Книги з теми "Coupled Procedure"

The development of transcatheter valve therapeutic modalities has reignited interest in the anatomy of the valvular complexes. Indeed, this knowledge is crucial for individuals who are involved in transcatheter valve therapies. The importance of anatomy for procedure indications, contraindications, performance, and device development are tremendous and cannot be overemphasized. Comprehension of the anatomy is the first step toward successful transcatheter valve therapy. This knowledge should be coupled with the ability to view and understand the valvular complex using different imaging modalities. The ability to have a three-dimensional understanding of the valvular component and its relation to the other cardiac structures is key in performing transcatheter valve procedures. This chapter discusses the aortic valve and the mitral valve complexes and reviews a novel way of understanding left-sided heart valve anatomy using multiple imaging modalities.

Conducting therapy with couples and families creates unique ethical considerations. During couple therapy and family therapy, therapists may encounter ethical difficulties when identifying the goals of treatment in the face of family members’ conflicting desires, deciding when to disclose information obtained privately from one client to other family members, and managing risk in order to maintain client safety. Therapists can minimize these ethical dilemmas by clearly articulating their policies both during consent procedures and throughout treatment. Additionally, therapists who work with couples and families must be mindful of their own values and competencies in order to engage in ethical practice.

Surgical treatment of male infertility is indicated in men with obstructive azoospermia due to epididymal and vassal blockage, in infertile men with a varicocele and oligozoospermia, and to harvest spermatozoa for future intracytoplasmic sperm injection (ICSI). Testis biopsy may be performed in men with normal testis volume and normal gonadotrophins to confirm the diagnosis of obstructive azoospermia. Furthermore, testis biopsies are indicated in men with risk factors for testis cancer, such as infertility and ultrasonograhic abnormalities.Varicocele repair seems effective in case of an infertility duration of at least 2 years, oligozoospermia, and otherwise unexplained infertility in a couple. The advantages of surgery in these couples are a fair chance of spontaneous pregnancies at relative low cost and with less obstetric problems and birth defect compared to pregnancies from IVF procedures.

This chapter introduces the book as a primer for radiographers working in theatres, and as a quick reference guide to cases that they may be unfamiliar with. Perfoming imaging during surgical procedures is one of the most common functions of radiographers, yet there is a dearth of available information on this topic. Radiography practice (including theatre imaging) is often learned on-site at teaching hospitals, concluding with a practical assessment once students have gained enough experience. However, the long duration of many surgical procedures coupled with limited placement time prevents many students from gaining exposure to sufficient numbers of procedures. In addition, similar procedures may vary widely depending on the surgical requirements of each case. This book is aimed at helping students and recently qualified radiographers in improving their knowledge and skills while not on theatre placement.

This review article presents a summary of the existing literature on well-established CBT treatments for substance use disorder. It provides an overview of the origins, procedure, and evidence for six CBT treatment models: relapse prevention (RP) and mindful-based relapse prevention (MBRP), guided self-change (GSC), community reinforcement approach (CRA), behavioral couples therapy (BCT), and personality-targeted brief interventions. Common intervention components include orienting clients towards a meaningful goal, teaching necessary skills to reduce substance use and successfully achieve the goal, and establishing plans to face potential relapses, which generally appear to produce moderate to large effects across contexts and substance-related outcomes.

In recent decades, increasing attention has been focused on the intravenous anaesthetic agents. This interest has been stimulated by the discovery and availability of agents with increasingly favourable pharmacokinetic and dynamic properties, coupled with advances in knowledge of pharmacology and advances in computer technology. For most patients and operative procedures, anaesthesia is induced with a bolus or fast infusion of a short-acting drug, most commonly propofol. Increasingly, anaesthesia is thereafter also maintained with an infusion of an agent with favourable kinetics, again usually of propofol, commonly supplemented with boluses or infusions of opioids. Propofol is also commonly used for procedural and intensive care sedation. It has highly favourable pharmacokinetics and pharmacodynamics for these applications as sedative or hypnotic agent—rapid, smooth onset, minimal accumulation, and rapid smooth offset of effect—but is by no means an ideal agent. In some specific situations, such as when its haemodynamic or respiratory effects are detrimental, use of alternative agents such as ketamine and etomidate are warranted. All the currently available agents have adverse effects, some of which are related to the active compound and some of which are related to the vehicle. Efforts are thus being made to develop new formulations, with fewer adverse effects, and to develop newer and better drugs. In the future we are also likely to see increasing use of older agents, but for newer indications (such as the use of ketamine as an antidepressant).

