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The Wonder and the Mystery: 10 Years of Reflections from the Annals of Family Medicine
by Robin GotlerPublished in association with the Annals of Family Medicine, The Wonder and the Mystery is an anthology of intimate personal stories and innovative ideas from the Annals' Reflections section. It includes a wide range of articles, from influential pieces on urgent topical issues to exceptional stories of unique individuals. These articles shed light on small moments and major life transitions. In the process, they help us find meaning in our own physical, emotional, and spiritual journeys. The one-of-a-kind stories and ideas in the book speak to all of us who are interested in health care and health, caring and connection: clinicians, patients, family members, researchers, policy makers, and more. The book reminds us that "the things we cannot measure may be the very things that will sustain us."
The Wonder of the Human Hand: Care and Repair of the Body's Most Marvelous Instrument (A Johns Hopkins Press Health Book)
by E. F. Shaw WilgisSpecialists from a world-class hand center remind us how very important hands are and describe how medicine helps people whose hands are impaired.Using our hands, we interact with the environment in ways that are more sophisticated, more varied, and more productive than any other part of our body. The delicate instrument that is the hand makes it possible for us to knead dough and perform a heart transplant; make contact with strangers, friends, and lovers; throw a baseball; and create a scale model of a skyscraper and build that skyscraper. From the most mundane activity to our most sublime achievement, the hand has helped us shape the world and given us a deeper understanding of our place in it. In The Wonder of the Human Hand, surgeons and hand specialists from the world-renowned Curtis National Hand Center describe how the hand is used in work, sports, and music, and trace the human fascination with hands in religion and art. They relate awe-inspiring stories of people throughout history—including major league pitcher Jim Abbott, orthopedic surgeon Dr. Liebe Diamond, and pianist Leon Fleisher—who accomplished great things with one hand, or with impaired or injured hands, and they tell of marvelous surgeries that create fingers where none exist.Recounting how the hand interprets the environment and returns tactile information to the brain, the book underscores the importance of the hand to people who cannot see or hear. Throughout, the authors explore how medical science restores bones, tendons, nerves, muscles, and blood vessels in hands injured through disease, accident, and combat—ever aware of how the form and function of the human hand combine harmoniously in everyday activities and Herculean efforts alike.
The Wondrous Story of Anesthesia
by Edmond I Eger II Lawrence J. Saidman Rod N. WesthorpeEdited and written by an international "who's who" of more than 100 authors, including anesthesiologists, nurse anesthetists, bench scientists, a surgeon, and representatives of industry, this text provides a comprehensive history of anesthesia, unique in its focus on the people and events that shaped the specialty around the world, particularly during the past 70 years when anesthesia emerged from empiricism and developed into a science-based practice.
The Work of Hospitals: Global Medicine in Local Cultures
by Eugenia Georges John M. Janzen Cheryl Mattingly Thomas L. Leatherman William C. Olsen Carolyn Sargent Anita Hannig Mark Nichter Adrienne E. Strong Vania Smith-Oka Morgan K. Hoke Samya R. Stumo Ghislain Emmanuel Sopoh Roch Christian Johnson Anita Chary Peter Rohloff Kayla Hurd Elisa Ej Sobo Emma Varley Claire WendlandIn the context of neoliberalism and global austerity measures, health care institutions around the world confront numerous challenges in attempting to meet the needs of local populations. Examples from Africa (including, Ethiopia, Ghana, and Congo), Latin America (Peru, Mexico, Guatemala), Western Europe (France, Greece), and the United States illustrate how hospitals play a significant role in the social production of health and disease in the communities where they are. Many low-resource countries have experienced increasing privatization and dysfunction of public sector institutions such as hospitals, and growing withdrawal of funding for non-profit organizations. Underlying the chapters in The Work of Hospitals is a fundamental question: how do hospitals function lacking the medications, equipment and technologies, and personnel normally assumed to be necessary? This collection of ethnographies demonstrates how hospital administrators, clinicians, and other staff in hospitals around the world confront innumerable risks in their commitment to deliver health care, including civil unrest, widespread poverty, endemic and epidemic disease, and supply chain instability. Ultimately, The Work of Hospitals documents a vast gulf between the idealized mission of the hospital and the implementation of this mission in everyday practice. Hospitals thus become “contested space” between policy and practice.
