Effects of Maternal Age and Age-Specific Preterm Birth Rates on Overall Preterm Birth Rates — United States, 2007 and 2014

    Reductions in births to teens and preterm birth rates are two recent public health successes in the United States (1,2). From 2007 to 2014, the birth rate for females aged 15–19 years declined 42%, from 41.5 to 24.2 per 1,000 females. The preterm birth rate decreased 8.4%, from 10.41% to 9.54% of live births (1). Rates of preterm births vary by maternal age, being higher among the youngest and oldest mothers. It is unknown how changes in the maternal age distribution in the United States have affected preterm birth rates. CDC used birth data to assess the relative contributions of changes in the maternal age distribution and in age-specific preterm birth rates to the overall decrease in preterm birth rates. The preterm birth rate declined in all age groups. The effects of age distribution changes on the preterm birth rate decrease were different in younger and older mothers. The decrease in the proportion of births to mothers aged ≤19 and 20−24 years and reductions in age-specific preterm rates in all age groups contributed to the overall decline in the preterm birth rate. The increase in births to mothers aged ≥30 years had no effect on the overall preterm birth rate decrease. The decline in preterm births from 2007 to 2014 is related, in part, to teen pregnancy prevention and the changing maternal age distribution. Effective public health strategies for further reducing preterm birth rates need to be tailored to different age groups.

     National Vital Statistics System data for all live births to U.S. residents in 2007 and 2014 were analyzed for the effects of maternal age on the decline in preterm birth rates. The analysis was limited to births with gestational age ≥20 weeks, as determined by the obstetric estimate. The year 2007 was the first year the obstetric estimate was available nationally (1,3). The year 2014 was the most recent year with final birth data available at the time of analysis. Preterm birth rates were defined as <37 completed weeks of gestation and expressed as a percentage of live births. Maternal age was categorized as ≤19, 20−24, 25−29, 30−34, and ≥35 years. Using rate decomposition methods, the change in preterm birth rates from 2007 to 2014 was divided into two components: 1) changes in the maternal age distribution, and 2) changes in the age-specific preterm birth rates (4). The two components were calculated relative to each other; one was held constant (by using the average value for the 2 years) as the observed variation in the other component was assessed. The sum of the two components across the age groups equaled the total preterm birth rate difference (4).

From 2007 to 2014, maternal age increased from a mean of 27.4 years to 28.3 years (Figure). A decrease in the percentage of births to mothers aged ≤24 years was observed, which included a 39.5% decrease in births to teens and an increase in births to women aged ≥25 years (Table).

From 2007 to 2014, the preterm birth rate decreased from 10.41% to 9.54%, an absolute rate difference of -0.87% (Table). A U-shaped relationship between maternal age and preterm birth was present in both years with the lowest preterm birth rate occurring among women aged 25−29 years (Table) (Figure). The decrease in preterm birth rates from 2007 to 2014 was observed for mothers at all ages <42 years. The absolute rate difference was highest among teens and lowest among women aged ≥35 years (Table).

   The decomposition analysis partitioned the overall observed rate difference of -0.87% into two parts, age distribution and age-specific rate components (Table). The change in age distribution contributed to the preterm birth rate decrease (as indicated by the negative values) only among mothers aged ≤24 years. In contrast, the age distribution component for mothers aged ≥25 years, and especially for mothers aged ≥30 years, offset this decline. When the age distribution components were summed across the age groups, a negligible effect (0.01) was observed on the overall change in preterm birth rates. The change in age-specific preterm birth rates contributed to the decline in preterm birth rate across all age groups.

    Examining the total effect of both components on the preterm birth rate decline by age group, the largest total effects were observed among mothers aged ≤19 and mothers aged 20−24 years (Table). In these two groups, the change in age distribution had a larger effect than the change in the age-specific preterm birth rate. For mothers aged 25−29 years, the total effect also contributed to the overall preterm birth rate decline because the age-specific rate component was greater than the age distribution component. For mothers aged ≥30 years, the total effect of both components did not contribute to the overall preterm birth rate decrease; the rate increases from the age distribution components were greater than the rate decreases from the age-specific rate components.