For around half of the couples who have trouble conceiving the cause of infertility is sperm-related. Intracytoplasmic sperm injection (ICSI) is the most common and successful treatment for male infertility. Here, the pioneers for the technique, along with authorities in the field, describe the underlying science of ICSI and other micromanipulation techniques. Practical advice for performing the techniques is covered in depth, including sperm selection, laser-assisted ICSI, and the use of piezo in ICSI. Examining the safety of ICSI in animal models as well as the impact of ICSI on the health and well-being of the children conceived through the procedure is discussed. This manual is an essential resource for clinical embryologists and laboratory personnel wishing to refine or develop techniques and improve outcomes.

The methods of coupled quantum field theory, which had great initial success in relativistic elementary particle physics and have subsequently played a major role in the extensive development of non-relativistic quantum many-particle theory and condensed matter physics, are at the core of this book. As an introduction to the subject, this presentation is intended to facilitate delivery of the material in an easily digestible form to students at a relatively early stage of their scientific development, specifically advanced undergraduates (rather than second or third year graduate students), who are mathematically strong physics majors. The mechanism to accomplish this is the early introduction of variational calculus with particle sources and the Schwinger Action Principle, accompanied by Green’s functions, and, in addition, a brief derivation of quantum mechanical ensemble theory introducing statistical thermodynamics. Important achievements of the theory in condensed matter and quantum statistical physics are reviewed in detail to help develop research capability. These include the derivation of coupled field Green’s function equations of motion for a model electron-hole-phonon system, extensive discussions of retarded, thermodynamic and non-equilibrium Green’s functions, and their associated spectral representations and approximation procedures. Phenomenology emerging in these discussions includes quantum plasma dynamic, nonlocal screening, plasmons, polaritons, linear electromagnetic response, excitons, polarons, phonons, magnetic Landau quantization, van der Waals interactions, chemisorption, etc. Considerable attention is also given to low-dimensional and nanostructured systems, including quantum wells, wires, dots and superlattices, as well as materials having exceptional conduction properties such as superconductors, superfluids and graphene.

Acute kidney injury (AKI) remains a challenging clinical problem for clinicians caring for critically-ill patients due largely to the paucity of specific therapeutic interventions aimed at mitigating poor outcome. Those patients most at risk for the development of AKI can often be identified by an assessment of demographic, clinical, diagnostic, and procedure-related factors couple with early and intensive bedside monitoring. Importantly, critically-ill patients are often exposed to multiple discrete risks that can accumulate during their course that can negatively impact not only the duration and severity of AKI, but also probability of recovery, and long-term functional decline and risk of development of chronic kidney disease. All critically-ill patients at risk of or with milder forms of AKI should have support individualized. A clear understanding of the scope, complexity, and general principals of prevention and management of AKI are indispensable in the care of these patients and will discussed in this chapter.

The management of natural resources is linked to broad issues of economic development, as well as to political stability, peace, and security, but it is also intimately connected to the political, economic, social, and cultural rights of individuals and communities relying on these resources. Bad management of natural resources often leads to ill-planned development, misappropriation of land, corruption, bad governance, misaligned budget priorities, lack of strong institutional reforms, and weak policies coupled with a continued denial of human rights of local communities. This book analyses in details the connections that exist between the management of natural resources and human rights, offering a new innovative human rights-based approach to natural resources management. To do it offers a comprehensive analysis of the different norms, procedures, and approaches developed under human rights law that are relevant to the management of natural resources. Advocating for a less market and corporate approach to the control, ownership, and management of natural resources, this book supports the development of holistic and coherent integration of human rights law in the overall international legal framework governing the management of natural resources.

The Collaborative/Therapeutic Assessment (C/TA) paradigm represents a significant shift from the traditional aims and techniques of psychological assessment. C/TA deliberately employs a variety of evidence-based techniques intended to maximize the potential that the process of assessment will result in meaningful therapeutic benefits for clients. The empirical support for the effectiveness of the C/TA approach is promising and demonstrates direct intervention effects on such indicators as self-esteem and symptomatology, as well as improvements in constructs and processes salient to continued psychological care, including the therapeutic alliance, treatment readiness, and distress. C/TA has also been shown to increase participation and retention in subsequent indicated mental health services for populations that traditionally are difficult to engage. This chapter describes the history and evidence-based theory behind C/TA approaches; describes the steps and procedures of the semi-stuctured Therapeutic Assessment model, and presents a thorough discussion of the application of a variety of therapeutic techniques (e.g., circular questioning, scaffolding, psychoeducation, shame modulation, mentalizing) in the context of the C/TA paradigm that increase the likelihood that assessment will result in clinically relevant outcomes. These techniques are applied in a variety of therapy models in psychology but have only recently been explicitly used in the context of psychological assessment for adults, couples, and families with children or adolescents.