The Work of Raymond J. Carroll
by Marie Davidian Xihong Lin Jeffrey S. Morris Leonard A. StefanskiThis volume contains Raymond J Carroll's research and commentary on its impact by leading statisticians. Each of the seven main parts focuses on a key research area: Measurement Error, Transformation and Weighting, Epidemiology, Nonparametric and Semiparametric Regression for Independent Data, Nonparametric and Semiparametric Regression for Dependent Data, Robustness, and other work. The seven subject areas reviewed in this book were chosen by Ray himself, as were the articles representing each area. The commentaries not only review Ray's work, but are also filled with history and anecdotes. Raymond J. Carroll's impact on statistics and numerous other fields of science is far-reaching. His vast catalog of work spans from fundamental contributions to statistical theory to innovative methodological development and new insights in disciplinary science. From the outset of his career, rather than taking the "safe" route of pursuing incremental advances, Ray has focused on tackling the most important challenges. In doing so, it is fair to say that he has defined a host of statistics areas, including weighting and transformation in regression, measurement error modeling, quantitative methods for nutritional epidemiology and non- and semiparametric regression.
The World Anti-Doping Code: Fit for Purpose? (Routledge Research in Sport, Culture and Society)
by Lovely DasguptaFollowing the recent doping scandals that have brought the highest echelons of international sport into disrepute, this book examines the elitism at the core of the World Anti-Doping Agency and considers how the current World Anti-Doping Code might be restructured. Analyzing the correlation between the commodification of sports and doping, and the role WADA plays in this context, it takes into consideration the perspectives of non-elite athletes as well as athletes from developing countries which have previously been excluded from the anti-doping discourse. It offers recommendations for improving the coordination and implementation of the World Anti-Doping Code and argues for the creation of a more inclusive anti-doping regime. This is an important resource for students of sports law, sports management and sports ethics, as well as vital reading for sports administrators, sports sociologists, sports policy makers, sports lawyers and arbitrators, as well as athletes themselves.
The World Health Organization between north and south
by Nitsan ChorevSince 1948, the World Health Organization (WHO) has launched numerous programs aimed at improving health conditions around the globe, ranging from efforts to eradicate smallpox to education programs about the health risks of smoking. In setting global health priorities and carrying out initiatives, the WHO bureaucracy has faced the challenge of reconciling the preferences of a small minority of wealthy nations, who fund the organization, with the demands of poorer member countries, who hold the majority of votes. In The World Health Organization between North and South, Nitsan Chorev shows how the WHO bureaucracy has succeeded not only in avoiding having its agenda co-opted by either coalition of member states but also in reaching a consensus that fit the bureaucracy's own principles and interests.Chorev assesses the response of the WHO bureaucracy to member-state pressure in two particularly contentious moments: when during the 1970s and early 1980s developing countries forcefully called for a more equal international economic order, and when in the 1990s the United States and other wealthy countries demanded international organizations adopt neoliberal economic reforms. In analyzing these two periods, Chorev demonstrates how strategic maneuvering made it possible for a vulnerable bureaucracy to preserve a relatively autonomous agenda, promote a consistent set of values, and protect its interests in the face of challenges from developing and developed countries alike.
