"A collection of prose poems and lineated poems that chronicle everyday frustrations, confusions, and joys connected mainly with motherhood and illness"--

A brutally frank memoir about doctors and patients in a health care system that puts the poor at risk. No Apparent Distress begins with a mistake made by a white medical student that may have hastened the death of a working-class black man who sought care in a student-run clinic. Haunted by this error, the author—herself from a working-class background—delves into the stories and politics of a medical training system in which students learn on the bodies of the poor. Part confession, part family history, No Apparent Distress is at once an indictment of American health care and a deeply moving tale of one doctor’s coming-of-age.

In the medical reports she transcribes for a living, Nancy Anne Nash would be identified as a athin white female in no acute distress.a In reality, she is in moderate distress and leading a troubled life, loving unsuitable men for all the wrong reasons. At work for Seattle-based Professional Dictation, she shines and is a leader in her field, while back home her life is complicated by boyfriend Tim, an alcoholic, twice-divorced father of two whom Nancy becomes determined to afix.a Along the way she enlists the aid of Timas daughter, Angela. Unfortunately, the emotional scars left from a childhood of chaos and instability prove too powerful to fix, and Nancy slowly self-destructs in a vortex of poor choices, good drugs, and very bad people, among them a self-absorbed female boss who destroys the one place where Nancy finds strength. Despite the odds, will she triumph and learns along the way that love isnat love if it hurts?

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

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.

The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.

Clear guidelines on the proper care and use of laboratory animals are being sought by researchers and members of the many committees formed to oversee animal care at universities as well as the general public. This book provides a comprehensive overview of what we know about behavior, pain, and distress in laboratory animals. The volume explores: Stressors in the laboratory and the animal behaviors they cause, including in-depth discussions of the physiology of pain and distress and the animal's ecological relationship to the laboratory as an environment. A review of euthanasia of lab animals-exploring the decision, the methods, and the emotional effects on technicians. Also included is a highly practical, extensive listing, by species, of dosages and side effects of anesthetics, analgesics, and tranquilizers.