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Required reading in many medical and healthcare institutions, How to Read a Paper is a clear and wide-ranging introduction to evidence-based medicine and healthcare, helping readers to understand its central principles, critically evaluate published data, and implement the results in practical settings. Author Trisha Greenhalgh guides readers through each fundamental step of inquiry, from searching the literature to assessing methodological quality and appraising statistics. How to Read a Paper addresses the common criticisms of evidence-based healthcare, dispelling many of its myths and misconceptions, while providing a pragmatic framework for testing the validity of healthcare literature. Now in its sixth edition, this informative text includes new and expanded discussions of study bias, political interference in published reports, medical statistics, big data and more. Offers user-friendly guidance on evidence-based healthcare that is applicable to both experienced and novice readers Authored by an internationally recognised practitioner and researcher in evidence-based healthcare and primary care Includes updated references, additional figures, improved checklists and more How to Read a Paper is an ideal resource for healthcare students, practitioners and anyone seeking an accessible introduction to evidence-based healthcare.
Now in its 5th edition, Wolters Kluwer's AJN Award Winning text,Theoretical Basis for Nursing , provides an overview of nursing theory that includes the essential information that a student needs to understand theory and its application to practice. Students-with little to no knowledge of nursing theory-will gain insight into how theory can affect their practice and make them better nurses. In Unit I, Students are ushered through the skills needed to develop, analyze, and evaluate theory for use in their careers. This skill set will help students pursuing all potential career paths-in nursing practice, research, administration, management, and/or education. As a unique focus in Unit II, grand theories are discussed in relation to 1) human needs, 2) interactive process, and 3) unitary process. This unit provides the perfect amount of information-just enough for the reader to 1) understand the basis of the work and 2) become enticed enough in the material to want to select one or two theories for primary source study. Also, because of an emphasis on middle range theory in nursing programs, the authors present an overview of selected middle range theories, examining their origins and growth. The broad range of middle range theories sampled will point students in the right direction to search for others appropriate to their practice. Some NEW! theories to this edition include aerohemodynamic theory, transtheoretical model of change, and the precede/proceed model. In Unit II, there will be an enhanced discussion of Evidence-based practice (EBP) and nursing theory. As its next frontier, nursing theory will increasingly focus on EBP protocols, and McEwen & Wills help students understand the inter-relatedness of theory, research, and practice. This edition includes an enhanced discussion of the history of EBP and practice-based evidence (PBE). In Unit III, students explore "shared theories," benefitting from the body of knowledge that can be distilled from other disciplines. This unit is unique to this text, and students will discover stories of how nurses have used shared theories in their own practice. In this edition, a NEW! chapter called "Ethical Theories and Principles" will be included in this unit. The text concludes with Unit IV, a summary of how theories should be and are applied in nursing. Functioning as a practical guide, separate chapters cover nursing practice, nursing research, nursing administration and management, and nursing education. The evolving development of practice theories and importance of evidence-based practice guidelines are critical to theory application in nursing today. NEW! In our application to practice chapter (Chapter 19), we will add examples of the theoretical underpinnings related to the clinical practice guidelines. Reinforcing its emphasis on practice, both the book and its resources on thePoint will include case studies with examples from nursing in general through advanced practice scenarios. Because Nursing Theory is often a reading and writing intensive course, this text comes with a Scholarly Writing in Nursing: Best Practices. This resource covers the basics of APA as well as good writing principles, and it also provides weblinks to additional resources. This edition will also feature improved indices making content in the text easier to find quickly. This text is accompanied by a robust instructor resource package featuring an Instructor's Guide, Case Studies with supportive curriculum, PowerPoints, and more. Theoretical Basis for Nursing, 5th Edition offers an inspiring message to readers to contribute to the ongoing development, application, analysis, and evaluation of concepts, principles, theories, and models to advance the discipline of nursing. According to authors McEwen & Wills, "As the health profession with the largest number of providers, nursing has the greatest potential to have the greatest impact on health and healthcare delivery."