The World Health Organization: A History (Global Health Histories)
by Marcos Cueto Theodore M. Brown Elizabeth FeeAccording to its Constitution, the mission of the World Health Organization (WHO) was nothing less than the 'attainment by all peoples of the highest possible level of health' without distinction of race, religion, political belief, economic status, or social condition. But how consistently and how well has the WHO pursued this mission since 1946? This comprehensive and engaging new history explores these questions by looking at its origins and its institutional antecedents, while also considering its contemporary and future roles. It examines how the WHO was shaped by the particular environments of the postwar period and the Cold War, the relative influence of the US and other approaches to healthcare, and its place alongside sometimes competing international bodies such as UNICEF, the World Bank, and the Gates Foundation. The authors re-evaluate the relative success and failure of critical WHO campaigns, from early malaria and smallpox eradication programs to struggles with Ebola today.
The World I Made For Her
by Thomas MoranJames Blatchley breathes and eats through tubes, slipping in and out of a coma. Nuala is the Irish immigrant nurse who coaxes him toward survival. The odd synergy of their relationship is both his link to reality and his inspiration to fantasy. This is the hypnotic story of the world that grows in the silence between them. In Thomas Moran's first novel, the New York Times Book Review saw evidence of his "incontestable conceptual gifts". In his "elegant writing", the Los Angeles Times found the promise of a serious new career. The New Yorker compared The Man in the Box to The Diary of Anne Frank, and the Los Angeles Times compared Thomas Moran to Eli Wiesel. And on the heels of this critical success comes The World I Made for Her. Nuala means "white shoulders" in Gaelic. Nuala's wild red hair falls in disarray over hers. James watches her moving deftly around him; changing his IV, attaching a fresh respirator tube. Nuala's movements are like dance to him through his morphine-clouded vision. His senses are numbed, his mind is dulled, but he hears her Irish spirit sing against the metronome of the life-support machines. He is drawn to the warmth of her. He carries Nuala in and out of consciousness with him, writing a secret love story in which she is, unknowingly, the heroine. In prose that moves seamlessly between fantasy and reality, The World I Made for Her is a novel of obsession and redemption that unfolds like a dream -- a story that will break your heart.
The World Of Colour (International Library Of Psychology Ser. #Vol. 6)
by Katz, DavidFirst Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.
The World Through Blunted Sight: An Inquiry into the Influence of Defective Vision on Art and Character
by Patrick Trevor-RoperA British ophthalmologist discusses his impressions of visually-impaired artists, including a number of the Impressionists.
The World of Plants in Renaissance Tuscany: Medicine and Botany (The History of Medicine in Context)
by Cristina BelloriniIn the sixteenth century medicinal plants, which until then had been the monopoly of apothecaries, became a major topic of investigation in the medical faculties of Italian universities, where they were observed, transplanted, and grown by learned physicians both in the wild and in the newly founded botanical gardens. Tuscany was one of the main European centres in this new field of inquiry, thanks largely to the Medici Grand Dukes, who patronised and sustained research and teaching, whilst also taking a significant personal interest in plants and medicine. This is the first major reconstruction of this new world of plants in sixteenth-century Tuscany. Focusing primarily on the medical use of plants, this book also shows how plants, while maintaining their importance in therapy, began to be considered and studied for themselves, and how this new understanding prepared the groundwork for the science of botany. More broadly this study explores how the New World's flora impacted on existing botanical knowledge and how this led to the first attempts at taxonomy.
The World the Plague Made: The Black Death and the Rise of Europe
by James BelichA groundbreaking history of how the Black Death unleashed revolutionary change across the medieval world and ushered in the modern ageIn 1346, a catastrophic plague beset Europe and its neighbours. The Black Death was a human tragedy that abruptly halved entire populations and caused untold suffering, but it also brought about a cultural and economic renewal on a scale never before witnessed. The World the Plague Made is a panoramic history of how the bubonic plague revolutionized labour, trade, and technology and set the stage for Europe&’s global expansion.James Belich takes readers across centuries and continents to shed new light on one of history&’s greatest paradoxes. Why did Europe&’s dramatic rise begin in the wake of the Black Death? Belich shows how plague doubled the per capita endowment of everything even as it decimated the population. Many more people had disposable incomes. Demand grew for silks, sugar, spices, furs, gold, and slaves. Europe expanded to satisfy that demand—and plague provided the means. Labour scarcity drove more use of waterpower, wind power, and gunpowder. Technologies like water-powered blast furnaces, heavily gunned galleons, and musketry were fast-tracked by plague. A new &“crew culture&” of &“disposable males&” emerged to man the guns and galleons.Setting the rise of Western Europe in global context, Belich demonstrates how the mighty empires of the Middle East and Russia also flourished after the plague, and how European expansion was deeply entangled with the Chinese and other peoples throughout the world.
