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Selasa, 30 Juli 2013

[Z616.Ebook] Free Ebook Outsiders VOL 03: Wanted (Outsiders (DC Comics Numbered)), by Judd Winick

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Written by Judd Winick Art by Carlos D'Anda, Karl Kerschl, Dan Jurgens, and others Cover by Doug Mahnke The thrilling third collection of the hot title collects OUTSIDERS #16-23! This volume includes the 3-part "Most Wanted" story arc featuring television personality John Walsh, as well as an IDENTITY CRISIS tie-in story guest-starring Batman!

Sales Rank: #1585858 in Books
Brand: DC Comics
Published on: 2005-10-19
Released on: 2005-11-01
Original language: English
Number of items: 1
Dimensions: 10.15" h x .48" w x 6.61" l, .62 pounds
Binding: Paperback
192 pages

Features

Used Book in Good Condition

From School Library Journal
Grade 9 Up–While the leader of the Outsiders, Nightwing, has deliberately maintained his emotional distance, the others have continued to develop friendships. But are they all who they seem to be? Arsenal has been receiving advice from Batman, but why would he be helping the Outsiders? How was the security base breached? Is one of the superheroes working against the group? Not only must they worry about one another, but the Outsiders also encounter an unexpected evil that does not come from someone with superpowers. Since this is outside of their realm of expertise, they must enlist the help of humankind–specifically John Walsh of Americas Most Wanted. Although this is an entertaining and exciting graphic novel, its an optional purchase. The background information required to follow the story is almost overwhelming, and readers who are not aficionados of the DC comic world could go crazy attempting to sort it all out. However, fans of the previous titles will not be disappointed as the characters continue to develop in engaging ways. Despite some typical graphic novel fare (heroines with large breasts and short skirts, for example), there is hardly any spandex to be seen, and the compelling artwork propels the story forward. Be aware, however, that there is some interspecies sex that might give some adults pause, and a story line involving a child prostitution ring is disturbing.–Heather M. Lisowski, Philip S. Miller Library, Castle Rock, CO
Copyright � Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From Booklist
Gr. 10-12. Former Real World cast member and the creator of the graphic novel Pedro and Me (2000) turns in something quite different here. The Outsiders is a team in turmoil, and readers will barely have a chance to get the characters straight before they are plunked into the middle of an even bigger, stranger drama----a brutal hunt for vengeance against a slavery cartel with ties to one of the team's own members. Things straighten out eventually as the Outsiders learn that Batman has been secretly pulling their strings, and a confrontation between the Caped Crusader and Outsider Nightwing, Batman's former protege, crackles with paranoia and leads to an exciting showdown. Character profiles, which appear at the beginning of the book, don't sufficiently set up the action, and the cliffhanger ending is a little confusing. The overall tone, however, is fittingly dark, the action scenes are extremely well choreographed, and Winick's surprisingly gritty writing (which includes occasional rough language) packs a plot twist into nearly every chapter. Add this to graphic novel collections in need of some hard-hitting superhero action. Jesse Karp
Copyright � American Library Association. All rights reserved

Most helpful customer reviews

0 of 0 people found the following review helpful.
Pretty good, but...
By C. Johnson
I love the first two books, but #3 is, well....

First, what's good:

The artwork is the best it's been so far in the series. There are a pile of pencillers working on this collection, but all of their unique styles fit well together. Also, the author (Judd Winick) throws some great curveballs at the reader, nice plot twists, and quirky humor.

What's bad:

A good chunk of this book is about child abuse. How the heck does this fit into this funny, action-packed, fantasy world that Winick has created for the series? They use the TV show "America's Most Wanted" (complete with real life hero John Walsh) and it just doesn't fit. Maybe Winick was trying to make the book feel more real, and it does give some insight into the past of a team member. Even so, it comes close to ruining the book. It's like when sit-coms throw in those weird episodes about something serious (like that Family Ties when Tom Hanks plays an alchoholic uncle, or that Different Strokes when Arnold is molested).

Anyway, the book ends with a cliffhanger that is resolved in a Teen Titans/Outsiders crossover book called "The Insiders." That book is MUCH better. "Wanted" is worth buying if you're planning to get "Insiders." Otherwise, have fun with Vols. 1 & 2 and skip this one.

