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.

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.

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.

This Handbook stands as the premier scholarly resource for Language and Social Interaction (LSI) subject matter and research, giving visibility and definition to this area of study and establishing a benchmark for the current state of scholarship. The Handbook identifies the five main subdisciplinary areas that make up LSI--language pragmatics, conversation analysis, language and social psychology, discourse analysis, and the ethnography of communication. One section of the volume is devoted to each area, providing a forum for a variety of authoritative voices to provide their respective views on the central concerns, research programs, and main findings of each area, and to articulate the present or emergent issues and directions. A sixth section addresses LSI in the context of broadcast media and the Internet. This volume's distinguished authors and original content contribute significantly to the advancement of LSI scholarship, circumscribing and clarifying the interrelationships among the questions, findings, and methods across LSI's subdisciplinary areas. Readers will come away richer in their understanding of the variety and depth of ways the intricacies of language and social interaction are revealed. As an essential scholarly resource, this Handbook is required reading for scholars, researchers, and graduate students in language and social interaction, and it is destined to have a broad influence on future LSI study and research.

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.

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.

Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.