Silent Risk

Author : Jason H. Collins, MD, MSCR
Publisher : Xlibris Corporation
Page : 238 pages
File Size : 41,8 Mb
Release : 2014-07-02
Category : Medical
ISBN : 9781499039092

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SILENT RISK by Jason H. Collins, MD, MSCR Pdf

With an estimated 8,000 deaths per year in the United States from complications of UCA, an initial goal of 50% reduction of loss is possible. To achieve this goal requires the recognition by the obstetrical community of the issue. Recent research into circadian rhythms may help explain why UCA stillbirth is an event between 2:00 a.m. and 4:00 a.m. Melatonin has been described as stimulating uterine contractions through the M2 receptor. Melatonin secretion from the pineal gland begins around 10:00 p.m. and peaks to 60 pg at 3:00 a.m. Serum levels decline to below 10 pg by 6:00 a.m. Uterine stimulation intensifies during maternal sleep, which can be overwhelming to a compromised fetus, especially one experiencing intermittent umbilical cord compression due to UCA. It is now time for the focus to be on screening for UCA, managing UCA prenatally, and delivery of the baby in distress defined by the American College of Obstetricians and Gynecologists as a heart rate of 90 beats per minute for 1 minute on a recorded nonstress test. The ability of ultrasound and magnetic resonance imaging (MRI) to visualize UCA is well documented. The 18-20 week ultrasound review should include the umbilical cord, its characteristics, and description of its placental and fetal attachment. Bettye Wilson, MEd, R.T.(R)(CT), RDMS, FASRT Fellow of The American Society of Radiologic Technologist recommended in RADIOLOGIC TECHNOLOGY March/April 2008, Vol. 79/No. 4 pg 333S-345S That an umbilical cord evaluation with sonography should include the appearance, composition, location, and size (and length) of the cord. In addition: Abnormal Insertion (in the placenta and fetus) Vasa Previa Abnormal composition (single umbilical artery) Cysts, Masses Hematoma Umbilical Cord Thrombosis Coiling (helices), collapse, knotting and prolapsed (funic presentation) Cord Events: Although many stillbirths are attributed to a cord accident, this diagnosis should be made with caution. Cord abnormalities, including a Nuchal Cord, are found in approximately 30% of normal births and may be an incidental finding. (American College of Obstetrics and Gynecology Practice Bulletin 2009) According to NICHD's recent stillbirth study, UCA is a significant cause of mortality (10%). This finding is in agreement with other international UCA studies. (Bukowski et al. 2011) These histologic criteria identify cases of cord accident as a cause of stillbirth with very high specificity. (Dilated fetal vessels, thrombosis in fetal vessels, avascular placental villi.) (Pediatr Dev Pathol 2012) Finally, defining the morbidity (injury) of cord compression, such as fetal neurologic injury or heart injury identified with umbilical cord blood troponin T levels or pulmonary injury, is the next major area of investigation.

Author : Jeff Gunhus
Publisher : Kensington Books
Page : 304 pages
File Size : 53,8 Mb
Release : 2019-12-31
Category : Fiction
ISBN : 9781496726223

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Silent Threat by Jeff Gunhus Pdf

“Super-high stakes, super-high concept, and super-charged action. This propulsive spy thriller changes all the rules—it will have you holding your breath until you discover the final shocking truth. Jeff Gunhus is a terrific talent.” —Hank Phillippi Ryan, national bestselling author of The Murder List A father charged with treason. A daughter sent to kill him. A shocking conspiracy that changes all the rules of the spy game for a new generation . . . With more than a dozen kills under her belt, ex-Marine Mara Roberts is one of the Agency’s most reliable assassins. But her latest target—a convicted traitor about to be released from prison—is different than her other marks. He’s a former agent who betrayed his country. He’s responsible for the death of Mara’s mother. And he happens to be Mara’s father . . . Scott Roberts knows that his daughter was sent to kill him. He realizes he has only one chance to change her mind, to convince her that he’s been framed for treason—and that every member of their family are pawns to be sacrificed, one by one. Mara isn’t sure she can trust her father. He is a master of manipulation, as ruthless as he is resourceful. But when her nephew is abducted, she agrees to follow Scott’s lead and expose the global elites who are pulling the strings. But first, they must infiltrate the highest levels of power. Then, they must attempt the unthinkable: Kidnap the President of the United States . . . “A brilliantly written thriller. Breakneck twists, political intrigue and bristling action scenes—Jeff Gunhus writes with a gripping and gritty authority.” —Simon Gervais, author of Hunt Them Down

