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This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.
Sixty-one tales narrated by Yaquis reflect this people's sense of the sacred and material value of their territory.
An analysis of the challenge that India's poison culture posed for colonial rule and toxicology's creation of a public role for science.
Although, as W.D. Billings notes in his chapter in this book. the development of physiological ecology can be traced back to the very beginnings of the study of ecology it is clear that the modern development of this field in North America is due in the large part to the efforts of Billings alone. The foundation that Billings laid in the late 1950s came from his own studies on deserts and subsequently arctic and alpine plants, and also from his enormous success in instilling enthusiasm for the field in the numerous students attracted to the plant ecology program at Duke University. Billings' own studies provided the model for subsequent work in this field. Physiological techniques. normally confined to the laboratory. were brought into the field to examine processes under natural environmental conditions. These field studies were accompanied by experiments under controlled conditions where the relative impact of various factors could be assessed and further where genetic as opposed to environmental influences could be separated. This blending of field and laboratory approaches promoted the design of experiments which were of direct relevance to understanding the distribution and abundance of plants in nature. Physiological mechanisms were studied and assessed in the context of the functioning of plants under natural conditions rather than as an end in itself.
This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the “macro system.” A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects.