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Graduate medical education (GME) continues its decades-long evolution. Evidence-based approaches are increasingly transforming the way we educate, evaluate, and promote GME trainees. Key to this transformation is our ability to recognize that'medical education” constitutes a true lifelong continuum, beginning with pre-medical education, then proceeding to medical school, residency (and potentially subsequent fellowship) training, and then finally the so-called maintenance of certification that continues throughout one's entire professional career. This book explores a broad range of important topics, including the novel concept of'coping intelligence,” the important role of'work-life integration,” professional coaching and mentorship, professional development and career-long learning, patient-provider relationship, the impact of the COVID-19 pandemic on medical education, as well as the introduction of modern technologies to ameliorate the effects of social distancing. The book further discusses two important aspects of GME program management: the process of establishing new GME programs as well as the highly intricate process of merging residency programs. Different aspects and perspectives are incorporated, including those of residents, faculty, and program leadership. The book ends with chapters on diversity, equity and inclusion, and the importance of community-based medical education.

International health security (IHS) is a broad and highly heterogeneous area. Within this general context, IHS encompasses subdomains that potentially influence (and more specifically endanger) the well-being and wellness of humans. The general umbrella of IHS includes, but is not limited to, natural disasters, emerging infectious diseases (EID) and pandemics, rapid urbanization, social determinants of health, population growth, systemic racism and discrimination, environmental matters, civilian violence and warfare, various forms of terrorism, misuse of antibiotics, and the misuse of social media. The need for this expanded definition of health security stems from the realization that topics such as EID; food, water, and pharmaceutical supply chain safety; medical and health information cybersecurity; and bioterrorism, although important within the overall realm of health security, are not only able to actively modulate the wellness and health of human populations, but also tend to do so in a synergistic fashion. This inaugural tome of a multi-volume collection, Contemporary Developments and Perspectives in International Health Security, introduces many of the topics directly relevant to modern IHS theory and practice. This first volume provides a solid foundation for future installments of this important and relevant book series.

The history of extra-corporeal membrane oxygenation (ECMO) reflects a true medical success story that has been the result of tremendous dedication, perseverance, teamwork, and years—if not decades—of hard work by countless providers, students, and advocates. This book, the final in a series of three on ECMO, traces the history of extra-corporeal support from the early years when therapy was offered as a last attempt at salvaging those patients who had lost almost all hope of survival, to the modern era and the role of ECMO in the contemporary management of critically ill patients, especially during the COVID-19 pandemic. The chapters illustrate how the technical aspects of ECMO have evolved, as well as the growing role of patient selection and team-based management. Although the role of ECMO for COVID-19 is still evolving, the chapters addressing this topic can serve as a foundation for the many complex systematic issues, beyond just the bedside care of ECMO patients, that must be acknowledged. Jorge Agustín Nicolás Ruiz de Santayana y Borrás, also known as George Santayana, has been credited with the quote: “Those who cannot remember the past are condemned to repeat it,” [George Santayana (1905) Reason in Common Sense, p. 284, volume 1 of The Life of Reason] a concept that clearly resonates with those involved in ECMO program development, patient selection and management. As such, the primary goal of this text is to help scholars of all levels better understand where we have been and where we are going.

