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Journal of Health Care for the Poor and Underserved

Vol. 1 (1990) through current issue

Journal of Health Care for the Poor and Underserved (JHCPU) is a peer-reviewed journal focusing on contemporary health care issues of medically underserved communities. JHCPU addresses such diverse areas as health care access, quality, costs, legislation, regulations, health promotion, and disease prevention from a North American, Central American, Caribbean, and sub-Saharan African perspective. Regular features include research papers and reports, literature reviews, policy analyses, and evaluations of noteworthy health care programs, as well as a regular column written by members of the Association of Clinicians for the Underserved. Journal of Health Care for the Poor and Underserved is the official journal of the Association of Clinicians for the Underserved (ACU).

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Just Don't Get Sick

Access to Health Care in the Aftermath of Welfare Reform

Karen Seccombe and Kim A Hoffman

The ability to obtain health care is fundamental to the security, stability, and well-being of poor families. Government-sponsored programs provide temporary support, but as families leave welfare for work, they find themselves without access to coverage or care. The low-wage jobs that individuals in transition are typically able to secure provide few benefits yet often disqualify employees from receiving federal aid.

Drawing upon statistical data and in-depth interviews with over five hundred families in Oregon, Karen Seccombe and Kim Hoffman assess the ways in which welfare reform affects the well-being of adults and children who leave the program for work. We hear of asthmatic children whose uninsured but working mothers cannot obtain the preventive medicines to keep them well, and stories of pregnant women receiving little or no prenatal care who end up in emergency rooms with life-threatening conditions.

Representative of poor communities nationwide, the vivid stories recounted here illuminate the critical relationship between health insurance coverage and the ability to transition from welfare to work.

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L'irrigation avec des eaux usées et la santé

Évaluer et atténuer les risques dans les pays à faible revenu

Edited by Pay Drechsel

Dans la plupart des pays en développement, les systèmes de traitement des eaux usées sont très peu étendus ou sont peu efficaces, ce qui engendre une pollution de l’eau à vaste échelle et l’utilisation d’eau de mauvaise qualité pour l’irrigation des cultures, notamment à proximité des centres urbains. Cela pose de grands risques pour la santé publique, en particulier lorsque la production est consommée crue.L’irrigation avec des eaux usées et la santé aborde ce sérieux problème d’un point de vue pratique et réaliste, en traitant des enjeux de l’évaluation des risques pour la santé et de leur atténuation dans le contexte des pays en développement. Le livre est donc un complément utile d’autres ouvrages consacrés au thème des eaux usées qui mettent l’accent sur les options de traitement haut de gamme et sur l’utilisation des eaux usées.Ce livre fait avancer le débat en couvrant également la réalité, répandue, de l’utilisation des eaux usées non traitées, des eaux grises et des excrétas. Il présente des méthodes d’avant-garde d’évaluation quantitative des risques de même que des solutions peu coûteuses pour la réduction des risques pour la santé, depuis le traitement jusqu’aux mesures adoptées sur la ferme et hors de la ferme, qui vont dans le sens de l’approche à barrières multiples préconisée dans les lignes directrices relatives à l’utilisation sans risque des eaux usées en agriculture publiées par l’Organisation mondiale de la santé en 2006.

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L'épidémiologie sans peine

L'objectif de cet ouvrage est de permettre au lecteur de prendre un premier contact avec l'épidémiologie, de se familiariser avec ses principaux concepts et ses méthodes les plus usuelles. Il offre un glossaire raisonné et systématique des principaux termes utilisés et donne la marche à suivre pour la réalisation d'une enquête épidémiologique. Il s'adresse donc à tous ceux qui, non formés à l'épidémiologie pendant leurs études, sont aujourd'hui confrontés à l'invasion par cette discipline de tous les domaines de la médecine et de la santé.

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La chaîne des médicaments

Perspectives pluridisciplinaires

Edited by Joseph Josy Lévy

Cet ouvrage collectif présente un large tour d'horizon qui met en relief les dimensions des représentations et des usages des médicaments et pointe les enjeux biomédicaux, socioéconomiques, culturels et éthiques qui les accompagnent.

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Les médias et la santé

Edited by Lise Renaud

Décideurs et intervenants de santé publique s’interrogent sur le rôle joué par les médias dans la construction des normes en matière de santé. Comment les médias contribuent-ils à la naissance et au renforcement de ces normes sociales? C’est à cette question encore peu étudiée que cherchent à répondre les auteurs de cet ouvrage, fruit du travail du Groupe de recherche Médias et santé. Nourri d’une réflexion théorique sur les normes et la santé, ainsi que sur la façon dont les médias contribuent à les façonner, un nouveau modèle dynamique interactif est d’abord proposé.

