Senin, 23 September 2013

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The Lucky Years: How to Thrive in the Brave New World of Health, by David B. Agus M.D.

“If you buy just one health book this year, then get The Lucky Years” (Howard Stern). In this groundbreaking guide, bestselling author David Agus shows how we can take control of our health like never before in the brave new world of medicine.

In his first bestseller, The End of Illness, David Agus revealed how to add vibrant years to your life by knowing the real facts of health. In The Lucky Years, he builds on that theme by showing why this is the luckiest time yet to be alive, giving you the keys to a new kingdom of wellness.

In this new golden age, you’ll be able to take full advantage of the latest science and technologies to customize your care. Imagine being able to: edit your DNA to increase a healthy lifespan; use simple technologies to avoid or control chronic conditions like pain, depression, high blood pressure, and diabetes; prolong natural fertility and have children in your forties; lose weight effortlessly without a trendy diet; reverse aging to look, feel, and physically be ten years younger; and turn cancer into a manageable condition you can live with indefinitely. That’s the picture of the future that you can enter—starting today.

With “practical health information fortified with exciting news from the forefront of modern medical technology” (Kirkus Reviews), this is an essential, important read. “If you have made a new year’s resolution to get healthier, you’ll find a buddy in David B. Agus’s new book” (The Boston Globe). Welcome to the Lucky Years.

  • Sales Rank: #36304 in Books
  • Brand: Simon Schuster
  • Published on: 2017-01-03
  • Released on: 2017-01-03
  • Original language: English
  • Number of items: 1
  • Dimensions: 8.37" h x .70" w x 5.50" l, .0 pounds
  • Binding: Paperback
  • 288 pages
Features
  • Simon Schuster

Review
"If you buy just one health book this year, then get The Lucky Years. In this important book, David Agus—one of the most inspiring, practical, and knowledgeable people I know—shows us how to participate in the world of personalized medicine. It’s easier than you think, if you have this book to guide you."
—Howard Stern, host of The Howard Stern Show


"Dr. Agus has done it again. The Lucky Years gives us a smart, informed, and sensible look at the latest medical breakthroughs and new technologies. Important and courageous, it tackles tough questions while showing us how to prolong the quality and length of our lives."
—Walter Isaacson, author of Steve Jobs and The Innovators

“We all have a vague sense that there is a revolution underway in the world of biology and medicine. We hear about major innovations like the sequencing of the genome, targeted drugs, and big data. But what to make of them? How will they improve our health and change our lives? We could not have a better guide to make sense of it all than David Agus. In this fascinating and illuminating book, David brings together a deep knowledge of science, good writing, and common sense. We are lucky to have him around.”
—Fareed Zakaria, host of Fareed Zakaria GPS

“The Lucky Years is an important and courageous book, raising big questions about health, longevity and what it means to live a meaningful life. With a reverence for data and the latest science, Dr. Agus gives us his vision for a bright future of health, helping everybody understand how to navigate their options in the way that’s best for them—and their loved ones.”
—Arianna Huffington, Editor-in-Chief of The Huffington Post and author of Thrive

“Dr. Agus offers an optimistic exploration of the new opportunities becoming available to us as exciting new technologies disrupt and revolutionize our understanding and practice of health care. Encouraging, but also clear-eyed and cautionary, The Lucky Years inspires us to take hold of the future of our own health—and, in turn, that of the planet.”
— Al Gore, 45th Vice President of the United States, Nobel Laureate in Peace, 2007

“Dr. David Agus describes how a series of scientific breakthroughs enables everyone to lengthen and improve their lives—a future in which our body's natural mechanisms can be enlisted to fight disease and our genes can be edited to eliminate inherited disease. It is an inspiring vision that we can embrace today.”
—Larry Ellison, Cofounder and Executive Chairman, Oracle Corporation

“The Lucky Years is a steady dose of actionable knowledge about the one thing relatable to everyone: life. It's the doctor-patient relationship we all want and deserve. Dr. Agus is a trusted voice in a field of uncertainty.”
—Ashton Kutcher

"It sometimes takes a genius to know the difference between what’s good and bad for us amid all the noise in health circles. Thanks, David Agus, for being that genius and writing The Lucky Years to guide us."
—Michael Dell, Founder, Chairman, and Chief Executive Officer of Dell, Inc.

“Everyone living today should read The Lucky Years to receive the enduring gift of Dr. David Agus’s wisdom. It will inspire you on a journey towards a life that is both more healthful and meaningful, and provide practical guidance for the path ahead. Dr. David Agus will show you what it truly means to live a healthy life in the lucky years.”
—Dov Seidman, author of How: Why How We Do Anything Means Everything

"In The Lucky Years, David Agus, one of the most interesting medical writers of our age, presents a provocative, highly informative way of understanding revolutions in health and healthcare today that will change the quality of our lives."
—Murray Gell-Mann, PhD, Nobel Laureate in Physics, 1969, and Distinguished Fellow and Cofounder of The Santa Fe Institute

"In The Lucky Years, David Agus once again gives us a clear path to better health. We are lucky to have such an incredible guide to such a critical subject."
—Marc Benioff, Chairman and CEO, salesforce.com

"[Dr. Agus] takes a hard look at the latest medical findings to show simple tips to living longer."
—New York Post

"If you have made a new year’s resolution to get healthier, you’ll find a buddy in David B. Agus’s new book, The Lucky Years."
—Boston Globe

"What is strongest here is Agus’s deft marshaling of research old and new, and his common-sense guidance on preventives such as sleep hygiene and the optimal level of exercise."
—Naure Magazine

"In previous volumes, Agus offered useful, accessible health tips for attaining prime physical health. Here, he expands on that platform by addressing readers from a futuristic vantage point and insightfully discusses how recent technological trends have the ability to boost both the medical industry's ability to effectively treat patients and its public perception, something that has incrementally declined through the last decade. . . . Readers interested in breakthrough clinical developments will find Agus' explorations of gene therapy, immunotherapy, and revolutionary stem cell research highly informative. . . . Practical health information fortified with exciting news from the forefront of modern medical technology."
—Kirkus Reviews

“Anyone who is depressed about the state of health care needs to read this book….This book will inspire all to live a more healthful and meaningful life!” 
—AANS Neurosurgeon

About the Author
David B. Agus, MD, author of the New York Times and international bestsellers The End of Illness and A Short Guide to a Long Life, is a professor of medicine and engineering at the University of Southern California and heads USC’s Westside Cancer Center and the Center for Applied Molecular Medicine. He is one of the world’s leading physicians and pioneering biomedical researchers, and is a CBS News contributor. He lives in Beverly Hills, California.

