Core Topics in Transesophageal Echocardiography (Cambridge Medicine (Hardcover))

Association of ED with chronic periodontal disease. Statistical analyses were performed by the Spearman's rank correlation coefficient and other methods. Statistical significance was accepted at the level of Pdysfunction and the systematic inflammatory changes associated with CPD. The present study also suggests that dental health is important as a preventive medicine for ED.

Treatment of solid wastes. Preventing waste production, recovery, waste collection, waste disposal, sanitation. Procedures, technical processes, legal foundations. Vermeiden, Verwerten, Sammeln, Beseitigen, Sanieren. Verfahrensweise, technische Realisierung, rechtliche Grundlagen. The initial chapters deal with technical methods of environmental protection, describe laws and legal regulations pertaining to waste disposal, explain the quantities and composition of the waste matter and give an overview of the treatments which are available.

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Methods and technical process of waste collection, transport, sorting, recapturing of valuable matter, biochemical and thermal conversion and depositing. Treatment of poisonous wastes and old sites are dealt with in the final chapters. I Failed the ed TPA. In this article, co-written by a teacher and a professor, the authors examine possible explanations for why Adam first author , a New York City public school special educator, failed the ed TPA, a teacher performance assessment required by all candidates for state certification.

Adam completed a yearlong teaching residency where he was the special…. The Electrostatic-Dipole ED concept significantly differs from a "pure" dipole confinement device [1] in that the charged particles are preferentially confined to the high-pressure region interior of the dipole coil by the assistance of a surrounding spherical electrostatic grid. In present ED experiments, a current carrying coil is embedded inside the grid of an IEC such as to produce a magnetic dipole field.

As particles begin accelerating away from the center region towards the outer electrostatic grid region, they encounter a strong electrostatic potential order of 10's of kilovolts retarding force. The particles then decelerate, reverse direction and re-enter the dipole field region where again magnetic confinement dominates. This process continues, emulating a complex harmonic oscillator motion. The resulting pressure profile averaged over the field curvature offers good plasma stability in the ED configuration.

The basic concept and results from preliminary experiments will be described. Effect of a redesigned fracture management pathway and 'virtual' fracture clinic on ED performance. Collaboration between the orthopaedic and emergency medicine ED services has resulted in standardised treatment pathways, leaflet supported discharge and a virtual fracture clinic review. Patients with minor, stable fractures are discharged with no further follow-up arranged. We aimed to examine the time taken to assess and treat these patients in the ED along with the rate of unplanned reattendance.

Prospectively collected administrative data from the electronic patient record system were analysed and compared before and after the change. Time for assessment and treatment of patients with orthopaedic injuries not requiring immediate operative management, and 7-day unplanned reattendance. Where plaster backslabs were replaced with removable splints, the consultation time was reduced. There was no change in treatment time for other injuries treated by the new discharge protocol.

There was a decrease in patients reattending the ED due to a missed fracture clinic appointment. This process did not require any new time resources from the ED staff. This process brought significant benefits to the ED as treatment pathways were agreed. The pathway reduced unnecessary reattendance of patients at face-to-face fracture clinics for a review of stable, self-limiting injuries.

For permission to use where not already granted under a licence please go to http: Experiment ED was to observe the effect of zero-gravity on cytoplasmic streaming in the aquatic plant named Elodea, commonly called water weed or water thyme. The phenomenon of cytoplasmic streaming is not well understood, but it is recognized as the circulation mechanism of the internal materials or cytoplasm of a cell. Cytoplasm is a gelatinous substance that has the ability to change its viscosity and flow, carrying various cell materials with it.

The activity can be stimulated by sunlight or heat. Science advisors from the Marshall Space Flight Center aided and assisted the students in developing the proposals for flight on Skylab. Psychiatric patients boarded in hospital EDs create crisis for patient care and hospital finances.

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As the supply of psychiatric beds dwindles, hospitals are devising innovative ways handle psych patients who come through the emergency department. Some collaborate with other hospitals, use separate pysch EDs or refer patients to residential treatment centers. In recent decades, the increasing crowdedness of the emergency departments has posed various problems for patients and healthcare systems worldwide. These problems include prolonged hospital stay, patient dissatisfaction and nurse burnout or job dissatisfaction.