0 of 0 people found the following review helpful.
Maybe the best one written
By Den
Maybe the best one written. Shortly after this they lost their visuals guy, and the writing went the same sad direction as the art. If you read outsiders a year or two after this, it is brief, farcical, and silly in a bizarre way that someone fails to be entertaining. This is dark, heavy, emotional, and high quality writing for a team of superheroes that manage to be both super and human.

0 of 0 people found the following review helpful.
Great Read
By Paul R. Baumeister Jr.
I gotta say that I'm getting to be huge fan of Winick's writing. This team book has all the great elements that will keep me coming back to it over and over (it's even earned a place on my bookshelf, as opposed to the comic box in my closet). The characters are fully realised people, not just two dimensional archetypes, and the humor is just dry enough to get an audible chuckle out of me.

Keep 'em coming, Mr Winick.

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[C924.Ebook] PDF Download Chord Progressions -- Theory and Practice: Everything You Need to Create and Use Chords in Every Key, by Dan Fox, Dick Weissman

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No matter what instrument you play, chords are an important part of your music. Chord Progressions: Theory and Practice breaks down how they're important and gives you all the information you need to create chords and use them in your own music. Start off by learning how to build simple major chords and eventually move on to more complex chords such as ninth, eleventh, thirteenth, and altered chords. Also learn to compose your own progressions using techniques such as passing chords, neighbor chords, pedal tones, and voice leading. Finally, learn how chord progressions are used in various styles of music---from early jazz to the music of today. This book is ideal for pianists, but it can be used successfully by any musician familiar with the grand staff.

After completing this book, you will have gained a clear understanding of chords and progressions in a variety of musical styles.

Sales Rank: #935297 in Books
Model: 00-35174
Published on: 2013-02-01
Original language: English
Number of items: 1
Dimensions: 12.00" h x 9.00" w x .25" l, .73 pounds
Binding: Paperback
96 pages

Most helpful customer reviews

0 of 2 people found the following review helpful.
CHORD THEORY
By HAROLD A.WILLIAMS
GOOD BASIC INFORMATION FOR LAYMEN AND PRO MUSICIANS !

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Senin, 29 Juli 2013

[N995.Ebook] PDF Download Witsec: Inside the Federal Witness Protection Program, by Pete Earley

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For decades no law enforcement program has been as cloaked in controversy and mystery as the Federal Witness Protection Program. Now, for the first time, Gerald Shur, the man credited with the creation of WITSEC, teams with acclaimed investigative journalist Pete Earley to tell the inside story of turncoats, crime-fighters, killers, and ordinary human beings caught up in a life-and-death game of deception in the name of justice.

WITSEC
Inside the Federal Witness Protection Program

When the government was losing the war on organized crime in the early 1960s, Gerald Shur, a young attorney in the Justice Department’s Organized Crime and Racketeering Section, urged the department to entice mobsters into breaking their code of silence with promises of protection and relocation. But as high-ranking mob figures came into the program, Shur discovered that keeping his witnesses alive in the face of death threats involved more than eradicating old identities and creating new ones. It also meant cutting off families from their pasts and giving new identities to wives and children, as well as to mob girlfriends and mistresses.

It meant getting late-night phone calls from protected witnesses unable to cope with their new lives. It meant arranging funerals, providing financial support, and in one instance even helping a mobster’s wife get breast implants. And all too often it meant odds that a protected witness would return to what he knew best–crime.

In this book Shur gives a you-are-there account of infamous witnesses, from Joseph Valachi to “Sammy the Bull” Gravano to “Fat Vinnie” Teresa, of the lengths the program goes to to keep its charges safe, and of cases that went very wrong and occasionally even protected those who went on to kill again.

He describes the agony endured by innocent people who found themselves in the wrong place at the wrong time and ended up in a program tailored to criminals. And along with Shur’s war stories, WITSEC draws on the haunting words of one mob wife, who vividly describes her life of lies, secrecy, and loss inside the program.

A powerful true story of the inner workings of one of the most effective and controversial weapons in the war against organized crime and the inner workings of organized crime itself–and more recently against Colombian drug dealers, outlaw motorcycle gang members, white-collar con men, and international terrorists–this book takes us into a tense, dangerous twilight world carefully hidden in plain sight: where the family living next door might not be who they say they are. . .