Excerpt. © Reprinted by permission. All rights reserved.
The Lucky Years CHAPTER 1 The Century of Biology The Cure Is Already Inside You
I’m fascinated by the idea that genetics is digital. A gene is a long sequence of coded letters, like computer information. Modern biology is becoming very much a branch of information technology.

—Richard Dawkins, British biologist and writer

Hardly a day goes by that I don’t get at least one question about whether or not X, Y, or Z is “healthful.” And yet I encounter a lot of skeptics and naysayers who want to go to battle against compelling, irrefutable data. It’s disheartening to hear that public trust in physicians has plummeted over the past several decades.1 In 1966, almost 75 percent of Americans said they had great confidence in the leaders of the medical profession; by 2012, that percentage had dwindled to some 30 percent. Why is this happening, and what does it mean for our collective and individual health? In another study, Princeton researchers found that people tend to regard scientists as they do CEOs and lawyers: all three types of professionals are perceived as highly competent but cold. Their work earns respect but not trust.

A couple of researchers at the University of Chicago in 2014 conducted a study of more than 1,350 randomly chosen Americans who provided written responses to questions. Astonishingly, half of Americans believe one of the following:2

1. Companies knowingly dump large quantities of dangerous chemicals into our water supply.

2. A US spy agency infected African Americans with HIV (and some are now saying that viruses with high mortality rates such as Ebola have been used for sinister purposes such as population control).

3. The government tells parents to give vaccines to their children even though that could increase their risk of developing autism.

4. US health officials withhold information about natural cures for cancer so that pharmaceutical companies can continue to profit.

5. The government and health officials pretend they don’t know that cell phones can cause cancer.

6. Genetically modified foods (GMOs) are a plot to shrink the global population by delivering foods that can be toxic to unsuspecting consumers.

To my chagrin, the greatest proportion of people in the study—more than one third—believed that corrupt practices occur routinely in my line of work. They subscribe to the idea that the FDA deliberately suppresses information about alternative cancer treatments that don’t entail drugs and radiation. Do any of these theories have merit? None do. Unfortunately, many people don’t know where to turn for unbiased, trustworthy information, so these dangerous mythologies persist. And merchants of doubt and fear will keep these ideas alive.

After the publication of The End of Illness, my first book, I went through a revealing experiment. My credibility and “persona” were put to the test when four focus groups categorized by age (two groups of twenty-one- to thirty-nine-year-olds and two groups of forty- to sixty-year-olds) were exposed to a series of clips of me on various television shows. Then they were each interviewed about their general impressions of health and reactions to my message. Mind you, these were people who were chosen because they actively gathered information on health and wellness, and none worked in a health care setting. I won points for coming across as warm, trustworthy, passionate, and knowledgeable, but it didn’t end there. I learned that Americans, broadly speaking, are inherently mistrustful of “experts”; they presume everyone is in someone’s financial pocket and worry doctors could push drugs for kickbacks rather than solely making decisions in the patient’s best health interest.

I also learned, this one to my surprise, that Americans perceive vitamins and drugs differently. They are psychologically averse to taking drugs, but not to taking vitamins. Why? Because, according to accepted wisdom, pharmaceutical companies promote drugs for their financial interests whereas purveyors of vitamins are motivated by your health interests. Suffice it to say, I walked away from the experience having learned that it’s more important to express human concern than to launch into a jargonistic lecture about medicine.

It can be hard to change people’s fierce beliefs about health, and that may be because holding on to them is part of our preprogrammed survival instinct. But we’re no longer residing in caves. Now that we live in an era of abundant information and data, we need to develop a new survival instinct that’s deft at navigating through the rapidly changing flow of information, some of it good, some of it not so good. Consider supplements, including those touted by popular physicians in the media. Most people are surprised to learn that supplements are almost entirely unregulated, so you don’t know what you’re really getting when you buy them, and their side effects and potential consequences to you could be hidden or, worse, unknown.
It’s Complicated but Promising
One of my most important pieces of advice to people who seek the secrets to living long and well, and deciphering the good from the bad information, is to honor your body as an exceedingly complex organism with its own unique nuances, patterns, preferences, and needs. And there is no “right” answer in health decisions. You have to make suitable decisions for you based on your personal values and unique health circumstances as your context evolves and changes throughout your life. As it turns out, we’re finally at a time in medicine where we can start to customize prescriptions for people—both general lifestyle interventions and specific drug and dosage recommendations to prevent, treat, or head off a disease. It doesn’t matter if you call it personalized or precision medicine. The goal is the same: to prolong the quality of individuals’ lives by using their personal health profiles to guide decisions about the prevention, diagnosis, and treatment of disease. And by profile, I don’t mean just one’s genetic code.

More than a decade has passed since scientists sequenced the entire human genome of about 30,000 total genes and 3 billion letters, and since then we’ve made many discoveries about the power we can wield over our individual DNA. Disease cannot be predicted by genes alone, for our genes don’t work in a vacuum. Instead, they are significantly influenced by complex interactions with our diet, behavior, stress, attitude, pharmaceuticals, and environment. Every day a new finding correlates these factors with risk for illness. So when a diagnosis does in fact come in, you probably cannot point the finger at any single culprit. The condition is likely caused by an elaborate network of forces interacting within the complex human body. And ultimately, the result is that certain genes get turned on or off, triggering pathways whose endpoints are illness.

