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Superbugs: An Arms Race against Bacteria
by William HallAntibiotics are powerful drugs that can prevent and treat infections, but they are becoming less effective as a result of drug resistance. Resistance develops because the bacteria that antibiotics target can evolve ways to defend themselves against these drugs. When antibiotics fail, there is very little else to prevent an infection from spreading. Unnecessary use of antibiotics in both humans and animals accelerates the evolution of drug-resistant bacteria, with potentially catastrophic personal and global consequences. Our best defenses against infectious disease could cease to work, surgical procedures would become deadly, and we might return to a world where even small cuts are life-threatening. The problem of drug resistance already kills over one million people across the world every year and has huge economic costs. Without action, this problem will become significantly worse. Following from their work on the Review on Antimicrobial Resistance, William Hall, Anthony McDonnell, and Jim O’Neill outline the major systematic failures that have led to this growing crisis. They also provide a set of solutions to tackle these global issues that governments, industry, and public health specialists can adopt. In addition to personal behavioral modifications, such as better handwashing regimens, Superbugs argues for mounting an offense against this threat through agricultural policy changes, an industrial research stimulus, and other broad-scale economic and social incentives.
Superbugs: The Race to Stop an Epidemic
by Matt McCarthy"An amazing, informative book that changes our perspective on medicine, microbes and our future."--Siddhartha Mukherjee, MD, New York Times bestselling author of The Emperor of All MaladiesA New York Times bestselling author shares this exhilarating story of cutting-edge science and the race against the clock to find new treatments in the fight against the antibiotic-resistant bacteria known as superbugs.Physician, researcher, and ethics professor Matt McCarthy is on the front lines of a groundbreaking clinical trial testing a new antibiotic to fight lethal superbugs, bacteria that have built up resistance to the life-saving drugs in our rapidly dwindling arsenal. This trial serves as the backdrop for the compulsively readable Superbugs, and the results will impact nothing less than the future of humanity.Dr. McCarthy explores the history of bacteria and antibiotics, from Alexander Fleming's discovery of penicillin, to obscure sources of innovative new medicines (often found in soil samples), to the cutting-edge DNA manipulation known as CRISPR, bringing to light how we arrived at this juncture of both incredible breakthrough and extreme vulnerability. We also meet the patients whose lives are hanging in the balance, from Remy, a teenager with a dangerous and rare infection, to Donny, a retired New York City firefighter with a compromised immune system, and many more.The proverbial ticking clock will keep readers on the edge of their seats. Can Dr. McCarthy save the lives of his patients infected with the deadly bacteria, who have otherwise lost all hope?
Supercritical Fluid Technology for Drug Product Development
by Uday B. Kompella Peter York Boris Y. ShekunovInterconnecting the fundamentals of supercritical fluid (SCF) technologies, their current and anticipated utility in drug delivery, and process engineering advances from related methodological domains and pharmaceutical applications, this volume unlocks the potential of supercritical fluids to further the development of improved pharmaceutical prod
Supercritical Fluids Technology in Lipase Catalyzed Processes
by Sulaiman Al-Zuhair Hanifa TaherEnzymes are currently used in various industries, most commonly in food, detergents, and pharmaceuticals production. Lipases are hydrolytic enzymes that demonstrate great potential as an alternative to conventional catalysts in a number of industrial applications. A complete understanding of enzymes, and their proteins structure and environmental behavior, can greatly aid in the further development of industrial applications. Supercritical Fluids Technology in Lipase Catalized Processes provides basic information about enzymes, their sources, reaction kinetics, and main industrial applications. The book focuses in lipases. their main sources, structure, and features, with an emphasis on their specificity and interfacial activity, and presents proven techniques for isolating, extracting, and purifying. Comprised of six compact chapters, this comprehensive guide introduces: Immobilization techniques and immobilized lipases that allow repeated use (which is essential from an economic point of view) Different bioreactor configurations using immobilized lipases The latest information on the available technologies in lipolytic reactions The advantages of nonaqueous media in biochemical synthesis over aqueous and solvent-free systems Material on the use of lipases in nonaqueous media to overcome the drawbacks usually encountered with the use of conventional chemical catalysts The use of supercritical fluids (SCFs) as a green alternative reaction medium Factors affecting the physical properties of lipases in this medium and, hence, their activity and stability A case study using supercritical carbon dioxide (SC-CO2) for biodiesel production Novel, cutting-edge technology, using immobilized enzymes to reduce the overall production cost Supercritical Fluids Technology in Lipase Catalized Processes outlines the main industrial applications of common enzymes and discusses relevant challenges and innovations emerging in the field.
