Comprehensive resource describing guidelines for safely reducing or stopping (deprescribing) antidepressants, benzodiazepines, gabapentinoids and z-drugs for patients, including step-by-step guidance for all commonly used medications, covering common pitfalls, troubleshooting, supportive strategies, and more. Most formal guidance on psychiatric medication relates to starting or switching medications with minimal guidance on deprescribing medication. In 2023, the World Health Organisation and the United Nations called for patients, as a human right, to be informed of their right to discontinue treatment and to receive support to do so. The Maudsley Deprescribing Guidelines fills a significant gap in guidance for clinicians by providing comprehensive and authoritative information on this important aspect of treatment. The evidence-based handbook provides an overview of principles to be used in deprescribing. This is derived from fundamental scientific principles and the latest research on this topic, combined with emerging insights from clinical practice (including from patient experts). Building on the recognised brand of The Maudsley Prescribing Guidelines, and the prominence of the authors' work, including in The Lancet Psychiatry on tapering antidepressants (the most read article across all Lancet titles when it was released). The Maudsley Deprescribing Guidelines covers topics such as: Why and when to deprescribe antidepressants, benzodiazepines, gabapentinoids and z-drugs Barriers and enablers to deprescribing including physical dependence, social circumstances, and knowledge about the discontinuation process Distinguishing withdrawal symptoms from dose reduction, such as poor mood, anxiety, and insomnia, from symptoms of the underlying disorder that medication was intended to treat The difference between physical dependence and addiction/substance use disorder Explanation of why and how to implement hyperbolic tapering in clinical practice Specific guidance on formulations of medication and techniques for making gradual reductions, including using liquid forms of medication, and other approaches Step-by-step guidance for safely stopping all commonly used antidepressants, benzodiazepines, gabapentinoids and z-drugs, including fast, moderate and slow tapering regimens or schedules for each drug, and guidance on how to tailor these to an individual Troubleshooting issues which can arise on stopping these medications, including akathisia, withdrawal symptoms, acute or protracted, and relapse. Written for anyone interested in safe deprescribing of psychiatric medications including psychiatrists, GPs, pharmacists, nurses, medical trainees, and interested members of the public. The Maudsley Deprescribing Guidelines is an essential resource on the subject that provides practical guidance on how to improve patient outcomes in this field of medicine.
The Byzantine Empire lasted for almost a thousand years after the fall of the Roman Empire in the West. The period covered by this catalogue is from the reign of Anastasius I (491518) until the capture of Constantinople by the Turks in 1453. When this catalogue was first published in 1974 it was hailed as containing more information in a concise form than any other single volume on the Byzantine series.
Increasing pressures to produce new products faster and cheaper are resulting in huge efforts to streamline and restructure the traditional new product development (NPD) process. The purpose of the book is to describe, assess and apply the latest constructs, methods, techniques and processes to enable managers, professionals, and practitioners to be more effective in designing, developing and commercializing new products and services. It provides guidance and support in formulating and executing NPD programs for business practitioners and MBA students. The book is written from an Integrated Product Development (IPD) perspective, linking all aspects of marketing, costing and manufacturing into the development process even before the first prototype is built. It covers the advanced tools necessary to achieve this such as virtual prototyping and fully integrated business systems, and explains the changes needed to organizational structure and thinking.
