Jie W Weiss and David J Weiss
- Published in print:
- 2008
- Published Online:
- January 2009
- ISBN:
- 9780195322989
- eISBN:
- 9780199869206
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195322989.003.0035
- Subject:
- Psychology, Cognitive Psychology
This chapter discusses the Clinical Decision Tree—a visual representation of a systematic understanding of an entire decision process in rendering clinical decisions in geriatric dentistry. To the ...
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This chapter discusses the Clinical Decision Tree—a visual representation of a systematic understanding of an entire decision process in rendering clinical decisions in geriatric dentistry. To the non-dentist, the Clinical Decision Tree may appear to be an overly complex sequence of decisions that could potentially contain a great deal of information. However, given clinical realities, this sequence of decisions is intuitively rendered by dentists in consultation with patients everyday. The Clinical Decision Tree identifies the initial and sequential outcomes that impact the clinical decision at various points in a process of shared decision making. It also identifies the order of outcomes involved in diseases, treatments and their protocols, and therapies in impacting positively on the oral health of a patient.Less
This chapter discusses the Clinical Decision Tree—a visual representation of a systematic understanding of an entire decision process in rendering clinical decisions in geriatric dentistry. To the non-dentist, the Clinical Decision Tree may appear to be an overly complex sequence of decisions that could potentially contain a great deal of information. However, given clinical realities, this sequence of decisions is intuitively rendered by dentists in consultation with patients everyday. The Clinical Decision Tree identifies the initial and sequential outcomes that impact the clinical decision at various points in a process of shared decision making. It also identifies the order of outcomes involved in diseases, treatments and their protocols, and therapies in impacting positively on the oral health of a patient.
Jeffrey Longhofer, Jerry Floersch, and Janet Hoy
- Published in print:
- 2012
- Published Online:
- September 2012
- ISBN:
- 9780195398472
- eISBN:
- 9780199979325
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195398472.001.0001
- Subject:
- Social Work, Research and Evaluation
Qualitative methods have become increasingly popular among researchers in the professions: social work, nursing, education, business, computer science, and occupational therapy. And while many ...
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Qualitative methods have become increasingly popular among researchers in the professions: social work, nursing, education, business, computer science, and occupational therapy. And while many comprehensive textbooks (in sociology, anthropology and psychology) describe the standard techniques and philosophical assumptions, when the audience is broadened to include practitioners, it is often assumed that practitioners are the consumers of research, not the producers. This book uses qualitative methods to engage practitioners as knowledge producers. In particular, theory-to-practice gaps are described as indispensable conditions for conducting research that matters in worlds of practice. Practitioners are encouraged to lead research by conducting engaged scholarship, which promotes collaboration between practitioners and researchers to address practice-related problems in real world settings. Whereas reductionist methods assume that practice unfolds in closed systems, where variables can be manipulated and controlled or used to predict, the argument developed in this work, using critical realist philosophy, supports the idea that practice takes place in complex open systems. This, in turn, requires a specific practice-to-research vocabulary: brute and institutional facts, contingency and necessity, essentialism, and the phenomenological practice gap. Engaged scholarship and critical realist assumptions are applied to three case studies that combine research questions with data collection techniques and analytic strategies. Thematic, grounded theory, and narrative research techniques are illustrated, including original quick-start instructions for using ATLAS.ti computer software. Institutional ethnography is described, and a case study is used to illustrate the influence of policy implementation on clinical practice.Less
Qualitative methods have become increasingly popular among researchers in the professions: social work, nursing, education, business, computer science, and occupational therapy. And while many comprehensive textbooks (in sociology, anthropology and psychology) describe the standard techniques and philosophical assumptions, when the audience is broadened to include practitioners, it is often assumed that practitioners are the consumers of research, not the producers. This book uses qualitative methods to engage practitioners as knowledge producers. In particular, theory-to-practice gaps are described as indispensable conditions for conducting research that matters in worlds of practice. Practitioners are encouraged to lead research by conducting engaged scholarship, which promotes collaboration between practitioners and researchers to address practice-related problems in real world settings. Whereas reductionist methods assume that practice unfolds in closed systems, where variables can be manipulated and controlled or used to predict, the argument developed in this work, using critical realist philosophy, supports the idea that practice takes place in complex open systems. This, in turn, requires a specific practice-to-research vocabulary: brute and institutional facts, contingency and necessity, essentialism, and the phenomenological practice gap. Engaged scholarship and critical realist assumptions are applied to three case studies that combine research questions with data collection techniques and analytic strategies. Thematic, grounded theory, and narrative research techniques are illustrated, including original quick-start instructions for using ATLAS.ti computer software. Institutional ethnography is described, and a case study is used to illustrate the influence of policy implementation on clinical practice.
