GLOBAL HEALTH CARE ISSUES AND POLICIES
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1 GLOBAL HEALTH CARE ISSUES AND POLICIES Carol Holtz, PhD, RN Professor of Nursing WellStar School of Nursing Kennesaw State University Kennesaw, Georgia JONES AND BARTLETT PUBLISHERS Sudbury, Massachusetts BOSTON TORONTO LONDON SINGAPORE
2 Introduction Acknowledgments Contributors xiii xxv xxvii Section I Global Healthcare Policy, Methods, and Delivery Chapter 1 Global Health in Developed Societies: Examples in the United States, United Kingdom, Sweden, and Israel 1 Carol Holtz United States 1 Sweden 21 United Kingdom 24 Israel 29 References 34 Chapter 2 Developing Countries: Mexico, China, and South Africa 39 Carol Holtz Mexico 39 China 50 South Africa 59 References 68 in
3 iv CONTENTS Chapter 3 Global Perspectives on Economics and Health Care 73 Marsha Burke, Govind Hariharan, Robert A. Lipson, and Caroline Aultman Introduction 73 Profiles of Five Healthcare Systems 74 Comparative Analysis of Healthcare Systems 84 Healthcare Productivity and Costs 87 Key Components of an Ideal Healthcare System 94 Acknowledgments 99 References 99 Chapter 4 Global Perspectives on Politics and Public Health Policy 103 Alexandra Toma, Michele Zebich-Knos, Richard B. Davis, and Enrique Paz Introduction 103 The United States Perspective 104 The Bolivian Perspective 113 A Multilateral Perspective 121 Conclusion 137 References 138 Chapter 5 Global Health Research Methods 143 Timothy A. Akers and Mary Anne Alabanza Akers Planning for Global Health Research: The 10/90 Debate 144 Accessing Data: Secondary Data 146 Collecting the Data: Primary Data 150 Geographical Information Systems (G1S) in Global Health Research 153 Conclusion 154 References 154 Chapter 6 International Research Ethics 157 Jonathan B. VanGeest and Deborah S. Cummins Research Ethics 157 The Use of Human Subjects in Research 158 Research Ethics in Today's Global Context 160 A Closer Look: Clinical Trials in the Prevention o/mtct of HIV 160 Reasonable Standard of Care Debate 162
4 V Basic Principles 164 Applications: Another Look at Clinical Trials in the Prevention ofmtct of HIV 169 Protecting Human Subjects Globally: A Need for Oversight andmonitoring 170 Conclusion ' 174 Case Studies 174 References 176 Appendix 6-A: Selected Web-Based Resources on Research Ethics 179 Section II Special Global Healthcare Issues Chapter 7 Infectious Diseases from a Global Perspective 181 Timothy A. Akers, Barbara J. Blake, and Robert A. Hanson Overview 181 Historically 182 People and Environment: Epidemiology and Regional Impact 183 Cholera 183 Dengue Fever (Arbovirus) 184 Malaria (Plasmodiums: falciparum, malariae, ovale, vivax) 184 Avian (Bird) Flu (H5N1) 185 West Nile Virus (Arbovirus) 186 SARS (Severe Acute Respiratory Syndrome) 186 Ebola (Hemorrhagic Fever) 187 Hepatitis A, B, and C 188 Syphilis (Treponema pallidum) 190 Tuberculosis (Mycobacterium tuberculosis) 190 Human Immunodeficiency Virus (HIV) IAcquired Immunodeficiency Syndrome (AIDS) 191 Interdisciplinary and Systemic Impact on Infectious Diseases 194 Prevention Intervention Strategies 195 Surveillance, Research, and Evaluation: Three Sides of the Same Coin 195 References 196
5 vi CONTENTS Chapter 8 Global Use of Complementary and Alternative Medicine (CAM) and Treatments 199 Ping Hu Johnson Introduction 199 CAM Defined: Complementary and Alternative or Traditional? 199 CAM in the United States 200 CAM in the World 203 Major Forms of CAM, Research and Technology 217 Legal and Ethical Issues 219 Influences of Politics, Economics, Culture, and Religion 225 Developing and Developed Societies 228 Case Study Examples 229 References 230 Chapter 9 Global Perspectives on Selected Chronic Cardiovascular Diseases 235 Bowman O. Davis, Jr. Introduction 235 Demographic and Socioeconomic Transition 236 The Underlying Role of Poverty 247 The Chronic Disease Burden 248 The Cardiovascular Disease Burden 250 Cardiovascular Disease Risk Factors 252 Conclusions 261 References 265 Chapter 10 Global Perspectives on Diabetes and Respiratory and Orthopedic Chronic Diseases 267 Janice Long, Betsy Rodriguez, and Carol Holtz Introduction: The Global Burden of Chronic (Noncommunicable) Diseases 267 Musculoskeletal Disorders 269 Diabetes 273 Asthma 278