The aim of this study was to investigate the effect of emergency department ED nurses' job specialization on their job satisfaction and the length of patient stay in the ED. This before-after quasi-experimental study was conducted from April to May at the Baqiyatallah Hospital, Tehran, Iran. Initially, 35 patients were recruited as controls and the length of their stay in the ED was measured in minutes via a chronometer; Moreover, nurses' job satisfaction was evaluated using the Mohrman-Cooke-Mohrman job satisfaction scale.

Then, a job specialization intervention was developed based on the stabilization model.

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After that, 35 new patients were recruited to the treatment group and received specialized care services. Accordingly, the length of their stay in the ED was measured. Moreover, the same nurses' job satisfaction was re-evaluated after the study. The study intervention lasted one month. Data were analyzed using the SPSS software version 20 and statistical tests such as the Kolmogrov-Smirnov, the paired and the independent t, and chi-square tests.

There was a significant difference between the two groups of patients concerning the length of their stay in the ED P nurses had greater job satisfaction after the study P job specialization intervention can improve nurses' satisfaction and relieve the crowdedness of the EDs. Treatment of stage IV non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Stage IV non-small cell lung cancer NSCLC is a treatable, but not curable, clinical entity in patients given the diagnosis at a time when their performance status PS remains good.

A systematic literature review was performed to update the previous edition of the American College of Chest Physicians Lung Cancer Guidelines. The use of pemetrexed should be restricted to patients with nonsquamous histology. Similarly, bevacizumab in combination with chemotherapy and as continuation maintenance should be restricted to patients with nonsquamous histology and an Eastern Cooperative Oncology Group ECOG PS of 0 to 1; however, the data now suggest it is safe to use in those patients with treated and controlled brain metastases.

Data at this time are insufficient regarding the safety of bevacizumab in patients receiving therapeutic anticoagulation who have an ECOG PS of 2. The role of cetuximab added to chemotherapy remains uncertain and its routine use cannot be recommended. Epidermal growth factor receptor EGFR tyrosine kinase inhibitors as first-line therapy are the recommended treatment of those patients identified as having an EGFR mutation.

The use of maintenance therapy with either pemetrexed or erlotinib should be considered after four cycles of first-line therapy in those patients without evidence of disease progression. The use of second- and third-line therapy in stage IV NSCLC is recommended in those patients retaining a good PS; however, the benefit of therapy beyond the third-line setting has not been demonstrated. In the elderly and in patients with a poor PS, the use of two-drug, platinum-based regimens is preferred.

Significant advances continue to be made, and the treatment of stage IV NSCLC has become nuanced and specific for particular histologic subtypes and clinical patient characteristics and according to the presence of specific genetic mutations. Evidence-based psychological treatments for eating disorders. Gabbard's Treatments of Psychiatric Disorders.

Ed overcrowding — matematic models for integrated solutions and decisions. So we are proposing a mathematics models for reciprocal accommodation of patients flows to the response capacity of the ED. If you are an educator creating a course for ed X or a corporate trainer using Open ed X for large-scale learning and development initiatives, then ed X E-Learning Course Development is the ideal book for you. Laboratory evaluation of the characteristics of EDS Illinois bottoms.

This interim report documents work carried out by Combustion Engineering, Inc. This report was prepared by Combustion Engineering, Inc. This report covers the results of a laboratory investigation to assess the fuel and ash properties of EDS vacuum bottoms. The results of the laboratory testing reported here were used in conjunction with Combustion Engineering's design experience to predict fuel performance and to develop appropriate boiler design parameters.

These boiler design parameters were used to prepare the engineering design study reported in EDS Interim Report FE, the second of the two reports on the predevelopment phase of the Hybrid Boiler Program. Perceptions of empowerment among ED nurses. Nurses' perceptions of empowerment have been linked to a number of variables in the hospital workplace, including job satisfaction, autonomy, and work effectiveness. Yet there have been no previous studies of perceptions of empowerment specifically among emergency department ED nurses. Registered nurses RNs employed in the EDs of 6 hospitals in a major health care system in the eastern United States were surveyed regarding their perceptions of empowerment.

