Andrew Powell

Eduardo A. Cavallo

The 2018 Macroeconomic Report, A Mandate to Grow, revisits the growth debate that has been raging in the region for the past half century. Viewing the debate from this long-term perspective allows for a focus on the structural factors that have prevented Latin America and the Caribbean from reaching the growth potential required to keep pace with faster growing regions and to fulfill the aspirations of its population.

Latin American and Caribbean Macroeconomic Report

A Mandate to Grow

Christopher C. H. Cook

This book addresses the concerns of clinicians, patients, and researchers regarding the place of spirituality in psychiatric practice.

Spirituality and Psychiatry

William D. Savedoff

Juan Carlos Navarro

Carmen Pagés

Carlos Scartascini

Rita Funaro

Lucía Madrigal

Suzanne Duryea

Juan Camilo Chaparro

María Victoria Rodríguez-Pombo

Eduardo Lora

Pablo Sanguinetti

Aimee Verdisco

Mariana Alfonso

Traditionally, the concept of quality of life has been viewed through objective indicators. Beyond Facts looks at quality of life through a new lens, namely, the perceptions of millions of Latin Americans. Using an enhanced version of the recently created Gallup World Poll that incorporates Latin America-specific questions, the Inter-American Development Bank surveyed people from throughout the region and found that perceptions of quality of life are often very different from the reality. These surprising findings have enormous significance for the political economy of the region and provide a wealth of information for policymakers and development practitioners to feast upon.

Understanding Quality of Life

Beyond Facts

Bisong Guo

Listen to Your Body shows how you can promote health and natural well-being by modifying everyday actions to improve the flow of qi (the universal principle of energy). Breathing, eating, drinking, resting, washing, and many other small but vital actions--if carried out in the right way--can result in profound changes in body function. To give readers an understanding of the body's own natural medicine, the authors provide a clear explanation of the foundations of Traditional Chinese Medicine (TCM) with reference to qi and its flow through the body's meridians, the balance of yin and yang, and the body's energy centers. Readers will learn how to "tune in" to the signals the body transmits to warn of impending health problems; numerous case histories illustrate how this highly developed information system of the body works. Later chapters address the art of relaxation, bringing together the TCM approach to health with recent scientific studies. Finally the authors describe in detail how to apply the natural medicine of the body to daily life. They discuss illness prevention and provide specific guidance for the management of a range of health disorders. Exercises and simple routines are given, together with the basis for their therapeutic effect.

The Wisdom of the Dao

Listen to Your Body

Background:By 2080, 1 in 7 of the European population will be over the age of 80 years. The elderly have greater comorbidities and require more frequent hospital admissions. There is a consequent responsibility for medical professionals to u2018get it rightu2019 for this cohort. Any rise in avoidable hospital complications and length of stay therefore has potentially huge implications for quality and safety of care and greatly increased financial cost.Pre-existing cognitive impairment in the elderly strongly predicts post-operative delirium. This is associated with longer hospital stays, increased peri-operative mortality and post-operative functional decline. Cognitive impairment should be routinely screened for and delirium risk factors aggressively minimised in the elderly. We performed a snapshot study of elderly patients admitted to 2 general surgical and 1 orthopaedic wards to investigate this issue.Methods:All patients over 75 years old (in total 37) admitted over 3 weeks were screened for delirium risk factors and their cognitive function was assessed daily using the Mini-Cog tool. A score of 0-2 indicated impairment and a drop in daily score was also noted. Drug charts and patient notes were also reviewed to identify patients that were taking cognition-affecting (u2018Beeru2019s criteriau2019 positive) medications and whether peri-operative screening for cognitive impairment had occurred.Results and Discussion:100% of our patients had 2 or more delirium risk factors. Notably, none had any documented pre-operative cognitive screening in hospital.35% of patients had a Mini-Cog score of 2 or less during their admission. Over 1 in 5 of patients dropped scores at least once and of these 3 were taking Beeru2019s positive drugs. Interestingly, 1 patient had scores that dropped over 3 days - in retrospect this clearly heralded clinical deterioration and subsequent admission to ITU.More than 40% (16 patients) of the patients were on 1 medication with cognition-altering effects, 12% were on 2 such drugs. Of these, 6 patientu2019s drugs were started in hospital.Conclusion:Despite the clear risks posed by cognitive impairment and peri-operative delirium in our elderly patients, these remain poorly recognised.Screening at any time throughout admission appears scant. Single point assessment can be misleading as it doesnu2019t identify all those with peri-operative delirium. Assessment should occur more frequently in u2018at-risku2019 elderly patients.

Andrew Powell

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