Children and Their Parents: A Comparative Study of the Legal Position of Children with Regard to Their Intentional and Biological Parents in English and Dutch Law

This is a book about children and their parents. There are many different kinds of children and at least about as many different kinds of parents. In addition to the many different disciplines that study children and their parents, such as sociology, psychology, child studies and gender studies, to name but a few, this study concerns a legal question with regard to the parent-child relationship, namely how the law assigns parents to children. This subject is approached in a comparative legal perspective and covers England and The Netherlands. The book contains a detailed comparison and analysis of the manner in which the law in the two jurisdictions assigns the status of legal parent and/or attributes parental responsibility to the child’s biological and intentional parents. The concept ‘procreational responsibility’, which is introduced in the concluding chapter of the book, may be used as a tool to assess and reform existing regulations on legal parent-child relationships. The structure of the book, which is based on a categorisation of different family types in a ‘family tree’, enables the reader to have easy access to family-specific information.FdR – Publicaties zonder aanstelling Universiteit Leide

Finding the Sentinel Lymph Node with a handheld differential magnetometer

In cancer staging, the Sentinel Lymph Node (SLN) procedure is a common method to assess the stage to which a cancer has progressed[1]. Currently, the SLN procedure is performed by injecting both a blue dye and a radionuclide tracer near or into the tumor area, and the first lymph node(s) draining the tumor area are located by means of visual inspection and a gamma probe which detects the radiation emitted by the radionuclide tracer. This combined procedure has proven to be very reliable and is used frequently, but suffers from some serious drawbacks that limit its applicability in general practice. These problems are mostly caused by the usage of ionizing radiation, which poses occupational hazards to medical staff and requires extensive logistics, which not all hospitals can offer. © 2013 IEEE

Nonsurgical treatment options for heavy menstrual bleeding

Treatment options for heavy menstrual bleeding depend on the uterine anatomy, the women's preferences and personal ideas, her age and her future child wish. If the uterus has a normal anatomy, treatment options include hormonal or non-hormonal drugs (including levonorgestrel releasing intra-uterine systems; LNG-IUS), endometrial ablation and hysterectomy. In general, the main advantage of pharmacological treatment is the reversibility and therefore the eligibility for women, independent of age and future child-wish. This article provides a literature review on the effectiveness of medical treatment (hormonal and non-hormonal) for heavy menstrual bleeding and to discuss the dilemmas experienced by women and doctors. A literature search was performed focusing on the effectiveness of hormonal and non-hormonal medical treatment of women suffering from heavy menstrual bleeding. For nonsteroidal anti-inflammatory drugs (NSAIDs) as well as tranexamic acid, direct evidence for comparison to placebo is available, for the other agents (oral progestins (luteal phase and long term); LNG-IUS; combined hormonal contraceptives (combined oral contraceptive pills, combined vaginal ring), evidence could be extracted from a recent network meta-analysis. Evidence on treatment effects on HMB of the progesterone only pill and the etonogestrel subdermal implant is lacking. LNG-IUS appears to be the best pharmacological treatment option for HMB in terms of reducing blood loss as well as improving symptoms. Professionals should be aware that a number of women want to avoid a hormone-containing treatment, this may be due to (expected) negative side effects. In conclusion, considering pharmacological treatment of HMB without underlying pathology, LNG-IUS seems to be the best option to reduce menstrual blood loss. However, it is advised to carefully listen what women want, think and believe and to make a shared tailor-made decision. Pharmacological treatment for HMB should be initiated as a surgical intervention can be avoided. However, women who are not receptive to first-line drug treatments should be given the opportunity to improve their quality of life by getting rid of disabling symptoms of heavy menstrual bleeding, by offering treatment with endometrial ablation or hysterectomy

A handheld SPIO-based sentinel lymph node mapping device using differential magnetometry

\u3cp\u3eSentinel lymph node biopsy has become a staple tool in the diagnosis of breast cancer. By replacing the morbidity-plagued axillary node clearance with removing only those nodes most likely to contain metastases, it has greatly improved the quality of life of many breast cancer patients. However, due to the use of ionizing radiation emitted by the technetium-based tracer material, the current sentinel lymph node biopsy has serious drawbacks. Most urgently, the reliance on radioisotopes limits the application of this procedure to small parts of the developed world, and it imposes restrictions on patient planning and hospital logistics. Magnetic alternatives have been tested in recent years, but all have their own drawbacks, mostly related to interference from metallic instruments and electromagnetic noise coming from the human body. In this paper, we demonstrate an alternative approach that utilizes the unique nonlinear magnetic properties of superparamagnetic iron oxide nanoparticles to eliminate the drawbacks of both the traditional gamma-radiation centered approach and the novel magnetic techniques pioneered by others. Contrary to many other nonlinear magnetic approaches however, field amplitudes are limited to 5 mT, which enables handheld operation without additional cooling. We show that excellent mass sensitivity can be obtained without the need for external re-balancing of the probe to negate any influences from the human body. Additionally, we show how this approach can be used to suppress artefacts resulting from the presence of metallic instruments, which are a significant dealbreaker when using conventional magnetometry-based approaches.\u3c/p\u3

Patients' motives and considerations on treatment decision-making for heavy menstrual bleeding:a qualitative study

BACKGROUND: Several treatment modalities for heavy menstrual bleeding are available. However, many women report being unsatisfied in their search for an appropriate and effective treatment. The aim of this study is to gain insights in the experienced impact of heavy menstrual bleeding and the motives and considerations of women during the decision-making process for treating heavy menstrual bleeding.METHODS: An interpretative qualitative study was performed, using in-depth interviews. In total, 14 semi-structured interviews were conducted with patients who consulted a physician for treatment of heavy menstrual bleeding. Participants were recruited via the Netherlands Patients Federation (N = 10) or via the outpatient clinic in the Máxima Medical Center (N = 4). The interviews were conducted by phone or online between February 2020 and March 2021. In the interviews three topics were addressed: (1) participant's experience with heavy menstrual bleeding, (2) experience with patient journey of treatment decision-making and (3) elaborating on alternative treatments for heavy menstrual bleeding. A thematic analysis was conducted.RESULTS: Fourteen participants aged between 30 and 59 years old were interviewed. Three main themes emerged; "Considerations in taking the (next) step to seek help", "Various sources of information can contribute, confuse or frighten decision-making process" and "A physician's understanding and a relationship of trust are needed to guide the decision-making process".CONCLUSION: Our results show that women's considerations and decision making strongly depend on the obtained information and experience, the relationship with the physician, the influence of the social environment, the pre-visit expectations/desires, the fear of treatment complications and uncertainty of the effect of the treatment. It is a physicians role to create a trusting and open atmosphere during consultation. Patient-centered communication is helpful to share knowledge, and gain insights into a patient's hopes, fears and worries.</p