Search results for: care-and-cure

The Care and cure of the insane v 2

Author : Joseph Mortimer Granville
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Occupational Voice

Author : Philippe H. Dejonckere
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Introduction The concept of occupational voice disorders Philippe H. Dejonckere "People using their voice professionally are at risk for occupational voice diseases, and require specific prevention and treatment" was the topic focused on by the third Pan European Voice Conference, organized in August 1999 at Utrecht University. The present book includes the main tutorial lectures, with reviews of the most relevant research data and opinions regarding this specific area of concern. Occupational voice users include not only singers and actors, but also teachers, politicians, lawyers, clergymen, telephone operators, etc.(1). The pathogenesis of voice disorders in such patients can be primarily related to their occupation, and thus, after adequate differential diagnosis, these need to be recognized as true occupational diseases, in the same way as, for example, occupational hearing loss (2). A surfeit of information is available on the potential damage from exposure to excessive noise levels(3,4). Noise-induced hearing loss is generally recognized as a typical occupational disease. The relationship between dose and effect is clear, as is documented in publications by the International Organization of Standardization (ISO) (5). The dose combines intensity and duration, and therefore, the concept of dosimetry is of major importance. Also of importance is the definition of the safe limits for exposure to noise. However, factors regarding individual susceptibility to noise and the reversibility of early effects also have to be considered, as well as possible preventive indices of noise-induced hearing loss (6). In some - but not all - respects, noise-induced hearing loss may be considered as a useful model for occupational voice disorders. Epidemiology Titze (7) compared the percentage of the US working population and of the voice-clinic load for different occupation categories: for example, telephone marketers constitute only 0.78% of the total workforce, but 2.3% of the clinic load; teachers represent 4.2% of the US workforce and 20% of the voice-clinic load. Studies based on questionnaires have suggested that teachers and aerobic instructors are at high risk for disabilities from voice disorders, and that these health problems may have significant work-related and economic effects (8,9). For example, Russel et al.(10) investigated the prevalence of self-reported voice problems in teachers: 16% of teachers reported voice problems on the day of the survey, 20% during the current teaching year, and 19% at some time during their career. Roughly speaking, we can conclude from the several studies published during the 1990s that about 20% of teachers experience voice disorders (11). Voice dosimetry Objective measurement of vocal use and vocal load is necessary for the identification of activities and working conditions that are at risk. Voice dosimeters can provide information on the total vocalization time and sound pressure level over a whole working day, in a real life situation (12-14). Just as noise dosimeters define acceptable levels of noise exposure, voice dosimeters help to define the average acceptable limits for vocal load. Hyperphonation Repeated mechanical vibrations transmitted to the body tissues by engines or machines are known to be able of eliciting - in certain conditions - specific kinds of pathology, which are also considered to be occupational diseases (15,16). The vibration may involve the whole body (e.g., in a vehicle) or mainly the hand, wrist, elbow, or shoulder (hand-held power tools). There are standards in the field of occupational health that stipulate the acceptable limits for tissue acceleration values, depending on the frequency (17). Titze's calculations suggest that the risk of damage from tissue vibration is exceeded by occupational vocalists, such as telephone marketers and teachers (18). In the last few years, much new and important information has materialized on the dangers of 'hyperphonation', i.e., loud and prolonged phonation beyond the physiological range. Laboratory experiments on canine larynges, hyper-phonated in vivo under anesthesia, demonstrated obvious damage to vocal fold epithelia (19). The basement membrane shows early lesions and seems to be particularly sensitive (20). A clinical study by Mann et al.(21) in drill sergeants, demonstrated significant increases in vocal fold edema, erythema and edge irregularity, and decreases in vocal fold mucosal wave and amplitude of excursion, following a five-day training period Voice fatigue, relief and recovery According to Titze (18) , two different aspects must be considered: Muscle fatigue: the muscle chemistry needs to be reset for the following contractions. Epithelial cells may die and be shed, due to repeated traumata. New cells have to develop underneath. Collagen and elastin fibers may have separated from the structural matrix of the lamina propria, and have to be removed and replaced by the fibroblasts. Detached protein debris will be removed and re-used by the fibroblasts to make new protein fibers that will support the connective tissue structure. Therefore, minor destruction and repair is continuous. Can the regenerative processes keep up with the destructive process, and what are the physiological time constants in these processes? When there is damage to the joints, ligaments, tendons, or other connective tissue, the recovery time will be proportional to the amount of localized tissue injury that has occurred. If muscle fatigue is the only complaint, the recovery period required will probably be shorter. Hypothetical curves for tissue injury and the recovery period for human phonation have been suggested by Titze (18). Nevertheless, vocal fatigue is still difficult to identify in practical and clinical situations, and Buekers has questioned the clinical relevance of voice endurance tests (13,14). Environmental factors The relative humidity of the air affects vocal function: the most common subjective complaints of teachers with regard to their working environment are the dryness and dustiness of the air. Professional singers note that singing is more difficult in a dry environment: dry air puts an increased strain on the phonatory apparatus and raises the demands on its efficacious and appropriate use (22). The human voice is very sensitive to decreases in the relative humidity of inhaled air because, in experimental conditions, even after short provocation, a significant increase in perturbation measures has been found (23). Noise is also a very common and relatively well-known risk factor in the working environment of professional voice users. It has been observed that the sound level of the speaking voice significantly increases in ambient noise levels starting from 40 dB (A) (about 3 dB for each 10 dB increase in ambient noise), due to the Lombard effect (24,25). In kindergartens, for example, noise levels have been found to vary between 75 and 80 dB (A) (26,27). Effects of stress Mendoza and Carballo investigated the effects of experimentally induced stress on voice characteristics (28). In conditions of stress, induced by means of a stressful environment and cognitive workload tasks, they observed: 1. an increase in F o with respect to baseline; 2. a decrease in pitch perturbation quotient and in amplitude perturbation quotient; 3. a lower presence of turbulent noise in the spectral zone in which the existence of harmonic components is not expected (2800-5800 Hz), with respect to harmonic energy in the 70-4500 Hz range; 4. an increase in harmonic energy in the 1600-4500 Hz range with respect to harmonic energy in the 70-1600 Hz range. The increase in F o seems to be considered a universal indicator of stress and of cognitive workload, as is the lowering of F o perturbation. The response to a stressful stimulus demands a high level of activation, which in turn produces elevated ergotropic arousal that would cause an increase in the tension of the vocal muscles, producing a higher and more tense voice. Mattiske et al. (29) report that teachers seem to experience a significant degree of stress during their work (30) , and there is some research evidence that anxiety and stress are associated with the development of voice problems (31). Marks (32) compares teachers' voices with those of nurses, and finds that psychological stress is reported more frequently by teachers. There are indications that stress, psychological tension, personality, and other psychological factors, may play an important role in voicing problems among teachers (30,33,34). Vocal fold lesions Phonotrauma may result in typical vocal fold lesions, to be interpreted as a direct consequence of mechanical stress and/or as tissue reaction to that stress. Vocal fold nodules and polyps are classical examples (35,36) , but also contact ulcerations/ granulomas of the vocal processes (35,36,37) , if not induced by acid re-flux. Vocal fold hemorrhage is generally consecutive to acute phonotrauma (35). Depending on reversibility and context, microsurgery may become indicated as an important element of the treatment (38,39). Care and cure Patients with occupational voice disorders should benefit from specific medical and paramedical treatments, as well as from technical aids, with respect to their particular pathogenesis. There are major economical aspects at stake, and occupational rehabilitation plays an important role. In a few cases, compensation and professional re-orientation is necessary. Outcomes of the various possible treatment strategies have still to be investigated. However, prevention is still essential. There are indications that vocal hygiene education programs could improve the voice by reducing vocal abuse in daily life and by practising specific strategies to maintain classroom order and to reduce the use of the voice during teaching (40). Further research is needed to demonstrate the usefulness of prevention strategies on the incidence of actual voice disorders.

