Livres : « Patients recruitment »

1

A, Cramer Joyce, dir. Patient recruitment in clinical trials. New York : Raven Press, 1992.

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A, Cramer Joyce, dir. Patient recruitment in clinical trials. New York : Raven Press, 1996.

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Research, Institute of Clinical, dir. Patient recruitment in clinical research : A guide to Europe. Marlow : Institute of Clinical Research, 2005.

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A, Brescia Bonnie, dir. Reinventing patient recruitment : Revolutionary ideas for clinical trial success. Aldershot, Hampshire, England : Gower, 2006.

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Diana L., Ph.D. Anderson. A Guide to Patient Recruitment and Retention. Thomson CenterWatch, 2004.

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Bachenheimer, Joan F., et Bonnie A. Brescia. Reinventing Patient Recruitment : Revolutionary Ideas for Clinical Trial Success. Taylor & Francis Group, 2017.

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Diana L., Ph.D. Anderson. A Guide to Patient Recruitment : Today's Best Practices & Proven Strategies. CenterWatch, 2001.

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Bachenheimer, Joan F., et Bonnie A. Brescia. Reinventing Patient Recruitment : Revolutionary Ideas for Clinical Trial Success. Taylor & Francis Group, 2017.

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Bachenheimer, Joan F., et Bonnie A. Brescia. Reinventing Patient Recruitment : Revolutionary Ideas for Clinical Trials Success. Ashgate Publishing, 2007.

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Bachenheimer, Joan F., et Bonnie A. Brescia. Reinventing Patient Recruitment : Revolutionary Ideas for Clinical Trial Success. Taylor & Francis Group, 2017.

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Bachenheimer, Joan F. Reinventing Patient Recruitment. Routledge, 2017. http://dx.doi.org/10.4324/9781315244839.

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Anderson-Foster, Diana L. Global Issues in Patient Recruitment and Retention. CenterWatch LLC, 2012.

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Anderson, Diana L. International Patient Recruitment : Regulatory Guidelines, Customs and Practices. D. L. Anderson International, 2007.

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Katirji, Bashar. Routine Clinical Electromyography. Sous la direction de Bashar Katirji. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190603434.003.0002.

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Nerve conduction studies and needle EMG represent the two essential parts of the clinical EMG study. In almost all patients, both studies need to be completed before a final conclusion is made. This chapter outlines the basic concepts of nerve conduction studies including stimulations, recordings, variables and sources of errors. This is followed by detailed discussions of basic pathophysiological changes that accompany peripheral nerve disorders. The chapter then covers the normal needle EMG findings including normal insertional activity, motor unit action potential morphology and recruitment. This is followed by details on abnormal spontaneous activity findings and changes in motor unit action potential morphology and recruitment seen on needle EMG with peripheral nerve and muscle disorders.

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Smets, Tinne, et Luc Deliens. Health services research in palliative care and end-of-life care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0198.

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Health services research in palliative care and end-of-life care involves the study of palliative care needs, access and quality of palliative care, and the feasibility, effectiveness, and cost of palliative and end-of-life care services and interventions. The evaluation of services and interventions involving patients with advanced illness presents unique challenges, both ethical and methodological. In this chapter, several research designs that are useful for the service evaluation of complex interventions in palliative care and end-of-life care are discussed and examples of studies using these designs are described. The designs that are described include both experimental and non-experimental designs. The problems and challenges that doing research with dying patients presents are subsequently described and possible solutions proposed. The challenges dealt with in this chapter include defining the intervention, determining relevant outcome measures, randomization of patients to intervention and control group, achieving recruitment and minimizing attrition, heterogeneity of the patient group, and obtaining informed consent.

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Brown, Richard F., et Terrance Albrecht. Enrolment in clinical trials. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198736134.003.0032.

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Cancer clinical trials are conducted to progress the efficacy of cancer treatments. The success of such clinical trials is dependent on enrolling cancer patients. However, enrolments rates remain low, and lower participation rates are reported in minority patients. The goal of this chapter is to outline issues involved in recruitment to clinical trials and to describe the ethical principles underlying informed consent. A model of communication skills training is presented to provide suggested strategies to aid communication between healthcare providers and patients about clinical trials. The programme involves training in shared decision-making, information flow, and the disclosure of information. The results of a pilot programme utilizing this model and skills are also presented.

