Selasa, 31 Maret 2015

[G857.Ebook] Fee Download "How Many More Questions?": Techniques for Clinical Interviews of Young Medically Ill Children, by Rochelle Caplan, Brenda Bursch

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How Many More Questions?: Techniques for Clinical Interviews of Young Medically Ill Children provides readers with a comprehensive framework to understand how 5-10 year old children use language to formulate and communicate their thoughts. The book then guides the reader in how to effectively elicit information about sensitive and stressful topics from young children, such as their emotions, difficulties, problems, worries, and illness. Seventeen exquisitely written chapters that include twelve developmental guidelines, techniques, case examples, and illustrative dialogues provide the reader with the tools needed to address specific communication challenges involved in speaking with young children who have pain, medical trauma, terminal illness, or specific disorders like epilepsy.

How Many More Questions? is useful for pediatric professionals who strive to acquire exceptional clinical interviewing skills and who no longer wish to hear children say, "When are we done?" The wide range of medical and non-medical professionals who work with young ill children, such as pediatricians, neurologists, psychiatrists, psychologists, neuropsychologists, social workers, nurses, child life specialists, as well as interested parents will use this book as a reference guide.

  • Sales Rank: #261862 in Books
  • Brand: Brand: Oxford University Press, USA
  • Published on: 2012-10-22
  • Released on: 2012-10-22
  • Original language: English
  • Number of items: 1
  • Dimensions: 6.00" h x .90" w x 9.10" l, 1.07 pounds
  • Binding: Paperback
  • 344 pages
Features
  • Used Book in Good Condition

Review

"The book is well structured, beginning with chapter overview and ending with summary points at the end of each section, making it concise and focused. This is an excellent text for paediatric and child-psychiatry residents in consultation liason service, and child-life specialists starting out their training. --The Psychiatrist


"With sensitivity and compassion for young children, and a focus on pragmatic and feasible solutions, the authors stress the importance of approaching clinical interviews in the contexts of the developmental stage of the child's communication skills, the impact of the specific illness on those skills, and the emotional and behavioral issues that so often arise from physical and psychological suffering." -- Steven C Schachter, MD, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA


"Condensing years of clinical wisdom, the authors outline twelve essential developmental guidelines that should be considered in interviews of all children. These guidelines are accompanied by detailed, real life case vignettes that illustrate specific interviewing approaches and, equally important, which words and questions to avoid. These principles come to life in the second section of the book where they used to show how careful, developmentally-appropriate interviewing techniques form the corner stone of the diagnostic assessment." -- Richard J. Shaw, MD, Professor of Psychiatry and Pediatrics, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA


"In this important and innovative book, Caplan and Bursch utilize a developmentally sensitive framework to provide professionals from a variety of disciplines with the interviewing skills necessary to conduct challenging clinical interviews with young children who have medical, psychiatric, and/or neurological illnesses. They proffer developmental guidelines for how to obtain accurate clinical information from young children. The authors also present engaging and excellent clinical vignettes throughout the volume that illustrate the principles of developmentally sensitive interviewing with a variety of high-risk youngsters. I enthusiastically recommend this book." -- Dante Cicchetti, PhD, McKnight Presidential Chair, William Harris Professor, and Professor of Child Psychology and Psychiatry, Institute of Child Development, University of Minnesota, Minneapolis, MN


"Caplan and Bursch understand how to talk to, and how to listen to, children. They also understand how to talk to adults who are struggling to do the same. In this remarkably successful book they provide us with a clear understanding of the child's world view, and with example after example, they show how what we think we are saying as adults can be heard differently." -- Christopher Eccleston, PhD. Centre for Pain Research, The University of Bath, UK.


"[This] is an essential, practical, developmentally sensitive guide for clinicians learning to elicit useful and accurate information from young children including those with language deficits or other mild cognitive impairments. They perceptively cover a broad range of challenging topics from talking with children who have epilepsy and its concomitant psychiatric, cognitive, linguistic and psychosocial comorbidities to talking with children who have experienced medical trauma or are dying of a terminal illness. The gentle wisdom and accumulated knowledge of Caplan and Bursch comes shining through as they take our hand and walk us through the many questions we have to ask children to understand their cognitive and emotional experiences of medical care. Just as children often ask, "Are we there yet?" Caplan and Bursch take us on a learning journey and expertly help us arrive at our destination of how to communicate clearly with children." -- Maryland Pao, MD, Bethesda, Maryland


"Thanks to Caplan and Bursch for providing an excellent reference for all practitioners who interact with young children as they sort out differential diagnoses involving physical, emotional and cognitive symptoms. The book contains many sample interviews that illustrate effective techniques along with practical guidelines for clinicians to become the child's "communication assistant" or "coach" partnering with the child and family to find the best possible solutions for their presenting concerns. I particularly appreciate the section that focuses on two of the most common somatic complaints, headaches and stomach aches, providing a laundry list of potential causes. The chapter discussing terminal illness is another invaluable component. This book is like having the Child Psychiatric Consult/Liaison team in your pocket." -- Beatrice Yorker, RN, MS, JD, Dean and Professor of Nursing, College of Health and Human Services, California State University, CA


