Clinical Challenges

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Clinical Challenges

JUDY. PICONE LUMBY (DEBBIE.),Debbie Picone
Clinical Challenges Book PDF

Author : JUDY. PICONE LUMBY (DEBBIE.),Debbie Picone
Publisher : Routledge
Page : 240 pages
File Size : 54,8 Mb
Release : 2021-03-31
Category : Electronic
ISBN : 0367717697

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Clinical Challenges by JUDY. PICONE LUMBY (DEBBIE.),Debbie Picone Pdf

Nurses work across the health care system in a great variety of roles. From patient care to administration, nurses see where the pressures are, and how well we are managing to look after some of the most vulnerable people in our society. Clinical Challenges explores contemporary issues central to nurses' work. Part I explores clinical concerns such as pain and wound management, the role of the nurse practitioner, and the effects of extending life. For many years the health sector has been coping with cutbacks in government funding, and Part II examines how this impacts on the way we handle social illnesses such as suicide and drug dependence, as well as the needs of our growing ageing population. Part III looks at management issues affecting nurses including the growing use of business strategies and rhetoric in the health care system, and the introduction of information systems and of more flexible ways of working. Written by nurses working in a variety of professional roles in the system and critiqued by experts in the field, Clinical Challenges offers valuable insights for nurses at every level, including students.

Transforming Clinical Research in the United States

Institute of Medicine,Board on Health Sciences Policy,Forum on Drug Discovery, Development, and Translation
Transforming Clinical Research in the United States Book PDF

Author : Institute of Medicine,Board on Health Sciences Policy,Forum on Drug Discovery, Development, and Translation
Publisher : National Academies Press
Page : 151 pages
File Size : 54,7 Mb
Release : 2010-10-22
Category : Medical
ISBN : 9780309163354

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Transforming Clinical Research in the United States by Institute of Medicine,Board on Health Sciences Policy,Forum on Drug Discovery, Development, and Translation Pdf

An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.

Clinical Challenges in Therapeutic Drug Monitoring

William Clarke,Amitava Dasgupta
Clinical Challenges in Therapeutic Drug Monitoring Book PDF

Author : William Clarke,Amitava Dasgupta
Publisher : Elsevier
Page : 0 pages
File Size : 50,6 Mb
Release : 2016-05-17
Category : Medical
ISBN : 0128020253

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Clinical Challenges in Therapeutic Drug Monitoring by William Clarke,Amitava Dasgupta Pdf

Clinical Challenges in Therapeutic Drug Monitoring: Special Populations, Physiological Conditions and Pharmacogenomics focuses on critical issues in therapeutic drug monitoring including special requirements of therapeutic drug monitoring important to special populations (infants and children, pregnant women, elderly patients, and obese patients). The book also covers issues of free drug monitoring and common interferences in using immunoassays for therapeutic drug monitoring. This book is essential reading for any clinician, fellow, or trainee who wants to gain greater insight into the process of therapeutic drug monitoring for individual dosage adjustment and avoiding drug toxicity for certain drugs within a narrow therapeutic window. The book is written specifically for busy clinicians, fellows, and trainees who order therapeutic drug monitoring and need to get more familiar with testing methodologies, issues of interferences, and interpretation of results in certain patient populations.

Challenges in Clinical Practice

Veronica Bishop,Irene Scott
Challenges in Clinical Practice Book PDF

Author : Veronica Bishop,Irene Scott
Publisher : Bloomsbury Publishing
Page : 208 pages
File Size : 51,7 Mb
Release : 2017-03-14
Category : Medical
ISBN : 9781403937377

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Challenges in Clinical Practice by Veronica Bishop,Irene Scott Pdf

Challenges in Clinical Practice aims to support nurses and other health care workers in taking the health care agenda forward. With the constant bombardment of changes in policy initiatives, and the accompanying challenges which face nurses and other health care professionals this book will be a welcome asset to a strained labour market. It addresses the key issues and critical challenges facing the health care services today such as clinical governance, managing change, supervision in practice and research based practice. Nurses represent the fastest growing users of IT and as such the importance and simplicity of IT in supporting current challenges is also explored. The demystification of IT is brilliantly executed here and useful samplers are provided. Central to all changes are the needs of clients and patients, and partnerships in care - the power bases of service provision. The complex realities of this are probed, sometimes disconcertingly, within this important text. Written and edited by key professionals in the field, this text is an invaluable resource for pre- and post-registration students, those in middle and senior management positions and all teaching staff within the health sector. It is essential reading for anyone who wants to accept the challenge of providing the best in health care services.

Clinical Practice Guidelines We Can Trust

Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines
Clinical Practice Guidelines We Can Trust Book PDF

Author : Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines
Publisher : National Academies Press
Page : 217 pages
File Size : 44,7 Mb
Release : 2011-06-16
Category : Medical
ISBN : 9780309216463

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Clinical Practice Guidelines We Can Trust by Institute of Medicine,Board on Health Care Services,Committee on Standards for Developing Trustworthy Clinical Practice Guidelines Pdf

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.