Superfuel: Ketogenic Keys to Unlock the Secrets of Good Fats, Bad Fats, and Great Health
by Dr James DiNicolantonio Dr Joseph MercolaNew York Times best-selling author Dr. Joseph Mercola teams up with cardiovascular expert Dr. James J. DiNicolantonio to cut through the confusion about how dietary fats affect our bodies--and set the record straight on how to eat for optimal health.Should you cook with coconut oil or vegetable oil? Eat butter, cream, or olive oil? Supplement with fish oil or flax oil? Sometimes it seems as if everyone has a different opinion on these crucial questions--but this book holds real answers. Best-selling author and teacher Dr. Joseph Mercola teams up with cardiovascular expert Dr. James DiNicolantonio to cut through the confusion about how dietary fats affect our bodies and set the record straight on how to eat for optimal well-being.Dr. DiNicolantonio, an internationally known and respected scientist, has spent nearly a decade studying the effects of different fats on the body. Dr. Mercola is one of the world's leading authorities on natural health. In Superfuel, they've gathered a wealth of information and insight in a form that's both impeccably researched and highly accessible.You'll read about: * The many health problems supposedly caused by saturated fat--that actually aren't * Why the so-called healthy vegetable oils are actually making you sick and fat * The optimal ratio of omega-3 to omega-6 fats in your diet * Foods that help resolve inflammation, increase longevity, and fight or prevent chronic illness * A cyclical ketogenic eating plan that keeps your body burning fat as healthy fuel * Supplemental fats such as fish oil, krill oil, and flax oil--what to take and how to choose * Which oils you should cook with, how to use them, and why * And much moreDrawing on Dr. DiNicolantonio's firsthand research at Saint Luke's Mid America Heart Institute, as well as hundreds of groundbreaking studies from the medical literature, Superfuel will give you the facts you need to optimize your fats and your health.
Superhuman
by Professor Lord Robert Winston Lori OliwensteinAccompanying the major new BBC documentary series, Superhuman explores the human bodys astonishing ability to heal, renew and regenerate itself. In recording the before, during and after of radical operations on real people it introduces us to the pioneering efforts of medical teams and alerts us to the ethical issues that new medical advances raise. Over six chapters Superhuman addresses significant developments within six key medical areas: cancer, infection, transplantation, trauma, repair and reproduction. Acknowledging the debt modern physicians owe to yesterday Superhuman begins by investigating the human bodys innate abilities to heal itself. And, as we gladly launch ourselves into an age of biotechnology, it questions whether we might now use all the information available to us to comprehend finally how our bodies work? If we can achieve that, perhaps becoming superhuman is truly within our reach. Chapter one introduces us to the trauma surgeons who have discovered that the shock that follows trauma can prove beneficial in saving the body and the brain. Chapter two chronicles the astonishing technology now being used in medical transplants and the contentious issues these processes excite. Should technology continue to develop apace how are doctors and patients to choose between using an artificial limb created specifically for a patient, a human limb grown from the patients own genetic information, or the alternative solutions offered by the animal kingdom? And is intervention of true benefit to the patient if it requires a lifetime of immuno-suppressing drugs? The recent successes of the Human Genome Project have dissolved the boundaries of regeneration with made-to-order organs no longer beyond our limits. Chapter three presents the scientists responsible for engineering human tissue from materials found in the body and outlines how they might help us might claim our lost powers of regeneration. Chapter four relates how we are faring in the battle against the old enemy cancer and tells how experts in this field are trying to regain control of the cancer cells that turn against us. Chapter five explains how we strive to combat the threats we all face living in a modern world teeming with globetrotters who share one feature we're all potential contagion-carriers. Superhuman goes on to inform of the dangers of pushing too far to eradicate infectious disease from our lives completely. Chapter six spotlights an area of considerable debate that will possibly alter the course of human evolution fertility and genetic manipulation. Superhuman discusses both the advantages and the dangers of new technologies in this area, arguing that they have many positive applications and that often the hazards are overstated, solely through fear. In an attempt never to lose sight of our humanity while inviting the superhuman in us all to work, Superhuman encourages a holistic approach to medicine and an open forum for the discussion of the future of medical science.