Care and Cure

Author : Jacob Stegenga
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The philosophy of medicine has become a vibrant and complex intellectual landscape, and Care and Cure is the first extended attempt to map it. In pursuing the interdependent aims of caring and curing, medicine relies on concepts, theories, inferences, and policies that are often complicated and controversial. Bringing much-needed clarity to the interplay of these diverse problems, Jacob Stegenga describes the core philosophical controversies underlying medicine in this unrivaled introduction to the field. The fourteen chapters in Care and Cure present and discuss conceptual, metaphysical, epistemological, and political questions that arise in medicine, buttressed with lively illustrative examples ranging from debates over the true nature of disease to the effectiveness of medical interventions and homeopathy. Poised to be the standard sourcebook for anyone seeking a comprehensive overview of the canonical concepts, current state, and cutting edge of this vital field, this concise introduction will be an indispensable resource for students and scholars of medicine and philosophy.

The Care and cure of the insane v 1

Author : Joseph Mortimer Granville
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Ayurveda at the Crossroads of Care and Cure

Author : A. Salema
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Care and Cure for Diabetics

Author : D. Chakraborty
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The Care and Cure of the Insane

Author : Joseph Mortimer Granville
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The Care and Cure of the Insane Volume 1

Author : Joseph Mortimer Granville
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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.