Patricia Canington
- Published in print:
- 1990
- Published Online:
- March 2012
- ISBN:
- 9780198521945
- eISBN:
- 9780191688478
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198521945.003.0009
- Subject:
- Psychology, Developmental Psychology
In recent years modern forms of meditation have been developed which possess therapeutic properties. This chapter describes how these new forms, simplified and divested of ...
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In recent years modern forms of meditation have been developed which possess therapeutic properties. This chapter describes how these new forms, simplified and divested of esoteric trappings and religious overtones, can be applied in clinical practice to achieve specific objectives. The orientation presented here is based on supervision of the teaching of approximately 7,000 people in clinical settings during the past fourteen years. Most of these people were identified by a medical team or through other professional assessment as being under high stress. In the discussion, the chapter attempts to identify the major clinical benefits that can be expected from the practice of meditation, to outline some of the available training options and to present recommendations for professionals wishing to utilize this form of therapy.Less
In recent years modern forms of meditation have been developed which possess therapeutic properties. This chapter describes how these new forms, simplified and divested of esoteric trappings and religious overtones, can be applied in clinical practice to achieve specific objectives. The orientation presented here is based on supervision of the teaching of approximately 7,000 people in clinical settings during the past fourteen years. Most of these people were identified by a medical team or through other professional assessment as being under high stress. In the discussion, the chapter attempts to identify the major clinical benefits that can be expected from the practice of meditation, to outline some of the available training options and to present recommendations for professionals wishing to utilize this form of therapy.
Fabrizio Benedetti
- Published in print:
- 2008
- Published Online:
- September 2009
- ISBN:
- 9780199559121
- eISBN:
- 9780191724022
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199559121.003.0010
- Subject:
- Neuroscience, Molecular and Cellular Systems
The recent neurobiological advances in placebo research can stimulate the development of new clinical trial designs for the validation of new treatments, and lead to an uncertainty principle, whereby ...
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The recent neurobiological advances in placebo research can stimulate the development of new clinical trial designs for the validation of new treatments, and lead to an uncertainty principle, whereby it is not possible to understand fully the action of a therapeutic agent. One of the main implications of the recent advances of placebo research is the possibility to induce drug-like effects without drugs, thus opening up the possibility to reduce drug intake. As social stimuli may activate the same biochemical and receptorial pathways onto which drugs act, several cognitive and affective factors can eventually modulate the action of drugs.Less
The recent neurobiological advances in placebo research can stimulate the development of new clinical trial designs for the validation of new treatments, and lead to an uncertainty principle, whereby it is not possible to understand fully the action of a therapeutic agent. One of the main implications of the recent advances of placebo research is the possibility to induce drug-like effects without drugs, thus opening up the possibility to reduce drug intake. As social stimuli may activate the same biochemical and receptorial pathways onto which drugs act, several cognitive and affective factors can eventually modulate the action of drugs.
Phebe Sessions and Anita Lightburn
- Published in print:
- 2005
- Published Online:
- April 2010
- ISBN:
- 9780195159226
- eISBN:
- 9780199893843
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195159226.003.0001
- Subject:
- Social Work, Health and Mental Health, Communities and Organizations
Creative and responsive community-based clinical practice has emerged through a host of initiatives and programs that are now recognized as important means for meeting mental health needs. There is ...
