Patients And Agents

Just down from Oxford in the depression of the Thirties, young Blore-Smith has the confidence of the callowest of youths, and the security of a sizeable private income. But when a car accident causes him to bump into Maltravers, an almost-famous film director, and Chipchase, a distinctly amateur psychoanalyst, he finds himself swept into an hilariously instructive - yet costly - adventure...

Sylhet, the area of Bangladesh most closely associated with overseas migration, has seen an increase in remittances sent home from abroad, introducing new inequalities. Social change has also been mediated by the global forces of Western biomedicine and orthodox Islam. This book examines the effects of these modernizing trends on mental health and on local, traditional healing as the new inequalities have exacerbated existing social tensions and led to increased vulnerability to mental illness. It is the young women of Sylhet who are most affected. The global economy has increased competition for resources and led to marriage being seen as a route to economic advancement. Parents prefer to give their daughters in marriage to families that will widen their social contacts and enhance their economic and social standing. Accordingly, the young wife's outsider status (and hence vulnerability to mental illness) has increased as it is no longer customary to give daughters in marriage to local kin. Yet, patients and their families do not work out tensions passively. They are active agents in the construction of their own diagnosis. The extent to which patients act or are acted upon is an investigation that runs throughout the book. Alyson Callan is a psychiatrist and anthropologist. She currently works as a consultant psychiatrist in Brent for the Central and North West London NHS Foundation Trust.

Patient-centered care for chronic illness is founded upon the informed and activated patient, but we are not clear what this means. We must understand patients as subjects who know things and as agents who do things. Bioethics has urged us to respect patient autonomy, but it has understood this autonomy narrowly in terms of informed consent for treatment choice. In chronic illness care, the ethical and clinical challenge is to not just respect, but to promote patient autonomy, understood broadly as the patients' overall agency or capacity for action. The primary barrier to patient action in chronic illness is not clinicians dictating treatment choice, but clinicians dictating the nature of the clinical problem. The patient's perspective on clinical problems is now often added to the objective-disease perspective of clinicians as health-related quality of life (HRQL). But HRQL is merely a hybrid transitional concept between disease-focused and health-focused goals for clinical care. Truly patient-centered care requires a sense of patient-centered health that is perceived by the patient and defined in terms of the patient's vital goals. Patient action is an essential means to this patient-centered health, as well as an essential component of this health. This action is not extrinsically motivated adherence, but intrinsically motivated striving for vital goals. Modern pathophysiological medicine has trouble understanding both patient action and health. The self-moving and self-healing capacities of patients can be understood only if we understand their roots in the biological autonomy of organisms. Taking the patient as the primary perceiver and producer of health has the following policy implications: 1] Care will become patient-centered only when the patient is the primary customer of care. 2] Professional health services are not the principal source of population health, and may lead to clinical, social and cultural iatrogenic injury. 3] Social justice demands equity in health capability more than equal access to health services.

A guide to the relations between a predicate and its arguments, for researchers and advanced students in linguistics. Engages foundational issues in both syntax and semantics, with attention to the correspondence between structure at the two levels. Chapters include discussion questions and suggestions for further reading.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

This book provides a pioneering approach to modeling the human diabetic patient using a software agent. It is based on two MASc (Master of Applied Science) theses: one looking at the evolution of the patient agent in time, and another looking the interaction of the patient agent with the healthcare system. It shows that the software agent evolves in a manner analogous to the human patient and exhibits typical attributes of the illness such as reacting to food consumption, medications, and activity. This agent model can be used in a number of different ways, including as a prototype for a specific human patient with the purpose of helping to identify when that patient’s condition deviates from normal variations. The software agent can also be used to study the interaction between the human patient and the health care system. This book is of interest to anyone involved in the management of diabetic patients or in societal research into the management of diabetes. The diabetic patient agent was developed using the Ackerman model for diabetes, but this model can be easily adapted for any other model subject with the necessary physiological data to support that model.