The Superior Colliculus: New Approaches for Studying Sensorimotor Integration
by William C. Hall Adonis MoschovakisThe Superior Colliculus: New Approaches for Studying Sensorimotor Integration discusses new experimental and theoretical approaches to investigating how the brain transforms sensory signals into the motor commands that are used to shift the direction of gaze. The material includes the potential models for sensorimotor integration in the primate bra
Supermacroporous Cryogels: Biomedical and Biotechnological Applications
by Ashok KumarThe process of cryogelation has been vigorously studied over the past two decades, with recent research focussing on applications of these polymer systems in various biomedical and biotechnological fields. While there is significant literature available as research publications, limited reviews, and book chapters, Supermacroporous Cryogels: Biomedi
Supermicrosurgical Lymphaticovenular Anastomosis
by Giuseppe Visconti Akitatsu Hayashi Johnson Chia-Shen YangThe supermicrosurgical procedure known as Lymphaticovenular Anastomosis, or LVA, is a minimally invasive physiologic surgical treatment of lymphedema, which has gained attention worldwide in recent years as technical limitations were overcome and surgical indications can now apply to a larger set of patients with lymphatic disease. Complex advanced-stage lymphedema cases and patients with lymphorrea still have functional lymphatic channels, and could benefit from lymphaticovenular anastomosis. The latest technologies, such as ultrahigh frequency ultrasound, allow now to perform a detailed preoperative planning, improving efficacy and reliability of the intervention. Additional technologies that are available, as for example Rest-Stress Lymphoscintigraphy, Laser Tomography and Photoacoustic Imaging are also presented in the book, as all concur to build a complete preoperative and intraoperative set of information. Supermicrosurgical Lymphaticovenular Anastomosis is ahandy, one-of-a-kind guide built on the experience of contributors that are experts in this highly specialized field, while presenting topics in a clear and complete fashion, with the support of over 240 illustrations and chapter-related videos for a thorough understanding of preparatory steps and microsurgical techniques. This volume will be a valued companion to the modern microsurgeon dealing with lymphedema who wants to refine supermicrosurgical skills but also be of interest for professionals to gain insight in latest and more traditional technologies, through the related dedicated chapters and videos. Via app: download the SN More Media app for free, scan a link with play button and videos directly on your smartphone or tablet.
Superoxide Ion: Chemistry and Biological Implications (CRC Press Revivals)
by Igor B. Afanas'evThe chemical properties of superoxide ion, its biological role, and the role of other oxygen radicals which arise as a result of its transformations are contained in this text. In Volume I the principal reactions of superoxide ion, including protonation reactions with proton donors, nucleophilic reactions with esters, alkyl halides and other compounds, electron transfer reactions with quinones and metal complexes, are described.
Superoxide Ion Chemistry and Biological Implications
by Igor B. Afanas'evThe chemical properties of superoxide ion, its biological role, and the role of other oxygen radicals which arise as a result of its transformations are contained in this text. In Volume I the principal reactions of superoxide ion, including protonation reactions with proton donors, nucleophilic reactions with esters, alkyl halides and other compounds, electron transfer reactions with quinones and metal complexes, are described. Basic quantitative data including rate constants and yields for the reactions of superoxide ion of all types are given in tables. This volume contains the mechanisms of the generation of oxygen radicals in cells and the interaction of superoxide ion with cell components. The role of superoxide ion in lipid peroxidation and destruction of proteins and nucleic acids is explained, as well as oxygen radicals in the mechanisms of toxic and therapeutic action of drugs, especially anticancer antibiotics. In addition, the action of superoxide ion and other oxygen radicals on plants, micro-, and macroorganisms is discussed, along with the role of oxygen radicals in normal metabolic and pathological processes.
Superstition: Belief in the Age of Science
by Robert L. ParkWhy the battle between superstition and science is far from overFrom uttering a prayer before boarding a plane, to exploring past lives through hypnosis, has superstition become pervasive in contemporary culture? Robert Park, the best-selling author of Voodoo Science, argues that it has. In Superstition, Park asks why people persist in superstitious convictions long after science has shown them to be ill-founded. He takes on supernatural beliefs from religion and the afterlife to New Age spiritualism and faith-based medical claims. He examines recent controversies and concludes that science is the only way we have of understanding the world.Park sides with the forces of reason in a world of continuing and, he fears, increasing superstition. Chapter by chapter, he explains how people too easily mistake pseudoscience for science. He discusses parapsychology, homeopathy, and acupuncture; he questions the existence of souls, the foundations of intelligent design, and the power of prayer; he asks for evidence of reincarnation and astral projections; and he challenges the idea of heaven. Throughout, he demonstrates how people's blind faith, and their confidence in suspect phenomena and remedies, are manipulated for political ends. Park shows that science prevails when people stop fooling themselves.Compelling and precise, Superstition takes no hostages in its quest to provoke. In shedding light on some very sensitive--and Park would say scientifically dubious--issues, the book is sure to spark discussion and controversy.
Supervised and Unsupervised Data Engineering for Multimedia Data
by Suman Kumar Swarnkar J P Patra Sapna Singh Kshatri Yogesh Kumar Rathore Tien Anh TranSUPERVISED and UNSUPERVISED DATA ENGINEERING for MULTIMEDIA DATA Explore the cutting-edge realms of data engineering in multimedia with Supervised and Unsupervised Data Engineering for Multimedia Data, where expert contributors delve into innovative methodologies, offering invaluable insights to empower both novices and seasoned professionals in mastering the art of manipulating multimedia data with precision and efficiency. Supervised and Unsupervised Data Engineering for Multimedia Data presents a groundbreaking exploration into the intricacies of handling multimedia data through the lenses of both supervised and unsupervised data engineering. Authored by a team of accomplished experts in the field, this comprehensive volume serves as a go-to resource for data scientists, computer scientists, and researchers seeking a profound understanding of cutting-edge methodologies. The book seamlessly integrates theoretical foundations with practical applications, offering a cohesive framework for navigating the complexities of multimedia data. Readers will delve into a spectrum of topics, including artificial intelligence, machine learning, and data analysis, all tailored to the challenges and opportunities presented by multimedia datasets. From foundational principles to advanced techniques, each chapter provides valuable insights, making this book an essential guide for academia and industry professionals alike. Whether you’re a seasoned practitioner or a newcomer to the field, Supervised and Unsupervised Data Engineering for Multimedia Data illuminates the path toward mastery in manipulating and extracting meaningful insights from multimedia data in the modern age.
Supervision and Mentoring in Healthcare
by Neil GopeeThis bestselling textbook introduces the theories, evidence and research that define supervision, mentoring, learning and student assessment in healthcare today. It combines an evidence-based approach that supports critical analysis with a sharp focus on how to provide effective supervision in everyday practice. Interprofessional in its scope, with reference to both the NMC and HCPC, it is essential reading for anyone taking on a supervisory, mentoring role across nursing, midwifery, social care and the allied health professions. Key features of the book include: · A companion website with a video from the author, a test yourself glossary and free SAGE journal articles to support you during your mentorship course and in practice · Example templates for you to use with students, such as learning contracts, lesson plans and professional development plans · Activities and reflection points which enhance your understanding and help you to develop your own approach to mentoring
Supervision and Mentoring in Healthcare
by Neil GopeeThis bestselling textbook introduces the theories, evidence and research that define supervision, mentoring, learning and student assessment in healthcare today. It combines an evidence-based approach that supports critical analysis with a sharp focus on how to provide effective supervision in everyday practice. Interprofessional in its scope, with reference to both the NMC and HCPC, it is essential reading for anyone taking on a supervisory, mentoring role across nursing, midwifery, social care and the allied health professions. Key features of the book include: · A companion website with a video from the author, a test yourself glossary and free SAGE journal articles to support you during your mentorship course and in practice · Example templates for you to use with students, such as learning contracts, lesson plans and professional development plans · Activities and reflection points which enhance your understanding and help you to develop your own approach to mentoring
Supervision and Support in Primary Care
by Jonathan Burton John LaunerThis unique and practical book provides a clear introduction to clinical supervision and support in primary care. Supervision and Support in Primary Care provides practical information and guidance on the nature and purpose of clinical supervision. It uses examples and perspectives from the world of mental health, Balint groups and self-directed learning, and examines the benefits and challenges of supervision within the primary care setting. Numerous case studies are used throughout to describe the wide range of current approaches to supervision for general practitioners, illustrating how this can contribute towards more effective clinical work and training. All those working within primary care will find this book valuable reading.