Let’s say you have a genetic vulnerability to stomach cancer and heart disease. Does this mean these ailments are your destiny? Far from it. Your lifestyle choices largely determine whether those inherited codes express themselves or not and become your liabilities in life. In other words, you get to choose—to some degree—how your DNA is manifested. Genetics account for about a quarter of aging—how fast or slow you age and whether or not you’re still getting carded at age forty. Habits can sometimes trump genes when it comes to the pace of your aging and how long you live. The nature vs. nurture debate has been clarified by the science of epigenetics—the science of controlling genes through environmental forces, such as diet and exercise. But my thoughts on epigenetics aren’t totally aligned with those of other doctors. I don’t, for example, subscribe to the theory that doing X, Y, and Z can change gene A, B, and C to effect outcome D, E, F. This is a complicated area of medicine where the data is still elusive. That said, I do believe that none of us is necessarily a victim of our DNA. And a lot of the advice doled out amid the hand waving is often good general advice, such as “eat real food” and “move more throughout the day.” Who can argue with that?

As an aside, I find it amusing that in the summer of 1960, at another meeting where Wanda Lunsford presented her reports about the power of parabiosis—which were largely ignored by the general media—findings from another rat study zipped out to the nation through the Associated Press.3 To quote the news directly: “How to Live Longer? Slow Eating! An experiment on rats has yielded hope that overweight people can prolong their life expectancy by as much as 20 percent. The Secret: Eat half as much.” Again, can we argue with that? So we can be the architects of our own future health, so long as we’re realistic about what we can control or hope to control.

Now, sometimes certain genes are, in and of themselves, enough to cause disease regardless of how we live. But the vast majority of conditions commonly diagnosed today are those that result from the intricate play between genes and the body’s contextualized environment. This helps explain why most of the women diagnosed with breast cancer, or any degenerative condition for that matter, don’t carry any inherited genetic mutations associated with the disease, nor do they have a family history of it. For example, Angelina Jolie’s double mastectomy in 2013 was the right choice for her because she had a genetic mutation known to dramatically increase the likelihood of breast (and ovarian) cancer, but this is uncommon; only 5 percent to 10 percent of breast cancer cases in women are attributed to a harmful mutation in BRCA1 and/or BRCA2 genes. Most women who have a mastectomy choose to do it for other reasons. And those who opt for a double mastectomy due to cancer in one breast but who don’t carry faulty genes linked to breast cancer will only increase their chances of survival negligibly—less than 1 percent over twenty years.

Heart disease, for another example, remains our number one killer for both men and women, but the most common causes of heart disease are not congenital heart defects. They are factors such as smoking, excessive use of alcohol or drug abuse, and the downstream effects of poor diet and unremitting stress, obesity, diabetes, and high blood pressure. Note that these are all factors that change a person’s context. In 2015, the number of obese individuals in the United States as measured by body mass index (BMI) finally overtook the number of people who are overweight. That wasn’t the year that people’s genes changed to code for obesity. Something in their environment—in their context—changed, leading to more obesity, which is defined as having a BMI of 30 or above. While that sounds like terrible news, the silver lining is that such variables as the environment are often changeable, thereby making the outcome—obesity—reversible. And that’s the kind of positive thinking we need going forward. Alongside that positive thinking will be new technologies that make ending obesity, as well as other maladies, possible.

Do you need to have your DNA profiled today? Not necessarily. My whole point is to show you how to take advantage of the most accessible, inexpensive tools in understanding your health and your health care needs. Besides, in the future doctors won’t have to analyze your entire genome. They’ll be able to use a simple blood test to look for genetic markers that are associated with certain risk factors. We already know of about three hundred markers that matter to human health. And dozens more will soon follow, if they haven’t already by the time you read this book.

I am confident that within five to ten years, each one of us can be living a life of prevention that’s so attuned to our individual contexts that diseases of today will be virtually eradicated. But this requires that we each get started now.
Steve Jobs’s Other Legacy
In 2007, I was asked to be on Steve Jobs’s medical team to help with his care and serve as a sounding board for him to discuss all the specialists he had in his circle. He was trying to stay as many steps ahead of his cancer as possible. This particular cadre of specialists not only included a handful of doctors from Stanford, close to where Steve lived and worked, but also entailed collaborations with Johns Hopkins and the Broad Institute of MIT and Harvard, as well as the liver transplant program of the University of Tennessee. We took an aggressive, integrated approach that leveraged the best anticancer technology at our disposal. This meant sequencing his tumors’ genes so we could pick specific drugs that would target the defects in the cells that made them rogue. It was a revolutionary approach and totally different from conventional therapy, which generally attacks cell division in all of a body’s cells, striking healthy ones along with cancerous ones.

For us on his medical team, it was like playing chess. We’d make our move with a certain cocktail of drugs, some of which were novel and just in development, and then wait to see what the cancer would do next. When it mutated and found a crafty way to circumvent the impact of the drugs we were using, we’d find another combination to throw at the cancer in our next chess move. I’ll never forget the day we doctors huddled in a hotel room with Steve to go over the results of the genetic sequencing for his cancer.

This type of sequencing isn’t as black-and-white as you might think. Just as interpreting someone’s genetic profile can be subjective, so can the actual sequencing. Even the best gene sequencers from different institutions can find slightly different DNA portraits for the same exact patient, which is what happened with Steve’s screening. After Steve verbally criticized some of us for using Microsoft PowerPoint rather than Apple’s Keynote for our presentations, he learned that Harvard’s results from testing his tumor’s DNA didn’t line up exactly with those from Johns Hopkins. This made our strategizing all the more challenging and demanded that we all get together to go over the molecular data and agree on a game plan.