Of the RNs eligible to participate, there were usable surveys. There was a moderate level of empowerment among the RNs who participated, consistent with the level of empowerment reported in several other studies of staff nurses and nurses in other positions. The moderate level of empowerment in this sample may be attributed to the many opportunities for RN involvement in the hospitals within this health care system. Nurse leaders can initiate programs focused on enhancing RN perceptions of empowerment. In addition, there is a need for further research among RNs with different specialty preparation.

Published by Mosby, Inc. Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1, bed tertiary care teaching hospital.

Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve.

A Natural Treatment for ED? Erectile dysfunction supplements and other natural Giocare, tra violenza ed ecologia della mente. Entrambe queste strade ci conducono dentro le false alternative della violenza. Full Text Available A cento anni dalla pubblicazione del Trattato di sociologia generale Pareto siamo a mantenere vivo ed attuale lo studio paretiano con una rilettura contemporanea del suo pensiero.

Pareto collega la definizione del filosofo napoletano alle tipologie di azione sociale e alla loro distinzione logiche, non-logiche. Full Text Available Introduction: Use of alternative venues to manage uncomplicated vaso-occlusive crisis VOC, such as a day hospital DH or ED observation unit, for patients with sickle cell anemia, may significantly reduce admission rates, which may subsequently reduce day readmission rates.

In the context of a two-institution quality improvement project to implement best practices for management of patients with sickle cell disease SCD VOC, we prospectively compared acute care encounters for utilization of 1 emergency department ED ; 2 ED observation unit; 3 DH, and 4 hospital admission, of two different patient cohorts with SCD presenting to our two study sites. Over 30 months patients at Site 1 and at Site 2 initiated 4, institutional visits, totaling 6, different acute care encounters, including combinations of encounters.

The range of encounters varied from a low of 0 of patients [ Patients at Site 2 were more likely to be admitted to the hospital during the study period DH was used more frequently at Site 1 1. Thirty-five percent of patients visited hospitals outside their home academic center. In this month assessment of two sickle cell cohorts, healthcare utilization varied dramatically between individual patients.

One cohort had more hospital admissions and ED encounters, while the other cohort had more day hospital encounters and used a sickle cell disease. Francois Roussely, President of Ed F. This document is the proceedings of the hearing of F. Roussely, President of Electricite de France Ed F , at the commission of economic affairs of the French house of commons, about the advisability of the construction of the EPR European pressurized reactor demonstration plant and about its possible financing by Ed F.

In a first part, F. Roussely recalls the European context of deregulation of energy markets and its impact of the French electric power industry opening of the French market, industrial and social actions of Ed F, need of a new generation of nuclear reactor, preservation of Ed F's energy mix, warranty of public utility, un-bundling between energy trade and distribution, Ed F's turnover and profitability, Ed F's foreign daughter companies.

In a second part, F. Roussely answers a series of questions asked by the different members of the commission concerning the different points presented in the first part. Suicide Prevention in an Emergency Department Population: Suicide is a leading cause of deaths in the United States.

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Although the emergency department ED is an opportune setting for initiating suicide prevention efforts, ED -initiated suicide prevention interventions remain underdeveloped. To determine whether an ED -initiated intervention reduces subsequent suicidal behavior. This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post- ED telephone calls focused on reducing suicide risk.

The primary outcome was suicide attempts nonfatal and fatal over the week follow-up period. The proportion and total number of attempts were analyzed. A total of participants were recruited, including females A total of participants Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts.

This article describes an observational study of caring behaviors in the emergency departments of 4 Ascension Health hospitals and the impact of these behaviors on patient loyalty to the associated hospital. These hospitals were diverse in size and geography, representing 3 large urban community hospitals in metropolitan areas and 1 in a midsized city. Research assistants from Purdue University West Lafayette, IN conducted observations at the first study site and validated survey instruments. The Purdue research assistants trained contracted observers at the subsequent study sites.

The research assistants conducted observational studies of caregivers in the emergency departments at 4 study sites using convenience sampling of patients. Caring behaviors were rated from 0 did not occur to 5 high intensity. The observation included additional information, for example, caregiver roles, timing, and type of visit.

Observed and unobserved patients completed exit surveys that recorded patient responses to the likelihood-to-recommend loyalty questions, patient perceptions of care, and demographic information. Common themes across all study sites emerged, including 1 the area that patients considered most important to an ED experience prompt attention to their needs upon arrival to the emergency department ; 2 the area that patients rated as least positive in their actual ED experience prompt attention to their needs upon arrival to the emergency department ; 3 caring behaviors that significantly affected patient loyalty eg, making sure that the patient is aware of care-related details, working with a caring touch, and making the treatment procedure clearly understood by the patient ; and 4 the impact of wait time to see a caregiver on patient loyalty.

