The autonomic nervous system plays a crucial role in the cardiovascular response to acute (dynamic) exercise in animals and humans. During exercise, oxygen uptake is a function of the triple-product of heart rate and stroke volume (i.e., cardiac output) and arterial-mixed venous oxygen difference (the Fick principle). The degree to which each of the variables can increase determines maximal oxygen uptake (). Both “central command” and “the exercise pressor reflex” are important in determining the cardiovascular response and the resetting of the arterial baroreflex during exercise to precisely match systemic oxygen delivery with metabolic demand. In general, patients with autonomic disorders have low levels of , indicating reduced physical fitness and exercise capacity. Moreover, the vast majority of the patients have blunted or abnormal cardiovascular response to exercise, especially during maximal exercise. There is now convincing evidence that some of the protective and therapeutic effects of chronic exercise training are related to the impact on the autonomic nervous system. Additionally, training induced improvement in vascular function, blood volume expansion, cardiac remodeling, insulin resistance and renal-adrenal function may also contribute to the protection and treatment of cardiovascular, metabolic and autonomic disorders. Exercise training also improves mental health, helps to prevent depression, and promotes or maintains positive self-esteem. Moderate-intensity exercise at least 30 minutes per day and at least 5 days per week is recommended for the vast majority of people. Supervised exercise training is preferable to maximize function capacity, and may be particularly important for patients with autonomic disorders.
The American electric utility system is quietly falling apart. Once taken for granted, the industry has become increasingly unstable, fragmented, unreliable, insecure, inefficient, expensive, and harmful to our environment and public health. According to Sovacool, the fix for this ugly array of problems lies not in nuclear power or clean coal, but in renewable energy systems that produce few harmful byproducts, relieve congestion on the transmission grid, require less maintenance, are not subject to price volatility, and enhance the security of the national energy system from natural catastrophe, terrorist attack, and dependence on supply from hostile and unstable regions of the world. Here arises The Dirty Energy Dilemma: If renewable energy systems deliver such impressive benefits, why are they languishing at the margins of the American energy portfolio? And why does the United States lag so far behind Europe, where conversion to renewable energy systems has already taken off in a big way? Corporate media parrot industry PR that renewable technologies just aren't ready for prime time. But Sovacool marshals extensive field research to show that the only barrier blocking the conversion of a significant proportion of the U.S. energy portfolio to renewables is not technological—the technology is there—but institutional. Public utility commissioners, utility managers, system operators, business owners, and ordinary consumers are hobbled by organizational conservatism, technical incompatibility, legal inertia, weak and inconsistent political incentives, ill-founded prejudices, and apathy. The author argues that significant conversion to technologically proven clean energy systems can happen only if we adopt and implement a whole new set of policies that will target and dismantle the insidious social barriers that are presently blocking decisions that would so obviously benefit society.
An exploration of commercially available technologies that can enhance energy security and address climate change and public policy options crucial to their adoption. Tackling climate change and improving energy security are two of the twenty-first century's greatest challenges. In this book, Marilyn Brown and Benjamin Sovacool offer detailed assessments of the most advanced commercially available technologies for strengthening global energy security, mitigating the effects of climate change, and enhancing resilience through adaptation and geo-engineering. They also evaluate the barriers to the deployment of these technologies and critically review public policy options crucial to their adoption. Arguing that society has all the technologies necessary for the task, Brown and Sovacool discuss an array of options available today, including high-efficiency transportation, renewable energy, carbon sequestration, and demand-side management. They offer eight case studies from around the world that document successful approaches to reducing emissions of greenhouse gases and improving energy security. These include the Danish approach to energy policy and wind power, Brazil's ethanol program, China's improved cookstove program; and the U.S. Toxics Release Inventory. Brown and Sovacool argue that meeting the twin challenges of climate change and energy security will allow us to provide energy, maintain economic growth, and preserve the natural environment—without forcing tradeoffs among them.
