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This volume provides multifaceted and multidisciplinary insights into the growing field of health studies. Providing inputs from the behavioural sciences as well as social sciences, it discusses the issues of recovery from illness, and growth and wellbeing, as situated in social and eco-cultural contexts, and addresses the modalities of health-related interventions in diverse contexts. The specific themes taken up by the contributors are post-trauma growth, resilience, gender and health, distress and wellness, indigenous healing, counselling and psychotherapy, disability-related interventions, self-healing, as well as health issues of special groups like adolescents and the elderly, cancer patients and those suffering from other chronic illnesses. Till recently, the medical model has prevailed as the chief form of understanding health and illness. This has led to marginalization of the context, localization of all health and wellness components within the individual, and to biological reductionism. The contributions to this volume propose corrective measures and provide diverse approaches in a balanced manner. This volume is useful for researchers and practitioners interested in health studies, including the behavioural sciences, social work, medical anthropology, and public health.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. Psychological and social problems created or exacerbated by cancer-including depression and other emotional problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and disruptions in work, school, and family life-cause additional suffering, weaken adherence to prescribed treatments, and threaten patients' return to health. Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to address patients' psychosocial health needs. All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators, health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.
Psychoneuroimmunology, Second Edition presents reports on the relationship between the nervous and immune systems. The book is divided into four sections. The first section details the role of neural structures and neurotransmitter signals in communication with the immune system. It documents the extensive neural connections with organs of the immune system; the dynamics of noradrenergic sympathetic innervation of spleen and thymus; and the evidence for immune signaling of the CNS. Part II elaborates the role of hormones in the modulation of immune functions; the basis for bidirectional communication between the neuroendocrine and immune systems; and the potential physiological implications of these neuroendocrine-immune system interactions. The third part addresses behavioral influences on immune response; the effects of conditioning, stress and social interactions in modulating immune responses; and the behavioral consequences of experimentally altered or genetically determined immunologic states. The final section presents the effects of psychosocial factors on immune responses and the potential impact of behavioral interventions in modulating immunity in healthy human subjects and in patients with AIDS. Neuroscientists, endocrinologists, and immunologists will find the book interesting.
This open access book is a systematic update of the philosophical and scientific foundations of the biopsychosocial model of health, disease and healthcare. First proposed by George Engel 40 years ago, the Biopsychosocial Model is much cited in healthcare settings worldwide, but has been increasingly criticised for being vague, lacking in content, and in need of reworking in the light of recent developments. The book confronts the rapid changes to psychological science, neuroscience, healthcare, and philosophy that have occurred since the model was first proposed and addresses key issues such as the model’s scientific basis, clinical utility, and philosophical coherence. The authors conceptualise biology and the psychosocial as in the same ontological space, interlinked by systems of communication-based regulatory control which constitute a new kind of causation. These are distinguished from physical and chemical laws, most clearly because they can break down, thus providing the basis for difference between health and disease. This work offers an urgent update to the model’s scientific and philosophical foundations, providing a new and coherent account of causal interactions between the biological, the psychological and social.
This multidisciplinary volume provides the latest information on the role of psychosocial factors in chronic, acute, and recurrent pain. Reporting on significant advances in our understanding of all aspects of pain, the volume is designed to help practitioners, students, and researchers in a wide range of health care disciplines think more comprehensively about the etiologies, assessment, and management of this prevalent--and debilitating--symptom. Chapters from leading clinical investigators address many of the most frequently encountered pain syndromes, focusing on the interplay of somatic and psychosocial factors in the experience, maintenance, and exacerbation of pain. Issues related to evaluation, prevention, and management are explored in depth, with coverage of such topics as the role of pain management in primary care settings, the prediction of responses to pain and responses to treatment, and the influence of gender.
Almost two decades ago, Drs. Meyer Friedman and Ray Rosenman de veloped the concept of the Type A coronary-prone behavior pattern and pioneered research in the area. Since then, much effort has been devoted to investigating both medical and psychosocial implications of this phenomenon by an impressive array of biomedical and behavioral scientists. On the basis of the National Heart, Lung, and Blood Institute's (NHLBI) recent Congressional mandate concerning disease prevention and control, the Division of Heart and Vascular Diseases undertook an intensive review of the existing literature in this area. The review underscored that the very nature of the concept of coronary-prone behavior requires examination by researchers from a variety of disciplines. Publication of findings in both the medical and behavioral literature, however, has created difficulties in gaining a truly com prehensive understanding of the total effort in this area. It became obvious that there was no coherent integration of information regarding the strength of the association between behaviors and disease processes (or outcomes), how be havioral factors associated with coronary heart disease were measured, the possible physiological mechanisms mediating the relationship between be havior and disease, whether intervention could be effective, and what forms of intervention appeared most promising. In short, a clear need existed to or ganize this information in a more coherent fashion so that it could be subjected to critical review by members of both the medical and behavioral scientific communities.
In DSM-IV, the relationships between physical illness and psychological factors are grouped under the classifications 'Somatoform Disorders' and 'Psychological Factors Affecting Medical Conditions'(PFAMC). This volume introduces the 'Diagnostic Criteria for Psychosomatic Research' (DCPR) as a new proposal for the PFAMC section of DSM-V. The DCPR approach focuses on psychological characteristics of patients presenting symptoms across different medical disorders related to the clinically relevant psychosocial constructs of abnormal illness behavior, i.e. somatization, demoralization, type A behavior, alexithymia, conversion, and irritability. The distinct DCPR categories are consistent with concepts expressed by outstanding authors in psychosomatic medicine and are therefore suggested as specifiers of PFAMC for the future DSM-V. The volume includes updates, reviews and empirical findings on psychological factors affecting various disorders in different clinical settings (endocrinology, gastroenterology, oncology, dermatology, eating disorders, consultation psychiatry). It is essential reading for psychiatrists, psychologists and physicians interested in psychosomatic medicine, and provides the basic tools for the diagnosis of DCPR conditions.