Author : Don Pendleton
Publisher : Gold Eagle
Page : 189 pages
File Size : 41,9 Mb
Release : 2010-07-01
Category : Fiction
ISBN : 9781426860560

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Silent Threat by Don Pendleton Pdf

When several German CEOs become victims in deadly accidents and their strategic companies are suddenly bought out, red flags are raised in U.S. intelligence circles. All signs indicate that the buyouts are being orchestrated by the head of a powerful cult and he's planning a terrorist attack. But getting to the cult leader and ending the threat proves to be challenging—especially when an army of zealous followers bristling with weapons are prepared to die for the cause. Mack Bolan is determined to infiltrate the group and destroy the organization before they unleash their plan of destruction. The cult leader may believe he can bring death, but there is only one Executioner.

Author : Misty Evans
Publisher : Beach Path Publishing, LLC.
Page : 317 pages
File Size : 53,6 Mb
Release : 2022-01-14
Category : Fiction
ISBN : 8210379456XXX

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Risk, SEALs of Shadow Force Romantic Suspense Series, Book 7 by Misty Evans Pdf

Danger stalks Jena… Past mistakes haunt Noah. When a stalker comes after her, will Noah be able to put the past behind him and keep her safe? Princess of pop, Jenavieve DuMont, knows better than to get close to a fan, but when she needs help protecting a prized show horse for her grandfather—as well as tracking down a missing portfolio of her latest songs—there’s only one man she can call on…her biggest fan ever. Former SEAL Noah Pierce has been in love with his best friend’s little sister since Jena stole his heart when they were just kids. He thought the two of them had it all until she refused to marry him once she hit the big time. All these years later, his heart is still a wreck, but Jena needs him. He can’t say no. Once he lands in Tennessee, Noah realizes the horse isn’t the only one in need of protection. When a stalker draws near, Jena loses more than her songs. A killer goes after those closest to her and will stop at nothing in order to ruin her life.

Author : Neil Cowan,Neil Russell-Jones
Publisher : Global Professional Publishi
Page : 204 pages
File Size : 51,5 Mb
Release : 2005
Category : Business & Economics
ISBN : 1845163621

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Risk Analysis and Evaluation by Neil Cowan,Neil Russell-Jones Pdf

"This book is about risk - that is those risks that affect an organisation in its everyday dealings with the world. Unlike many books on risk it is not solely an exercise in quantitative analysis but also seeks to examine the whole range of risks that face an organisation."--BOOK JACKET.

Author : Misty Evans
Publisher : Beach Path Publishing, LLC.
Page : 1959 pages
File Size : 52,8 Mb
Release : 2022-01-18
Category : Fiction
ISBN : 8210379456XXX

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SEALs of Shadow Force Romantic Suspense Series Box Set, Books 1-7 by Misty Evans Pdf

The SEALs of Shadow Force will take you on undercover and make you risk it all. Meet the men and women that make up the Shadow Force International family! Under the supervision of Beatrice Reese, the former SEALs, spies, and tech experts risk their lives every day against terrorists, crime lords, and serial killers. Along the way, they fight to protect the ones they love and gain their happily-ever-afters. This special collection includes SEVEN fast paced, action-packed romantic suspense novels filled with alpha males, strong heroines, and sizzling romance. This collection will keep you reading late into the night, enthralled from beginning to end! Books in the SEALs of Shadow Force Series: Fatal Truth – Trace and Savanna Fatal Honor – Miles and Charlotte Fatal Courage – Jax and Ruby Fatal Love – Cal and Beatrice; Connor and Sabrina Fatal Vision – Colton and Shelby; Connor and Sabrina Fatal Thrill – Jon and Jaya Risk – Noah and Jena SEALs of Shadow Force Box Set, Books 1-7 quantity