"History is without question the most important diagnostic tool in the armamentarium of anyone who provides healthcare to children, and yet it is often the most challenging thing to obtain. Critical portions of the history can only be obtained from the child him or herself...That is why this wonderful book...is such a gift to any healthcare professional who needs to communicate effectively with kids, be it pediatricians, pediatric subspecialists such as neurologists or psychiatrists, nurses, psychologists or social workers. By providing clear and concise information...this book provides an essential reference for pediatric healthcare professionals." -- Amy Brooks-Kayal, MD, Chief and Ponzio Family Chair in Pediatric Neurology Children's Hospital Colorado Professor of Pediatrics, Neurology and Pharmaceutical Sciences University of Colorado


"The provision of sample interviews illustrating the rights and wrongs of asking children about their symptoms and opinions are invaluable. These vignettes also illustrate how to bring the parents into the picture by obtaining the permission and establishing the readiness of the child...This book will be invaluable for trainees in a variety of mental health, counselling and medical programs, and for more advanced practitioners to enhance their skills. I will certainly be using this book in my teaching and to enrich my own practice." -- Mary Lou Smith, PhD, CPsych, Department of Psychology, University of Toronto; and Neuropsychologist and Associate Senior Scientist, Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, Ontario Canada


"The authors should be applauded for putting together such an important work. I enthusiastically endorse this book which I think will be an important addition to the pediatric literature for years to come." -- Joseph I. Sirven, MD, Editor-in-Chief, epilepsy.com


"This is a wonderful tool for all professionals working with children. The authors provide one of the first written coaching guidelines with a rich developmental framework. The understanding of a child's perception of his/her feelings and thoughts about medical and behavioral care and the ability to respond accurately to a child's needs is essential. Few comprehensive resources designed to empower children through communication are available to healthcare professionals. The authors have made an outstanding contribution to improving the health of children." -- Susan M. Wechter, PhDc, RN, PPCPNP-BC, Walsh University Nursing School, Doody's


About the Author

Rochelle Caplan, MD, is Professor Emeritus of Psychiatry in the UCLA Department of Psychiatry and Directed the UCLA Pediatric Neuropsychiatry clinical program for twenty years. She completed her medical studies at the Jerusalem University Hadassah Medical School and her training in adult and child psychiatry at the Tel-Aviv University Sackler Medical School. Dr. Caplan is a pediatric neuropsychiatrist with clinical and research expertise in how children use language to formulate their thoughts and present them to the listener. She has devoted her clinical career to the evaluation and treatment of children with severe behavior/emotional problems due to psychiatric and neurological disorders. Her research has used psycholinguistic, behavior/emotions, and brain imaging measures to study abnormalities in the development of communication skills, behavior/emotions, and brain in children with psychiatric and neurological disorders.



Brenda Bursch, PhD, is a medical psychologist with clinical and research interests in pediatric pain, palliative care, somatization, and illness falsification. She received her PhD from Claremont Graduate School in 1990 and is a Professor in the Departments of Psychiatry & Biobehavioral Sciences and Pediatrics at the David Geffen School of Medicine at UCLA, where she has been on faculty since 1994. She is the Clinical Director of the Pediatric Psychiatry Consultation Liaison service, overseeing child psychiatry consultations for pediatric medical inpatients. She has presented lectures at professional conferences within the United States and abroad, and has published numerous scientific articles and book chapters.

Most helpful customer reviews

2 of 2 people found the following review helpful.
A Good Read
By lori grapes
This is one of the best books I've read on how to talk to children. As a parent and a psychotherapist, I wish the book had been around 20 years ago. I wish I'd understood at the beginning of my journey in both those endeavors, what a child means when he or she says, "How many more questions?" It means the child is overwhelmed, and that the dialogue one is attempting to have with the child has lost its value as a source of relief and has become another source of discomfort. The book is clinical in nature--it gives the reader advice on how to help kids talk about what they're feeling--yet is written in prose that is so accessible, you hardly notice you've digested half its contents. The examples given by the authors in the form of dialogue between child and doctor, are instructive and entertaining. The solutions to this dilemma (for doctors, parents, and children!) are relatively simple, and are presented in a way that make them seem intuitive.

2 of 2 people found the following review helpful.
If you work with children please read this!
By SFR
As a seasoned Speech and Language Pathologist, and as the parent of a child with epilepsy, I not only feel qualified, buy compelled, to write a review about "How Many More Questions?". The authors have absolutely nailed the linguistic, emotional and cognitive development of normally developing children, and especially of children who are challenged by illnesses, and provide the healthcare professional with the skills necessary to truly listen to their patients through a myriad of hands-on examples. I suggest this be mandatory reading for all professionals who love and work with children!

1 of 1 people found the following review helpful.
A must read for parents of sick children too.
By DW
This brilliantly written book was marketed to professionals. But every parent who has a child with medical, emotional or mental issues should read it to learn how they and doctors should talk to a sick child. From this book everyone will get insights on how it is to be a child in a hospital, the misunderstandings that can arise, and how a correct approach can relieve fears and facilitate correct diagnoses.

See all 19 customer reviews...