'Bad Science' hilariously exposed the tricks that quacks and journalists use to distort science, becoming a 400,000 copy bestseller. Now Ben Goldacre puts the $600bn global pharmaceutical industry under the microscope. What he reveals is a fascinating, terrifying mess. Doctors and patients need good scientific evidence to make informed decisions. But instead, companies run bad trials on their own drugs, which distort and exaggerate the benefits by design. When these trials produce unflattering results, the data is simply buried. All of this is perfectly legal. In fact, even government regulators withhold vitally important data from the people who need it most. Doctors and patient groups have stood by too, and failed to protect us. Instead, they take money and favours, in a world so fractured that medics and nurses are now educated by the drugs industry. The result: patients are harmed in huge numbers. Ben Goldacre is Britain's finest writer on the science behind medicine, and 'Bad Pharma' is the book that finally prompted Parliament to ask why all trial results aren't made publicly available - this edition has been updated with the latest news from the select committee hearings. Let the witty and indefatigable Goldacre show you how medicine went wrong, and what you can do to mend it.
The bite of the tsetse fly - a burning sting into the skin - causes a descent into violent fever and aching pains. Severe bouts of insomnia are followed by mental deterioration, disruption of the nervous system, coma and ultimately death. Sleeping sickness, also known as Human African trypanosomiasis, is one of Africa's major killers. It puts 60 million people at risk of infection, occurs in 36 countries in sub-Saharan Africa, and claims the lives of many thousands of people every year. Transmitted by the tsetse fly, trypanosomiasis affects both humans and cattle. The animal form of the disease severely limits livestock production and farming, and in people the toxic effects of the treatment for the brain disease can be as painful and dangerous as the disease itself. Existing in the shadow of malaria and AIDS, it is an overlooked disease, ignored by pharmaceutical companies and largely neglected by the western world. Peter Kennedy has devoted much of his working life to researching sleeping sickness in Africa, and his autobiographical account shares not only his trials and experiences, evoking our empathy with the affected patients, but an explanation of the disease, including its history and its future. Interwoven with African geography, his compassionate story reveals what it is like to be a young doctor falling in love with Africa, and tells of his building of a vocation in the search for a cure for this cruel disease.
In this publication, description of the basic histology tissues is followed by a description of the histology of the different organs and systems in the human. The subject contents is presented on a relevant clinical level, and students in both medicine and dentistry, as well as related health professions, such as nursing, occupational therapy and physiotherapy, will find it simple and meaningful. The terminology used in the publication correlates with the writing style used as standard in English medical, dental and health care science' schools.
The authoritative guide for Data Monitoring Committees--fully revised and updated The number of clinical trials sponsored by government agencies and pharmaceutical companies has grown in recent years, prompting an increased need for interim monitoring of data on safety and efficacy. Data Monitoring Committees (DMCs) are an essential component of many clinical trials, safeguarding trial participants and protecting the credibility and validity of the study. Data Monitoring Committees in Clinical Trials: A Practical Perspective, 2nd Edition offers practical advice for those managing and conducting clinical trials and serving on Data Monitoring Committees, providing a practical overview of the establishment, purpose, and responsibilities of these committees. Examination of topics such as the composition and independence of DMCs, statistical, philosophical and ethical considerations, and determining when a DMC is needed, presents readers with a comprehensive foundational knowledge of clinical trial oversight. Providing recent examples to illustrate DMC principles, this fully-updated guide reflects current developments and practices in clinical trial oversight and offers expanded coverage of emerging issues and challenges in the field. This new second edition covers the most current information on DMC policies, issues in monitoring trials using new designs, and recent trial publications relevant to DMC decision-making. - Presents practical advice for those managing and conducting clinical trials and serving on Data Monitoring Committees - Illustrates the types of challenging issues Data Monitoring Committees face in practical situations - Provides updated and expanded coverage of topics including regulatory and funding agency guidelines and trial designs and their associated demands and limitations - Includes a new chapter addressing legal issues that affect DMC members and discusses general litigation concerns relevant to clinical research - Expands treatment of current journal publications addressing DMC issues Data Monitoring Committees in Clinical Trials: A Practical Perspective, 2nd Edition is a must-have text for anyone engaged in DMC activities as well as trial sponsors, clinical trial researchers, regulatory and bioethics professionals, and those associated with clinical trials in academic, government and industry settings.
