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v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Clinical practice guidelines were initially developed within the context of evidence-based medicine with the goal of putting medical research findings into practice. However, physicians do not always follow them, even when they seem to apply to the particular patient they have to treat. This phenomenon, known as clinical inertia, represents a significant obstacle to the efficiency of care and a major public health problem, the extent of which is demonstrated in this book. An analysis of its causes shows that it stems from a discrepancy between the objective, essentially statistical nature of evidence-based medicine on the one hand and the physician’s own complex, subjective view (referred to here as “medical reason”) on the other. This book proposes a critique of medical reason that may help to reconcile the principles of evidence-based medicine and individual practice. The author is a diabetologist and Professor of Endocrinology, Diabetology and Metabolic Diseases at Paris 13 University. He has authored several books, including one to be published by Springer (Philosophy and Medicine series) under the title: The Mental Mechanisms of Patient Adherence to Long Term Therapies, Mind and Care. , Diabetology and Metabolic Diseases at the Paris 13-University. He has also published Pourquoi Se soigne-t-on, Enquête sur la rationalité morale de l’observance (2007), Clinique de l’Observance, L’Exemple des diabètes (2006), and Une théorie du soin, Souci et amour face à la maladie (2010). An English adaptation of the first book is published by Springer (Philosophy and Medicine) under the title: The Mental Mechanisms of Patient Adherence to Long Term Therapies, Mind and Care.
For over 30 years, the stepped care approach has been used in the management and treatment of hypertension. This approach advocates the use of initial monotherapy to reach the desired blood pressure, and the subsequent use of additional drugs with complementary modes of action, until the target BP is achieved. However, current control rates for hypertension suggest that such an approach may be outdated and no longer effective in the management of hypertension. Clinical trials have shown that more than 50% of patients require a combination of drug therapies to achieve their target BP. Some proponents of combination therapy have argued that the risk of adverse side effects and non-compliance will be lower than that compared to monotherapy, which initially requires higher doses to be administered to be effective. Consequently, there have been increasing calls of the necessity for a much more combined approach in the treatment of hypertension. Adding to this, Combination Therapy in Hypertension will cover current control rates of blood pressure worldwide, the benefits of monotherapy and combination therapy, examine the effectiveness, risk of adverse effects, compliance, and cost of the available therapies and will also include information on relevant outcome studies.
This book surveys the scientific, cultural, and legal history of Shaken Baby Syndrome from inception to formal dissolution. It exposes extraordinary failings in the criminal justice system's treatment of what is, in essence, a medical diagnosis of murder.--Publisher's description.
The Diabetes Textbook: Clinical Principles, Patient Management and Public Health Issues (2nd Edition) addresses diabetes from a comprehensive, multidisciplinary perspective. Its purpose is to integrate state-of-the-art information on diabetes from specialists in various disciplines, including epidemiology, public health, pathophysiology, non-pharmacologic and pharmacologic treatment, patient support, acute and chronic complications, new and unproven therapies, and prevention. The main benefit of “The Diabetes Textbook” is its integrative approach. The book is therefore intended for three main types of readers: 1) physicians and health professionals seeking a comprehensive approach to diabetes; 2) those with previous expertise in a specific professional area who want to expand their knowledge; and 3) those interested in learning about topics not previously covered, who will find the contents of “The Diabetes Textbook” both enriching and innovative. The Diabetes Textbook is intended for a broad readership, including professors of medicine and related disciplines (nursing, nutrition, psychology); general physicians; internists and specialists, e.g. in ophthalmology, endocrinology, cardiology, obstetrics and gynecology, pediatrics, geriatrics, epidemiology and public health. To address these readers’ needs, the second edition is divided into the following eleven sections: 1) Magnitude of the Problem from an Individual and Social Context, 2) Diagnosis, Classification and Mechanisms of Disease, 3) Global Experiences in Diabetes Care, 4) Basic Components of Management: Patient-Centeredness, Evidence-Based Medicine, and Outcomes, 5) Resources of Support for Persons with Diabetes, 6) Drug Therapy, 7) Cardiovascular Risk Factors, 8) Acute Complications, 9) Chronic Complications, 10) Diabetes in Special Populations, and 11) Novel Therapeutic Approaches: Evidence-Based and Non-Proven, and Diabetes Prevention.
