Amytrophic Lateral Sclerosis (ALS or motor neurone disease) is a progressive neurodegenerative disease that can cause profound suffering for both the patient and their family. Whilst new treatments for ALS are being developed, these are not curative and offer only the potential to slow its progression. Palliative care must therefore be integral to the clinical approach to the disease. Palliative Care in Amyotrophic Lateral Sclerosis: From diagnosis to bereavement reflects the wide scope of this care; it must cover not just the terminal phase, but support the patient and their family from the onset of the disease. Both the multidisciplinary palliative care team and the neurology team are essential in providing a high standard of care and allowing quality of life (both patient and carer) to be maintained. Clear guidelines are provided to address care throughout the disease process. Control of symptoms is covered alongside the psychosocial care of patients and their families. Case studies are used to emphasise the complexity of the care needs and involvement of the patient and family, culminating in discussion of bereavement. Different models of care are explored, and this new edition utilizes the increase in both the evidence-base and available literature on the subject. New topics discussed include complementary therapies, personal and family experiences of ALS, new genetics research, and updated guidelines for patient care, to ensure this new edition remains the essential guide to palliative care in ALS.

Patients with mental health issues present frequently in primary care and their consultations are often more challenging and time-consuming than those involving physical illness. For many patients there remains a significant stigma associated with mental ill-health and overcoming this adds further complexity to the consultation. Improving the Mental Health Consultation provides a simple 'short circuit' tool to help GPs and other healthcare professionals to explain mental health problems simply and effectively to their patients. The tool is straightforward, easy to convey within the confines of a 10-minute consultation and extremely effective in helping to break down the stigma that patients often feel. The tool has been developed and refined during over ten years of consultations in primary care. The detailed explanations of how to use the tool during the consultation, along with the extensive case studies, will help you to improve your mental health consultations and so help your patients deal better with their diagnosis. From anxiety to OCD and chronic fatigue to fibromyalgia, the book also provides detailed coverage of diagnosis and classification using ICD-11 and DSM-IV, and management using the latest NICE guidelines.

This book presents a broad range of perspectives on the topic of CPAP adherence. This includes theoretical underpinnings of adherence; multi-disciplinary practical approaches as well as special considerations in diverse clinical populations, age groups and cultures by authors from five continents. CPAP Adherence is a novel and highly relevant publication for sleep physicians, psychologists, dentists, respiratory therapists, sleep technicians, family physicians as well as PAP and oral appliance providers. This book will help improve patient care and quality of life.

This book is a point-of-care resource for effective sexual and reproductive healthcare for patients of all ages, sexual orientations, gender identities and medical backgrounds in the primary care setting. This useful guide is divided into three parts, and other than part three, which deals exclusively with transgender and gender diverse patients, all content will relate to patients of all gender identities. Part one presents sexual and reproductive health (SRH) using a lifespan approach, including chapters on pediatrics, adolescents and young adults, adults, and older adult patients. Part two presents an approach to common SRH issues that span multiple age groups, including contraception and family planning, sexually transmitted infections and cancer screenings as well as sexual and reproductive health in the setting of common medical conditions. Part three is dedicated to sexual and reproductive health for transgender and gender non-binary patients, including psychosocial, medical, surgical and legal aspects of health. This book provides primary care clinicians with a framework for providing effective sexual and reproductive healthcare to patients of all ages, sexual orientations and gender identities in a way that is inclusive, focuses on health, and addresses the needs unique to specific populations.

The business side of running a medical practice may be unappealing but it's crucial "How to Manage Your GP Practice" is written for GPs and other health professionals running their own practices.It tells you in simple, engaging style what the pitfalls are and how to avoid them.It illustrates the good and bad ways of negotiating through management issues, using case examples and lightening the messages with witty cartoons.

Written by a GP with over 10 years' experience editing a leading GP magazine, and an accountant whose firm advises over 2500 GPs, the information here is sound, relevant and up to date. It provides reliable and reassuring information for doctors starting out in their careers as well as those looking to refresh their management skills.

The previous edition of this book for the Membership of the Royal College of General Practitioners examination proved to be hugely popular since publication in 2005. But now the MRCGP exam and Summative Assessment have merged to become the compulsory nMRCGP, and with this has come a change in the format of the written exam. Rather than Paper 1 and Paper 2 there is now a single Applied Knowledge Test consisting of one three hour exam. This new edition reflects all these changes. In addition, updates include revised guidelines and questions on relatively new topics such as practice based commissioning. This book will continue to familiarise you with the types of questions found in the new exam and also covers good exam technique to optimise your results with the knowledge you have. The questions have been divided into papers, so you can practice exam timing, and you can also use the book to test yourself on specific subjects by referring to the topic-based question index. Compared with the limited alternative preparation material for this examination, this book gives far better explanations of answers, and the information is presented more accessibly. It is essential for all examination candidates.