This book focuses on group sequential methods for clinical trials with co-primary endpoints based on the decision-making frameworks for: (1) rejecting the null hypothesis (stopping for efficacy), (2) rejecting the alternative hypothesis (stopping for futility), and (3) rejecting the null or alternative hypothesis (stopping for either futility or efficacy), where the trial is designed to evaluate whether the intervention is superior to the control on all endpoints. For assessing futility, there are two fundamental approaches, i.e., the decision to stop for futility based on the conditional probability of rejecting the null hypothesis, and the other based on stopping boundaries using group sequential methods. In this book, the latter approach is discussed. The book also briefly deals with the group sequential methods for clinical trials designed to evaluate whether the intervention is superior to the control on at least one endpoint. In addition, the book describes sample size recalculation and the resulting effect on power and type I error rate. The book also describes group sequential strategies for three-arm clinical trials to demonstrate the non-inferiority of experimental intervention to actively control and to assess the assay sensitivity to placebo control.
Correctly understanding and using medical statistics is a key skill for all medical students and health professionals. In an informal and friendly style, Medical Statistics from Scratch provides a practical foundation for everyone whose first interest is probably not medical statistics. Keeping the level of mathematics to a minimum, it clearly illustrates statistical concepts and practice with numerous real-world examples and cases drawn from current medical literature. Medical Statistics from Scratch is an ideal learning partner for all medical students and health professionals needing an accessible introduction, or a friendly refresher, to the fundamentals of medical statistics.
A clinical psychiatrist explores the effects of DMT, one of the most powerful psychedelics known.
- A behind-the-scenes look at the cutting edge of psychedelic research.
- Provides a unique scientific explanation for the phenomenon of alien abduction experiences.
From 1990 to 1995 Dr. Rick Strassman conducted U.S. Government-approved and funded clinical research at the University of New Mexico in which he injected sixty volunteers with DMT, one of the most powerful psychedelics known. His detailed account of those sessions is an extraordinarily riveting inquiry into the nature of the human mind and the therapeutic potential of psychedelics. DMT, a plant-derived chemical found in the psychedelic Amazon brew, ayahuasca, is also manufactured by the human brain. In Strassman's volunteers, it consistently produced near-death and mystical experiences. Many reported convincing encounters with intelligent nonhuman presences, aliens, angels, and spirits. Nearly all felt that the sessions were among the most profound experiences of their lives.
Strassman's research connects DMT with the pineal gland, considered by Hindus to be the site of the seventh chakra and by Rene Descartes to be the seat of the soul. DMT: The Spirit Molecule makes the bold case that DMT, naturally released by the pineal gland, facilitates the soul's movement in and out of the body and is an integral part of the birth and death experiences, as well as the highest states of meditation and even sexual transcendence. Strassman also believes that "alien abduction experiences" are brought on by accidental releases of DMT. If used wisely, DMT could trigger a period of remarkable progress in the scientificexploration of the most mystical regions of the human mind and soul.