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Creative and responsive community-based clinical practice has emerged through a host of initiatives and programs that are now recognized as important means for meeting mental health needs. There is increasing evidence that these alternative approaches are an important addition to traditional practice and that they have a special role in meeting the needs of those whom traditional services have failed to help. This chapter tries to orient the reader to the field of community-based clinical practice and its increasing significance. It focuses on addressing what community-based clinical practice is, why it is re-emerging now, what traditions it is building upon and expanding, and what significant ideas are fueling its development.Less
Creative and responsive community-based clinical practice has emerged through a host of initiatives and programs that are now recognized as important means for meeting mental health needs. There is increasing evidence that these alternative approaches are an important addition to traditional practice and that they have a special role in meeting the needs of those whom traditional services have failed to help. This chapter tries to orient the reader to the field of community-based clinical practice and its increasing significance. It focuses on addressing what community-based clinical practice is, why it is re-emerging now, what traditions it is building upon and expanding, and what significant ideas are fueling its development.
Elizabeth Haxby, David Hunter, and Siân Jaggar (eds)
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199558612
- eISBN:
- 9780191595011
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199558612.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
Clinical governance is integral to healthcare and all doctors must have an understanding of both basic principles, and how to apply them in daily practice. Within the Clinical Governance framework, ...
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Clinical governance is integral to healthcare and all doctors must have an understanding of both basic principles, and how to apply them in daily practice. Within the Clinical Governance framework, patient safety is the top priority for all healthcare organizations, with the prevention of avoidable harm a key goal. Traditionally, medical training has concentrated on the acquisition of knowledge and skills related to diagnostic intervention and therapeutic procedures. The need to focus on non-technical aspects of clinical practice, including communication and team working, is now evident; ensuring tomorrow's staff are competent to function effectively in any healthcare facility. This book provides a guide to how healthcare systems work; their structure, regulation and inspection, and key areas including risk management, resource effectiveness, and wider aspects of knowledge management. This book presents a simple overview of clinical governance in context, highlighting important principles required to function effectively in a pressurized healthcare environment. It is presented in short sections based on the original seven pillars of clinical governance. These have been expanded to include the fundamental principles of systems, team working, leadership, accountability, and ownership in healthcare, with examples from everyday practice. Examples from all branches of medicine are presented to facilitate understanding.Less
Clinical governance is integral to healthcare and all doctors must have an understanding of both basic principles, and how to apply them in daily practice. Within the Clinical Governance framework, patient safety is the top priority for all healthcare organizations, with the prevention of avoidable harm a key goal. Traditionally, medical training has concentrated on the acquisition of knowledge and skills related to diagnostic intervention and therapeutic procedures. The need to focus on non-technical aspects of clinical practice, including communication and team working, is now evident; ensuring tomorrow's staff are competent to function effectively in any healthcare facility. This book provides a guide to how healthcare systems work; their structure, regulation and inspection, and key areas including risk management, resource effectiveness, and wider aspects of knowledge management. This book presents a simple overview of clinical governance in context, highlighting important principles required to function effectively in a pressurized healthcare environment. It is presented in short sections based on the original seven pillars of clinical governance. These have been expanded to include the fundamental principles of systems, team working, leadership, accountability, and ownership in healthcare, with examples from everyday practice. Examples from all branches of medicine are presented to facilitate understanding.
Anita Lightburn and Phebe Sessions
- Published in print:
- 2005
- Published Online:
- April 2010
- ISBN:
- 9780195159226
- eISBN:
- 9780199893843
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195159226.003.0002
- Subject:
- Social Work, Health and Mental Health, Communities and Organizations
The culture of mental health care is being reshaped through community-based innovations, both across the United States and internationally, that are enabling healing and recovery in community. This ...