These analyses included all births; however, sensitivity analyses restricting to singleton births produced similar results. The overall absolute rate difference for singletons during this period was -0.85%, compared with the -0.87% for all births.

Discussion

     The overall decline in the preterm birth rate from 2007 to 2014 was related to declines in age-specific preterm birth rates and a decrease in prevalence of births to teens and women aged 20−24 years. The contribution from mothers aged ≥24 years to the age-distribution component was offset by an increased prevalence of births to older mothers who have high rates of preterm birth. Thus, the total age distribution component masked divergent influences of younger and older mothers on the overall preterm birth rate decline. Because of this, the influence of younger mothers on the overall preterm birth rate decline is more appropriately indicated by examining the age-specific total effects in the decomposition analysis. Considering relative effects of both age distribution and age-specific preterm birth rate components, only mothers aged ≤29 years contributed to the overall rate decline, with the largest contributions from teens and women aged 20−24 years.

   Other studies have documented increased preterm birth rates among teen and older mothers compared with mothers in their mid-twenties to early thirties. Although teen and older mothers might share some common preterm birth risk factors, such as low socioeconomic status, extremes of body mass index, and smoking, physiologic immaturity is a risk factor for teen mothers and the prevalence of preexisting chronic disease is greater among older mothers. This heterogeneity of risk for preterm births according to maternal age and the variation in changes in age-specific preterm birth rates, combined with the changes in maternal age distribution over time, suggest the need for varying preterm birth prevention strategies across the reproductive life span.

The findings in this report are subject to at least one limitation: the relationship of preterm birth with maternal age is associative, not causal. The analysis did not assess the impact of other pregnancy outcomes, such as elective termination or fetal death, or of potential confounders, such as maternal race/ethnicity, obstetric history, smoking, socioeconomic status, body mass index, chronic or pregnancy-related conditions, prenatal care, and delivery method. The effects on preterm birth rates of maternal 17-hydroxyprogesterone use, a preterm birth prevention strategy that increased during this period , were not examined and the effects of maternal age on spontaneous, medically indicated, early, or late preterm births were not assessed.

The overall decline in the preterm birth rate from 2007 to 2014 is related in part to the changing maternal age distribution associated with the success of teen pregnancy prevention and declines in unintended pregnancy. Teen pregnancy prevention is one of CDC’s Winnable Battles . Although teen pregnancy prevention and family planning have many positive health and societal effects, the results of this analysis suggest these programs might also have direct effects on reducing preterm birth rates. Based on recent data, 75% of pregnancies to teens aged 15−19 years and 59% of pregnancies to women aged 20−24 years are unintended . The need for prevention of first and repeat teen pregnancies continues. Prevention of unintended pregnancy and encouragement of optimal birth spacing is one part of a five-part strategy for preterm birth prevention. Other strategies include improved access to preconception care, preterm birth risk identification and treatment, reduction of elective delivery before 39 weeks gestation, and single embryo transfer in assisted reproductive technology. These strategies need to be implemented throughout the reproductive life span to reduce preterm births for all maternal ages.

 FIGURE. Percentages of live births (LBs) and preterm births (PTBs), by maternal age —United States, 2007 and 2014

                         

November is National Prematurity Awareness Month

In 2016, about 1 in 10 babies was born too early in the United States. Learn about the problem, risk factors, and what we can do to reduce premature birth.

About Premature Birth

A developing baby goes through important growth throughout pregnancy—including in the final months and weeks. Premature (also known as preterm) birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. The earlier a baby is born, the higher the risk of death or serious disability. In 2015, preterm birth and low birth weight accounted for about 17% of infant deaths. Babies who survive can have breathing issues, intestinal (digestive) problems, and bleeding in their brains. Long-term problems may include developmental delay (not meeting the developmental milestones for his or her age) and lower performance in school.

