Reviews the book, Children in Family Contexts: Perspectives on Treatment by Lee Combrinck-Graham (Ed.) (2006). Owners of the first edition will recognize the structure and format of the current text. ...As in the first edition, the present volume is divided into sections. It begins with child mental health fundamentals in family context and progresses to cover salient issues related to different family structures (remarried systems, e.g.), children facing specific challenges (children in alcoholic families), and the interaction between families and larger systems (school consultation, children in immigrant families). Some of these topic areas mirror the first edition, and some familiar authors sign on for updated versions of their chapters. Like all good second acts, however, maintaining the integrity, story lines, and cast of its predecessor is only half the battle. There's nothing worse than a sequel attempting to cash in on the original with nothing new to say, and Combrinck-Graham has produced a modernized sequel complete with salient topics (story lines?) relevant to today's clinician. This volume offers a range of expertise that expands our understanding of many important aspects of family-sensitive treatment. This range of voices represents the fields of psychiatry, psychology, pediatrics, and social work and professional contexts from university faculty to community agencies to independent practice. All manage to bring depth and understanding to a way of working with people that is both simple and multifaceted, intuitive and obtuse. It is a volume that has much to offer student, supervisor, and seasoned clinician. Perhaps best of all, it may at once sharpen the skills and enliven the imagination of those child clinicians who see problems, opportunities, and hope primarily through the lens of the family. And if it provokes, even a little bit, the inner artist within us, then both we and our clients (and perhaps their refrigerators, too) will be better off because of it. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
We present the light curves and spectral data of two exceptionally luminous gamma-ray outbursts observed by the Large Area Telescope experiment on board the Fermi Gamma-ray Space Telescope from 3C ...273 in 2009 September. During these flares, having a duration of a few days, the source reached its highest gamma-ray flux ever measured. This allowed us to study, in some details, their spectral and temporal structures. The rise and the decay are asymmetric on timescales of 6 hr, and the spectral index was significantly harder during the flares than during the preceding 11 months. We also found that short, very intense flares put out the same time-integrated energy as long, less intense flares like that observed in 2009 August.
We report on a detailed investigation of the {gamma}-ray emission from 18 broad-line radio galaxies (BLRGs) based on two years of Fermi Large Area Telescope data. We confirm the previously reported ...detections of 3C 120 and 3C 111 in the GeV photon energy range; a detailed look at the temporal characteristics of the observed {gamma}-ray emission reveals in addition possible flux variability in both sources. No statistically significant {gamma}-ray detection of the other BLRGs was found, however, in the considered data set. Though the sample size studied is small, what appears to differentiate 3C 111 and 3C 120 from the BLRGs not yet detected in {gamma}-rays is the particularly strong nuclear radio flux. This finding, together with the indications of the {gamma}-ray flux variability and a number of other arguments presented, indicates that the GeV emission of BLRGs is most likely dominated by the beamed radiation of relativistic jets observed at intermediate viewing angles. In this paper we also analyzed a comparison sample of high-accretion-rate Seyfert 1 galaxies, which can be considered radio-quiet counterparts of BLRGs, and found that none were detected in {gamma}-rays. A simple phenomenological hybrid model applied for the broadband emission of the discussed radio-loud and radio-quiet type 1 active galaxies suggests that the relative contribution of the nuclear jets to the accreting matter is {>=}1% on average for BLRGs, whereas it is {<=}0.1% for Seyfert 1 galaxies.
We report Fermi Large Area Telescope (LAT) observations and broadband spectral modeling of the radio-loud active galaxy 4C +55.17 (z = 0.896), formally classified as a flat-spectrum radio quasar. ...Using 19 months of all-sky survey Fermi-LAT data, we detect a {gamma}-ray continuum extending up to an observed energy of 145 GeV, and furthermore we find no evidence of {gamma}-ray variability in the source over its observed history. We illustrate the implications of these results in two different domains. First, we investigate the origin of the steady {gamma}-ray emission, where we re-examine the common classification of 4C +55.17 as a quasar-hosted blazar and consider instead its possible nature as a young radio source. We analyze and compare constraints on the source physical parameters in both blazar and young radio source scenarios by means of a detailed multiwavelength analysis and theoretical modeling of its broadband spectrum. Second, we show that the {gamma}-ray spectrum may be formally extrapolated into the very high energy (VHE, {>=}100 GeV) range at a flux level detectable by the current generation of ground-based Cherenkov telescopes. This enables us to place constraints on models of extragalactic background light within LAT energies and features the source as a promising candidate for VHE studies of the universe at an unprecedented redshift of z = 0.896.