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Les soins de santé primaires

Critiques d'une orthodoxie

Edited by Roberson Édouard

Depuis la Conférence d’Alma Ata, en 1978, les soins de santé primaires (SSP) ont changé de nature. On en a fait la pierre angulaire de toute réforme des systèmes de santé. Aussi est-ce quasiment un problème moral aujourd’hui d’en questionner l’omniprésence. Comment en sommes-nous arrivés là ? Qu’est-ce qui fait que les SSP ont pu nous apparaître si nécessaires qu’on en ait fait une orthodoxie ? Mais, en fait, de quoi s’agit-il ? Qui sont les acteurs de cette transformation de vocation ? Au nom de quelles promesses ? Pour quels résultats ? Cet ouvrage questionne les aboutissements, la pertinence et les finalités latentes de l’orthodoxie des SSP, c’est-à-dire leur généralisation. Les auteurs mettent en évidence certains risques de dérive inhérents à la promesse de santé pour tous ainsi que la propension, paradoxale, que le principe d’équité promu par cette orthodoxie (re)produise les inégalités qu’elle prétend pourtant combattre.

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Living in Death’s Shadow

Family Experiences of Terminal Care and Irreplaceable Loss

Emily K. Abel

What is it like to live with—and love—someone whose death, while delayed, is nevertheless foretold? In Living in Death’s Shadow, Emily K. Abel, an expert on the history of death and dying, examines memoirs written between 1965 and 2014 by family members of people who died from chronic disease. In earlier eras, death generally occurred quickly from acute illnesses, but as chronic disease became the major cause of mortality, many people continued to live with terminal diagnoses for months and even years. Illuminating the excruciatingly painful experience of coping with a family member’s extended fatal illness, Abel analyzes the political, personal, cultural, and medical dimensions of these struggles.

The book focuses on three significant developments that transformed the experiences of those dying and their intimates: the passage of Medicare and Medicaid, the growing use of high-tech treatments at the end of life, and the rise of a movement to humanize the care of dying people. It questions the exalted value placed on acceptance of mortality as well as the notion that it is always better to die at home than in an institution. Ultimately, Living in Death’s Shadow emphasizes the need to shift attention from the drama of death to the entire course of a serious chronic disease.

The chapters follow a common narrative of life-threatening disease: learning the diagnosis; deciding whether to enroll in a clinical trial; acknowledging or struggling against the limits of medicine; receiving care at home and in a hospital or nursing home; and obtaining palliative and hospice care. Living in Death’s Shadow is essential reading for everyone seeking to understand what it means to live with someone suffering from a chronic, fatal condition, including cancer, AIDS, Alzheimer’s, and heart disease.

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Living Safely, Aging Well

A Guide to Preventing Injuries at Home

Dorothy A. Drago, M.P.H.

As we age, our sense of balance and our vision, hearing, and cognition become less sharp. Aging-related changes greatly increase our risk of injury. In Living Safely, Aging Well, nationally recognized safety expert Dorothy A. Drago spells out how to prevent injury while cooking, gardening, sleeping, driving—and just walking around the house. In the first part of the book, Drago describes the causes of injuries by type—falls, burns, poisoning, and asphyxia—and explains how to decrease the risk of each. She then explores the home environment room by room, pointing out potential hazards and explaining how to avoid them, for example, by installing night lights, eliminating glass coffee tables, and using baby monitors. Lively line drawings make it easy for readers to visualize risks and implement prevention techniques. Living Safely, Aging Well pays special attention to hazards encountered by people with Alzheimer’s disease and other forms of dementia. A chapter devoted to health literacy helps people and caregivers make the best use of the medical care system and a chapter on driving helps evaluate when it is no longer safe to be behind the wheel.

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Living with Lymphoma

A Patient's Guide

Elizabeth M. Adler, PhD foreword by W. Jeffrey Baker, MD introduction by Michael R. Bishop, MD

When neurobiologist Elizabeth M. Adler was diagnosed with non-Hodgkin lymphoma almost twenty years ago, she learned everything she could about the disease, both to cope with the emotional stress of her diagnosis and to make the best possible decisions for her treatment. In Living with Lymphoma, she combines her scientific expertise and personal knowledge with a desire to help other people who have lymphoma manage this complex and often baffling disease. With the availability of more effective treatment regimens, many people with lymphoma are living longer; in fact, there are more than 700,000 lymphoma survivors in the United States alone. Given this change in the lymphoma landscape, the second edition of this book places a greater emphasis on survivorship. The new edition includes the latest information on lymphoma diagnosis, treatment, and incidence and describes the most recent update to the WHO system of lymphoma classification and staging. Adler discusses new targeted therapies like ibrutinib and idelalisib and describes how other treatments, including radiation therapy and stem cell transplants, have been modified while others have been discontinued. She also addresses new developments, such as the possible role of lack of sunlight and vitamin D in the pathogenesis of lymphoma, and the use of medical marijuana. The book includes suggestions for further reading, including the latest material available online.

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