Preterm Birth in the United States

Reducing preterm birth is a national public health priority. Preterm birth rates decreased from 2007 to 2014, and CDC research shows the decline in preterm births is partly due to fewer teens and young women giving birth. Despite this success, the preterm birth rate rose for the second straight year in 2016, and about 1 in 10 babies (10%) was born too early in the United States. Additionally, racial and ethnic differences in preterm birth rates remain. For example, in 2016, the rate of preterm birth among non-Hispanic black women (14%) was about 50% higher than the rate of preterm birth among non-Hispanic white women (9%).

Risk Factors

Experts don’t know all the reasons that some babies are born too early. Some things (called risk factors) can increase the chance that a woman will have a preterm birth. However, a woman can still have a premature birth even if she has no known risk factors.
Risk factors for preterm birth include—

• Social characteristics
  • Black race
  • Teens and women over age 35
  • Low socioeconomic position

• Health behaviors
  • Tobacco use
  • Alcohol or drug abuse
• Medical and pregnancy characteristics
  • Mental health (stress, depression)
  • Pregnancy history (short time between pregnancies, delivering a baby preterm in the past, being pregnant with multiples)
  • Pregnancy complications (preeclampsia, placenta previa or placental abruption)
  • Medical disorders (thyroid disease, obesity, asthma, diabetes, high blood pressure)
  • Fertility treatments (assisted reproductive technology or other treatments)
  • Infection within the uterus

Novel Drug Delivery Systems Yie Chien

                     
                 

A comprehensive treatment of the science, technology, and regulation of rate-controlled administration

 of therapeutic agents, with coverage of the basic concepts, fundamental principles, biomedical 

rationales, and potential applications. This revised and updated edition (first in 1982) incorporates

                                              

       

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Schwartz's Principles of Surgery

THE WORLD'S #1 SURGERY TEXT--UPDATED TO INCLUDE STATE-OF-THE-ART EVIDENCE-BASED SURGICAL CARE AND LEADERSHIP GUIDANCE FOR TRAINEES AND PRACTICING SURGEONS

A Doody's Core Title for 2015!

The Tenth Edition of Schwartz's Principles of Surgery maintains the book's unmatched coverageof the foundations of surgery while bringing into sharper focus new and emerging technologies. We have entered a new era of surgery in which minimally invasive surgery, robotic surgery, and the use of computers and genomic information have improved the outcomes and quality of life for patients. With these advances in mind, all chapters have been updated with an emphasis on evidence-based, state-of-the-art surgical care. An exciting new chapter, "Fundamental Principles of Leadership Training in Surgery," expands the scope of the book beyond the operating room to encompass the actual development of surgeons. This edition is also enriched by an increased number of international chapter authors and a new chapter on Global Surgery. More than ever, Schwartz's Principles of Surgery is international in scope--a compendium of the knowledge and technique of the world's leading surgeons.

Features

• More clinically relevant than ever, with emphasis on high-yield discussion of diagnosis and treatment of surgical disease, arranged by organ system and surgical specialty
• Content is supported by boxed key points, detailed anatomical figures, diagnostic and management algorithms, and key references
• Beautiful full-color design
• New companion DVD includes eight high-quality, narrated videos:
• Laparoscopic Inguinal Hernia Repair
• Kidney Transplant
• Laparoscopic Cholecystectomy
• Thyroidectomy
• Right Colectomy
• Sigmoid Colectomy
• Laparoscopic Incisional Hernia Repair
• Open Posterior Component Separation

                            

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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 18th Edition

This distinguished reference carries on a 70-year legacy as the world's most thorough, useful, readable, and understandable text on the principles and techniques of surgery. Its peerless contributors deliver all the well-rounded, state-of-the-art knowledge you need to richly grasp the pathophysiology and optimal management of every surgical condition―so you can make the best clinical decisions, avoid complications, manage unusual situations, and achieve the best possible outcomes. It is a valuable review tool for certification/recertification preparation, and an indispensable source of guidance on overcoming the challenges that arise in everyday practice. As an Expert Consult title, the thoroughly updated 18th edition comes with access to the complete contents online, fully searchable―enabling you to consult it rapidly from any computer with an Internet connection. In addition, this Premium Edition includes timely clinical updates online, plus links to MEDLINE, downloadable illustrations, bonus journal articles, review questions, and much more.

• Offers a more distinguished team of contributors and a better blend of clinical and basic-science information than any other source, providing you with the best possible understanding of the clinical issues surrounding every operative situation.
• Features a more user-friendly format, a larger and more helpful array of full-color illustrations, and a more versatile and well-constructed web site than other resources―making the answers that you need easier to locate and understand quickly.
• Offers an organization and content that parallels the written board American Board of Surgery exam, providing excellent preparation for certification and recertification.

• Includes access to the complete contents online, fully searchable, PLUS timely updates to reflect new scientific and clinical developments · references linked to MEDLINE · downloadable illustrations · bonus articles from important surgery periodicals (such as Surgical Clinics of North America, the American Journal of Surgery, Operative Techniques in General Surgery, and Seminars in Colon and Rectal Surgery) · review questions · and other valuable features.
• Incorporates an enhanced emphasis on surgical outcomes to mirror the growing importance of this topic.
• Delivers comprehensive updates to keep you current with the latest research, techniques, and emerging procedures in the field, as well as completely new chapters on "Surgical Patient Safety" and "Regenerative Medicine."

                                 

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Oxford Textbook of Surgery

The Oxford Textbook of Surgery, 2nd Edition provides a comprehensive reference on all aspects of 

general surgery, and includes substantial sections on the subspecialties such as orthopedics, pediatric

 surgery, neurosurgery, and cardiac surgery. It has been designed for specialist and trainee surgeons 

working in any part of the world. The uniques, full-color design of the Textbook has been enhanced for 

this edition. There are major new sections on, for example, molecular biology and evidence-based 

surgery. Other key sections, written by world authorities, include those on endoscopic surgery, surgical 

nutrition, response to injury, the design and interpretation of clinical trials, causes of cancer, vascular 

surgery and the selection of surgical trainees. Almost every other section has been rewritten by a new 

contributor or heavily revised to reflect new developments and emphases in the field. Like 

other Oxford Textbooks there is an emphasis on the 'humane' approach with chapters on counseling 

bereaved relatives, pain relief and the care of the dying. An international faculty combine to make this 

a unique contribution to the field.

                            

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Mastery of Surgery: 5th (Fifth) Edition

                                      



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Key Notes on Plastic Surgery

This is the new edition of the concise but comprehensive handbook that should be owned by all surgical trainees specialising in plastic surgery. Taking a pithy systematic approach, Key Notes on Plastic Surgery offers the latest developments within the field in bullet point form and includes key papers for viva voces. It is informed by the current FRCS (Plast) curriculum, making it ideal preparation for the UK exit examination or equivalent international board exam.

Key features

• Fully covers the entire scope of plastic surgery
• Clearly divided into 10 sections with logical subheadings for easy fact-finding
• Acts as an adjunct to the established longer texts
• Brand new chapter on ethics and the law – a compulsory component of the oral examination
• Illustrations outlining key surgical procedures and relevant anatomy

Fully revised to include all the latest clinical guidelines, Key Notes on Plastic Surgery is the perfect rapid reference tool for trainees in plastic surgery and dermatologic surgery who require quick, accurate answers

                                     

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Grabb and Smith's Plastic Surgery (GRABB'S PLASTIC SURGERY)

Thoroughly revised for its Sixth Edition, Grabb and Smith's Plastic Surgery is the only comprehensive single-volume reference on the full range of aesthetic and reconstructive procedures in plastic surgery. Featuring more than 1,900 photographs and line drawings, this world-renowned reference guides you through virtually every aesthetic and reconstructive surgical challenge, including implants; craniosynostosis syndromes; rhinoplasty; soft tissue and skeletal injuries; tendon transfer; wound care; and more.

This edition features the latest clinical recommendations and procedures, including breast prosthetics, tissue expansion, flexor tendon surgery, reconstruction of the auricle and otoplasty, correction of ptosis and canthoplasty, face lifts, and more.

