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Our hearts have evolved to be extremely efficient, long-lasting
pumps that exquisitely match the needs of our bodies. This book is
about how the heart does this; how can a heart pump the blood for
up to 100 years while the best Formula 1 racing engine has a
working life measured in hours? Why is the heart so efficient, and
how are worn out parts replaced while working? How does it generate
the force to act as a pump, how is it controlled electrically, and
how can it repair itself?This book addresses these questions from
physiological and molecular perspectives in language that aims to
be accessible to all interested in biology and with liberal
illustrations.The story of how the heart works is presented in the
context of its origins:The book begins with a discussion of why the
word heart is universally used as a metaphor for reason and emotion
and traces its origins in modern and ancient languages. The last
chapter offers advice on how to preserve the heart by matching our
lifestyles more closely to how it evolved.
The concept of evidence-based medicine was launched in 1991 as a
new paradigm to inform medical practice and has risen to be
regarded as the gold standard. It rapidly gained the attention of
medics, health service managers and the general media as it
presented a means to improve efficiency and effectiveness of
service delivery. Despite its stunning success in capturing the
health agenda, the campaign that launched evidence-based medicine
has also attracted criticism, particularly from clinicians and
philosophers concerned about its selective views of knowledge and
evidence, and for its denigration of reasoning, clinical experience
and judgement.Evidence-Based Medicine traces this movement from its
launch to its meteoric rise, examining what it has done for
healthcare and medicine in the context of changes in science policy
and the long-running criticism held against the movement for its
inherent weaknesses.As evidence-based medicine will remain an
important feature of healthcare in the decades to come, this book
is perfect for healthcare professionals, medical scientists, health
service managers and public health experts looking for a critical
examination of the topic.
This book sets out the unique and paradoxical position biomedical
science finds itself in, in the early 21st (superscript st)
century. Science has never been stronger in shaping the world we
live in; progress in medical science during most of the last
century has helped to transform health care and prolong our lives;
almost daily advances in biological science promise hope for the
future and yet medical science has been in serious decline for the
past three decades.Biomedical Science in the 21st (superscript st)
Century: Sunset or New Dawn? sets out the recent decline in the
context of medical science's stunning past successes. Professor
Sheridan discusses the failure to translate new discoveries in
biological science into medical advances; the dramatic decline in
research productivity in the pharmaceutical industry in the context
of falling numbers of clinical scientists; the disruption of
medical science during prolonged and repeated reforms of health
care delivery; changing social and political attitudes towards
health care and science; the loss of trust in big pharmaceutical
companies and recent revelations of fraud in science. The book
deals with the creative nature of original science, how it is
driven by curiosity and self-motivation and how these can be
stifled by pettifogging managerialism.The book presents a vision of
what medical science can deliver during the coming half century and
what is needed to overcome the present challenges. It questions the
assumptions that big is best in the organisation of science and
suggests a new model for drug development based on a restoration of
trust and a more constructive relationship between regulators and
industry.
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