I wish we could have saved him or turned his cancer into a chronic condition that could be controlled at the molecular level so he could go on to live a longer life and eventually die of something else. I have faith that one day cancer will be a manageable condition much in the way people can live with arthritis or type 1 diabetes for a long time before succumbing to, say, an age-related heart attack or stroke. Imagine being able to edit not only your own genes to live longer, but those of a cancer to keep it at bay, silence its copying power, and stop it in its tracks. From a rudimentary perspective, genes are your body’s instructions, encoded in DNA. And cancer involves genes with a defect or defects that enable the “bad” cells containing those genes to block their own death or to continually divide, creating more rogue cells that can then maim the body’s tissues and functionality. So with molecular anti-cancer therapies, it’ll be like fixing the typos and misspellings in your personal “document” to live as long as humanly possible. Cancer will become a manageable life sentence, not a death sentence.

One genetic editing tool already exists. It’s called CRISPR, which stands for Clustered Regularly Interspaced Short Palindromic Repeats. This genome editing tool is remarkably easy to use and effective, but it raises many concerns because of its ability to alter human DNA in a way that can be passed along to one’s children and future generations. On the one hand, it can be used to cure diseases inherited from birth or acquired in life. In a fantastic review of the technology for the New England Journal of Medicine, Dr. Eric Lander, director of MIT and Harvard’s Broad Institute, describes some of its utility:

Genome editing also holds great therapeutic promise. To treat human immunodeficiency virus (HIV) infection, physicians might edit a patient’s immune cells to delete the CCR5 gene, conferring the resistance to HIV carried by the 1 percent of the US population lacking functional copies of this gene. To treat progressive blindness caused by dominant forms of retinitis pigmentosa, they might inactivate the mutant allele in retinal cells. . . . Editing of blood stem cells might cure sickle cell anemia and hemophilia.4

But where there’s a yin, there’s a yang. The other side of this story is that this incredibly powerful technology can be used to control qualities that were previously uncontrollable, such as intelligence, athleticism, and beauty. And we just don’t know what revising the human genome to create permanent genetic modifications might mean for future generations. What if you edit one part of the gene to reduce the risk of X but then inadvertently increase the risk of Y? As Lander notes, “For example, the CCR5 mutations that protect against HIV also elevate the risk for West Nile virus, and multiple genes have variants with opposing effects on risk for type 1 diabetes and Crohn’s disease.” Indeed, our knowledge is incomplete, but we’ll be learning more as we move forward and try to deal with these possibilities—and challenges—on technical, logistical, moral, and ethical levels. I concur with Lander’s concluding statement: “It has been only about a decade since we first read the human genome. We should exercise great caution before we begin to rewrite it.”

Over the past few years, thousands of laboratories around the world have begun to use CRISPR technology in their research. In April 2015, Chinese scientists reported that, for the first time, they had edited the genomes of human embryos.5 Wow! This was all made possible by a single discovery in 2012 by Jennifer A. Doudna, a biochemist at the University of California, Berkeley, who changed this field virtually overnight. Discoveries like this are now happening all the time around the world, and we need to be ready. It used to take a long time for new scientific knowledge or technologies published in the medical literature to enter mainstream medicine and fellow research labs, let alone the average doctor’s visit. While it’s been estimated that seventeen years usually passes before research evidence becomes part of clinical practice, that lag time will diminish quickly in the Lucky Years.6 You’ll be able to benefit from the findings of a new study or from a new technology in a matter of hours or days, not years or decades. But we’ll have to figure out what to do with technologies like CRISPR before we unleash those into a clinical setting.

Unlike Jobs’s binary world of computer programming, my field was a source of agony for him because I had to reconcile the hazy line between the science and art of medicine. He couldn’t understand why I couldn’t “debug” him like an Apple engineer.

But I learned again over those four years how important it is to tune in to your body. Steve had an admirable ability to listen to himself and know what his body wanted and needed. Although some will argue that he may have made some unwise choices early on in his fight against cancer—rejecting potentially life-saving surgery and turning to acupuncture, diet, and dietary supplements—that’s not the point. I’m a firm believer that each one of us should be able to make our own decisions when it comes to our health. No one can take away the fact Steve was always true to his wishes, values, and personal health decisions. That he may have lowered his chances of survival by taking an alternative route first is immaterial. It was part of his journey, and he wasn’t doing anything unethical. Steve was instrumental in choosing his therapy and his way of life from beginning to end. For him it was about how his choices made him feel. And he remained very much in tune with himself up to his last breath, letting that intuition guide his every action. I wish for that kind of mentality in not only myself, but in all my patients, friends, and loved ones.

Steve once said to me: “Health sounds like something I’m supposed to eat, but it tastes really bad.” He made sure I kept the word health out of the title of my first book. But I’m using it this time in the subtitle because health has a different context now. We live in an exciting time, a world that is increasingly affording us all the opportunity to thrive for as long as we choose.
Old Wine in a New Bottle
At the end of the eighteenth century, the British scholar Thomas Robert Malthus wrote a controversial set of six books in which he meticulously calculated the end of the world based on the expanding population. At the time, the world housed 800 million people (to put that into perspective, that’s a little less than half the number of people who used Facebook in 2015). He predicted that once the world population hit 2 billion, there would be apocalyptic famine and war. The planet wouldn’t be able to sustain that number of people given its finite resources and arable land. Although Malthus’s computations were incredibly accurate, and many contemporary people would agree with one of Malthus’s assertions—“The power of population is indefinitely greater than the power in the earth to produce subsistence for man”—take a look around you. Obviously, we failed to elicit his predicted outcome, dubbed the Malthusian catastrophe.

In 2011, we surpassed the 7-billion mark, and we are headed to a whopping 8 billion by 2030, maybe sooner. Malthus could not have foreseen the impact that technological innovation would have. It has allowed us to thrive for millennia, and will continue to do so, but only if we prioritize it like never before. Yes, we need to fix global warming, develop plans for water security, solve poverty and pollution, end world hunger, prevent chronic disease, and discover new energy sources—and we can accomplish all of this through innovation in the Lucky Years.