Supervision for Occupational Therapy: Practical Guidance for Supervisors and Supervisees
by Stephanie TempestSupervision for Occupational Therapy is a practical text that guides both supervisors and supervisees to make the most out of supervision opportunities. While supervision in occupational therapy is vital as a mechanism for public and professional safety, learning how to do it successfully on-the-job can be a daunting prospect. By gathering stories from different professions, sectors, and parts of the world, this book is a hands-on guide to help occupational therapists navigate the complexities of supervision throughout their careers. This book presents, for the first time, the 3Cs for Effective Supervision (Connections, Content, and Continuing development), which offers a platform for supervisors and supervisees to frame their supervision practices. The chapters discuss common models and theories for supervision, ideas for how to structure relationships and sessions, templates and question guides for enhancing conversations, and practical strategies for dealing with common challenges. The book also considers the impact of workforce issues, diverse populations, and regional/rural/remote practice on supervision. Offering career-span advice and a process of self- and professional development to work through, this book provides a way to scaffold and support supervisors' and supervisees' learning and practice of supervision throughout working life. It is an essential guide for all occupational therapists. The eResources for this book are available at www.Routledge.com/9780367552428
Supervision of Learning and Assessment in Healthcare
by Neil GopeeUpdated in line with contemporary healthcare practice, this bestselling textbook introduces the theories, evidence and research behind effective student supervision and assessment. By developing your understanding of how people learn, the book enables you to facilitate student learning and development while also building your skills in a wide range of different aspects of assessment. Inter-professional in scope, the book is essential reading for anyone preparing for or undertaking a supervisory role in nursing, midwifery, social care and the allied health professions. Key Features and updates: Reflects the move away from the mentorship role to learning supervisors and assessors Includes a new chapter on the application of simulation in healthcare education Fully updated with the latest research, policies and guidance, with reference to both the NMC and HCPC Action and reflection points consolidate your learning and help develop your own supervisory style
Supervision of Learning and Assessment in Healthcare
by Neil GopeeUpdated in line with contemporary healthcare practice, this bestselling textbook introduces the theories, evidence and research behind effective student supervision and assessment. By developing your understanding of how people learn, the book enables you to facilitate student learning and development while also building your skills in a wide range of different aspects of assessment. Inter-professional in scope, the book is essential reading for anyone preparing for or undertaking a supervisory role in nursing, midwifery, social care and the allied health professions. Key Features and updates: Reflects the move away from the mentorship role to learning supervisors and assessors Includes a new chapter on the application of simulation in healthcare education Fully updated with the latest research, policies and guidance, with reference to both the NMC and HCPC Action and reflection points consolidate your learning and help develop your own supervisory style
Supervisory Relationship
by Mary E. Sarnat Mary Gail Frawley-O'DeaIn the past two decades, many psychodynamic therapists have begun to view the relational processes taking place between patient and therapist as a central source of transformation. Yet traditional paradigms of clinical supervision, focusing primarily on didactic teaching, have limitations for training therapists to work in these new ways. This groundbreaking volume is the first to elaborate a comprehensive contemporary model of supervision. Using a wealth of examples and vignettes, the authors show how working within the vicissitudes of the supervisory relationship can allow the supervisee to gain a deeper understanding of the treatment method being taught. Key topics discussed include issues of power and authority, regression in the supervisory relationship, rethinking the "teach/treat" question, parallel process as a relational phenomenon, working with group process in case conference, and the role of the organization in supporting training. This is a richly informative resource for psychologists, psychiatrists, social workers, psychoanalysts, and others involved in clinical supervision and training. It also will serve as a text for courses in supervision and organizational psychology.