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The culture of mental health care is being reshaped through community-based innovations, both across the United States and internationally, that are enabling healing and recovery in community. This chapter presents where the evolving traditions of community-based clinical practice have been most influential. As the practice examples in this volume are previewed, the values and perspectives of community work come to life. The chapter shows that mental health care is being transformed through clinicians' recognition that working with the resourcefulness and meaning of community is more than simply working in community.Less
The culture of mental health care is being reshaped through community-based innovations, both across the United States and internationally, that are enabling healing and recovery in community. This chapter presents where the evolving traditions of community-based clinical practice have been most influential. As the practice examples in this volume are previewed, the values and perspectives of community work come to life. The chapter shows that mental health care is being transformed through clinicians' recognition that working with the resourcefulness and meaning of community is more than simply working in community.
Martha Morrison Dore and Anita Lightburn
- Published in print:
- 2005
- Published Online:
- April 2010
- ISBN:
- 9780195159226
- eISBN:
- 9780199893843
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195159226.003.0012
- Subject:
- Social Work, Health and Mental Health, Communities and Organizations
The evaluation of social programs and clinical practice has become an essential component of collective efforts to solve, ameliorate, or prevent the problems and difficulties that negatively impact ...
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The evaluation of social programs and clinical practice has become an essential component of collective efforts to solve, ameliorate, or prevent the problems and difficulties that negatively impact communities and erode the lives of the people living in them. Indeed, the evaluation enterprise now wears multiple hats: (1) as facilitator in the development and implementation of new programs and services; (2) as a key source of understanding and direction in the revision of established programs; and (3) as the identifier, interpreter, and disseminator of program results. This chapter presents a constructivist approach to evaluation that honors the principles of community-based clinical practice. This approach is the context for the three broadly defined roles of evaluation just described. A model is presented that is synchronous with these principles. The goal is to enable those involved in implementing community-based clinical practice models to view evaluation as an essential tool in building their programs and practice.Less
The evaluation of social programs and clinical practice has become an essential component of collective efforts to solve, ameliorate, or prevent the problems and difficulties that negatively impact communities and erode the lives of the people living in them. Indeed, the evaluation enterprise now wears multiple hats: (1) as facilitator in the development and implementation of new programs and services; (2) as a key source of understanding and direction in the revision of established programs; and (3) as the identifier, interpreter, and disseminator of program results. This chapter presents a constructivist approach to evaluation that honors the principles of community-based clinical practice. This approach is the context for the three broadly defined roles of evaluation just described. A model is presented that is synchronous with these principles. The goal is to enable those involved in implementing community-based clinical practice models to view evaluation as an essential tool in building their programs and practice.
Anita Lightburn and Phebe Sessions (eds)
- Published in print:
- 2005
- Published Online:
- April 2010
- ISBN:
- 9780195159226
- eISBN:
- 9780199893843
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195159226.001.0001
- Subject:
- Social Work, Health and Mental Health, Communities and Organizations
This volume builds the bridge between books on community practice and on clinical practice, including 33 chapters written by social workers, psychologists, and psychiatrists, for clinicians making ...
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This volume builds the bridge between books on community practice and on clinical practice, including 33 chapters written by social workers, psychologists, and psychiatrists, for clinicians making the transition to community-based work. This is the first handbook to address this gap and provide guidance for today's community practitioners. Its overarching goal is to support the ongoing development of community-based mental health care, drawing on practical examples. This collection outlines the history and philosophy of community practice, and also illustrates the state of the art, with examples from early intervention and development programs, school-based practice, and community mental health services for children, families, and adults.Less
This volume builds the bridge between books on community practice and on clinical practice, including 33 chapters written by social workers, psychologists, and psychiatrists, for clinicians making the transition to community-based work. This is the first handbook to address this gap and provide guidance for today's community practitioners. Its overarching goal is to support the ongoing development of community-based mental health care, drawing on practical examples. This collection outlines the history and philosophy of community practice, and also illustrates the state of the art, with examples from early intervention and development programs, school-based practice, and community mental health services for children, families, and adults.
