Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
138
result(s) for
"Pearce, Keith"
Sort by:
كوكبنا
يتناول هذا الكتاب كوكبا في خطر، غير أنه كوكب يمكن إنقاذه. فهو يتعجب من مرونة الطبيعة وقدرتها على الاستمرار في غمرة الفوضى من المناطق القطبية التي تساعد على استقرار المناخ العالمي، إلى الصحاري التي تخصب الغابات، والمحيطات والجبال التي تولد الأمطار فوق الأراضي العشبية. من هنا يشكل هذا الكتاب نداء الكتاب نداء أخيرا إلى العمل، من أجل عملية ترميم بيئية كبيرة، لتعزيز تجدد الطبيعة، وذلك بدءا من اليوم. لذلك، يوجه الكتاب هذه الدعوة، ويعتبر أن الأوان لم يفت بعد، وأن هذه المهمة ممكنة وضرورية من أجل استمرار البشرية. إذا كنا نريد مستقبلا آمنا، لا يمكننا أن نستنفد «كوكبنا» بعد الآن. يأخذنا هذا الكتاب برحلة عبر مختلف العوالم البيولوجية في كوكبنا ليروي قصصا عن الدمار غير المسبوق الذي ألحقته أيادي البشر بالطبيعة. ويشرح كيف خربوا خلال ذلك كثيرا من الدورات الطبيعية التي تشكل أنظمة دعم الحياة على الأرض.
BOOK
Echocardiographic assessment of the right heart in adults: a practical guideline from the British Society of Echocardiography
The structure and function of the right side of the heart is influenced by a wide range of physiological and pathological conditions. Quantification of right heart parameters is important in a variety of clinical scenarios including diagnosis, prognostication, and monitoring response to therapy. Although echocardiography remains the first-line imaging investigation for right heart assessment, published guidance is relatively sparse in comparison to that for the left ventricle. This guideline document from the British Society of Echocardiography describes the principles and practical aspects of right heart assessment by echocardiography, including quantification of chamber dimensions and function, as well as assessment of valvular function. While cut-off values for normality are included, a disease-oriented approach is advocated due to the considerable heterogeneity of structural and functional changes seen across the spectrum of diseases affecting the right heart. The complex anatomy of the right ventricle requires special considerations and echocardiographic techniques, which are set out in this document. The clinical relevance of right ventricular diastolic function is introduced, with practical guidance for its assessment. Finally, the relatively novel techniques of three-dimensional right ventricular echocardiography and right ventricular speckle tracking imaging are described. Despite these techniques holding considerable promise, issues relating to reproducibility and inter-vendor variation have limited their clinical utility to date.
Journal Article
A practical guideline for performing a comprehensive transthoracic echocardiogram in adults: the British Society of Echocardiography minimum dataset
Since cardiac ultrasound was introduced into medical practice around the middle twentieth century, transthoracic echocardiography has developed to become a highly sophisticated and widely performed cardiac imaging modality in the diagnosis of heart disease. This evolution from an emerging technique with limited application, into a complex modality capable of detailed cardiac assessment has been driven by technological innovations that have both refined ‘standard’ 2D and Doppler imaging and led to the development of new diagnostic techniques. Accordingly, the adult transthoracic echocardiogram has evolved to become a comprehensive assessment of complex cardiac anatomy, function and haemodynamics. This guideline protocol from the British Society of Echocardiography aims to outline the minimum dataset required to confirm normal cardiac structure and function when performing a comprehensive standard adult echocardiogram and is structured according to the recommended sequence of acquisition. It is recommended that this structured approach to image acquisition and measurement protocol forms the basis of every standard adult transthoracic echocardiogram. However, when pathology is detected and further analysis becomes necessary, views and measurements in addition to the minimum dataset are required and should be taken with reference to the appropriate British Society of Echocardiography imaging protocol. It is anticipated that the recommendations made within this guideline will help standardise the local, regional and national practice of echocardiography, in addition to minimising the inter and intra-observer variation associated with echocardiographic measurement and interpretation.
Journal Article
What is a valve clinic?
The prevalence of heart valve disease is increasing as the population ages. A series of studies have shown current clinical practice is sub-optimal. Some patients are referred for surgery at advanced stages of disease with impaired ventricular function or not even considered for surgery. Valve clinics seek to improve patient outcomes by providing an expert-led, patient-centred framework of care designed to provide an accurate diagnosis with active surveillance of valve pathology and timely referral for intervention at guideline directed trigger points. A range of different valve clinic models can be adopted depending on local expertise combining the skill set of cardiologist, physiologist/scientist and nurses. Essential components to all clinics include structured clinical review, echocardiography to identify disease aetiology and severity, patient education and access to both additional diagnostic testing and a multi-disciplinary meeting for complex case review. Recommendations for training in heart valve disease are being developed. There is a growing evidence base for heart valve clinics providing better care with increased adherence to guideline recommendations, more timely referral for surgery and better patient education than conventional care.
Journal Article
Echocardiographic assessment of aortic stenosis: a practical guideline from the British Society of Echocardiography
The guideline provides a practical step-by-step guide in order to facilitate high-quality echocardiographic studies of patients with aortic stenosis. In addition, it addresses commonly encountered yet challenging clinical scenarios and covers the use of advanced echocardiographic techniques, including TOE and Dobutamine stress echocardiography in the assessment of aortic stenosis.
Journal Article
Uncovering the treatable burden of severe aortic stenosis in the UK
ObjectiveTo estimate the population prevalence and treatable burden of severe aortic stenosis (AS) in the UK.MethodsWe adapted a contemporary model of the population profile of symptomatic and asymptomatic severe AS in Europe and North America to estimate the number of people aged ≥55 years in the UK who might benefit from surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI).ResultsWith a point prevalence of 1.48%, we estimate that 291 448 men and women aged ≥55 years in the UK had severe AS in 2019. Of these, 68.3% (199 059, 95% CI 1 77 201 to 221 355 people) would have been symptomatic and, therefore, more readily treated according to their surgical risk profile; the remaining 31.7% of cases (92 389, 95% CI 70 093 to 144 247) being asymptomatic. Based on historical patterns of intervention, 58.4% (116 251, 95% CI 106 895 to 1 25 606) of the 199 059 symptomatic cases would qualify for SAVR, with 7208 (95% CI 7091 to 7234) being assessed as being in a high, preoperative surgical risk category. Among the remaining 41.6% (82 809, 95% CI 73 453 to 92 164) of cases potentially unsuitable for SAVR, an estimated 61.7% (51 093, 95% CI 34 780 to 67 655) might be suitable for TAVI. We estimate that 172 859 out of 291 448 prevalent cases of severe AS (59.3%) will subsequently die within 5 years without proactive management.ConclusionsThese data suggest a high burden of severe AS in the UK requiring surgical or transcatheter intervention that challenges the ongoing capacity of the National Health Service to meet the needs of those affected.
Journal Article
When are people willing to help others? Links with eudaimonic versus hedonic motives
This study (N = 491) examined how hedonic orientation (prioritizing pleasure, comfort/painlessness) and eudaimonic orientation (prioritizing authenticity, excellence, growth) relate to behaviours that help or hinder others and to willingness to help others in different situations. We found that eudaimonic orientation related positively to helping others and negatively to hindering others, whereas hedonic orientation related positively to hindering others. Differences were found across helping situations such that eudaimonic orientation related to willingness to help others even when the results are in the future, the recipient cannot be seen, and the helping is personally costly, whereas hedonic orientation related to a preference to help others when the results are immediate, the recipient can be seen, and the helping is not personally costly. These findings support a characterization of eudaimonia as a focus on long-term, abstract, and big-picture concerns, and hedonia as a focus on immediate, concrete, and self-focused concerns.
Journal Article
Safety and efficacy of physiologist-led dobutamine stress echocardiography
Dr Porter in his editorial comment (1) on a physiologist-led stress echo service (2) acknowledges that the service was safe in terms of adverse effects but is concerned that ‘the interpretation of the study was also done by the cardiac physiologist’. He reminds us ‘that the biggest danger associated with dobutamine stress echocardiography is in misinterpreting the data obtained…’.
Journal Article
Prevalence, characteristics and clinical impact of work-related musculoskeletal pain in echocardiography
Background
Work-related musculoskeletal pain (WRMSP) is increasingly recognised in cardiac ultrasound practice. WRMSP can impact workforce health, productivity and sustainability. We sought to investigate the prevalence, characteristics and clinical impact of WRMSP.
Methods
Prospective electronic survey of 157 echocardiographers in 10 institutions. Data acquired on demographics, experience, working environment/pattern, WRMSP location, severity and pattern, the impact on professional, personal life and career.
Results
129/157 (82%) echocardiographers completed the survey, of whom 109 (85%) reported WRMSP and 55 (43%) reported work taking longer due to WRMSP. 40/129 (31%) required time off work. 78/109 (60%) reported sleep disturbance with 26/78 (33%) of moderate or severe severity. 56/129 (45%) required medical evaluation of their WRMSP and 25/129 (19%) received a formal diagnosis of musculoskeletal injury. Those with 11+ years of experience were significantly more likely to receive a formal diagnosis of WRMSP (p = 0.002) and require medication (p = 0.006) compared to those with 10 years or less experience.
Conclusion
WRMSP is very common amongst echocardiographers, with a fifth having a related musculoskeletal injury. WRMSP has considerable on impact on personal, social and work-related activities. Strategies to reduce the burden of WRMSP are urgently required to ensure sustainability of the workforce and patient access to imaging.
Journal Article
British Society of Echocardiography guideline for the transthoracic echocardiographic assessment of adult patients with obstructive hypertrophic cardiomyopathy receiving myosin-inhibitor therapy
The presence and magnitude of the LVOT obstruction is a predictor of disease progression to heart failure and mortality [10] and therefore an important indicator in this patient population. Treatment is primarily aimed at improving quality of life in those with restricting symptoms. All echocardiography data will be taken in to account at a clinical review in combination with symptoms when considering dose alterations. The role of echocardiography and recommended Mavacamten protocol A full comprehensive echocardiographic assessment in accordance with the British Society of Echocardiography Hypertrophic Cardiomyopathy guideline [15, 16] should be undertaken before initiation of treatment with Mavacamten.
Journal Article