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A few years ago, as the editor of Kidney International, I was ap proached by Drs. Cohen, Kassirer, and Harrington who suggested that a new feature should be included in each monthly issue of the journal. They suggested that it should employ a case discussion format such as that used frequently at specialty rounds in teaching hospitals, and that the discussion should place a special emphasis on the relationship between basic science and important problems in clinical nephrology. The summary of an actual patient history would first be presented to exemplify a particular clinical problem, a seasoned person of proven expertise would be invited to deliver a well-documented analysis of the relevant issues, and perhaps most ambitiously of all, a critical audience would be assembled to challenge the principal discussant in an open ended, question-and-answer period. The entire affair would be recorded at the time of the live conference and transcribed subse quently in preparation for publication as a "Nephrology Forum. " I must confess that I was somewhat hesitant at first to endorse their proposal because, at the time, Kidney International had just begun to establish a solid reputation for the publication of high quality, peer reviewed manuscripts dealing with the clinical and laboratory research interests of the international nephrological community.
Data suggest that exposure to secondhand smoke can result in heart disease in nonsmoking adults. Recently, progress has been made in reducing involuntary exposure to secondhand smoke through legislation banning smoking in workplaces, restaurants, and other public places. The effect of legislation to ban smoking and its effects on the cardiovascular health of nonsmoking adults, however, remains a question. Secondhand Smoke Exposure and Cardiovascular Effects reviews available scientific literature to assess the relationship between secondhand smoke exposure and acute coronary events. The authors, experts in secondhand smoke exposure and toxicology, clinical cardiology, epidemiology, and statistics, find that there is about a 25 to 30 percent increase in the risk of coronary heart disease from exposure to secondhand smoke. Their findings agree with the 2006 Surgeon General's Report conclusion that there are increased risks of coronary heart disease morbidity and mortality among men and women exposed to secondhand smoke. However, the authors note that the evidence for determining the magnitude of the relationship between chronic secondhand smoke exposure and coronary heart disease is not very strong. Public health professionals will rely upon Secondhand Smoke Exposure and Cardiovascular Effects for its survey of critical epidemiological studies on the effects of smoking bans and evidence of links between secondhand smoke exposure and cardiovascular events, as well as its findings and recommendations.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
A comprehensive summary of high-flux dialyzers and their properties Dialyzers today are developed with high permeability and biocompatibility in mind, even though the definition of these so- called high-flux dialyzers remains controversial. In the Japanese reimbursement system, dialyzers are divided into five types, ranging from I to V, in accordance with their clearance for beta2- microglobulin (beta2-MG). Classes IV and V (beta2-MG clearance greater or equal to 50 and 70 ml/min, respectively, at a blood flow rate of 200 ml/min) are the most common ones, used in more than 90% of Japanese dialysis patients. Membranes used in types IV and V dialyzers are called high-performance membranes (HPMs) and are characterized by an exceptionally high flux rate, permeability and biocompatibility. The book at hand covers all aspects of these HPM dialyzers, including their definitions and characteristics, clinical experiences and basic investigations. Moreover, historical HPMs and several membranes with special characteristics that are not categorized into classes IV or V are discussed. Providing a summary of commercially available HPM dialyzers, this publication not only serves as a textbook for those interested in state-of the-art dialysis treatment, but is also a concise database of the products available.
The hemodynamic evaluation of patients with acute circulatory failure and respiratory failure has in the past usually been performed using invasive procedures but in recent years less invasive monitoring devices have been introduced. Echocardiography can be used for both the diagnosis and the management of circulatory and respiratory failure. This book provides all the essential information required by readers in order to perform optimal hemodynamic management of the critically ill based on echocardiographic guidance. After an introductory section on basic principles, hemodynamic assessment using echocardiography is discussed in detail. The diagnosis and management of all types of circulatory and acute respiratory failure by means of echocardiography are then rigorously considered, and specific situations such as thoracic trauma and acute aortic syndrome are examined. The final section is devoted to future issues and applications.
This book is designed to introduce doctoral and graduate students to the process of conducting scientific research in the social sciences, business, education, public health, and related disciplines. It is a one-stop, comprehensive, and compact source for foundational concepts in behavioral research, and can serve as a stand-alone text or as a supplement to research readings in any doctoral seminar or research methods class. This book is currently used as a research text at universities on six continents and will shortly be available in nine different languages.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
“In the heart of this world, the Lord of life, who loves us so much, is always present. He does not abandon us, he does not leave us alone, for he has united himself definitively to our earth, and his love constantly impels us to find new ways forward. Praise be to him!” – Pope Francis, Laudato Si’ In his second encyclical, Laudato Si’: On the Care of Our Common Home, Pope Francis draws all Christians into a dialogue with every person on the planet about our common home. We as human beings are united by the concern for our planet, and every living thing that dwells on it, especially the poorest and most vulnerable. Pope Francis’ letter joins the body of the Church’s social and moral teaching, draws on the best scientific research, providing the foundation for “the ethical and spiritual itinerary that follows.” Laudato Si’ outlines: The current state of our “common home” The Gospel message as seen through creation The human causes of the ecological crisis Ecology and the common good Pope Francis’ call to action for each of us Our Sunday Visitor has included discussion questions, making it perfect for individual or group study, leading all Catholics and Christians into a deeper understanding of the importance of this teaching.