A bonus DVD-ROM with full text and color images from the book gives you fast, convenient access to surgical procedures and guides you through new, recommended endoscopic techniques, laser procedures, and microsurgery options.

                             

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Essential Practice of Surgery: Basic Science and Clinical Evidence

Current Essentials of Surgery

Essential coverage of surgery!

 In the popular one-disorder-per-page format, this pocket guide features bulleted, high-yield information on over 400 common surgical diagnoses. With key equations and formulae, a clinical pearl per page, plus references, this book truly is essential in critical care

                                       

                                         

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The Protein Protocols Handbook (Methods in Molecular Biology)

This greatly enhanced second edition introduces 60 critically important new chapters dealing with topics and techniques that have emerged since the first edition, as well as significantly updating the remaining articles. The new chapters cover many rapidly developing areas, particularly the application of mass spectrometry in protein characterization, as well as the now well-established 2-D PAGE technique in proteomics. The section on glycoprotein analysis has also been significantly expanded, and methods for the production of single-chain and phage-displayed antibodies have been added to the section on antibodies. Each readily reproducible method follows the highly praised format of the Methods in Molecular Biology™ series, offering a concise summary of its basic theory, a complete materials list, a step-by-step protocol for its successful execution, and extensive notes on avoiding pitfalls and on modifying the method to function within your own experimental circumstances.

                                

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Drug Targeting Organ-Specific Strategies Hardcover – January 15, 2001 by Grietje Molema (

How are medicines transported intact through the body to their specific target sites without triggering side effects? The answer is "Drug Targeting".

This thoroughly application-oriented book gives comprehensive answers to this and many other questions that confront scientists daily in chemical, pharmaceutical and medical research. A concise overview of the most important basic theories, modern forms of therapy and molecular biological tools, it represents a comprehensible introduction to the topic. The book then goes on to deal with strategies for target applications, divided according to target site, for example brain, lungs, liver, blood vessels and tumor cells. The third part is devoted to special, modern techniques, from phage display methods, via the use of tissue slices right up to pharmacokinetic modeling. Throughout, the focus remains on the practical aspect and successful application of the method in question, although a glance at what the future holds is also included. A volume that every pharmaceutically oriented research group should own

                                      

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Drug Delivery Systems (Methods in Molecular Biology)

In this concise and systematic book, a team of experts select the most important, cutting-edge technologies used in drug delivery systems. They take into account significant drugs, new technologies such as nanoparticles, and therapeutic applications. The chapters present step-by-step laboratory protocols following the highly successful Methods in Molecular Biology™ series format, offering readily reproducible results vital for pharmaceutical physicians and scientists.

                                                    

                                               

     

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Drug Delivery: Principles and Applications

An indispensable tool for those working at the front lines of new drug development
Written for busy professionals at the forefront of new drug development, Drug Delivery gets readers quickly up to speed on both the principles and latest applications in the increasingly important field of drug delivery.
Recent developments in such areas as combinatorial chemistry, proteomics, and genomics have revolutionized researchers' ability to rapidly identify and synthesize new pharmacological compounds. However, delivery-related properties remain a significant reason for clinical trial failures.
Bringing together contributions by leading international experts, Drug Delivery covers the entire field in a systematic but concise way. It begins with an in-depth review of key fundamentals, such as physiochemical and biological barriers; drug delivery pathways; metabolism; drug formulation; pharmacokinetic and pharmacodynamic issues; and more. The remainder of the book is devoted to the systematic examination-including overviews, timely examples, and extensive references-of a host of specific subjects, including:
* Receptor-mediated drug delivery
* Prodrug delivery approaches
* Oral protein and peptide drug delivery
* Gene therapy and gene delivery
* Ultrasound-mediated drug delivery
* Polycationic peptides and proteins in drug delivery
* Pulmonary drug delivery
* Antibody-directed drug delivery
* Efflux transporters in drug excretion
* Intellectual property issues in drug delivery


                                


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Drug Transporters: Molecular Characterization and Role in Drug Disposition (Wiley Series in Drug Discovery and Development)

This new edition overviews drug transporters and presents the principles of drug transport and associated techniques, featuring new chapters on multidrug and toxin extrusion proteins, placental transport,  in silico approaches in drug discovery, and regulatory guidance for drug transport studies in drug development.