This book presents an extensive collection of high-yield case vignettes with recommendations for a comprehensive approach to cultural psychiatry. Culture is defined from an anthropological perspective, with an emphasis on aspects of culture beyond race, ethnicity, and other traditional demographic categories. The goal of this book is to offer clinical applications of cultural psychiatry via examination of special populations, systems, and settings. With ever-changing geopolitical environments, institutional structures, and sociodynamics, attention and consideration of context is paramount. Theoretical models and specific frameworks for evaluating cultural influence on the manifestation, development, and treatment response of mental health illnesses are presented. The chapters are organized to showcase different ways in which culture plays into everyday clinical practice. Emphasis is placed on the full sum of the care delivery transaction within a larger context, including public and community systems of care. Real-world case examples are discussed in each chapter to help contextualize the dynamic nature that culture plays in practice across inpatient and outpatient settings. Each case presents with relevant academic and historical background and practical operational advice for psychiatrists providing care within these respective communities. The authors address diverse clinical cases related to refugee and asylum seekers, military service members, survivors of human trafficking, incarcerated populations, and more. Training recommendations and best practices are outlined including psychopharmacology, psychosocial treatments, and cultural adaptations to evidence based treatments. Diversity in Action: Case Studies in Cultural Psychiatry is a useful resource for all psychiatrists, psychologists, general practitioners, social workers, nurses, administrators, public policy officials, and all medical professionals working with a culturally diverse subset of patients seeking mental health.

The new edition of this best-selling title from the popular 100 cases series explores common scenarios that will be encountered by the medical student and junior doctor when working in the community setting, and which are likely to feature in qualifying examinations. The book covers a comprehensive range of presentations from tiredness to tremor. Comprehensive answers highlight key take home points from each case and provide practical advice on how to deal with the challenges that occur in general practice at all levels.

This indispensable toolkit is full of practical hints and tips to enhance and develop the role of nursing in general practice. The user-friendly, straight-forward style makes it great for quick reference, bringing together all the basic information required to find a clear career path. This toolkit, along with the linked on-line material, prepares readers for adjusting their roles in accordance with patient needs, personal and professional aims and career aspirations. It is ideal for all nurses and health care assistants in general practice, including healthcare students wanting a career in general practice. Practice managers, PCT managers, health care educators and general practitioners will also find it of great interest.

This fascinating book presents 100 biographies of general practitioners, the majority of whom have made key contributions to the development of general practice and medicine, but also some who have influenced society through engineering, literature, music, politics, sport and other fields. Organised into four different time periods and with key themes in each, the reader will gain an insight into the background of these individuals and what led to their decision to enter the speciality, discover their successes and occasional failures, while also learning about significant events in the history of general practice, medical education, medical politics, medical research, the Royal College of General Practitioners and society as a whole. Key features: * Highly readable and visual introduction to the history of general practice * Includes 100 biographies of a variety of general practitioners from 1640 to the present day * Describes both successes and failures in the development of the specialty and how these have helped direct and shape current clinical practice * Key themes covered include academia and research, medical education, medical politics and society * Ideal for anyone wishing to gain a broader insight into the history of this important specialty, as well as those interested in medical biography Written in an accessible style, and illustrated throughout, the book is an invaluable guide for academics, doctors or students with a special interest in general practice, medical education, medical history or social history.

Professional medicine has often been seen as a field that discriminates against women as doctors and patients. Yet women are entering medicine in increasing numbers. This 1998 book explores the position of women in the medical profession in Australia and the UK, asking the key question 'Do women doctors make a difference?' Based on an extensive survey of general practitioners and specialists, the book evokes the culture of contemporary medicine by describing the experiences of doctors themselves, often in their own words. Pringle employs a distinctive theoretical approach, but writes accessibly and with insight about a profession that is slowly being transformed. She notes the success of women in entering medicine and describes the ways in which they have challenged medical authority and practice. This is an original and important work that contains new visions for medical practice.

