Researcher

While many effective interventions have been developed with the potential to significantly reduce morbidity and mortality from cancer, they are of no benefit to the health of populations if they cannot be delivered. In response to this challenge, Advancing the Science of Implementation across the Cancer Continuum provides an overview of research that can improve the delivery of evidence-based interventions in cancer prevention, early detection, treatment, and survivorship. Chapters explore the field of implementation science and its application to practice, a broad synthesis of relevant research and case studies illustrating each cancer-focused topic area, and emerging issues at the intersection of research and practice in cancer. Both comprehensive and accessible, this book is an ideal resource for researchers, clinical and public health practitioners, medical and public health students, and health policymakers.Less

Body dysmorphic disorder (BDD) is a devastating yet underrecognized illness. People with BDD are preoccupied with the belief that they look abnormal or ugly—when they actually do not. Their appearance preoccupations cause clinically significant distress or impairment in occupational, academic, social, or other areas of functioning. Psychosocial functioning and quality of life are typically markedly impaired, and rates of suicidality are very high. BDD is common, yet this disorder often goes undiagnosed and untreated. This book provides an up-to-date, comprehensive, and clinically focused overview of this intriguing, complex, and often severe disorder. The book contains nine sections: (1) patients, history, and classification; (2) phenomenology and epidemiology; (3) morbidity; (4) BDD in special populations; (5) assessment; (6) etiology and pathophysiology; (7) recommended treatments; (8) cosmetic treatment; and (9) BDD’s relationship to other disorders. Measures for assessing BDD are provided in the Appendix. Written by leading researchers and clinicians in the field, this book is for anyone who wants to better understand BDD, help patients overcome it, or conduct scientific research to advance knowledge. It is for mental health clinicians, primary care clinicians, and pediatricians, as well as surgeons, dermatologists, and others who provide cosmetic (aesthetic) treatment; cosmetic treatment is commonly received but virtually never alleviates BDD symptoms. This book is also for researchers and students who are interested in anxiety disorders, eating disorders, and obsessive-compulsive and related disorders. Although it is geared toward a professional audience, this book is also for anyone who is interested in or has been affected by BDD.Less

This book is intended to target a broad audience of clinicians, clinical researchers, students in geriatrics and gerontology fields, and family caregivers of older adults interested in complementary, alternative, and integrative medicine. It provides an update on recent research in integrative medicine used for the treatment and prevention of mental, cognitive, and physical disorders of aging. The content of this book will increase clinicians’ familiarity with recent research findings in the field of integrative medicine, and will broaden their understanding of the use of these interventions in clinical practice. The discussion of the data is provided in textbook format, covering different fields of integrative medicine and written by an international group of opinion leaders and researchers in their respective areas of expertise; thus this work can be used for training by students of integrative medicine and gerontology. Individual chapters can be used as references on a particular topic for interested individuals and can be obtained online. Clinicians and researchers who are dedicated to the treatment and study of older adults might consider this volume an essential part of their library.Less

Psychiatric factors play a significant role in the ongoing human immunodeficiency virus (HIV) pandemic. In less than four decades, advances in HIV medical care and research have transformed acquired immune deficiency syndrome (AIDS) from a rapidly fatal illness of unknown cause into a chronic, manageable illness. Vast strides have been made in clinical care and pathogenesis research in the fields of HIV prevention and psychiatric care, including pre- (PreP) and and post-exposure (PEP) prophylaxis. Although AIDS is an entirely preventable infectious illness, HIV transmission continues throughout the world. Transmission of HIV continues to be fueled by many factors, including stigma of HIV and mental illness as well as discrimination, criminalization, and risky behaviors. A comprehensive biopsychosocial approach to sexual health and mental health and diminution of stigma are key to both HIV prevention and HIV care. Integration of psychiatric care into HIV prevention and treatment entails use of a biopsychosocial approach that maintains a view of each individual with HIV as a member of a family, community, and society who deserves to be treated with dignity and compassion. This textbook provides an update on HIV medicine and psychiatry; introduces the concept of HIV/AIDS as “the great magnifier of maladies”; explores the paradoxes and disparities of HIV care; explains how HIV psychiatry is a paradigm for the psychiatric care of the medically ill (psychosomatic medicine); and sets the stage for an understanding of how integrated care can prevent transmission of HIV and reduce morbidity and mortality in persons with HIV.Less

Since the first “test tube baby” was born over 40 years ago, in vitro fertilization and other assisted reproductive technologies (ARTs) have advanced in extraordinary ways, producing millions of babies. About 20% of Americans use infertility services, and that number is growing. ARTs enable gay and lesbian couples, single parents, and now others to have offspring. Prospective parents can also use preimplantation genetic diagnosis to avoid passing on certain mutations to their children and to avoid abortions of fetuses with these mutations. Other future parents routinely choose the sex of their child and whether to give birth to twins. In the United States, these procedures are largely unregulated, and a large commercial market has rapidly grown, using “egg donors,” buying and selling human eggs and sperm, and using gestational surrogates. Potential parents; policymakers; doctors, including reproductive endocrinologists; and others thus face critical complex questions about the use—or possible misuse—of ARTs. This book examines ethical, social, and policy questions about these crucial technologies. Based on in-depth interviews, Robert Klitzman explores how doctors and patients struggle with quandaries of whether, when, and how to use ARTs. He articulates the full range of these crucial issues, from economic pressures to moral and social challenges of making decisions that will profoundly shape these offspring. The book explores, too, broader social and moral questions regarding gene editing, CRISPR, and eugenics. Klitzman argues for closer regulation of these technologies, which are altering future generations and the human species as a whole.Less

The majority of people who experience incarceration have a history of harmful alcohol, tobacco, and/or illicit drug use. Some discontinue use of these substances while in custody. Others—notably including some people who inject drugs—continue to use drugs in prison, typically in avoidably high-risk circumstances. Rapid relapse to risky substance use after release from prison is common and is associated with a range of health and social problems, and increased risk of both death and reincarceration. Effective measures to reduce the incarceration of people who use drugs, and to minimize drug-related harms both in prison and after release from custody, are urgently required. However, the evidence base to inform effective responses remains weak, and implementation of evidence-based responses remains patchy. Drawing on the expertise of 40 authors from 10 countries, this book reviews what is known about the epidemiology of substance use in people who experience incarceration. It presents what is known about the health, social, and criminal justice consequences of harmful substance use in this population and discusses key policy reforms that have the potential to achieve better health outcomes. In addition to reviewing what is known, the book identifies key knowledge gaps and makes recommendations for future research.Less

Embodied Selves and Divided Minds examines how research in embodied cognition and enactivism can contribute to our understanding of the nature of self-consciousness, the metaphysics of personal identity, and the disruptions to self-awareness that occur in cases of psychopathology. It begins with the assumption that if we take embodiment seriously and view the self as physically grounded in the living animal body, then we will be in a better position to make sense of how a minded subject persists across time. However, instead of relying solely on puzzle cases to discuss diachronic persistence and the sense of self, this work looks to schizophrenia and dissociative identity disorder as case studies. Here we find real-life examples of disruptions to embodied self-experience that appear to indicate a fragmentation of the self. Rather than concluding that these disorders count as genuine instances of multiplicity, the book’s discussion of the self and personal identity allows us to understand the characteristic symptoms of these disorders as significant disruptions to self-consciousness. The concluding chapter then examines the implications of this theoretical framework for the clinical treatment of schizophrenia and dissociative identity disorder. Thus, the work as a whole reveals how a critical dialogue between Philosophy and Psychiatry can contribute to new insights about self-consciousness, personal identity, and psychopathology.Less

Genetic Counseling Research: A Practical Guide is an online resource devoted to research methodology in genetic counseling. It offers step-by-step guidance for conducting research, from the development of a question to the publication of findings. Genetic counseling examples and practical tips guide readers through the research and publication processes. With a highly accessible, pedagogical approach, this resource will help promote quality research by genetic counselors and research supervisors—and in turn, increase the knowledge base for genetic counseling practice, other aspects of genetic counseling service delivery, and professional education.Less