The World's Emergency Room: The Growing Threat to Doctors, Nurses, and Humanitarian Workers
by Michael VanRooyenTwenty years ago, the most common cause of death for medical humanitarians and other aid workers was traffic accidents; today, it is violent attacks. And the death of each doctor, nurse, paramedic, midwife, and vaccinator is multiplied untold times in the vulnerable populations deprived of their care. In a 2005 report, the ICRC found that for every soldier killed in the war in the Democratic Republic of the Congo, more than 60 civilians died due to loss of immunizations and other basic health services.The World's Emergency Room: The Growing Threat to Doctors, Nurses, and Humanitarian Workers documents this dangerous trend, demonstrates the urgent need to reverse it, and explores how that can be accomplished. Drawing on VanRooyen's personal experiences and those of his colleagues in international humanitarian medicine, he takes readers into clinics, wards, and field hospitals around the world where medical personnel work with inadequate resources under dangerous conditions to care for civilians imperiled by conflict. VanRooyen undergirds these compelling stories with data and historical context, emphasizing how they imperil the key doctrine of medical neutrality, and what to do about it.
The World's Healthiest Foods
by George MateljanWhat are the best foods to eat? In his previous books, George Mateljan shared the basics of how to eat healthier. In The World's Healthiest Foods, he takes healthy eating to a whole new level by providing in-depth understanding of which foods are the best and why. George spent ten years with a team of nutritional scientists to write the World's Healthiest Foods, the most complete guide for the healthiest way of eating that has ever been published in one book. In The World's Healthiest Foods George reveals for the first time his secrets, recipes, and menus that make the Healthiest Way of Eating enjoyable, practical, convenient and easy. Easy to read and easy to understand, this book can help anyone to eat healthier. The Healthiest Way of Eating Plan helps you eat healthier by focusing on the delicious nutrient-rich World's Healthiest Foods, which provide the greatest number of nutrients for the least number of calories. The Plan features some of the book's 500 recipes, many of which take less than 7 minutes to prepare. He also shares with you how you can make a five course meal for two in 15 minutes using these recipes! Most Effective Way to Lose Weight and stay slim because the World's Healthiest Foods are not fattening foods but foods that provide a rich concentration of vitamins, minerals, antioxidants (and other important nutrients) instead of calories. The Healthiest Way of Cooking Method is the culmination of George's lifelong passion for food. George wanted to improve on the traditional methods of cooking, which he found could result in a 50-80% loss of the nutrients in food. George spent years in the kitchen working to develop a better way of cooking that is healthier as well as fast and easy. It also preserves the most nutrients and brings out the great flavor of The World's Healthiest Foods without damaging fats or oils by exposure to high heat.
The World's Worst Problems
by Walter DoddsThis book addresses the worst problems currently facing humanity and those that may pose future threats. The problems are explained and approached through a scientific lens, and categorized based on data involving global mortality, vulnerability, and threat level. The book presents indices of problem severity to compare relative intensity of current and potential crises. The approach avoids emotional argument using mainly empirical evidence to support the classification of relative problem severity. The author discusses multiple global problems and ranks them. He also explores specific solutions to each problem, links problems to human behavior from a social science perspective, considers international cooperation, and finally pathways to solutions.The book discusses confirmation bias and why this necessitates a scientific approach to tackle problems. The moral assumption that each person has the same rights to life and minimal suffering, and that the natural world has a right to exist, forms the basis of ranking problems based on death, suffering, and harm to the natural world. A focus is given to potential disasters such as asteroid collisions and super-volcanic eruptions, which are then presented in chapters that address specific contemporary global issues including disease, hunger, nuclear weapons and climate change. Furthermore the author then ranks the problems based on an index of problem severity, considering what other people think the worst problems are. The relative economic costs to solve each of these problems, individual behavior in the face of these problems, how people could work together internationally to combat them, and a general pathway toward solutions form the basis of the final chapters. This work will appeal to a wide range of readers, students considering how they can help the world, and scientists and policy makers interested in global problem solving.
