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1
Waldron, Jill. Asthma care in the community. Chichester, West Sussex: J. Wiley & Sons, 2007.
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2
Hertz, Karen. Fragility Fracture Nursing: Holistic Care and Management of the Orthogeriatric Patient. Cham: Springer Nature, 2018.
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3
J, McCormick Deborah, Hrsg. Concepts in health and wellness. Clifton Park, NY: Delmar/Cengage Learning, 2011.
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4
Hochschuler, Stephen. Treat your back without surgery: The best non-surgical alternatives for eliminating back and neck pain. Alameda, CA: Hunter House Publishers, 1998.
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5
Hochschuler, Stephen. Treat your back without surgery: The best non-surgical alternatives for eliminating back and neck pain. Alameda, CA: Hunter House Publishers, 1998.
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6
Bob, Reznik, Hrsg. Treat your back without surgery: The best non-surgical alternatives for eliminating back and neck pain. 2. Aufl. Alameda, CA: Hunter House Publishers, 2002.
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7
Babiuk, Gary. Holistic changes in school structure and organization. 2000.
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8
Thompson, Sanja, Nicola Lovett, Sarah Pendlebury und John Grimley Evans, Hrsg. Oxford Case Histories in Geriatric Medicine. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199699261.001.0001.
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The cases in this volume have been selected to show the spectrum of acute medicine in older patients. These are often with atypical or non-specific presentations, on a background of complex co-morbidity and the attendant management and ethical dilemmas. The format follows that of other books in the series: case descriptions with questions followed by answers including detailed discussion of the diagnosis, treatment, and management dilemmas including ethical and holistic aspects of care. This structure was chosen as it is very difficult to illustrate the practical process of clinical management through a conventional textbook format. The authors believe it is more interesting and educational to consider real cases and one’s own management plan, than to read a text that does not require the same interactive effort on the part of the reader.
9
Waldron, Jill. Asthma Care in the Community. Wiley & Sons, Incorporated, John, 2007.
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10
Waldron, Jill. Asthma Care in the Community. Wiley-Interscience, 2007.
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11
Santy-Tomlinson, Julie, und Karen Hertz. Fragility Fracture Nursing: Holistic Care and Management of the Orthogeriatric Patient. Springer, 2018.
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12
Foster, Helen, und Paul A. Brogan, Hrsg. The multidisciplinary approach to management. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199592630.003.0007.
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The multidisciplinary team 378The role of the clinical nurse specialist 380The role of the physiotherapist 382The role of the occupational therapist 384The role of the podiatrist 385Transitional care 387• The experienced MDT is integral to the holistic management of children and young people with rheumatic disease with the patient and family at the centre (...
13
Guzzeta, Cathie, Leslie Kolkmeier und Barbara Montgomery Dossey. Holistic Nursing: A Handbook for Practice. 2. Aufl. Aspen Publishers, 1995.
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14
Montgomery, Dossey Barbara, und American Holistic Nurses' Association, Hrsg. Holistic nursing: A handbook for practice. 2. Aufl. Gaithersburg, Md: Aspen Publishers, 1995.
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15
Pagnini, Francesco, und Zachary Simmons. Providing holistic care for the individual with ALS: Research gaps and future directions. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757726.003.0017.
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Much progress has been made in understanding, measuring, and managing quality of life and psychological well-being in individuals with ALS, but there are gaps. Anxiety and depression have been carefully explored in the ALS literature, but coping, resilience, sexuality, intimacy, and end-of-life concerns require more attention. Psychological interventions have been under-explored. Further research on mindfulness, hypnosis, and on complementary and alternative medicines is needed, with particular attention to early evidence that psychological interventions may lead to physical as well as psychological benefits. Attention to the psychological consequences of cognitive dysfunction in ALS would greatly benefits patients and caregivers. The impact of technology needs further study. Rapid advances in genetics, brain-computer interfaces, and new treatments, communicated virtually instantaneously via the internet, will inevitably contrast with the slower pace of implementation, resulting in surges of hope and disappointment. Optimal care is holistic, incorporating both physical and psychological assessment and management.
16
Adam, Sheila, Sue Osborne und John Welch. Respiratory problems. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.003.0004.