Extra-corporeal membrane oxygenation (ECMO) is an innovative therapy that is used to support the physiologic needs of a patient during illnesses associated with acute severe respiratory and/or cardiac failure. ECMO is used in those life-threatening situations in which the oxygenation, ventilation, and circulatory support needs of the patient cannot be adequately maintained with a maximal conventional ventilator or pharmaceutical support. Essentially, ECMO is a simple pump circuit that can be used to support the role of failing lungs or hearts while therapies are aimed at organ recovery. While simple in concept and theory, this text illustrates the complexities associated with clinical use. The use of ECMO has evolved substantially overall the years–in part due to broader and growing applications, a better understanding of the technologies and how they can be used (especially in the context of long term human-ECMO circuit interactions), objective tools for patient selection, management protocols, and, most importantly, a growing body of evidence-based science and literature that demonstrates the effectiveness of this highly invasive, resource-intensive, and complex tool. The goal of this text is to draw from established thought leaders and experts around the world and present a comprehensive review of the rapidly-evolving and expanding literature regarding the spectrum of applications for ECMO. While by no means is this implied to be the final and exhaustive text on this topic, it does aim to be as comprehensive and up-to-date as possible which is, in itself, a challenge given how quickly this field is evolving. This text is aimed at students and providers, at all levels, who might have interest or be involved in the care of these critically ill patients. Chapters focus on how programs can be structured, the specific details of patient selection, management, and expanding roles of ECMO. Both basic and sophisticated concepts are presented with the goal that all may learn. We also present an objective assessment of some of the evolving challenges and limitations to ECMO in the context of the increased utilization and expansion of this therapy, combined with “sicker” patients, and the ongoing journey towards improved outcomes while offering a salvage therapy to patients who might otherwise die.

As demonstrated in the first book, the management of patients with profound respiratory failure or cardiogenic shock has evolved significantly over the years with advances in diagnostic and therapeutic options. While the mortality for these often-overlapping problems remains high, progress in the multi-disciplinary approach to these complex clinical problems has improved survival substantially. The focus of this second book is to explore some of the advanced topics and current literature regarding the management of patients requiring extra-corporeal membrane oxygenation (ECMO). As illustrated in the spectrum of topics discussed, ECMO is not only a complex therapy in itself, but the challenges, problems, and complications that arise in this unique area of medicine require engagement by many diverse disciplines. While there are many physiological issues such as organ protection, management of circuit complications, and optimal lung and cardiac protection for recovery, the use of ECMO also introduces a variety of legal and ethical challenges, particularly end-of-life issues (including brain death) in patients for whom recovery, despite extra-corporeal support, is most likely futile. Each of the chapters, written by world-renowned experts in the field, highlights a different important aspect in understanding the complex dynamics of extra-corporeal support and its impact on human pathophysiology. While many of the topics discussed involve sophisticated concepts, each chapter was written with the goal of providing a comprehensive review suitable for any level of training and experience. Many of the topic discussed highlight the state-of-the-art literature along with expert experiences and perspectives as we try to learn more about the overlapping art and science of a field of medicine that has only recently been accepted as a mainstream treatment option. Students of ECMO, ranging from early stage healthcare providers to master physicians, will benefit from the insights presented.

Since the publication of the first volume of Contemporary Developments and Perspectives in International Health Security, a lot has happened in this rapidly evolving area. Perhaps the most dominant global event of the past eighteen months is the COVID-19 pandemic. Within this general context, the importance of the multiple and diverse international health security (IHS) subdomains is becoming evident, especially when one begins to appreciate the interconnectedness of the modern world and the interdependence of various existing societal systems. Moreover, this complexity presents our civilization with both dangers and opportunities, and among the most pronounced opportunities is our ability to effectively'work together and coordinate” as humanity. With a goal to summarize and synthesize our collective experiences from the COVID-19 pandemic, this second tome of Contemporary Developments and Perspectives in International Health Security is a repository of knowledge and a practical resource for those who seek to learn about the current pandemic as well as for those who may already be preparing for the'next pandemic” or as yet unforeseen IHS threats. In addition to the COVID-19 global response, topics discussed in this book include climate change, mental health, supply chain management, and clinical diagnostics, among others.

The COVID-19 pandemic has transformed healthcare systems worldwide. Even as the world transitions out of the pandemic, numerous health threats remain, the biggest of which is climate change. This book examines both the virus and climate change in the context of international health security. It begins with chapters on the effect of COVID-19 on pregnancy and the perinatal period and its relationship to toxic stress. Subsequent chapters address climate change and its effects on human health and wellbeing, natural disaster frequency and severity, and occupational accidents.