The Worldwide Face of Elder Abuse
by Pamela B. Teaster Elizabeth Podnieks Georgia J. AnetzbergerThis book provides a picture of the abuse of older adults, organized by World Health Region and locating the problem within an area’s historic and present societal treatment of older persons. An actual and emblematic case study of the abuse of an older adult frames each chapter. Using the case study as a touchstone, each chapter guides the reader’s understanding of elder abuse in the region or country through the use of empirical data and research on the problem, explaining its usefulness and limitations as well as guiding frameworks utilized to address the problem. The book highlights the efforts of leading figures in each area or region who are addressing the problem, explaining existing policies and future initiatives to address the abuse of older adults. By providing a holistic and person-centered picture of the issue and problem of elder abuse, based on actual experiences as well as national and international statistics and research and politics and policy, this book is an invaluable resource for students, academics, social service practitioners, health professionals, law enforcement, and policymakers around the world.
The Would-Be Daddy
by Jacqueline DiamondSafe Harbor surgeon Marshall Davis and staff psychologist Franca Brightman have different opinions on almost everything, but especially on children. She's been fostering kids for years, while he only wants to raise his own child. <P><P>But one night when Franca desperately needs tenderness, Marshall is there for her, and they find comfort in each other's arms. She brushes it off as a moment of weakness. Until she discovers she's pregnant. Franca wants this baby, and she knows Marshall does, too-but only on his terms. Does this mean war...or a wedding? Enjoy a special bonus short story from #1 New York Times bestselling author Debbie Macomber, MY FUNNY VALENTINE
The Wounded Storyteller: Body, Illness & Ethics
by Arthur W. FrankUpdated second edition: “A bold and imaginative book which moves our thinking about narratives of illness in new directions.” —Sociology of Heath and IllnessSince it was first published in 1995, The Wounded Storyteller has occupied a unique place in the body of work on illness. A collective portrait of a so-called “remission society” of those who suffer from illness or disability, as well as a cogent analysis of their stories within a larger framework of narrative theory, Arthur W. Frank’s book has reached a large and diverse readership including the ill, medical professionals, and scholars of literary theory.Drawing on the work of such authors as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known—Gilda Radner’s battle with ovarian cancer—to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilities. Their stories are more than accounts of personal suffering: They abound with moral choices and point to a social ethic.In this new edition Frank adds a preface describing the personal and cultural times when the first edition was written. His new afterword extends the book’s argument significantly, discussing storytelling and experience, other modes of illness narration, and a version of hope that is both realistic and aspirational. Reflecting on his own life during the creation of the first edition and the conclusions of the book itself, he reminds us of the power of storytelling as way to understand our own suffering.“Arthur W. Frank’s second edition of The Wounded Storyteller provides instructions for use of this now-classic text in the study of illness narratives.” —Rita Charon, author of Narrative Medicine“Frank sees the value of illness narratives not so much in solving clinical conundrums as in addressing the question of how to live a good life.” —Christianity Today
The Wrong Billionaire's Bed: Billionaire Boys Club 3 (Billionaire Boys Club)
by Jessica ClareFans of J.S. Scott, Louise Bay and Melody Anne - prepare to be dazzled by Jessica Clare's Billionaire Boys Club. The Billionaire Boys Club is a secret society of six incredibly wealthy men who have vowed success in business - at any cost. But success when it comes to love is a different matter...Audrey Petty's always been the responsible one. The good twin. She'd be the perfect girlfriend for her childhood crush, billionaire Cade Archer...except that she's pretty sure she's not even on his radar. But when fate decrees that Audrey spend time with Cade at his remote cabin retreat, it's a dream come true... Until she meets her worst nightmare.Billionaire playboy Reese Durham is used to seducing women to get what he wants. But when stiff, too-proper Audrey arrives at his buddy's mountain lodge it's clear that Audrey's in love with Cade...and it's clear to Reese that blackmailing Audrey with this information can get her to agree to just about anything. Like furtive kisses, or a secret rendezvous in the woods. Audrey may think she knows what she wants, but Reese is determined to show her what she needs...Want more irresistible romance? Look for the rest of Billionaire Boys Club titles, starting with Stranded With A Billionaire, as well as the sizzling spinoff series, Billionaires and Bridesmaids, starting with The Billionaire And The Virgin.