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[E503.Ebook] PDF Ebook How We Do Harm: A Doctor Breaks Ranks About Being Sick in America, by Otis Webb, MD Brawley, Paul Goldberg

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How We Do Harm: A Doctor Breaks Ranks About Being Sick in America, by Otis Webb, MD Brawley, Paul Goldberg

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How We Do Harm: A Doctor Breaks Ranks About Being Sick in America, by Otis Webb, MD Brawley, Paul Goldberg

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How We Do Harm: A Doctor Breaks Ranks About Being Sick in America, by Otis Webb, MD Brawley, Paul Goldberg

How We Do Harm exposes the underbelly of healthcare today—the overtreatment of the rich, the under treatment of the poor, the financial conflicts of interest that determine the care that physicians' provide, insurance companies that don't demand the best (or even the least expensive) care, and pharmaceutical companies concerned with selling drugs, regardless of whether they improve health or do harm.

Dr. Otis Brawley is the chief medical and scientific officer of The American Cancer Society, an oncologist with a dazzling clinical, research, and policy career. How We Do Harm pulls back the curtain on how medicine is really practiced in America. Brawley tells of doctors who select treatment based on payment they will receive, rather than on demonstrated scientific results; hospitals and pharmaceutical companies that seek out patients to treat even if they are not actually ill (but as long as their insurance will pay); a public primed to swallow the latest pill, no matter the cost; and rising healthcare costs for unnecessary—and often unproven—treatments that we all pay for. Brawley calls for rational healthcare, healthcare drawn from results-based, scientifically justifiable treatments, and not just the peddling of hot new drugs.

Brawley's personal history – from a childhood in the gang-ridden streets of black Detroit, to the green hallways of Grady Memorial Hospital, the largest public hospital in the U.S., to the boardrooms of The American Cancer Society—results in a passionate view of medicine and the politics of illness in America - and a deep understanding of healthcare today. How We Do Harm is his well-reasoned manifesto for change.

  • Sales Rank: #181276 in eBooks
  • Published on: 2012-01-31
  • Released on: 2012-01-31
  • Format: Kindle eBook

Review

“My friend and colleague Otis Brawley has written a raw and honest portrayal of our health care system. There are certain to be special interest organizations and medical groups that take issue with Dr.Brawley's conclusions, but few can argue with the scientific rigor he has demonstrated in writing this book. Otis is the go- to oncologist I send so many patients to see, because he is not only a great doctor, but also a compassionate man. As we discuss the transformation of health care in this country, put Dr. Brawley's book at the top of your list.”-Sanjay Gupta, Associate Chief of Neurosurgery Grady Memorial Hospital, Chief Medical Correspondent, CNN

“Otis Brawley is one of America’s truly outstanding physician scientists.  In How We Do Harm, he challenges all of us-- physicians, patients, and communities-- to recommit ourselves to the pledge to 'do no harm.'”-David Satcher,Former Surgeon General of the United States, Director, Satcher Health Leadership Institute, Morehouse School of Medicine

“Sweeping, honest and brave . . . How We Do Harm dazzles with a wealth of  scientific insight, but its genius lies in the author’s recounting of individual patient stories that illuminate the dark underbelly of medicine’s missteps. Brawley does not shrink from revealing medicine’s warts, butthis book  offers much more. It is a  triumph of humanity and clarity in which oncology becomes a Rorschach for the practice of American medicine. You will finish this arresting book reluctantly, with a new appreciation of what American medicine could be.”-Harriet A .Washington, author of Deadly Monopolies: The Shocking Corporate Takeover of Life Itself and the Consequences for Your Health and Our Medical Future and Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present

“Dr. Brawley is a premier academic oncologist and a minority doctor in the nation's largest inner city hospital. How We Do Harm places in stark contrast the health care resources available to the rich and the poor, the insured and the uninsured, the white community and the community of color . He makes  the  cogent  point that more testing, screening, and interventions available to the rich does not always  mean better medical care .”-Bruce Chabner, MD, Director of Clinical Research, Massachusetts General Hospital Cancer Center

“Otis Brawley shares in equal measure his compelling personal story, the development of modern medical oncology, and the wide range of his strong opinions.  Whether you agree with him or not, the reader is given access to Dr. Brawley’s unambiguous scientific and ethical framework.  He provides an anvil for shaping your own perspectives and biases.”-Michael A. Friedman, MD, President and Chief Executive Officer, Director Comprehensive Cancer Center, City of Hope

“A tough-minded, solidly argued indictment of health care. . . Brawley’s sense of outrage is palpable.” -The Boston Globe

"A powerful contribution to the ongoing discussion on health-care reform.”-Kirkus

This book is shockingly detailed and it should serve as a wake-up call to fix the dismal mess and rethink the politics of illness in America. Dr. Brawley provides a well-reasoned manifesto for change.”-Tucson Citizen


“Any who want to know how behind-the scenes healthcare works will find this a key title." –Midwest Book Review

About the Author

DR. OTIS BRAWLEY is the chief medical and scientific officer and executive vice president of the American Cancer Society. Dr. Brawley currently serves as professor of hematology, oncology, medicine and epidemiology at Emory University. He is also a CNN medical consultant. He is a graduate of the University of Chicago, Pritzker School of Medicine, and completed a residency in internal medicine at University Hospitals of Cleveland, Case-Western Reserve University, and a fellowship in medical oncology at the National Cancer Institute.

