Suchergebnisse

Annotation With the United States and other developed nations spending as much as 14 percent of their GDP on medical care, economists and policy analysts are asking what these countries are getting in return. Yet it remains frustrating and difficult to measure the productivity of the medical care service industries. This volume takes aim at that problem, while taking stock of where we are in our attempts to solve it. Much of this analysis focuses on the capacity to measure the value of technological change and other health care innovations. A key finding suggests that growth in health care spending has coincided with an increase in products and services that together reduce mortality rates and promote additional health gains. Concerns over the apparent increase in unit prices of medical care may thus understate positive impacts on consumer welfare. When appropriately adjusted for such quality improvements, health care prices may actually have fallen. Provocative and compelling, this volume not only clarifies one of the more nebulous issues in health care analysis, but in so doing addresses an area of pressing public policy concern.

Intro -- Table of Contents -- The Right to Health -- The Black Health Crisis: Poverty and Discrimination -- Health of the Black Child -- The Black Student in Medicine -- The Black Doctor -- Meeting the Challenge -- Summing Up -- Notes -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- R -- S -- T -- U -- V -- W -- Y.

Optimal care of the injured patient requires the delivery of appropriate, definitive care shortly after injury. Over the last 30 to 40 years, civilian trauma systems and trauma centres have been developed in the United States based on experience gained in military conflicts, particularly in Korea and Vietnam. A similar process is evolving in Canada. National trauma committees in the US and Canada have defined optimal resources to meet the goal of rapid, appropriate care in trauma centres. They have introduced programs (verification or accreditation) to externally audit trauma centre performance based on these guidelines. It is generally accepted that implementing trauma systems results in decreased preventable death and improved survival after trauma. What is less clear is the degree to which each facet of trauma system development contributes to this improvement. The relative importance of national performance guidelines and trauma centre audit as integral steps toward improved outcomes following injury are reviewed. Current Trauma Association of Canada guidelines for trauma centres are presented and the process of trauma centre accreditation is discussed.

Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC.

"The historical context of colonisation situates the analysis in Children, Care and Crime of the involvement of children with care experience in the criminal justice system in an Australian jurisdiction (New South Wales), focusing on residential care, policing, the provision of legal services, and interactions in the Children's Court. While the majority of children in care do not have contact with the criminal justice system, this book explores why those with care-experience, and Indigenous children, are over-represented in this system. Drawing on findings from an innovative, mixed-method study - court observations, file reviews, and qualitative interviews - the book investigates historical and contemporary processes of colonisation and criminalisation. The book outlines the impact of trauma and responses to trauma, including inter-generational trauma caused by policies of colonisation and criminalisation. It then follows a child's journey through the continuum of care to the criminal justice system, examining data at each stage including: the residential care environment; interactions with police; the provision of legal services; and experiences at the Children's Court. Drawing together an analysis of the gendered and racialised treatment of women and girls with care-experience in the criminal justice system, the book particularly focuses on legacies of forced removal and apprenticeship which targeted Aboriginal and Torres Strait Islander women and girls. Through analysing what practices from England and Wales might offer the NSW context and, the findings are enriched by promoting further reflection on how decriminalisation pathways might be imagined. While there have been many policy initiatives developed to address criminalisation, in all parts of the study little evidence was found of implementation and impact. To conclude, the book examines the way that 'hope tropes' are regularly deployed in child protection and criminal justice to dangle the prospect of reform, and even to produce pockets of success, only to be whittled away by well-worn pathways to routine criminalisation. The conclusion also considers what a transformative agenda would look like and how monitoring and accountability mechanisms are key to new ways of operating. Finally, the book explores strengths-based approaches and how they might take shape in the child protection and criminal justice systems. Children, Care and Crime is aimed at researchers, lawyers and criminal justice practitioners, police, Judges and Magistrates, policy-makers and those working in child protection, the criminal justice system or delivering services to children or adults with care-experience. The research is multidisciplinary and therefore will be of broad appeal to the criminology, law, psychology, sociology, and social work disciplines. The book is most suitable for undergraduate courses focusing on youth justice and policing, and postgraduates researching in this field"--

In this remarkable book, Gary Wright focuses thirty years' experience as a family physician, and his Ph.D. in philosophy, to address the nature of good medical reasoning. Wright folds cognitive science into a pragmatist framework developed by John Dewey; this alternative view of mind and medical judgment leads to a model of reasoning that offers realistic guidance for medical decisions, one that each of us would want our own physicians to adopt.

Intro -- Medical Care of Prisoners and Detainees -- Contents -- Chairman's introduction : ethics, the doctor, and the prisoner -- Medical services in prison: lessons from two surveys -- Discussion -- Minimum standards for medical services in prisons and jails -- Discussion -- Standards of medical care and protection in detention camps -- Discussion -- Problems arising from biological experimentation in prisons -- Discussion -- Penitentiary medicine in France -- Organization of medical care of prisoners and detainees in Poland -- Discussion -- The Canadian experience -- Discussion -- Medical psychiatric survey in Alabama State Prison [submitted in title only] -- Discussion -- The English Prison Medical Service: its historical background and more recent developments -- Discussion -- Violence in prisoners and patients -- Discussion -- The interaction between prisoners, victims and their social networks -- Discussion -- Management of conflict in correctional institutions -- Discussion -- Chairman's closing remarks -- Appendix 1 Standard Minimum Rules for the Treatment of Prisoners (United Nations) -- Appendix 2 Association of State Correctional Administrators. Policy guidelines: health services -- Appendix 3 Administrative regulations : State of Illinois Department of Corrections, Adult Division, Sections 836, 837, 817 -- Appendix 4 ACA Manual of Correctional Standards Health and Medical Service Corrections Evaluation Report -- Appendix 5 Extract from The Emerging Rights of the Confined -- Index of Contributors -- Subject Index.