionable disparities in U.S. health care—a system that persistently fails sick and disabled children despite annual expenditures of $1.8 trillion. In Child Health in America, Palfrey explores the meaning of advocacy to children's health and describes how health providers, community agencies, teachers, parents, and others can work together to bring about needed change. Palfrey presents a conceptual framework for child health advocacy consisting of four interconnected components: clinical, group, professional, and legislative. Describing each of these concepts in useful and compelling detail, she is also careful to provide examples of best practices. This original and progressive work affirms the urgent need for child advocacy and provides valuable guidance to those seeking to participate in efforts to help all children live healthier, happier lives.

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Chronic Conditions, Fluid States

Chronicity and the Anthropology of Illness

Edited and with an introduction by Lenore Manderson and Carolyn Smith-Morris

Chronic Conditions, Fluid States explores the uneven impact of chronic illness and disability on individuals, families, and communities in diverse local and global settings. To date, much of the social as well as biomedical research has treated the experience of illness and the challenges of disease control and management as segmented and episodic. Breaking new ground in medical anthropology by challenging the chronic/acute divide in illness and disease, the editors, along with a group of rising scholars and some of the most influential minds in the field, address the concept of chronicity, an idea used to explain individual and local life-worlds, question public health discourse, and consider the relationship between health and the globalizing forces that shape it.

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Cities and the Health of the Public

Edited by Nicholas Freudenberg, Sandro Galea, and David Vlahov

The essays commissioned for this book analyze the impact of city living on health, focusing primarily on conditions in the United States. With 16 chapters by 24 internationally recognized experts, the book introduces an ecological approach to the study of the health of urban populations. This book assesses the primary determinants of well-being in cities, including the social and physical environments, diet, and health care and social services. The book includes chapters on the history of public health in cities, the impact of urban sprawl and urban renewal on health, and the challenges facing cities in the developing world. It also examines conditions such as infectious diseases, violence and disasters, and mental illness.

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Classrooms and Clinics

Urban Schools and the Protection and Promotion of Child Health, 1870-1930

Richard A. Meckel

Classrooms and Clinics is the first book-length assessment of the development of public school health policies from the late nineteenth century through the early years of the Great Depression. Richard A. Meckel examines the efforts of early twentieth-century child health care advocates and reformers to utilize urban schools to deliver health care services to socioeconomically disadvantaged and medically underserved children in the primary grades. Their goal, Meckel shows, was to improve the children’s health and thereby improve their academic performance.

Meckel situates these efforts within a larger late nineteenth- and early twentieth-century public discourse relating schools and schooling, especially in cities and towns, to child health. He describes and explains how that discourse and the school hygiene movement it inspired served as critical sites for the constructive negotiation of the nature and extent of the public school’s—and by extension the state’s—responsibility for protecting and promoting the physical and mental health of the children for whom it was providing a compulsory education.

Tracing the evolution of that negotiation through four overlapping stages, Meckel shows how, why, and by whom the health of schoolchildren was discursively constructed as a sociomedical problem and charts and explains the changes that construction underwent over time.  He also connects the changes in problem construction to the design and implementation of various interventions and services and evaluates how that design and implementation were affected by the response of the civic, parental, professional, educational, public health, and social welfare groups that considered themselves stakeholders and took part in the discourse. And, most significantly, he examines the responses called forth by the question at the heart of the negotiations: what services are necessitated by the state’s and school’s taking responsibility for protecting and promoting the health and physical and mental development of schoolchildren.  He concludes that the negotiations resulted both in the partial medicalization of American primary education and in the articulation and adoption of a school health policy that accepted the school’s responsibility for protecting and promoting the health of its students while largely limiting the services called for to the preventive and educational.

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