The notion that experiments performed generations ago, like those of Wanda Lunsford, are relevant today should inspire great optimism. I only wonder how many other long-lost studies are holding the key to effective remedies and cures to our modern afflictions. And I also sometimes wonder if we have all the drugs we’d ever need to treat our ailments, but we just don’t know which ones to try on which diseases.

For another example of old ideas once considered crazy or unbelievable gaining a new life in twenty-first-century medicine, take the story of William B. Coley and his “Toxins.”

Most helpful customer reviews

30 of 32 people found the following review helpful.
Promising but over promises
By Tam Hunt
This is an interesting book and a nice overview of modern health science and medicine. But it's promise to provide useable knowledge about how to extend life and health in "the lucky years" isn't really borne out. It's aspirational and points to coming developments in stem cell treatments and personalized medicine. But those parts of the book are a small fraction of the total. In short, I expected a lot more detailed manual on how personal habits and knowledge combined with recent medical breakthroughs would allow me to reasonably expect to dramatically increase my life span and my quality of life. And this the book doesn't do.

44 of 48 people found the following review helpful.
Great book -- review from an MD
By b dubner
i am a physician and i find dr agus's books informative and easy to read. he applies the concepts of research to actual day to day living. I'm a huge fan. I refer to his book multiple times a day when speaking with patients in my practice and I also try to follow his advice personally. Great book.

49 of 51 people found the following review helpful.
all of this great advice aside
By Amazon Customer
Dr Agus has proven, once again, his talent at breaking down complex medical issues into an easy-to-understand check-list for your life. Dr Agus' book teaches you that the "data" of your medical history is a blue-print for the future of your health... And, more importantly, that your future can be a long and healthy journey. When you finish reading this book, you will immediately want to run to your medicine cabinet and flush your vitamins down the toilet, forget about that juice cleanse and, instead, stick to a healthy Mediterranean diet, consider some aspirin for your heart health and wear sneakers to work. Not to mention, Agus' belief in the importance of sleep, yoga, relaxation and exercise. However, all of this great advice aside, Agus' assertion that we should take "control" of our health is an important and welcome message. He urges readers to track their own health, listen to their bodies and to document it all -- both for yourself and others to learn from.... This book might not only improve your health but also that of many generations to come....

See all 154 customer reviews...

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Senin, 16 September 2013

[Q895.Ebook] PDF Ebook Myths of Sexuality: Representations of Women in Victorian Britain, by Lynda Nead

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Myths of Sexuality: Representations of Women in Victorian Britain, by Lynda Nead

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Myths of Sexuality: Representations of Women in Victorian Britain, by Lynda Nead

"Myths of Sexuality" is a pioneering work of feminist art history. It tells how the depiction of women in art defined and confined their role in Victorian Britain. This book offers an analysis of the regulation of women's behaviour in the 19th century. Victorian notions of acceptable and unacceptable female behaviour pervade 19th century culture and reveal themselves in this book in the popular art of the time. Lynda Nead shows how paintings intended for public exhibitions in particular participated in the production of a bourgeois morality. She shows too how women were represented in medical, legal, religious and literary texts, focusing especially on the treatment of prostitution, adultery, and female philanthropy.

  • Sales Rank: #1408642 in Books
  • Published on: 1990-10
  • Ingredients: Example Ingredients
  • Original language: English
  • Number of items: 1
  • Dimensions: 9.00" h x 6.00" w x .75" l,
  • Binding: Paperback
  • 240 pages

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[G927.Ebook] PDF Download Qualitative Research & Evaluation Methods, by Michael Quinn Patton

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Qualitative Research & Evaluation Methods, by Michael Quinn Patton

The book that has been a resource and training tool for countless applied researchers, evaluators, and graduate students has been completely revised with hundreds of new examples and stories illuminating all aspects of qualitative inquiry. Patton has created the most comprehensive, systematic and up-to-date review of qualitative methods available.

Patton has retained and expanded upon the Exhibits that highlight and summarize major issues and guidelines, the summative sections, tables, and figures as well as the sage advice of the Sufi Master, Halcolm. This revision will help readers integrate and make sense of the great volume of qualitative works published in the past decade. 

  • Sales Rank: #74526 in Books
  • Brand: Brand: SAGE Publications, Inc
  • Published on: 2001-10
  • Ingredients: Example Ingredients
  • Original language: English
  • Number of items: 4
  • Dimensions: 1.63" h x 7.28" w x 10.20" l, 2.93 pounds
  • Binding: Hardcover
  • 688 pages
Features
  • Used Book in Good Condition

Review

"Paton has a distinguished career as an evaluation researcher and his experience in applying the tools of qualitative research to address the questions and concerns of those in the world of practice come through clearly… a gem of a discussion of sampling strategies in qualitative research that is useful not only to prospective researchers but also to more seasoned ones. It is the most complete and carefully reasoned consideration of sampling in qualitative research that I have encountered"

(Organizational Research Methods)

About the Author

Michael Quinn Patton is an independent consultant with more than 40 years’ experience conducting applied research and program evaluations. He lives in Minnesota, where, according to the state’s poet laureate, Garrison Keillor, “all the women are strong, all the men are good-looking, and all the children are above average.” It was this interesting lack of statistical variation in Minnesota that led him to qualitative inquiry despite the strong quantitative orientation of his doctoral studies in sociology at the University of Wisconsin. He was on the faculty of the University of Minnesota for 18 years, including 5 years as director of the Minnesota Center for Social Research, where he was awarded the Morse-Amoco Award for innovative teaching. Readers of this book will not be surprised to learn that he has also won the University of Minnesota storytelling competition.