Intensive Care Unit Manual is a practical, hands-on, how-to manual that covers the full spectrum of conditions encountered in the ICU, guiding you step-by-step from your initial approach to the patient through diagnosis and treatment. Compact, affordable, and comprehensive, the ICU Manual puts all the critical care information you need right at your fingertips! Stay at the forefront of critical care with a practice-oriented, relevant, and well-illustrated account of the pathophysiology of critical disease, presented in a highly readable format. Gain valuable insight into the recognition, evaluation, and management of critical conditions such as respiratory, hemodynamic, and infectious diseases; management of ICU patients with special clinical conditions; cardiovascular, hematologic, and neurological disorders; poisoning and overdoses; trauma and burns; and much more! Grasp the latest developments in critical care with extensive updates and revisions to several key chapters, as well as brand-new chapters on Alcohol Withdrawal Syndromes; Acute Heart Failure Syndromes; Noninvasive Ventilation; and more ICU conditions. Understand and apply the most important ICU practices, including management of acute respiratory failure, mechanical ventilation, invasive hemodynamic monitoring, and the care of patients with special needs, AIDS, end-stage renal disease, or end-stage liver disease. Get convenient access to the full text and image library online at Expert Consult, in addition to online-only text, figures, and tables from the Alcohol Withdrawal Syndromes and Acute Heart Failure Syndromes chapters.
From the author of Day of Reckoning, the acclaimed critique of Ronald Reagan’s economic policy (“Every citizen should read it,” said The New York Times): a persuasive, wide-ranging argument that economic growth provides far more than material benefits. In clear-cut prose, Benjamin M. Friedman examines the political and social histories of the large Western democracies–particularly of the United States since the Civil War–to demonstrate the fact that incomes on the rise lead to more open and democratic societies. He explains that growth, rather than simply a high standard of living, is key to effecting political and social liberalization in the third world, and shows that even the wealthiest of nations puts its democratic values at risk when income levels stand still. Merely being rich is no protection against a turn toward rigidity and intolerance when a country’s citizens lose the sense that they are getting ahead. With concrete policy suggestions for pursuing growth at home and promoting worldwide economic expansion, this volume is a major contribution to the ongoing debate about the effects of economic growth and globalization.
This comprehensive resource is edited by experts at the Mayo Clinic--a world-renowned center for echocardiography. In this revision, the editors plan to incorporate new imaging strategies in the diagnosis of congenital heart disease in both peds and adult populations. In particular, more detail on 3-D echo, information on the proper usage of TEE, and the increasing importance of followup MRI will be presented. Based on reviewer comments, the editors will include more MRI angiograms, more detailed information on prosthetic valve and posttransplant care, and more correlative anatomic examples in relevant chapters.
Environmental harm is commonly associated with companies that extract, consume, and pollute our shared natural resources. Rarely are the 'unseen polluters,' the financiers that sponsor and profit from eco-damaging corporations, placed at the forefront of the environmental debate. By focusing on these unseen polluters, Benjamin Richardson provides a comprehensive examination of socially responsible investment (SRI), and offers a guide to possible reform. Richardson proposes that greater regulatory supervision of SRI will help ensure that the financial sector prioritizes ethically-based investments. In Socially Responsible Investment Law, he suggests that new governmental reforms should encourage companies to participate in socially responsible investments by providing a better mix of standards and incentives for SRI through measures that include redefining the fiduciary responsibilities of institutional investors to incorporate environmental concerns. By doing so, Richardson posits that corporate financiers, including banks, hedge funds, and pension plans, will become more accountable to the goals of ensuring sustainable development.
Avoiding Common Prehospital Errors, will help you develop the deep understanding of common patient presentations necessary to prevent diagnostic and treatment errors and to improve outcomes. Providing effective emergency care in the field is among the most challenging tasks in medicine. You must be able to make clinically vital decisions quickly, and perform a wide range of procedures, often under volatile conditions. Written specifically for the prehospital emergency team, this essential volume in the Avoiding Common Errors Series combines evidence-based practice with well-earned experience and best practices opinion to help you avoid common errors of prehospital care. Look inside and discover... • Concise descriptions of each error are followed by insightful analysis of the “hows” and “whys” underlying the mistake, and clear descriptions of ways to avoid such errors in the future. • “Pearls” highlighted in the text offer quick vital tips on error avoidance based on years of clinical and field experience. • Focused content emphasizes "high impact" areas of prehospital medicine, including airway management, cardiac arrest, and respiratory and traumatic emergencies.
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