This collective monograph aims at contributing to an improved understanding of the epistemic presumptions, sociocultural implications and historically backgrounds of the newly emerging and currently expanding approach of systems biology. In doing so, it offers empirically grounded, valuable and reflexive information about a paradigmatic shift in the biosciences for a wide range of scientists working in the interdisciplinary areas of systems biology, synthetic biology, molecular biology, biology, the philosophy of science, the sociology of science and scientific knowledge, science and technology studies, technology assessment and the like. The authors of this monograph share the theoretical methodological premise that science is a culturally and socially embedded practice which characterizes our culture as a scientific one and at the same time draws its innovative potential from its socio-cultural context. This dialectic relationship lies at the heart of the current development of systems biology which is conceived as a so-called successor of '-omics' research and triggered by high-throughput information technologies. At the same time a need for a holistic conceptualization of complex biological processes emerges. The title Contextualizing Systems Biology suggests that this book analyzes the development and advent of systems biology from different theoretical and methodological perspectives. We investigate a variety of contexts ranging from the analysis of cognitive contexts (such as basic theoretical concepts) to regulative contexts (policies) to the concrete application of a systems biology in the socio-scientific context of a European research project. In empirically analyzing these different and interrelated layers and dimensions of systems biology, the scope of the book goes beyond present attempts to investigate the advent of new approaches in the biological sciences as it frames and assesses systems biology from an interdisciplinary and integrated perspective.
This book offers a collection of expert reviews on the use of plant-based antioxidant therapies in disease prevention and treatment. Topics discussed include the uses of plant and nutritional antioxidants in the contexts of reproductive health and prenatal development, healthcare and aging, noncommunicable chronic diseases, and environmental pollution. The text is complemented by a wealth of color figures and summary tables.
This volume addresses the structural and functional roles of the cytoskeleton and its dysfunctions which often lead to disease. It provides thorough discussion of microtubules, microfilaments, intermediate filaments, and cytoskeletal functions and dysfunctions in different organ systems. Comprehensive yet concise. The Cytoskeleton In Health And Disease presents cutting-edge discoveries balanced with background information and highlights the new aspects of the research and its impact on the design of new strategies or the identification of new targets for therapeutic intervention. There is a significant need for a book on this topic, as interest in the cytoskeleton continues to grow as causes and cures for cytoskeletal diseases are further explored in biomedical research. This book is essential reading for scientists, students, and teachers interested in expanding their knowledge related to the cytoskeleton. New researchers entering the field will find classic and well as contemporary information not easily found in the current literature or internet resources.
Crash Course - your effective every-day study companion PLUS the perfect antidote for exam stress! Save time and be assured you have the essential information you need in one place to excel on your course and achieve exam success. A winning formula now for over 20 years, each series volume has been fine-tuned and fully updated - with an improved full-colour layout tailored to make your life easier. Especially written by senior students or junior doctors - those who understand what is essential for exam success - with all information thoroughly checked and quality assured by expert Faculty Advisers, the result are books which exactly meet your needs and you know you can trust. This volume concisely brings together the wide range of skills needed for interpreting or conducting medical research and audit. It starts with the basics of medical data analysis and interpretation, followed by how to critically review published studies and even extends to advice on career advancement including CV writing, securing academic opportunities and teaching. This book will allow you to build competence and confidence in the world of medical research. ? Provides the exam syllabus in one place - saves valuable revision time Written by senior students and recent graduates - those closest to what is essential for exam success Quality assured by leading Faculty Advisors - ensures complete accuracy of information Features the ever popular 'Hints and Tips' boxes and other useful aide-memoires - distilled wisdom from those in the know Updated self-assessment section matching the latest exam formats - confirm your understanding and improve exam technique fast
This extensively revised second edition is a unique and portable handbook focusing on clinical trials in surgery. It includes new educational materials addressing the rapid evolution of novel research methodologies in basic science, clinical and educational research. The underlying principles of clinical trials, trial design, the development of a study cohort, statistics, data safety, data monitoring, and trial publication for device and drug trials are also discussed. Clinical Trials provides a comprehensive resource on clinical trials in surgery and describes all the stages of a clinical trial from generating a hypothesis through to trial publication and is a valuable resource for all practicing and trainee academic surgeons.
Includes a revised taxonomic outline for the phyla Bacteroidetes, Planctomycetes, Chlamydiae, Spirochetes, Fibrobacters, Fusobacteria, Acidobacteria, Verrucomicrobia, Dictyoglomi, and Gemmatomonadetes based upon the SILVA project as well as a description of more than 153 genera in 29 families. Includes many medically important taxa.