PAUL GOLDBERG is an award-winning investigative reporter who covers oncology for The Cancer Letter, a weekly publication focused on drug development and the politics of cancer. His articles have appeared in The New York Times, The Wall Street Journal, The Washington Post, The Washington Monthly and he has been featured on 60 Minutes, 20/20, CNN and NPR. Goldberg is also the author of two books on the Soviet human rights movement.

Excerpt. © Reprinted by permission. All rights reserved.
Chapter 1

Chief Complaint
 

SHE WALKS THROUGH the emergency-room doors sometime in the early morning. In a plastic bag, she carries an object wrapped in a moist towel.
She is not bleeding. She is not in shock. Her vital signs are okay. There is no reason to think that she will collapse on the spot. Since she is not truly an emergency patient, she is triaged to the back of the line, and other folks, those in immediate distress, get in for treatment ahead of her. She waits on a gurney in a cavernous, green hallway.
The “chief complaint” on her chart at Grady Memorial Hospital, in downtown Atlanta, might have set off a wave of nausea at a hospital in a white suburb or almost any place in the civilized world. It reads, “My breast has fallen off. Can you reattach it?”
She waits for at least four hours—likely, five or six. The triage nurse doesn’t seek to determine the whereabouts of the breast.
Obviously, the breast is in the bag.
*   *   *
I am making rounds on the tenth floor when I get a page from Tammie Quest in the Emergency Department.
At Grady, we take care of patients who can’t pay, patients no one wants. They come to us with their bleeding wounds, their run-amok diabetes, their end-stage tumors, their drama. You deal with this wreckage for a while and you develop a coping mechanism. You detach. That’s why many doctors, nurses, and social workers here come off as if they have departed for a less turbulent planet.
Tammie is not like that. She emotes, and I like having her as the queen of ER—an experienced black woman who gives a shit. When Dr. Quest pages me, I know it isn’t because she needs a social interaction. It has to be something serious.
“We are wanted in the ER,” I tell my team.
The cancer team today consists of a fellow, a resident, two medical students, and yours truly, in a flowing white coat, as the attending physician. I lead the way down the hall. Having grown up Catholic, I can’t help thinking of the med students and young doctors as altar boys following a priest.
I am a medical oncologist, the kind of doctor who gives chemotherapy. My other interests are epidemiology and biostatistics. I am someone you might ask whether a drug works, whether you should get a cancer screening test, and whether a white man’s cancer differs from a black man’s cancer. You can also ask me if we are winning the “war” on the cluster of diseases we call cancer. As chief medical officer of the American Cancer Society—a position I have held since 2007—I often end up quoted in the newspapers, and I am on television a lot. In addition to my academic, journalistic, and public-policy roles, I have been taking care of cancer patients at Grady for nearly a decade, first as the founding director of the cancer center, and now as chief doctor at the ACS.
My retinue behind me, I keep up a fast pace, this side of a jog. Bill Bernstein, the fellow, is the most senior of the group. Bill is a Newton, Massachusetts, suburbanite, still boyish. He is having trouble adjusting to the South, to Atlanta, to its inner city. He is trying, but it’s hard to miss that black people and poor people perplex him. Contact with so much despair makes him awkward. But he has a good heart, a surfeit of common sense—and he is smart. Whatever we teach him at Grady will make him a better doctor wherever he ends up.
Grady suffers from what the administration here calls a “vertical transportation problem.” Our elevators are slow at best, broken at worst. We head for the stairs, rushing down to the first floor, then through long, green hallways into the ER.
Grady is a monument to racism. Racism is built into it, as is poverty, as is despair. Shaped like a capital letter H, Grady is essentially two hospitals with a hallway—a crossover—in the middle to keep things separate but equal for sixteen stories.
In the 1950s and ’60s, white patients were wheeled into the front section, which faces the city. Blacks went to the back of the H. This structure—built in 1953—was actually an improvement over the previous incarnation. The Big H—the current Grady—replaced two separate buildings—the whites got a brick building, the blacks a run-down wood-frame structure. Older Atlantans continue to refer to the place in a chilling plural, the Gradys.
You end up at Grady for four main reasons. It could happen because you have no insurance and are denied care at a private hospital, or because you are unconscious when you arrive by ambulance. When your lights are out, you are in no position to ask to be taken to a cleaner, better-lit, suburban palace of medicine. A third, small contingent are older black folks with insurance, who could go anywhere but have retained a dim memory of Grady as the only Atlanta hospital that accepted us. The fourth category, injured cops and firemen, know that we see a lot of shock and trauma and are good at it. We are their ER of choice.
Today, our 950-bed behemoth stands for another form of segregation: poor versus rich, separate but with no pretense of equality. Grady is Atlanta’s safety-net hospital. It is also the largest hospital in the United States.
The ER, arguably the principal entry point to Grady, was built in the center of the hospital, filling in some of the H on the first floor. To build it, Grady administrators got some federal funds in time for the 1996 Summer Olympics. This fueled financial machinations, which led to criminal charges, which led to prison terms. (In retrospect, the bulk of the money was put to good use. Many of the victims of the Olympic Park bombing came through our ER.)
The hallways here are incredibly crowded, even by the standards of inner-city hospitals. Patients are triaged into three color-coded lines—surgery, internal medicine, obstetrics—and placed on gurneys two-deep, leaving almost no room for staff to squeeze through.
You might see a homeless woman drifting in and out of consciousness next to a Georgia Tech student bloodied from being pistol-whipped in an armed robbery, next to a fifty-seven-year-old suburban secretary terrified by a sudden loss of vision, next to a twenty-eight-year-old hooker writhing in pain that shoots up from her lower abdomen, next to a conventioneer who blacked out briefly in a cylindrical tower of a downtown hotel, next to a fourteen-year-old slum dweller who struggles for breath as his asthma attack subsides.
When I first arrived in Atlanta and all of this was new to me, I took my wife, Yolanda, through the Grady ER on a Friday night.
“Oh, the humanity,” she said.
Yolanda, a lawyer with the U.S. Securities and Exchange Commission, feels happier above the Mason-Dixon Line.
*   *   *
TAMMIE Quest—I use her real name—is cute, has a broad, infectious smile, and comes from privilege. She grew up in Southern California and frequently refers to herself as a “black Valley girl.”
Though she identifies with the West Coast, a lot of Atlanta has rubbed off on her in the Grady ER.
No two ERs are alike. Ours tells the story of Atlanta more clearly, more poignantly than its skyline. Patients everywhere are scared of their wounds or diseases that rage inside them. Here, in the middle of this big, hot, loud, violent city, they have an added fear: they are terrified of each other, often with good cause.
Elsewhere, patients might trust us doctors, admire us, even bow to our robes, our honorifics, and the all-caps abbreviations that follow our names. Here, not so much.
A place called Tuskegee is about two hours away from here. It’s where government doctors staged a medical experiment in the thirties: they watched black men die of syphilis, withholding treatment even after effective drugs were invented.
Tuskegee is not an abstraction in these parts. It’s a physical place, as palpable as a big, deep wound, and eighty-plus years don’t mean a thing. Tuskegee is a huge, flashing CAUTION sign in the consciousness of Southern black folks. It explains why they don’t trust doctors much and why good docs such as Tammie have to fight so hard to earn their elementary trust.
Like me, Tammie is a member of the medical-school faculty at Emory University, and, like me, she has several academic interests. One of these interests is end-of-life care for cancer patients: controlling the symptoms when someone with advanced cancer shows up in your ER.
Seeing us approach, she walks toward us and hands me a wooden clipboard with the Grady forms. I look at her face, gauging the mixture of sadness, moral outrage, and fatigue.
She says something like “This patient needs someone who cares,” and disappears.
I glance at the chief complaint.
“Holy shit,” I say to Bill Bernstein and, more so, to myself.
I introduce myself to a trim, middle-aged, black woman, not unattractive, wearing a blue examination gown conspicuously stamped GRADY. (At Grady, things such as gowns, infusion pumps, and money tend to vanish.)
From the moment Tammie paged me, I knew that the situation had to be more than a run-of-the-mill emergency. This patient clearly is not about to die on the examination table. She doesn’t need emergency treatment. Before anything, she needs somebody to talk to. She needs attention, both medical and human.
The patient, Edna Riggs, is fifty-three. She works for the phone company and lives on the southeast side of Atlanta.
Sitting on an exam table, she looks placid. When she extends her hand, it feels limp. She makes fleeting eye contact. This is depression, maybe. Shame does the same thing, as does a sense of doom. Fatalism is the word doctors have repurposed to describe this last form of alienation.
In medicine, we speak a language of our own, and Edna’s physical problem has a name in doctorese: automastectomy. It’s a fan...

