Explore the vast range of titles available.

\"Family therapy trainees are inundated with a multitude of family therapy theories. They also have difficulty shifting from an individualistic view to one of seeing interactions and systems. How do therapists hone their own methods with all of these choices? And how do they learn how to best treat families with all of the focus being taken away from their clients and redirected instead on processes? Perhaps most importantly, how can they learn through an inductive process of exploring what has occurred during the therapeutic session? Veteran therapist and founder of Structural Family Therapy, Salvador Minuchin, goes back to basics with his two co-authors Michael D. Reiter and Charmaine Borda in The Craft of Family Therapy. In this book they teach readers basic communication and family therapy skills using some of Dr. Minuchin's most interesting and illuminating cases. Not only do readers re-learn basic techniques, such as reframing and joining, but they are treated to an in-depth commentary on each case, with Dr. Minuchin emphasizing the techniques he uses that allow him to refocus attention from the Identifying Patient to the family as a whole. The book ends with three supervision transcripts from Dr. Minuchin's students, whose commentary illuminates the struggles, fears, and insecurities that new family therapists face and how they can overcome them. Each of these chapters ends with a consultation interview that Dr. Minuchin conducted with each supervisees case family.\"-- Provided by publisher.

Background Borrelia ( B. ) burgdorferi sensu lato, including the tick-transmitted agents of human Lyme borreliosis, have particularly complex genomes, consisting of a linear main chromosome and numerous linear and circular plasmids. The number and structure of plasmids is variable even in strains within a single genospecies. Genes on these plasmids are known to play essential roles in virulence and pathogenicity as well as host and vector associations. For this reason, it is essential to explore methods for rapid and reliable characterisation of molecular level changes on plasmids. In this study we used three strains: a low passage isolate of B. burgdorferi sensu stricto strain B31(−NRZ) and two closely related strains (PAli and PAbe) that were isolated from human patients. Sequences of these strains were compared to the previously sequenced reference strain B31 (available in GenBank) to obtain proof-of-principle information on the suitability of next generation sequencing (NGS) library construction and sequencing methods on the assembly of bacterial plasmids. We tested the effectiveness of different short read assemblers on Illumina sequences, and of long read generation methods on sequence data from Pacific Bioscience single-molecule real-time (SMRT) and nanopore (Oxford Nanopore Technologies) sequencing technology. Results Inclusion of mate pair library reads improved the assembly in some plasmids as did prior enrichment of plasmids. While cp32 plasmids remained refractory to assembly using only short reads they were effectively assembled by long read sequencing methods. The long read SMRT and nanopore sequences came, however, at the cost of indels (insertions or deletions) appearing in an unpredictable manner. Using long and short read technologies together allowed us to show that the three B. burgdorferi s.s. strains investigated here, whilst having similar plasmid structures to each other (apart from fusion of cp32 plasmids), differed significantly from the reference strain B31-GB, especially in the case of cp32 plasmids. Conclusion Short read methods are sufficient to assemble the main chromosome and many of the plasmids in B. burgdorferi . However, a combination of short and long read sequencing methods is essential for proper assembly of all plasmids including cp32 and thus, for gaining an understanding of host- or vector adaptations. An important conclusion from our work is that the evolution of Borrelia plasmids appears to be dynamic. This has important implications for the development of useful research strategies to monitor the risk of Lyme disease occurrence and how to medically manage it.

Children with sensory abnormalities (SAs) have a variety of social problems resulting in poorer social functioning than children with typical development (TD). We describe the relationship between SAs and social functioning in school-age children with SAs, children with TD and a clinical comparison sample of children with autism spectrum disorder (ASD). Children with SAs demonstrated impaired social functioning on standardized measures. Children with SAs demonstrated worse social functioning than children with TD and equivalent social functioning to children with ASD. Increased SAs were associated with poorer social functioning across all groups. The results suggest that children with SAs experience clinically significant problems with social functioning and future research is needed to develop interventions to support social functioning in this population.