A number of correlations between caring behaviors and patient loyalty were statistically significant P loyalty but that occurred least frequently. The study showed through factor analysis that some caring. Carbon dioxide is the main greenhouse gas and its amount still increase in the atmosphere. Air pollution and greenhouse effect caused by CO2 emission have become a major threat to the environment on a global scale. Carbon dioxide sequestration i. The most costly stage is capture of CO2, therefore there is a need to search new solutions of this technology.

For this purpose it was examined Na-X synthetic zeolites, that were silver and PEI polyethyleneimine activated. For Na-X-PEI activated it is observed a distinct organic compound in the form of coatings on Na-X crystals causing a sealing of pores in tested zeolite. Further examination of these materials concern determination of surface properties and experiments of CO2 sorption. But SEM- EDS analysis enable to determine the extent of activation, what is very important in determination of optimal conditions for such treatment in order to obtain better sorbent of CO2.

Deciding about treatments that prolong life. Learn about the treatments and how they would Goldman L, Schafer AI, eds. Learning beyond High School Walls. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. Expand ED Options students live the connection between mastering new…. Tackling causes and costs of ED presentation for American football injuries: American tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually.

Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department ED treatment of football-related injury across all age groups in a large nationally representative data set.

Patient-specific injuries were identified using the primary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code and categorized by type and anatomical region. Standard descriptive methods examined patient demographics, diagnosis categories, and ED and inpatient outcomes and charges. During the study period football players presented for ED treatment , The proportion of admitted patients who required surgical interventions was Among individuals admitted to inpatient care, mean hospital length of stay was 2.

With typical blocks being constructed from 1-unit 1U 10x10x10 cm increments, the Tech Ed Sat-3p has a 3U volume with a 30 cm length. The project uniquely pairs advanced university students with NASA researchers in a rapid design-to-flight experience lasting semesters.

The Tech Ed Sat Nano-Satellite Series provides a rapid platform for testing technologies for future NASA Earth and planetary missions, as well as providing students with an early exposure to flight hardware development and management. ED leadership competency matrix: A successful ED relies on its leaders to master and demonstrate core competencies to be effective in the many arenas in which they interact and are responsible.

A unique matrix model for the assessment of an ED leadership's key administrative skill sets is presented. The model incorporates capabilities related to the individual's cognitive aptitude, experience, acquired technical skills, behavioral characteristics, as well as the ability to manage relationships effectively.

Based on the personnel inventory using the matrix, focused evaluation, development, and recruitment of ED key leaders occurs. This dynamic tool has provided a unique perspective for the evaluation and enhancement of overall ED leadership performance. It is hoped that incorporation of such a model will similarly improve the accomplishments of EDs at other institutions. Emergency department ED utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm.

Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED , as in the case of suicide, self-harm, manic episodes or psychotic episodes.

Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes. Insertional Achilles tendinopathy IAT is a challenging overuse disorder. An active year-old man patient with chronic IAT was studied.

Clinical assessment battery was composed by visual analogue scale for pain during the Achilles tendon palpation test, passive straight leg raise test, single leg hop test, Patient-Specific Functional Scale, and Foot and Ankle Ability Measure. The patient was treated over a 8 weeks period using the Ed UReP guidelines plus 8 sessions of I-ASTM, applied with a solid instrument to the Achilles tendon and to the muscle fibrotic areas previously identified during evaluation.

Clinically significant improvements were observed in all outcome measures, and a resume of patient's usual sports activities without pain or limitations was possible after treatment. Results lasted over a 6-month follow-up. To the best of our knowledge, this is the first study applying a comprehensive approach based on accurate physical assessment, and using the Ed UReP theoretical model. The combination of the Ed UReP model and manual therapy was effective in resolving the patient's symptoms and restore his usual sport activities. While these results cannot be generalized, the present findings could provide a valuable foundation for future researches.

Characterising non-urgent users of the emergency department ED: A retrospective analysis of routine ED data. The pressures of patient demand on emergency departments EDs continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care.