This book offers a systematic introduction to the engineering principles and techniques of cavitation in biomedicine on the basis of its physics and mechanism. Adopting an interdisciplinary approach, it covers areas of interest ranging from physics and engineering to the biological and medical sciences. Individual chapters introduce the fundamentals of cavitation, describe its characterization, control and imaging techniques, and present cavitation-enhanced thermal and mechanical effects and their applications. Intended as both a reference work for graduate students, and as a guide for scientists and engineers who work with cavitation in biomedicine, it provides a broad and solid foundation of knowledge. The aim is to bridge the different disciplines involved, and to promote cross-discipline research, thus encouraging innovations in the scientific research and engineering applications alike. Dr. Mingxi Wan is a professor at Department of Biomedical Engineering, Xi'an Jiao Tong University, Xi'an, Shaanxi, China; Dr. Yi Feng works at Department of Biomedical Engineering, Xi'an Jiao Tong University, Xi'an, Shaanxi, China; Dr. Gail ter Haar is a professor at The Institute of Cancer Research, Sutton, Surry, UK.
A practical guide to network meta-analysis with examples and code In the evaluation of healthcare, rigorous methods of quantitative assessment are necessary to establish which interventions are effective and cost-effective. Often a single study will not provide the answers and it is desirable to synthesise evidence from multiple sources, usually randomised controlled trials. This book takes an approach to evidence synthesis that is specifically intended for decision making when there are two or more treatment alternatives being evaluated, and assumes that the purpose of every synthesis is to answer the question for this pre-identified population of patients, which treatment is best ? A comprehensive, coherent framework for network meta-analysis (mixed treatment comparisons) is adopted and estimated using Bayesian Markov Chain Monte Carlo methods implemented in the freely available software WinBUGS. Each chapter contains worked examples, exercises, solutions and code that may be adapted by readers to apply to their own analyses. This book can be used as an introduction to evidence synthesis and network meta-analysis, its key properties and policy implications. Examples and advanced methods are also presented for the more experienced reader. Methods used throughout this book can be applied consistently: model critique and checking for evidence consistency are emphasised. Methods are based on technical support documents produced for NICE Decision Support Unit, which support the NICE Methods of Technology Appraisal. Code presented is also the basis for the code used by the ISPOR Task Force on Indirect Comparisons. Includes extensive carefully worked examples, with thorough explanations of how to set out data for use in WinBUGS and how to interpret the output. N etwork Meta-Analysis for Decision Making will be of interest to decision makers, medical statisticians, health economists, and anyone involved in Health Technology Assessment including the pharmaceutical industry.
The volume is designed to provide an integrated overview of the results from the last fifteen years of research on Chromogranins in relation to cell biology, physiology and biomedicine. The different chapters highlight novel activities of these proteins, including their role in granule biogenesis, hormone co-storage, stimulus-processing-secretion coupling, autonomic sympathetic/parasympathetic balance, immune and cardiocirculatory function, and the response to stress. Biomedical aspects are also illustrated with focus on the prognostic and diagnostic significance of Chromogranin in the presence of tumors, cardiovascular diseases and inflammatory conditions. The volume is of interest for laboratory and clinical scientists, PhD and Post-doc students that will be inspired to go deep inside the molecular, biochemical, physiological, pharmacological and clinical aspects of these fascinating multifaceted proteins.
Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. "Revision ACL Reconstruction: Indications and Technique" provides detailed strategies for planning and executing revision ACL reconstructions. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery and complex technical considerations.