We report on a detailed investigation of the high-energy {gamma}-ray emission from NGC 1275, a well-known radio galaxy hosted by a giant elliptical located at the center of the nearby Perseus ...cluster. With the increased photon statistics, the center of the {gamma}-ray-emitting region is now measured to be separated by only 0.46 arcmin from the nucleus of NGC 1275, well within the 95% confidence error circle with radius {approx_equal}1.5 arcmin. Early Fermi Large Area Telescope (LAT) observations revealed a significant decade-timescale brightening of NGC 1275 at GeV photon energies, with a flux about 7 times higher than the one implied by the upper limit from previous EGRET observations. With the accumulation of one year of Fermi-LAT all-sky-survey exposure, we now detect flux and spectral variations of this source on month timescales, as reported in this paper. The average >100 MeV {gamma}-ray spectrum of NGC 1275 shows a possible deviation from a simple power-law shape, indicating a spectral cutoff around an observed photon energy of {epsilon}{sub {gamma}} = 42.2 {+-} 19.6 GeV, with an average flux of F{sub {gamma}} = (2.31 {+-} 0.13) x 10{sup -7} photons cm{sup -2} s{sup -1} and a power-law photon index, {Gamma}{sub {gamma}} = 2.13 {+-} 0.02. The largest {gamma}-ray flaring event was observed in 2009 April-May and was accompanied by significant spectral variability above {epsilon}{sub {gamma} {approx}}> 1-2 GeV. The {gamma}-ray activity of NGC 1275 during this flare can be described by a hysteresis behavior in the flux versus photon index plane. The highest energy photon associated with the {gamma}-ray source was detected at the very end of the observation, with the observed energy of {epsilon}{sub {gamma}} = 67.4 GeV and an angular separation of about 2.4 arcmin from the nucleus. In this paper we present the details of the Fermi-LAT data analysis, and briefly discuss the implications of the observed {gamma}-ray spectral evolution of NGC 1275 in the context of {gamma}-ray blazar sources in general.
We report on a detailed investigation of the {gamma}-ray emission from 18 broad line radio galaxies (BLRGs) based on two years of Fermi Large Area Telescope (LAT) data. We confirm the previously ...reported detections of 3C 120 and 3C 111 in the GeV photon energy range; a detailed look at the temporal characteristics of the observed {gamma}-ray emission reveals in addition possible flux variability in both sources. No statistically significant {gamma}-ray detection of the other BLRGs was however found in the considered dataset. Though the sample size studied is small, what appears to differentiate 3C 111 and 3C 120 from the BLRGs not yet detected in {gamma}-rays is the particularly strong nuclear radio flux. This finding, together with the indications of the {gamma}-ray flux variability and a number of other arguments presented, indicate that the GeV emission of BLRGs is most likely dominated by the beamed radiation of relativistic jets observed at intermediate viewing angles. In this paper we also analyzed a comparison sample of high accretion-rate Seyfert 1 galaxies, which can be considered radio-quiet counterparts of BLRGs, and found none were detected in {gamma}-rays. A simple phenomenological hybrid model applied for the broad-band emission of the discussed radio-loud and radio-quiet type 1 active galaxies suggests that the relative contribution of the nuclear jets to the accreting matter is {ge} 1% on average for BLRGs, while {le} 0.1% for Seyfert 1 galaxies.
Background Radiofrequency ablation of intramural ventricular substrate is often limited by insufficient tissue penetration despite high energy settings. As lesion dimensions have a direct and ...negative relationship to impedance, reducing the baseline impedance may increase the ablation effect on deep ventricular tissue. Methods This study included 16 patients with ventricular tachycardia or frequent ventricular premature complexes refractory to ablation with irrigated catheters. After a failed response to radiofrequency ablation, impedance was modulated by adding or repositioning return patches in an attempt to decrease the circuit impedance. Ablation was repeated at a similar location and power settings, and the effect on arrhythmia suppression and adverse effects were evaluated. Results Six patients with idiopathic ventricular premature complexes originating from the left ventricular summit (n=4) or papillary muscles (n=2), 6 patients with noninfarct related ventricular tachycardia and 4 patients with infarct-related ventricular tachycardia had unsuccessful response to radiofrequency ablation at critical sites (number of applications: 10.4±3.1, power: 42.3±2.9 W, duration: 55.3±25.5 seconds, impedance reduction: 14.6±3.5 Ω, low-ionic solution was used in 81.25%). Modulating the return patches resulted in reduced baseline impedance (111.7±8.2 versus 134.7±6.6 Ω, P<0.0001), increased current output (0.6±0.02 versus 0.56±0.02 Amp; P<0.0001) and greater impedance drop (16.8±3.0 Ω, P<0.001). Repeat ablation at similar locations had a successful effect in 12 out of 16 (75.0%) patients. During a follow-up duration of 13±5 months, 10 out of 12 (83.3%) patients remained free of arrhythmia recurrence. The frequency of steam pops was similar between the higher and lower baseline impedance settings (7.1 versus 8.2%; P=0.74). Conclusions In patients with deep ventricular substrate, reducing the baseline impedance is a simple, safe, and effective technique for increasing the effect of radiofrequency ablation. However, its combination with low-ionic solutions may increase the risk for steam pops and neurological events.
PDF