This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: Odds ratios were calculated to compare non-urgent attenders between groups.

There were 3,, first time attendances to EDs , of which , were defined as non-urgent Alternative services are required to manage non-urgent demand, currently being borne by the ED and the ambulance service, particularly in out of hours. Electricite de France, the French electric utility, has to face a formidable mutation. The deregulation of the power market will lead to a social, commercial, judicial, financial and international 'big-bang'.

The company has been weakened by disappointing results and by an embarrassing running into debts. This dossier analyzes the consequences of the deregulation of the French power market on the future evolution of Ed F. It includes the analysis made by a French economist, E. Cohen, an interview and a portrait of F. Roussely, head of Ed F, a presentation of Easenergy, a start-up of Ed F which makes partnerships with US energy-related companies, the worries of Ed F's employees and the redistribution of the syndicates power inside the company, the controversy around Ed F's results and the points that remained in the shade, Ed F's European competitors and the progressive opening of the French power market, EDF's production tool and its availability 58 nuclear reactors, hydroelectric power plants and 26 thermal power plants , the costly foreign markets strategy of Ed F and the under-capitalization of the company.

Testosterone deficiency causes penile fibrosis and organic erectile dysfunction in aging men. We studied the possible correlation between age, testosterone deficiency, cavernosal fibrosis and erectile dysfunction ED. The strength of the relationships found was estimated by Odds Ratio. A significant difference was found in age, percentage of collagen fibers, testosterone levels between patients with Positive Rigiscan PR and Negative Rigiscan NR.

This study demonstrates a strong association among age, testosterone deficiency, cavernosal fibrosis and ED with PR. Age, testosterone deficiency and cavernosal fibrosis are potentially correctable factors of cavernosal fibrosis and organic ED. Further, prospective studies are needed to evaluate if testosterone treatment , alone or in association with PDE5 inhibitors, may lower the risk of cavernosal fibrosis or decrease the severity the fibrosis in ED patients.

Factorial analysis confirmed an acceptable related-factors solution for the SMI- ED , thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales.

This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group.

Findings from the psychometric evaluation of SMI- ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population. Full Text Available Objective: Note critiche sui rapporti tra diritto ed economia. Il saggio inquadra teoricamente i principali rapporti fra diritto ed economia e analizza i vari metodi e approcci dell'analisi economica del diritto, rilvandone gli aspetti critici e discutendo infine gli approcci comportamentali e la "nudge theory".

Structure of catalase determined by Micro ED. Micro ED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2. Here we present the structure of bovine liver catalase determined from a single crystal at 3.

The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of Micro ED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination.

Elementi ed esercizi di geometria analitica e proiettiva. This document presents the consolidated results of Ed F group for Ethane dimethanesulfonate EDS perturbs epididymal epithelial cell function in vitro. The formation of sperm granulomas in the epididymis following exposure to EDS , a Leydig cell toxicant, was reported by Cooper and Jackson in Recent work suggests that EDS may effect the epididymis directly. An in vitro system was developed to determine the nature of any direct effect. The caput epididymis from adult rats was dissected free of connective tissue and small pieces of the tissue were enzymatically digested until plaques of epididymal epithelial cells were obtained.

Plaques were cultured on an extracellular matrix gelled on top of a semipermeable filter creating dual-compartment environments. The epithelial cells maintained typical morphology and protein secretion in this culture system for several days. EDS caused decreased secretion of several proteins, including a 39 Kd molecule. Interestingly, a 39 Kd protein was also shown to disappear from sperm taken from the caput epididymidis following in vivo exposure to EDS. Unlabelled cultures were fixed and processed for light microscopy. No alterations in morphological integrity were observed. Thus, epididymal epithelial cell function is directly altered by EDS exposure.

Moments of disaster response in the emergency department ED. We experience our lives as a series of memorable moments, some good and some bad. Undoubtedly, the experience of participating in disaster response, is likely to stand out as a memorable moment in a nurses' career. This presentation will describe five distinct moments of nursing in the emergency department ED during a disaster response.

A Hermeneutic Phenomenological approach informed by van Manen underpins the research process. Thirteen nurses from different countries around the world participated in interviews about their experience of working in the ED during a disaster. Thematic analysis resulted in five moments of disaster response which are common to the collective participant experience.