Sales Rank: #160190 in Books
Brand: Brand: Bantam
Published on: 2003-04-01
Released on: 2003-04-01
Original language: English
Number of items: 1
Dimensions: 6.90" h x 1.00" w x 4.15" l, .50 pounds
Binding: Mass Market Paperback
448 pages

Features

Used Book in Good Condition

From Publishers Weekly
Earley, an Edgar fact-crime award winner for Circumstantial Evidence, and Shur present a fascinating third-person account of Shur's 25-year career with the Department of Justice. Starting out as a federal attorney who recruited witnesses to take down the New York crime syndicate, Shur immediately saw the need to protect those who might testify against organized crime. After years of ardent advocacy, Shur created what would become the Witness Protection Program (WITSEC). As this book shows, WITSEC's 30-year history has been anything but tranquil. Some witnesses started up new crime syndicates or haplessly revealed their true identities. Others, wanting to remain in the spotlight, presented false testimony at congressional hearings. Still others took their indispensability as witnesses to mean they were to live forever on government subsistence checks. Additionally, Shur and WITSEC faced infighting among the federal agencies that most used the program, notably, the FBI, IRS and DEA; and the physical protection of witnesses and their families was often badly handled by a poorly organized U.S. Marshals Service. Yet WITSEC has managed to protect thousands of witnesses from certain death for having offered incriminating testimony to authorities. Since the book brazenly cheers Shur's every contribution to WITSEC, it is not the well-rounded work that it should be; nevertheless, this is an eye-opening account of a significant government program, with firsthand testimony by a woman identified only as "Witness X," who has been relocated by the program. (Feb. 4)Forecast: This BOMC alternate selection has plenty of drama and action to satisfy true-crime fans. The dramatic cover photo of a man in the dark, his outline silhouetted by light, will draw attention.

From Library Journal
WITSEC, or the Witness Protection Program, has alternately been praised as the key to the destruction of organized crime and damned for "buying" testimony and setting vicious criminals loose on unsuspecting communities. Here Shur, the driving force behind WITSEC for over 30 years, and journalist Earley present the history of the program, warts and all. Conceived as a way to help mob informants, WITSEC was underfunded, understaffed, and foisted on the unwilling U.S. marshals. But over the years it became much more organized and professional, even as it began to draw controversy. Some relocated criminals continued their criminal careers, families were broken up, and some noncriminal witnesses felt like criminals themselves. Included is a first-person account of the relocated wife of a mobster, who describes the terror and devastation of leaving her old life behind. While Shur's perspective is foremost, the authors bend over backward to present dissenting opinions. Overall, the impression is of a program that works staggeringly well despite its shortcomings. For all true-crime collections. Deirdre Root, Middletown P.L., OH
Copyright 2002 Reed Business Information, Inc.

From the Inside Flap
For decades no law enforcement program has been as cloaked in controversy and mystery as the Federal Witness Protection Program. Now, for the first time, Gerald Shur, the man credited with the creation of WITSEC, teams with acclaimed investigative journalist Pete Earley to tell the inside story of turncoats, crime-fighters, killers, and ordinary human beings caught up in a life-and-death game of deception in the name of justice.
WITSEC
Inside the Federal Witness Protection Program
When the government was losing the war on organized crime in the early 1960s, Gerald Shur, a young attorney in the Justice Department's Organized Crime and Racketeering Section, urged the department to entice mobsters into breaking their code of silence with promises of protection and relocation. But as high-ranking mob figures came into the program, Shur discovered that keeping his witnesses alive in the face of death threats involved more than eradicating old identities and creating new ones. It also meant cutting off families from their pasts and giving new identities to wives and children, as well as to mob girlfriends and mistresses.
It meant getting late-night phone calls from protected witnesses unable to cope with their new lives. It meant arranging funerals, providing financial support, and in one instance even helping a mobster's wife get breast implants. And all too often it meant odds that a protected witness would return to what he knew best-crime.
In this book Shur gives a you-are-there account of infamous witnesses, from Joseph Valachi to "Sammy the Bull" Gravano to "Fat Vinnie" Teresa, of the lengths the program goes to to keep its charges safe, and of cases that went verywrong and occasionally even protected those who went on to kill again.
He describes the agony endured by innocent people who found themselves in the wrong place at the wrong time and ended up in a program tailored to criminals. And along with Shur's war stories, WITSEC draws on the haunting words of one mob wife, who vividly describes her life of lies, secrecy, and loss inside the program.
A powerful true story of the inner workings of one of the most effective and controversial weapons in the war against organized crime and the inner workings of organized crime itself-and more recently against Colombian drug dealers, outlaw motorcycle gang members, white-collar con men, and international terrorists-this book takes us into a tense, dangerous twilight world carefully hidden in plain sight: where the family living next door might not be who they say they are. . .

