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'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.
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."
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.
Today, when many parents seem reluctant to have their children vaccinated, even with long proven medications, the Salk vaccine trial, which enrolled millions of healthy children to test an unproven medical intervention, seems nothing short of astonishing. In Selling Science, medical historian Stephen E. Mawdsley recounts the untold story of the first large clinical trial to control polio using healthy children - 55,000 healthy children - revealing how this long-forgotten incident cleared the path for Salk's later trial. Mawdsley describes how, in the early 1950s, Dr. William Hammon and the National Foundation for Infantile Paralysis launched a pioneering medical experiment on a previously untried scale. Conducted on over 55,000 healthy children in Texas, Utah, Iowa, and Nebraska, this landmark study assessed the safety and effectiveness of a blood component, gamma globulin, to prevent paralytic polio. The value of the proposed experiment was questioned by many prominent health professionals as it harbored potential health risks, but as Mawdsley points out, compromise and coercion moved it forward. And though the trial returned dubious results, it was presented to the public as a triumph and used to justify a federally sanctioned mass immunization study on thousands of families between 1953 and 1954. Indeed, the concept, conduct, and outcome of the GG study were sold to health professionals, medical researchers, and the public at each stage. At a time when most Americans trusted scientists, their mutual encounter under the auspices of conquering disease was shaped by politics, marketing, and at times, deception. Drawing on oral history interviews, medical journals, newspapers, meeting minutes, and private institutional records, Selling Science sheds light on the ethics of scientific conduct, and on the power of marketing to shape public opinion about medical experimentation.
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.
Bridge the gap between research and practice with DePoy and Gitlin's Introduction to Research: Understanding and Applying Multiple Strategies, 4th Edition. This completely updated, user-friendly text helps you better understand not only the research process, but also research designs and their applications to the real world of clinical practice. Covering multiple research strategies (including both qualitative and quantitative research), it gives you a balanced approach to various research traditions, addressing the key issues that are emerging in today's health care environment. Case examples provide real-life snapshots of what it is like to participate in different types of research processes, identify research dilemmas relevant to chapter subjects, and alert you to problems you might encounter. Authors make the topics more accessible, so research becomes more relevant - and topics come to life. Covers experimental-type, naturalistic, and mixed method design strategies to improve your ability to compare, contrast, and integrate different methods. Presents complex information clearly in a highly readable, and easy-to-understand, manner. Includes detailed discussions of qualitative and quantitative methodologies, a unique and balanced focus that makes this text more comprehensive than others in its field. NEW! Up-to-date research methods, strategies, and references, like digital sources, visual methods, and geographical analysis, give you the latest information on research in diverse areas of health and human services.
Targeted therapies were initially developed to exploit the upregulation and dependence on key oncogenic pathways critical to cancer progression. Additionally, they also presented as a method to overcome chemoresistance by supplementing conventional therapeutic regimens with targeted therapies. However, the development of resistance to these combinatorial approaches has led to the reassessment of currently available therapeutic options to overcome resistance to targeted therapy. This book aims to provide an update on the advancements in the therapeutic arms race between cancer, clinicians and scientists alike to overcome resistance to targeted therapies. Subject experts provide a comprehensive overview of the challenges and solutions to resistance to several conventional targeted therapies in addition to providing a discussion on broad topics including targeting components of the tumor microenvironment, emerging therapeutic options, and novel areas to be explored concerning nanotechnology and the epigenome.
This book is about the various roles of bioactive ceramides and other sphingolipids in cellular biology. The enigmatic biophysical and biochemical properties of ceramides and their propensity to influence membranes whether as rafts or protein-permeable channels are heavily discussed. Metabolism of ceramides and their metabolites is also focused with ceramide synthase family of proteins being a target of extensive review. Ceramide 1-phosphate and other sphingolipids are also presented in cellular physiology and pathophysiology. Prokaryotic origins of mitochondria at the level of membranes and the occurrence of apoptosis in bacteria are presented. Many aspects of ceramide and sphingolipid biology are addressed in this book. Its focus is the metabolism of ceramide in normal and diseased states and the biophysical and biochemical mechanisms governing the bioactivity of these molecules. Sphingolipid research has surged over the past thirty years and this book gathers the recent findings of various aspects of sphingolipid biochemistry. World-renowned scientists from the field of lipid biology, specifically sphingolipid biochemistry, were gathered to write this book. Scholars from most continents of the globe committed to write diligently about their expertise and the newest findings in the relevant fields. This book came to fruition after almost a year and a half of laborious preparation and diligent writings. This book is targeted to the experienced reader who is looking to read about the various aspects of bioactive ceramide signaling, as well as to the newcomer into the field, as the topics are explained in concise yet very informative manner. The authors and editor wish all readers a pleasant time reading this volume, and are adamant that this book will meet all expectations.
Machine learning and big data is hot. It is, however, virtually unused in clinical trials. This is so, because randomization is applied to even out multiple variables Modern medical computer files often involve hundreds of variables like genes and other laboratory values, and computationally intensive methods are required This is the first publication of clinical trials that have been systematically analyzed with machine learning. In addition, all of the machine learning analyses were tested against traditional analyses. Step by step statistics for self-assessments are included The authors conclude, that machine learning is often more informative, and provides better sensitivities of testing than traditional analytic methods do
Learn the basics and more of gastrointestinal diseases. Gastrointestinal diseases have become a major medical, social and economic burden worldwide. The larger the number of patients suffering from gastric ulcer and colorectal cancer, the greater the need to properly diagnose and cure. This book is a comprehensive guide through GI diseases, which can be used by practitioners and patients. It will allow: - to explore the mechanisms underlying GI diseases - to accurately diagnose and find the best treatment - to learn how to alleviate GI disease symptoms by changing diet and lifestyle This guide has been written by experts in the field who understand the needs of doctors and their patients. With this book, you will make sure that the GI disease can be properly managed.
This book offers an in-depth discussion of the latest strategies in the field of drug design and their applications in various disorders, in order to encourage readers to undertake their own projects.It also includes the contemporary application of drug-designing methodologies to inspire others to further expand the utility of this field in other diseases.It is intended for advanced undergraduate and graduate students, postdocs, researchers, lecturers and professors in bioinformatics, computational biology, medicine, pharmaceutics and other related fields.
Together with Volume 1, this book provides an inclusive overview of the molecular and cellular mechanisms of carcinogenesis and offers comprehensive insights into related clinical and therapeutic aspects. This second volume complements the first by presenting and concisely explaining the carcinogenesis of various tumor entities such as non-melanoma skin cancers, bone and soft tissue tumors, pancreatic cancers, hepatocellular cancer and neuroendocrine tumors. As in volume one, each chapter illuminates the similarities and dissimilarities of changed signaling pathways in the different organ systems and depicts potential therapeutic strategies. The focus of volume two lies on the presentation of modern molecular biological techniques for diagnosis, as well as strategies for biomarker identification and validation. Furthermore, it discusses potential therapeutic targets and individualized treatment strategies, offering a valuable resource for all basic scientists and medical researchers interested in translational cancer research.
This book covers basic research topics such as the structure-function relationships of neuropilins and mechanisms of neuropilin-mediated signal transduction, details the most important roles of the neuropilins in developmental biology, and addresses their roles in various conditions such as cancer and various eye diseases. The two neuropilin genes encode scaffold receptors that can bind several different ligands, and also associate with many other receptors and modify their activity. Further, it has been confirmed that they play important roles in the shaping of major organs and tissues such as the nervous system and the vascular system, and that they can modulate immune responses. The book offers a helpful guide for biomedical researchers and all scientists active in the neurosciences, vascular and molecular biology, as well as developmental biology and immunology.
