This concise & practical reference tailored for fellows residents & medical students rotating on gastroenterology subspecialty services covers both inpatient & outpatient management of gastroenterology with the same clinical practicality as the widely popular Washington Manual[trademark] of Medical Therapeutics". With gastroenterology continuing to expand as a specialty there is a wealth of new insights on disease pathophysiology diagnostic tools & management options that this manual helps to address. It is the result of a collaborative effort of residents fellows & clinical faculty from the distinguished Washington University School of Medicine & serves as a practical quick reference guide to the diagnosis & treatment of gastrointestinal ailments. New features include. two new chapters included: Liver Transplantation Genetic Testing in GI Disease. Chapter on nutrition has been revised to reflect Malnutrition both over & under nutrition. Consistent formatting of chapters including the format of individual diseases & symptoms revised to follow specific subheadings. It is extensively updated to include chapter rewrites where necessary. Dont miss the other key topics in " Washington Manual[trademark] Subspecialty Consult Series": Allergy Asthma & Immunology Hematology & Oncology Infectious Disease Nephrology & Rheumatology. The " Washington Manual[trademark]" is a registered mark belonging to Washington University in St. Louis to which international legal protection applies. The mark is used in this publication by LWW under license from Washington University." ...

Microbrews killer coffee lush forests a pristine coastline eco-minded locals & music & art galore Pacific Northwesterners have it good & they don t mind sharing. Sandra Bao Lonely Planet Writer. Our Promise You can trust our travel information because Lonely Planet authors visit the places we write about each & every edition. We never accept freebies for positive coverage & you can rely on us to tell it like we see it. Inside This Book 4 local authors 55 detailed maps 64 parks & reserves 69 pubs microbreweries & wineries Inspirational photos Clear easy-to-use maps In-depth background Outdoors feature Comprehensive planning tools At-a-glance practical info ...

Washington Square marks the culmination of Jamess apprentice period as a novelist. With sharply focused attention upon just four principal characters James provides an acute analysis of middle-class manners & behaviour in the New York of the 1870s a period of great change in the life of the city. This change is explored through the device of setting the novels action during the 1840s similarly a period of considerable turbulence as the United States experienced the onset of rapid commercial & industrial expansion. Through the relationships between Austin Sloper a celebrated physician & his sister Lavinia Penniman his daughter Catherine & Catherines suitor Morris Townsend James observes the contemporary scene as a site of competing styles & performances where authentic expression cannot be articulated or is subject to suppression. ...

Frank no ordinary sixteen-year-old lives with his father outs Ide a remote Scottish village. Their life is to say the least unconventional. Franks mother abandoned them years ago: his elder brother Eric is confined to a psychiatric hospital; & his father measures out his eccentricities on an imperial scale. Frank has turned to strange acts of violence to vent his frustrations. In the bizarre daily rituals there is some solace. But when news comes of Erics escape from the hospital Frank has to prepare the ground for his brothers inevitable return
- an event that explodes the mysteries of the past & changes Frank utterly. Iain Banks celebrated first novel is a work of extraordinary originality imagination & horrifying compulsion: horrifying because it enters a mind whose realities are not our own whose values of life & death are alien to our society; & compulsive because the humour & compassion of that mind reach out to us all.
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Two years after I killed Blyth I murdered my young brother Paul for quite different reasons than Id disposed of Blyth & then a year after that I did for my young cousin Esmerelda more or less on a whim. Thats my score to date. Three. I havent killed anybody for years & dont intend to ever again. It was just a stage I was going through. Enter
- if you can bear it
- the extraordinary private world of Frank just sixteen & unconventional to say the least.