"From the Hardcover edition.

Most helpful customer reviews

0 of 0 people found the following review helpful.
Interesting and easy read. Hard for any start-up
By PhillyFilly
Interesting and easy read. Hard for any start-up, but harder when the largest element is people. Just enough info to give you an inside view without being bogged down in bureaucratic or messy detail. ++

0 of 0 people found the following review helpful.
Five Stars
By Dan Davidson
A great read!!

24 of 26 people found the following review helpful.
Into Obscurity -- Not So Easily Accomplished!
By Daniel J. Maloney
I found WITSEC to be fascinating from cover to cover. Gerald Shur was one of the original founders of the federal Witness Protection Program. For many years, he was the lynchpin in bringing increasing levels of organization and professionalism to a once informal "make it up as you go along" experimental program.

Now retired and finally free to give an insider's view of the program and its successes and failures, Gerald Shur offers a sometimes captivatingly honest and direct chronicle of the challenges and growing pains the program went through over the years. He is able to give an honest appraisal of the good decisions and successes the program has had, and even more admirable, he is able to state and own the program's shortcomings and outright failures. I admire the fact that Shur has been able to step aside from this work that he lived and breathed for so many years and offer a fairly objective story of the program.

At one point in the book, a relocated witnesses' wife tells her own personal story. It is a touching and sad story of a woman who had to abandon herself without notice and chronicles the 25 years after she was first relocated. I cannot imagine, even after having read this book, how difficult it must be to leave one's entire identity behind in order to "become someone completely new" -- birth history, family, origins, family support systems, and familiar surroundings -- all in order to help save a partner's life or one's own! While some have been extremely critical of the purpose of the witness protection program over the years, this is no glamorous escape for criminals who would be otherwise incarcerated for their entire lives. During my reading, it sometimes struck me that the cost of giving up one's entire "life" in order to be protected is as stiff a price to pay as going to prison.

The Witness Protection program has been responsible for assisting in effectively paralyzing "organized crime" as we once knew in the United States. For over the last thirty years, this program, along with enforcement of the RICO statute and aggressive prosecution have very clearly limited the extent to which organized groups can impose their criminal behavior on others.

Peter Earley and Gerald Shur do an excellent job of providing an engaging and thoroughly entertaining chronicle of the first three decades of the Witness Protection Program from its start through its later development. In addition to its history, and a number of tales of harsh human drama, this is by no means a ponderous read. At points, as a reader I was simply howling in laughter at some of the characters that the program was expected to "protect". Even some of the agents had some extremely funny "three stooges" moments, as unintentional blunders became narrow escapes from harm's way.

Highly recommended

James J. Maloney
Saint Paul, Minnesota USA

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Jumat, 19 Juli 2013

[Z995.Ebook] Free Ebook Telecommunications Demystified, by Carl R. Nassar

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Telecommunications Demystified, by Carl R. Nassar

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Telecommunications Demystified provides details of�developments in telecommunications, and their underlying theory, are thoroughly examined in this sweeping tutorial. The book first builds a strong mathematical foundation, introduces the basic concepts of analogue and digital telecommunications, and then develops more complex topics such as source and channel coding, baseband and carrier modulation, estimation and synchronization, multiple access schemes, and trellis-coded modulation. Includes several MATLAB� tutorials that permit readers to model various telecommunications systems.