This completely revised second edition of Genomic Medicine reflects the rapidly changing face of applied and translational genomics in the medical and health context and provides a comprehensive coverage of principles of genetics and genomics relevant to the practice of medicine. New topics included include bioinformatics, proteomics, microbial genomics and genomic education. Detailed discussions of genetic/genomic testing and screening and the ethical, legal, and social issues (ELSI) crucially address genethics and genomethics in the practice of Genomic Medicine. This online resource all includes clinical practice-oriented chapters highlighting genomic applications (array comparative genomic hybridization, exome genome sequencing and new generation sequencing) in clinical diagnosis of congenital developmental malformations, Mendelian genetic disorders, and complex cardiovascular, neuro-psychiatric, ophthalmic, dermatologic, inflammatory and pediatric disorders. It also discusses microbial genomics with emphasis on the role of genomics in targeted antimicrobial therapy and development of genomic class of new vaccines. New developments in gene/ cell-based somatic therapy, regenerative medicine and targeted molecular therapy are also covered.Less

Spiritual sickness troubles American medicine. Through a death-denying culture, medicine has gained enormous power—an influence it maintains by distancing itself from religion and spirituality, which too often remind us of our mortality. As a result of this separation of medicine from spiritual traditions, patients facing serious illness infrequently receive adequate spiritual care despite the large body of empirical data demonstrating its import to patient meaning-making, quality of life, and medical utilization. This secular–sacred divide also unleashes depersonalizing social forces through the market, technology, and legal-bureaucratic powers that reduce clinicians to tiny cogs in an unstoppable machine. Hostility to Hospitality is one of the first books of its kind to explore these hostilities threatening medicine and offer a path forward for the partnership of modern medicine and spirituality. Drawing from interdisciplinary scholarship including empirical studies, interviews, history and sociology, theology, and public policy, the authors argue for structural pluralism as the missing piece to changing hostility to hospitality.Less

Works on inborn errors of metabolism (IEMs) have traditionally focused on classical biochemistry, clinical presentation, and standard treatment approaches. Inborn Errors of Metabolism is an expansion on this model, one that establishes an innovative pathway approach and provides a new authority on this family of disease. Alongside the standard cadre of molecular and clinical underpinnings, this title includes coverage of new-born screenings and an overarching treatment of IEMs as complex diseases — how basic alterations can lead to complex secondary and tertiary effects in metabolism that contribute to increasingly recognized natural histories of disease.Less

Pity, disgust, fear, cure, and prevention—all are words that Americans have used to make sense of what today we call intellectual disability. Inventing the Feeble Mind explores the history of this disability in the United States from its several identifications over the past 200 years—idiocy, imbecility, feeblemindedness, mental defect, mental deficiency, mental retardation, and most recently intellectual disability. Using institutional records, private correspondence, personal memories, and rare photographs, James Trent argues that the economic vulnerability of intellectually disabled people (and often their families), more than the claims made for their intellectual and social limitations, has shaped meaning, services, and policies in United States history.Less

Landmark Papers in Pain offers a comprehensive inventory of over 80 key studies in pain medicine from the last 100 years. Pain medicine, a relatively new specialty, has proven increasingly relevant to medical practitioners in every field. The specialism of pain has emerged over the past 50 years, largely due to the persistence of experts and new medical evidence that points to its necessity. Today, it is a distinct and integral part of global medical practice. Each paper in this book is accompanied by a concise commentary on the significance of the original findings written by an expert in pain. The reviews discuss how the papers influenced the development of the speciality and how the findings have advanced our global comprehension of pain. Together, the selected papers and reviews chart the growth of an embryonic field into the modern speciality of pain medicine. Complied by leading specialists in the field, the papers included in this book are significant for any student, researcher, clinical practitioner, or medical historian interested in pain medicine. Organized into eight distinct topics and cross-referenced by topics and author of original paper, the book is comprehensive in its coverage and easy to use. A review of the contemporary and historical research that shaped the speciality of pain, Landmark Papers in Pain is essential reading for all medical practitioners with an interest in pain medicine and pain research.Less