The Wuhan Cover-Up: And the Terrifying Bioweapons Arms Race (Children’s Health Defense)
by Robert F. Kennedy Jr.&“RFK Jr. exposes the decades of lies.&”—Luc Montagnier, Nobel laureate From the New York Times, Wall Street Journal, USA Today, and Publishers Weekly bestselling author of The Real Anthony Fauci comes an explosive exposé of the cover-up behind the true origins of COVID-19. &“Gain-of-function&” experiments are often conducted to deliberately develop highly virulent, easily transmissible pathogens for the stated purpose of developing preemptive vaccines for animal viruses before they jump to humans. More insidious is the &“dual use&” nature of this research, specifically directed toward bioweapons development. The Wuhan Cover-Up pulls back the curtain on how the US government's increase in biosecurity spending after the 2001 terror attacks set in motion a plan to transform the National Institute of Allergy and Infectious Diseases (NIAID), under the direction of Dr. Anthony Fauci, into a de facto Defense Department agency. While Dr. Fauci zealously funded and pursued gain-of-function research, concern grew among some scientists and government officials about the potential for accidental or deliberate release of weaponized viruses from labs that might trigger worldwide pandemics. A moratorium was placed on this research, but true to form, Dr. Fauci found ways to continue unperturbed—outsourcing some of the most controversial experiments offshore to China and providing federal funding to Wuhan Institute of Virology's (WIV's) leading researchers for gain-of-function studies in partnership with the Chinese military and the Chinese Communist Party. Robert F. Kennedy Jr.'s meticulously researched and rigorously sourced analysis leads readers on a staggering journey to learn about: the key enablers and henchmen pushing for gain-of-function research the economic motives behind gain-of-function research successfully engineered &“chimeric viruses&” that can infect and kill humans the coordinated effort to silence speculation of COVID-19&’s laboratory genesis the complicity of scientific journals to hide the origins of COVID-19 the role of the Wuhan Institute of Virology in China&’s biowarfare/biodefense program the relationships between US health, military, and intelligence bureaucracies and scientists and their Chinese counterparts the roles of Bill Gates and Sir Jeremy Farrar in orchestrating a global cover-up The Wuhan Cover-Up unveils a global conspiracy of epic proportion and lethal consequence.
