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Showing 1 - 13 of 13 matches in All Departments
This expos, Whistleblower Doctor-The Politics and Economics of Pain and Dying, concerns Dr. David K. Cundiff's efforts over 32 years to improve the quality of palliative care and hospice services for cancer and AIDS patients at the LA County + USC Medical Center. Over a nine year period, he improved the care of terminally ill cancer and AIDS patients at the LA County + USC Medical Center by directing a popular "Pain and Palliative Care Consultation Service." Unfortunately for the financial bottom line of the hospital, better pain and symptom control of terminally ill patients led to more patients at home and fewer patients occupying Medicaid-funded hospital beds. The unintended consequence of Medicaid's dysfunctional hospital-centric funding system was the closure of Dr. Cundiff's Consultation Service in 1995. Dr. Cundiff subsequently blew the whistle by writing 83 incident reports about patients receiving poor pain and symptom management. He also wrote an op-ed piece in the LA Times about poor palliative care and widespread institutionalized inefficiencies due to dysfunctional Medicaid financial incentives rewarding a higher hospital census. The hospital retaliated by firing Dr. Cundiff, and the California Medical Board revoked his medical license, both supposedly over a single clinical treatment decision. In a patient with alcoholism, liver failure, and a deep venous thrombosis (DVT, leg vein clot), Dr. Cundiff stopped anticoagulant medications because of the high risk of serious bleeding. Unfortunately, the patient later died of thromboses in his lungs (pulmonary emboli). This reasonable judgment call was not the real reason the Medical Board revoked Dr. Cundiff's license. He challenged the institutionalized inefficiencies in charity hospitals spawned by Medicaid. In researching the scientific evidence regarding anticoagulant drug treatment of venous thromboembolism (VTE: deep venous thrombosis and pulmonary emboli), Dr. Cundiff serendipitously discovered that these drugs do not reduce the risk of death in these patients. In fact, they increase the chance of dying due to bleeding and rebound hypercoagulability (increased clotting after stopping anticoagulants). Up to 20,000 Americans die unnecessarily each year due to bleeding and rebound clotting from these drugs for prophylaxis and treatment of VTE. While many bleed to death or suffer major nonfatal bleeding, drug companies and medical special interests earn from $17 - $25 billion per year in the U.S. from unnecessary and harmful anticoagulation treatments. Dr. Cundiff's peer-reviewed medical journal publications challenging anticoagulant treatment of VTE have been ignored by drug company funded anticoagulant drug researchers. Federal government health regulators in the FDA and NIH have refused to issue a detailed transparent, public critique of his challenges to the evidence basis of anticoagulation for VTE. Drug company financial clout is killing people.The major goals of this book include: improving the pain and symptom control of cancer and AIDS patients, stopping the epidemic of deaths and injuries from the use of anticoagulant drugs, changing the Medicaid reimbursement system for the LA County Department of Health Services and other places where it fosters inefficiencies and poor medical care, and reinstating Dr. Cundiff's medical license.
A leading scientist argues that we must consider deploying climate engineering technology to slow the pace of global warming. Climate engineering-which could slow the pace of global warming by injecting reflective particles into the upper atmosphere-has emerged in recent years as an extremely controversial technology. And for good reason: it carries unknown risks and it may undermine commitments to conserving energy. Some critics also view it as an immoral human breach of the natural world. The latter objection, David Keith argues in A Scientist's Case for Climate Engineering, is groundless; we have been using technology to alter our environment for years. But he agrees that there are large issues at stake. A leading scientist long concerned about climate change, Keith offers no naive proposal for an easy fix to what is perhaps the most challenging question of our time; climate engineering is no silver bullet. But he argues that after decades during which very little progress has been made in reducing carbon emissions we must put this technology on the table and consider it responsibly. That doesn't mean we will deploy it, and it doesn't mean that we can abandon efforts to reduce greenhouse gas emissions. But we must understand fully what research needs to be done and how the technology might be designed and used. This book provides a clear and accessible overview of what the costs and risks might be, and how climate engineering might fit into a larger program for managing climate change.
Four boys set out to stop a band of criminals who are destroying Indian graves in the area. In the process, they learn more than they intended to learn and are helped by a very unusual ally.
Because people learn within social capital networks, an educational praxis is needed within families and schools that develops student critical consciousness about why and how to expand ties to new learning communities of exemplars. Such praxis would involve both overtly negotiating truth claims about culture and class in classroom discussions and also placing students in learning situations of legitimate peripheral participation within communities beyond their initial personal reach. Through critical pedagogy, participants in this study discovered that they were able to reflect on their situation in the world and to plan for social action to transform their situation by developing their own unique social capital networks of success and fulfillment.
A radically different take on STAR TREK is revealed in this collection of novels that focus on the struggle of a freedom-hungry rebellion against an oppressive alien regime. VOYAGER: In a reversal of events from VOYAGER's first episode, two lost travelers from the other side of the galaxy are flung into the middle of the Alliance, the alien empire that oppresses humans, Vulcans, and countless other races. One of these travelers has the potential to completely alter the balance of power, and as both sides struggle to get to the stranger first, treachery throws everything into a tailspin. NEW FRONTIER: Almost a century after the fall of the Terran Empire, its long-time rivals, the Romulans, have absorbed many of the fringe civilizations spread across that part of the galaxy. One of its slaves, M'k'nzy of Calhoun - who in this universe will never become Captain MacKenzie Calhoun of the Starship EXCALIBUR - learns courage and the value of freedom from an unlikely teacher, a Romulan named Soleta. DEEP SPACE NINE: One fallen dictator's struggle to regain her power and her position leads to the discovery of a bold rebel plan for a decisive military strike that will bring down the Alliance, once and for all. But while Kira Nerys navigates the tangle of politics, sex, and military intrigue that she believes will allow her reclaim her station, cracks form in the rebel leadership, leading to a showdown that will change the course of the Mirror Universe.
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