Learning While Caring is about what the author has learned during his half-century career as a cancer doctor. During this time, medicine has changed greatly. It has become more scientifically based, more institutionally located, and now comprises almost one-fifth of the US economy. Despite these changes, much remains the same, especially the primary obligation of the doctor to the patient. Also during this period, most of the developed world has recognized health care as a right for all its members. This has been resulted in greatly improved care for many, but not for all. For the last 25 years the United States has been experimenting on how this should be achieved, beginning with the proposed but not enacted Clinton Health Security proposal and currently with the Affordable Care Act. While efficiency and cost control are essential, cost cannot be the only parameter of success. Access to high-quality health care must be made available to all. Proper education for an informed public must include an understanding of the general principles of biology, while that of a doctor must result in a familiarity with the humanities and social sciences. An academic physician has three responsibilities: patient care, teaching, and research. These latter two, while essential, must not conflict, compromise, or limit the doctor-patient relationship. This book is about the author’s activities in all three endeavors. Since his specialty is oncology, this is the major subject, but most of the information is applicable to all caring physicians.Less

This book addresses (1) candidate mechanisms across addictive behaviors, including impulsivity (Chapters 1–5); reward sensitivity (Chapter 2); behavioral sensitization and cross-sensitization to addictive, stressful, or endogenous illness-related stimuli (Chapters 1, 5–8, 13); and genetics (Chapter 11). Addictions frequently combine with other psychiatric disorders; each increases severity of the other (Chapters 1, 7, 13). Genetic or epigenetic mechanisms underlying addictive processes may overlap with those involved in predisposing illnesses (Chapters 5, 11, 13). Addressed are (2) resilience to addictions despite substance use (Chapters 1, 3–5, 7, 13); (3) clinical contexts of addictive behavior, including nicotine (Chapter 3, early onset), opiates (Chapter 4; resilience and impulsivity), alcohol (Chapter 5; stimulant-like effects), stimulants (Chapter 9), marijuana and cannabinoids (Chapter 10; endocannabinoid systems strategic role in motivation and reward), nonpharmacological addictions (Chapter 8; sexual addictions), and interactions between addictions and other recurrent/progressive brain diseases (Chapters 1, 13). Topics include (4) strategies for addiction prevention and treatment, including targets related to impulsivity (Chapters 1, 2, 4, 5), decision-making (Chapter 2), sensitization (Chapters 1, 13), and prevention (Chapters 5, 13); nonpharmacological treatments for impulsivity (Chapters 2, 4), decision-making (Chapter 2), and sensitization prevention (Chapter 13), pharmacogenetics (Chapter 11), and study design and analysis strategies that account for complex neurobehavioral interactions underlying addiction treatment (Chapter 12). Chapter 13 integrates addictive and other psychiatric diseases, especially regarding progression and sensitization, in a clinically oriented manner. Understanding the basic neurobehavioral mechanisms and sources of resilience against them will lead to more effective prevention, diagnosis, and treatment.Less

Post-traumatic stress disorder (PTSD) is a maladaptive and debilitating psychiatric disorder characterized by an extreme sense of fear at the time of trauma occurrence, with characteristic re-experiencing, avoidance, and hyperarousal symptoms in the months and years following the trauma. PTSD can occur in up to 25% of subjects who have experienced severe psychological trauma, such as combat veterans, refugees, and assault victims. Why are some people resilient, whereas others develop debilitating PTSD? Notably, PTSD is among the most likely of psychiatric disorders to be understood from the perspective of environmental influences interacting with genetic vulnerability, since diagnosis requires a specific, highly traumatizing, fear-evoking experience. In addition, a large amount of evidence now supports a model in which PTSD can be viewed, in part, as a disorder of fear dysregulation. This is particularly exciting because the neural circuitry underlying fear behavior in mammals is among the most well-understood behavioral circuits in neuroscience. Further, the study of fear behavior and its underlying circuitry has led to rapid progress in understanding learning and memory processes. By combining molecular-genetic approaches with a mechanistic understanding of fear circuitry, great progress is possible in the understanding, diagnosis, and treatment of PTSD. This book examines the basic neural mechanisms that mediate complex responses and adaptations to psychological trauma; it describes what is currently known about how these biological processes are impaired in individuals with PTSD, and how environmental exposure to trauma interacts with the brain to create the syndrome of PTSD.Less

