Objective: To provide an updated guideline for the surgical and medical termination of pregnancy. This guideline discusses and compares the safety and effectiveness of currently available pregnancy termination procedures.
The termination of a pregnancy medically or operatively before fetal viability; deﬁnition of viability varies from state to state
A S S E S S M E N T O F T H E PAT I E N T
Abortion may not be denied in ﬁrst 3 months of pregnancy in any state.
Physical assessment is crucial before an elective abortion: Ultrasound should be performed if there is a discrepancy between dates and uterine size. Patient’s blood type and Rh type must be evaluated; if Rh negative, RhoGAM should be administered prophylactically. Careful patient counseling should be performed. ...
Vaccinating girls and women before sexual debut, and therefore before exposure to HPV
infection, provides an excellent opportunity to decrease the incidence of cervical cancer over
time. As these vaccines protect against HPV types responsible for about 70% of cervical
cancers, there will be a continued need to screen women who have been vaccinated as well
as those who have not been vaccinated.
Mobile advertising is a rapidly growing sector providing brands,
agencies and marketers the opportunity to connect with consumers
beyond traditional and digital media directly on their
mobile phones. This document is an overview on the mobile
media channels available to advertisers today, including the benefits
offered by each, and considerations to use in selecting and
optimizing mobile advertising campaigns
This document is adjunct to the MMA Mobile Advertising Guidelines,
which provide technical specifications, global formats,
guidelines and best practices for each mobile channel.
Two major approaches to cryopreservation are known, i.e., conventional freeze-thaw
procedures and vitrification, which is defined as a glass-like solidification (Karlsson &
Toner, 1996). While freeze-thaw procedures minimize the probability of intracellular ice
formation, vitrification attempts to prevent ice formation throughout the entire sample
during the cooling and warming process (Kuleshova et al., 2007). Recently, the potential of
vitrification has been tested for tissue-engineered constructs.
The insurance sector is an infrastructural pillar of the financial services sector and the
economy as a whole. It plays a key role in economic development. Several empirical
studies suggest a strong correlation between the development of financial intermediaries
and economic growth. According to Patrick (1966)
there are two, possibly coexisting,
relationships between the financial sector and economic growth.
Companies are required to prepare their financial statements each year as per the provisions of
the Companies Act and have them audited by a practicing Chartered Accountant or a firm of
Chartered Accountants registered with the Institute of Chartered Accountants of India. The
Companies Act permits companies to choose their financial year end. The audited financial
statements must be approved by the shareholders in an annual meeting of the shareholders,
which should be convened by the company normally within six months from the end of the
Research has suggested a link between nutritional deficiencies in early (including prenatal)
life, and the development of chronic diseases—cardiovascular disease, diabetes mellitus,
hypertension, stroke, cancer, and osteoporosis, among others—some decades later (World
Health Organization 2000a, 2000b; Jacoby 2004). A possible link between early nutritional
deficiencies and obesity has also been suggested, and it remains an area of ongoing research
(Pan American Health Organization 2003).
It is clear from the studies cited below, that good bedside manner and professionalism are
extremely important to patients. Plunkett and Midland (2000) found that “well-educated”
Caucasians (from Chicago, Michigan, US) placed an emphasis on communication skills
when selecting an obstetrician. In contrast, patients who were to undergo surgery decided
the surgical reputation of the OB/GYN was more important than bedside manner.
Living arrangements, particularly overcrowded
conditions and a lack of privacy, have been
associated with conflict within families. Although
abuse can occur when the abuser and the older
person suffering abuse live apart, the older person is
more at risk when living with the caregiver.
The early theories on the subject also sought to
associate dependency with increased risk of abuse.
In contrast, the final essay certainly carries the most interesting and audacious
research of the book. There Bonfand reaches the deepest confrontation between cinema
and painting by discussing the limits of their relation: when cinema, looking for its true
essence, rediscovers at the same time the origins of painting and so is aimed to produce
images ‘not made by the hand of man’: acheiropoietos images.
In recent years, however, major changes have greatly diminished the city’s
ability to both retain and create a sizable middle class. Even as the inflow of
new arrivals to New York has surged to levels not seen since the 1920s, the cost
of living has spiraled beyond the reach of many middle class individuals and,
particularly, families. Increasingly, only those at the upper end of the middle
class, who are affluent enough to afford not only the sharply higher housing
prices in every corner of the city but also the steep costs of child care and private
schools, can afford...
It is estimated that transitioning to a low-carbon and climate resilient economy and more broadly
„greening growth‟ over the next 20 years will require significant investment and consequently private
sources of capital on a much larger scale than previously - particularly given the current state of
government finances. There is already international agreement on the need to increase financing for
climate mitigation and adaptation – with international financing commitments already having been made.
Mehta and Shahpar (2004) present a cost-effectiveness analysis of household air pollution
control interventions by WHO regions with significant SFU prevalence. Benefits are
healthy years gained from reduced risk of ALRI in children and COPD in adult females
and males based on regional data from WHO. An improved stove is assumed to reduce
SFU pollution exposure and health effects by 75 percent. Per household annualized cost
of cooking systems range across regions from $40-90 for LPG, $10-20 for kerosene, and
$3-24 for improved stove ($3-5 in Africa and Asia).
There is no consensus on the definition of the financial cycle. In what follows, the term will
denote self-reinforcing interactions between perceptions of value and risk, attitudes towards
risk and financing constraints, which translate into booms followed by busts. These
interactions can amplify economic fluctuations and possibly lead to serious financial distress
and economic dislocations.
At the time of writing, many of the larger retailers are re-engineering their
business processes, and they also re-consider their organisation. Due to
improvements in infrastructure and logistics (e.g. the just in time principle) as well
as information technology advances (e.g. through Electronic Data Interchange;
EDI), many retailers are currently centralising their sourcing policies. Table 10
shows recent developments in this respect, while table 11 gives an outlook on
current trends and the expected evolution....
When you evaluate contractors on the basis of cost alone, you are unlikely to end up with the
best-qualified firm, and you put the sculpture at great risk.
If you are unable to obtain an exception to the sealed-bid method, be sure that the project
specifications are clear and detailed and describe every aspect of the work involved. Require a
list of all projects completed within the past several years. Ask each bidder to describe the
qualifications of all personnel who will be involved in the project, not just the principals.
Globalization is taking hold of all sectors of society. Not surprisingly, many residency
applicants are interested in global health training opportunities during their graduate
medical education. Meanwhile, residency programs grapple with the challenges of
establishing and expanding global health programming. The past decade has witnessed a
rise in number of non-profit organizations dedicated to global health exposure for future
physicians. Child and Family Health International, Doctors for Global Health, and
Community for Children are a few examples.
This guideline does not include recommendations covering every detail of the recognition
and initial management of ovarian cancer. Instead this guideline has tried to focus on those
areas of clinical practice (i) that are known to be controversial or uncertain; (ii) where there
is identifiable practice variation; (iii) where there is a lack of high quality evidence; or (iv)
where NICE guidelines are likely to have most impact. More detail on how this was
achieved is presented later in the section on ‘Developing Clinical Evidence Based
In Germany, the cheque has never become as important as it has in many other countries of the
western world. In terms of numbers it accounts for a mere 1.3% of all cashless transactions, in terms
of value just 2.7%. It is used for only 0.1% of all payments at retailers. On account of the increase in
more efficient debit card payments, the importance of the cheque is steadily decreasing. A further
decline in cheque payments in retail business can be expected as the eurocheque guarantee ceased
at the end of the year 2001. Although the number and value of...