Clinical Trial Design Challenges in Mood Disorders

Mauricio Tohen,Charles Bowden,Andrew A. Nierenberg,John Geddes
Clinical Trial Design Challenges in Mood Disorders Book PDF

Author : Mauricio Tohen,Charles Bowden,Andrew A. Nierenberg,John Geddes
Publisher : Academic Press
Page : 192 pages
File Size : 50,9 Mb
Release : 2015-01-24
Category : Medical
ISBN : 9780124051768

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Clinical Trial Design Challenges in Mood Disorders by Mauricio Tohen,Charles Bowden,Andrew A. Nierenberg,John Geddes Pdf

Poor clinical trial designs result in failed studies wasting research funds and limiting the advancement of cures for disorders. Clinical Trial Design Challenges in Mood Disorders outlines classic problems researchers face in designing clinical trials and discusses how best to address them for the most definitive and generalizable results. Traditional trial designs are included as well as novel analytic techniques. The book examines information on high placebo response, the generalizability of studies conducted in the developing world, the duration of maintenance studies, and the application of findings into clinical practice. With representation from contributors throughout the world and from academia, industry, regulatory agencies, and advocacy groups, this book will contribute toward improved clinical trial design and valid, precise, and reliable answers about what works better and faster for patients. Summarizes common trial design problems and their solutions Encompasses funding, subject selection, regulatory issues and more Identifies best practices for definitive and generalizable results Includes traditional trial designs and novel analytic techniques Represents academia, industry, regulatory agencies, and advocacy groups

Clinical Knowledge Management

Rajeev K. Bali
Clinical Knowledge Management Book PDF

Author : Rajeev K. Bali
Publisher : IGI Global
Page : 359 pages
File Size : 41,5 Mb
Release : 2005-01-01
Category : Computers
ISBN : 9781591403005

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Clinical Knowledge Management by Rajeev K. Bali Pdf

"This book establishes a convergence in thinking between knowledge management and knowledge engineering healthcare applications"--Provided by publisher.

Opportunities to Address Clinical Research Workforce Diversity Needs for 2010

National Research Council,Institute of Medicine,Board on Health Sciences Policy,Policy and Global Affairs,Committee on Women in Science and Engineering,Committee on Opportunities to Address Clinical Research Workforce Diversity Needs for 2010
Opportunities to Address Clinical Research Workforce Diversity Needs for 2010 Book PDF

Author : National Research Council,Institute of Medicine,Board on Health Sciences Policy,Policy and Global Affairs,Committee on Women in Science and Engineering,Committee on Opportunities to Address Clinical Research Workforce Diversity Needs for 2010
Publisher : National Academies Press
Page : 146 pages
File Size : 52,5 Mb
Release : 2006-06-21
Category : Medical
ISBN : 9780309143882

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Opportunities to Address Clinical Research Workforce Diversity Needs for 2010 by National Research Council,Institute of Medicine,Board on Health Sciences Policy,Policy and Global Affairs,Committee on Women in Science and Engineering,Committee on Opportunities to Address Clinical Research Workforce Diversity Needs for 2010 Pdf

Based on a 2003 workshop, this study describes current public and private programs and recommends ways to recruit and retain more women and underrepresented minorities into clinical research, especially physician-scientists and nurses. Federal sponsors should improve data collection, evaluate existing training programs, and increase the diversity of study section review panels. Public and private sponsors should create funding mechanisms with flexible career paths, and universities and professional societies should both play enhanced roles in fostering diversity. A significant push is needed to recruit minorities into nursing and provide more clinical research training for nurse-scientists, nursing students, and nursing faculty.

100 Diagnostic Challenges in Clinical Medicine

David R Ramsdale
100 Diagnostic Challenges in Clinical Medicine Book PDF

Author : David R Ramsdale
Publisher : World Scientific Publishing Company
Page : 256 pages
File Size : 42,7 Mb
Release : 2009-03-04
Category : Medical
ISBN : 9789814365284

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100 Diagnostic Challenges in Clinical Medicine by David R Ramsdale Pdf

100 Diagnostic Challenges in Clinical Medicine is composed of one hundred well-illustrated clinical scenarios and their appropriate investigations. A wide variety of specialties are covered including cardiology, neurology, dermatology, endocrinology, tropical medicine, haematology, metabolic medicine, radiology, ophthalmology, venereology, and infectious diseases. Presenting the relevant investigations corresponding to each case in an interesting and easy-to-read Q&A format concerning diagnosis and management, this book serves as an ideal, and hopefully enjoyable, study aid for medical students and junior doctors who are preparing for clinical examinations in medicine. By solving the problems posed by these challenging clinical cases, the reader will gain additional practice in diagnosis and treatment strategies.