Musculoskeletal ultrasound (MSUS) is rapidly becoming a standard part of many rheumatologists' daily clinical practice. MSUS is safe, increasingly widely available, relatively low cost, non-invasive, and hence very acceptable to the patient. Current problems with availability of training, mentoring, and accreditation procedures need to be overcome for MSUS to reach its full potential for rheumatologists. MSUS is capable of improving clinical diagnosis and the accuracy of intervention. MSUS is more sensitive than clinical examination in the detection of synovitis and effusion and is capable of rapid targeted assessment of widely spaced joints coupled with clinical correlation. MSUS has advantages over other imaging modalities; the ability to display dynamic real-time movement makes it the imaging modality of choice for tendon problems. It is significantly more sensitive than plain radiology in the demonstration of early erosive changes, and although its sensitivity is less than that of MRI for the detection of erosions it is far more practical, timely, and available. The combination of sensitivity in detection of synovitis, tenosynovitis, and erosions makes it an ideal imaging modality in the context of an early arthritis clinic. Power Doppler has been shown to be an effective way of evaluating synovitis and hence is of value in early diagnosis and monitoring of inflammatory arthritides. The accuracy of placement of local injection therapies is enhanced by MSUS, and it significantly increases the diagnostic success rate of aspiration of joints and bursas. The flexibility of ultrasound as a tool for rheumatologists is shown by its application in the assessment of vasculitides, peripheral nerve pathology, salivary glands, and skin lesions.

Musculoskeletal ultrasound (MSUS) is rapidly becoming a standard part of many rheumatologists’ daily clinical practice. MSUS is safe, increasingly widely available, relatively low cost, non-invasive, and hence very acceptable to the patient. Current problems with availability of training, mentoring, and accreditation procedures need to be overcome for MSUS to reach its full potential for rheumatologists. MSUS is capable of improving clinical diagnosis and the accuracy of intervention. MSUS is more sensitive than clinical examination in the detection of synovitis and effusion and is capable of rapid targeted assessment of widely spaced joints coupled with clinical correlation. MSUS has advantages over other imaging modalities; the ability to display dynamic real-time movement makes it the imaging modality of choice for tendon problems. It is significantly more sensitive than plain radiology in the demonstration of early erosive changes, and although its sensitivity is less than that of MRI for the detection of erosions it is far more practical, timely, and available. The combination of sensitivity in detection of synovitis, tenosynovitis, and erosions makes it an ideal imaging modality in the context of an early arthritis clinic. Power Doppler has been shown to be an effective way of evaluating synovitis and hence is of value in early diagnosis and monitoring of inflammatory arthritides. The accuracy of placement of local injection therapies is enhanced by MSUS, and it significantly increases the diagnostic success rate of aspiration of joints and bursas. The flexibility of ultrasound as a tool for rheumatologists is shown by its application in the assessment of vasculitides, peripheral nerve pathology, salivary glands, and skin lesions.

Since the first “test tube baby” was born over 40 years ago, in vitro fertilization and other assisted reproductive technologies (ARTs) have advanced in extraordinary ways, producing millions of babies. About 20% of Americans use infertility services, and that number is growing. ARTs enable gay and lesbian couples, single parents, and now others to have offspring. Prospective parents can also use preimplantation genetic diagnosis to avoid passing on certain mutations to their children and to avoid abortions of fetuses with these mutations. Other future parents routinely choose the sex of their child and whether to give birth to twins. In the United States, these procedures are largely unregulated, and a large commercial market has rapidly grown, using “egg donors,” buying and selling human eggs and sperm, and using gestational surrogates. Potential parents; policymakers; doctors, including reproductive endocrinologists; and others thus face critical complex questions about the use—or possible misuse—of ARTs. This book examines ethical, social, and policy questions about these crucial technologies. Based on in-depth interviews, Robert Klitzman explores how doctors and patients struggle with quandaries of whether, when, and how to use ARTs. He articulates the full range of these crucial issues, from economic pressures to moral and social challenges of making decisions that will profoundly shape these offspring. The book explores, too, broader social and moral questions regarding gene editing, CRISPR, and eugenics. Klitzman argues for closer regulation of these technologies, which are altering future generations and the human species as a whole.