Author : Lajpat Ray Chandnani
Publisher : Notion Press
Page : 502 pages
File Size : 55,7 Mb
Release : 2017-03-14
Category : Reference
ISBN : 9781946556967

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General Insurance, Reinsurance and Risk Management Glossary by Lajpat Ray Chandnani Pdf

General Insurance, Reinsurance and Risk Management Glossary is designed to provide accurate and authoritative yet simplistic and understandable definitions on commonly used words, terms, concepts and abbreviations used in the Industry. It is divided into sections in alphabetical order and wherever applicable, terms are cross-referenced with other terms. This glossary is a must for: • Insurance personnel • Surveyors and other claims specialists, • Advocates, • Insurance consultants, • Financial and legal consultants, • Agents, • Brokers, • Risk managers, • Loss control managers, • Insurance authorities, • CEOs and other corporate managers, • Corporate or school, college, university and other libraries • Students of insurance, reinsurance and risk management as well Bancassurance courses • Laymen who wish to better understand their own insurance coverage.

Author : K. H. Spencer Pickett
Publisher : John Wiley & Sons
Page : 287 pages
File Size : 47,7 Mb
Release : 2005-07-29
Category : Business & Economics
ISBN : 9780471740087

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Auditing the Risk Management Process by K. H. Spencer Pickett Pdf

Risk management is a part of mainstream corporate life that touches all aspects of every type of organization. Auditors must focus firmly on risk: risk to the business, the executives, and the stakeholders. Auditing the Risk Management Process incorporates all the latest developments in risk management as it applies to auditors, including the new Committee of Sponsoring Organizations of the Treadway Commission (COSO) enterprise risk paper. Auditing the Risk Management Process includes original risk maps and process models developed by the author, explaining where and how topics fit within an overall audit framework, all the latest developments in risk management as it applies to auditors, and insight into how enterprise risk management affects the responsibilities of both internal and external auditors.

Author : Stefano Carta
Publisher : EOLSS Publications
Page : 514 pages
File Size : 45,5 Mb
Release : 2009-11-29
Category : Electronic
ISBN : 9781905839667

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PSYCHOLOGY – Volume II by Stefano Carta Pdf

Psychology theme in a set of three volumes is one of a number of many theme subjects covered by the Encyclopedia of Biological, Physiological and Health Sciences, a component of the global Encyclopedia of Life Support Systems (EOLSS), which is an integrated compendium of twenty such component Encyclopedias. The three-volume set is organized in seven main areas that try to cover essential information about such this wide and complex field of human knowledge from its neurobiological correlates, to the study of how the human mind imagines and how it produces symbols that guide human behavior, to the most advanced clinical interventions within the psychotherapeutic realm. These three volumes are aimed at the following five major target audiences: University and College Students, Educators, Professional Practitioners, Research Personnel and Policy Analysts, Managers, and Decision Makers and NGOs.

Author : Jason H. Collins, MD, MSCR
Publisher : Xlibris Corporation
Page : 114 pages
File Size : 43,8 Mb
Release : 2013-10-31
Category : Medical
ISBN : 9781493114658

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SILENT RISK by Jason H. Collins, MD, MSCR Pdf

