Interferometric Observatories in Earth Orbit

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76217/1/AIAA-1728-623.pd

Maximal care considerations when treating patients with end-stage heart failure: ethical and procedural quandaries in management of the very sick

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy. These criteria for subsequent listing are based on clinical outcome data but also reflect the reality of organ shortage. Lack of compliance and non-adherence to lifestyle changes represent relative contraindications to heart transplant candidacy. Mechanical circulatory support therapy using ventricular assist devices is becoming a more prominent therapeutic option for patients with end-stage heart failure who are not candidates for transplantation, which also requires strict criteria to enable beneficial outcome for the patient. Physicians need to critically reflect that in many cases, the patient’s best interest might not always mean pursuing maximal technological options available. This article reflects on the multitude of critical issues that health care providers have to face while caring for patients with end-stage heart failure

The 'lost child' as figure of trauma and recovery in early post-war cinema: Fred Zinnemann's The Search (1948) and Natan Gross's Unzere Kinder (1948)

The article examines the figure of the ‘lost child’ in feature films of the immediate post-war period. The figure’s enormous symbolic value as innocent victim and future generation, granted the ‘lost child’ a key position in post-war discourse, including films which tried to grapple with the moral and physical destruction of the continent after 1945. National film industries, particularly of the perpetrator nation, employed the ‘lost child’ for genre stories in which the post-war chaos is being mastered and a new, masculine national self is re-built. However, films made by victim groups outside a national context rely on the ‘lost child’ to broach the destruction of their identity by war and persecution. Analysing two films, Fred Zinnemann’s The Search (1948) and Nata Gross’s Unzere Kinder (1948), I argue that they use the child figure to deal with traumatization and make it part of the reconstruction of communal intergenerational relations. This does not result in stories of masculine mastery but in narratives that incorporate moments of trauma process emerging around destroyed mother-child relations. The films, encoding traumatization in film language, develop a rich cinematic language along questions of identity and form a first instance of posttraumatic cinema

Pompe disease diagnosis and management guideline

ACMG standards and guidelines are designed primarily as an educational resource for physicians and other health care providers to help them provide quality medical genetic services. Adherence to these standards and guidelines does not necessarily ensure a successful medical outcome. These standards and guidelines should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. in determining the propriety of any specific procedure or test, the geneticist should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen. It may be prudent, however, to document in the patient's record the rationale for any significant deviation from these standards and guidelines.Duke Univ, Med Ctr, Durham, NC 27706 USAOregon Hlth Sci Univ, Portland, OR 97201 USANYU, Sch Med, New York, NY USAUniv Florida, Coll Med, Powell Gene Therapy Ctr, Gainesville, FL 32611 USAIndiana Univ, Bloomington, in 47405 USAUniv Miami, Miller Sch Med, Coral Gables, FL 33124 USAHarvard Univ, Childrens Hosp, Sch Med, Cambridge, MA 02138 USAUniversidade Federal de São Paulo, São Paulo, BrazilColumbia Univ, New York, NY 10027 USANYU, Bellevue Hosp, Sch Med, New York, NY USAColumbia Univ, Med Ctr, New York, NY 10027 USAUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Imitators of exercise-induced bronchoconstriction

Exercise-induced bronchoconstriction (EIB) is described by transient narrowing of the airways after exercise. It occurs in approximately 10% of the general population, while athletes may show a higher prevalence, especially in cold weather and ice rink athletes. Diagnosis of EIB is often made on the basis of self-reported symptoms without objective lung function tests, however, the presence of EIB can not be accurately determined on the basis of symptoms and may be under-, over-, or misdiagnosed. The goal of this review is to describe other clinical entities that mimic asthma or EIB symptoms and can be confused with EIB

True heterotopic bone in the paralyzed patient

In past years the clinical and radiologic presentation of true heterotopic bone in the paralyzed patient has been confused with osteomyelitis, neoplasm, trauma, and thrombophlebitis. We reviewed 376 paralyzed patients' roentgenographic files and found 78 patients with soft tissue ossification unassociated with infection, neoplasm, or underlying fractures, which we called true heterotopic bone. From this population the usual spectrum of radiologic findings is described, so that the radiologist may separate roentgenographically a group of patients from other types of ectopic ossification.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46816/1/256_2004_Article_BF00347167.pd

Civil society and global governance : the possibilities for global citizenship

In this article we reassert the role of governance as well as of civil society in the analysis of citizenship. We argue that to analyse global civil society and global citizenship it is necessary to focus on global governance. Just as states may facilitate or obstruct the emergence and development of national civil society, so too global governance institutions may facilitate or obstruct an emerging global civil society. Our key contention is that civil society at the global level thrives through its interaction with strong facilitating institutions of global governance. We start with a discussion of civil society and citizenship within the nation-state, and from there develop a model of global civil society and citizenship. Through analysing the impacts of various modes of global governance, we identify strategically appropriate forms of political and social engagement that best advance the prospects for global citizenship. <br /