Robotic technology represents the latest development in minimally-invasive surgery. Nevertheless, robotic-assisted surgery seems to have specific disadvantages such as an increase in costs and prolongation of operative time. A general clinical implementation of the technique would only be justified if a relevant improvement in outcome could be demonstrated. This is also true for laparoscopic fundoplication. The present study was designed to compare robotic-assisted (RALF) and conventional laparoscopic fundoplication (CLF) with the focus on operative time, costs und perioperative outcome. Forty patients with gastro-esophageal reflux disease were randomized to either RALF by use of the daVinci Surgical System or CLF. Nissen fundoplication was the standard anti-reflux procedure. Peri-operative data such as length of operative procedure, intra-and postoperative complications, length of hospital stay, overall costs and symptomatic short-term outcome were compared. The total operative time was shorter for RALF compared to CLF (88 vs. 102 min; p = 0.033) consisting of a longer set-up (23 vs. 20 min; p = 0.050) but a shorter effective operative time (65 vs. 82 min; p = 0.006). Intraoperative complications included one pneumothorax and two technical problems in the RALF group and two bleedings in the CLF group. There were no conversions to an open approach. Mean length of hospital stay (2.8 vs. 3.3 days; p = 0.086) and symptomatic outcome thirty days postoperatively (10% vs. 15% with ongoing PPI therapy; p = 1.0 and 25% vs. 20% with persisting mild dysphagia; p = 1.0) was similar in both groups. Costs were higher for RALF than for CLF (3244 euros vs. 2743 euros, p = 0.003). In comparison with CLF, operative time can be shorter for RALF if performed by an experienced team. However, costs are higher and short-term outcome is similar. Thus, RALF can not be favoured over CLF regarding perioperative outcome.

Sixty-six guinea pigs with dental disease were presented to the University of Veterinary Medicine, Vienna, Austria, from 2006 to 2010. Almost all patients had a history of eating difficulties (95 per cent) and underwent clinical and oral examination as well as CT of the head. Findings on extra- and intraoral examination were asymmetric elongation (n=28) and symmetric bridging (n=24) of cheek teeth, obliquely worn incisors (n=17), palpable lower jaw swellings (n=13), exophthalmos (n=10) and incisor macrodontia (n=6). Eighty per cent of guinea pigs with exophthalmos showed ipsilateral periapical disease of the maxillary cheek teeth on CT. Ninety-two per cent of patients with palpable lower jaw swellings showed corresponding dental pathologies on CT. Periapical disease of incisors (n=11) and cheek teeth (n=32) were the most common findings on CT. All abnormally large incisors were found on oral examination and CT, but macrodontia of cheek teeth could only be visualised by CT. Deviation of the lower jaw evaluated in awake animals by visual inspection appeared to correlate with cheek teeth abnormalities. Results emphasise the importance of diagnostic imaging, in particular CT, in guinea pigs with dental disease in order to localise lesions and underlying aetiologies.

PurposeThe present randomised pilot trial was designed to compare robot-assisted (RALF) and conventional laparoscopic fundoplication (CLF) focussing on post-operative quality of life (QOL) and functional outcome. Any long-lasting advantages for patients in this regard could be a justification for the use of RALF for the treatment of gastroesophageal reflux disease (GERD).MethodsForty patients with GERD were randomised to either RALF or to CLF. During a follow-up period of 12 months, patients’ QOL and functional outcome were investigated using disease-specific questionnaires.ResultsThere were no significant differences in the mean QOL (1.3 versus 1.1; P = 0.374) and functional outcome (1.27 versus 1.3; P = 0.913) between both groups. Minor side effects such as bloating and persistent diarrhoea were present in four patients of each group.ConclusionThe present study did not show any benefit for RALF over CLF regarding QOL and functional outcome at 12 months’ follow-up.

Kinetic roughening of a randomly growing surface can be modelled by the Kardar-Parisi-Zhang equation with a time-independent (``spatially quenched'' or ``columnar'') random noise. In this paper, we use the field-theoretic renormalization group approach to investigate how randomly moving medium affects the kinetic roughening. The medium is described by the stochastic differential Navier-Stokes equation for incompressible viscous fluid with an external stirring force. We find that the action functional for the full stochastic problem should be extended to be renormalizable: a new nonlinearity must be introduced. Moreover, in order to correctly couple the scalar and velocity fields, a new dimensionless parameter must be introduced as a factor in the covariant derivative of the scalar field. The resulting action functional involves four coupling constants and a dimensionless ratio of kinematic coefficients. The one-loop calculation (the leading order of the expansion in \\(=4-d\\) with \\(d\\) being the space dimension) shows that the renormalization group equations in the five-dimensional space of those parameters reveal a curve of fixed points that involves an infrared attractive segment for \\(>0\\).

Ecosystem management requires understanding society's goals for an ecosystem and managing for some optimal solution. Unlike terrestrial ecosystem managers, coastal and marine ecosystem management seldom integrates across sectors or scientific disciplines to achieve desired social benefits. An Integrated Ecosystem Assessment (IEA) considers the ecosystem (including humans) as a unit and can assist in setting goals, determining an ecosystem's ability to support ecological processes and society's desires, and predicting the outcome of alternatives. The use of Coupled Ecological-Societal Systems Models utilised within the Integrated Assessment and Ecosystem Management Protocol (IAEMP) allows managers to extend a graphical picture of risk hypotheses to forecast scenarios that can be analysed relative to management goals. Scenarios predicted to meet management goals are evaluated against management constraints to select the \"optimal\" option for a management action in an adaptive management process. The IAEMP thus helps characterise potential causes of environmental problems, select appropriate response options, and implement and evaluate the selected option, thereby either addressing the concern or improving the ecosystem model for future decisions.

We study the stochastic Kardar-Parisi-Zhang equation for kinetic roughening where the time-independent (columnar or spatially quenched) Gaussian random noise \\(f(t, x)\\) is specified by the pair correlation function \\( f(t, x)f(t', x') ^(d) ( x-x')\\), \\(d\\) being the dimension of space. The field-theoretic renormalization group analysis shows that the effect of turbulent motion of the environment (modelled by the coupling with the velocity field described by the Kazantsev-Kraichnan statistical ensemble for an incompressible fluid) gives rise to a new nonlinear term, quadratic in the velocity field. It turns out that this \"induced\" nonlinearity strongly affects the scaling behaviour in several universality classes (types of long-time, large-scale asymptotic regimes) even when the turbulent advection appears irrelevant in itself. Practical calculation of the critical exponents (that determine the universality classes) is performed to the first order of the double expansion in \\(=4-d\\) and the velocity exponent \\(\\) (one-loop approximation). As is the case with most \"descendants\" of the Kardar-Parisi-Zhang model, some relevant fixed points of the renormalization group equations lie in \"forbidden zones,\" i.e. in those corresponding to negative kinetic coefficients or complex couplings. This persistent phenomenon in stochastic non-equilibrium models requires careful and inventive physical interpretation.

Renal cell carcinoma (RCC) represents the sixth-leading cancer-specific cause of death worldwide. This is mainly caused by metastatic or locally advanced RCC. Approximately 25-30% of patients present with metastasis during the initial diagnosis. Furthermore, 20-30% of patients develop metastatic disease following initial curative surgery. Metastatic RCC is characterized by a poor prognosis with a median overall survival of less than 2 years. Today, targeted therapies such as VEGF receptor inhibitors and antagonists as well as mTOR inhibitors represent the standard of care in metastatic RCC. Conventional chemotherapies or cytokine-based medications have been abandoned due to inferior clinical efficacy compared with targeted therapies. In Germany, sunitinib, pazopanib, temsirolimus, and bevacizumab have been approved for first-line treatment and sorafenib, axitinib, and everolimus for second-line treatment. Prognostic models, assessing individual risk profiles, have been developed in the last 15 years, which are crucial for the design of trials, patient counseling, and initiation of goal-directed therapies.