Since ancient times, plants have been used as a prime natural source of alternative medicines and have played an important role in our lives. The old tradition of medicinal plant application has turned into a highly profitable business in the global market, resulting in the release of a large number of herbal products. People have tried to find different sources of medicines to alleviate pain and cure different illnesses. Due to severe constraints of synthetic drugs and the increasing contraindications of their usage, there is a growing interest world over in the usage of natural products based on medicinal herbs, hence, there is an ever expanding market of herbs and herbal based medicinal preparations all over the world. This has culminated into an exponential increase in number of research groups in different geographical locations and generation of volume of research data in the field in a short span of time. The path breaking advancement in research methods and interdisciplinary approaches is giving birth to newer perspectives. Therefore, it becomes imperative to keep pace with the advancement in research and development in the field of medicinal herbs. There are a large number of researchers in different parts of the world working on various aspects of medicinal plants and 'herbal medicines'. The idea is to bring their recent research work into light in the form of a book. The proposed book contains chapters by the eminent researchers in different countries and working with different disciplines of medicinal plants. Articles pertain to different disciplines such as: 1. Resources and conservation of medicinal plants 2. Biosynthesis and metabolic engineering of medicinal plants 3. Tissue culture, propagation and bioreactor technology of medicinal plants 4. Phytochemical research on medicinal plants 5. Herbal medicines and plant-derived agents in cancer prevention and therapy 6. Herbal medicines and plant-derived agents in metabolic syndrome management 7. Herbal medicines and plant-derived agents in modulation of immune-related disorders 8. Herbal medicines and hepatotoxicity The book will prove itself an asset for the researchers, professionals and also students in the area of medicinal plants and mechanism of their action.
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.
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.
This detailed second edition provides key updates on well-established methods as well as coverage of recently emerging sophisticated techniques and methods that are essential for an in-depth and state-of-the-art understanding of skeletal development and homeostasis and the pathological mechanisms that cause skeletal degeneration. The first half of the book examines cell and molecular biological aspects of osteoarthritis and osteoporosis, while the remainder of the collection focuses on in vivo models of skeletal tissue injury, degeneration, and repair. Written for the highly successful Methods in Molecular Biology series, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Authoritative and up-to-date, Osteoporosis and Osteoarthritis, Second Edition aims to assist investigators concerned with research topics broadly related to osteoporosis, osteoarthritis, intervertebral disc degeneration, as well as other musculoskeletal disorders.
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.
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.
The detailed volume aims to provide a comprehensive hands-on manual covering all the techniques involved in the cellular and molecular identification and characterization of both normal hematopoietic and leukemic stem cells, both from human patients and from mouse models of human leukemia. The book also covers the most frequently used experimental approaches for the generation of such stem cell-based models of human leukemia. Written for the highly successful Methods in Molecular Biology series, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and tips on troubleshooting and avoiding known pitfalls. Authoritative and comprehensive, Leukemia Stem Cells: Methods and Protocols serves as an ideal guide for researchers, both expert and novice, seeking to further our knowledge of this vital avenue of cancer research.
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.
Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice, 4th Edition Bernadette Mazurek Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN and Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN Enhance your clinical decision-making capabilities and improve patient outcomes through evidence-based practice. Develop the skills and knowledge you need to make evidence-based practice (EBP) an integral part of your clinical decision-making and everyday nursing practice with this proven, approachable text. Written in a straightforward, conversational style, Evidence-Based Practice in Nursing & Healthcare delivers real-world examples and meaningful strategies in every chapter to help you confidently meet today's clinical challenges and ensure positive patient outcomes. NEW! Making Connections: An EBP Exemplar opens each unit, immersing you in an unfolding case study of EBP in real-life practice. NEW! Chapters reflect the most current implications of EBP on health policy and the context, content, and outcomes of implementing EBP competencies in clinical and academic settings. NEW! Learning objectives and EBP Terms to Learn at both the unit and chapter levels help you study efficiently and stay focused on essential concepts and vocabulary. Making EBP Real features continue to end each unit with real-world examples that demonstrate the principles of EBP applied. EBP Fast Facts reinforce key points at a glance. Clinical Scenarios clarify the EBP process and enhance your rapid appraisal capabilities.
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