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A requirement for respiratory support is the most frequent cause of critical care admission. Effective care requires an appreciation of the relevant anatomy and physiology, skills of physical assessment and use of monitoring, knowledge of a range of airway and breathing problems and the different challenges they present, and an understanding of the most appropriate means of airway management and respiratory support. This chapter details essential respiratory physiology and the advantages, disadvantages, and potential complications of different methods of monitoring and respiratory support, including holistic care of patients with artificial airways and various modes of mechanical ventilation, the use of nitric oxide, prone positioning and extra-corporeal devices, and management of the weaning patient.
17
Adam, Sheila, Sue Osborne und John Welch, Hrsg. Critical Care Nursing. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.001.0001.
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This textbook encompasses the knowledge, skills, and expertise needed to deliver excellent nursing care to critically ill patients. Emphasis is placed on a holistic and compassionate approach towards humanizing the impact of the environment, organ support, and monitoring, as well as critical illness itself. Chapters cover the general aspects of critical care such as the critical care environment or critical care continuum and specific organ systems and diseases. The structure of the systems chapters reminds the reader of the underlying anatomy and physiology as well as highlighting areas of particular relevance to critical care. The focus on priorities for management builds on the ABCDE assessment and offers insight into key interventions in urgent situations as well as outlining evidence-based practice. The book is ideal for those new to the critical care environment, but will also act as a reminder for more experienced nurses when faced with a new situation or when teaching/mentoring students. The patient and their family remain the centre of all This new edition brings the definitions, pathophysiology, and management of fast-changing and challenging areas such as ARDS, sepsis and multiple organ dysfunction, resuscitation, and acute kidney injury up to date as well as including any evidence-based changes associated with nursing practice in critical care. A new chapter covers major incident planning and management and the role of critical care in pandemic situations.
18
Alder, Catherine A., Mary Guerriero Austrom, Michael A. LaMantia und Malaz A. Boustani. Aging Brain Care. Herausgegeben von Robert E. Feinstein, Joseph V. Connelly und Marilyn S. Feinstein. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.003.0008.
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While fragmented care is a problem across the entire health care delivery system, it is especially problematic for vulnerable older adults with dementia and late-life depression. Most older adults have multiple chronic conditions. Cognitive impairment and mood disorders complicate the management of these comorbid conditions by interfering with the patient’s ability to monitor and report symptoms and comply with the care plan. To reduce fragmentation and promote integrated care, each medical provider must adopt a more holistic view of health care, recognizing the importance of communication and collaboration among all providers and the potential impact of any one action on the patient’s overall health. The Aging Brain Care (ABC) model provides a structure for integrating evidence-based interventions for dementia and depression into the primary care environment. By extending the delivery of care beyond the clinic, ABC offers patient-centered services aimed at coordinating care across multiple providers, settings, and community resources.
19
Strada, E. Alessandra. The Third Domain of Palliative Care. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199798551.003.0004.
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This chapter describes palliative psychology competencies in the third domain of palliative care, which focuses on identifying and addressing psychological and psychiatric needs in the patient and the family. Palliative psychology is a holistic discipline. It emphasizes not only the management of distress, but also the importance of facilitating psychospiritual well-being for the patient and for family caregivers. Because psychotherapy is one of the main psychological interventions provided by psychologists, this chapter defines palliative psychotherapy as a relevant framework for the palliative care setting. The essential components related to structure, delivery, and therapeutic stance are discussed. This chapter also discusses major depression, anxiety, and anticipatory grief reactions. Nonpharmacological and pharmacological approaches are discussed.
20
Murphy, Claire Louise, Yiannis Ioannou und Nicola Ambrose. Juvenile systemic lupus erythematosus. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198739180.003.0008.
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Juvenile-onset systemic lupus erythematosus (JSLE) is similar to adult-onset SLE, but there are distinct differences in clinical features, serology, and management requirements. It is more aggressive than adult-onset SLE with frequent renal and haematological manifestations and higher mortality rates. The cause of JSLE is unknown but appears to be multifactorial with genetic, immunological, hormonal, and environmental influences. Macrophage activation syndrome is a potentially life-threatening complication, and may mimic the underlying disease or be confused with sepsis. Transferring care from paediatric to adult care can be a difficult milestone and should be tailored to the individual patient. Management requires a multisystemic, holistic approach with recognition of psychosocial factors that occur during normal childhood and adolescence. International collaboration and further research is needed to optimize care for these patients.
