Some of these drugs are truly transformative, offering major improvements in how long patients live or how they feel--but what is often missing from the popular narrative is that, far too often, these new drugs have marginal or minimal benefits. Some are even harmful. In Malignant, hematologist-oncologist Dr. Vinayak K. Prasad writes about the many sobering examples of how patients are too often failed by cancer policy and by how oncology is practiced. Throughout this work, Prasad illuminates deceptive practices which- promote novel cancer therapies long before credible data are available to support such treatment; and- exaggerate the potential benefits of new therapies, many of which cost thousands and in some cases hundreds of thousands of dollars.Prasad then critiques the financial conflicts of interest that pervade the oncology field, the pharmaceutical industry, and the US Food and Drug administration.This is a book about how the actions of human beings--our policies, our standards of evidence, and our drug regulation--incentivize the pursuit of marginal or unproven therapies at lofty and unsustainable prices. Prasad takes us through how cancer trials are conducted, how drugs come to market, and how pricing decisions are made, asking how we can ensure that more cancer drugs deliver both greater benefit and a lower price. Ultimately, Prasad says,- more cancer clinical trials should measure outcomes that actually matter to people with cancer;- patients on those trials should look more like actual global citizens;- we need drug regulators to raise, not perpetually lower, the bar for approval; and- we need unbiased patient advocates and experts.This well-written, opinionated, and engaging book explains what we can do differently to make serious and sustained progress against cancer--and how we can avoid repeating the policy and practice mistakes of the past.

    Charting the most cutting-edge scientific breakthroughs, and marshalling his decades of research and clinical practice, Walker explains how we can harness sleep to improve learning, mood and energy levels, regulate hormones, prevent cancer, Alzheimer's and diabetes, slow the effects of aging, and increase longevity. He also provides actionable steps towards getting a better night's sleep every night.

    On one side are parents, bombarded with stories about the dangers of vaccines, now wary of immunizing their sons and daughters. On the other side are doctors, scared to send kids out of their offices vulnerable to illnesses like whooping cough and measles--the diseases of their grandparents.How did anyone come to view vaccines with horror? The answer is rooted in one of the most powerful citizen activist movements in our nation's history. In Deadly Choices, infectious disease expert Paul Offit relates the shocking story of anti-vaccine America--its origins, leaders, influences, and impact. Offering strategies to keep us from returning to an era when children routinely died from infections, Deadly Choices is a vigorous and definitive rebuttal of the powerful anti-vaccine movement.

    Their choices are limited by mountains, rivers, seas, and concrete. To understand world events, news organizations and other authorities often focus on people, ideas, and political movements, but without geography, we never have the full picture. Now, in the relevant and timely Prisoners of Geography, seasoned journalist Tim Marshall examines Russia, China, the USA, Latin America, the Middle East, Africa, Europe, Japan and Korea, and Greenland and the Arctic—their weather, seas, mountains, rivers, deserts, and borders—to provide a context often missing from our political reportage: how the physical characteristics of these countries affect their strengths and vulnerabilities and the decisions made by their leaders.In ten, up-to-date maps of each region, Marshall explains in clear and engaging prose the complex geo-political strategies of these key parts of the globe. What does it mean that Russia must have a navy, but also has frozen ports six months a year? How does this affect Putin’s treatment of Ukraine? How is China’s future constrained by its geography? Why will Europe never be united? Why will America never be invaded? Shining a light on the unavoidable physical realities that shape all of our aspirations and endeavors, Prisoners of Geography is the critical guide to one of the major (and most often overlooked) determining factors in world history.

    The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800. Why?Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics ("young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries"), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

    The word conjures up images of horrific diseases sweeping the globe and killing everyone in their path. But such highly lethal illnesses almost never create pandemics. The reality is deadly serious but far more subtle.In Pandemics: What Everyone Needs to Know�, Peter Doherty, who won the Nobel Prize for his work on how the immune system recognizes virus-infected cells, offers an essential guide to one of the truly life-or-death issues of our age. In concise, question-and-answer format, he explains the causes of pandemics, how they can be counteracted with vaccines and drugs, and how we can better prepare for them in the future. Doherty notes that the term "pandemic" refers not to a disease's severity but to its ability to spread rapidly over a wide geographical area. Extremely lethal pathogens are usually quickly identified and confined. Nevertheless, the rise of high-speed transportation networks and the globalization of trade and travel have radically accelerated the spread of diseases. A traveler from Africa arrived in New York in 1999 carrying the West Nile virus; one mosquito bite later, it was loose in the ecosystem. Doherty explains how the main threat of a pandemic comes from respiratory viruses, such as influenza and SARS, which disseminate with incredible speed through air travel. The climate disruptions of global warming, rising population density, and growing antibiotic resistance all complicate efforts to control pandemics. But Doherty stresses that pandemics can be fought effectively. Often simple health practices, especially in hospitals, can help enormously. And research into the animal reservoirs of pathogens, from SARS in bats to HIV in chimpanzees, show promise for our prevention efforts.Calm, clear, and authoritative, Peter Doherty's Pandemics is one of the most critically important additions to the What Everyone Needs to Know� series.What Everyone Needs to Know� is a registered trademark of Oxford University Press.

