The Tangled History of Cardiac Care David S. Jones
Still the leading cause of death worldwide, heart disease challenges researchers, clinicians, and patients alike. Each day, thousands of patients and their doctors make decisions about coronary angioplasty and bypass surgery. In Broken HeartsDavid S. Jones, MD, PhD, sheds light on the nature and quality of those decisions. He describes the debates over what causes heart attacks and the efforts to understand such unforeseen complications of cardiac surgery as depression, mental fog, and stroke.
Why do doctors and patients overestimate the effectiveness and underestimate the dangers of medical interventions, especially when doing so may lead to the overuse of medical therapies? To answer this question, Jones explores the history of cardiology and cardiac surgery in the United States and probes the ambiguities and inconsistencies in medical decision-making. Based on extensive reviews of medical literature and archives, this historical perspective on medical decision-making and risk highlights personal, professional, and community outcomes.
"Very informative and containing important insights, Broken Hearts is thoroughly researched, well written, and the only work of its kind dealing with these treatments of heart disease." —Christopher Lawrence, University College London
David S. Jones is the A. Bernard Ackerman Professor of the Culture of Medicine at Harvard University.
Beauty without the Breast is a personal testimony of life with cancer, and at the same time both an appeal to the importance of the voice of women in securing better health and a call-to-action for expanded access to care and control in low- and middle-income countries.
Felicia Knaul, PhD, has dedicated her professional life to health and social development. After diagnosis in 2007 with breast cancer, she merged the personal with the professional to document her experience in a work that transmits her own journey. The story at once contrasts her difficult but inspiring experience with that of the majority of women throughout the world who face not only the challenge of the disease but also stigma, discrimination and lack of access to health care. This wrenching contrast is the cancer divide – an equity imperative in global health.
Beauty without the Breast lays bare many of the barriers that affect women in all parts of the world and highlights the role of men, the family, and the community in responding to the challenge of breast cancer. Knaul candidly addresses through her own experience, issues of survivorship and life with the long-term effects of treatment and the chronic nature of the disease.
It is also a call-to-action that brings to light the unforeseen challenge to health and health systems of breast cancer in LMICs. Knaul, a health economist by training who has lived and worked for two decades in Latin America, also shares her journey as a professional in developing a better understanding of the burden of this disease and demonstrating the need to develop more effective policies to meet this challenge.
New Course offered through the Department of Global Health and Social Medicine
This spring, the Department will launch Design, Implementation and Evaluation of Global Health Research. Held on Mondays from 2:00-4:00 pm at 641 Huntington Avenue, room 107, the course will cover different approaches to implementation/delivery science including community participatory research, quality improvement, mixed methods analysis, and case studies. Lectures will use case examples of research in health delivery and include a required tutorial allowing graduate students to develop research questions and a plan to design, implement, and prepare to evaluate their own research. Joia Mukherjee, MD, MPH, is the course director and many Department faculty will offer a vast array of lecture topics. For a schedule of specific topics, please check the 641 Huntington Avenue lobby screen, and for more information about the course, please contact Christina Lively.
Global Health Delivery Case Studies
The full Global Health Delivery (GHD) Case Collection is available for free download directly from GHDonline.org! Each of the 30+ Harvard Business School-style teaching case studies and companion teaching notes are designed to educate current and future managers on how health care leaders implement value-based principles. Visit Global Health Delivery Project for complete information.
The Family Van, founded in 1992 by HMS Dean for Students and lecturer at the Department of Global Health and Social Medicine Nancy Oriol, MD, has released a new study in the January 2013 issue of Health Affairs showing that the Family Van model leads to improved patient health and reduced costs for emergency care. One aspect of the study shows that patients who initially present with high blood pressure show significant reductions in blood pressure, risk of heart attack, and stroke during follow-up visits. Oriol believes that a major contributor to the Family Van's success comes because it has become part of Boston's poorest and most medically underserved communities by providing health care through an integrated approach--meeting people where they are and knowing that people's social, cultural, and/or economic conditions play a large part in a medical diagnosis. To read more about the Family Van, please see the Harvard Medical School article "All in the Family," written by Jake Miller, and the study inHealth Affairs.
Open Heart a film by Kief Davidson has been nominated for an Academy Award for Best Documentary Short Subject. The film, featuring doctors and staff from Harvard Medical School, Brigham and Women's Hospital, as well as Partners In Health patients, brings awareness about Rheumatic Heart Disease to the world stage. Watch the trailerhere and congratulations!
Join us for a screening of Open Heart followed by a panel discussion Rheumatic Heart Disease in Africa: Academic Partnerships for Health and Human Rights with the film's protagonist, Dr. Emmanuel Rusingiza Kamanzi, pediatric cardiologist at the University Teaching Hospital of Kigali, Rwanda (CHUK). The program will be held in the TMEC Amphitheater, 260 Longwood Avenue, Boston, on Tuesday, February 26, 2013 from 3:30-5:30 p.m.
Congratulations toChunling Lu, PhD, on receiving the Charles H. Hood Foundation Child Health Research Award. The Medical Foundation at Health Resources in Action manages the award. Dr. Lu's abstract is titled The Effectiveness of Community Financing Approach in Improving Child Nutrition Status in Rwanda. The Charles H. Hood Foundation was incorporated in 1942 to improve the health and quality of life for children through grant support of New England-based pediatric research. The grants support hypothesis-driven clinical, basic science, public health, health services research, and epidemiology projects focused on child health. To read Dr. Lu's hypothesis-driven research, click here.