21
Donovan, Joan. A DESCRIPTIVE STUDY OF THE CREATION AND EARLY DEVELOPMENT OF A HOLISTIC HEALTH CENTER. 1990.
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22
Adam, Sheila, Sue Osborne und John Welch. The patient within the critical care environment. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.003.0003.
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Both critical illness and treatment in the critical care unit are extremely stressful, presenting great physical and psychological challenges for patients and their families. There are a range of compensatory responses to stress which may be adaptive, but severe or prolonged stress can induce a destructive spiral of decompensation. The importance of a holistic approach to care cannot be overemphasized; this chapter sets out the priorities of care for critically ill patients, and the common needs and problems for both patients and their families. The issues discussed include the mechanisms of stress in critical illness, the promotion of sleep, use of analgesia and sedation, management of delirium, complications of immobility, mouth, eye, and skin care, infection control, requirements for safe transfer, and care of the dying patient.
23
Exploring the Spiritual Dimensions in Care (Key Management Skills in Nursing). Quay Books,a division of Mark Allen Publishing Ltd, 1996.
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24
McClement, Susan, und Genevieve Thompson. The meaning of dignity in psychosocial care. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198806677.003.0008.
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Individuals living with life-limiting illness experience a myriad of physical, psychosocial and existential challenges. Psychosocial care is an holistic approach that aims to mitigate the distress engendered by these challenges. One important facet of such care includes tending to patient dignity. This chapter discusses what dignity is, why it is important, and how dignity conserving care can be weaved into daily clinical encounters. Palliative care is a type of health care for individuals facing life-threatening illness and their families that involves ongoing evaluation and management of a person’s pain and other physical symptoms. It also involves the provision of psychosocial care—care that attends to a person’s emotional, social, and spiritual well-being. This whole-person approach to the care of individuals is concerned with addressing a range of needs that can improve quality of life.
25
Baron, Alan, John Hassard, Fiona Cheetham und Sudi Sharifi. Inside the Compassionate Organization. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198813958.001.0001.
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The literature on management and organization studies suggests the time is right for a focus on ‘care and compassion’. The aim of this book is to answer this call by examining the cultural changes found within a particular ‘compassionate organization’—an English hospice—from its altruistic beginnings to the more professionalized culture of today. The study seeks to understand how its members identify or fail to identify with an organization where issues of life and death take centre stage and explores some of the problems the Hospice faces regarding its representation in society. These strands are then drawn together to consider the interrelationships between culture, identity, and image in the organization. An ethnographic approach—including participant observation, extended interviews, and group meetings—was used to study this organization over a period of almost two years. This enabled the production of a nuanced, sensitive, and holistic interpretation of the case study Hospice as inferred from the views of both insiders and outsiders. The findings shed new light on the literature in management studies by proposing a view of culture as a sense-making context that facilitates group socialization underpinning a sense of personal and organizational identity. The study suggests a link between culture and group identification, making discussions about culture almost inseparable from those around identity. With regard to identity and image, however, the study suggests a dynamic and iterative relationship with a continuous flow between interpretation and reinterpretation influenced by the all-pervading cultural context.
26
Adam, Sheila, Sue Osborne und John Welch. Sepsis and multiple organ dysfunction. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.003.0010.
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Sepsis—a dysregulated systemic inflammatory response to infection—occurs at some point in most critical illnesses, and is the most common cause of multiple organ dysfunction syndrome (MODS). Patients with MODS always present great challenges to the critical care team and are often at high risk of death. This chapter discusses the latest thinking about the infective causes and complex evolution of sepsis, with details of how each of the main body systems can be affected (e.g. in the form of acute respiratory distress syndrome) and how different organ functions can be assessed and dysfunction recognized. The priorities, principles, and practicalities of holistic care and management of patients with sepsis and MODS, including adjunct therapies and blood purification, is also described.