The 5 themes emerge as Notification as a nurse finds out that the ED will be receiving casualties , Waiting waiting for the patients to arrive to the ED , Patient Arrival the arrival of the first patients to the ED , Caring for patients caring for people affected by the disaster and Reflection the moment the disaster response comes to an end. This paper provides an in-depth insight into the experience of nursing in the ED during a disaster response which can help generate awareness and inform future disaster preparedness of emergency nurses.

Published by Elsevier Ltd. Vascular management and care has become a truly multidisciplinary enterprise as the number of specialists involved in the treatment of patients with vascular diseases has steadily increased. While in the past, treatments were delivered by individual specialists, in the twenty-first century a team approach is without doubt the most effective strategy. In order to promote professional excellence in this dynamic and rapidly evolving field, a shared knowledge base and interdisciplinary standards need to be established.

Pan Vascular Medicine, 2nd edition has been designed to offer such an interdisciplinary platform, providing vascular specialists with state-of-the art descriptive and procedural knowledge. Basic science, diagnostics, and therapy are all comprehensively covered. In a series of succinct, clearly written chapters, renowned specialists introduce and comment on the current international guidelines and present up-to-date reviews of all aspects of vascular care.

Imaging pelvic floor disorders. This volume builds on the success of the first edition of imaging pelvic floor disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail.

Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. Stoker, Jaap [Amsterdam Univ. L Women' s Hospital.

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Lunar architecture and urbanism, 2nd ed. As the space population grows over time, persistent issues of human urbanism will eclipse within a historically short time the technical challenges of space exploration that dominate current efforts. Although urban design teams will have to integrate many new disciplines into their already renaissance array of expertise, doing so will enable them to adapt ancient, proven solutions to opportunities afforded by expanding urbanism offworld.

This paper updates the author's original treatment of the subject. Provides a unique theoretical treatment of charged-particle optics. Displays novel unpublished results on several topics. Provides insight into the properties of charged-particle devices. Treats wave optical properties of the electron. Presents the resolution limit of electron microscopes and novel theoretical treatment of the Stern-Gerlach effect. This second edition is an extended version of the first edition of Geometrical Charged-Particle Optics.

The updated reference monograph is intended as a guide for researchers and graduate students who are seeking a comprehensive treatment of the design of instruments and beam-guiding systems of charged particles and their propagation in electromagnetic fields. Wave aspects are included in this edition for explaining electron holography, the Aharanov-Bohm effect and the resolution of electron microscopes limited by diffraction.

Several methods for calculating the electromagnetic field are presented and procedures are outlined for calculating the properties of systems with arbitrarily curved axis. Detailed methods are presented for designing and optimizing special components such as aberration correctors, spectrometers, energy filters monochromators, ion traps, electron mirrors and cathode lenses. In particular, the optics of rotationally symmetric lenses, quadrupoles, and systems composed of these elements are discussed extensively.

Beam properties such as emittance, brightness, transmissivity and the formation of caustics are outlined. Relativistic motion and spin precession of the electron are treated in a covariant way by introducing the Lorentz-invariant universal time and by extending Hamilton's principle from three to four spatial dimensions where the laboratory time is considered as the fourth pseudo-spatial coordinate. Using this procedure and introducing the self action of the electron, its accompanying electromagnetic field and its radiation field are calculated for arbitrary motion.

In addition, the Stern. The book on transesophageal echocardiography covers the following issues: Development of transesophageal echocardiography, technical advances; indications and contraindication for transesophageal echocardiography; systematic of the medical examination process; cardiac valves and valve prostheses; mitral and aortic valvuloplasty, TAVI and interventional treatment of mitral regurgitation; infectious endocarditis; one-way and effluence disturbances of the left and right ventricle; diseases of the thoracic aorta; undefined right ventricle enlargement; lung embolism, acute infarct complications; TEE during anesthesia and perioperative intensive medicine, cardiac sources of embolism; cardiac tumors, mediastinal lymph nodes; pericardiac diseases; congenital heart diseases in childhood and adulthood; catheter interventions and heart valve reconstruction; surgically corrected congenital cardiac defects; intracavitary versus transesophageal echocardiography; three-dimensional TEE; coronary diagnostics; ischemia and vitality diagnostics.

Fundamentals of environmental engineering. Particular scope was allowed for the description of the linkages between the individual environmental areas - for instance, waste combustion and clean air, waste deposition at landfills and treatment of leachate, residual products from successful water and air pollution control measures. For all those who have to familiarize themselves with the complex subject of 'environmental engineering' while in training or during continuing education this book offers a broad approach to the essential general, technical and legal bases.

Handbook of radioactive medicine standard. Now, the radioactive medicine standard has been instituted the Ministry of Health and Welfare announcement No. While the radioactive medicines are used for the treatment of malignant tumors and others, the accuracy and fastness as the diagnostic medicines have been regarded as important. Recently, more safe and convenient medicines have appeared.

Since these emit radiation, prudent consideration must be given to their handling. In order to make the properties and qualities of radioactive medicines appropriate, the standard is instituted for all of them based on the Drugs, Cosmetics and Medical Instruments Act. Since the medicines which do not accord with the standard cannot be produced, imported and sold according to the Act, the users must be familiar with the contents of the standard. The Ministry of Health and Welfare announcement No.

The standard comprises common rules, the general rules on medicine production, the provisions for individual medicines 94 kinds , 14 general testing methods, and the attached table showing the characteristics of 20 radioactive nuclides contained in the radioactive medicines described in this standard.

Green's functions in quantum physics. The new edition of a standard reference will be of interest to advanced students wishing to become familiar with the method of Green's functions for obtaining simple and general solutions to basic problems in quantum physics.

The main part is devoted to the simplest kind of Green's functions, namely the solutions of linear differential equations with a -function source. It is shown that these familiar Green's functions are a powerful tool for obtaining relatively simple and general solutions of basic problems such as scattering and bound level information.

The bound-level treatment gives a clear physical understanding of ''difficult'' questions such as superconductivity, the Kondo effect, and, to a lesser degree, disorder-induced localization. The more advanced subject of many-body Green's functions is presented in the last part of the book.

Throughout, it demonstrates the powerful and unifying formalism of Green's functions across many applications, including transport properties, carbon nanotubes, and photonics and photonic crystals. Met Ed gets reprieve: The continued solvency of Met Ed is a matter of speculation because the present credit formula is based on liquid assets which the PUC did not address.

While the action taken by the bankers gives Met Ed a reprieve, it does not provide a long-term solution. The Revolving Credit Agreement will expire on October 1. Met Ed is still faced with the problem of relicensing Three Mile Island-1 unit and the cost of underwriting the cleanup of the No. Since the first edition of Pediatric Uroradiology, very significant advances have been made in the imaging and treatment of common and important pediatric urologic disorders such as vesicoureteric reflux, urinary tract infection, and upper urinary tract dilatation.

This revised and extended version takes full account of the sometimes dramatic changes. Where appropriate, new contents have been included, e. This book describes in detail all aspects of pediatric uroradiology. While it is written primarily from the point of view of the radiologist, it includes essential information for the pediatrician, pediatric surgeon, and urologist.

It is specifically designed to aid the clinician in decisions on imaging management. The newest techniques and the changing relevance of imaging and interventional procedures are presented, and the diverse problems associated with the changing anatomy, physiology, and pathophysiology from the newborn period to adulthood are explained. The whole spectrum of imaging features of agenesis, anomalies, dysplasia, parenchymal diseases, neoplastic diseases, stone disease, renal vascular hypertension, renal failure, renal transplantation, and genitourinary trauma is covered.

Individual chapters are devoted to vesicoureteric reflux, urinary tract infection, upper urinary tract dilatation, voiding dysfunction, and neurogenic bladder. A new chapter on the clinical management of common nephrourologic disorders, with the subtitle ''guidelines and beyond,'' explains how imaging is embedded in the whole process of clinical management today. Short conclusions are included at the end of chapters and sections to provide the reader with the key information on the specific topic under consideration.

A new chapter on the clinical management of common nephrourologic disorders, with the subtitle 'guidelines and beyond,' explains how imaging is embedded in the whole process of clinical management today. Operational and financial impact of physician screening in the ED. Physician screening is one of many front-end interventions being implemented to improve emergency department ED efficiency. We aimed to quantify the operational and financial impact of this intervention at an urban tertiary academic center.