6 VU Preventing Limb Amputations: A Diabetes Intervention Case Study Involving Working Across Borders in Latin America (Five Andean Countries: Bolivia, Ecuador, Peru, Colombia and Venezuela) 282 References 294 Chapter 11 Overview of Cancer for Allied Healthcare Professionals: A Public Health Perspective 299 Linda G. Alley, Temeika L. Fairley, Cheryll Cardinez, and Paran Pordell Introduction 299 Key Cancer and Public Health Concepts and Definitions 300 Cancer Prevention 309 Early Detection, Screening, and Education 315 Cancer Care Considerations 323 Noteworthy Compilations of Cancer Information 333 Conclusions 333 References 334 Chapter 12 Global Perspectives on Violence, Injury, and Occupational Healthcare 343 Carol Holtz Violence 343 Injury 352 Occupational Health 357 References 365 Chapter 13 Global Perspectives on Nutrition 369 Carol Holtz, Kathy Plitnick, and Marvin Friedman Introduction 369 Types of Nutritional Challenges 371 Food Safety and Security 379 Nutrition and Poverty 380 Nutrition Emergencies 381 Nutritional Challenges in Vulnerable Populations 383 Nutrition Case Studies 386 References 393
7 viii CONTENTS Chapter 14 Global Perspectives on Mental Health 397 Mary Ann Camann Overview 397 Global Perspective The Results of Research and Technology 397 Legal and Ethical Issues 399 Regional Mental Health Issues and Outcomes 403 Summary 414 References 416 Chapter 15 Global Perspectives on Environmental Health 419 Marvin Friedman Global Issues Lessons in Environmental Health 419 Principles of Environmental Health 422 Principles of Toxicology 425 Legal and Ethical Issues 427 What Is the Environment? 428 Sustainable Development 434 References 435 Section -illi? Lifespan Health Issues Chapter 16 Global Health in Reproduction and Infants 437 Carol Holtz and Suzanne Grisdale Background 437 Reproductive Rights 439 Adolescent Reproductive Health 440 Fertility 443 Infertility 444 Family Planning and Contraception 445 Abortion 447 Maternal Mortality and Morbidity 450 Accessing Reproductive Health Care 451 A Comparison of Customs and Practices of Pregnancy, Delivery, and Postpartum Care in Africa, China, and Mexico 453
8 ix Infant Health 461 Sexually Transmitted Diseases (STDs) 467 Violence Against Women 469 Male Reproductive Health 471 Conclusion 472 References 472 Chapter 17 Global Health of Children 477 Kathie Aduddell Introduction Background and Historical Perspective 478 Childhood Mortality and Morbidity Statistics: Measuring Health in Children..480 What Are the Health Problems for Children? 481 Larger Ramifications of Children's Health Problems 484 Approaches to Child Health Around the World 487 Future Challenges 490 References 493 Chapter 18 Global Health of the Older Adult 495 David B. Mitchell Introduction 495 Mortality and Morbidity Statistics 498 Research and Technology 507 Legal and Ethical Issues 509 Influences of Politics, Economics, Culture, and Religion 511 Case Study Examples 515 Conclusion 518 Acknowledgments 518 References 518 Appendix I8-A: 20 Questions about Global Aging 522 Answers 523
9 Worldwide Issues and Trends by Specific Country Chapter 19 Establishing Medical and Nursing Education Programs in the Country of Georgia 527 Judith L. Wold, H. Kenneth Walker, and Natia Partskhladze Introduction 527 The Georgian Healthcare System 531 Healthcare Reform 536 Access to Information 536 Nursing 536 Women and Children 544 Medical Education 545 Business Education 545 Healthcare Management 545 Scholarly Activities and Biomedical Research 546 Emergency Medical Care and Other Initiatives 546 Discussion 547 References 549 Chapter 20 A Unique Perspective on Health Care in Panama 551 Larry Purnell Overview 551 Education 559 Communication 561 Spirituality and Religion 564 Research and Demonstration Projects 565 Healthcare Practices 568 Traditional Practitioners and Herbal Medicine 577 Case Study 578 Critical Thinking Questions 580 Bibliography and References 581 Chapter 21 Health and Environmental Design: The Relationship Between Health and Place in a Philippine Urban Setting 583 Mary Anne Alabanza Akers and Timothy A. Akers
10 xi Introduction 583 Health and Place 585 Early Environmental Design Health Interventions 585 Current Environmental Design Approaches to Health 586 The Environment and Health 589 Urbanization in Asia 590 Baguio City: A City Founded on Health and Healing 591 A Case Study of Health and Place: Street Vendors in Downtown Baguio 591 An Environmental Design Proposal to Address Health in Baguio City's Central Business District 597 Conclusion." 598 References 598 Chapter 22 Building Cultural Competence: A Nursing Practicum in Oaxaca, Mexico 601 David Bennett and Carol Holtz Need for Cultural Competence 601 Impact of Study Abroad and Immersion Experiences on Cultural Competence 602 Language Acquisition and Increased Fluency 602 Experiential Learning 603 Problem-Based Learning 603 Achieving Praxis 604 Development of the Study-Abroad Practicum 604 Implementation of the Nursing Practicum in Oaxaca 608 Student Outcomes 611 Lessons Learned 612 Conclusion 613. References 614 Index 615
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