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164 of 172 people found the following review helpful.
The Unfortunate Reality of American Medicine
By Loyd Eskildson
First, a few words on Dr. Otis Brawley and my bias - he's the Chief Medical Officer for the American Cancer Society, Professor of Medicine at Emory University, and a CNN medical consultant. As for my bias, after reading his book and bio, I would trust him to give me the best medical recommendations. I wish I lived closer so he could be my physician - I'm really impressed!

'First, do no harm' is the first precept of medical ethics taught in medical school 'How We Do Harm' is Dr. Brawley's description of the real world, of how medical practice deviates from that basic ethic. The bulk of the book consists of anecdotal examples that he has become aware of.

Dr. Brawley begins by comparing how much America spends on health care vs. other nations. We're now at 18% of GDP, and Switzerland is #2 - at 12%, obviously much lower. We spend 3.5X as much on health care as on food. Canadians spend half what we do, and are ranked #7 in life expectancy. We're #50. More is not better - in fact, American health care is making our nation sick, in an economic sense.

Many health care providers allege that they're financially short-changed by Medicare and Medicaid; others contend that the relatively low reimbursement rates of those programs is a form of 'cost-shifting' that raises rates for others. Dr. Brawley, however, states that providers can still make money at those reduced rates treating complex cases involving uncontrolled diabetes, kidney failure, heart disease, and late-stage cancer.