    What? Is the bed already saturated with somebody else's damp before my patient comes to exhale in it his own damp? Has it not had a single chance to be aired? No, not one. It has been slept in every night."From the best known work of Florence Nightingale (1820–1910), the originator and founder of modern nursing, comes a collection of notes that played an important part in the much needed revolution in the field of nursing. For the first time it was brought to the attention of those caring for the sick that their responsibilities covered not only the administration of medicines and the application of poultices, but the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet. Miss Nightingale is outspoken on these subjects as well as on other factors that she considers essential to good nursing. But, whatever her topic, her main concern and attention is always on the patient and his needs.One is impressed with the fact that the fundamental needs of the sick as observed by Miss Nightingale are amazingly similar today (even though they are generally taken for granted now) to what they were over 100 years ago when this book was written. For this reason, this little volume is as practical as it is interesting and entertaining. It will be an inspiration to the student nurse, refreshing and stimulating to the experienced nurse, and immensely helpful to anyone caring for the sick.

    This is a disturbing, well-researched wake-up call for improving the current system of drug supply and manufacturing.Several decades ago, penicillin, vitamin C, and many other prescription and over-the-counter products were manufactured in the United States. But with the rise of globalization, antibiotics, antidepressants, birth control pills, blood pressure medicines, cancer drugs, among many others are made in China and sold in the United States. China's biggest impact on the US drug supply is making essential ingredients for thousands of medicines found in American homes and used in hospital intensive care units and operating rooms. The authors convincingly argue that there are at least two major problems with this scenario. First, it is inherently risky for the United States to become dependent on any one country as a source for vital medicines, especially given the uncertainties of geopolitics. For example, if an altercation in the South China Sea causes military personnel to be wounded, doctors may rely upon medicines with essential ingredients made by the adversary. Second, lapses in safety standards and quality control in Chinese manufacturing are a risk. Citing the concerns of FDA officials and insiders within the pharmaceutical industry, the authors document incidents of illness and death caused by contaminated medications that prompted reform. This probing book examines the implications of our reliance on China on the quality and availability of vital medicines.

    Our lives are full of medical myths, half-truths, and misconceptions - pieces of information so ingrained in our culture that we assume they must be true. Despite the proliferation of "Doctor Google," medical myths are all around us. How do you determine the accuracy of medical information that you find online, in books or magazines, or passed to you by friends or family? Using faulty information to treat a medical condition can be at best ineffective and at worst, deadly. Dr. Novella has built his career educating patients, the public, students, and professionals about the highest standards in medical science and practice. He believes in challenging your beliefs and putting everything you think you know to the test. These 24 revealing lectures are an empowering learning experience that will give you evidence-based guidelines for good health, will enhance your ability to be better informed about common medical myths, and will strengthen your skills at assessing the scientific truth behind medical information and advice - whether you're having an important conversation with your doctor or taking a trip down the medicine aisle of your local pharmacy. Learn where to find good information about health topics and how to spot an unreliable source. Dr. Novella will guide you.

    What's the prescription for success? National Geographic Explorer Dan Buettner has traveled the globe to uncover the best strategies for longevity found in the Blue Zones: places in the world where higher percentages of people enjoy remarkably long, full lives. And in this dynamic book he discloses the recipe, blending this unique lifestyle formula with the latest scientific findings to inspire easy, lasting change that may add years to your life.Buettner's colossal research effort, funded in part by the National Institute on Aging, has taken him from Costa Rica to Italy to Japan and beyond. In the societies he visits, it's no coincidence that the way people interact with each other, shed stress, nourish their bodies, and view their world yields more good years of life. You'll meet a 94-year-old farmer and self-confessed "ladies man" in Costa Rica, an 102-year-old grandmother in Okinawa, a 102-year-old Sardinian who hikes at least six miles a day, and others. By observing their lifestyles, Buettner's teams have identified critical everyday choices that correspond with the cutting edge of longevity research-and distilled them into a few simple but powerful habits that anyone can embrace.