He has authored six other SAGE books: Utilization-Focused Evaluation, Creative Evaluation, Practical Evaluation, How to Use Qualitative Methods for Evaluation, Essentials of Utilization-Focused Evaluation, and Family Sexual Abuse: Frontline Research and Evaluation. He has edited or contributed articles to numerous books and journals, including several volumes of New Directions in Program Evaluation, on subjects as diverse as culture and evaluation, how and why language matters, HIV/AIDS research and evaluation systems, extension methods, feminist evaluation, teaching using the case method, evaluating strategy, utilization of evaluation, and valuing. He is the author of Developmental Evaluation: Applying Complexity Concepts to Enhance Innovation and Use and coauthor of Getting to Maybe: How the World Is Changed, a book that applies complexity science to social innovation. His creative nonfiction book, Grand Canyon Celebration: A Father–Son Journey of Discovery, was a finalist for Minnesota Book of the Year.

He is a former president of the American Evaluation Association and recipient of both the Alva and Gunnar Myrdal Award for Outstanding Contributions to Useful and Practical Evaluation and the Paul F. Lazarsfeld Award for Lifelong Contributions to Evaluation Theory from the American Evaluation Association. The Society for Applied Sociology presented him the Lester F. Ward Award for Outstanding Contributions to Applied Sociology.

He is on the faculty of The Evaluators’ Institute and teaches workshops for the American Evaluation Association’s professional development courses and Claremont University’s Summer Institute. He is a founding trainer for the International Program for Development Evaluation Training, sponsored by The World Bank and other international development agencies each summer in Ottawa, Ontario.

He has conducted applied research and evaluation on a broad range of issues, including antipoverty initiatives, leadership development, education at all levels, human services, the environment, public health, medical education, employment training, agricultural extension, arts, criminal justice, mental health, transportation, diversity initiatives, international development, community development, systems change, policy effectiveness, managing for results, performance indicators, and effective governance. He has worked with organizations and programs at the international, national, state, provincial, and local levels and with philanthropic, not-for-profit, private sector, international agency, and government programs. He has worked with people from many different cultures and perspectives.

He has three children―a musician, an engineer, and a nonprofit organization development and evaluation specialist―and one granddaughter. When not evaluating, he enjoys exploring the woods and rivers of Minnesota with his partner, Jean―kayaking, cross-country skiing, and snowshoeing―and occasionally hiking in the Grand Canyon. He enjoys watching the seasons change from his office overlooking the Mississippi River in Saint

Most helpful customer reviews

1 of 1 people found the following review helpful.
A good start, but not quite enough
By Jane Rosenthal
I enjoyed the book overall. I found the stories enlightening and intelligent, and the stories provided a nice context/backstory for the research Patton discusses. In that sense it is a good intro book for qualitative methods, and I found his discussion on qualitative evaluation more helpful than the discussion on basic or applied qualitative research. I found it to be a bit limiting when I set out to actually do the research in that the book disn't provide enough guidance in the work of analysis. More guidance on the actual process of analysis would have been very helpful. In addition, I found much of the discussion on the use of technology a bit dated and overly light in some ways, such as Patton's discussion on the traps that researchers can fall into in data collection when using computer programs.

29 of 30 people found the following review helpful.
Good starting point for novice interviewers
By A Customer
As a senior in college who is conducting interviews with high school and college students, I would recommend this book. It provides an excellent jumping off point for both novice student interviewers as well as seasoned teachers. Patton, himself an experienced interviewer, and also an award-winning teacher and storyteller, outlines all the necessary steps involved in the interview process in a very entertaining way. The book reads much like a textbook, complete with original cartoons, historical examples, and vast personal experience. Moreover, inspirational and often amusing quotes kickoff each section. Appearing throughout the book is the fictional sage-like character Halcolm, a philosophical alter ego of Patton, who, "like his name (pronounced slowly)," forces the reader to ask "how come?" (p. A2).
Patton has divided Qualitative Research and Evaluation into three main parts: Conceptual Issues in Qualitative Inquiry, Qualitative Designs and Data Collection, and finally Analysis, Interpretation, and Reporting. Under each section are many subsections, all clearly laid out in a very detailed table of contents. For example, Conceptual Issues is divided into four subcategories: The Nature of Qualitative Inquiry, Strategic Themes in Qualitative Inquiry, Variety in Qualitative Inquiry: Theoretical Orientations, and finally Particularly Appropriate Qualitative Applications. Furthermore, these four subcategories are then broken down in additional detail in the table of contents. The titles of these sections (and chapters) are somewhat typical for the text as a whole in that they rely on sociological terminology that may be unfamiliar to beginners. At first glance, the table of contents appears to be little more than a patchwork of intellectual vocabulary, but the book reads in much simpler terms.
The index to the book is also very useful for finding numerous narrowed down focuses. I found this the most helpful. For example, when I wanted to find out about transcribing interviews, I was able to find all of the relevant chapters and information at once.
Unfortunately, however, Patton's broad scope is also his main weakness. It is very easy to become bogged down by the mass amount of details and by his many examples. Also, for scholars primarily interested in the interview process, only the final section is useful, especially in the field of analysis.
Patton attempts to cover all of the basics of interviewing, and provides an excellent outline, but nothing can compare to actual experience. Nevertheless, it is highly recommended that first-time interviewers consult Patton's book for an introductory guide, and even veteran interviewers can learn something from Patton's vast experience.
Researchers will also find Patton's 36 pages of single-spaced references very helpful, and graduate students will find it invaluable for dissertations.

0 of 0 people found the following review helpful.
It certainly was a good resource to have on hand in writing up the ...
By Karen
Patton's book is one of the foundational sources in most entry level qualitative classes. It is helpful but very wordy. At times, it is difficult to wade through it all. If one has time, this book is a must in addition to other qualitative books. It certainly was a good resource to have on hand in writing up the methodology section of my dissertation.

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[K101.Ebook] PDF Ebook Stainless Steels (Asm Specialty Handbook) (06398G), by Joseph R. Davis

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Stainless Steels (Asm Specialty Handbook) (06398G), by Joseph R. Davis

Your single resource for stainless information - culled from the ASM Handbooks.