Hayes and Williams’ Family Law, now in its sixth edition, provides critical and case-focused discussion of the key legislation and debates affecting adults and children. The volume takes a critical approach to the subject and includes ‘talking points’ and focused ‘discussion questions’ throughout each chapter which highlight areas of debate or controversy. The introductory chapter within this edition provides a discussion of the law’s understanding of ‘family’ and the extent to which this has changed over time, a detailed overview of the meaning of private and family life within Article 8 of the ECHR, and a discussion of the Family Justice Review and subsequent developments. Part 1 of this edition, supplemented by the ‘Latest Developments’ section, outlines the most up-to-date statistics on the incidence of marriage, civil partnerships and divorce, discusses recent case law on the validity of marriage such as Hayatleh v Mofdy [2017] EWCA Civ 70 and K v K (Nullity: Bigamous Marriage) [2016] EWHC 3380 (Fam), and highlights the recent Supreme Court decision (In the Matter of an Application by Denise Brewster for Judicial Review (Northern Ireland) [2017] 1 WLR 519) on the pension rights of unmarried cohabitants. It also considers the litigation concerning the prohibition of opposite-sex civil partnership registration from the judgment of the Court of Appeal in Steinfeld and Keidan v Secretary of State for Education [2017] EWCA Civ 81 to the important decision of the Supreme Court in R (on the application of Steinfeld and Keidan) (Application) v Secretary of State for International Development (in substitution for the Home Secretary and the Education Secretary) [2018] UKSC 32. This edition also provides an in-depth discussion of the recent Supreme Court decision in Owens v Owens [2018] UKSC 41 regarding the grounds for divorce and includes discussion of Thakkar v Thakkar [2016] EWHC 2488 (Fam) on the divorce procedure. Further, this edition also considers the flurry of cases in the area of financial provision on divorce such as Waggott v Waggott [2018] EWCA Civ 722; TAB v FC (Short Marriage: Needs: Stockpiling) [2016] EWHC 3285; FF v KF [2017] EWHC 1903 (Fam); BD v FD (Financial Remedies: Needs) [2016] EWHC 594 (Fam); Juffali v Juffali [2016] EWHC 1684 (Fam); AAZ v BBZ [2016] EWHC 3234 (Fam); Scatliffe v Scatliffe [2016] UKPC 36; WM v HM [2017] EWFC 25; Hart v Hart [2017] EWCA Civ 1306; Sharp v Sharp [2017] EWCA Civ 408; Work v Gray [2017] EWCA Civ 270, and Birch v Birch [2017] UKSC 53. It also considers the recent decision of the Supreme Court in Mills v Mills [2018] UKSC 38 concerning post-divorce maintenance obligations between former partners, and the Privy Council decision in Marr v Collie [2017] UKPC 17 relating to the joint name purchase by a cohabiting couple of investment property.Part 2 focuses on child law, examining the law on parenthood and parental responsibility, including the parental child support obligation. This edition includes discussion of new case law on provision of child maintenance by way of global financial orders (AB v CD (Jurisdiction: Global Maintenance Orders)[2017] EWHC 3164), new case law and legislative/policy developments on section 54 of the Human Fertilisation and Embryology Act 2008 (parental orders transferring legal parenthood in surrogacy arrangements), and new cases on removing and restricting parental responsibility (Re A and B (Children: Restrictions on Parental Responsibility: Radicalisation and Extremism) [2016] EWFC 40 and Re B and C (Change of Names: Parental Responsibility: Evidence) [2017] EWHC 3250 (Fam)). Orders regulating the exercise of parental responsibility are also examined, and this edition updates the discussion with an account of the new Practice Direction 12J (on contact and domestic abuse), and controversial case law addressing the tension between the paramountcy of the child’s welfare and the protected interests of a parent in the context of a transgender father’s application for contact with his children (Re M (Children) [2017] EWCA Civ 2164). Part 2 also examines the issue of international child abduction, including in this edition the Supreme Court’s latest decision, on the issue of repudiatory retention (Re C (Children) [2018] UKSC 8). In the public law, this edition discusses the Supreme Court’s clarification of the nature and scope of local authority accommodation under section 20 of the Children Act 1989 (Williams v London Borough of Hackney [2018] UKSC 37). In the law of adoption, several new cases involving children who have been relinquished by parents for adoption are examined (Re JL & AO (Babies Relinquished for Adoption),[2016] EWHC 440 (Fam) and see also Re M and N (Twins: Relinquished Babies: Parentage) [2017] EWFC 31, Re TJ (Relinquished Baby: Sibling Contact) [2017] EWFC 6, and Re RA (Baby Relinquished for Adoption: Final Hearing)) [2016] EWFC 47).