The Social Nature of Antibiotic Overprescription in China


Book Description

Offering a rarely seen glimpse into the realities of one of the biggest global public health crises in modern time, Wang’s book focuses on doctor–patient interactions in China to demonstrate the potential effects of health communication, doctor–patient relationship, and a matrix of social factors on overprescription of antibiotics. Based on a community-based survey, the book describes empirical findings regarding the high prevalence of non-prescribed antibiotics use for common colds among children in China. It covers the potential effects of overprescription on caregivers' attitudes and how physicians make prescribing decisions in medical consultations. Drawing from evidence in medical interaction data, readers are introduced to further empirical findings regarding the communicative behaviors that patient caregivers use to pressure for antibiotic prescriptions in real medical consultations. Following this, Wang reports findings regarding the communicative behaviors that physicians use to make treatment recommendations and caregivers use to launch treatment negotiations, leading to a discussion of the effect of the doctor–patient relationship on antibiotic overprescription. The book culminates in practice recommendations and provides teaching scenarios in which physicians successfully engage the caregivers into conversations to shape their expectations for antibiotic prescriptions in medical consultations. An important resource for scholars and students in health communication, linguistics, medical humanities, and medical sociology. Practitioners who are interested in understanding and improving clinical practices as well as policymakers aiming to combat antibiotic resistance will also find this book useful.




Prescribing Under Pressure


Book Description

Tanya Stivers examines parent-physician conversations in detail showing how parents put pressure on doctors in largely covert ways, for instance in specific communication practices for explaining why they have brought their child to the doctoc or answering a history-taking question.




Becoming Human


Book Description

Winner of the William James Book Award Winner of the Eleanor Maccoby Book Award “A landmark in our understanding of human development.” —Paul Harris, author of Trusting What You’re Told “Magisterial...Makes an impressive argument that most distinctly human traits are established early in childhood and that the general chronology in which these traits appear can...be identified.” —Wall Street Journal Virtually all theories of how humans have become such a distinctive species focus on evolution. Becoming Human looks instead to development and reveals how those things that make us unique are constructed during the first seven years of a child’s life. In this groundbreaking work, Michael Tomasello draws from three decades of experimental research with chimpanzees, bonobos, and children to propose a new framework for psychological growth between birth and seven years of age. He identifies eight pathways that differentiate humans from their primate relatives: social cognition, communication, cultural learning, cooperative thinking, collaboration, prosociality, social norms, and moral identity. In each of these, great apes possess rudimentary abilities, but the maturation of humans’ evolved capacities for shared intentionality transform these abilities into uniquely human cognition and sociality. “How does human psychological growth run in the first seven years, in particular how does it instill ‘culture’ in us? ...Most of all, how does the capacity for shared intentionality and self-regulation evolve in people? This is a very thoughtful and also important book.” —Tyler Cowen, Marginal Revolution “Theoretically daring and experimentally ingenious, Becoming Human squarely tackles the abiding question of what makes us human.” —Susan Gelman “Destined to become a classic. Anyone who is interested in cognitive science, child development, human evolution, or comparative psychology should read this book.” —Andrew Meltzoff




The Use of Drugs in Food Animals


Book Description

The use of drugs in food animal production has resulted in benefits throughout the food industry; however, their use has also raised public health safety concerns. The Use of Drugs in Food Animals provides an overview of why and how drugs are used in the major food-producing animal industriesâ€"poultry, dairy, beef, swine, and aquaculture. The volume discusses the prevalence of human pathogens in foods of animal origin. It also addresses the transfer of resistance in animal microbes to human pathogens and the resulting risk of human disease. The committee offers analysis and insight into these areas: Monitoring of drug residues. The book provides a brief overview of how the FDA and USDA monitor drug residues in foods of animal origin and describes quality assurance programs initiated by the poultry, dairy, beef, and swine industries. Antibiotic resistance. The committee reports what is known about this controversial problem and its potential effect on human health. The volume also looks at how drug use may be minimized with new approaches in genetics, nutrition, and animal management.