• Describes drug transporter families, mechanisms, and clinical implications along with experimental methods for studying and characterizing drug transporters
• Includes new chapters on multidrug and toxin extrusion proteins, placental transport and in silico approaches in drug discovery
• Has a new chapter covering regulatory guidance for the evaluation of drug transport in drug development with global criteria used for drug transporters in clinical trials
• Arranges material to go from fundamental mechanisms to clinical outcomes, making the book useful for novice and expert readers

                                                      

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Drug Delivery and Targeting: For Pharmacists and Pharmaceutical Scientists

                   

The advances in biotechnology and molecular biology over recent years have resulted in a large number of novel molecules with the potential to revolutionize the treatment and prevention of disease. However, such potential is severely compromised by significant obstacles to delivery of these drugs in vivo. These obstacles are often so great that effective drug delivery and targeting is now recognized as the key to effective development of many therapeutics. Advanced drug delivery and targeting can offer significant advantages to conventional drugs, such as increased efficiency, convenience, and the potential for line extensions and market expansion. An accessible and easy-to-read textbook, Drug Delivery and Targeting for Pharmacists and Pharmaceutical Scientists is the first book to provide a comprehensive introduction to the principles of advanced drug delivery and targeting, their current applications and potential future developments, including:

*Methods to optimize therapeutic efficacy, and the related commercial implications

*Difficulties with drug absorption, unwanted distribution and premature inactivation / elimination

*Attempts to minimize toxicity or alter immunogenicity

*Methods to achieve rate-controlled drug release and effective drug targeting

*Novel and established routes of delivery 

*Use of new generation technologies such as biosensors, microchips, stimuli-sensitive hydrogels and plasmid-based gene therapy

This volume is indispensable for pharmaceutical students, scientists and researchers.

                            

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Design of Controlled Release Drug Delivery Systems McGraw-Hill

This is a rigorous exploration of the state of the art in controlled release drug delivery. Written by an International team of experts, this comprehensive text offers pharmaceutical scientists and engineers working in the field, state-of-the-art design principles for the development and bioengineering of drug delivery systems/technology. Readers will find drug delivery systems presented with a particular emphasis on the design principles and their physiological/pathological basis.For each specific design principle, the contributors briefly introduce the relevant pharmacokinetics (where necessary) and include the challenges of different biological barriers that need to be overcome. This in-depth text features detailed coverage of: physiological and biochemical barriers to drug delivery; pharmacokinetics and pharmacodynamics of drug delivery; diffusion and dissolution strategies; rodrugs Bioadhesive and gastric retentive systems; physiological and biochemical barriers to drug delivery; targeted drug delivery; device controlled and programmable drug delivery; and, more.A comprehensive reference on the biochemical, physical, and technical aspects of drug delivery systems, this title includes:; Pharmacokinetics and Pharmacodynamics - Applications in the Design of Controlled Release Drug Delivery Systems; Barriers to Drug Delivery: Physiological and Biochemical Aspects; Prodrugs as Delivery Systems; Diffusion Controlled Systems; Dissolution Controlled Systems; Osmotic Controlled Systems; Biodegradable Polymeric Delivery Systems; Gastric Retention Retentive Dosage Forms; Device Controlled Delivery of Powders; Physical Targeting of Approaches for Drug Delivery; Ligand Based Drug Targeting Approaches for Drug Delivery; Programmable Drug Delivery Systems; and, Carrier and Vector Mediated Delivery Systems for Biological Macromolecules.

                                               

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Ross and Wilson Anatomy & Physiology in Health and Illness 12th Edition | PDF | 2014

This title is unique among textbooks in its appeal to a wide range of healthcare professionals including nurses, nursing students, students in the allied health professions and complementary / alternative medicine, paramedics and ambulance technicians. Each chapter provides an explanation of the normal structure and functions of the human body and the effects of disease or illness on normal physiology. The text is written in straightforward language and is complemented by over 400 extensive clear, colour illustrations.