    From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once-idyllic farm towns; it's a heartbreaking trajectory that illustrates how this national crisis has persisted for so long and become so firmly entrenched. Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, Macy endeavors to answer a grieving mother's question-why her only son died-and comes away with a harrowing story of greed and need. From the introduction of OxyContin in 1996, Macy parses how America embraced a medical culture where overtreatment with painkillers became the norm. In some of the same distressed communities featured in her bestselling book Factory Man, the unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death.Through unsparing, yet deeply human portraits of the families and first responders struggling to ameliorate this epidemic, each facet of the crisis comes into focus. In these politically fragmented times, Beth Macy shows, astonishingly, that the only thing that unites Americans across geographic and class lines is opioid drug abuse. But in a country unable to provide basic healthcare for all, Macy still finds reason to hope-and signs of the spirit and tenacity necessary in those facing addiction to build a better future for themselves and their families.

    Key Features: The Author Uses A Reader-Friendly, Narrative Style Making The Text Engaging And Accessible To A Broad Range Of Students. The Text Illustrates The Multidisciplinary Nature Of Public Health And The Complex Ethical And Political Issues Central To It. It Includes Discussions Of Epidemiological Investigation, Biomedical Research, Environmental Assessment, Analyses Of Individual And Group Behavior, Massive Data Collection Efforts, And Policy Developments. New To This Edition: New Discussions About U.S. Health Care Reform New Discussions Of The Globalization Of National Economies And Its Effect On The Health Of Populations Expanded Discussions On Health Disparities New Analysis Of What Went Wrong Just After Hurricane Katrina Updated Discussions Of Developments In Topics Such Are H1N1 Swine Flu, Hormone Replacement Therapy, FDA Regulation, HPV Vaccine Controversy Planning For Healthy People 2020 And Much More.

    Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.The problem, Reinhardt says, is not one of economics but of social ethics. There is no American political consensus on a fundamental question other countries settled long ago: to what extent should we be our brothers' and sisters' keepers when it comes to health care? Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America finances health care, and he offers a penetrating ethical analysis of recent reform proposals. At this point, he argues, the United States appears to have three stark choices: the government can make the rich help pay for the health care of the poor, ration care by income, or control costs. Reinhardt proposes an alternative path: that by age 26 all Americans must choose either to join an insurance arrangement with community-rated premiums, or take a chance on being uninsured or relying on a health insurance market that charges premiums based on health status.An incisive look at the American health care system, Priced Out dispels the confusion, ignorance, myths, and misinformation that hinder effective reform.

    In 2006, 227 million antidepressant prescriptions were dispensed in the United States, more than any other class of medication; in that same year, the United States accounted for 66 percent of the global antidepressant market. In "Comfortably Numb, "Charles Barber provides a much-needed context for this disturbing phenomenon. Barber explores the ways in which pharmaceutical companies first create the need for a drug and then rush to fill it, and he reveals that the increasing pressure Americans are under to medicate themselves (direct-to-consumer advertising, fewer nondrug therapeutic options, the promise of the quick fix, the blurring of distinction between mental illness and everyday problems). Most importantly, he convincingly argues that without an industry to promote them, non-pharmaceutical approaches that could have the potential to help millions are tragically overlooked by a nation that sees drugs as an instant cure for all emotional difficulties. Here is an unprecedented account of the impact of psychiatric medications on American culture and on Americans themselves.

     For decades, technology encouraged people to squander their time and intellect as passive consumers. Today, tech has finally caught up with human potential. In Cognitive Surplus, Internet guru Clay Shirky forecasts the thrilling changes we will all enjoy as new digital technology puts our untapped resources of talent and goodwill to use at last. Since we Americans were suburbanized and educated by the postwar boom, we've had a surfeit of intellect, energy, and time-what Shirky calls a cognitive surplus. But this abundance had little impact on the common good because television consumed the lion's share of it-and we consume TV passively, in isolation from one another. Now, for the first time, people are embracing new media that allow us to pool our efforts at vanishingly low cost. The results of this aggregated effort range from mind expanding-reference tools like Wikipedia-to lifesaving-such as Ushahidi.com, which has allowed Kenyans to sidestep government censorship and report on acts of violence in real time. Shirky argues persuasively that this cognitive surplus-rather than being some strange new departure from normal behavior-actually returns our society to forms of collaboration that were natural to us up through the early twentieth century. He also charts the vast effects that our cognitive surplus- aided by new technologies-will have on twenty-first-century society, and how we can best exploit those effects. Shirky envisions an era of lower creative quality on average but greater innovation, an increase in transparency in all areas of society, and a dramatic rise in productivity that will transform our civilization. The potential impact of cognitive surplus is enormous. As Shirky points out, Wikipedia was built out of roughly 1 percent of the man-hours that Americans spend watching TV every year. Wikipedia and other current products of cognitive surplus are only the iceberg's tip. Shirky shows how society and our daily lives will be improved dramatically as we learn to exploit our goodwill and free time like never before.