It is a measure of the rapidity of the changes The work has been revised and updated, and taking place in the food industry that yet another following the logic of the flow sheets there is some edition of the Food Industries Manual is required simplification and rearrangement among the chap after a relatively short interval. As before, it is a ters. Food Packaging now merits a separate pleasure to be involved in the work and we hope chapter and some previous sections dealing mainly that the results will continue to be of value to with storage have been expanded into a new readers wanting to know what, how and why the chapter covering Food Factory Design and Opera food industry does the things which it does. tions. For this edition we have made a major depar There is one completely new chapter, entitled ture from the style of earlier editions by comple Alcoholic Beverages, divided into Wines, Beers tely revising the layout of many of the chapters. and Spirits. There is a strain of thought which Previously the chapters were arranged as a series does not yet consider the production of those of notes on specific topics, set out in alphabetical drinks to be a legitimate part of the food industry, order in the manner of an encyclopaedia.
Neoliberalism has been the defining paradigm in global health since the latter part of the twentieth century. What started as an untested and unproven theory that the creation of unfettered markets would give rise to political democracy led to policies that promoted the belief that private markets were the optimal agents for the distribution of social goods, including health care. A vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs, this case study, set in post-Soviet Tajikistan’s remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine a "revolving drug fund" program—used by numerous nongovernmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities. Provocative, rigorous, and accessible, Blind Spot offers a cautionary tale about the forces driving decision making in health and development policy today, illustrating how the privatization of health care can have catastrophic outcomes for some of the world’s most vulnerable populations.
Born in 1875, the German lyric poet Rainer Maria Rilke published his first collection of poems in 1898 and went on to become renowned for his delicate depiction of the workings of the human heart. These translations by M.D. Herter Norton offer Rilke's work to the English-speaking world in an accurate, sensitive, modern version.
The term ‘visual perception’ covers a very wide range of psychological functions. This title, originally published in 1970, which provides a broad survey of this vast field of knowledge, would have proved a valuable general account for students taking degree courses in psychology at the time. Professor Vernon examines a large number of experiments carried out over the previous twenty years, their findings, the conclusions drawn from them, and – equally important – the still unanswered questions which some of them raised. As the title suggests, Professor Vernon considers that – while much knowledge of the simpler perceptual processes had been gained in laboratory experiments – perhaps too little investigation had been undertaken into the more complex processes which normally determine understanding of and response to environment: the processes of identification and classification that depend to a considerable extent on learning, memory, attention, reasoning and language. An extensive bibliography is provided.
Since Dr. Brizendine wrote The Female Brain ten years ago, the response has been overwhelming. This New York Times bestseller has been translated into more than thirty languages, has sold nearly a million copies between editions, and has most recently inspired a romantic comedy starring Whitney Cummings and Sofia Vergara. And its profound scientific understanding of the nature and experience of the female brain continues to guide women as they pass through life stages, to help men better understand the girls and women in their lives, and to illuminate the delicate emotional machinery of a love relationship. Why are women more verbal than men? Why do women remember details of fights that men can’t remember at all? Why do women tend to form deeper bonds with their female friends than men do with their male counterparts? These and other questions have stumped both sexes throughout the ages. Now, pioneering neuropsychiatrist Louann Brizendine, M.D., brings together the latest findings to show how the unique structure of the female brain determines how women think, what they value, how they communicate, and who they love. While doing research as a medical student at Yale and then as a resident and faculty member at Harvard, Louann Brizendine discovered that almost all of the clinical data in existence on neurology, psychology, and neurobiology focused exclusively on males. In response to the overwhelming need for information on the female mind, Brizendine established the first clinic in the country to study and treat women’s brain function. In The Female Brain, Dr. Brizendine distills all her findings and the latest information from the scientific community in a highly accessible book that educates women about their unique brain/body/behavior. The result: women will come away from this book knowing that they have a lean, mean, communicating machine. Men will develop a serious case of brain envy.