Balances a solid theoretical treatment of subjects with practical applications and examples
Covers both digital and analogue telecommunications systems, including digital modulation techniques
The accompanying material includes MATLAB� tutorials that permit readers to model various telecommunications systems and an electronic version of the book

Sales Rank: #3432743 in eBooks
Published on: 2013-10-22
Released on: 2013-10-22
Format: Kindle eBook

Review

"Professor Nassar has an uncanny ability to demystify the complexities of telecommunications systems engineering." --Dale N. Hatfield, former chief, Office of Engineering and Technology, Federal Communications Commission

"Provides a wide-ranging tutorial on theory and practical issues using the requisite math and equations. This book does not provide primarily a circuit-design or even a system-level, block-diagram treatment; instead, it seeks to explain the underlying principles, problems, techniques, and constraints of standard telecommunication functions. The book covers networks, source coding/decoding, modulators and demodulators, channel coding and decoding, trellis-coded modulation, filtering and equalizers, signal detection and estimation, and error detection and correction, among other topics. I won't mislead you and say this book is an easy read or a quick read. If you plan to get the most out of it, you need to pay attention and follow the equations and derivations, which include integrals, differentials, matrices, and more. Fortunately, the author clearly explains the transitions from one equation to the next without those fear-inducing phrases, such as "we can see," "the derivation is left as an exercise to the reader," and "it can be shown." If you want to increase your understanding of the issues and answers in digital-communications systems and some analog systems, this book should help." --EDN Magazine

About the Author
Carl Nassar is a professor of electrical engineering at Colorado State University, where he specializes in telecommunications research. He lives in Fort Collins, Colorado.

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0 of 0 people found the following review helpful.
Intuitive and Entertaining
By A Customer
I found this book an excellent re-introduction to communication theory. Dr. Nassar explains esoteric subjects in a well-thought, intuitive way. I strongly recommend this book for engineers who are starting to explore communications, as well as for those who are well-versed in the field and know the equations, but may not completely appreciate the understanding that they convey.

0 of 0 people found the following review helpful.
A Practicing Engineers Perspective
By david lee
Telecommunications Demystified is an accessable, well-written, and refreshing book. Other books on the subject of channel coding often gloss over examples,leaving too many details to the reader. This book however was step by step and easy to follow. I found Dr Nassar writing style refreshing.

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Kamis, 18 Juli 2013

[S635.Ebook] Ebook Management and Cost Accounting (with CourseMate and eBook Access Card), by Colin Drury

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Now in its eighth edition, this international bestseller has been widely recognised as the definitive textbook on management and cost accounting for over 25 years. Colin Drury expertly blends the theory and practice of management and cost accounting with extensive assessment questions and illuminating Real World Views, to fulfil all undergraduate and professional course needs in a single textbook. Management and Cost Accounting is ideally suited for use on management accounting and cost accounting modules taught on undergraduate accounting courses and for students preparing for the cost and management accounting examinations of the professional accountancy bodies at intermediate or advanced level. It is also appropriate for use by postgraduate and higher national diploma students studying cost and management accounting for the first time.

Sales Rank: #3110662 in Books
Published on: 2012-03-16
Original language: English
Number of items: 1
Dimensions: 10.00" h x 7.50" w x 1.00" l, .0 pounds
Binding: Paperback
783 pages

Review
"Providing a balance between theory and practical relevance, this excellent text is ideally suited to both management accounting undergraduate courses and professional courses." Clare Guthrie, Principal Lecturer in Management Accounting, Manchester Metropolitan University, UK

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About the Author
Colin Drury BA MBA ACMA is Emeritus Professor at Huddersfield University and a leading textbook author for a generation of accounting students. His books have been widely recommended by the main professional accounting bodies for their examinations. He is an active researcher and published in the main peer-reviewed journals including Management Accounting Research and European Accounting Review, with his research focussing on the application of management accounting techniques in British industry.

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Selasa, 16 Juli 2013

[P939.Ebook] Ebook Why We Hurt: The Natural History of Pain, by Dr. Frank T. Vertosick Jr., Frank Vertosick Jr.

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A top neurosurgeon and acclaimed author's unique and highly readable study of the paradox of pain, with fascinating anecdotes on childbirth, migraines, cancer, and more.

Medical science has made brilliant discoveries over the last century but as any cancer patient can attest, it has yet to conquer, or even fully comprehend, pain. Beginning with his own battle against severe migraines, and citing numerous case studies of his patients, in Why We Hurt Dr. Frank Vertosick explains how pain evolved, and by highlighting the critical functions it serves, he helps us to understand its value. Well written, expertly researched, and movingly told, each chapter offers an amalgam of medicine, history, anthropology, drama, inspiration, and practical advice on a myriad of pain syndromes, from back pain to angina, arthritis to carpal tunnel syndrome. A skilled writer and compassionate physician, Vertosick believes knowledge is often the first, and best, analgesic, and in Why We Hurt, "he offers fascinating insight into the greatest mystery of all: what it means to be human" (The Seattle Times).

Sales Rank: #732721 in Books
Color: Other
Published on: 2001-06-14
Original language: English
Number of items: 1
Dimensions: 8.50" h x .78" w x 5.50" l, .90 pounds
Binding: Paperback
312 pages

Features

ISBN13: 9780156014038
Condition: New
Notes: BRAND NEW FROM PUBLISHER! 100% Satisfaction Guarantee. Tracking provided on most orders. Buy with Confidence! Millions of books sold!

Amazon.com Review
If you've been paying attention, you've noticed by now that pain and suffering infiltrate nearly every part of life. Whether it's an executive nursing a quiet ulcer in the boardroom or a wailing child holding a skinned knee on the playground, this uniquely unpleasant signal must be important; if it weren't, we could more easily ignore it. Neurosurgeon Frank T. Vertosick Jr. explains the evolutionary, physiological, and psychological reasons for pain in Why We Hurt: The Natural History of Pain. Not a paean to despair, the book helps to ease suffering through understanding and learning just how far we've come in the short history of palliative practice. Vertosick's long experience working with sufferers of hideously intractable pain, and his own long battle with migraine, provides depth and illustrative stories that draw the reader into what might otherwise be dry medicalese.

It's heartening to see more surgeons like Dr. Vertosick coming to accept the often-strong psychological basis of pain and appropriate nonsurgical, nonpharmacologic treatments for it. Certainly, as in the case of the woman whose trigeminal nerve was eroded by a circulatory tangle, cutting and suturing have their appropriate place. And the author found several years ago that simple acetaminophen was all he needed to stave off his headaches. His gentle explanations and usually uplifting stories help us prepare for our own episodes of suffering. Though it might seem like small comfort, learning Why We Hurt can be as powerful as the strongest narcotic, with no side effects. --Rob Lightner

From Publishers Weekly
This accessible and compassionate exploration of physical pain should be of great interest since, at one time or another, almost everyone has experienced severe or recurrent pain. As a neurosurgeon, Vertosick (When the Air Hits Your Brain) has treated patients with migraines, back problems, neuralgia, rheumatoid arthritis, angina and cancer. Drawing on case histories from his practice and on scientific research, he surveys the experience and the processes of pain, as well as the idea of it. He gives a brief, clearly stated history of painful conditions, explains how and why pain strikes and describes the various ways medical intervention can ease or eradicate pain. He also reflects on his wife's labor pains; details the history of anesthesia (a medical invention that he rates as "high among the greatest achievements of our age"); and tells a series of stories about how he and his patients have dealt with their pain. He recounts, for example, how he worked with Anne, a patient whose ruptured disc prevented her from walking on one of her legs. First he tried physical therapy, steroids and narcotic medications to alleviate her pain. Then, when all these treatments failed, he performed the back surgery that enabled her to recover. Combining personal narrative with scientific explanation, Vertosick, who describes himself as "a bit of a wimp" who dislikes seeing patients in pain, displays an enormous dedication to relieving suffering. (June)
Copyright 2000 Reed Business Information, Inc.

From Booklist
Neurosurgeon Vertosick's interest in pain began as a boy of 8 or 9, when he saw TV's Dr. Ben Casey cure a cancer patient's severe pain. He is also personally acquainted with pain from his long history of migraine. He examines the pain of migraine and also of phantom limbs (felt where a limb has been amputated), ruptured discs, and birth. Drawing from his practice and both scientific and literary medical writings, he fashions some of the strongest chapters out of such personal events as his wife's labor giving birth to their first child and his father's bouts of angina. In his account of tic doloreux, or facial nerve pain, he smoothly blends history, literature, anatomy, and neurology. The chapters on carpal tunnel syndrome and rheumatoid arthritis deal strikingly with those timely topics, and Vertosick's exploration of malingering and the lack of pain is fascinating. He is obviously a deeply caring physician, who humbly says that "the true business of a physician is not saving lives but easing pain." William Beatty