With an estimated 8,000 deaths per year in the United States from complications of UCA, an initial goal of 50% reduction of loss is possible. To achieve this goal requires the recognition by the obstetrical community of the issue. Recent research into circadian rhythms may help explain why UCA stillbirth is an event between 2:00 a.m. and 4:00 a.m. Melatonin has been described as stimulating uterine contractions through the M2 receptor. Melatonin secretion from the pineal gland begins around 10:00 p.m. and peaks to 60 pg at 3:00 a.m. Serum levels decline to below 10 pg by 6:00 a.m. Uterine stimulation intensifies during maternal sleep, which can be overwhelming to a compromised fetus, especially one experiencing intermittent umbilical cord compression due to UCA. It is now time for the focus to be on screening for UCA, managing UCA prenatally, and delivery of the baby in distress defined by the American College of Obstetricians and Gynecologists as a heart rate of 90 beats per minute for 1 minute on a recorded nonstress test. The ability of ultrasound and magnetic resonance imaging (MRI) to visualize UCA is well documented. The 18–20 week ultrasound review should include the umbilical cord, its characteristics, and description of its placental and fetal attachment. The American Association of Ultrasound Technologists has defined these parameters for umbilical cord abnormalities: B.1.4• Abnormal insertion B.1.5• Vasa previa B.1.6• Abnormal composition B.1.7• Cysts, hematomas, and masses B.1.8• Umbilical cord thrombosis B.1.9• Coiling, collapse, knotting, and prolapse B.1.10• Umbilical cord evaluation with sonography includes the appearance, composition, location, and size of the cord Cord Events: Although many stillbirths are attributed to a cord accident, this diagnosis should be made with caution. Cord abnormalities, including a Nuchal Cord, are found in approximately 30% of normal births and may be an incidental finding. (American College of Obstetrics and Gynecology Practice Bulletin 2009) According to NICHD’s recent stillbirth study, UCA is a significant cause of mortality (10%). This finding is in agreement with other international UCA studies. (Bukowski et al. 2011) These histologic criteria identify cases of cord accident as a cause of stillbirth with very high specificity. (Dilated fetal vessels, thrombosis in fetal vessels, avascular placental villi.) (Pediatr Dev Pathol 2012) Finally, defining the morbidity (injury) of cord compression, such as fetal neurologic injury or heart injury identified with umbilical cord blood troponin T levels or pulmonary injury, is the next major area of investigation.

Author : Charles Seymour Robinson
Publisher : Unknown
Page : 328 pages
File Size : 47,8 Mb
Release : 1884
Category : Presbyterian Church
ISBN : OXFORD:590847222

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Sermons on Neglected Texts by Charles Seymour Robinson Pdf

Author : Anonim
Publisher : Unknown
Page : 614 pages
File Size : 45,8 Mb
Release : 1878
Category : Livestock
ISBN : WISC:89094210655

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National Live Stock Journal by Anonim Pdf

Author : Anonim
Publisher : Unknown
Page : 616 pages
File Size : 53,7 Mb
Release : 1878
Category : Electronic
ISBN : CHI:098415697

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The National Live-stock Journal by Anonim Pdf

Author : Stefan Kirchner
Publisher : GRIN Verlag
Page : 270 pages
File Size : 55,7 Mb
Release : 2008
Category : Administration of justice
ISBN : 9783640212590

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Wartime Rape by Stefan Kirchner Pdf

Document from the year 2008 in the subject Law - European and International Law, Intellectual Properties, Universit Paris-Sorbonne (Paris IV), 81 entries in the bibliography, language: English, abstract: About 5.4 million people have been killed in the wars in the Democratic Republic of Congo (D.R.C.), the former Zaire. 45,000 die every month and hundreds of thousands of women have been raped here in recent years. Wartime rapes are anything but new and have been employed not only to terrorize the population but also as weapon of genocide in Rwanda, Bosnia and Darfur. The Eastern Congolese provinces of North and South Kivu have been affected by particular gruesome acts of violence and thousands of victims suffer from rape-induced fistulae, ruptures of the walls which separate the victim's vagina from her rectum. According to UN staff and doctors in the region, all armed groups in the region are involved in rapes and despite the 2002 Pretoria Accord which put an official end to the war, attacks and rapes continue to this very day. Many survivors are forced out of their homes and their families abandoned and left to fend for themselves. Therefore, apart from medical treatment and psychological counseling, there is a strong demand for justice. But due to the weak position of women in Congolese society, justice is much harder to get by than medical treatment. Although the Congolese Penal Code and Military Penal Code penalize these crimes, the reaction by the Congolese government to the atrocities remains insufficient, making a solution based on Congolese criminal law unlikely. The practical application of the D.R.C.'s domestic laws is found wanting and the law does not have the deterrent effect which is required to prevent future atrocities, also due to the traditional position of women in Congolese society continues to be reflected in the law: According to Art. 448 of the D.R.C.'s family code, a married woman has to obtain her husband's permission to bring a case to c

Author : Anonim
Publisher : Unknown
Page : 526 pages
File Size : 46,6 Mb
Release : 1873
Category : Electronic
ISBN : STANFORD:36105010303894

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To-day by Anonim Pdf