Food—We all need it and we all want it. We want it delicious, and ideally not toxic. But how the heck do we make sense of the choices paraded before us, when the so-called experts can’t agree and the guidelines change from day to day? Recommendations based on simple, sterile laboratory analysis of one nutrient, one effect, have no place in the pantheon of science… nor the pantry of any respectable chef. Michael S. Fenster, MD, interventional cardiologist, and professional chef, separates fact from fiction and wheat from chaff. Invoking the power of the total Food Experience that every chef and food lover understands, he helps diners focus on what they’re eating in a powerful explosion of ceremony and substance. As the Food Shaman, Chef Dr. Mike combines modern knowledge from a variety of disciplines with the ancient ritual of the first chefs and healers: the shaman. The result is a quantum leap in understanding the power of the Food Experience, and why it must nurture our soul through delightful tastes and textures beyond basic nutrition.
This highly anticipated new edition brings together an expert group of authors to provide a comprehensive, systematic resource on genetic diseases of the eye. This richly illustrated title covers areas such as: malformations; refractive errors, the cornea, glaucoma and cataracts; retina and the optic nerve; eye movement disorders, and systemic disease of the eye. The new edition remains grounded in a sound clinical approach to the patient with a genetic disease that affects the eye. Oxford Genetics is a comprehensive, cross-searchable collection of resources offering quick and easy access to Oxford University Press's prestigious genetics texts. Joining Oxford Medicine Online these resources offer students, specialists and clinical researchers the best quality content in an easy-to-access format. Online only benefits include downloading images and figures to PowerPoint and downloading chapters to PDF.
Libraries facing diminished budgets and increased demand for innovative services need to explore all potential funding sources, including the more than six billion dollars that are available in annual foundation and corporate giving. This work offers advice on access to such prospective givers.
Meat and meat products. Fish and fish products. Dairy products. Flour and baked goods. Fats and fatty foods. Coffee, tea and cocoa. Fruit juices and soft drinks. Preserves. Pickles and sauces. Confectionery products. Snack foods. Fereezing and refrigeration. Dehydration and dried products. Canning. Handling and storage.
Beyond Residency offers practical, no-nonsense advice about the business and economics of being a medical doctor. Used as a textbook in the Business of Medicine Course at East Carolina University's Brody School of Medicine, this edition is designed to work more broadly for other institutions teaching business of medicine courses and for new physicians starting out in practice. Recalling his days in medical school, Marc Lyles, senior director of health care affairs for the Association of American Medical Colleges said, "Whenever we asked a business question we were always told, 'Don't worry about that. You need to learn the medical side before you worry about the business side.'" He states that between 2003 and 2007, the majority of students were satisfied with their medical and clinical training. However, less than half felt that enough time was devoted to the practice of medicine, especially to medical economics. The Brody School of Medicine addresses that discrepancy, offering its Business of Medicine Course as a fourth-year elective and as a postgraduate class for students in the Department of Physical Medicine and Rehabilitation. Topics addressed include time value of money, contracts, RVUs, disability and life insurance, and investment plans such as traditional IRAs and Roth IRAs. In 2015, the Business of Medicine Course received a positive score of 4.68/5 (94%) for its value to medical students, and Beyond Residency received a score of 3.89/4 (97%) for its effectiveness in teaching students the business of medicine. Beyond Residency helps students to understand important yet under-explored areas that will impact them as practicing physicians.
An award-winning physician-writer exposes how pervasive cracks in the health care system cost us time, energy, and lives—and how we can fix them. There’s an unspoken assumption when we go to see a doctor: the doctor knows our medical story and is making decisions based on that story. But reality frequently falls short. Medical records vanish when we switch doctors. Critical details of life-saving treatment plans get lost in muddled electronic charts. The doctors we see change according to specialty, hospital shifts, or an insurer’s whims. Physician Ilana Yurkiewicz calls this phenomenon fragmentation, and, she argues, it’s the central failure of health care today. In this gripping narrative from medicine’s front lines, Yurkiewicz reveals how a system that doesn’t talk to itself puts insupportable burdens on physicians, patients, and caregivers, forcing them to heroic lengths to hold the pieces together—barely. The stories she tells are at once harrowing and commonplace. A patient narrowly averts an unnecessary, invasive heart procedure by producing a worn rhythm strip he has carried in his pocket for a decade. A man diagnosed with leukemia while visiting from abroad has thirty-one physicians, but no one he can call “his” doctor, with tragic consequences. When Yurkiewicz’s own father falls ill, a culture that incentivizes health care providers to react with quick fixes to the problems immediately before them—often to the neglect of a patient’s overall narrative—leads to weeks of additional suffering and a risky hospital transfer. The system is hanging by a thread, and we need better solutions. Yurkiewicz issues a clear-eyed call for change, naming concrete reforms doctors and policymakers can make, and empowering patients and their loved ones to advocate for themselves in the meantime. Urgent, radiantly humane, and ultimately hopeful, Fragmented a prescription for what really needs fixing in modern medicine.