  • Sales Rank: #2204231 in Books
  • Published on: 1995-01-01
  • Original language: English
  • Number of items: 1
  • Dimensions: 11.50" h x 9.00" w x 1.50" l, 1.10 pounds
  • Binding: Hardcover
  • 576 pages

From the Publisher
Published: 1994

Most helpful customer reviews

0 of 0 people found the following review helpful.
good reference book, one of the best general offerings on stainless.
By one off buyer
I've used this refernce oin the past and it offers a bit on most issues that arise for stainless steels.

Would love to see a revised volue at some point.

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Rabu, 11 September 2013

[I827.Ebook] Free PDF The New York, Westchester & Boston Railway: J. P. Morgan's Magnificent Mistake (Railroads Past and P), by Herbert H Harwood

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The New York, Westchester & Boston Railway: J. P. Morgan's Magnificent Mistake (Railroads Past and P), by Herbert H Harwood

When the New York, Westchester & Boston Railway opened in 1912, it was one of the engineering wonders of the American railroad world. Built to the highest level of engineering standards and operated with strict punctuality, the ""Westchester"" was a high-speed, high-capacity electric line designed to develop and serve upper-income communities in one of New York City's most rapidly growing suburban areas. Unbeknownst to most, reigning financial power J. Pierpont Morgan was behind the funding of the line.

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  • Sales Rank: #2939277 in Books
  • Published on: 2008-07-09
  • Released on: 2008-07-09
  • Original language: English
  • Number of items: 1
  • Dimensions: 10.26" h x .64" w x 7.32" l, 1.33 pounds
  • Binding: Hardcover
  • 155 pages

Review

""This book is an absolute gem. A wonderful, not to say definitive, account of a strange and unusual chapter in the overall story of electric railways in America."" --Brian J. Cudahy, author of A Century of Subways--Brian J. Cudahy, author of A Century of Subways

From the Publisher
"This book is an absolute gem. A wonderful, not to say definitive, account of a strange and unusual chapter in the overall story of electric railways in America." --Brian J. Cudahy, author of A Century of Subways

"In well-researched and organized text, Harwood tells the story of the NYW&B from beginning to end. This was an unusual railroad that went from start-up to abandonment in little more than a quarter century." --William D. Middleton, co-editor of Encyclopedia of North American Railroads

About the Author

Herbert H. Harwood, Jr., spent 30 years in various management positions at the Chesapeake & Ohio and the Baltimore & Ohio as well as their successor, CSX Transportation. He has written 12 books on railroad and electric railway history. He lives in Baltimore, Maryland.

Most helpful customer reviews

5 of 5 people found the following review helpful.
Good history, great business analysis
By Joseph Marty
Good read about construction of a commuter rail line through southern Westchester County, NY. Its excellent historical references and good writing should make this interesting for non-railfans. Harwood's strength is his insightful business analysis of why and how this very expensive line got built and then abandoned. Reads like a good mystery novel in parts, with Harwood zooming back from fascinating minutiae about routing choices to J.P. Morgan's strategic -- but not entirely clear -- plans for his railroad investments. Fun to read.

2 of 2 people found the following review helpful.
"A good read indeed"
By Ralph Russano
Excellent history of the railway that I grew up nearby in the Bronx New York.

0 of 0 people found the following review helpful.
NYBWR
By Walter
Coming up on 100th Aniversary of its opening, and having explored some of the abandoned ROW / stations back in the 1970's, I wanted to learn about this railroad. Excellent written book going over the dubious payments and "strange" decisions made that doomed this endeavor before it started. Would have liked to see more of the construction photos and any taken during the scrapping, but there are other books dedicated to that.

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Senin, 09 September 2013

[Q589.Ebook] Ebook Real-Time Software Design for Embedded Systems, by Hassan Gomaa

Ebook Real-Time Software Design for Embedded Systems, by Hassan Gomaa

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Real-Time Software Design for Embedded Systems, by Hassan Gomaa

This tutorial reference takes the reader from use cases to complete architectures for real-time embedded systems using SysML, UML, and MARTE and shows how to apply the COMET/RTE design method to real-world problems. The author covers key topics such as architectural patterns for distributed and hierarchical real-time control and other real-time software architectures, performance analysis of real-time designs using real-time scheduling, and timing analysis on single and multiple processor systems. Complete case studies illustrating design issues include a light rail control system, a microwave oven control system, and an automated highway toll system. Organized as an introduction followed by several self-contained chapters, the book is perfect for experienced software engineers wanting a quick reference at each stage of the analysis, design, and development of large-scale real-time embedded systems, as well as for advanced undergraduate or graduate courses in software engineering, computer engineering, and software design.

  • Sales Rank: #1402122 in Books
  • Published on: 2016-05-27
  • Original language: English
  • Number of items: 1
  • Dimensions: 9.96" h x 1.22" w x 6.97" l, .0 pounds
  • Binding: Hardcover
  • 602 pages

Most helpful customer reviews

0 of 0 people found the following review helpful.
Another great book by Dr. Hassan Gomaa.
By Linus Freeman
This book is a very fluid book to read on analysis and architectural design fot real-time embedded systems building on Dr. Gomaa's other books on software design and advanced design for software product lines.

0 of 0 people found the following review helpful.
One of the few modern, practical books on designing software for real-time embedded systems
By Software Designer
Software design for the real-time embedded systems domain has nearly become a lost art. Hassan Gomaa's text is a welcome presence and a must-read for any software engineer / computer scientist working on industrial real-time and embedded systems. This is truly one of the few modern and practical texts on the subject.