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70 of 77 people found the following review helpful.
Good read, but not always right
By William C. Tom
Dr. Vertosick has written a fine collection of vignettes of patients suffering from chronic pain, from his perspective as a practicing neurosurgeon. Detracting from his storytelling skills, however, are the errors of fact and intepretation which appear throughout the book.
Most egregious is the confusion of nitrous oxide for nitric oxide, the molecule used ubiquitously in our bodies for vascular regulation and neurotransmission. This is not simply a spelling error, since Dr. Vertosick goes ahead and mistakenly identifies the subject of the 1998 Nobel prize (nitric oxide) as "laughing gas" (nitrous oxide). Despite the similarity in nomenclature, the two gases are completely different in their physiological roles and effects.
Perhaps in an effort to justify the grandiose title, many appeals to evolutionary theory are made. These efforts are stretches at best, and wrong at times. For example, the speculation that the malaise produced by the flu may be adaptive to humans by limiting viral spread through social contact ignores the fact that the individual, not the group, is the most important locus of Darwinian selection. A more likely adaptive explanation for the clinical symptoms of the flu is that inactivity and fever allow the infected body to concentrate its physiological resources against the invaders.
In a discussion on how nitroglycerin relieves the crushing chest pain (and myocardial ischemia) of angina, the explanation was given that the body's arteries dilate, thus making it easier for the suffering heart to pump blood forward. In fact. the major effect of nitroglycerin is to dilate the veins, providing the heart with lesser volumes of blood to pump.
While lauding the pain relief given to his laboring wife by epidural analgesia, Dr. Vertosick reports that the epidural prolonged the birth process. Although there is a correlation between the use of an epidural and longer labor, the current medical literature attributes this to the likelihood that women with complicated- and longer - labor are more likely to request an epidural, not that an epidural prolongs the childebirth process.
Finally, and this probably falls in the "nitpicking" category, the bacterium causing leprosy belongs to the same genus as that causing tuberculosis, not the same species as claimed in the book.
I did not read the book with an intention to find errors, but there are mistakes which jump out at the biomedically literate reader. I would still recommend the book as a good introduction to the problem of chronic pain, written with sympathy and clinical insights. However, it is disturbing that a book written by a physician would contain so many factual errors of a biological or medical nature. I wish the author - or his editors - would clean up the text for a second edition.

46 of 52 people found the following review helpful.
lfootemd
By Leslie Arden Foote
After reading the introduction I had great hopes of gaining some unique perspectives on pain from a teleologic standpoint. Unfortunately reading further only led to crushing disappointment.
This is a book on pain that comes from a very narrow focus. Each chapter, opened with a clinical vignette, attempts to educate the reader as to the presumed cause of pain and then the treatment options. Written from the perspective of a neurosurgeon, it's no surprise where this all goes. Unfortunately not everything in the realm of pain is going to take on the appearance of a nail which the author enjoys using his hammer on at the conclusion of each chapter.
Chronic pain is an elusive character and seldom conforms to our needs for a "structural" answer. The author has sadly limited his overview of pain to those situations where a "surgical answer" is awaiting. Those varieties of pain that so often elude us in Medicine, such as Fibromyalgia, are not even addressed. What's more distressing is that the emotional component of pain is given virtually no space in the book, and indeed is ignored. The Vignette on the malingerer is a case in point. The author's idea of therapy was to announce to the patient that "nothing's wrong" and go home. As much as malingering is a nuisance in any clinical setting, there still is pain--you just won't find it on an xray.
As a primary care physician I am concerned about the tone of this book. Many patients in my practice are in chronic pain SINCE they underwent one of these fancy neurosurgical proceedures. It's clear to any of us that see patients in the aftermath of surgery that Medicine does not possess all the answers since it finds it distasteful to deal with the psychosomatic components of pain. The author only reinforces that viewpoint.
In addition to the errors that the first reviewer noted I would like to add that acupuncture does not "treat the imagination" as the author smugly suggests. If a placebo effect were the only explanation than how does that explain the effects observed in veterenary settings?
This is a book that may produce false hope in individuals with chronic pain.