In By the Bedside of the Patient, Nortin Hadler places current efforts to reform medical education--from the undergraduate level through residency programs and on to continuing medical education--in historical context. In doing so, he traces the evolution of medical school curricula, residency and fellowship programs, and the clinical practices they promoted. Hadler examines crucial junctures in history to locate the seeds for reform. Some believe that medical education and training should highlight literature, ethics, and culture, while others emphasize science and efficiency to abbreviate the time from entry to licensure. Neither of these approaches, Hadler argues, maintains or improves patient care, which should be at the core of medical education and practice. Hadler contends that most reform attempted thus far constitutes, at best, little more than a reshuffling of the basic curriculum and, at worst, an augmenting of medicine's predilection to measure, grade, and record. Examining generational changes in medical education, Hadler mines sixty years of training and practice to identify mistaken approaches and best practices. Ultimately, in the contemporary era of managed care, Hadler argues for a clinical practice that draws on the best available scientific knowledge, transmits the wisdom of experienced clinicians, reforges an empathetic relationship between physician and patient, and treats each patient as an individual--all centered on restoring the mandate to care.
The medical profession today is not controlled by doctors or nurses. It's controlled by corporations, administrators, and bureaucratsit's become a business. Scrubbed Out presents a critique of the today's business of medicine and the profit-driven mindset that ignores human needs. Salah D. Salman is a doctor himself, concerned with the double standards and unscrupulous dealings of today's community of health care decision-makers. He does not hesitate to place the blame where it belongssometimes even with major teaching institutions and professional societies. Dr. Salman believes that a revolution is necessary to turn the system around, and offers the radical solutions necessary to reverse the trends of a downward-spiraling industry.
American medicine attracts some of the brightest and most motivated people the country has to offer, and it boasts the most advanced medical technology in the world, a wondrous parade of machines and techniques such as PET scans, MRI, angioplasty, endoscopy, bypasses, organ transplants, and much more besides. And yet, writes Dr. Eric Cassell, what started out early in the century as the exciting conquest of disease, has evolved into an overly expensive, over technologized, uncaring medicine, poorly suited to the health care needs of a society marked by an aging population and a predominance of chronic diseases. In Doctoring: The Nature of Primary Care Medicine, Dr. Cassell shows convincingly how much better fitted advanced concepts of primary care medicine are to America's health care needs. He offers valuable insights into how primary care physicians can be better trained to meet the needs of their patients, both well and sick, and to keep these patients as the focus of their practice. Modern medical training arose at a time when medical science was in ascendancy, Cassell notes. Thus the ideals of science--objectivity, rationality--became the ideals of medicine, and disease--the target of most medical research--became the logical focus of medical practice. When clinicians treat a patient with pneumonia, they are apt to be thinking about pneumonia in general--which is how they learn about the disease--rather than this person's pneumonia. This objective, rational approach has its value, but when it dominates a physician's approach to medicine, it can create problems. For instance, treating chronic disease--such as rheumatoid arthritis, diabetes, stroke, emphysema, and congestive heart failure--is not simply a matter of medical knowledge, for it demands a great deal of effort by the patients themselves: they have to keep their doctor appointments, take their medication, do their exercises, stop smoking. The patient thus has a profound effect on the course of the disease, and so for a physician to succeed, he or she must also be familiar with the patient's motivations, values, concerns, and relationship with the doctor. Many doctors eventually figure out how to put the patient at the center of their practice, but they should learn to do this at the training level, not haphazardly over time. To that end, the training of primary care physicians must recognize a distinction between doctoring itself and the medical science on which it is based, and should try to produce doctors who rely on both their scientific and subjective assessments of their patients' overall needs. There must be a return to careful observational and physical examination skills and finely tuned history taking and communication skills. Cassell also advocates the need to teach the behavior of both sick and well persons, evaluation of data from clinical epidemiology, decision making skills, and preventive medicine, as well as actively teaching how to make technology the servant rather than the master, and offers practical tips for instruction both in the classroom and in practice. Most important, Doctoring argues convincingly that primary care medicine should become a central focus of America's health care system, not merely a cost-saving measure as envisioned by managed care organizations. Indeed, Cassell shows that the primary care physician can fulfill a unique role in the medical community, and a vital role in society in general. He shows that primary care medicine is not a retreat from scientific medicine, but the natural next step for medicine to take in the coming century.
