And In Health

Are you sick and tired of being sick and tired? When you first met your spouse you probably had a physical response to the emotions you felt. You’d get butterflies in your stomach, your heart would race, and your palms would sweat. So why is it that after you’re married, it’s so hard to make the connection between your physical health and your emotional well-being when you’re facing relational stress? If your emotional pain feels physical and your physical pain feels emotional, your marriage may be making you sick—literally. Join Dr. David Hawkins and his sons, an internist and a surgeon, as they explore the effects relational stress and trauma can have on our bodies. You will learn to . . . recognize the link between emotional and physical pain embrace the power of choice to become empowered by hope find a path forward to ultimate restoration and regain your life No matter what kind of pain you’re experiencing, or how long your health has been in decline, you don’t have to stay stuck. Discover hope and healing when you take control of your life.

A frank, humorous exploration of interabled dating, love, and marriage Ben Mattlin’s wife, ML, recalls falling in love with his confidence and sheer determination. On one of their earliest dates, he persuaded her to ride on his lap in his wheelchair on their way home from an Elvis Costello concert. Thirty years later, they still travel like this from time to time, undaunted by the curious stares following them down the street. But In Sickness and in Health is more than an “inspiring” story of how a man born with spinal muscular atrophy—a congenital and incurable neuromuscular condition—survived childhood, graduated from Harvard, married an able-bodied woman, built a family with two daughters and a cat and a turtle, established a successful career in journalism, and lived happily ever after. As Mattlin considers the many times his relationship has been met with surprise or speculation by outsiders—those who consider his wife a “saint” or him just plain “lucky” for finding love—he issues a challenge to readers: why should the idea of an “interabled” couple be regarded as either tragic or noble? Through conversations with more than a dozen other couples of varying abilities, ethnic backgrounds, and orientations, Mattlin sets out to understand whether these pairings are as unusual as onlookers seem to think. Reflecting on his own experience he wonders: How do people balance the stresses of personal-care help with the thrill of romance? Is it possible that the very things that appear to be insurmountable obstacles to a successful relationship—the financial burdens, the physical differences, the added element of an especially uncertain future—could be the building blocks of an enviable level of intimacy and communication that other couples could only dream of? We meet Shane Burcaw, a twenty-three-year-old writer, who offers a glimpse of his first forays into dating with a disability. There’s Rachelle Friedman, the “paralyzed bride,” as the media refers to her, and her husband, discussing the joys and challenges of a new marriage and a growing family. And Christina Crosby and her partner, Janet Jakobsen, reflect on how Crosby’s disabling accident called for them to renegotiate their roles and expectations in their long-term relationship. What emerges is a candid glimpse into the challenges and joys of interabled love—from the first blush of sexual awakening to commitment and marriage and through to widowhood.

This book offers engaging and digestible lessons for couples navigating the life change that a cancer diagnosis brings. Dan Shapiro draws on his more than twenty-five years of clinical work as a health psychologist who has researched and worked with couples facing cancer, and on his own experiences of being both the patient (having and beating Hodgkin’s lymphoma in his twenties) and the supporter/advocate (when his wife was diagnosed with breast cancer) to weave together insights on facing cancer while maintaining a strong relationship. And in Health gives advice in short lessons on the main areas of concern or conflict that can come from life with cancer—from diagnosis to treatment and life post-treatment. Topics include: • How to forge yourselves into a powerful team and evade common conflicts • Dealing with physicians and getting the best care possible, along with tips for navigating the medical world • Strategies for coping with the emotions that can interfere with your relationship—anger, mood swings, spouse fears, and depression • Distinguishing between supportive and draining people in your lives, and learning to invite and accept help • Opening to new types of intimacy and making peace with dependence

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

This is a story about a young husband, man, father, and pastor whose faith was tested in the most unusual and unexpected ways. It's a story of love to one woman, faith in one God, and gift of one child.

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.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

How does the need to obtain and deliver health services engender particular (im)mobility forms? And how is mobility experienced and imagined when it is required for healthcare access or delivery? Guided by these questions, Healthcare in Motion explores the dynamic interrelationship between mobility and healthcare, drawing on case studies from across the world and shedding light on the day-to-day practices of patients and professionals.