Noninferiority Testing in Clinical Trials

Tie-Hua Ng
Noninferiority Testing in Clinical Trials Book PDF

Author : Tie-Hua Ng
Publisher : CRC Press
Page : 212 pages
File Size : 43,5 Mb
Release : 2014-12-01
Category : Mathematics
ISBN : 9781466561496

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Noninferiority Testing in Clinical Trials by Tie-Hua Ng Pdf

Take Your NI Trial to the Next Level Reflecting the vast research on noninferiority (NI) designs from the past 15 years, Noninferiority Testing in Clinical Trials: Issues and Challenges explains how to choose the NI margin as a small fraction of the therapeutic effect of the active control in a clinical trial. Requiring no prior knowledge of NI testing, the book is easily accessible to both statisticians and nonstatisticians involved in drug development. With over 20 years of experience in this area, the author introduces the basic elements of the NI trials one at a time in a logical order. He discusses issues with estimating the effect size based on historical placebo control trials of the active control. The book covers fundamental concepts related to NI trials, such as assay sensitivity, constancy assumption, discounting, and preservation. It also describes patient populations, three-arm trials, and the equivalence of three or more groups.

Virtual Clinical Trials

National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Drug Discovery, Development, and Translation
Virtual Clinical Trials Book PDF

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Drug Discovery, Development, and Translation
Publisher : National Academies Press
Page : 127 pages
File Size : 45,7 Mb
Release : 2019-11-16
Category : Medical
ISBN : 9780309494885

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Virtual Clinical Trials by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Sciences Policy,Forum on Drug Discovery, Development, and Translation Pdf

Successful drug development relies on accurate and efficient clinical trials to deliver the best and most effective pharmaceuticals and clinical care to patients. However, the current model for clinical trials is outdated, inefficient and costly. Clinical trials are limited by small sample sizes that do not reflect variations among patients in the real world, financial burdens on participants, and slow processes, and these factors contribute to the disconnect between clinical research and clinical practice. On November 28-29, the National Academies of Sciences, Engineering, and Medicine convened a workshop to investigate the current clinical trials system and explore the potential benefits and challenges of implementing virtual clinical trials as an enhanced alternative for the future. This publication summarizes the presentations and discussions from the workshop.

Health Professions Education

Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit
Health Professions Education Book PDF

Author : Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit
Publisher : National Academies Press
Page : 191 pages
File Size : 47,7 Mb
Release : 2003-07-01
Category : Medical
ISBN : 9780309133197

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Health Professions Education by Institute of Medicine,Board on Health Care Services,Committee on the Health Professions Education Summit Pdf

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Cognitive-Behavioral Therapy for Anxiety Disorders

Gillian Butler,Melanie Fennell,Ann Hackmann
Cognitive Behavioral Therapy for Anxiety Disorders Book PDF

Author : Gillian Butler,Melanie Fennell,Ann Hackmann
Publisher : Guilford Press
Page : 241 pages
File Size : 51,6 Mb
Release : 2010-04-20
Category : Psychology
ISBN : 9781606238691

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Cognitive-Behavioral Therapy for Anxiety Disorders by Gillian Butler,Melanie Fennell,Ann Hackmann Pdf

Helping therapists bring about enduring change when treating clients with any anxiety disorder, this invaluable book combines expert guidance, in-depth exploration, and innovative clinical strategies. The authors draw on extensive experience and research to provide a framework for constructing lucid formulations of complex cases. They identify obstacles that frequently arise during the early, middle, and later stages of treatment and present a wide range of practical solutions. The volume demonstrates clear-cut yet flexible ways to enhance client engagement, foster metacognitive awareness, facilitate emotional processing, address low self-esteem and fear of uncertainty, and much more. Reproducible handouts and forms are included.

Psychological Challenges in Obstetrics and Gynecology

Jayne Cockburn,Michael E Pawson
Psychological Challenges in Obstetrics and Gynecology Book PDF

Author : Jayne Cockburn,Michael E Pawson
Publisher : Springer Science & Business Media
Page : 336 pages
File Size : 47,8 Mb
Release : 2007-09-05
Category : Medical
ISBN : 9781846288081

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Psychological Challenges in Obstetrics and Gynecology by Jayne Cockburn,Michael E Pawson Pdf

This book empowers the obstetrician-gynecologist to play a key coordinating role, and to communicate effectively with all parties and health workers involved in psychological care. It provides information not typically covered by their training: communication skills, coping and adjustment in pregnancy, and communicating with cancer patients. Easy-to-read with stand-alone chapters, this book covers key aspects of OB/GYN, and addresses areas not covered elsewhere. The book offers topics in psychological care to trainees and specialists in O & G, helps them understand the emotional problems their patients face, and shows them how to undertake psychological care.

Small Clinical Trials

Institute of Medicine,Board on Health Sciences Policy,Committee on Strategies for Small-Number-Participant Clinical Research Trials
Small Clinical Trials Book PDF

Author : Institute of Medicine,Board on Health Sciences Policy,Committee on Strategies for Small-Number-Participant Clinical Research Trials
Publisher : National Academies Press
Page : 221 pages
File Size : 48,8 Mb
Release : 2001-01-01
Category : Medical
ISBN : 9780309171144

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Small Clinical Trials by Institute of Medicine,Board on Health Sciences Policy,Committee on Strategies for Small-Number-Participant Clinical Research Trials Pdf

Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.