27
Wood, Jayne, und Maureen Carruthers. Palliative care in the intensive cardiac care unit. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0078.
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Specialist palliative care services originally focused on improving the quality of life for patients with a diagnosis of cancer in the terminal phase of their illness. However, organizations, such as the World Health Organization, supported by recent national strategies, such as the End of Life Care Strategy (United Kingdom, 2008), promote the early integration of specialist palliative care into the management of patients with incurable disease, irrespective of the diagnosis. The primary goal of the intensive cardiac care unit is to help patients survive acute threats to their lives. However, the suddenness and severity of illness, particularly when associated with an underlying cardiological diagnosis, often means that the provision of optimal specialist palliative care is challenging. This chapter addresses key issues relating to the provision of specialist palliative care in the challenging and complex environment of the intensive cardiac care unit, including symptom control, end of life care, decision making, and communication. The benefits of multidisciplinary working for effective quality improvement in patient care and best support for patients, families/carers, and staff are also addressed. The importance of interdisciplinary working is highlighted, and, by embedding the principles of holistic care into daily practice, the intensive cardiac care unit can ensure that patients and their families/carers receive the support they need in a timely manner from individuals who are well supported in what is often considered to be one of the most challenging medical environments.
28
Ng, Wan-Fai, Arjan Vissink, Elke Theander und Francisco Figueiredo. Sjögren’s syndrome—management. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0128.
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Management of Sjögren's syndrome (SS) encompasses confirmation of diagnosis, disease assessment, and treatment of glandular and systemic manifestations including special situations such as pregnancy and SS-related lymphoma. The American European Consensus Group classification criteria 2002 are the current gold standard for the diagnosis of SS. Salivary gland sialometry, sialochemistry, and ultrasound and tear osmolarity may be useful adjuncts. Symptoms of SS are non-specific and must be actively explored. When assessing patients with SS, it is important to consider not only objective parameters such as abnormalities in blood tests and changes in tear and salivary flow, but also patient-reported outcome measures and impact on quality of life. Current management of patients with SS is hampered by the lack of evidence-based strategies. The symptoms experienced by patients with SS are often not fully appreciated by clinicians, which may contribute to the suboptimal management of the condition. Management of fatigue remains a major challenge and a holistic, multidisciplinary approach is recommended. Factors that may contribute to fatigue should be fully addressed. Recent advances in the understanding of the pathogenic mechanisms of SS have informed more targeted therapeutic strategies with some promising data. Optimal management of SS requires expertise from different disciplines. Combined clinics with rheumatology, oral medicine, and ophthalmology input will improve care and communications as well as reduce the number of clinic visits for patients and healthcare-related cost. Effective link between pSS specialists, dentists, opticians, and general practitioners will facilitate early diagnosis and reduce risk of long-term disability of SS.
29
Buckley, Marcia J., und Ann Syrett. Palliative Emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190204709.003.0009.
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This chapter highlights four emergencies that occur in palliative care: hemorrhage, spinal cord compression, seizures, and superior vena cava syndrome. It is imperative to understand their etiology, pathophysiology, workup, and management in order to rapidly and expertly respond to these emergencies. Palliative advanced practice registered nurses possess a unique skill set combining holistic care of patients with the ability to manage acute, often potentially devastating symptoms that affect the patient’s goals and wishes. Disease state needs to be considered when making treatment and management decisions during these palliative emergencies. The chapter presents an overview of pharmacological and nonpharmacological treatments to prevent and manage these palliative emergencies.
30
Abu-Bonsrah, Nancy, C. Rory Goodwin, Rajiv R. Iyer und Daniel M. Sciubba. Spinal Tumors: Surgical Considerations and Approaches. Herausgegeben von Mehul J. Desai. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199350940.003.0023.
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This chapter examines the preoperative and operative considerations that should influence the management of neoplasms affecting the spinal column. The three broad categories of spinal tumors (extradural, intradural extramedullary, and intramedullary) are described. The patient and tumor subtype factors that can create challenges in the treatment of these patients are discussed. This chapter also covers scoring systems that can help physicians in counseling and management of patients diagnosed with tumors affecting the spinal column. A multidisciplinary approach should be used to ensure that patients with spinal neoplasms receive holistic, comprehensive care.