Diabetes mellitus is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. The latest edition of this reference provides endocrinologists with the latest advances in the diagnosis and management of diabetes. Beginning with an overview of epidemiology, pathophysiology and metabolism, the next sections discuss presentations of diabetes, therapeutic management, complications, and comorbidities. The following chapters cover diabetes in certain population groups, education and technology, nutrition, glucose monitoring, and research. The book concludes with a section dedicated to Type 1 diabetes, and a selection of journal reviews. Flow diagrams, tables and figures further enhance the comprehensive text. Key points Latest edition of comprehensive reference detailing latest advances in diagnosis and management of diabetes Covers numerous therapeutic methods Complete sections dedicated to Type 1 diabetes and journal reviews Highly illustrated with flow diagrams, tables and figures
How can we accept that we ought to stop smoking, follow a diet, exercise, or take medications? The goal of this book is to describe the mechanisms of patients’ adherence to long-term therapies, whose improvement, according to the World Health Organization (WHO), would be more beneficial than any biomedical progress. For example, approximately half of the patients do not regularly follow medical prescriptions, resulting in deleterious effects on people’s health and a strong impact on health expenditure. This book describes how our beliefs, desires, and emotions intervene in our choices concerning our health, by referring to concepts developed within the framework of the philosophy of mind. In particular, it tries to explain how we can choose between an immediate pleasure and a remote reward—preserving our health and our life. We postulate that such an “intertemporal” choice can be directed by a “principle of foresight” which leads us to give priority to the future. Just like patients’ non-adherence to prescribed medications, doctors often don’t always do what they should: They are non-adherent to good practice guidelines. We propose that what was recently de-scribed as “clinical inertia” could also represent a case of myopia: From time to time doctors fail to consider the long-term interests of their patient. Both patients’ non-adherence and doctors’ clinical inertia represent major barriers to the efficiency of care. However, it is also necessary to respect patients’ autonomy. The analysis of relationship between mind and care which is provided in this book sheds new light on the nature of the therapeutic alliance between doctor and patient, solving the dilemma between the ethical principles of beneficence and autonomy.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Inner and Outer Heartwork: Strategies for Synchronizing Spiritual and Physical Well-being By Dr. Emmanuel Eroume A Egom Explore the transformative journey where spiritual insights meet physical health in "Inner and Outer Heartwork." This groundbreaking book bridges the often-overlooked gap between the tangible aspects of health and the profound influence of spiritual wellness. Dr. Egom, a seasoned cardiologist with a deep spiritual understanding, presents a compelling narrative that integrates scientific precision with spiritual depth. In these pages, you will discover practical strategies to balance your physical and spiritual health, enhancing your overall vitality and quality of life. Whether you are a healthcare professional, a spiritual seeker, or someone striving for a healthier, more integrated life, this book offers valuable insights and tools to nurture both your body and soul. Embrace a holistic approach to well-being with Dr. Egom as he guides you through understanding and harnessing the power of the spiritual heart in tandem with the physical. "Inner and Outer Heartwork" is more than a book—it's a pathway to a richer, fuller life where care and spirit unite.
During the last two decades, evidence of increasing trends of several endocrine-related disorders has been strengthened. These disorders often come with lack of uniform diagnosis and/ or even unclear endocrine disruption. The later is mainly due to abnormal classical changes in the blood- released hormone to its targeted organ, abnormal communication between cells within a tissue or organ (paracrine), within the same cell (intracrine) or signals which act on the same cell (autocrine). This challenging status drives endocrinologists to the urgent need to address enormous knowledge gaps in this wide field of research (Endocrinology). From the perspective point of view that "hormones control our bodies", we need to get these hormones rebalanced so we can restore overall health. That is simply endocrinology!