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Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of “C- dition C (Crisis),” as it was called to distinguish it from “Condition A (Arrest). ”We thought it absurd to intervene only after cardiac arrest had occurred,because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.
This edition of the Manual of Neonatal Care has been completely updated and extensively revised to reflect the changes in fetal, perinatal, and neonatal care that have occurred since the sixth edition. This portable text covers current and practical approaches to evaluation and management of conditions encountered in the fetus and the newborn, as practiced in high volume clinical services that include contemporary prenatal and postnatal care of infants with routine, as well as complex medical and surgical problems. Written by expert authors from the Harvard Program in Neonatology and other major neonatology programs across the United States, the manual’s outline format gives readers rapid access to large amounts of valuable information quickly. The Children’s Hospital Boston Neonatology Program at Harvard has grown to include 57 attending neonatologists and 18 fellows who care for more than 28,000 newborns delivered annually. The book also includes the popular appendices on topics such as common NICU medication guidelines, the effects of maternal drugs on the fetus, and the use of maternal medications during lactation. Plus, there are intubation/sedation guidelines and a guide to neonatal resuscitation on the inside covers that provide crucial information in a quick and easy format.
Emphasising the multi-disciplinary nature of palliative care the fourth edition of this text also looks at the individual professional roles that contribute to the best-quality palliative care.
This book is the first of a new series which will present the proceedings of the newly established Nestlé Nutrition Workshop Series: Clinical & Performance Programme aimed at adult nutrition. Undernutrition is a common phenomenon in elderly people, and malnutrition reaches significant levels in those being in hospital, nursing homes or home care programs. Consequences of malnutrition often go unrecognised owing to the lack of specific validated instruments to assess nutritional status in frail elderly persons. The Mini Nutritional Assessment (MNA) provides a single, rapid assessment of nutritional status in the elderly of different degrees of independence, allowing the prevalence of protein-energy malnutrition to be determined and to evaluate the efficacy of nutritional intervention and strategies. Easy, quick and economical to perform, it enables staff to check the nutritional status of elderly people when they enter hospitals or institutions and to monitor changes occurring during their stay. Moreover, the MNA is predictive of the cost of care and length of stay in hospital. This publication will be of immense assistance to heads of geriatric teaching units, teachers in nutrition, clinicians general practitioners and dieticians, enabling them to better detect, recognise and start treatment of malnutrition in the elderly.
Vitamin D deficiency, circulating levels lower than 15 ng/ml, is an epidemic disease worldwide with more than a billion people suffering of it in the beginning of the 21-century. Besides its impact on mineral and bone metabolism, these low vitamin D levels are also associated with a diversity of non-skeletal complications, among them cardiovascular disease, diabetes mellitus, multiple sclerosis, cancer, tuberculosis, and immune system dysfunction. Chronic Kidney Disease is also a very common disease, affecting more than 10% of the world population, ranging from stage 1 to stage 5 before dialysis. Approximately 1% of the population in industrialized countries is affected by end-stage renal disease (ESRD), needing a renal replacement therapy either hemodialysis or peritoneal dialysis, and ultimately by renal transplantation. Those CKD patients are more susceptible to exhibit reduced vitamin D stocks. Consequently, more than eighty percent of CKD patients have either insufficient or deficient vitamin D levels for multiple reasons.
Stroke Nursing is the leading guide for optimal stroke care, facilitating the provision of evidence-based practice across the stroke journey, and covering the sixteen elements of care outlined in the UK's Stroke-Specific Education Framework (SSEF). Drawing from years of clinical and research experience, the authors provide practical guidance on the essential areas of stroke nursing, including stroke classification, stabilisation, thrombolysis and thrombectomy, rehabilitation and recovery, nutrition and oral care, palliative and long-term care, physical impairment management, and more. Now in its second edition, this indispensable guide helps practitioners expand their knowledge, skills and competence in all areas of stroke nursing services. Adopts a practical and evidence-based approach to stroke management, exploring UK and international perspectives Authored by expert clinicians and leaders in the field of nursing practice, research and education Includes updated case studies and practice examples, expanded coverage of clinical application in practice, and new discussions of the knowledge and skills required by nurses Stroke Nursing is essential reading for students of nursing and neuroscience, and is the definitive reference for practicing nurses and healthcare professionals caring for stroke patients.
Can human social evolution be described in terms common to other sciences, most specifically, as an energy process? The Eighth Day reflects a conviction that the human trajectory, for all its uniqueness and indeterminism, will never be satisfactorily understood until it is framed in dynamics that are common to all of nature. The problem in doing this, however, lies in ourselves. The major social theories have failed to treat human social evolution as a component of broader natural processes. The Eighth Day argues that the energy process provides a basis for explaining, comparing, and measuring complex social evolution. Using traditional ecological energy flow studies as background, society is conceived as a self-organization of energy. This perspective enables Adams to analyze society in term of the natural selection of self-organizing energy forms and the trigger processes basic to it. Domestication, civilization, socioeconomic development, and the regulation of contemporary industrial nation-states serve to illustrate the approach. A principal aim is to explore the limitation that energy process imposes on human social evolution as well as to clarify the alternatives that it allows. Richly informed by contemporary anthropological historicism, sociobiology, and Marxism, The Eighth Day avoids simple reductionism and denies facile ideological categorization. Adams builds on work in nonequilibrium thermodynamics and theoretical biology and brings three decades of his own work to an analysis of human society that demands an extreme materialism in which human thought and action find a central place.
This annual edition presents the most recent statistics since 1990 of over 80 health indicators for WHO's 193 Member States. This fourth edition includes an expanded set of over 76 key indicators and a section with 10 highlights in global health statistics in the past year. This book has been collated from publications and databases of WHO's technical programmes and regional offices. The core set of indicators was selected on the basis of relevance for global health, availability and quality of data, and accuracy and comparability of estimates. The statistics for the indicators are based on an interactive process of data collection, compilation, quality assessment, and estimation between WHO technical programmes and its Member States. In this process, WHO strives to maximize accessibility, accuracy, comparability, and transparency of country health statistics. In addition to national statistics, this publication presents statistics on the inequalities in health outcomes and interventions coverage within countries, disaggregated by urban/rural setting, wealth/assets, and educational level. Such statistics are primarily derived from the analysis of household surveys and are only available for a limited number of countries.
The Change Laboratory is a method for formative intervention in work communities that supports this kind of organizational learning. It is a path breaker in the area of work place learning due to its strong theoretical and research basis and the way that it integrates the change of organizational practices and individuals’ learning. It provides a way to develop practitioners’ transformative agency and capacity for creating and implementing new conceptual and practical tools for mastering their joint activity.