Mechanisms of antibiotic resistance


Book Description

Antibiotics represent one of the most successful forms of therapy in medicine. But the efficiency of antibiotics is compromised by the growing number of antibiotic-resistant pathogens. Antibiotic resistance, which is implicated in elevated morbidity and mortality rates as well as in the increased treatment costs, is considered to be one of the major global public health threats (www.who.int/drugresistance/en/) and the magnitude of the problem recently prompted a number of international and national bodies to take actions to protect the public (http://ec.europa.eu/dgs/health_consumer/docs/road-map-amr_en.pdf: http://www.who.int/drugresistance/amr_global_action_plan/en/; http://www.whitehouse.gov/sites/default/files/docs/carb_national_strategy.pdf). Understanding the mechanisms by which bacteria successfully defend themselves against the antibiotic assault represent the main theme of this eBook published as a Research Topic in Frontiers in Microbiology, section of Antimicrobials, Resistance, and Chemotherapy. The articles in the eBook update the reader on various aspects and mechanisms of antibiotic resistance. A better understanding of these mechanisms should facilitate the development of means to potentiate the efficacy and increase the lifespan of antibiotics while minimizing the emergence of antibiotic resistance among pathogens.




Combating Antimicrobial Resistance


Book Description

As of 2017, the emergence and spread of antimicrobial resistance continues unabated around the world, leaving devastating health and economic outcomes in its wake. Those consequences will multiply if collaborative global action is not taken to address the spread of resistance. Major drivers of antimicrobial resistance in humans have been accelerated by inappropriate antimicrobial prescribing in health care practices; the inappropriate use of antimicrobials in livestock; and the promulgation of antibiotic resistance genes in the environment. To explore the issue of antimicrobial resistance, the Forum of Microbial Threats planned a public workshop. Participants explored issues of antimicrobial resistance through the lens of One Health, which is a collaborative approach of multiple disciplines - working locally, nationally, and globally - for strengthening systems to counter infectious diseases and related issues that threaten human, animal, and environmental health, with an end point of improving global health and achieving gains in development. They also discussed immediate and short-term actions and research needs that will have the greatest effect on reducing antimicrobial resistance, while taking into account the complexities of bridging different sectors and disciplines to address this global threat. This publication summarizes the presentations and discussions from the workshop.




Treatment Recommendations in Chinese Outpatient Clinical Interaction


Book Description

Treatment decision-making is a significant phase in outpatient interaction. Distinct formats of treatment recommendations may exert influences on both opportunities and consequences for patient participation in the process. Taking naturally occurring Chinese outpatient clinical conversations as the data and drawing from the analytic apparatuses provided by Conversation Analysis, this book represents an attempt to conduct a systematically descriptive and analytic study of the position and composition of treatment recommendations in doctor-patient interactions in Chinese outpatient clinics. By incorporating the analysis of epistemic and deontic orientations into the examination of particular linguistic resources employed to formulate the initiation, construction of, and responses to treatment recommendations, the study uncovers how Chinese doctors and patients steer the interactional trajectories of treatment decision-making through talk-in-interaction. The book can serve as a reference to the research on treatment decision-making in various kinds of Chinese medical settings. In addition, the insights from the study could provide a reference for understanding how Chinese doctors’ medical authority and patients’ agency are generally executed, challenged, and sustained via talk in the new era of patient-centered medical care.




Pain Management and the Opioid Epidemic


Book Description

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.




Extending the Cure


Book Description

Our ability to treat common bacterial infections with antibiotics goes back only 65 years. However, the authors of this report make it clear that sustaining a supply of effective and affordable antibiotics cannot be without changes to the incentives facing patients, physicians, hospitals, insurers, and pharmaceutical manufacturers. In fact, increasing resistance to these drugs is already exacting a terrible price. Every day in the United States, approximately 172 men, women, and children die from infections caused by antibiotic-resistant bacteria in hospitals alone. Beyond those deaths, antibiotic resistance is costing billions of dollars through prolonged hospital stays and the need for doctors to resort to ever more costly drugs to use as substitute treatments. Extending the Cure presents the problem of antibiotic resistance as a conflict between individual decision makers and their short-term interest and the interest of society as a whole, in both present and future: The effort that doctors make to please each patient by prescribing a drug when it might not be properly indicated, poor monitoring of discharged patients to ensure that they do not transmit drug-resistant pathogens to other persons, excesses in the marketing of new antibiotics, and the broad overuse of antibiotics all contribute to the development and spread of antibiotic-resistant bacteria. The book explores a range of policy options that would encourage patients, health care providers, and managed care organizations to serve as more responsible stewards of existing antibiotics as well as proposals that would give pharmaceutical firms greater incentives to develop new antibiotics and avoid overselling. If the problem continues unaddressed, antibiotic resistance has the potential to derail the health care system and return us to a world where people of all ages routinely die from simple infections. As a basis for future research and a spur to a critically important dialogue, Extending the Cure is a fundamental first step in addressing this public health crisis. The Extending the Cure project is funded in part by the Robert Wood Johnson Foundation through its Pioneer Portfolio.




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.