“The shortest distance between a human being and the truth,” so goes the saying, “is a story.” These stories told by Dr. Scott Abramson, drawing upon his forty years of medical experience and from coaching colleagues in the mission of physician communication, embody some of these human truths: truths about listening, connection, faith, bereavement, death, teamwork, empathy, courage, grace, joy, leadership, parenting, burnout, the challenges of work-life balance, and the secret of happiness. For back of cover
Changes in the healthcare field have threatened the once sacred relationship between patient and physician. While much has been written for physicians and other healthcare providers on the subject of the doctor-patient relationship, information tailored for patients remains lacking. This volume offers practical information to help patients make the most of their interaction with their doctors. Among the topics are finding the right physician, gaining telephone access, ensuring good communication between health care providers, protecting personal information, seeking a second opinion, and using walk-in clinics. In-depth interviews with primary care physicians and medical specialists provide a unique perspective on issues of importance to patients, from pediatrics to geriatrics.
Fall from Grace is a candid, personal history of an academic physician and biotechnology executive that reflects on medicine as it was in the mid-twentieth century and chronicles the changes in society and medicine during the second half of that century. The book investigates the social revolution of those times; the scientific and technological advances that occurred; the influence of the computer and the digital revolution; the entry of corporate management into health care; and the effects of the profit motive on the care of patients. All of these have had enormous influence on the role of the physician in health care. The inadequacies, over the years, of the fee-for-service system and the consequent governmental involvement in reimbursement systems are discussed and compared with other health care payment systems around the world. The net effect of these various forces has been to benefit patients through greatly improved technology yet has caused medicine to evolve from an art form focused on personal care to a more technical exercise largely controlled by fiscal considerations. These changes also refashioned the role of the physician from healer and counselor into manager of an impersonal health care team. The book provides a view of the current state of medicine, patients, and physicians and a perspective on the future.
The chaotic state of today's health care is the result of an explosion of effective medical technologies. Rising costs will continue to trouble U.S. health care in the coming decades, but new molecular strategies may eventually contain costs. As life expectancy is dramatically extended by molecular medicine, a growing population of the aged will bring new problems. In the next fifty years genetic intervention will shift the focus of medicine in the United States from repairing the ravages of disease to preventing the onset of disease. Understanding the role of genes in human health, says Dr. William B. Schwartz, is the driving force that will change the direction of medical care, and the age-old dream of life without disease may come close to realization by the middle of the next century. Medical care in 2050 will be vastly more effective, Schwartz maintains, and it may also be less expensive than the resource-intensive procedures such as coronary bypass surgery that medicine relies on today. Schwartz's alluring prospect of a medical utopia raises urgent questions, however. What are the scientific and public policy obstacles that must be overcome if such a goal is to become a reality? Restrictions on access imposed by managed care plans, the corporatization of charitable health care institutions, the increasing numbers of citizens without health insurance, the problems with malpractice insurance, and the threatened Medicare bankruptcy—all are the legacy of medicine's great progress in mastering the human body and society's inability to assimilate that mastery into existing economic, ethical, and legal structures. And if the average American life span is 130 years, a genuine possibility by 2050, what social and economic problems will result? Schwartz examines the forces that have brought us to the current health care state and shows how those same forces will exert themselves in the decades ahead. Focusing on the inextricable link between scientific progress and health policy, he encourages a careful examination of these two forces in order to determine the kind of medical utopia that awaits us. The decisions we make will affect not only our own care, but also the system of care we bequeath to our children. This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1998.
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