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The Political Economy of Pharmaceutical Clinical Trials
Focusing on the professional roles of those involved, as well as key research practices, Fisher assesses the risks and advantages for physicians and patients alike when pharmaceutical drug studies are used as an alternative to standard medical care.
This volume examines important aspects of China's century-long search to provide appropriate and effective health care for its people. Four subjects—disease and healing, encounters and accommodations, institutions and professions, and people's health—organize discussions across case studies of schistosomiasis, tuberculosis, mental health, and tobacco and health. Among the book’s significant conclusions are the importance of barefoot doctors in disseminating western medicine, the improvements in medical health and services during the long Sino-Japanese war, and the important role of the Chinese consumer. Intended for an audience of health practitioners, historians, and others interested in the history of medicine and health in China, the book is one of three commissioned by the China Medical Board to mark its centennial in 2014.
The Human and Ecological Cost of Colonial Silver Mining in the Andes
On the basis of an examination of the colonial mercury and silver production processes and related labor systems, Mercury, Mining, and Empire explores the effects of mercury pollution in colonial Huancavelica, Peru, and Potosí, in present-day Bolivia. The book presents a multifaceted and interwoven tale of what colonial exploitation of indigenous peoples and resources left in its wake. It is a socio-ecological history that explores the toxic interrelationships between mercury and silver production, urban environments, and the people who lived and worked in them. Nicholas A. Robins tells the story of how native peoples in the region were conscripted into the noxious ranks of foot soldiers of proto-globalism, and how their fate, and that of their communities, was -- and still is -- chained to it.
Égales devant la santé?
Le système de santé canadien, bien qu’universel, présente un portrait contrasté des états de santé et de l’espérance de vie. Si les résidents de Richmond en Colombie-Britannique peuvent espérer vivre 81 ans, ceux de la région du Nunavik ne peuvent guère imaginer dépasser 65 ans. Revenu, éducation et littératie sont quelques uns des déterminants qui entraînent une variation dans la distribution de la bonne et de la mauvaise santé.Qu’advient-il lorsqu’on compare les profils de santé des communautés de langue officielle minoritaire à la communauté linguistique majoritaire? Ces communautés ont-elles accès aux mêmes services de santé et dans les mêmes conditions? Ce sont là les questions sur lesquelles se penchent les auteurs en analysant les enquêtes nationales de santé produites par Statistique Canada, plus particulièrement l’Enquête nationale de santé dans les collectivités canadiennes (ESCC). Ils examinent en premier lieu le concept même de minorité nationale et de groupe en situation minoritaire dans le contexte canadien ainsi que la situation démographique et sociopolitique de ces groupes. Ils posent ensuite le cadre théorique qui leur a permis d’intégrer le fait minoritaire parmi les déterminants de la santé et présentent les résultats de recherche qui exposent les différences en matière de santé en défaveur des minorités linguistiques. Enfin, ils ouvrent la réflexion sur la perspective canadienne sur la santé, notamment en termes de politique et d’équité.
A Short History of Fever
Christopher Hamlin’s magisterial work engages a common experience—fever—in all its varieties and meanings. Reviewing the representations of that condition from ancient times to the present, More Than Hot is a history of the world through the lens of fever. The book deals with the expression of fever, with the efforts of medical scientists to classify it, and with fever’s changing social, cultural, and political significance. Long before there were thermometers to measure it, people recognized fever as a dangerous if transitory state of being. It was the most familiar form of alienation from the normal self, a concern to communities and states as well as to victims, families, and healers. The earliest medical writers struggled for a conceptual vocabulary to explain fever. During the Enlightenment, the idea of fever became a means to acknowledge the biological experiences that united humans. A century later, in the age of imperialism, it would become a key element of conquest, both an important way of differentiating places and races, and of imposing global expectations of health. Ultimately the concept would split: "fevers" were dangerous and often exotic epidemic diseases, while “fever” remained a curious physiological state, certainly distressing but usually benign. By the end of the twentieth century, that divergence divided the world between a global south profoundly affected by fevers—chiefly malaria—and a north where fever, now merely a symptom, was so medically trivial as to be transformed into a familiar motif of popular culture. A senior historian of science and medicine, Hamlin shares stories from individuals—some eminent, many forgotten—who exemplify aspects of fever: reflections of the fevered, for whom fevers, and especially the vivid hallucinations of delirium, were sometimes transformative; of those who cared for them (nurses and, often, mothers); and of those who sought to explain deadly epidemic outbreaks. Significant also are the arguments of the reformers, for whom fever stood as a proxy for manifold forms of injustice. Broad in scope and sweep, Hamlin’s study is a reflection of how the meanings of diseases continue to shift, affecting not only the identities we create but often also our ability to survive.