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An efficient use of resources & an effective management of waste are essential features of an environmentally sustainable economy. However in many developing countries waste management facilities are both inefficient & insufficient. Some of the broad causes of sub-optimal waste management in developing countries like those in South Asia are poor existing disposal systems as well as lack of awareness of the environmental externalities. The pertinent question then is
- what is so worrisome about inefficient & undeveloped waste management systems? The answer is that they cause major damages to the environment which in turn causes health hazards. The fast pace of economic growth & the consequent changes in the standard of living on the one hand & population growth on the other have led to increasing volumes of waste at an alarming rate. Due to lack of awareness amongst the masses in most developing countries management of waste is very difficult. Much of this waste has proved to be extremely toxic. The latest scientific assessment report of the Intergovernmental Panel on Climate Change (IPCC) issued in Paris on 2 February 2007 blames humans squarely for environmental damages like global warming sea level rise changing weather patterns (including severity of storms/cyclones) & freak weather in many parts of the globe. Detrimental consequences of being lax with waste management impacts human health adversely & in the final count any negative impact on human capital impedes development of society. However it is important to remember that though waste has a deleterious impact on the environment at global & local levels & immediate steps have to be taken to implement effective waste management methods it is also important to remember that waste contains resources which can be reused or recycled to deliver economic value resulting in greater resource efficiency.
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Mark Johnson's father had 'LOVE' tattooed across his left hand but that didn't stop the beatings. The Johnson children would turn up to school with broken fingers & chipped teeth but no one ever thought of investigating their home life. Mark just slipped through the cracks & kept on falling. For years. Constantly in trouble at school Mark began stealing at the age of seven was drinking by the age of eight & took his first hit of heroin aged eleven. A sensitive intelligent boy he could never stay on the right path & though Art College beckoned he ended up in Portland prison instead. With searing honesty WASTED documents Mark's descent into the depths of addiction & criminality. Homeless hooked on heroin & crack no one
- least of all Mark
- believed he would survive. & yet
- astonishingly
- he somehow pulled himself through & now runs his own thriving tree surgery business employing & helping other recovering addicts. His story is at once shocking & inspiring
- a compelling account of his struggle to save himself & help save others in the process.




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A retired career anorexic examines herself & her & our culture in a masterpiece of confessional literature. At the age of four Marya Hornbacher looked in a mirror & decided she was fat. At nine she was bulimic. At twelve she was anorexic. By the time she was eighteen shed been hospitalized five times once in the loony bin. Her doctors & her parents had given up on her; they were watching her die. But Marya decided to live. Four years on now 22 here is her harrowing tale powerfully told in a virtuoso mix of memoir cultural criticism & psychological examination. Here is the amazingly articulate fury of a clever woman made stupid by her culture who threw away her teenage years in a continuous cycle of bingeing & vomiting or just plain starvation. The first book to explore from the inside the intimate relationship between eating disorders & 1990s cultures historically unprecedented obsession with body diet & gender; not a testimony to a miracle cure but the story of one womans travels to the darker side of reality & her decision to find her way back on her own terms. Hornbacher is articulate clever & has all the persuasive zeal of a convert furious at the pressures that made her what she was. Paradoxically her painful journey is also gripping and!dare one say it!.entertaining in a way that no fiction could ever be. A compulsive read. Publishing News; A gritty unflinching look at eating disorders written from the raw disintegrated centre of young pain with stark candour & power. New York Times / The slimming industry is worth GBP1billion in GB alone / The UK has 3.5 million anorexics & bulimics ...

The wristwatch is the only jewellery that most men will wear although many would not want to call it that. A watch may be a practical device for the sole purpose of telling the time as accurately as possible a complicated machine a wearable design object or a status symbol. Some watch wearers like scuba divers or pilots rely on their timepieces for safety & survival. Gene Stones The Watch" covers all these things & more. It ranges over the world of watches without prejudice mixing the old with the new & the expensive with the economical. It introduces the fifty major brands that any watch collector must be familiar with. Essential wisdom on buying collecting maintaining & wearing watches is provided. & an encyclopedic glossary offers a crash course in watch lore. Best of all are the more than 500 photographs of terrific watches including remarkable details of dials & movements & selected for their beauty & diversity from collections around the world." ...

First published in 1953 this authoritative work which was based on a lifetimes practical experience has been in continuous demand & is recognized as a classic work on the subject. Its great strength lies in the descriptions & principles of watch & clock construction in an easy-to-follow manner. The book opens with a description of the various tools & materials essential for good work; details are then given concerning the construction & repair of the various types of movement trains motion work & gearing the various forms of escapement keyless mechanisms balances & balance springs pendulums striking & repeating mechanisms calendars chronograph work & chronometers. The subject of cleaning is given careful consideration while filing & turning the two most important operations in watch & clock making are given special attention. The construction of specialist tools for repair work many of which were designed by the author is explained in some detail & illustrated by working drawings. In addition an appendix lists the various causes of failure & bad time-keeping. ...