As for Tea Party allegations of ObamaCare medical rationing, per 'Death Panels', Dr. Brawley says this is already happening - via insurance companies. Yet, irrational spending is still rampant. We need to return to a focus on not doing harm, peddling snake-oil and false hope - that will lower costs and improve quality. The current financial incentives driving medical practice have a bad impact on patient health and costs. Doctors who own labs order more tests than those who don't. Some community oncology practices hold regular meetings to inform physicians about treatment techniques that maximize billing. 'Disease Mongering' is overly prevalent - the proactive marketing of disease with free initial tests followed by lots of expensive for-pay follow-up. Another example - 'Zero,' an advocacy group that sponsors prostate screening vans, receives funding from the makers of Depend diapers. (Prostate removal, usually not required or recommended, subsequent to these screenings creates incontinence.)

Professional medical societies have chosen collegiality over patient well-being. Professional doctor societies issue 'evidence-based' guidelines for performing expensive procedures that are anything but evidence-based. Many patient advocacy groups act as unquestioning advocates for drug companies and medical specialists, not realizing that the interests they advocate run counter to their own. Debates between Tea Partiers and fictional characters created by PR firms further mislead.

Pseudoscience, greed, myths, lies, fraud, and looking the other way have far too often taken the place of science in directing health care. Good health care will have to be won in a public struggle, just as civil rights were. We need more stress on prevention, starting with health education.

Bottom-Line: Dr. Brawley is to be commended for shattering the 'good-old boy' image of medicine. Reality is that, like Wall Street, the profession is driven by outrageous greed. Days of family practitioners making house calls, accepting payment in eggs and chickens (if paid at all), are long gone. My most recent health care experiences (dental and medical) both follow Dr. Brawley's observations. Also amazing is the disparity between providers' 'list prices' and the prices paid by insurance firms - if list prices matched even the highest insurance payment, far fewer uninsured patients would be bankrupted by health care, and expenditures wasted on health care overheads (advertising, patient 'selection,'care review) would drop.

"How We Do Harm" is an invaluable contribution to those wanting to improve health care.

86 of 88 people found the following review helpful.
Horror stories about health care, Breast Cancer, PSA Test
By jwt99
I could not put this book down. I would say this is a must read for anyone that might get or who has cancer. Also anyone who has a chronic health problem should put this book in their library.

I think Dr. Brawley gives compelling examples that illustrate how our health care systen is broken.

Read this book!

This is an excellent book unless you are a quack, a greed driven doctor or drug rep. Dr.Brawley points out that we should not waste valiable tax money or even insurance money on unproven cures or on drugs that cost 10-20 times as much as a proven drug. All medical care should be research based, rational and above all "do no harm".

I hate to tell you this, but we as a country cannot afford to waste massive amounts of money anymore. If we don't get serious about health care it will break the country. We cannot afford to transfer wealth to quack doctors or for procedures that don't work. A spinal fusion costs about $80,000 yet 80% of the research says it does no good and it does a lot of harm. Is this any way to run a health care system?

If you don't believe Dr. Brawley read the research for yourself.

Use a little of your time to dig and see if he is telling the truth.

A lot of the raw research is locked up tight and hard to access and not easy for a lay person to understand. We must rely on honest doctors like Dr. Brawley to tell us the truth about our healthcare system

The chapters on the "PSA" test for prostate cancer were shocking to say the least.

All the examples about the breast cancer problems are on point. My wife went through this several years ago and thank goodness we had a doctor whose first words were us was " I don't give any treatment that has not been through a double blind study."

We feel like my wife received excellent treatment without receiving too much treatment. Too much can be as bad as too litttle as Dr. Brawley states.

Dr. Brawley points out through his examples that "raw greed" on the part of hospitals, doctors and drug companies has layed waste to our health care system.

The economic incentives are all on the side of more care not appropriate care. There is a vast difference between the two.

Thank you Dr. Brawley.

72 of 74 people found the following review helpful.
Terrible and true
By Kara Smigel
Dr. Brawley (excuse me, Otis) has written a book about the kind of things doctors say to each other, but not out loud and certainly not for publication. The contrast of healthcare for the overprivileged to the lack of care for the underserved (and the sea of confusion for those in-between) should not exist in the United States, and yet it does. That so much of this happens in the care of people with cancer is really unforgivable. Many will be unhappy with the author, but many more will have to agree that he is indeed telling the truth -- and doing so in a way that is compulsively readable. Otis knows how to get your attention and weave a tale that points out the things you should be seeing. He does not claim to have the answers and is free with admitting his own missteps along the way. I already sent a copy to my niece who is a 2nd year resident at an inner-city hospital and told her to be sure to pass it around once she has read it.

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Sabtu, 28 Maret 2015

[D991.Ebook] Get Free Ebook Theorizing a New Agenda for Architecture:: An Anthology of Architectural Theory 1965 - 1995, by Kate ed. Nesbitt

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Theorizing a New Agenda for Architecture:: An Anthology of Architectural Theory 1965 - 1995, by Kate   ed. Nesbitt

Theorizing a New Agenda for Architecture: An Anthology of ArchitecturalTheory collects in a single volume the most significant essays on architectural theory of the last thirty years.

A dynamic period of reexamination of the discipline, the postmodern eraproduced widely divergent and radical viewpoints on issues of making, meaning, history, and the city. Among the paradigms presented arearchitectural postmodernism, phenomenology, semiotics, poststructuralism, deconstruction, and feminism.