31
Webb, Andrew, Derek Angus, Simon Finfer, Luciano Gattinoni und Mervyn Singer, Hrsg. Oxford Textbook of Critical Care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.001.0001.
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Since the first edition of the Oxford Textbook of Critical Care was published there have been many advances in in our understanding and management of critical illness. The first edition was prefaced with a note on the exacting nature of critical care—the holistic complexity of the patient with multisystem dysfunction, the out-of-hours commitment, the often stressful and highly charged situations requiring considerable agility of brain and hand, and the continuing evolution (and occasional revolution) in perceived ‘best practice’. These challenging demands are precisely what attract the critical care practitioner to the specialty. The importance of strong support mechanisms—from colleagues, national and international societies, and robust educational and research outputs—is paramount to sustain and enhance the quality of care patients receive. The format used in the first edition with system-orientated sections continues. Each section has been subdivided into short topics grouped according to clinical problems, facilitating manageable and relevant searches in electronic media. It is a single-volume major reference book aiming to cover the breadth of clinical and organizational aspects of adult critical care medicine in readable chunks. The editors acknowledge that every single topic cannot possibly be covered in detail, but hope the book’s comprehensive nature will be found useful by all health care providers who look after critically-ill patients. There are often local, national, and international differences in philosophy and management strategy. Some of these differences are seemingly contradictory and it is often difficult for physicians in one country to assimilate information produced for another. This is an international text attempting to give a balanced view where international differences exist. The book informs, rather than dictates.
32
Ng, Wan-Fai, Arjan Vissink, Elke Theander und Francisco Figueiredo. Sjögren’s syndrome—management. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199642489.003.0128_update_001.
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Management of Sjögren’s syndrome (SS) encompasses confirmation of diagnosis, disease assessment, and treatment of glandular and systemic manifestations including special situations such as pregnancy and SS-related lymphoma. The American European Consensus Group (AECG) classification criteria 2002 are the current gold standard for the diagnosis of SS. Salivary gland sialometry, sialochemistry, and ultrasound and tear osmolarity may be useful adjuncts. Recently, preliminary classification criteria of the American College of Rheumatology have been introduced as an alternative to the AECG criteria. Symptoms of SS are non-specific and must be actively explored. When assessing patients with SS, it is important to consider not only objective parameters such as abnormalities in blood tests and changes in tear and salivary flow, but also patient-reported outcome measures and impact on quality of life. Current management of patients with SS is hampered by the lack of evidence-based strategies. The symptoms experienced by patients with SS are often not fully appreciated by clinicians, which may contribute to the suboptimal management of the condition. Management of fatigue remains a major challenge and a holistic, multidisciplinary approach is recommended. Factors that may contribute to fatigue should be fully addressed. Recent advances in the understanding of the pathogenic mechanisms of SS have informed more targeted therapeutic strategies with some promising data. Optimal management of SS requires expertise from different disciplines. Combined clinics with rheumatology, oral medicine, and ophthalmology input will improve care and communications as well as reduce the number of clinic visits for patients and healthcare-related cost. Effective link between pSS specialists, dentists, opticians, and general practitioners will facilitate early diagnosis and reduce risk of long-term disability of SS.
33
Kreitzer, Mary Jo, Mary Koithan und Andrew Weil, Hrsg. Integrative Nursing. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190851040.001.0001.
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Fully updated and revised, the second edition of Integrative Nursing is a complete roadmap to holistic patient care, providing a step-by-step guide to assess and clinically treat conditions through a variety of combined methodologies including traditional and alternative therapies with all aspects of lifestyle. This text identifies both the skills and theoretical frameworks for interprofessional systems leaders to consider and implement integrative healthcare strategies within institutions, including several case studies involving practical nursing-led initiatives. This volume covers the foundations of the field; the most effective ways to optimize wellbeing; principles of symptom management for many common disorders like sleep, anxiety, pain, and cognitive impairment; the application of integrative nursing techniques in a variety of clinical settings and among a diverse patient population; and integrative practices around the world and how they impact planetary health. The academic rigor of the text is balanced by practical and relevant content that can be readily implemented into practice for both established professionals as well as students enrolled in undergraduate or graduate nursing programs. Integrative health and medicine is defined as healing-oriented care that takes account of the whole person (body, mind, and spirit) as well as all aspects of lifestyle; it emphasizes the therapeutic relationship and makes use of appropriate therapies, both conventional and alternative. Series editor Andrew Weil, MD, is Professor and Director of the Arizona Center for Integrative Medicine at the University of Arizona. Dr. Weil’s program was the first such academic program in the U.S., and its stated goal is “to combine the best ideas and practices of conventional and alternative medicine into cost effective treatments without embracing alternative practices uncritically.”