This book comprehensively reviews soft tissue, bone, ligament, and nerve injury of the hand and wrist unique to baseball. Organized into three sections, the book begins with a discussion on fractures of the hand and wrist, including the distal radius, scaphoid, and phalanges. Following this, section two examines ligament injuries from the wrist to the thumb. Section three then concludes the book with an analysis of tendon and nerve injuries. Chapters include high-quality images and tables to supplement expertly written text. Unique and thorough, Hand and Wrist Injuries in Baseball is an invaluable resource for orthopedics surgeons and sports medicine specialists, as well as primary care physicians, emergency room physicians, pediatricians, athletic trainers, and therapists.

The book discusses the impact of genetics, social determinants of health, the environment, and lifestyle in the burden of cardiometabolic conditions in African American and Hispanic/Latinx populations. It includes fully updated and revised chapters on genetics and CVD risk, epidemiology of cardiovascular health, cardiovascular imaging, dyslipidemias and other emerging risk factors, obesity and metabolic syndrome, heart failure, and genetic variations in CVD. Unique aspects within African American and Hispanic/Latinx populations are explored with suggested appropriate therapeutic interventions. New chapters focus on ASCVD risk assessment, emerging precision medicine concepts, the impact of diabetes, resilience and CVD survival, and lifestyle and dieting considerations. Written by a team of experts, the book examines the degree to which biomedical and scientific literature can clarify the impact of genetic variation and environment on cardiovascular disease. The Second Edition of Cardiovascular Disease in Racial and Ethnic Minority Populations is an essential resource for physicians, residents, fellows, and medical students in cardiology, internal medicine, family medicine, clinical lipidology, and epidemiology.

We invest more in health care than ever before, yet we are more anxious about doctors, hospitals, and the NHS in general. As perceptions of patients' rights have expanded, so has the transparency of the difficult choices that are routine. Government has become more critical of the NHS and the public less willing to wait for treatment. Why does demand for health care consistently exceed supply and how should Government manage the problem? There is a danger that improved rights for the strong and articulate will ignore less visible, or unpopular interests. How should the rights of elderly patients, or children, or those with terminal illnesses be balanced? Who should decide: the government, doctors, NHS managers, citizens, or the courts? How should decision-makers be held accountable, and by whom? How should governance regulate the NHS? As patients become 'consumers' of medical care, what choice do they have as to how, where, and when they will be treated; and should this include hospitals abroad? This completely revised new edition puts patients' rights into their political, economic and managerial contexts. It considers the implications of the Bristol Inquiry and the rhetoric of patients as 'consumers' of care. In balancing the rights of individuals with those of the community as a whole, it deals with one of the most pressing problems in contemporary society.

Primary care providers (physicians, nurse practitioners, physician assistants) make decisions on a daily basis regarding treatment for musculoskeletal problems, including referrals to orthopedic surgeons and other specialists. Despite the large number of patients presenting with musculoskeletal complaints, primary care providers often feel poorly educated about how to assess and manage these conditions. Now in its fully revised second edition, Principles of Orthopedic Practice for Primary Care Providers continues to be a go-to resource for clinicians interested in the effective treatment of musculoskeletal disorders. Written by expert orthopedic, physical medicine and pain management specialists at major Harvard teaching hospitals, the second edition of Principles of Orthopedic Practice for Primary Care Providers represents a high-yield and succinct resource on the assessment and management of musculoskeletal conditions. Chapters overview specific body parts, typical presentations of disease, options for diagnostic testing, treatment paradigms, and anticipated outcomes of management both in the primary care setting and following specialist consultation. The text offers suggested pathways for working up and treating these problems with an emphasis on when referral to a specialist, or surgical intervention, is needed. While all previous chapters have been fully revised, this edition also includes nine brand new chapters, including chapters on pain management, hip-spine syndrome, adult spinal deformity, sports-related injuries, and cost and quality in musculoskeletal care.