13 of 15 people found the following review helpful.
A terrible instrument
By ealovitt
C.S. Lewis said in his book, "The Problem of Pain": "Pain as God's megaphone is a terrible instrument." It gets our attention and warns us of danger. Unfortunately, some doctors don't listen to that same megaphone when treating their patients.
According to a recent "New York Times" article, "More than a third of seriously ill patients who requested that doctors ease their discomfort instead of prolonging their lives appear to have had their wishes overlooked, a new study [published in the "Journal of the American Geriatrics Society"] reports".
"Why We Hurt" claims that, "three of four cancer patients will die in poorly controlled pain, and the percentage climbs higher still for those succumbing to malignancies with a talent for invading bones and nerves, including cancers of the breast, prostate, rectum, pancreas, and cervix."
This must be disquieting information for people who are suffering from terminal illnesses like cancer or AIDS, especially since doctors already tend to undermedicate for pain---think of all of the criminal and civil lawsuits pending for over-prescription of OxyContin, and it is easy to understand why some doctors avoid the heavy-duty painkillers or their prolonged usage.
Dr. Vertosick has treated some nightmarish pain problems during his career as a neurosurgeon. This book contains many case histories of patients in agony, connected by the overarching theme of why it is necessary to feel pain. Each story explains why we are connected in such a hurtful way to our inner and outer worlds.
According to Dr. Vertosick, "when stripped of pain's discipline, we neglect our bodies until they become battered beyond recognition....The hands and feet of longtime diabetics and paralytics...become deformed and covered with pressure sores. Patients with trigeminal neuralgia who have their corneas rendered numb by alcohol nerve blocks will ultimately go blind from unchecked corneal scarring."
There is also the sad story of Jimmy, the boy who was born without the ability to feel pain.
"Why We Hurt" is a book that both teaches and fascinates. I learned that neurosurgery can help at least some people (including cancer patients) who suffer from intractable pain. There are only a couple of areas where I found Dr. Vertosick to be overly optimistic. One concerns the efficacy of back surgery. Read this book, and then read the prologue to Dr. Jerome Groopman's "Second Opinions" for an example of where back surgery (spinal fusion) worsened the patient's condition. My own neurologist has told me that 60% of patients who underwent back surgery felt that it didn't do any good.
The question of whether newborn babies feel pain is another gray area where this author tends toward optimism. He feels that they are not yet fully connected to sensations of pain. However, I've read research to the contrary: newborn infants who have been operated on without anesthesia not only feel pain, they remember it.
These two small quibbles aside, please read this book. You may someday have to make choices on pain control, and this is a good place to start learning what those choices may entail, and (if it's any comfort) why it is `natural,' i.e. in accordance with human evolution, that you feel the way you do.

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Rabu, 10 Juli 2013

[D204.Ebook] Download PDF New Principles of Best Practice in Clinical Audit, by Robin Burgess, John Moorhead

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With the NHS committed to making quality the centre of treatment, clinical audit - a proven and effective process for measuring quality and driving its improvement - has never been a more topical issue. Now thoroughly updated and rewritten, this new edition describes the process by which health professionals, managers and other NHS staff can assess the standard of care they deliver and how closely it corresponds with recommended best practice. It sets out the key principles of clinical audit practice, detailing advances in recent years such as simplified and accelerated audit, improved patient involvement, attention to ethics and methodology and the embedding of clinical audit in organisational governance as well as clinical practice. This book is essential reading for all those who undertake clinical audit or are training to do so, including health practitioners, managers and commissioners in the NHS. It will also be useful to patients who contribute to audit governance. Reviews from the first edition: This book should be available in all trusts and recommended to those of both junior and senior status who are about to invest time and energy in an audit project.' MEDICAL PROTECTION SOCIETY [W]ell-structured with summaries set out as key points throughout. The appendices give invaluable information on numerous websites for clinical guidelines, on clinical audit and clinical governance.' PHYSIOTHERAPY JOURNAL

Sales Rank: #3135049 in Books
Published on: 2011-01-20
Original language: English
Number of items: 1
Dimensions: 9.75" h x 6.50" w x .75" l, .90 pounds
Binding: Paperback
214 pages

Features

ISBN13: 9781846192210
Condition: New
Notes: BRAND NEW FROM PUBLISHER! 100% Satisfaction Guarantee. Tracking provided on most orders. Buy with Confidence! Millions of books sold!

About the Author
Chief Executive, Healthcare Quality Improvement Partnership

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