34
Adam, Sheila, Sue Osborne und John Welch. Renal problems. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199696260.003.0007.
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The kidneys normally excrete metabolic waste products in urine while maintaining fluid, electrolyte, and acid–base balance. However, critical illness frequently leads to renal impairment, loss of these functions, and potentially life-threatening complications. This chapter describes the functional anatomy and physiology of the renal system, important risk factors for acute kidney injury, and how renal function can be monitored and maintained. The methods, advantages, disadvantages, and practical management of different types of renal replacement therapy are discussed, together with essential aspects of holistic patient care.
35
Nissenson, Allen R., John Moran und Robert Provenzano. Overview of dialysis patient management and future directions. Herausgegeben von Jonathan Himmelfarb. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0267_update_001.
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Nearly 2 million patients worldwide have end-stage renal disease (ESRD) and require dialysis or kidney transplantation. The advent of clinical dialysis in the 1950s has had a huge impact on the way ESRD and acute kidney injury are managed, but several decades later, the morbidity and mortality in patients with ESRD remain unacceptably high and patients often have a poor quality of life. Many believe that we have focused attention on a few key treatment-related outcomes, and have done well with these (i.e. anaemia, adequacy of dialysis, metabolic bone disease), but achieving great results in only these domains has clearly not been sufficient to drive improvements in survival or patient-reported outcomes. Recent experience with integrated care management, focusing on comorbidity management, offers promise. In addition, a number of investigators have been challenging the current thrice-weekly, diffusion-based treatment paradigm and have been developing approaches to emulate the function of natural kidneys. Thus an ideal care delivery model would focus on the holistic needs of the patient with kidney disease, while the ideal form of renal replacement therapy would mimic native kidneys, operating continuously, removing solutes with a molecular-weight spectrum similar to that of native kidneys, removing water and solutes on the basis of individual patient needs, and would be biocompatible, wearable, and ideally implantable. It would also be low cost, reliable, and safe. A few years ago, these technical requirements would have seemed impossible to achieve, but with advances in the sciences of nanotechnology and microfluidics, renal replacement of the future may come closer to this ideal.
36
Rocker, Graeme M., Joanne Michaud-Young und Robert Horton. Caring for the patient with advanced chronic obstructive pulmonary disease. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0152.
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The global prevalence of chronic obstructive pulmonary disease (COPD) is high and rising. Patients and families living with advanced disease often experience biopsychosocial symptom burdens over a long trajectory, leaving them housebound when they require support the most. Current models of care, by placing a disproportionate focus on the provision of acute and facility-based services, do little to address the complex needs of those vulnerable patients and families who struggle to easily access primary care services. This chapter provides an overview of conventional COPD treatments and highlights some newer understandings and management approaches for patients living with high symptom burden despite optimized conventional treatments, including the use of opioids. It provides some concrete examples of models of care that employ interventions and holistic approaches to care that can improve patient and family outcomes. The move towards an integrated care approach to COPD will help patients and their families reach informed decisions about their care throughout the trajectory of COPD.
37
McCabe, Candy, Richard Haigh, Helen Cohen und Sarah Hewlett. Pain and fatigue. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0012.
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Pain and fatigue are the prominent problems for those with a rheumatic disease, and are often underestimated by clinicians. Symptoms may fluctuate in quality and intensity over time and commonly will vary over the course of a day. For pain, clinical signs and symptoms will be dependent on the source of the pain and whether causative underlying pathology is identifiable or not. Fatigue may range from mild effects to total exhaustion and may include cognitive and emotional elements, with a complex, probably multicausal, pathway. Theoretical knowledge of potential mechanistic pathways for pain and fatigue should be used to inform assessment and treatment approaches. Best practice recommends a multidisciplinary and holistic treatment approach with the patient an active participant in the planning of their care, and self-management. Many patients with chronic musculoskeletal conditions will not achieve a pain-free or fatigue-free status. Medication use must therefore balance potential benefit against short- and long-term side effects. Rheumatology centres should offer specific fatigue and pain self-management support as part of routine care. Emphasis should be given to facilitating self-management strategies for both pain and fatigue to help the patient optimize their quality of life over years or a lifetime of symptoms. Interventions should include behaviour change and cognitive restructuring of pain/fatigue beliefs, as well as access to relevant self-help groups and charitable organizations. Referral for specialist advice from regional or national clinics on pain relief and management should be considered if pain interferes significantly with function or quality of life despite local interventions.
38
McCabe, Candy, Richard Haigh, Helen Cohen und Sarah Hewlett. Pain and fatigue. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199642489.003.0012_update_001.
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Pain and fatigue are the prominent problems for those with a rheumatic disease, and are often underestimated by clinicians. Symptoms may fluctuate in quality and intensity over time and commonly will vary over the course of a day. For pain, clinical signs and symptoms will be dependent on the source of the pain and whether causative underlying pathology is identifiable or not. Fatigue may range from mild effects to total exhaustion and may include cognitive and emotional elements, with a complex, probably multicausal, pathway. Theoretical knowledge of potential mechanistic pathways for pain and fatigue should be used to inform assessment and treatment approaches. Best practice recommends a multidisciplinary and holistic treatment approach with the patient an active participant in the planning of their care, and self-management. Many patients with chronic musculoskeletal conditions will not achieve a pain-free or fatigue-free status. Medication use must therefore balance potential benefit against short- and long-term side effects. Rheumatology centres should offer specific fatigue and pain self-management support as part of routine care. Emphasis should be given to facilitating self-management strategies for both pain and fatigue to help the patient optimize their quality of life over years or a lifetime of symptoms. Interventions should include behaviour change and cognitive restructuring of pain/fatigue beliefs, as well as access to relevant self-help groups and charitable organizations. Referral for specialist advice from regional or national clinics on pain relief and management should be considered if pain interferes significantly with function or quality of life despite local interventions.
39
Pratt, George, und Peter Lambrou. Instant Emotional Healing: Acupressure for the Emotions. Broadway, 2000.
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40
Doherty, Michael, Johannes Bijlsma, Nigel Arden, David J. Hunter und Nicola Dalbeth. Introduction: the comprehensive approach. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0020.
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This introductory chapter to the section on management of osteoarthritis (OA) emphasizes the need for a full assessment of the patient, not just in terms of joint symptoms and examination findings but a full holistic assessment of the person, including the impact of OA on their life, their illness perceptions of OA, and the presence of comorbidities. An individualized package of care can then be developed. Patients should be fully informed about OA and fully involved in all management decisions. Apart from education, which is an ongoing not one-off process, other core treatments to be considered in every person with OA are exercise (both strengthening and aerobic) and strategies to reduce adverse mechanical factors, including weight loss if overweight or obese. Topical non-steroidal anti-inflammatory drugs are the safest analgesic drug to try first for peripheral joint OA. Other treatments can be selected as required from a wide range of drug and non-pharmacological options, to address the needs of the individual. The patient requires regular follow-up for reassessment and re-adjustment of management as required. Currently there are sparse data on predictors of response to treatment, limiting a stratified medicine approach. Caveats to the research evidence for OA and its transition to clinical practice are discussed, and one way of improving this (reporting overall treatment effect and the proportion attributable to placebo in clinical trials) is presented. Optimizing contextual effects, which are an integral part of any treatment and which may explain the majority of improvement that a patient experiences for their OA, is emphasized as a key aspect of care.
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Hochschuler, Stephen, und Bob Reznik. Treat Your Back Without Surgery: The Best Non-Surgical Alternatives to Eliminating Back and Neck Pain. Hunter House Publishers, 1999.
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