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Greener, Mark. Strategies and Tactics That Improve Patient Recruitment and Retention in Clinical Studies. D&md Publications, 2005.

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Intricate Ecosystem of Patient Recruitment in Clinical Research : A Transformational Look into What Recruitment Strategies Will Work in 2022 and Beyond. Independently Published, 2022.

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Lucangelo, Umberto, et Massimo Ferluga. Pulmonary mechanical dysfunction in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0084.

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In intensive care units practitioners are confronted every day with mechanically-ventilated patients and should be able to sort out from all the data available from modern ventilators to tailored patient ventilatory strategy. Real-time visualization of pressure, flow and tidal volume provide valuable information on the respiratory system, to optimize ventilatory support and avoiding complications associated with mechanical ventilation. Early determination of patient–ventilator asynchrony, air-trapping, and variation in respiratory parameters is important during mechanical ventilation. A correct evaluation of data becomes mandatory to avoid a prolonged need for ventilatory support. During dynamic hyperinflation the lungs do not have time to reach the functional residual capacity at the end of expiration, increasing the work of breathing and promoting patient-ventilator asynchrony. Expiratory capnogram provides qualitative information on the waveform patterns associated with mechanical ventilation and quantitative estimation of expired CO2. The concept of dead space accounts for those lung areas that are ventilated but not perfused. Calculations derived from volumetric capnography are useful indicators of pulmonary embolism. Moreover, alveolar dead space is increased in acute lung injury and its value decreased in case of positive end-expiratory pressure (PEEP)-induced recruitment, whereas PEEP-induced overdistension tends to increment alveolar dead space.

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Muders, Thomas, et Christian Putensen. Pressure-controlled mechanical ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0096.

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Beside reduction in tidal volume limiting peak airway pressure minimizes the risk for ventilator-associated-lung-injury in patients with acute respiratory distress syndrome. Pressure-controlled, time-cycled ventilation (PCV) enables the physician to keep airway pressures under strict limits by presetting inspiratory and expiratory pressures, and cycle times. PCV results in a square-waved airway pressure and a decelerating inspiratory gas flow holding the alveoli inflated for the preset time. Preset pressures and cycle times, and respiratory system mechanics affect alveolar and intrinsic positive end-expiratory (PEEPi) pressures, tidal volume, total minute, and alveolar ventilation. When compared with flow-controlled, time-cycled (‘volume-controlled’) ventilation, PCV results in reduced peak airway pressures, but higher mean airway. Homogeneity of regional peak alveolar pressure distribution within the lung is improved. However, no consistent data exist, showing PCV to improve patient outcome. During inverse ratio ventilation (IRV) elongation of inspiratory time increases mean airway pressure and enables full lung inflation, whereas shortening expiratory time causes incomplete lung emptying and increased PEEPi. Both mechanisms increase mean alveolar and transpulmonary pressures, and may thereby improve lung recruitment and gas exchange. However, when compared with conventional mechanical ventilation using an increased external PEEP to reach the same magnitude of total PEEP as that produced intrinsically by IRV, IRV has no advantage. Airway pressure release ventilation (APRV) provides a PCV-like squared pressure pattern by time-cycled switches between two continuous positive airway pressure levels, while allowing unrestricted spontaneous breathing in any ventilatory phase. Maintaining spontaneous breathing with APRV is associated with recruitment and improved ventilation of dependent lung areas, improved ventilation-perfusion matching, cardiac output, oxygenation, and oxygen delivery, whereas need for sedation, vasopressors, and inotropic agents and duration of ventilator support decreases.

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Venet, Fabienne, et Alain Lepape. Immunoparesis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0313.

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In parallel with an exaggerated pro-inflammatory response, critically-ill patients develop an immunosuppressive phase, termed immunoparesis/immunoparalysis or immune reprogramming. Innate and adaptive immune responses are affected. In particular, impaired neutrophil recruitment to injury sites and abnormal accumulation in remote sites; monocyte deactivation with preferential anti-inflammatory cytokine production and altered antigen presentation capacity; and a dramatic lymphopenia associated with major induction of apoptosis, functional, and phenotypic alterations have been described. The intensity and duration of this injury-induced immune dysfunction have been associated with an increased risk of death and secondary nosocomial infections. Innovative therapeutic strategies aiming at restoring immunological functions are currently being tested. GM-CSF appears to be an interesting candidate while IFN-γ‎ and IL-7 represent novel future therapeutic approaches. There is thus an urgent need for further clinical trials of such immunoadjuvant therapies that should include large cohorts of critically-ill patients stratified by relevant markers of immune dysfunction.

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Hartley, Nigel. Volunteering and the challenges of change. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198788270.003.0013.

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Hospice leaders in the UK seem to fear that volunteers will respond disruptively to change. This chapter poses a number of questions around the challenges of change in volunteer development in hospices It considers how to introduce to facilitate new and necessary models of recruitment, training and education programmes arguing that renegotiating terms and conditions with hospice volunteers while rearticulating expectations is crucial if hospices are to continue to be relevant in a new world of health and social care. We regularly hear about the key role volunteers have brought to the success of the modern hospice movement and of the importance Cicely Saunders attached to involving volunteers even before the first patients were admitted to St Christopher’s Hospice in Sydenham in 1967.

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Cuartero, Mireia, et Niall D. Ferguson. High-frequency ventilation and oscillation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0098.

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High-frequency oscillatory ventilation (HFOV) is a key member of the family of modes called high-frequency ventilation and achieves adequate alveolar ventilation despite using very low tidal volumes, often below the dead space volume, at frequencies significantly above normal physiological values. It has been proposed as a potential protective ventilatory strategy, delivering minimal alveolar tidal stretch, while also providing continuous lung recruitment. HFOV has been successfully used in neonatal and paediatric intensive care units over the last 25 years. Since the late 1990s adults with acute respiratory distress syndrome have been treated using HFOV. In adults, several observational studies have shown improved oxygenation in patients with refractory hypoxaemia when HFOV was used as rescue therapy. Several small older trials had also suggested a mortality benefit with HFOV, but two recent randomized control trials in adults with ARDS have shed new light on this area. These trials not show benefit, and in one of them a suggestion of harm was seen with increased mortality for HFOV compared with protective conventional mechanical ventilation strategies (tidal volume target 6 mL/kg with higher positive end-expiratory pressure). While these findings do not necessarily apply to patients with severe hypoxaemia failing conventional ventilation, they increase uncertainty about the role of HFOV even in these patients.

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Knowledge and access to information on recruitment of underrepresented populations to cancer clinical trials. Rockville, MD : Agency for Healthcare Research and Quality, 2005.

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Payne, Sheila, et Sara Morris. The modern context of palliative care. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198788270.003.0002.

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Evidence suggests that in the past support services for patients and family carers of terminally ill people have often been unavailable or inadequate in addressing their needs. This chapter will briefly summarize the context of hospice and palliative care services. The chapter argues that definitions of palliative care are culturally and temporally dependent, exemplified by the changing terminology used in the United Kingdom. One of the challenges facing service deliverers is the necessity to work collaboratively across health and social care services, and statutory and voluntary sector organizational boundaries. The funding and organizational positioning of hospice and palliative care services are often contingent upon health care systems and resources. All roles require careful recruitment, dedicated training, and consistent support to provide effective contributions from volunteers. The chapter ends by providing a short description of three studies investigating the role of volunteers undertaken in the United Kingdom.

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Ware, Lorraine B. Pathophysiology of acute respiratory distress syndrome. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0108.

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The acute respiratory distress syndrome (ARDS) is a syndrome of acute respiratory failure characterized by the acute onset of non-cardiogenic pulmonary oedema due to increased lung endothelial and alveolar epithelial permeability. Common predisposing clinical conditions include sepsis, pneumonia, severe traumatic injury, and aspiration of gastric contents. Environmental factors, such as alcohol abuse and cigarette smoke exposure may increase the risk of developing ARDS in those at risk. Pathologically, ARDS is characterized by diffuse alveolar damage with neutrophilic alveolitis, haemorrhage, hyaline membrane formation, and pulmonary oedema. A variety of cellular and molecular mechanisms contribute to the pathophysiology of ARDS, including exuberant inflammation, neutrophil recruitment and activation, oxidant injury, endothelial activation and injury, lung epithelial injury and/or necrosis, and activation of coagulation in the airspace. Mechanical ventilation can exacerbate lung inflammation and injury, particularly if delivered with high tidal volumes and/or pressures. Resolution of ARDS is complex and requires coordinated activation of multiple resolution pathways that include alveolar epithelial repair, clearance of pulmonary oedema through active ion transport, apoptosis, and clearance of intra-alveolar neutrophils, resolution of inflammation and fibrinolysis of fibrin-rich hyaline membranes. In some patients, activation of profibrotic pathways leads to significant lung fibrosis with resultant prolonged respiratory failure and failure of resolution.

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Banerjee, Amitava, et Kaleab Asrress. Screening for cardiovascular disease. Sous la direction de Patrick Davey et David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0351.

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Screening involves testing asymptomatic individuals who have risk factors, or individuals who are in the early stages of a disease, in order to decide whether further investigation, clinical intervention, or treatment is warranted. Therefore, screening is classically a primary prevention strategy which aims to capture disease early in its course, but it can also involve secondary prevention in individuals with established disease. In the words of Geoffrey Rose, screening is a ‘population’ strategy. Examples of screening programmes are blood pressure monitoring in primary care to screen for hypertension, and ultrasound examination to screen for abdominal aortic aneurysm. The effectiveness and feasibility of screening are influenced by several factors. First, the diagnostic accuracy of the screening test in question is crucial. For example, exercise ECG testing, although widely used, is not recommended in investigation of chest pain in current National Institute for Health and Care Excellence guidelines, due to its low sensitivity and specificity in the detection of coronary artery disease. Moreover, exercise ECG testing has even lower diagnostic accuracy in asymptomatic patients with coronary artery disease. Second, physical and financial resources influence the decision to screen. For example, the cost and the effectiveness of CT coronary angiography and other new imaging modalities to assess coronary vasculature must be weighed against the cost of existing investigations (e.g. coronary angiography) and the need for new equipment and staff training and recruitment. Finally, the safety of the investigation is an important factor, and patient preferences and physician preferences should be taken into consideration. However, while non-invasive screening examinations are preferable from the point of view of patients and clinicians, sometimes invasive screening tests may be required at a later stage in order to give a definitive diagnosis (e.g. pressure wire studies to measure fractional flow reserve in a coronary artery). The WHO’s principles of screening, first formulated in 1968, are still very relevant today. Decision analysis has led to ‘pathways’ which guide investigation and treatment within screening programmes. There is increasing recognition that there are shared risk factors and shared preventive and treatment strategies for vascular disease, regardless of arterial territory. The concept of ‘vascular medicine’ has gained credence, leading to opportunistic screening in other vascular territories if an individual presents with disease in one territory. For example, post-myocardial infarction patients have higher incidence of cerebrovascular and peripheral arterial disease, so carotid duplex scanning and measurement of the ankle–brachial pressure index may be valid screening approaches for arterial disease in other territories.

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Burns, Tom, et Mike Firn. Operational and team management. Sous la direction de Tom Burns et Mike Firn. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198754237.003.0026.

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Outreach in community mental health is a complex and labour-intensive activity that relies on coordination, communication, and clear procedures. This chapter looks at team systems and processes in a typical week that help ensure a safe, efficient, patient-centred, equitable, and timely service that has effective outcomes. Leadership, accountability, and responsibility frameworks are explored, and strategies for the effective recruitment, selection, and supervision of staff discussed. Role functions within the multidisciplinary team—such as team leader, psychiatrist, and case manager—are explained, and a typical weekly schedule for a team presented. Effective communication and coordination strategies are discussed, including the format and functions of the handover and review meetings.

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Heinrich, Paul. The role of the actor in medical education. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198736134.003.0055.

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The role of standardized or simulated patient, whether played by professional actor or lay member of the public, is an acting role, requiring at least a basic level of acting. This chapter proposes a taxonomy of five different modes of performance in medical education, namely, assessment, audit, experiential learning, demonstration, and instruction. Each role play mode comprises three players—actor, role-player, and educator—who work together in what might be called a simulation triad. Each mode leads to a distinctive mode of performance, which determines the roles and relationships within the simulation triad, and the nature of the decisions that need to be made in relation to recruitment, training, performance, and feedback. It is hoped that this proposed taxonomy of performance may contribute to clarification for the future development of medical simulation.

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