By gathering these influential articles from a vast array of books and journals into a comprehensive anthology, Kate Nesbitt has created a resource of great value. Indispensable to professors and students of architecture and architectural theory, Theorizing a New Agenda also serves practitioners and the general public, as Nesbitt provides an overview, a thematic structure, and a critical introduction to each essay.

The list of authors in Theorizing a New Agenda reads like a "Who's Who" of contemporary architectural thought: Tadao Ando, Giulio Carlo Argan, Alan Colquhoun, Jacques Derrida, Peter Eisenman, Marco Frascari, Kenneth Frampton, Diane Ghirardo, Vittorio Gregotti, Karsten Harries, Rem Koolhaas, Christian Norberg-Schulz, Aldo Rossi, Colin Rowe, Thomas Schumacher, Ignasi de Sol-Morales Rubi, Bernard Tschumi, Robert Venturi and Denise Scott Brown, and Anthony Vidler. A bibliography and notes on all the contributors are also included.

  • Sales Rank: #428197 in Books
  • Brand: Brand: Princeton Architectural Press
  • Published on: 1996-03-01
  • Original language: English
  • Number of items: 1
  • Dimensions: 9.38" h x 1.50" w x 6.25" l, 2.57 pounds
  • Binding: Paperback
  • 384 pages
Features
  • Used Book in Good Condition

Review
This is a thorough and comprehensive introduction to a small but challenging field of intellectual endeavor. Colin Davies, Architects' Journal

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2 of 2 people found the following review helpful.
A great place to start
By Joshua T. Eadie
A great place to start. Lays out some architectural theory and opinions. Not too detailed, but a worthwhile investment. This book is required reading in most Architecture programs as it was in mine.

0 of 0 people found the following review helpful.
Interesting addition
By Archi Student
I only needed this book for a paper but I was surprised by how much I enjoyed it.It made a great addition to my library. Some texts were slightly confusing to grasp so I had to go over them again to fully understand all the details but atleast every passage has a short introduction at the beginning that summarizes the main idea, there by making it easier to understand.

0 of 1 people found the following review helpful.
Five Stars
By Preeti S.
The products are good. But the shipping takes quite a time.

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Jumat, 27 Maret 2015

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  • Published on: 1966-01-01
  • Binding: Paperback

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Ancient Egypt: Its Culture and History, by J. E. Manchip White

For 30 centuries, before Greece's glory or Rome's grandeur came into being, mankind played out a drama along the banks of the Nile which for sheer splendor, mighty works, and significance to civilization, is unique. The lure of Egyptology is as old as the Pyramids themselves; what is new is the modern work done in the field. Few books make so up-to-date and thorough a survey of what is known, in a form suited for the general reader, as this fine work, first published as recently as 1952, and now with a new Introduction for this edition by the author.
Central to all facts about ancient Egypt is the Nile; this is where the author starts us in our understanding of the civilization. With a vivid picture of the land, cut off by deserts on all sides, but watered and sheltered like a 675-mile oasis, we see how the culture sprang up; how it produced the astonishing figure of the Pharaoh, half-god, half-king, yet living, loving, mortal man; we learn all that modern scholarship has discovered about him. Closely allied to the Pharaoh were the priests and the state officials, form the Vizier to the Chancellor to such lesser officials as the Director of the King's Dress; the facts about their interrelationships, roles, and modes of life make for the most interesting kind of reading here. Not surprisingly, architects and craftsmen played a highly important part in what was, despite its pomp and magnificence, an eminently practical culture; and White gives us a fine account of their methods and meaning to the life of Egypt. A complete chapter is devoted to the commoner, the peasant, the man who brought food for all from the soil along the river and on whose labor all of Egypt's achievements were built.
One of the most valuable portions of this book is its historical section. In three chapters we are given, in vivid capsule form, the entire history of ancient Egypt from prehistoric times to the end of the dynasties. A fold-out chart enables the reader to relate the various periods quickly. Maps of the ancient region are provided; and for this edition an expanded, updated bibliography has been compiled.

  • Sales Rank: #898935 in Books
  • Published on: 1970-06-01
  • Released on: 1970-06-01
  • Original language: English
  • Number of items: 1
  • Dimensions: .59" h x 5.46" w x 8.50" l, .69 pounds
  • Binding: Paperback
  • 217 pages

Most helpful customer reviews

31 of 31 people found the following review helpful.
Take a tour of the Nile, its people and their Gods.
By callan@umbc.edu
This is an informative and comprehensive introduction to Egyptology. Starting with an analysis of the Nile and how this majestic river is pivotal to understanding this ancient culture, White brings us through a descriptive tour of each of the important contributors to Ancient Egyptian culture; the Pharoh, the Priest, the Architect, the Craftsman and the commonly disregarded peasant. This book, albeit occasionally too factual, has a wealth of information included in its mere 200 pages. The three historical chapters are a welcome synthesis to all of the factual data that was presented earlier. The fold-out summary of the major Pharohs, architectural advances and other contemporary cultures is great for keeping all of the important dates, places and people straight. I would recommend this book to anyone interested in learning about the wonders of Egypt.