Following the familiar, easy-to-use at a Glance format, and in full-colour, this new edition provides an accessible introduction and revision aid for medical, nursing and all health sciences students. Thoroughly updated and now fully supported by a set of web-based flashcards, Anatomy at a Glance provides a user-friendly overview of anatomy to encapsulate all that the student needs to know. Anatomy at a Glance: Addresses the basic concepts of anatomy in an highly visual, easy-to-remember way Features two new chapters outlining anatomical terminology and basic embryology Includes more coverage of imaging techniques such as CT and MRI Offers free online flashcards for self-assessment and revision at www.wiley.com/go/anatomyataglance This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from Google Play or the MedHand Store. To find out more about the at a Glance series, please visit www.ataglanceseries.com
Now in its third edition, A Handbook of Diction for Singers is a complete guide to achieving professional levels of diction in Italian, German, and French. Combining traditional approaches in the teaching of diction with new material not readily available elsewhere, author David Adams presents the sounds of each language in logical order, along with essential information on matters such as diacritical marks, syllabification, word stress, and effective use of the variety of foreign-language dictionaries. A Handbook of Diction for Singers places particular emphasis on the characteristics of vowel length, the sequencing of sounds between words, as well as the differences between spoken and sung sounds in all three languages, all while taking care to clarify concepts typically difficult for English-speaking singers. This revised third edition offers significantly expanded coverage of each language as well as a new chapter that introduces readers to the specific sounds unique to those languages. The result is a concise yet thorough treatment of the three major languages of the classical vocal repertory, and an invaluable reference for vocalists and voice teachers.
New to Hart Publishing, this is the seventh edition of the classic casebook on tort, the first of its kind in the UK, and for many years now a bestselling and very popular text for students. This new edition retains all the features that have made it such a popular and respected text, with extensive commentary, questions and notes supplementing the selection of cases and statutes which form the core of the book. Taking a broadly contextual approach, the book addresses all the main topics in tort law, is up-to-date, doctrinally sound, stimulating and highly readable.
Mechanical Circulatory Support: Principles and Applications offers innovative approaches to complex clinical scenarios and represents the current state-of-the-art for managing patients on mechanical circulatory support devices. Topics are presented in a concise fashion, making it a practical resource for care givers who need a user's manual in the heat of the moment during patient care as well as a reference for a better understanding of the unique components of every device available for human use. This book provides a comprehensive, up-to-date analysis of the most relevant issues facing health care providers in the management of advanced heart failure. With content that features patient selection strategies, implantation techniques, device specific considerations, and management of clinical challenges in the post-operative setting, this textbook offers evidence-based answers to the complex questions facing nurses, perfusionists, advanced practice providers, and physicians.
David Quammen is simply the best natural essayist working today."--Tim Cahill, author of Lost in My Own Backyard "Lively writing about science and nature depends less on the offering of good answers, I think, than on the offering of good questions," said David Quammen in the original introduction to Natural Acts. For more than two decades, he has stuck to that credo. In this updated version of curiosity leads him from New Mexico to Romania, from the Congo to the Amazon, asking questions about mosquitoes (what are their redeeming merits?), dinosaurs (how did they change the life of a dyslexic Vietnam vet?), and cloning (can it save endangered species?). This revised and expanded edition best-loved "Natural Acts" columns, which first appeared in Outside magazine in the early 1980s, and includes recent pieces such as "Planet of Weeds," an influential new Natural Acts is an eye-opening journey that will please both Quammen fans and newcomers to his work. Song lyrics have been redacted from this ebook owing to permissions issues.
Publisher's Note: Products purchased from 3rd Party sellers are not guaranteed by the Publisher for quality, authenticity, or access to any online entitlements included with the product. For more than 30 years, Perez and Brady's Principles and Practice of Radiation Oncology has been the must-have standard reference for radiation oncologists and radiation oncology residents who need a comprehensive text covering both the biological and physical science aspects of this complex field as well as disease site-specific information on the integrated, multidisciplinary management of patients with cancer. The book has established itself as the discipline’s "text-of-record," belonging on the shelf of all of those working in the field. The Seventh Edition continues this tradition of excellence with extensive updates throughout, many new chapters, and more than 1,400 full-color illustrations that highlight key concepts in tumor pathogenesis, diagnosis, and targeted radiation therapy.
A depiction of the history of North America and the United States told through maps old and new. The history starts with the peoples who first settled the land tens of thousand years ago, and continues to the present day. Includes a timeline of American history, a guide to the fifty U.S. states, and a map showing the birthplace of every U.S. president.