We also extend additional congratulations to Chunling Lu, PhD, on her appointment to the Scientific Advisory Committee at China's Health Times newspaper. Founded in January 2000, the Health Times sees its responsibility as the 'Chinese people's health consultant.' It has been promulgating a healthy lifestyle to the public, as well as promoting the value of a strong life. After a decade of effort, Health Times has become a leading publication among China's mainstream health and lifestyle media outlets. The newspaper has an excellent reputation in the health industry and beyond and is widely influential. Congratulations Chunling!
Paul E. Farmer , Cameron T. Nutt, Claire Wagner, Claude Sekabaraga, Tej Nuthulaganti, Didi Bertrand Farmer, Antoinette Habinshuti, Soline Dusabeyesu Mugeni, Jean-Claude Karasi, and Peter C. Drobac. Reduced premature mortality in Rwanda: lessons from success an analysis of Rwanda's approach to delivering healthcare in a setting of post-conflict poverty and lessons learned that could be adopted by other poor countries. BMJ 2013; 345 doi: http:://dx.doi.org/10. 1136/bmju.f65 (Published 18 January 2013).
Paul E. Farmer and John Meara have written an article for Surgery discussing the "call to action for the academic surgical community to accept and nurture what many view as the new field of global surgery." Farmer and Meara write about the converse-side of accessibility of surgical care in resource-limited settings. Literature has been written from the patient's perspective, now Farmer and Meara explore the corresponding structural, financial, and sociocultural barriers to providing this care from the U.S. academic surgeon's perspective. The article titled Invited commentary: The agenda for academic excellence in “global” surgery can be accessed online at Science Direct.
Zirui S, Hill C, Bennet J, Vavasis, A and Nancy E Oriol, Mobile Clinic in Massachusetts associated with cost savings from lowering blood pressure and emergency department use. Colleagues conducted the first-ever evaluation of the clinical and economic impact of a large urban mobile health clinic, using longitudinal data on 1,134 predominantly black and Hispanic patients. They found that through repeated visits with screening and health coaching, the mobile clinic was associated with reductions in blood pressure that translated into about a 32.2 percent relative risk reduction in heart attacks and 44.6 percent relative risk reduction in stroke for these patients. The authors estimated that lowering the rate of these potential incidents was associated with savings of $235,234. In addition, the mobile clinic was associated with 2,800 emergency department visits avoided over 30 months through patient self-reported data, which was estimated to have saved approximately $1.4 million in emergency department costs over the study period. The authors recommend policymakers consider mobile health clinics as a clinically beneficial and potentially cost-effective delivery model, not only to provide health care to underserved communities, but also to help lower emergency department visits due to a lack of access among this population. Health Affairs, 2013 Jan;32(1):36-44. doi: 10.1377/hlthaff.2011.1392.
On January 16, 2013, Eric Krakauer, MD, PhD, gave a lecture in the Global Oncology Lecture Series titled "Palliative Care in Resource-Limited Settings." (Dr. Paul Farmer delivered the November lecture titled "Delivering Cancer Care in Settings of Extreme Poverty.") The Harvard Global Oncology Seminar Series highlights work at the intersection of global health and oncology, focuses on applying and expanding existing global health strategies to cancer and palliative care in resource-poor settings, and fosters networking and collaboration among all Harvard-affiliated institutions. For more information or to learn about future events, please contact them at firstname.lastname@example.org.
In February 2013, Arthur Kleinman, MD, gave the Vice Chancellor’s Lecture at the University of the Free State and the Vice Chancellor’s Lecture at the University of Cape Town in South Africa. He will then travel to Australia for sabbatical leave where he will be writing a book on care giving. Together with Professors Emmanuel Akyeampong and Allan Hill, he is co-editor of Culture, Substance Abuse and Mental Illness in Africa (an edited book in press at Indiana University Press). Kleinman is also completing a book with Professor Iain Wilkinson, "A Passion for Society" Social Suffering and the Social Sciences. He continues to direct Harvard's Asia Center.
Global Health Delivery Summer Intensive (GHDI) formerly the Global Health Effectiveness (GHE) Program is now accepting applications for the fifth annual session (July 1-26, 2013). Please forward this announcement to anyone seeking training in value-based health care delivery or link to the Global Health Delivery website. Information and application are online - applications will be accepted through March 1, 2013. Please e-mail Amy Scheffler for more information.
GHDonline Expert Panel GHDonline will host a site-wide Expert Panel on Building Capacity for Diagnostics where resources are limited on February 25-31, 2013. Renowned experts will share experiences and GHDonline members are welcome to ask questions and to share insights. For updates and more information on the Panel, check out our calendar of events. On conclusion of the Panel, check our website for a summary of key lessons to be added to our existing set of peer-reviewed Discussion Briefs.
Not yet a members of GHDonline? Visit GHDonline to sign up.
Conference on Ethical Issues in Universal Health Coverage to Be Held April 18-19, 2013
The conference explores the question: can universal coverage be achieved even in the world’s lowest-income countries? China's recent health reform—that in three years has extended health coverage, including innovative financing initiatives in some of the poorest provinces, to 95% of Chinese citizens—has focused the attention of governments of low-income countries on universal coverage. The World Health Organization's annual report of 2010, Health Systems Financing: The Path to Universal Coverage, identified the prospects for universal coverage in even the least-developed countries and sparked an international effort to pursue this once-elusive goal.
On January 28, 2013, the Human Brain Project announced that the European Commission funded their grant proposal, led by Henry Markham of Ecole Polytechnique Federale de Lausanne, for approximately 1 billion euros. This is a flagship project of several collaborating European universities and businesses to develop a detailed model of the human brain to further knowledge of how it works, developing a database and applications to advance neuromedicine, neuroinformatics and neurorobotics. As part of this project, Christine Mitchell, RN, MS, MTS, will work with colleagues at Karolinska Institute in Stockholm. To view the executive summary and the extensive preliminary report from the earlier “blue brain project” please visit the Human Brain Project website.