Minimum intervention

Finally, the minimum intervention concept is the most important. This is because, as discussed above, any action taken on an object is irreversible, as time is irreversible. Any treatment applied changes the object and will interfere or preclude other analyses that one might want to do in the future. This is particularly important given the fast development of more sophisticated analytical techniques that can provide data that had not even been envisaged only 50 years ago. 

In accordance with the general conservation principle of minimum intervention, the main objective is to conserve the glass, and not to recover transparency, through removal of corrosion products and deposits. Only in exceptional circumstances, therefore, may weathering layers be removed to increase the transparency of the glass or to support its interpretation. In any case, damage to the hydrated layer must be avoided this layer is considered to be the skin of the glass, which protects it from further attack. 

If consolidation is necessary, all efforts should be taken to minimize the adulteration of intrinsic material. Treatment should be directly related to the artifact s mechanical or physical ability to withstand the anticipated environment or function. Careful analysis supports minimum intervention so that the least amount of intrinsic fabric is altered. 

The applied methodology for repair and strengthening that is in compliance with the principle of minimum interventions - maximum protection increases the... 

The aim of monitoring and surveillance programs is to prolong access patency and function using minimum intervention. 

Other kind of preoccupations presented in the previous paragraphs had lead to the notion of reversibility of interventions in the sense that it could be possible to go back to pre-intervention stage. Perfect reversibility is hard or even unattainable (some interventions such as cleaning being intrinsically irreversibly) and other terms such as Removability and Retreatability have been proposed (Appelbaum 1987 Munoz-Vifias 2005). Munoz-Vifias (2005) links the difficulties of reversing treatments to the notion of minimum intervention . 

Adequate asset condition beyond minimum intervention levels to prevent unplanned closure. 

As referred to above, most of the modules involve the intervention of a third party, the so-called notified bodies. These bodies are designated by Member States as being competent to carry out the certification tasks for which they are notified. As a precondition for their notification they must fulfil the minimum criteria which are set out in the relevant directives. These conditions vary from independence, impartiality and professional integrity, to technical competence, possession of or access to necessary facilities and to liability insurance. Once notified, the Commission publishes a list of all notified bodies in the Official Journal, It is worth noting that there is free competition between notified bodies and that manufacturers can make their own choice from all notified bodies notified within the European Union. 

Protection is the branch of electric power engineering concerned with the principles of design and operation of equipment (called relays nr protective relays ) which detect abnormal power system conditions and initiate corrective action as quickly as possible in order to return the power system to its normal state. The quickness of response is an essential element of protective relaying systems—response times of the order of a few milliseconds are often required. Consequently, human intervention in the protection of system operation is not possible. The response must be automatic, quick, and should cause a minimum amount of disruption to the power system. 

Economic studies should consider the costs of all the resources and services used in the process of care. In addition, the outcomes that are a consequence of the health or social care interventions evaluated need to be included. For dementia, these include the costs of hospital inpatient and out-patient care, primary and community-based health-care services, social welfare services, and care provided by voluntary agencies or by femily and friends. Ideally, a broad perspective reflecting the costs and outcomes to society should be adopted. As a minimum, the perspective of the analysis should include the costs and outcomes to key health and social care providers or funders and to patients and their families. 

To be useful to those concerned with choices in the allocation of health and social care resources, the data for economic evaluations need to be timely, relevant, credible and accurate (Davies, 1998). As a minimum, the costs associated with the interventions should be estimated from activity data, which quantify resources used, and price or unit cost data. Often evidence from well-controlled prospective trials with high internal validity is required to establish whether differences in economic end points are directly attributable to the interventions. However, the economic evaluations of acetylcholinesterase inhibitors estimated costs from retrospective analysis of available datasets Qonsson et al, 1999b), analysis of published literature (e.g. Stewart et al, 1998) and expert opinion (e.g. O Brien et al, 1999 Neumann et al, 1999). This means that it is not clear whether differences in costs were due to the anticholinesterase inhibitors or to other factors such as availability of services in different areas, the living situation of the patient, or disease severity. 

Surgical intervention has become an integral therapy in combination with pharmacologic management of IE. Valve replacement is the predominant intervention, and it is used in a minimum of 25% for all cases of IE.1 Surgery may be indicated if the patient has unresolved infection, ineffective antimicrobial therapy (often associated with fungal IE), more... 

Human toxicity data are limited to secondary citations. Because these citations provided no experimental details, they cannot be considered reliable. Deaths have occurred from aniline ingestion and skin absorption, but doses were unknown. Reviews of the older literature indicate that a concentration of 5 ppm was considered safe for daily exposures, concentrations of 7 to 53 ppm produced slight symptoms after several hours, a concentration of 40 to 53 ppm was tolerated for 6 h without distinct symptoms, a concentration of 130 ppm may be tolerated for 0.5 to 1 h without immediate or late sequalae, and 100 to 160 ppm was the maximum concentration that could be inhaled for 1 h without serious disturbance. In studies of accidents with unknown exposure concentrations, methemoglobin levels of up to 72% were measured. Recoveries occurred with a minimum of medical intervention following cessation of exposure. 

The system is used for the isolation of multimilligrams to grams of impurities, intermediates, and reference materials. A high degree of automation enables operation with minimum operator intervention and recoveries of >80% with... 

Adjunct to percutaneous coronary intervention (PCI) IVBolus, IVInfusion 180mcg/kg before PCI initiation then continuous drip of 2 mcg/kg/min and a second 180 mcg/kg bolus 10 min after the first. Maximum 15 mg/h. Continue until hospital discharge or for up to 18-24 hr. Minimum 12 hr is recommended. Concurrent aspirin and heparin therapy is recommended. 

An adequate trial of antidepressant medication is defined as treatment with therapeutic doses of a drug for a total of 4 weeks. After 4 weeks of antidepressant treatment, patients can be divided into three groups those who have achieved a full response, those who have achieved a partial response, and those who have not responded. In the case of patients who achieve full remission, treatment should continue for a minimum of 4-6 months, or longer if the patient has a history of recurrent depression (see Maintenance Treatment of Major Depression later in this chapter). If a partial response has been achieved by 4 weeks, a full response may be evident within an additional 2 weeks without further intervention. If the symptoms do not respond at all, the dose should be increased, a different antidepressant should be used, or the therapy should be augmented with another medication (see Treatment-Resistant Depression later in this chapter). 

An additional problem with the DSM-IV criteria is the short duration. In earlier nosologies (e.g., Washington University criteria), a minimum of 4 weeks was required. In double-blind, placebo-controlled trials, a duration of less than 3 months is often associated with a higher placebo response rate. Thus, the longer an episode, the greater the clinician s confidence that a patient will need and will respond to medical intervention. 

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