Now in four convenient volumes, Field’s Virology remains the most authoritative reference in this fast-changing field, providing definitive coverage of virology, including virus biology as well as replication and medical aspects of specific virus families.
This book covers the latest advances in non-muscle invasive bladder cancer care. It provides a review of the available evidence base for the efficacy of a range of therapeutic techniques, diagnostic procedures and risk factors. Management of Non-Muscle Invasive Bladder Cancer features detailed guidance in uniformly formatted chapters on how to properly apply a range of available therapeutic treatments relevant for patient care. It is a valuable resource for all trainee and practising medical professionals who treat these patients.
McKinsey & Company's #1 best-selling guide to corporate valuation, now in its sixth edition Valuation is the single best guide of its kind, helping financial professionals worldwide excel at measuring, managing, and maximizing shareholder and company value. This new sixth edition provides insights on the strategic advantages of value-based management, complete detailed instruction, and nuances managers should know about valuation and valuation techniques as applied to different industries, emerging markets, and other special situations. The accompanying DCF model download allows you to complete computations automatically for error-free analysis and valuation of real companies. The model ensures that all important measures, such as return on investment capital and free cash flow are calculated correctly, so you can focus on the company's performance rather than computational errors. Valuation lies at the crossroads of corporate strategy and finance. In today's economy, it has become an essential role—and one that requires excellence at all points. This guide shows you everything you need to know, and gives you the understanding you need to be effective. Estimate the value of business strategies to drive better decision making Understand which business units a corporate parent is best positioned to own Assess major transactions, including acquisitions, divestitures, and restructurings Design a capital structure that supports strategy and minimizes risk As the valuation function becomes ever more central to long- and short-term strategy, analysts and managers need an authoritative reference to turn to for answers to challenging situations. Valuation stands ahead of the field for its reputation, quality, and prestige, putting the solutions you need right at your fingertips.
Maximum likelihood estimation is a general method for estimating the parameters of econometric models from observed data. The principle of maximum likelihood plays a central role in the exposition of this book, since a number of estimators used in econometrics can be derived within this framework. Examples include ordinary least squares, generalized least squares and full-information maximum likelihood. In deriving the maximum likelihood estimator, a key concept is the joint probability density function (pdf) of the observed random variables, yt. Maximum likelihood estimation requires that the following conditions are satisfied. (1) The form of the joint pdf of yt is known. (2) The specification of the moments of the joint pdf are known. (3) The joint pdf can be evaluated for all values of the parameters, 9. Parts ONE and TWO of this book deal with models in which all these conditions are satisfied. Part THREE investigates models in which these conditions are not satisfied and considers four important cases. First, if the distribution of yt is misspecified, resulting in both conditions 1 and 2 being violated, estimation is by quasi-maximum likelihood (Chapter 9). Second, if condition 1 is not satisfied, a generalized method of moments estimator (Chapter 10) is required. Third, if condition 2 is not satisfied, estimation relies on nonparametric methods (Chapter 11). Fourth, if condition 3 is violated, simulation-based estimation methods are used (Chapter 12). 1.2 Motivating Examples To highlight the role of probability distributions in maximum likelihood estimation, this section emphasizes the link between observed sample data and 4 The Maximum Likelihood Principle the probability distribution from which they are drawn"-- publisher.