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Rabu, 04 September 2013

[M814.Ebook] Download PDF The Art of Advocacy in International Arbitration - 2nd Edition, by R. Doak Bishop and Edward G. Kehoe

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The Art of Advocacy in International Arbitration - 2nd Edition, by R. Doak Bishop and Edward G. Kehoe

Written by today s leading arbitrators and counsel, this remarkably candid guide provides insight into the practitioner s approach, conduct, style, and techniques that have proven most effective. While the facts and the law are fundamental, a successful outcome is the product of painstaking document review, witness interviews, legal research, strategizing and focusing the case, and developing compelling written and oral presentations. How to properly perform these tasks is the subject of this book. And where the first edition focused mainly on the cultural differences in advocacy performed in various regions of the world, this new edition expands on this theme by addressing each functional aspect of an international arbitration and the techniques that have been developed for good written and oral advocacy. Intended to assist both the novice in learning the techniques of advocacy, and the experienced advocate in improving his skills, this is an essential reference.

  • Sales Rank: #1465829 in Books
  • Brand: Brand: Juris Net
  • Published on: 2010-05-01
  • Original language: English
  • Dimensions: 9.00" h x 6.25" w x 1.75" l, 2.25 pounds
  • Binding: Hardcover
  • 667 pages
Features
  • Used Book in Good Condition

Review
"This volume of essays contains many keys to the perceptions one might expect of arbitrators from leading legal traditions. From the advocate s perspective, a foreign arbitrator may seem to be arbitrarily dismissive of some procedural niceties and astonishingly mesmerised by others; but assumptions to that effect are at the advocate s peril. There is always a reason for the arbitrators attitude, and that reason will invariably be a function of their cultural baggage. Mr. Bishop has brought together a cosmopolitan group of distinguished practitioners of which he is himself a full-fledged member who in these pages open quite a few fascinating trunks and valises. Above all, these pages are filled not with abstractions, but with a myriad of concrete suggestions which invariably merit consideration." --- Jan Paulsson, Freshfields Bruckhaus Deringer, Head of the firm s International Arbitration Group. He has also been involved in 17 ICSID cases.

"This excellent book, which is written by some of the leading practitioners in their field, deals with the finer points of advocacy in international arbitration and litigation. This book provides the reader with a blueprint for constructing their styles of advocacy and helps to navigate through the different complex rules and procedures that make up this hybrid system of dispute resolution in the international arena. This book is essential for all those involved in international arbitration and litigation. The techniques of preparing for written and oral advocacy from different cultures discussed therein should stand the advocate in good stead with any tribunal." --Christopher To, Secretary General, HKIAC; Asian Dispute Review, January 2007

The contributing authors are experienced arbitration practitioners from different legal and cultural traditions - the result is a rich variety of perspectives on advocacy skills in international arbitration. . . . The main benefit of this guide is that it is practice-oriented. The reader is offered concrete advice on how to develop effective lawyering skills in all aspects of the arbitral process, from the choice of the tribunal to the preparation and presentation of a case before it. . . . More importantly, the reader can gain a better understanding of the diverse legal and cultural traditions that underlie advocacy in international arbitration, which will in turn help the advocate adapt his or her advocacy style to that which best suits his or her audience. --Sarah Wazen, Hanotiau & Van Den Berg, Brussels

About the Author
R. Doak Bishop is a litigation Partner and a member of King & Spalding s Latin American Practice Group. Mr. Bishop has over 27 years experience focusing on international arbitration and litigation of oil and gas, energy, construction, and environmental disputes. He has developed a national reputation for his experience in international arbitration, serving both as an arbitrator and counsel in large business disputes. Mr. Bishop is Board Certified in Civil Trial Law by the Texas Board of Legal Specialization. Mr. Bishop presently serves as Vice Chairman of the Institute of Transnational Arbitration (1990-present) and as a member of the U.S. delegation to the NAFTA Advisory Committee on Private Commercial Disputes. He has previously served as Chairman of the Litigation Section of the State Bar of Texas (1998) and Co-Chair of the American Bar Association International Litigation Committee (1998-1999). His experience in litigation and arbitration includes: international litigation and arbitration; oil & gas and energy disputes; construction disputes; environmental disputes; high technology disputes. Mr. Bishop received his B.A. degree with high honors and departmental distinction from Southern Methodist University in 1973, and his J.D. degree with honors from The University of Texas in 1976 where he served as Research Editor of the Texas Law Review. Edward G. Kehoe is the head of King & Spalding s New York Business Litigation Department, and he co-heads the Firm s International Arbitration Practice with Doak Bishop. Mr. Kehoe received his bachelor s degree in accounting at Lehigh University, and he graduated cum laude from St. John s Law School where he was a member of the St. John s Law Review. He has more than 19 years experience in international business arbitration and litigation, with a focus on energy, professional services liability, construction, pharma, and insurance. He is recognized in Chambers USA for international arbitration, where it states that he drew spontaneous applause from esteemed sources for his sophistication and success in handling a number of sizable matters. According to The Legal 500 publication, clients and peers comment that he is held in very high regard for his international arbitration skills. He was selected by his peers as a New York Super Lawyer, and honored in the Corporate Counsel Magazine as one of the Nation s Top Litigators in business litigation. He is a member of the Panel of Neutrals for the AAA International Centre for Dispute Resolution. Mr. Kehoe also is a frequent writer and lecturer on international arbitration issues; he is a member of the Board of Editors of Global Arbitration Review, and the International Bar Association; and he sits on the Advisory Board of the Institute for Transnational Arbitration. List of Contributors: GUILLERMO AGUILAR PIERRE BIENVENU NIGEL BLACKABY JAMES H. CARTER BERNARDO M. CREMADES STEPHEN L. DRYMER DIETER FLADER L. YVES FORTIER MARK FRIEDMAN EMMANUEL GAILLARD TERESA GIOVANNIN MICHAEL HWANG STEPHEN JAGUSCH TOBY LANDAU PETER LEAVER IGNACIO MADALENA CRAIG MILES SOPHIE NAPPERT JAN PAULSSON PHILIPPE PINSOLLE LUCY REED DAVID W. RIVKIN CATHERINE ROGERS ANTHONY SINCLAIR HENRY FORBES SMITH GUIDO SANTIAGO TAWIL MARTIN VALASEK

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