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The global response to the COVID-19 pandemic is the greatest science policy failure in a generation. We knew this was coming. Warnings about the threat of a new pandemic have been made repeatedly since the 1980s and it was clear in January that a dangerous new virus was causing a devastating human tragedy in China. And yet the world ignored the warnings. Why? In this short and hard-hitting book, Richard Horton, editor of the medical journal The Lancet, scrutinizes the actions that governments around the world took – and failed to take – as the virus spread from its origins in Wuhan to the global pandemic that it is today. He shows that many Western governments and their scientific advisors made assumptions about the virus and its lethality that turned out to be mistaken. Valuable time was lost while the virus spread unchecked, leaving health systems unprepared for the avalanche of infections that followed. Drawing on his own scientific and medical expertise, Horton outlines the measures that need to be put in place, at both national and international levels, to prevent this kind of catastrophe from happening again. Were supposed to be living in an era where human beings have become the dominant influence on the environment, but COVID-19 has revealed the fragility of our societies and the speed with which our systems can come crashing down. We need to learn the lessons of this pandemic and we need to learn them fast because the next pandemic may arrive sooner than we think.
This well-written text is designed to help students and health professionals understand oncology through real-life clinical scenarios, helping treatment and management decisions. Bridging the gap between theory and practice, this practical case-based format is fun to use and imparts a sense of reality to the learning process. The first chapter presents clinically relevant data from molecular biology, statistics and trial analysis, and Quality of Life research with an emphasis on what practising clinicians should know, but might have difficulty finding elsewhere in a digestible form. The second chapter, Making Management Decisions in Oncology presents the principles which guide decision making in oncology and covers the integration of tumour factors, patient factors and treatment factors into the decision making process. Cancer management requires the skills of a variety of clinicians - surgical oncologists, radiation oncologists, medical oncologists, palliative care physicians, oncology nurses and others. The integration of these disciplines into the overall management of each major tumour type has been emphasised in subsequent chapters.
'I couldn't imagine a better guidebook for making sense of a tragic and momentous time in our lives. Covid by Numbers is comprehensive yet concise, impeccably clear and always humane' Tim Harford How many people have died because of COVID-19? Which countries have been hit hardest by the virus? What are the benefits and harms of different vaccines? How does COVID-19 compare to the Spanish flu? How have the lockdown measures affected the economy, mental health and crime? This year we have been bombarded by statistics - seven day rolling averages, rates of infection, excess deaths. Never have numbers been more central to our national conversation, and never has it been more important that we think about them clearly. In the media and in their Observer column, Professor Sir David Spiegelhalter and RSS Statistical Ambassador Anthony Masters have interpreted these statistics, offering a vital public service by giving us the tools we need to make sense of the virus for ourselves and holding the government to account. In Covid by Numbers, they crunch the data on a year like no other, exposing the leading misconceptions about the virus and the vaccine, and answering our essential questions. This timely, concise and approachable book offers a rare depth of insight into one of the greatest upheavals in history, and a trustworthy guide to these most uncertain of times.
This book overturns the idea that psychiatric drugs work by correcting chemical imbalance and analyzes the professional, commercial and political vested interests that have shaped this view. It provides a comprehensive critique of research on drugs including antidepressants, antipsychotics and mood stabilizers.
Recounting the fenoterol epidemic—a major medical controversy that took place more than 15 years ago—this narrative explores the involvement of the asthma drug that caused numerous asthma deaths. Although the epidemic occurred in New Zealand, its shocking discoveries and subsequent consequences attracted worldwide attention in medical journals and conferences. Neil Pearce, the researcher who discovered that fenoteral was the cause of the epidemic, tells this personal story while raising concerns about drug safety internationally and analyzing the battle between money and science in medical research.
One hundred years ago a series of seminal documents, starting with the Flexner Report of 1910, sparked an enormous burst of energy to harness the power of science to transform higher education in health. Professional education, however, has not been able to keep pace with the challenges of the 21st century. A new generation of reforms is needed to meet the demands of health systems in an interdependent world. The report of the Commission on the Education of Health Professionals for the 21st Century, a global independent initiative consisting of 20 leaders from diverse disciplinary backgrounds and institutional affiliations, articulates a fresh vision and recommends renewed actions. Building on a rich legacy of educational reforms during the past century, the Commission's findings and recommendations adopt a global and multi-professional perspective using a systems approach to analyze education and health, with a focus on institutional and instructional reforms.
Decisions made by the food, tobacco, alcohol, pharmaceutical, gun, and automobile industries have a greater impact on today's health than the decisions of scientists and policymakers. As the collective influence of corporations has grown, governments around the world have stepped back from their responsibility to protect public health by privatizing key services, weakening regulations, and cutting funding for consumer and environmental protection. Today's corporations are increasingly free to make decisions that benefit their bottom line at the expense of public health. Lethal but Legal examines how corporations have impacted -- and plagued -- public health over the last century, first in industrialized countries and now in developing regions. It is both a current history of corporations' antagonism towards health and an analysis of the emerging movements that are challenging these industries' dangerous practices. The reforms outlined here aim to strike a healthier balance between large companies' right to make a profit and governments' responsibility to protect their populations. While other books have addressed parts of this story, Lethal but Legal is the first to connect the dots between unhealthy products, business-dominated politics, and the growing burdens of disease and health care costs. By identifying the common causes of all these problems, then situating them in the context of other health challenges that societies have overcome in the past, this book provides readers with the insights they need to take practical and effective action to restore consumers' right to health.
Inspired by a hugely successful series entitled Treating Individuals, originally published in The Lancet, this volume will become essential reading for any professional involved with performance and evaluation of trials and systematic reviews or clinical patient care. There are many books explaining the importance of evidence-based medicine and how randomised clinical trials (RCTs) and systematic reviews should be performed. However, this is the first book to tackle the apparent conflict between the importance of evidence-based decision making and the widely-held view that it is often very difficult to apply the overall results of RCTs and systematic reviews to decisions about individual patients in routine clinical practice. The book brings together experienced clinicians, statisticians and trialists to focus on the two key questions that are most frequently asked by clinicians. Is the evidence relevant to my clinical practice? How can I judge whether the probability of benefit from treatment in my current patient is likely to differ substantially from the average probability of benefit reported in the relevant trial or systematic review? These questions are addressed from methodological and clinical perspectives, and potential approaches to improving the targeting of treatment are considered, with detailed reviews of several areas of medicine and surgery where useful progress has been made.
Not since the printing press has a media object been as celebrated for its role in the advancement of knowledge as the scientific journal. From open communication to peer review, the scientific journal has long been central both to the identity of academic scientists and to the public legitimacy of scientific knowledge. But that was not always the case. At the dawn of the nineteenth century, academies and societies dominated elite study of the natural world. Journals were a relatively marginal feature of this world, and sometimes even an object of outright suspicion. The Scientific Journal tells the story of how that changed. Alex Csiszar takes readers deep into nineteenth-century London and Paris, where savants struggled to reshape scientific life in the light of rapidly changing political mores and the growing importance of the press in public life. The scientific journal did not arise as a natural solution to the problem of communicating scientific discoveries. Rather, as Csiszar shows, its dominance was a hard-won compromise born of political exigencies, shifting epistemic values, intellectual property debates, and the demands of commerce. Many of the tensions and problems that plague scholarly publishing today are rooted in these tangled beginnings. As we seek to make sense of our own moment of intense experimentation in publishing platforms, peer review, and information curation, Csiszar argues powerfully that a better understanding of the journal’s past will be crucial to imagining future forms for the expression and organization of knowledge.