One of the biggest challenges faced in medical research had been to create accurate and relevant models of human disease. A number of good animal models have been developed to understand the pathophysiology. However, not all of them reflect the human disorder, a classic case being Usher's syndrome where the mutant mice do not have the same visual and auditory defects that patients face. There are others which have been even more difficult to model due to the multi-factorial nature of the condition and due to lack of discovery of a single causative gene such as age-related macular degeneration or Alzheimer's syndrome. Thus a more relevant and accurate system will allow us to make better predictions on relevant therapeutic approaches. The discovery of human pluripotent stem cells in 1998 followed by the technological advances to reprogram somatic cells to pluripotent-stem cell-like cells in 2006 has completely revolutionized the way we can now think about modelling human development and disease. This now coupled with genome editing technologies such as TALENS and CRISPRs have now set us up to develop in vitro models both 2D as well as 3D organoids, which can more precisely reflect the disease in the patients. These combinatorial technologies are already providing us with better tools and therapeutics in drug discovery or gene therapy. This book summarizes both the technological advances in the field of generation of patient specific lines as well as various gene editing approaches followed by its applicability in various systems. The book will serve as a reference for the current state of the field as it: -Provides a comprehensive overview of the status of the field of patients derived induced pluripotent stem cells. -Describes the use of cardiac cells as a main featured component within the book. -Examines drug toxicity analysis as a working example throughout the book.
Nursing and Healthcare Research at a Glance is perfect for nursing and healthcare students, as well as newly qualified practitioners and anyone looking for a refresher or introduction to research. Covering a broad range of topics gathered under key sections, this essential book combines informative diagrams and images to provide memorable information for students on one page, and accessible, clearly written text on the facing page. It includes information on a range of quantitative and qualitative research methods, the process of gaining ethical permission, conducting research with special groups including children, and successfully conducting reviews of the literature. Key features include: * Clear and informative full colour illustrations throughout * An emphasis on need-to-know research information for busy students and healthcare staff * A wide range of research methods, currently used in modern healthcare research * An impressive line-up of specialist and well-known experts in the field of health and nursing research This book provides quick access to the principles and reality of research and its implementation within the education and practice environment. It is essential reading for anyone in health service education and service settings with limited time who need to draw on research evidence.
When data from all aspects of our lives can be relevant to our health - from our habits at the grocery store and our Google searches to our FitBit data and our medical records - can we really differentiate between big data and health big data? Will health big data be used for good, such as to improve drug safety, or ill, as in insurance discrimination? Will it disrupt health care (and the health care system) as we know it? Will it be possible to protect our health privacy? What barriers will there be to collecting and utilizing health big data? What role should law play, and what ethical concerns may arise? This timely, groundbreaking volume explores these questions and more from a variety of perspectives, examining how law promotes or discourages the use of big data in the health care sphere, and also what we can learn from other sectors.
New discoveries in the field of stem cells increasingly dominate
the news and scientific literature revealing an avalanche of new
knowledge and research tools that are producing therapies for
cancer, heart disease, diabetes, and a wide variety of other
diseases that afflict humanity. The Handbook of Stem Cells
integrates this exciting area of life science, combining in two
volumes the requisites for a general understanding of adult and
embryonic stem cells. Organized in two volumes entitled Pluripotent
Stem Cells & Cell Biology and Adult & Fetal Stem Cells,
this work contains contributions from the world s experts in stem
cell research to provide a description of the tools, methods, and
experimental protocols needed to study and characterize stem cells
and progenitor populations as well as a the latest information of
what is known about each specific organ system.
This volume presents the latest developments and techniques used to study the physiopathology, diagnosis, and treatment of pre-eclampsia. Written for clinicians, obstetricians, basic scientists, researchers, and students the chapters in this book provide methods to study placental function using in vitro and ex vivo model systems, comprehensive genetic analysis of pre-eclampsia, identifying critical angiogenic factors associated with the development of pre-eclampsia, and controlled experiments that investigate potential therapies. Written in the highly successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, tips on troubleshooting and avoiding known pitfalls, as well as a description of the limitations and advantages of the described techniques. Cutting-edge and comprehensive, Pre-Eclampsia: Methods and Protocols is a valuable resource for anyone interested in learning more about the critical role of the placenta in the maternal-fetal relationship.
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