The #1 choice for more than 35 years for those involved in the care of adolescents and young adults, Neinstein's Adolescent and Young Adult Health: A Practical Guide, 7th Edition is your go-to resource for practical, authoritative guidance. The fully updated seventh edition, edited by Drs. Debra K. Katzman, Catherine M. Gordon, S. Todd Callahan, Richard J. Chung, Alain Joffe, Susan L. Rosenthal, and Maria E. Trent, offers a comprehensive view of the interdisciplinary nature of the field and is inclusive of the wide variety of health professionals who care for adolescents and young adults. This award-winning text features a full-color design, several new chapters, numerous algorithms, bulleted text throughout for quick reference at the point of care, and fresh perspectives from new editors-making it ideal for daily practice or certification examination preparation. Features significant revisions and new content on opioid use, vaping, gun violence, survivors of childhood cancer and other chronic illnesses, COVID, and more. Includes new chapters on Palliative Care and End of Life, Quality Improvement, Research, and Healthcare for Minoritized, Disenfranchised, and Marginalized Adolescents and Young Adults. Includes key topics such as technology use, the care of transgender adolescents and young adults, reproductive health, sports medicine, college health, and more Features a globally diverse editorial team and authors who are experts in their respective areas and who reflect the demographics of this wide-ranging field Offers comprehensive, evidence-based content from cover to cover, as well as numerous resources and websites on nearly every topic, where professionals, adolescents and young adults, and parents can find up-to-date information Continues to be a highly useful resource for pediatricians, family practitioners, gynecologists, internists, nurse practitioners, physician assistants, residents, medical students, and fellows practicing in traditional primary care and specialty settings serving adolescents and young adults, as well as in school-based and college health centers, juvenile detention centers, emergency departments, urgent care centers and any other facility that provides care to this population." Enrich Your eBook Reading Experience Read directly on your preferred device(s), such as computer, tablet, or smartphone. Easily convert to audiobook, powering your content with natural language text-to-speech.

This comprehensive text on the pharmacological, medical, and legal aspects of drug abuse has been thoroughly updated for the Fourth Edition, and a new chapter on club drugs added. The chapter on medical effects was completely rewritten to focus on infections that develop in i.v. drug abusers, and information on the international regulation of drug use was added to the chapter on drug abuse and the law. The book is written at a level appropriate for upper level undergraduate students, graduate or medical students, and drug counselors. All major drugs of abuse are covered: tobacco, opiods, central stimulants (including cocaine, amphetamine, and caffeine), alcohol and other sedatives marijuana, club drugs (MDMA, GHB, and ketamine), hallucinogens, and volatile solvents. For each type the authors discuss history and culture, the characteristic patterns of use, subjective and physiological effects, mechanisms of pharmacological action, and toxic effects. Epidemiological aspects are discussed as well as pharmacological treatment possibilities where applicable.

American medicine attracts some of the brightest and most motivated people the country has to offer, and it boasts the most advanced medical technology in the world, a wondrous parade of machines and techniques such as PET scans, MRI, angioplasty, endoscopy, bypasses, organ transplants, and much more besides. And yet, writes Eric Cassell, what started out early in the century as the exciting conquest of disease, has evolved into an overly expensive, over technologized, uncaring medicine, poorly suited to the health care needs of a society marked by an aging population and a predominance of chronic diseases. In Doctoring: The Nature of Primary Care Medicine, the author shows convincingly how much better fitted advanced concepts of primary care medicine are to America's health care needs. He offers valuable insights into how primary care physicians can be better trained to meet the needs of their patients, both well and sick, and to keep these patients as the focus of their practice. Modern medical training arose at a time when medical science was in ascendancy, Cassell notes. Thus the ideals of science, objectivity and rationality became the ideals of medicine, and disease, the target of most medical research, became the logical focus of medical practice. When clinicians treat a patient with pneumonia, they are apt to be thinking about pneumonia in general, which is how they learn about the disease, rather than this person's pneumonia. This objective, rational approach has its value, but when it dominates a physician's approach to medicine, it can create problems. For instance, treating chronic disease, such as rheumatoid arthritis, diabetes, stroke, emphysema, and congestive heart failure, is not simply a matter of medical knowledge, for it demands a great deal of effort by the patients themselves: they have to keep their doctor appointments, take their medication, do their exercises, stop smoking. The patient thus has a profound effect on the course of the disease, and so for a physician to succeed, he or she must also be familiar with the patient's motivations, values, concerns, and relationship with the doctor. Many doctors eventually figure out how to put the patient at the center of their practice, but they should learn to do this at the training level, not haphazardly over time. To that end, the training of primary care physicians must recognize a distinction between doctoring itself and the medical science on which it is based, and should try to produce doctors who rely on both their scientific and subjective assessments of their patients' overall needs. There must be a return to careful observational and physical examination skills and finely tuned history taking and communication skills. Cassell also advocates the need to teach the behavior of both sick and well persons, evaluation of data from clinical epidemiology, decision making skills, and preventive medicine, as well as actively teaching how to make technology the servant rather than the master, and offers practical tips for instruction both in the classroom and in practice. Most important, Doctoring argues convincingly that primary care medicine should become a central focus of America's health care system, not merely a cost-saving measure as envisioned by managed care organizations. Indeed, Cassell shows that the primary care physician can fulfill a unique role in the medical community, and a vital role in society in general. He shows that primary care medicine is not a retreat from scientific medicine, but the natural next step for medicine to take in the coming century.

