This edition incorporates current research methodology—including molecular and genetic clinical research—and offers an updated syllabus for conducting a clinical research workshop.Emphasis is on common sense as the main ingredient of good science. The book explains how to choose well-focused research questions and details the steps through all the elements of study design, data collection, quality assurance, and basic grant-writing. All chapters have been thoroughly revised, updated, and made more user-friendly.

    It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease. Magisterial in its breadth of perspective and depth of research and now revised to reflect the growing danger of the avian flu, The Great Influenza is ultimately a tale of triumph amid tragedy, which provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. John M. Barry has written a new afterword for this edition that brings us up to speed on the terrible threat of the avian flu and suggest ways in which we might head off another flu pandemic.

    Being Mortal by Atul Gawande - A 20-minute Summary Inside this Instaread Summary: • Overview of the entire book• Introduction to the important people in the book• Summary and analysis of all the chapters in the book• Key Takeaways of the book• A Reader's Perspective Preview of this summary: Chapter 1 Gawande grew up in Ohio. His parents were immigrants from India and both were doctors. His grandparents stayed in India, and there were few older people in his neighborhood, so he had little experience with aging or death until he met his wife’s grandmother, Alice Hobson. Hobson was seventy-seven and living on her own in Virginia. She was a spirited widow who fixed her own plumbing and volunteered with Meals On Wheels. However, Hobson was losing strength and height steadily each year as her arthritis worsened.Gawande’s father enthusiastically adopted the customs of his new country, but he could not understand the way in which seniors were treated in the US. In India, the elderly were treated with great respect and lived out their lives with family.In the United States, Sitaram Gawande, Gawande’s grandfather, likely would have been sent to a nursing home like most of the elderly who cannot handle the basics of daily living by themselves. However, in India, Sitaram Gawande was able to live in his own home and manage his own affairs, with family constantly around him. He died at the age of one hundred and ten when he fell off a bus during a business trip.Until recently, most elderly people stayed with their families. Even as the nuclear family unit became predominant, replacing the multi-generational family unit, people cared for their elderly relatives. Families were large and one child, usually a daughter, would not marry in order to take care of the parents.This has changed in much of the world, where elderly people end up struggling to live alone, like Hobson, rather than living with dignity amid family, like Sitaram Gawande.One cause of this change can be found in the nature of knowledge. When few people lived to be very old, elders were honored. Their store of knowledge was greatly useful. People often portrayed themselves as older to command respect. Modern society’s emphasis on youth is a complete reversal of this attitude. Technological advances are perceived as the territory of the young, and everyone wants to be younger. High-tech job opportunities are all over the world, and young people do not hesitate to leave their parents behind to pursue them.In developed countries, parents embrace the concept of a retirement filled with leisure activities. Parents are happy to begin living for themselves once children are grown. However, this system only works for young, healthy retirees, but not for those who cannot continue to be independent. Hobson, for example, was falling frequently and suffering memory lapses. Her doctor did tests and wrote prescriptions, but did not know what to do about her deteriorating condition. Neither did her family… About the Author With Instaread Summaries, you can get the summary of a book in 30 minutes or less. We read every chapter, summarize and analyze it for your convenience.

    From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once-idyllic farm towns; it's a heartbreaking trajectory that illustrates how this national crisis has persisted for so long and become so firmly entrenched. Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, Macy endeavors to answer a grieving mother's question-why her only son died-and comes away with a harrowing story of greed and need. From the introduction of OxyContin in 1996, Macy parses how America embraced a medical culture where overtreatment with painkillers became the norm. In some of the same distressed communities featured in her bestselling book Factory Man, the unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death.Through unsparing, yet deeply human portraits of the families and first responders struggling to ameliorate this epidemic, each facet of the crisis comes into focus. In these politically fragmented times, Beth Macy shows, astonishingly, that the only thing that unites Americans across geographic and class lines is opioid drug abuse. But in a country unable to provide basic healthcare for all, Macy still finds reason to hope-and signs of the spirit and tenacity necessary in those facing addiction to build a better future for themselves and their families.