McKINSEY'S TRUSTED GUIDE TO TEACHING CORPORATE VALUATION, NOW IN ITS 25TH YEAR Valuation, University Edition, Sixth Edition, is filled with the expert guidance from McKinsey & Company that students and professors have come to rely on. New to the fully revised and updated Sixth Edition: New case studies that clearly illustrate how vital valuation techniques and principles are applied in real-world situations Expanded content on advanced valuation techniques New content on the strategic advantages of value-based management that reflect the economic events of the past decade For twenty-five years Valuation has remained true to its core principles and offers a step-by-step approach to valuation, including: Analyzing historical performance Forecasting performance Estimating the cost of capital with practical tips Interpreting the results of a valuation in light of a company's competitive situation Linking a company's valuation multiples to the core drivers of its performance The University Edition contains End-of-Chapter Review Questions, helping students master key concepts from each chapter. Wiley also offers an Online Instructor's Manual with a full suite of learning resources for professors and students. www.wileyvaluation.com
1. General trends and coupling schemes. 1.1. Introduction. 1.2. The aligned coupling scheme. 1.3. The pair coupling scheme. 1.4. Competition between aligned and pair coupling. 1.5. Quasi-particles -- 2. The collective vibrational model. 2.1. Vibrations in quantum mechanics. 2.2. The energy spectrum for shape oscillations. 2.3. Electromagnetic transition strengths. 2.4. The hydrodynamic collective parameters. 2.5. Comparison with experiment. 2.6. Sum rules -- 3. The unified model for vibrations. 3.1. Even-even nuclei. 3.2. Odd-mass nuciei - weak coupling. 3.3. Excitation of vibrational states in inelastic scattering -- 4. The vibrating potential model (VPM). 4.1. The adiabatic approximation. 4.2. The possibility of going to higher order. 4.3. The vibrating potential model (VPM). 4.4. Discussion -- 5. The E1 photoresonance. 5.1. The collective model. 5.2. The independent particle model (IPM). 5.3. The compatibility of the two approaches. 5.4. The unified model. 5.5. The structure of the photoresonance -- 6. The collective rotational model. 6.1. The two-particle rotor. 6.2. The asymmetric rotor model. 6.3. The symmetric rotor model. 6.4. K = 0 bands. 6.5. The symmetric core model. 6.6. K = 1/2 bands. 6.7. Electromagnetic moments and transitions. 6.8. Band mixing -- 7. The unified model for rotations. 7.1. The aligned wave-function. 7.2. The Nilsson model. 7.3. Intrinsic structure. 7.4. Even-even nuclei. 7.5. Odd-mass nuclei - strong coupling. 7.6. Excitation of rotational states in inelastic scattering -- 8. The moment of inertia. 8.1. The irrotational flow model. 8.2. The rotational flow model. 8.3. The two-fluid model. 8.4. The cranking model. 8.5. The pushing model -- 9. Hartree-Fock seH-consistent field theory : spherical nuclei. 9.1. Hartree theory. 9.2. Hartree-Fock (HF) theory. 9.3. Realistic and effective interactions. 9.4. Hartree-Fock calculations for closed-shell nuclei. 9.5. The shell model.
Unequalled in scope, depth, and clinical precision, Retina, 5th Edition keeps you at the forefront of today’s new technologies, surgical approaches, and diagnostic and therapeutic options for retinal diseases and disorders. Comprehensively updated to reflect everything you need to know regarding retinal diagnosis, treatment, development, structure, function, and pathophysiology, this monumental ophthalmology reference work equips you with expert answers to virtually any question you may face in practice. Consult this title on your favorite e-reader with intuitive search tools and adjustable font sizes. Elsevier eBooks provide instant portable access to your entire library, no matter what device you're using or where you're located. Examine and evaluate the newest diagnostic technologies and approaches that are changing the management of retinal disease, including future technologies which will soon become the standard. Put the very latest scientific and genetic discoveries, diagnostic imaging methods, drug therapies, treatment recommendations, and surgical techniques to work in your practice. Benefit from the extensive knowledge and experience of esteemed editor Dr. Stephen Ryan, five expert co-editors, and a truly global perspective from 358 other world authorities across Europe, Asia, Australasia, and the Americas. Make the best use of new technologies with expanded and updated coverage of optical coherence tomography (OCT), fundus imaging, and autofluorescence imaging. Apply the latest knowledge on anti-VEGF therapy for age related macular degeneration, diabetic retinopathy and vein disease. Learn about artificial vision, drug delivery to the posterior segment, advances in macular surgery, vitrectomy, and complex retinal detachment, with updates on tumors, retinal genetics, cell biology, important basic science topics, and much more. Get the most out of new pharmacologic approaches in the management of age-related macular degeneration and diabetic retinopathy. In your practice, diagnostic evaluations, and now even treatments, will be influenced by recent scientific discoveries such as in the areas of nanotechnology, neuro protection, stem cells and gene therapy, among other scientific contributions. View videos of surgical procedures and access the complete contents of Retina, 5th Edition online at www.expertconsult.com, fully searchable, with regular updates and a downloadable image gallery.
In Fundamentals of Digital Audio, Alan P.Kafauver and David Patschke present a systematic overview of the elements for digital recording and reproducing sound. With Ideas grounded in the principles of acoustics, the authors exptore the essential issues involved in preserving, transferring, and modifying sound recordings in the digital domain. In addition to references on historic methods of sound reproduction, this book includes detailed information about the latest digital audio technology. Of special interest is the coverage of storage media and compression technologies. The authors detail a comprehensive introduction and evolution of data storage and media standards, including CD/DVD/Blu-ray/HD DVD, as well as fully (but plainly) detailing associated digital audio compression algorithms. They catalog in detail the processes involved in digitally editing recorded sound, presenting a step-by-step editing and mastering session. Fundamentals of Digital Audio is an essential textbook for anyone who wants to better understand or work with recorded sound using today's digital equipment. The book contains many diagrams and illustrations through which the authors share their expertise with the reader, Among the few books that treats this subject both comprehensively and understandably, the new edition of Fundamentals of Digital Audio should continue to be an indispensable text in this area.
An expert on Jewish backgrounds offers a substantial commentary on Matthew in the latest addition to the Baker Exegetical Commentary on the New Testament series.
This work is focused on different aspects within the loop of multiscale modeling: On the cellular level, effects of adrenergic regulation and the Long-QT syndrome have been investigated.On the organ level, a model for the excitation conduction system was developed and the role of electrophysiological heterogeneities was analyzed.On the torso level a dynamic model of a deforming heart was created and the effects of tissue conductivities on the solution of the forward problem were evaluated
A single source of much of the information that doctors and other health care workers need in order to learn if a birth defect or genetic condition can be diagnosed prenatally." -- American Journal of Human Genetics
**Selected for Doody's Core Titles® 2024 with "Essential Purchase" designation in Pediatric Surgery** Now in brilliant full color and reflecting recent significant changes in the field, Critical Heart Disease in Infants and Children, 3rd Edition, keeps you abreast of the skills and knowledge required to safely care for children with congenital and acquired heart disease in the ICU. Pediatric intensivists, cardiologists, cardiac surgeons, and anesthesiologists from leading centers around the world provide a well-rounded perspective on basic scientific principles, medical and pharmacologic treatments, surgical techniques, and equipment. - Features comprehensive updates throughout the text, including indications, techniques, potential complications in perioperative management of patients, and surgical techniques for congenital heart disease. - Covers recent advances in the treatment of pulmonary hypertension, developments in mechanical assist devices, heart and lung transplantation, and interventional cardiac catheterization. - Features an all-new, full-color format that speeds navigation and helps clarify complex concepts. - Contains 27 new chapters with an emphasis on the team approach to patient care in the ICU including creating multidisciplinary teams, quality and performance improvement, training , and challenges and solutions to developing a cohesive team environment. - Includes a detailed chapter on bedside ultrasound, walking you through the techniques you're most likely to encounter in the ICU. - Employs well-documented tables, text boxes, and algorithms to make clinical information easy to access, and more than two dozen video clips provide a more complete understanding of echocardiography, imaging modalities, pulmonary hypertension, and more. - Describes the basic pharmacology and clinical applications of new pharmacologic agents. - Examines issues affecting adults with congenital heart disease. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices. - Offers four completely new chapters: Cardiac Trauma, Congenital Heart Disease in the Adult, Congenitally Corrected Transposition of the Great Arteries, and Outcome Evaluation. - Describes the basic pharmacology and clinical applications of all of the new pharmacologic agents. - Details important refinements and developments in surgical techniques, including the Ross pulmonary autograft replacement of the aortic valve, video-assisted fluoroscopy, and the extracardiac Fontan connection, and discusses their indications and potential complications. - Explores the latest advances in the treatment of pulmonary hypertension, new developments in mechanical assist devices, heart and lung transplantation, and interventional cardiac catheterization. - Examines issues affecting adults with congenital heart disease.
Highly Commended, BMA Medical Book Awards 2013Previously published as Textbook of Clinical Neuropsychiatry, this book has been re-titled and thoroughly updated, redesigned, and enhanced to include the fundamentals of neuroscience. This highly acclaimed text provides a definitive, clinically oriented, yet comprehensive book covering neuropsychiatry
The United States government invests billions each year on equipping armed forces with the most advanced military equipment. The root of the American defense acquisition system is driven by a combination of national interests and domestic political requirements. While fundamentally the defense acquisition system has produced results for the United States military, improvements are needed in order to continue to move forward in advancing military tactics and technology. Exploring both the systemic and political levels of the system, Sorenson argues that the United States will fall behind if the current defense acquisition system is not reformed. This book brings together elements of this complicated system, such as national security requirements, and the changes that are needed in both the structural and political pillars. A combination of political interests and the needs of the military, serviced by an ever-shrinking defense industry, make a genuine acquisition reform even more difficult, resulting in reform that is more symbolic than genuine.
Thoroughly revised and updated, this Fourth Edition is the most comprehensive, current reference on lung cancer, with contributions from the world's foremost surgeons, radiation oncologists, medical oncologists, pulmonologists, and basic scientists. Coverage includes complete information on combined modality treatments for small cell and non-small cell lung cancer and on complications of treatment and management of metastases. Emphasis is also given to early detection, screening, prevention, and new imaging techniques. This edition has expanded thoracic oncology chapters including thymus, mesothelioma, and mediastinal tumors, more detailed discussion of targeted agents, and state-of-the-art information on newer techniques in radiotherapy. Other highlights include more international contributors and greater discussion of changes in lung cancer management in each region of the world. A new editor, Giorgio Scagliotti, MD from the University of Turin, has coordinated the accounts of European activities. A companion website includes the full text online and an image bank.
The most-trusted resource for physiatry knowledge and techniques, Braddom's Physical Medicine and Rehabilitation remains an essential guide for the entire rehabilitation team. With proven science and comprehensive guidance, this medical reference book addresses a range of topics to offer every patient maximum pain relief and optimal return to function. In-depth coverage of the indications for and limitations of axial and peripheral joints through therapies enables mastery of these techniques. Optimize the use of ultrasound in diagnosis and treatment. A chapter covering PM&R in the international community serves to broaden your perspective in the field. Detailed illustrations allow you to gain a clear visual understanding of important concepts. New lead editor - Dr. David Cifu - was selected by Dr. Randall Braddom to retain a consistent and readable format. Additional new authors and editors provide a fresh perspective to this edition. Features comprehensive coverage of the treatment of concussions and military amputees. Includes brand-new information on rehabilitating wounded military personnel, the latest injection techniques, speech/swallowing disorders, head injury rehabilitation, and the rehabilitation of chronic diseases. New chapters on pelvic floor disorders and sensory impairments keep you at the forefront of the field. Reader-friendly design features an updated table of contents and improved chapter approach for an enhanced user experience. Expert Consult eBook version included with purchase. This enhanced eBook experience gives access to the text, figures, over 2,500 references, 51 videos, and 750 self-assessment questions on a variety of devices.
Children with brain and spinal tumors account for 20-25% of childhood cancers. Until the early 1990s there had been little progress in the development of new treatments, and outcomes were not improving despite advances seen in other childhood cancers. During the past 10 years, however, there has been a dramatic increase in interest in the subject a
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