The Care and Cure of Crippled Children

Author : Gathorne Robert Girdlestone
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Care and Cure of Inebriates in the District of Columbia

Author : United States. Congress. House. Committee on the District of Columbia
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Care and Cure of the Insane

Author : Granville J. Mortimer
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Food for Health and Cure

Author : Marie F. Dubreuil
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This book is a precious gift that anyone can be happy to receive, have, read, and empower themselves with beneficial knowledge to be healthy and stay healthy as long as possible. To be healthy makes no distinction in religion, race, color, creed, power, well-being, social status or how famous and talented you are or what political party you choose. What's in this book makes no distinction about your choice of love, romance, and type of family, work, career, business, and sexual preference. The goal of this book is to be happy, healthy, live a prosperous life, get along with each other, and tolerate each other, smile, and laugh, say hi, hello, look at each other, and do much more with each other. Once in a while, take time ask yourself, who am I? Why am I here on this earth at this time in this century with all these other people? You can say to yourself, I could've been born in another century with all the other people. But I am here in this century with all the other people with you and me. Let us be healthy, love each other, and live longer.

Food for Health and Cure Part Two

Author : Marie F. Dubreuil
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This book is a precious gift that anyone can receive, be happy to have, read, and empower themselves with beneficial knowledge to be healthy and stay healthy for as long as possible. In this book, you will find home remedies to some of todays most common diseases. Food for Health and Cure Part Two will turn your kitchen and refrigerator into a medicine cabinet full of flavor and variety. Using good food to protect, heal, and maintain the body in good condition is the purpose of this book. Whether you are a physician, nurse, dietician, personal trainer, or any other human being, this book is the perfect tool to increase your knowledge on food and good health.

The Care and Cure of the Insane Vol 2 of 2

Author : Joseph Mortimer Granville
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Excerpt from The Care and Cure of the Insane, Vol. 2 of 2: Being the Reports of the Lancet Commission on Lunatic Asylums, 1875-6-7, for Middlesex, the City of London, and Surrey, (Republished by Permission); With a Digest of the Principal Records Extant, and a Statistical Review of the Work of Each Asylum V II. Medical Treatment VIII. Certifying IX. Removal to an Asylum X. Diagnosis XI. Classification XII. Sleep XIII. Restraints XIV. Change XV. Food XVI. Clothing. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.

A Child Welfare Problem

Author : William Henry Slingerland
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The Heart and Blood Vessels Their Care and Cure and the General Management of the Body

Author : Imanuel H. Hirschfeld
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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 was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. 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. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant.

Discovering Precision Health

Author : Lloyd Minor
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Today we are on the brink of a much-needed transformative moment for health care. The U.S. health care system is designed to be reactive instead of preventive. The result is diagnoses that are too late and outcomes that are far worse than our level of spending should deliver. In recent years, U.S. life expectancy has been declining. Fundamental to realizing better health, and a more effective health care system, is advancing the disruptive thinking that has spawned innovation in Silicon Valley and throughout the world. That's exactly what Stanford Medicine has done by proposing a new vision for health and health care. In Discovering Precision Health, Lloyd Minor and Matthew Rees describe a holistic approach that will set health care on the right track: keep people healthy by preventing disease before it starts and personalize the treatment of individuals precisely, based on their specific profile. With descriptions of the pioneering work undertaken at Stanford Medicine, complemented by fascinating case studies of innovations from entities including the Chan Zuckerberg Biohub, GRAIL, and Impossible Foods, Minor and Rees present a dynamic vision for the future of individual health and health care. You'll see how tools from smartphone technology to genome sequencing to routine blood tests are helping avert illness and promote health. And you'll learn about the promising progress already underway in bringing greater precision to the process of predicting, preventing, and treating a range of conditions, including allergies, mental illness, preterm birth, cancer, stroke, and autism. The book highlights how biomedical advances are dramatically improving our ability to treat and cure complex diseases, while emphasizing the need to devote more attention to social, behavioral, and environmental factors that are often the primary determinants of health. The authors explore thought-provoking topics including: The unlikely role of Google Glass in treating autism How gene editing can advance precision in treating disease What medicine can learn from aviation liHow digital tools can contribute to health and innovation Discovering Precision Health showcases entirely new ways of thinking about health and health care and can help empower us to lead healthier lives.

The Healing Arts

Author : Peter Elmer
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"The book will appeal to students, teachers, health workers and general readers who wish to develop a critical awareness of medicine in the past. The essays are complemented by a selection of primary and secondary readings in the companion volume, Health, Disease and Society in Europe, 1500-1800: A Source Book."--BOOK JACKET.

Illness and Cure in Tonga

Author : Siosiane Fanua Bloomfield
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Health Economics in Development

Author : Philip Musgrove
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This publication contains a collection of papers which span 21 years of the author's thought and experiences regarding the subject on health economics, working at the Pan American Health Organization, the World Health Organization and the World Bank. The papers consider a range of topics including: the connection between public health and economics; the issue of equity in health; effectiveness and efficiency, particularly in relation to communicable diseases and malnutrition; health financing; how the burden of ill health is measured; the roles of the state and the market in health. The empirical material refers to a variety of specific health problems or interventions, including: smoking, polio, malaria, immunisation and various forms of malnutrition.