    . .Our health care system is in critical condition. Each year, fewer Americans can afford it, fewer businesses can provide it, and fewer government programs can promise it for future generations.We need a cure, and we need it now.Harvard Business School's Clayton M. Christensen--whose bestselling The Innovator's Dilemma revolutionized the business world--presents The Innovator's Prescription, a comprehensive analysis of the strategies that will improve health care and make it affordable.Christensen applies the principles of disruptive innovation to the broken health care system with two pioneers in the field--Dr. Jerome Grossman and Dr. Jason Hwang. Together, they examine a range of symptoms and offer proven solutions.YOU'LL DISCOVER HOW"Precision medicine" reduces costs and makes good on the promise of personalized careDisruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors workPatient networks enable better treatment of chronic diseasesEmployers can change the roles they play in health care to compete effectively in the era of globalizationInsurance and regulatory reforms stimulate disruption in health care

    Lara, a superstar nurse who tries to battle her way back from a near-ruinous prescription-drug addiction. The outspoken but compassionate Juliette, a fierce advocate for her patients. And Sam, a first-year nurse, struggling to find her way in a gossipy mean-girl climate she likens to “high school, except for the dying people.”The result is a riveting page-turner, insightful and thought-provoking, that will leave readers feeling smarter about their healthcare and undeniably appreciative of the incredible nurses who provide it.

    Cohen show us that the antidote to our ever-growing rates of obesity and chronic diseases, such as heart disease and diabetes, lies not in our medical care system or in more health education but rather in how our environment affects our behavior.

    Jack Geiger, M.D., New York Times Book Review

    

    The fastest growing of these is Parkinson's: the number of people with Parkinson's doubled to over 6 million over the last 25 years and is projected to double again by 2040. Harmful pesticides known to cause Parkinson's proliferate, many people remain undiagnosed and untreated, research funding stagnates, and the most effective treatment is now a half century old. In Ending Parkinson's Disease, four leading doctors and advocates offer a bold but actionable pact to prevent, advocate for, care for, and treat one of the great health challenges of our time. This is a critical guide for anyone who has or could be touched by this disease.

    Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In Powerful Medicines, he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced.This is a comprehensive behind-the-scenes look at issues that affect everyone: our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.In this engagingly written book, Dr. Avorn asks questions that will interest every consumer: How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible. This is a passionate and provocative call for action as well as a compelling work of clear-headed science.From the Hardcover edition.

    It may feel as if your world has shifted on its axis, and you'll never get your bearings. Navigating your way through the morass of doctors, medical terms, and the healthcare system can be daunting, especially when you want only what's best for the person you love. Dr. John Cassidy has devoted the past twenty-five years to helping families cope with traumatic brain injury; Mindstorms is his compassionate, comprehensive manual to demystifying this often frightening and life-changing condition. More than 6.3 million Americans live with a severe disability caused by a traumatic brain injury. In fact, because it's so commonplace, but little talked of, TBI is often referred to as the "silent epidemic." In these pages, Dr. Cassidy walks you through the different types of brain injury; explodes the common myths surrounding it; demonstrates the ways in which TBI may affect memory, behavior, and social interaction; explores the newest options in treatment and rehabilitation; and shows you how to hold on to your own sense of self as you journey through. Along with the practical information you'll need, Mindstorms offers a constellation of instructive, moving stories from families and patients who are slowly, but surely, finding their way back. Their experiences are sure to inspire you and yours.

    The Sackler name adorns the walls of many storied institutions: Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing OxyContin, a blockbuster painkiller that was a catalyst for the opioid crisis.Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling.

    We all have one, but most of us will never see one. The heart surgeon now has that privilege but, for centuries, the heart was out of reach even for surgeons. So when a surgeon nowadays opens up a ribcage and mends a heart, it remains something of a miracle, even if, to some, it is merely plumbing. As with plumbers, the quality of surgeons’ work varies. As with plumbers, surgeons’ opinion of their own prowess and their own attitude to risk are not always reliable. Measurement is key. We’ve had a century of effective evidence-based medicine. We’ve had barely a decade of thorough monitoring of clinical outcomes. Thanks to the ground-breaking risk modelling of pioneering surgeons like Samer Nashef, we at last know how to judge whether an operation is in a patient’s best interest, which hospital and surgeon would be best for that operation, when it might best be performed and what the exact level of risk is. We have at last made what is important in surgery measurable. But how should surgeons, and their patients, use these newfound insights? Ever since his days as a medical student, Samer Nashef has challenged the medical profession to be more open and more accurate about the success of surgical procedures, for the sake of the patients. In The Naked Surgeon, he unclothes his own profession to demonstrate to his reader (and prospective patient) many revelations, such as the paradox at the heart of the cardiac surgeon’s craft: the more an operation is likely to kill you, the better it is for you. And he does so with absolute clarity, fluency and not a little wit.

    That's more than die from motor vehicle accidents, breast cancer, or AIDS--three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.To Err Is Human breaks the silence that has surrounded medical errors and their consequence--but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agenda--with state and local implications--for reducing medical errors and improving patient safety through the design of a safer health system.This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes.Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errors--which begs the question, "How can we learn from our mistakes?"Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care.To Err Is Human asserts that the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates--as well as patients themselves.First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine