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.