More than ever, society faces painful choices in the allocation of resources for health care. How it makes these choices, and how wise they are, will determine the quality and character of health care for years to come. David Mechanic examines existing and impending dilemmas the American health care system must manage as it confronts these choices. He explores conceptual approaches to health and health care, showing how these translate into research, and defines a strategy for informed choice. The result is a masterful volume by one of our leading medical sociologists at the peak of his career. Mechanic looks at the continuing emphasis on biomedical technology in the context of growing economic, constraints, as medical care becomes more expensive and demands become greater. He examines the discrepancy between public expectations and how health care is actually provided, and points out increasing discordance between demographic trends and disease patterns and the medical system's emphasis on acute care. Of particular concern is the enormous gap between entitlements for medical care and the increasing need for long-term care. This gap is of particular concern because of the United States's enormous investment in health care, which now consumes 11 percent of the Gross National Product, Although there is no particular consensus on what is an appropriate level of investment in health, policymakers are impatient with the medical system's apparent inability to control costs, and are concerned as well about the competition for resources between health and other sectors. Mechanic examines new trends, such as managed care, and transformation of the role of those who provide health care from patient advocates to allocators of services-a crucial distinction. The choices that will have to be made in the next decades are difficult They will also be painful, but they are inevitable. The key challenge will be to respond to the anxieties of the 37 million uninsured children and adults, the growing numbers of frail elderly, and the needs of patients with serious mental illness and other chronic disabilities. All of this must be accomplished while maintaining a high level of service for the rest of the population, and without breaking the bank. To achieve this, Mechanic argues, health services must be shaped to enhance function and quality of life, and not simply in response to technological imperatives. In its profound understanding of the social and political context, in which competitive initiative, the growth of regulation, new health care systems, and approaches for making research sensitive to patients are all evident, "Painful Choices "provides a framework for responsive and meaningful policy analysis.
Inescapable Decisions" examines the disarray in the American health care system and proposes major corrective strategies. Mechanic shows that the high-technology interventionist type of medicine commonly practiced in the United States has lost its sense of priorities and balance. Expensive and sometimes dangerous procedures of unknown efficacy are used excessively and often inappropriately, while many basic preventive and primary care services remain unavailable to those who need them the most. This incredibly complex system of care operates in an environment of heavy-landed rules and regulations and enormous waste of resources.
From Popular Mechanics (9.6 million readers every month), the hands-down experts on the subject of how things work, comes the most complete and up-to-date DIY guide ever published. This highly sophisticated household manual will instantly become the gold standard for anybody who fixes anything. Filled with color photos, drawings, and diagrams, this encyclopedic how-to covers every area of concern to house and apartment owners, with information on planning ahead; decorating; repairs and improvements; security; infestation, rot, and d& electricity; plumbing; heating; outdoor care; and tools and skills. And it’s easy to find the solution to the particular problem that concerns you, without having to go from page to page of continuous text: the straightforward design breaks down the subjects into clearly defined, color-coded chapters. So whether you’re looking for advice on applying finishes, adding decorative paint effects, constructing walls, fixing the roof, or installing a burglar alarm, the instructions are here. • National Publicity • Cross Marketing on the Website, PM zone • Featured in PM’s “Great Stuff Column” • Featured in PM E-Newsletter (125,000 subscribers) • Included in PM “Wish List for Guys” Gift Registry • Advertising in PM Magazine
Introduction to Continuum Mechanics is a recently updated and revised text which is perfect for either introductory courses in an undergraduate engineering curriculum or for a beginning graduate course. Continuum Mechanics studies the response of materials to different loading conditions. The concept of tensors is introduced through the idea of linear transformation in a self-contained chapter, and the interrelation of direct notation, indicial notation, and matrix operations is clearly presented. A wide range of idealized materials are considered through simple static and dynamic problems, and the book contains an abundance of illustrative examples of problems, many with solutions. Serves as either a introductory undergraduate course or a beginning graduate course textbook. Includes many problems with illustrations and answers.