We conducted a 2-year before-after analysis of a physician screening system at an urban tertiary academic center with 90 annual visits. Financial impact consisted of the ED and inpatient revenue generated from the incremental capacity and the reduction in left without being seen LWBS rates. The ED and inpatient margin contribution as well as capital expenditure were based on available published data.

We summarized the financial impact using net present value of future cash flows performing sensitivity analysis on the assumptions. Operationally, despite a In addition to improving operational measures, the implementation of a physician screening program in the ED allowed for an incremental increase in patient care capacity leading to an overall positive financial impact. In Utah, the statewide distance education network Ed Net enables students from five rural and suburban high schools to learn Russian and earn college credits. Classes are taught on one….

Ed F-Gaz de France. No merger without dismembering. Gathering together the two historical French energy monopolies, Electricite de France Ed F and Gaz de France GdF , and warranting low electricity and gas prices is still an attractive idea for some political and syndicate representatives. However, such a merger would create a dominating position which is forbidden with respect to Brussels criteria. In the laboratory, the Full Text Available Murray Pittock, ed. Edinburgh University Press, Review of the edited volume: Psychological and psychopathological variables associated with eating disorders ED.

The aim of this study was to compare some psychological and psychopathological variables usually associated with different types of patients with eating disorders ED. A total of 22 variables psychological, psychopathological and specifically related to TCA were analyzed in three groups of patients with anorexia nervosa AN, bulimia nervosa BN and eating disorders not otherwise specified EDNOS.

The sample consisted of 76 patients diagnosed with ED mean age The following questionnaires were administered: Generally no significant differences between groups, except for the variables related to the BSQ and EDI-2 questionnaires, were found. The study of the correlations among the different variables specifically related to eating disorders and others, showed differences between groups.

The present study shows few differences with respect to psychopathological symptoms among the different types of ED. Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach.

In the NYP program, patients are identified as appropriate candidates for the program at triage. Administrators note that patients with complex problems requiring extensive workups are not suitable for the telemedicine approach. The most challenging aspect of implementing a successful telemedicine program in the ED is getting the workflows right, according to administrators.

An earlier ED -based telemedicine program piloted at UCSD ran into difficulties because the model required the involvement of two physicians, and some insurers did not want to pay for the telemedicine visits. However, patients were receptive. Occupational stress in the ED: Occupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which affect ED staff have not been established.

We conducted a systematic review of literature examining the sources of organisational stress in the ED , their link to adverse health outcomes and interventions designed to address them. A narrative review of contextual factors that may contribute to occupational stress was also performed. All articles written in English, French or Spanish were eligible for conclusion. Study quality was graded using a modified version of the Newcastle-Ottawa Scale. Twenty-five full-text articles were eligible for inclusion in our systematic review.

Most were of moderate quality, with two low-quality and two high-quality studies, respectively. While high demand and low job control were commonly featured, other studies demonstrated the role of insufficient support at work, effort-reward imbalance and organisational injustice in the development of adverse health and occupational outcomes.

We found only one intervention in a peer-reviewed journal evaluating a stress reduction programme in ED staff. Our review provides a guide to developing interventions that target the origins of stress in the ED. It suggests that those which reduce demand and increase workers' control over their job, improve managerial support, establish better working relationships and make workers' feel more valued for their efforts could be beneficial.

We have detailed examples of successful interventions from other fields which may be applicable to this setting. Italian Society of Andrology registry on penile prosthesis surgery. Full Text Available Objectives: The Italian Society of Andrology, i. Purpose of this first report is to present a baseline data analysis of the characteristics of penile implant surgery in Italy. The INSIST- ED Registry is open to all surgeons implanting penile prostheses all brands, all models in Italy, providing anonymous patient, device, surgical procedure, outcome, follow-up data, for both first and revision surgeries.

A Registry project Board overviews all the steps of the project, and a Registry Monitor interacts with the Registry implanting surgeons. As by April 8, , 31 implanting surgeons actively joined the Registry, entering surgical procedures in its database, that comprise: Implanted devices account for: Leading primary ED etiologies in first implant surgeries resulted: Two intraoperative complications have been recorded. Main reasons for 57 revision surgeries were: Surgical settings for patients undergoing a first penile implant were: This baseline data analysis shows that: Full Text Available The pressures of patient demand on emergency departments EDs continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times.

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