Barbara J. Burns
- Published in print:
- 2002
- Published Online:
- January 2009
- ISBN:
- 9780195134575
- eISBN:
- 9780199864065
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195134575.003.0001
- Subject:
- Social Work, Health and Mental Health, Communities and Organizations
This chapter argues that there are reasons for hope in terms of improved treatment and better outcomes in the field of child mental health. It cites four factors that provide the basis for hope and ...
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This chapter argues that there are reasons for hope in terms of improved treatment and better outcomes in the field of child mental health. It cites four factors that provide the basis for hope and the rationale for taking action to implement care in the community instead of institutional settings. There is increasing evidence documenting positive outcomes for community-based interventions, improved understanding about how to change clinical practice, the availability of tools and training approaches to improve clinical practice, and policy to facilitate and support the implementation of selected community-based interventions. The aims of the book and overview of the subsequent chapters are presented.Less
This chapter argues that there are reasons for hope in terms of improved treatment and better outcomes in the field of child mental health. It cites four factors that provide the basis for hope and the rationale for taking action to implement care in the community instead of institutional settings. There is increasing evidence documenting positive outcomes for community-based interventions, improved understanding about how to change clinical practice, the availability of tools and training approaches to improve clinical practice, and policy to facilitate and support the implementation of selected community-based interventions. The aims of the book and overview of the subsequent chapters are presented.
James L. Hallenbeck
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780195165784
- eISBN:
- 9780199999897
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195165784.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview ...
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Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview of death and dying to specific approaches to symptom management. As an introduction to both the art and science of palliative care, the book reflects the perspectives of one physician who has dedicated his career to this rapidly evolving field. It links real stories of illness with practical advice, thereby delineating clinical practice in a way that reflects the daily concerns of clinicians.Less
Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview of death and dying to specific approaches to symptom management. As an introduction to both the art and science of palliative care, the book reflects the perspectives of one physician who has dedicated his career to this rapidly evolving field. It links real stories of illness with practical advice, thereby delineating clinical practice in a way that reflects the daily concerns of clinicians.
Richard Heller
- Published in print:
- 2005
- Published Online:
- September 2009
- ISBN:
- 9780198529743
- eISBN:
- 9780191723919
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198529743.001.0001
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This book aims to show the value of developing and applying an evidence base to public health. The application of evidence to clinical practice is well established, and the field of evidence-based ...
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This book aims to show the value of developing and applying an evidence base to public health. The application of evidence to clinical practice is well established, and the field of evidence-based medicine accepted as a basic clinical science, not so for public health. The book examines the methods used for Evidence Based Medicine, and shows how these can be applied to public health. In the process, a number of new measures are necessary to extend clinical measures to the population. Population impact measures are described and their value in public health policy-making described and discussed. The book identifies evidence for population health as an appropriate field of study. The chapters are divided in three sections to follow the structure of the Population Health Evidence Cycle: Ask the question, Collect the evidence, and Understand and use the evidence.Less
This book aims to show the value of developing and applying an evidence base to public health. The application of evidence to clinical practice is well established, and the field of evidence-based medicine accepted as a basic clinical science, not so for public health. The book examines the methods used for Evidence Based Medicine, and shows how these can be applied to public health. In the process, a number of new measures are necessary to extend clinical measures to the population. Population impact measures are described and their value in public health policy-making described and discussed. The book identifies evidence for population health as an appropriate field of study. The chapters are divided in three sections to follow the structure of the Population Health Evidence Cycle: Ask the question, Collect the evidence, and Understand and use the evidence.
Jennifer Radden and John Z. Sadler
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780195389371
- eISBN:
- 9780199866328
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195389371.003.0009
- Subject:
- Philosophy, Moral Philosophy, General
The brief concluding chapter returns to the questions, first introduced in Chapter 5, of whether, and how, virtue can be taught. The preceding discussions have laid out reasons why virtue should be ...
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The brief concluding chapter returns to the questions, first introduced in Chapter 5, of whether, and how, virtue can be taught. The preceding discussions have laid out reasons why virtue should be taught to those who will practice psychiatry. There is a growing body of evidence indicating it is possible to deepen and augment the affective and moral responses making up character traits such as empathy, for example, using a range of pedagogical techniques that harness imaginative capabilities. Alongside the practice skills they learn, the virtues of the good practitioner in psychiatry should and can be habituated and deepened using such techniques, it is argued. As well as to the acquisition of more technical skills, emphasis ought to be placed on character training.Less
The brief concluding chapter returns to the questions, first introduced in Chapter 5, of whether, and how, virtue can be taught. The preceding discussions have laid out reasons why virtue should be taught to those who will practice psychiatry. There is a growing body of evidence indicating it is possible to deepen and augment the affective and moral responses making up character traits such as empathy, for example, using a range of pedagogical techniques that harness imaginative capabilities. Alongside the practice skills they learn, the virtues of the good practitioner in psychiatry should and can be habituated and deepened using such techniques, it is argued. As well as to the acquisition of more technical skills, emphasis ought to be placed on character training.
Lorene M. Nelson, Caroline M. Tanner, Stephen K. Van Den Eeden, and Valerie M. McGuire
- Published in print:
- 2004
- Published Online:
- September 2009
- ISBN:
- 9780195133790
- eISBN:
- 9780199863730
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195133790.003.19
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter describes the principals and practice of evidence-based medicine (EBM), its limitations, and future directions for EBM. The goal of EBM is to provide high quality information in “real ...
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This chapter describes the principals and practice of evidence-based medicine (EBM), its limitations, and future directions for EBM. The goal of EBM is to provide high quality information in “real time” for neurologists to use in practice. Evidence-based medicine provides a set of tools to formulate a clinically important question about a particular patient and to efficiently access and critically evaluate relevant information. Neuroepidemiologic studies provide the groundwork for evidence-based medicine by supplying research about patient risk, prognosis, and harm.Less
This chapter describes the principals and practice of evidence-based medicine (EBM), its limitations, and future directions for EBM. The goal of EBM is to provide high quality information in “real time” for neurologists to use in practice. Evidence-based medicine provides a set of tools to formulate a clinically important question about a particular patient and to efficiently access and critically evaluate relevant information. Neuroepidemiologic studies provide the groundwork for evidence-based medicine by supplying research about patient risk, prognosis, and harm.
Richard F. Heller
- Published in print:
- 2007
- Published Online:
- September 2009
- ISBN:
- 9780198569541
- eISBN:
- 9780191724077
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198569541.003.0023
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter discusses the development of clinical epidemiology. It shows that the population approach, through epidemiological theory and practice, has found a ready and sustained application in ...
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This chapter discusses the development of clinical epidemiology. It shows that the population approach, through epidemiological theory and practice, has found a ready and sustained application in clinical practice through clinical epidemiology and evidence-based medicine. The challenge to epidemiologists is to build on the success of clinical epidemiology, and build and institutionalize epidemiology as key to the development and implementation of an evidence base for population health.Less
This chapter discusses the development of clinical epidemiology. It shows that the population approach, through epidemiological theory and practice, has found a ready and sustained application in clinical practice through clinical epidemiology and evidence-based medicine. The challenge to epidemiologists is to build on the success of clinical epidemiology, and build and institutionalize epidemiology as key to the development and implementation of an evidence base for population health.
Cicely Saunders, Mary Baines, and Robert Dunlop
- Published in print:
- 1995
- Published Online:
- November 2011
- ISBN:
- 9780192625144
- eISBN:
- 9780191730009
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192625144.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
The new edition of this book has been updated to incorporate recent advances in both the approach to, and treatment of, the terminally ill. Based on many years of monitoring clinical practice and ...
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The new edition of this book has been updated to incorporate recent advances in both the approach to, and treatment of, the terminally ill. Based on many years of monitoring clinical practice and research at St Christopher's Hospice, the author presents practical, balanced advice on the general ethical and medical principles of caring for dying patients. This will continue to be an invaluable handbook for all hospice physicians and nurses as a compassionate source of factual information.Less
The new edition of this book has been updated to incorporate recent advances in both the approach to, and treatment of, the terminally ill. Based on many years of monitoring clinical practice and research at St Christopher's Hospice, the author presents practical, balanced advice on the general ethical and medical principles of caring for dying patients. This will continue to be an invaluable handbook for all hospice physicians and nurses as a compassionate source of factual information.
Michael I. Bennett
- Published in print:
- 2007
- Published Online:
- November 2011
- ISBN:
- 9780198530251
- eISBN:
- 9780191729980
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198530251.003.0002
- Subject:
- Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
Clinical practice in palliative care is focused primarily on improving the quality of life for people that are facing advanced and incurable disease. As such, clinical trials are used to test and ...
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Clinical practice in palliative care is focused primarily on improving the quality of life for people that are facing advanced and incurable disease. As such, clinical trials are used to test and quantify the benefits and harms of a particular clinical treatment. This chapter discusses the principles of designing clinical trials in palliative care and how to design experimental studies that seek to examine the effects of clinical interventions.Less
Clinical practice in palliative care is focused primarily on improving the quality of life for people that are facing advanced and incurable disease. As such, clinical trials are used to test and quantify the benefits and harms of a particular clinical treatment. This chapter discusses the principles of designing clinical trials in palliative care and how to design experimental studies that seek to examine the effects of clinical interventions.
Susan C. Ayers and D. Russell Lyman
- Published in print:
- 2005
- Published Online:
- April 2010
- ISBN:
- 9780195159226
- eISBN:
- 9780199893843
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195159226.003.0016
- Subject:
- Social Work, Health and Mental Health, Communities and Organizations
Shirley, a 33-year-old African-American mother of seven children, became involved with agency clinicians in 1988, after all the children had been removed from her care multiple times by the state's ...
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Shirley, a 33-year-old African-American mother of seven children, became involved with agency clinicians in 1988, after all the children had been removed from her care multiple times by the state's child protective agency. Shirley, who had become a mother at 16, was about to lose them permanently. More than a decade later, in 2003, Shirley remains involved with the Guidance Center, Inc., a community agency serving the comprehensive developmental, mental health, and family support needs of children and families in Somerville and Cambridge, Massachusetts. Today, Shirley is a psychologically stronger woman who has developed more effective parenting skills. The Guidance Center's community-based clinical practice model evolved in response to the needs of parents like Shirley. The model and practice were crafted through the creative mix of visionary leadership and active, experienced, flexible staff, who worked with Shirley and other courageous families and children needing mental health intervention. This chapter uses Shirley's story throughout to put the Guidance Center's model and the development of its integrated service continuum into a historical context. It also illustrates how a combination of descriptive clinical research, knowledge of best practice, and dynamic advocacy can be used to secure resources, facilitate change, and ultimately create a comprehensive continuum of care for troubled children and families.Less
Shirley, a 33-year-old African-American mother of seven children, became involved with agency clinicians in 1988, after all the children had been removed from her care multiple times by the state's child protective agency. Shirley, who had become a mother at 16, was about to lose them permanently. More than a decade later, in 2003, Shirley remains involved with the Guidance Center, Inc., a community agency serving the comprehensive developmental, mental health, and family support needs of children and families in Somerville and Cambridge, Massachusetts. Today, Shirley is a psychologically stronger woman who has developed more effective parenting skills. The Guidance Center's community-based clinical practice model evolved in response to the needs of parents like Shirley. The model and practice were crafted through the creative mix of visionary leadership and active, experienced, flexible staff, who worked with Shirley and other courageous families and children needing mental health intervention. This chapter uses Shirley's story throughout to put the Guidance Center's model and the development of its integrated service continuum into a historical context. It also illustrates how a combination of descriptive clinical research, knowledge of best practice, and dynamic advocacy can be used to secure resources, facilitate change, and ultimately create a comprehensive continuum of care for troubled children and families.