The United States spends greatly more per person on health care than any other country but the evidence shows that care is often poor and inappropriate. Despite expenditures of 1.7 trillion dollars in 2003, and growing substantially each year, services remain fragmented and poorly coordinated, and more than 46 million people are uninsured. Why can't America, with its vast array of resources, sophisticated technologies, superior medical research and educational institutions, and talented health care professionals, produce higher quality care and better outcomes? In The Truth about Health Care, David Mechanic explains how health care in America has evolved in ways that favor a myriad of economic, professional, and political interests over those of patients. While money has always had a place in medical care, "big money" and the quest for profits has become dominant, making meaningful reforms difficult to achieve. Mechanic acknowledges that railing against these influences, which are here to stay, can achieve only so much. Instead, he asks whether it is possible to convert what is best about health care in America into a well functioning system that better serves the entire population. Bringing decades of experience as an active health policy participant, researcher, teacher, and consultant to the public and private sectors, Mechanic examines the strengths and weaknesses of our system and how it has evolved. He pays special attention to areas often neglected in policy discussions, such as the loss of public trust in medicine, the tragic state of long-term care, and the relationship of mental health to health care. For anyone who has been frustrated by uncoordinated health networks, insurance denials, and other obstacles to obtaining appropriate care, this book will provide a refreshing and frank look at the system's current and future dilemmas. Mechanic's thoughtful roadmap describes how health plans, healthcare professionals, policymakers, and consumer groups can work together to improve access, quality, fairness, and health outcomes in America. About the Author:
Helps students improve their problem solving skills by supplementing standard introductory-level texts. Features step-by-step worked solutions to over 220 mechanics problems.
Written with the aim of broadening the subject base, this book focuses on those areas where topics in mechnaical, aeronautical and civil engineering employ common principles. Theoretical topics in solid mechanics are illustrated through many worked examples and exercises chosen to assist the reader in recognising the necessary problem solving techniques. The book is therefore suitable for both single discipline and broad-based courses that include mechanics as applied in engineering and design. The underlying theme is to show how the load carrying capacity of materials and structures used in engineering may be determined.
Fluid mechanics, the study of how fluids behave and interact under various forces and in various applied situations—whether in the liquid or gaseous state or both—is introduced and comprehensively covered in this widely adopted text. Revised and updated by Dr. David Dowling, Fluid Mechanics, 5e is suitable for both a first or second course in fluid mechanics at the graduate or advanced undergraduate level. Along with more than 100 new figures, the text has been reorganized and consolidated to provide a better flow and more cohesion of topics. Changes made to the book's pedagogy in the first several chapters accommodate the needs of students who have completed minimal prior study of fluid mechanics. More than 200 new or revised end-of-chapter problems illustrate fluid mechanical principles and draw on phenomena that can be observed in everyday life
Exploring the mechanical features of biological cells, including their architecture and stability, this textbook is a pedagogical introduction to the interdisciplinary fields of cell mechanics and soft matter physics from both experimental and theoretical perspectives. This second edition has been greatly updated and expanded, with new chapters on complex filaments, the cell division cycle, the mechanisms of control and organization in the cell, and fluctuation phenomena. The textbook is now in full color which enhances the diagrams and allows the inclusion of new microscopy images. With around 280 end-of-chapter exercises exploring further applications, this textbook is ideal for advanced undergraduate and graduate students in physics and biomedical engineering. A website hosted by the author contains extra support material, diagrams and lecture notes, and is available at www.cambridge.org/Boal.
The essential "tool" to help drivers get through any car-related situation, from a simple mechanical problem to a full-blown crisis, "Nutz and Boltz Automotive Survival Guide" includes tips on how to handle brake failures, blowouts, breakdowns, car jackings, car fires, engine maintenance, road-trip preparations, and more. 20 line drawings.