2 of 2 people found the following review helpful.
Think Like an Egyptian
By lin
I have only a passing interest in Egypt, but I came across this at a used bookstore and thought it looked good so I picked it up. I'm very glad I did, because it was a fascinating read --well written and well organized. I was most amazed by how the author is able to take you from a familiar western mindset, and put you into the mind-boggling Egyptian mindset. I was raised in both a western and eastern culture and the values and outlook of the Ancient Egyptians is unlike anything I have ever experienced. This mind shift is all done smoothly and painlessly, and will give you a better appreciation for their values and ways of thinking and possibly change the way you see life as well. This is very crucial in order to understand how their society worked, and how to interpret the history they have left behind.

I highly recommend it for anyone who knows little about Ancient Egyptian culture and history, and would be curious to know more. You don't need to be scholarly or intensely interested in Egypt to enjoy it. It's a fairly small book, about the size of a typical trade paperback-- not an intimidating tome or textbook, but still packed with excellent information that will satisfy a more than introductory interest in Ancient Egypt.

1 of 1 people found the following review helpful.
Gem of a Book
By Katherine Zurenda
I loved this book. It was the first book I bought on ancient Egyptian culture and I think it was the best choice I could possibly make. Jammed packed with information and illustrations. It's certainly worth owning this gem.

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[B146.Ebook] Download Ebook Electrical Calculations and Guidelines for Generating Station and Industrial Plants 1st edition

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Electrical Calculations and Guidelines for Generating Station and Industrial Plants 1st edition

  • Published on: 1709
  • Binding: Hardcover

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Senin, 23 Maret 2015

[Z868.Ebook] Free PDF Chemistry Experiments for Instrumental Methods, by Donald T. Sawyer, William R. Heineman, Janice M. Beebe

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Chemistry Experiments for Instrumental Methods, by Donald T. Sawyer, William R. Heineman, Janice M. Beebe

The only self-contained modern laboratory manual for advanced undergraduate courses in instrumental analysis. Consists of over 50 experiments demonstrating the theory and practice of electrochemical methods, methods based on electromagnetic radiation, and separation methods. Experiments are introduced with a review of the physical principles on which the experimental procedures are based.

  • Sales Rank: #111984 in Books
  • Published on: 1984-09-03
  • Ingredients: Example Ingredients
  • Original language: English
  • Number of items: 1
  • Dimensions: 11.06" h x .78" w x 8.50" l, 2.33 pounds
  • Binding: Paperback
  • 448 pages

From the Publisher
The only self-contained modern laboratory manual for advanced undergraduate courses in instrumental analysis. Consists of over 50 experiments demonstrating the theory and practice of electrochemical methods, methods based on electromagnetic radiation, and separation methods. Experiments are introduced with a review of the physical principles on which the experimental procedures are based.

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Jumat, 20 Maret 2015

[R427.Ebook] Free Ebook Derivative Pricing in Discrete Time (Springer Undergraduate Mathematics Series), by Nigel J. Cutland, Alet Roux

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Derivative Pricing in Discrete Time (Springer Undergraduate Mathematics Series), by Nigel J. Cutland, Alet Roux

This book covers mathematical modeling of financial markets and rational pricing of derivatives, a theory which underpins modern financial practice. Emphasizing clarity and rigor throughout, the theme is the problem of finding a fair price for a derivative.

  • Sales Rank: #3799362 in Books
  • Brand: Brand: Springer
  • Published on: 2012-09-07
  • Released on: 2012-09-07
  • Original language: English
  • Number of items: 1
  • Dimensions: 9.25" h x .78" w x 6.10" l, .95 pounds
  • Binding: Paperback
  • 325 pages
Features
  • Used Book in Good Condition

Review

From the reviews:

“Derivative Pricing in Discrete Time introduces the basic ideas of financial derivatives with a minimum of prerequisites. … Indeed, as an undergraduate-level mathematical treatment of the subject, this is the best textbook I have seen. … I would recommend the book to students preparing for financial careers, such as actuaries. Practical pricing models should make more sense with the theoretical grounding provided by this book.” (John Curran, MAA Reviews, May, 2014)

From the Back Cover

Derivatives are financial entities whose value is derived from the value of other more concrete assets such as stocks and commodities. They are an important ingredient of modern financial markets.

This book provides an introduction to the mathematical modelling of real world financial markets and the rational pricing of derivatives, which is part of the theory that not only underpins modern financial practice but is a thriving area of mathematical research. The central theme is the question of how to find a fair price for a derivative, which is defined to be a price at which it is not possible for any trader to make a risk free profit by trading in the derivative. To keep the mathematics as simple as possible, while explaining the basic principles, only discrete time models with a finite number of possible future scenarios are considered.

The authors first examine the simplest possible financial model, which has only one time step, where many of the fundamental ideas occur, and are easily understood. Proceeding slowly, the theory progresses to more realistic models with several stocks and multiple time steps, and includes a comprehensive treatment of incomplete models. The emphasis throughout is on clarity combined with full rigour. The later chapters deal with more advanced topics, including how the discrete time theory is related to the famous continuous time Black-Scholes theory, and a uniquely thorough treatment of American options.

The book assumes no prior knowledge of financial markets, and the mathematical prerequisites are limited to elementary linear algebra and probability. This makes it accessible to undergraduates in mathematics as well as students of other disciplines with a mathematical component. It includes numerous worked examples and exercises, making it suitable for self-study.

About the Author
Cutland, Department of Pure Mathematics, University of Hull.

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