Carol M. Ashton and Nelda P. Wray
- Published in print:
- 2013
- Published Online:
- September 2013
- ISBN:
- 9780199968565
- eISBN:
- 9780199346080
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199968565.003.0005
- Subject:
- Public Health and Epidemiology, Public Health
Evidence-based medicine is clinical care guided by the best-available scientific evidence generated from clinical research linked with the clinical acumen of the individual physician. It is built ...
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Evidence-based medicine is clinical care guided by the best-available scientific evidence generated from clinical research linked with the clinical acumen of the individual physician. It is built upon the principles of clinical epidemiology, and requires the physician to collect valid, reliable, and complete data from the patient, and in turn, use external evidence from clinical research to guide the patient’s care. Ways have been developed to help doctors deal with the explosion in the volume of clinical literature, evaluate the quality of individual studies, synthesize evidence from multiple studies addressing the same clinical question, and judge the applicability of the literature to the individual patient at hand. Methods have also been developed for the creation of clinical practice guidelines, but such guidelines can be undermined by financial conflicts of interest. The greatest challenge, however, is in getting physicians and patients to apply the evidence in clinical practice.Less
Evidence-based medicine is clinical care guided by the best-available scientific evidence generated from clinical research linked with the clinical acumen of the individual physician. It is built upon the principles of clinical epidemiology, and requires the physician to collect valid, reliable, and complete data from the patient, and in turn, use external evidence from clinical research to guide the patient’s care. Ways have been developed to help doctors deal with the explosion in the volume of clinical literature, evaluate the quality of individual studies, synthesize evidence from multiple studies addressing the same clinical question, and judge the applicability of the literature to the individual patient at hand. Methods have also been developed for the creation of clinical practice guidelines, but such guidelines can be undermined by financial conflicts of interest. The greatest challenge, however, is in getting physicians and patients to apply the evidence in clinical practice.
Paul Farquhar-Smith
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199558612
- eISBN:
- 9780191595011
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199558612.003.0013
- Subject:
- Public Health and Epidemiology, Public Health
This chapter discusses research governance, which aims to facilitate the conduct of high quality, ethical scientifically valid research, while protecting both subjects and investigators. Good ...
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This chapter discusses research governance, which aims to facilitate the conduct of high quality, ethical scientifically valid research, while protecting both subjects and investigators. Good research governance mandates meticulous record keeping and trial surveillance, and drives a quality research culture. The Research Governance Framework explicitly sets out national standards supported by legislation for research conducted within the NHS in the United Kingdom. This document defines the roles and responsibilities of all those involved in research, and the implementation of the framework using Good Clinical Practice (GCP) principles and standard operating procedures (SOPs). It also highlights the importance of meticulous documentation and monitoring (local and external) during any trial. These mechanisms ensure continual assessment of the quality of conduct of research and allow continuing trial development and improvement.Less
This chapter discusses research governance, which aims to facilitate the conduct of high quality, ethical scientifically valid research, while protecting both subjects and investigators. Good research governance mandates meticulous record keeping and trial surveillance, and drives a quality research culture. The Research Governance Framework explicitly sets out national standards supported by legislation for research conducted within the NHS in the United Kingdom. This document defines the roles and responsibilities of all those involved in research, and the implementation of the framework using Good Clinical Practice (GCP) principles and standard operating procedures (SOPs). It also highlights the importance of meticulous documentation and monitoring (local and external) during any trial. These mechanisms ensure continual assessment of the quality of conduct of research and allow continuing trial development and improvement.