Monster, pickup, flatbed, tank � trucks have so many important functions! This informative book gives readers an inside look at the mechanics of trucks. Detailed illustrations with clear labels and accessible language break down complex principles, systems, and parts so that readers can easily process this fascinating material. They�ll love learning about the engineering behind these incredible vehicles, and gain an appreciation for modern machinery and how it has evolved over time with advances in technology. This visually rich approach to a high-interest subject will draw in even reluctant readers.
This textbook offers an introductory course to structural mechanics for architects, including problems and solutions. It follows a completely different approach to structural mechanics than the usual books for engineering schools, making it much more attractive for architecture students and practitioners. It also offers a different point of view for engineering students, as it provides them with a more intuitive understanding of structural mechanics and the models therein.Instead of studying the classical theory of linear elasticity and then particularizing it to simple structures, this book analyzes structures in a historic and also typological order. The book starts with cable structures and stone arches, followed by trusses and, finally, frame structures made of beams. For every typology, the latest, state-of-the-art theory in the field is introduced in a very didactic way.
This book assembles 21 essays on the history of mechanics and mathematical physics written by David Speiser. Covering a period from the beginning of the seventeenth century to the eighteenth, the essays discuss developments in elasticity, rigid bodies, gravitation, the principle of relativity, optics, and first principles. They examine the work of Galileo, Huygens, Newton, Leibniz, the Bernoullis, Euler, Maupertuis, and Lambert.
This book, which has only one very distant forerunner authored by David A. Hills with David Nowell, represents a very big step that is the quantification of these problems and represents the twenty-five years’ worth of work which have gone on at Oxford since the first book on the subject. Fatigue (popularly ‘metal fatigue’) is the primary failure mode of all machines, engines, transmissions and indeed almost all mechanical devices. The propagation of cracks is well understood and is treated in the subject Fracture Mechanics. By contrast, the nucleation of cracks is very hard to quantify and this remains the case with so-called ‘free initiation’ and, to a lesser extent, at cracks nucleated from stress raising features. But the third form of nucleation, where cracks start from the edges of rubbing components, that is, at joints, is potentially a very much better-defined environment, and therefore, the problem is amendable to attack by applied mechanics and experiment. The contents are of value both to those embarking on research on the subject and to practitioner in industry.
This text is adressed to professional engineers, offering a broad introduction to the principal themes of continuum mechanics and structural dynamics. This edition includes a greater focus on worked examples, problems and solutions to engage the reader.
Fracture mechanics is an interdisciplinary subject that predicts the conditions under which materials fail due to crack growth. It spans several fields of interest including: mechanical, civil, and materials engineering, applied mathematics and physics. This book provides detailed coverage of the subject not commonly found in other texts.Analytical Fracture Mechanics contains the first analytical continuation of both stress and displacement across a finite-dimensional, elastic-plastic boundary of a mode I crack problem. The book provides a transition model of crack tip plasticitythat has important implications regarding failure bounds for the mode III fracture assessment diagram. It also presents an analytical solution to a true moving boundary value problem for environmentally assisted crack growth and a decohesion model of hydrogen embrittlement that exhibits all three stages of steady-state crack propagation.The text will be of great interest to professors, graduate students, and other researchers of theoretical and applied mechanics, and engineering mechanics and science. Presents the only analytical proven solution technique amenable to the second-order nonlinear partial differential equation governing a mode I elastoplastic crack problem Places emphasis on the near crack tip partial differential equations governing plasticity and process zone theory in environmental cracking phenomena Provides fundamental solutions of linear elastic fracture mechanics Explains how transport-controlled stage II environmental crack growth can be mapped onto the classic Stefan problem Predicts failure curves on fracture assessment diagram for mode III crack problem as transition occurs from plastic strip to finite-dimensional plastic zone Gives a summary of pertinent equations of linear elasticity and plasticity
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