Ovarian Cancer Immunotherapy provides a broad overview of several aspects of basic sciences and clinical and therapeutic aspects of immunotherapy for ovarian cancer, as well as state-of-the-art information on molecular genetics and biology. Chapters are written by a team of expert contributors from around the world and explore topics such as antibody therapeutics for ovarian carcinoma, emerging serum biomarkers, ovarian cancer immunity, adoptive cell immunotherapy, the biology of dendritic cells, the role of growth factors, and more. Readers will also gain a better understanding of the molecular and cellular events that underlie ovarian cancer immunology. This book is an ideal reference for clinicians and medical students caring for patients with ovarian cancer, including attending surgeons and physicians, and clinical fellows and residents in the disciplines of gynecologic oncology, medical oncology, and surgical oncology.Less

In the 21st century, the primary challenge for health care is chronic illness. To meet this challenge, we need to think anew about the role of the patient in health and health care. There have been widespread calls for patient-centered care, but this model of care does not question deeply enough the goals of health care, the nature of the clinical problem, and the definition of health itself. We must instead pursue patient-centered health, which is a health perceived and produced by patients. We should not only respect, but promote patient autonomy as an essential component of this health. Objective health measures cannot capture the burden of chronic illness, so we need to draw on the patient's perspective to help define the clinical problem. We require a new definition of health as the capacity for meaningful action. It is recognized that patients play a central role in chronic illness care, but the concept of health behavior retards innovation. We seek not just an activated patient, but an autonomous patient who sets and pursues her own vital goals. To fully enlist patients, we must bridge the gap between impersonal disease processes and personal processes. This requires understanding how the roots of patient autonomy lie in the biological autonomy that allows organisms to carve their biological niche. It is time for us to recognize the patient as the primary customer for health care and the primary producer of health. Patient agency is both the primary means and primary end of health care.Less

Phase I trials are a critical first step in the study of novel cancer therapeutic approaches. Their primary goals are to identify the recommended dose, schedule and pharmacologic behavior of new agents or new combinations of agents and to describe the adverse effects of treatment. In cancer therapeutics, such studies have particular challenges. Due to the nature of the effects of treatment, most such studies are conducted in patients with advanced malignancy, rather than in healthy volunteers. Furthermore, the endpoints of these trials are usually measures adverse effects rather than molecular target or anti-tumor effects. These factors render the design, conduct, analysis and ethical aspects of phase I cancer trials unique. As the only comprehensive book on this topic, this online resource for oncology trainees and specialists explains cancer drug development and includes information on Phase 0 Trials, immunotherapeutics, and updated information on the process, pitfalls, and logistics of Phase I Trials.Less

Prescription Drug Diversion and Pain provides an interdisciplinary overview of medications used to treat chronic pain, and the benefits and risks that are posed by long-term use of opioids. Use of these life-saving medications must be carefully managed to prevent serious side effects, which may include physical dependence, addiction, and even death. In recent years, the risk of these side effects has led to increased attention on the development of alternative treatments for chronic pain. This book not only offers a single, comprehensive source for understanding the specialized nature of the opioid crisis, but also addresses provocative topics including how pain drugs came to be regulated by the US government and the rarely discussed aggressive marketing behind the spread of these drugs. Chapters are written by expert contributors from diverse backgrounds in medicine, psychiatry, pharmacy, nursing, law, and bioethics. Prescription Drug Diversion and Pain is a must-read for healthcare professionals, chronic pain patients and caregivers, policymakers and regulatory officials, drug treatment providers, and those in the pharmaceutical industry seeking to address the current opioid crisis.Less