Supine Percutaneous Nephrolithotomy and ECIRS
by Cesare Marco Scoffone András Hoznek Cecilia Maria CraccoPNL is the gold standard for the management of large and/or otherwise complex renal stones. Since its introduction in the seventies PNL has undergone considerable evolution, mainly driven by the improvement in access techniques, endoscopic instrument technology, lithotripsy devices and drainage management. The conventional prone position for PNL has been challenged in the last two decades by a variety of modifications, including the supine and Galdakao-modified supine Valdivia positions, which make simultaneous retrograde working access to the collecting system possible and have proven anesthesiological advantages. The Galdakao-modified supine Valdivia position allowed the development of ECIRS (Endoscopic Combined IntraRenal Surgery), a technique exploiting a combined antegrade and retrograde approach to the upper urinary tract, using both rigid and flexible endoscopes with the related accessories. The synergistic teamwork of ECIRS provides a safe and efficient, minimally-invasive procedure for the treatment of all kinds of urolithiasis. The aim of this book is to share with the urologic community worldwide our experience, our standardization of all the steps, and tips and tricks for the procedure.
Supplemental Nutrition Assistance Program
by Julie A. CaswellFor many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U. S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families. In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.
Supplies Management for Health Services (Routledge Revivals)
by Stanley HymanFirst published in 1979, Supplies Management for Health Services looks at the characteristics and problems of hospital suppliers and examines the way in which the hospital and the National Health Service deal with supplies problems and relations with suppliers. Beginning with a description of the National Health Service and its supplies’ organisations and the role of the Department of Health and Social Security in this field, the book then reports on the detailed studies made over two years of the supplies’ problems of ten London area health authorities and ten London manufacturers of medical equipment. The NHS situation is then contrasted with the supplies’ situation in three non-health organisations and with the health supplies situation in France and West Germany. The final part of the book analyses the information obtained, proposes a means of assessing supplies systems, and evaluates the NHS situation. This is followed by the realistic proposals for reform, advocating a system similar to that used in British defence services, based on a central procurement agency, close cooperation with private manufacturers, and manufacture by government where necessary. This book will surely interest students of economics and global health.
Supply Chain Management (Elements of Improving Quality and Safety in Healthcare)
by Sharon J. WilliamsCreating a well-integrated, resilient, and highly transparent supply chain is central to effective and safe patient care. But managing healthcare supply chains is complex; common challenges include the underuse, overuse, and misuse of health resources. This Element introduces the key principles and definitions of healthcare supply chains. Practical insights into the design and operation of healthcare supply chains are provided. Core characteristics of effective supply chain management such as performance management, systems thinking, and supply chain integration are examined along with the application of specific supply chain design and improvement approaches. Finally, the Element proposes areas that require further development both in research and practice. This title is also available as open access on Cambridge Core.
Supply Chain Management in the Drug Industry
by Hedley ReesThis book bridges the gap between practitioners of supply-chain management and pharmaceutical industry experts. It aims to help both these groups understand the different worlds they live in and how to jointly contribute to meaningful improvements in supply-chains within the globally important pharmaceutical sector. Scientific and technical staff must work closely with supply-chain practitioners and other relevant parties to help secure responsive, cost effective and risk mitigated supply chains to compete on a world stage. This should not wait until a drug has been registered, but should start as early as possible in the development process and before registration or clinical trials. The author suggests that CMC (chemistry manufacturing controls) drug development must reset the line of sight - from supply of drug to the clinic and gaining a registration, to the building of a patient value stream. Capable processes and suppliers, streamlined logistics, flexible plant and equipment, shorter cycle times, effective flow of information and reduced waste. All these factors can and should be addressed at the CMC development stage.