This book covers competing risks and multistate models, sometimes summarized as event history analysis. These models generalize the analysis of time to a single event (survival analysis) to analysing the timing of distinct terminal events (competing risks) and possible intermediate events (multistate models). Both R and multistate methods are promoted with a focus on nonparametric methods.
This book, part of the European Society of Intensive Care Medicine textbook series, provides detailed up-to-date information on the physical, cognitive, and psychological impairments that are frequently present following a stay in an intensive care unit and examines in depth the available preventive and therapeutic strategies, including adapted rehabilitation programs. Beyond acquainting readers with the multiple facets of post-intensive care syndrome (PICS), the book aims to promote the effective follow-up of patients, thereby enhancing their ability to work and their functional autonomy, and to identify risk factors for the development of PICS as a stimulus to beneficial organizational changes in intensive care departments. The background to the book is the realization by healthcare providers that the quality of life of patients who have required a stay in an intensive care unit can be severely impaired or even become unacceptable. All too often, the diverse sequelae are overlooked by specialists of other disciplines. Moreover, families and caregivers are also at high risk of post-traumatic stress disorder and depression. The European Society of Intensive Care Medicine has developed the Lessons from the ICU series with the vision of providing focused and state-of-the-art overviews of central topics in Intensive Care and optimal resources for clinicians working in Intensive Care. This book, written by renowned experts in the field, will facilitate the transmission of key knowledge with significant clinical and financial benefits.
This book identifies trends in critical care medicine that will form the basis for practice over the next ten years. Predicting the future is always risky. Nevertheless, the ideas articulated in this book are likely to serve as a road map for intensivists, hospital administrators, and governmental leaders interested in healthcare as they seek to improve the quality and efficiency of hospital-based services.
Aneurysmal subarachnoid hemorrhage (aSAH) still represents a significant cause of morbidity and mortality around the world and its outcome can be dramatically impacted by early and expert care. SAH treatment comprises early neurosurgical or endovascular treatment of the ruptured aneurysm, strategies to reduce further neurological injury, and managing systemic complications. In fact, management of aSAH is a multidisciplinary issue and the current state of knowledge is in rapid evolution. Nevertheless, the guidelines are not up to date. The last American aSAH guidelines were issued in 2012 and covered literature up until May 2010, and in 2013 members of the Guidelines Committee of the European Stroke Organization reviewed them from a European standpoint. Since then, considerable advances have been made in diagnostic methods, surgical and endovascular techniques, and clinical management paradigms. Subarachnoid hemorrhage is still a relevant health problem and, although its incidence varies among populations, a quarter of patients affected by aSAH die and approximately half of survivors are left with some persistent neurological deficit. Taking into account the fact that the prognosis of aSAH patients is affected by multiple factors and that some of them can be influenced by therapeutic strategies and management procedures, we believe that there is a need to reassess which interventions provide the greatest benefit to patients.
Measuring the quality of a complex service like critical care that combines the highest technology with the most intimate caring is a challenge. Recently, con sumers, clinicians, and payers have requested more formal assessments and comparisons of the quality and costs of medical care [2). Donabedian [1) pro posed a framework for thinking about the quality of medical care that separates quality into three components: structure, process, and outcome. An instructive analogy for understanding this framework is to imagine a food critic evaluating the quality of a restaurant. The critic might comment on the decoration and lighting ofthe restaurant, how close the tables are to each other, the extent ofthe wine list and where the chef trained. These are all evaluations of the restaurant structure. In addition, the critic might comment on whether the service was courteous and timely - measures of process. Finally, the critic might comment on outcomes like customer satisfaction or food poisoning. Similarly, to a health care critic, structure is the physical and human resources used to deliver medi cal care. Processes are the actual treatments offered to patients. Finally,outcomes are what happens to patients, for example, mortality, quality of life,and satisfac tion with care (Table 1). There is a debate about which of these measurements is the most important measure of quality.
"This 2nd edition of Critical care nephrology continues to provide comprehensive coverage of the latest advances in critical care procedures for the adult or pediatric patient with renal diseases or disorders. It presents a common language and standardized guidelines to help multi-disciplinary physicians caring for the critically ill communicate more effectively. "--BOOK JACKET.
This simple idea will not be the one thing that turns you into the best lover she ever had. But, this little 30-Second trick can be extremely helpful in extending sexual intercourse (as a treatment for men with premature ejaculation (pe in men) or for those without pe who just want to extend lovemaking for an outrageously long time). Use it as a stand-alone technique or in combination with other tantric or medical ideas. Dr. Runels, the inventor of the P-Shot® procedure and the author of this book, has been treating sexual dysfunction in both men and women for three decades and has trained over 5,000 physicians in 56 countries. In one survey, this method was found to improve sexual stamina in 83% of the men who deploy the technique.
