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Medicine Trails

Medicine Trails
Author: Mavis McCovey
Publisher:
Total Pages: 343
Release: 2009
Genre: Biography & Autobiography
ISBN: 9781597141178

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One of the few modern first-person accounts of Native American healers tells us about Indian life in this world and about life in the visionary medicine womans world. A compelling history.


Mosquito Trails

Mosquito Trails
Author: Alex M. Nading
Publisher: Univ of California Press
Total Pages: 287
Release: 2014-08-22
Genre: Medical
ISBN: 0520282620

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Dengue fever is the world’s most prevalent mosquito-borne illness, but Alex Nading argues that people in dengue-endemic communities do not always view humans and mosquitoes as mortal enemies. Drawing on two years of ethnographic research in urban Nicaragua and challenging current global health approaches to animal-borne illness, Mosquito Trails tells the story of a group of community health workers who struggle to come to terms with dengue epidemics amid poverty, political change, and economic upheaval. Blending theory from medical anthropology, political ecology, and science and technology studies, Nading develops the concept of “the politics of entanglement” to describe how Nicaraguans strive to remain alive to the world around them despite global health strategies that seek to insulate them from their environments. This innovative ethnography illustrates the continued significance of local environmental histories, politics, and household dynamics to the making and unmaking of a global pandemic.


The Prevention and Treatment of Missing Data in Clinical Trials

The Prevention and Treatment of Missing Data in Clinical Trials
Author: National Research Council
Publisher: National Academies Press
Total Pages: 163
Release: 2010-12-21
Genre: Medical
ISBN: 030918651X

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Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.


The Fever Trail

The Fever Trail
Author: Mark Honigsbaum
Publisher: Macmillan
Total Pages: 356
Release: 2003-05
Genre: History
ISBN: 9780312421809

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Literally Italian for "bad air," malaria once plagued Rome, tropical trade routes and colonial ventures into India and South America and the disease has no known antidote aside from the therapeutic effects of the "miraculous" quinine. This first book from journalist Honigsbaum is a rousing history of the search for febrifuge or, more specifically, the rare red cinchona tree, the bark from which quinine is derived.


Small Clinical Trials

Small Clinical Trials
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 221
Release: 2001-01-01
Genre: Medical
ISBN: 0309171148

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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.


Virtual Clinical Trials

Virtual Clinical Trials
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 127
Release: 2019-11-16
Genre: Medical
ISBN: 0309494885

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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.


The Trials of Psychedelic Therapy

The Trials of Psychedelic Therapy
Author: Matthew Oram
Publisher: JHU Press
Total Pages: 413
Release: 2018-10-01
Genre: Medical
ISBN: 1421426218

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The rise—and fall—of research into the therapeutic potential of LSD. After LSD arrived in the United States in 1949, the drug's therapeutic promise quickly captured the interests of psychiatrists. In the decade that followed, modern psychopharmacology was born and research into the drug's perceptual and psychological effects boomed. By the early 1960s, psychiatrists focused on a particularly promising treatment known as psychedelic therapy: a single, carefully guided, high-dose LSD session coupled with brief but intensive psychotherapy. Researchers reported an astounding 50 percent success rate in treating chronic alcoholism, as well as substantial improvement in patients suffering from a range of other disorders. Yet despite this success, LSD officially remained an experimental drug only. Research into its effects, psychological and otherwise, dwindled before coming to a close in the 1970s. In The Trials of Psychedelic Therapy, Matthew Oram traces the early promise and eventual demise of LSD psychotherapy in the United States. While the common perception is that LSD's prohibition terminated legitimate research, Oram draws on files from the Food and Drug Administration and the personal papers of LSD researchers to reveal that the most significant issue was not the drug's illegality, but the persistent question of its efficacy. The landmark Kefauver-Harris Drug Amendments of 1962 installed strict standards for efficacy evaluation, which LSD researchers struggled to meet due to the unorthodox nature of their treatment. Exploring the complex interactions between clinical science, regulation, and therapeutics in American medicine, The Trials of Psychedelic Therapy explains how an age of empirical research and limited government oversight gave way to sophisticated controlled clinical trials and complex federal regulations. Analyzing the debates around how to understand and evaluate treatment efficacy, this book will appeal to anyone with an interest in LSD and psychedelics, as well as mental health professionals, regulators, and scholars of the history of psychiatry, psychotherapy, drug regulation, and pharmaceutical research and development.