Truth and Lies in the Age of AIDS
In the era of the Internet and Oprah, in which formerly taboo information is readily available or freely confided, secrecy and privacy have in many ways given way to an onslaught of confession. Yet for those who are HIV positive, decisions about disclosure of their diagnosis force them to confront intimate, fundamental, and rarely discussed questions about truth, lies, sex, and trust. Drawing from interviews with over seventy gay men and women, intravenous drug users, sex workers, bisexual men, and heterosexual men and women, the authors provide a detailed portrait of moral, social, and psychological decision making. The interviews convey the complex emotions of love, lust, longing, hope, despair, and fear that shape individual dilemmas about whether to disclose to, deceive, or trust others concerning this disease. Some of those interviewed revealed their diagnosis widely; others told no one. Some struggled and ultimately told their partners; others spoke in codes or half-truths. One woman discovered her husband's diagnosis in a diary; when confronted, he denied it. Each year in the United States, 40,000 new cases of HIV arise, yet approximately one-third of the 900,000 Americans who are infected do not know it. As treatments have improved, unsafe sexual behavior has increased and efforts at prevention have stalled. Many of those infected continue to fear and experience rejection and discrimination. Addressing broad debates about the nature of secrecy, morality, and silence, this book explores public policy questions in the light of the nuanced, private decisions that are shaping the course of an epidemic and have broader indications for all.
Eliminating Injury and Death on Canadian Roads
It is possible to eliminate death and serious injury from Canada’s roads. In other jurisdictions, the European Union, centres in the United States, and at least one automotive company aim to achieve comparable results as early as 2020. In Canada, though, citizens must turn their thinking on its head and make road safety a national priority.
Since the motor vehicle first went into mass production, the driver has taken most of the blame for its failures. In a world where each person’s safety is dependent on a system in which millions of drivers must drive perfectly over billions of hours behind the wheel, failure on a massive scale has been the result. When we neglect the central role of the motor vehicle as a dangerous consumer product, the result is one of the largest human-made means for physically assaulting human beings. It is time for Canadians to embrace internationally recognized ways of thinking and enter an era in which the motor vehicle by-product of human carnage is relegated to history.
No Accident examines problems related to road safety and makes recommendations for the way forward. Topics include types of drivers; human-related driving errors related to fatigue, speed, alcohol, and distraction and roads; pedestrians, cyclists, and public transit; road engineering; motor vehicle regulation; auto safety design; and collision-avoidance technologies such as radar and camera-based sensors on vehicles that prevent crashes. This multi-disciplinary study demystifies the world of road safety and provides a road map for the next twenty years. Includes a foreword by Ralph Nader.
Addressing Gaps in Global Policy and Research
Noncommunicable diseases (NCDs)—including cardiovascular disease, diabetes, asthma and other chronic respiratory conditions, and cancers—are the leading causes of death worldwide. An estimated 36 million people die from such diseases each year; this represents roughly two out of three deaths globally. Eighty percent of these fatalities occur in developing countries. The statistics are staggering, yet millions of these deaths are preventable. This is an urgent global health issue that demands analysis of gaps in NCD research, new policies and practices, and actionable recommendations to close the gaps. The Johns Hopkins Institute for Applied Economics, Global Health, and the Study of Business Enterprise convened an NCD Working Group of leading scholars to examine a wide range of issues that both the private and public sectors must address to make sustainable progress in NCD prevention and treatment in lower- and middle-income countries. Collected in this volume are essays on five key areas where strengthened policies and health systems can have the most impact in the near future. • Accelerating regulatory harmonization • Structuring supply chains • Improving access to interventions • Restructuring primary care • Promoting multisectoral and intersectoral action While there is a growing literature on the problem of NCDs, none of the available studies provides background on the range of challenges matched with specific steps that can be taken by the public sector, private sector, and civil society working together. Noncommunicable Diseases in the Developing World presents a framework for understanding the salience of specific policy recommendations and detailed steps that can be taken now to move forward in the global campaign against NCDs. This book will be of interest to practitioners, scholars, and students in public health as well as those framing and implementing health policies in the private and public sectors.