The XX Brain: The Groundbreaking Science Empowering Women to Maximize Cognitive Health and Prevent Alzheimer's Disease
by Lisa Mosconi"In The XX Brain, Lisa meticulously guides us in the ways we can both nourish and protect ourselves, body and mind, to ensure our brains remain resilient throughout our lives."--from the foreword by Maria ShriverThe first book to address cognitive enhancement and Alzheimer's prevention specifically in women--and to frame brain health as an essential component of Women's Health.In this revolutionary book, Dr. Lisa Mosconi, director of the Women's Brain Initiative at Weill Cornell Medical College, provides women with the first plan to address the unique risks of the female brain.Until now, medical research has focused on "bikini medicine," assuming that women are essentially men with breasts and tubes. Yet women are far more likely than men to suffer from anxiety, depression, migraines, brain injuries, and strokes. They are also twice as likely to end their lives suffering from Alzheimer's disease, even when their longer lifespans are taken into account. But in the past, the female brain has received astonishingly little attention and was rarely studied by medical researchers-- resulting in a wealth of misinformation about women's health.The XX Brain confronts this crisis by revealing how the two powerful X chromosomes that distinguish women from men impact the brain first and foremost and by focusing on a key brain-protective hormone: estrogen.Taking on all aspects of women's health, including brain fog, memory lapses, depression, stress, insomnia, hormonal imbalances, and the increased risk of dementia, Dr. Mosconi introduces cutting-edge, evidence-based approaches to protecting the female brain, including a specific diet proven to work for women, strategies to reduce stress, and useful tips for restorative sleep. She also examines the controversy about soy and hormonal replacement therapy, takes on the perils of environmental toxins, and examines the role of our microbiome. Perhaps best of all, she makes clear that it is never too late to take care of yourself.The XX Brain is a rallying cry for women to have full access to information regarding what is going on in their brains and bodies as well as a roadmap for the path to optimal, lifelong brain health.
The Yale Guide to Women's Reproductive Health: From Menarche to Menopause
by Mary Jane Minkin Carol V. WrightThis book is for every woman who has wished for an unhurried, personal conversation with a sympathetic doctor who will answer her questions about reproductive health. With warmth and understanding, the authors respond to questions about the gynecological issues that concern women today.
The Yale Pharyngeal Residue Severity Rating Scale
by Steven B. Leder Paul D. NeubauerThis text is a reliable, validated, anatomically defined, and image-based tool to determine residue location and severity when performing fiberoptic endoscopic evaluation of swallowing (FEES). Based upon research by Drs. Leder and Neubauer, an easily interpreted, readily learned, and hierarchically organized pharyngeal residue severity rating scale was developed for speech-language pathologists, otolaryngologists, and other health care professionals who perform and interpret FEES. The Yale Pharyngeal Residue Severity Rating Scale works equally well for any swallow of interest, whether it is the first, subsequent clearing, or last swallow. The endoscopist simply has to match their chosen swallow with its scale mate. The Yale Pharyngeal Residue Severity Rating Scale can be used for both clinical advantages and research opportunities. Clinically, clinicians can now accurately classify vallecula and pyriform sinus residue severity as none, trace, mild, moderate, or severe for diagnostic purposes, determination of functional therapeutic change, and precise dissemination of shared information. Research uses include tracking outcomes for clinical trials, investigating various swallowing interventions, demonstrating efficacy of specific interventions to reduce pharyngeal residue, determining morbidity and mortality associated with pharyngeal residue in different patient populations, and improving the training and accuracy of FEES interpretation by students and clinicians. The Yale Pharyngeal Residue Severity Rating Scale is an important addition to the deglutologist's tool box.
The Yale Swallow Protocol
by Steven B. Leder Debra M. SuiterThe Yale Swallow Protocol is an evidence-based protocol that is the only screening instrument that both identifies aspiration risk and, when passed, is able to recommend specific oral diets without the need for further instrumental dysphagia testing. Based upon research by Drs. Steven B. Leder and Debra M. Suiter, an easily administered, reliable and validated swallow screening protocol was developed and can be used by speech-language pathologists, nurses, otolaryngologists, oncologists, neurologists, intensivists and physicians assistants. In addition, the protocol can be used in a variety of environments, including acute care, rehabilitation and nursing homes. The Yale Swallow Protocol meets all of the criteria necessary for a successful screening test, including being simple to administer, cross-disciplinary, cost effective, acceptable to patients and able to identify the target attribute by giving a positive finding when aspiration risk is present and a negative finding when aspiration risk is absent. Additionally, early and accurate identification of aspiration risk can significantly reduce health-care costs associated with recognized prandial aspiration.