Family Physicians need to be expert and active providers of mental health care. Their rapport with patients and accessibility enable them to control minor mental health conditions before these problems become critical. Brief Mental Health Interventions for the Family Physician is an ideal resource for Family Physicians. It provides a "refresher course" of sensible paths toward resolution of common mental health problems. It features an easy to read style, and well-focused references. The book summarizes the basic components of brief therapy and reviews how to conduct a brief therapy interview. It also includes chapters on specific clinical conditions and situations that routinely confront the family physician. Each chapter includes an outline, a case example or vignette, and a concise discussion of brief therapy strategies for the disorder. Primary care physicians will find this convenient text an ideal handy reference and review.

How did doctors make a living? Making a Medical Living explores the neglected socio-economic history of medical practice, beginning with the first voluntary hospital in 1720 and ending with national health insurance in 1911. It looks at private practice and how this was supplemented by public appointments. In this innovative study, Anne Digby makes use of new archival sources of information to produce a compelling picture of ordinary rather than elite doctors, and of the dynamics of provincial rather than metropolitan practice. From the mid-eighteenth century doctors travelled to see ordinary patients, developed specialisms and expanded institutions. Despite limitations in treatment, doctors raised demand for their services as illuminating case studies of women, children, the poor and the affluent show. But doctors did not limit their own numbers, and were largely unsuccessful in restricting competition from other practitioners, with the significant exception of women. Consequently, many GPs struggled to make a living by seeing numerous patients at low fees. Doctors' entrepreneurial activity thus helped shape English medicine into a distinctive pattern of general and specialist practice, and of public and private health care.

When patient meets doctor, as well as engaging in a transaction with a clinical purpose, they react to one another as people. Their personalities and ability to make relationships in general also affect the professional interaction. As with other relationships, things can go wrong. The outcome of a consultation may not then be what was hoped for or intended on either side. What may be lost, or not even achieved, is a sense of working with one another - hence the 'problem patient' or 'quack doctor'. This book describes the factors that may complicate the clinical transaction between patient and doctor, emphasising and explaining the influence of often unconscious personal aspects. This is encompassed within a readily applied and concise model, which yields a fresh analysis and understanding. The insight gained can help doctors, within their own consultational styles, to better manage their interaction with patients. Plentiful clinical case vignettes illustrate this approach to understanding and managing clinical transactions and will be welcomed by clinical students and doctors in training, as well as by their trainers.

When patient meets doctor, as well as engaging in a transaction with a clinical purpose, they react to one another as people. Their personalities and ability to make relationships in general also affect the professional interaction. As with other relationships, things can go wrong. The outcome of the consultation may not then be what was hoped for or intended on either side. This 1994 book considers the factors which may cause problems in the doctor-patient relationship, emphasising and explaining the often unconscious personal aspects of doctor and patient within a model studied from various perspectives. Through this insight doctors can be helped to manage their interactions with patients within their own consultational style, thereby avoiding many unnecessary professional relationship problems. This analysis, which is well-illustrated by clinical case vignettes, is sure to be welcomed by clinicians, trainees and course organisers in all areas where communication between individuals plays an important role.

This is the first book to explore the impact of 'burnout' on the current NHS GP workforce and how this can be addressed, from an insider GP perspective. Adam Staten, recently qualified GP, and Euan Lawson, Fellow of the RCGP with over 20 years experience, discuss in engaging, accessible chapters how burnout manifests psychologically, the complex reasons why GPs burn out and the individual and broader impact this can have. Most importantly, the book offers practical advice on how to avoid burning out and combat the negative effects of an increasingly high-pressure role, exploring how GPs can develop resilience and work in a way that builds a healthier work-life balance. A section is dedicated to the array of GP job options, with testimonies from practitioners working in diverse areas from education and academia to military and humanitarian settings. This book explores the challenges of working in general practice today, but it also demonstrates the potential for every GP to experience a personally and professionally satisfying career. Providing practical, workable advice and links to resources for help and support, the book enables readers to find opportunity within the perceived 'crisis'. By reading this book, you will find the means to improve not just your own working life but also to enhance the way you deliver care to your patients.

During the last 8-10 years the research on homocysteine has become very active. Hundreds of articles are now published each year. A disturbed homocysteine metabolism can be an underlying factor for pregnancy complications and fetal malformations, cardiovascular disease, dementia, psychiatric and neurologic disorders and possibly carcinogenesis. A disturbed homocysteine metabolism can in most cases be normalized by treatment with folate and/or vitamines B12 and B6. Many of these findings therefore directly concern most practitioners.