"The chapter on the nervous system, has excellent informative diagrams where even the plexus appear understandable even to a novice. This is the book's strength and as a reference tool for patients would be helpful. " Date: July 2014

                               

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•  Carefully refined, clear and unambiguous text which omits the unnecessary detail that can confuse the student new to the subject
• Highly illustrated with clear colour diagrams and photographs
• Regular sequences of headings, lists and bullet points help with learning and revision
• Learning outcomes related to the sections within each chapter
• Common prefixes, suffixes and roots commonly used in anatomy and physiology
• Appendix containing useful biological values for easy reference
• Access to additional electronic resources, including high-quality animations, colouring exercises, case studies, self-testing questions, an audio pronunciation guide and weblinks
• An accompanying Colouring and workbook that facilitates structured learning and revision of the material in this book.

text fully revised and updated with developments in the field

colour photographs

glossary

new and revised illustrations

significantly enhanced electronic ancillaries featuring a fully searchable, customisable electronic version of the text, new animations, an electronic colouring in /labelling feature, case studies, over 300 self-assessment exercises such as MCQs, crosswords, drag and drop, ‘hangman’ etc with answers

extra electronic resources for lecturers including the full image bank

ABC of Anxiety and Depression

                   
ABC of Anxiety and Depression is a practical guide to the assessment, treatment and management of patients with anxiety and depression as they commonly present in primary care.

It begins with an introduction to views on the understanding of anxiety and depression. The following chapters cover how anxiety and depression present in different patient groups such as children and young people, adults, older people and during antenatal/postnatal periods. It then addresses anxiety and depression as comorbidities with chronic illness, and within special populations and settings.

The options for treatment and management of anxiety and depression are considered with guidance on when referral to secondary care may be appropriate and the current best practice in psychological therapies, drug treatment and social interventions. Cases are used to illustrate the complexities of managing patients with anxiety and depression.

The title concludes with an important chapter on practitioner well-being.

ABC of Anxiety and Depression is a practical resource all general practitioners and family physicians working with patients with anxiety and depressive disorders. It is also relevant for primary health care professionals who are part of clinical teams treating patients with anxiety and depression, and conditions where anxiety and depression are common comorbidities, as well as psychologists, counsellors, social workers, and medical and nursing students.



                                          

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The Dictionary of Virology, 4th Edition

Rapidly expanding technologies in the field of virology, identification of novel viral agents, and the 2005 report (8th edition) of the International Congress of Taxonomy of Viruses (ICTV) addressing reclassification of several viruses generated the 20% new material in Mahy’s 4th edition of The Dictionary of Virology. The previous edition of this book was published in 2001; the 2009 edition includes recent advancements, such as newly described viruses (e.g., severe acute respiratory syndrome (SARS) human coronavirus, human metapneumoviruses, bocaviruses, and Rabensburg virus), reclassification schemes of viruses (for instance, the unassigned Anellovirus genus), and descriptions of new technologies (e.g., microarray analyses and microRNAs) that have profoundly affected the field of virology. This comprehensive desk reference provides concise definitions of virologic terms; enables quick fact checking; and provides useful, often difficult to find, information—such as the origin of virus names, determination of ICTV-approved virus abbreviations, and locations and sources of viral isolations. An appendix of current ICTV-recognized virus families, subfamilies, genera, and type species is especially useful.

However, this reference is limited to viruses infecting vertebrate hosts; thus, it excludes viruses of plants, bacteria, fungi, invertebrates (except for arboviruses that have dual replication cycles within invertebrates and vertebrate hosts) or viruses (the newly described virophages of mimiviruses). The increasing quantity of information about viruses of vertebrates ranging from fish to primates presented the author with considerable space difficulties. He compensated for this situation, however, by citing literature sources at the end of entries for readers seeking more information. Additionally, considerable cross-referencing enhances the utility of the book. On the basis of inclusion of new information in the field and my personal experience with previous editions of The Dictionary of Virology, I highly recommend this volume to students, virologists, microbiologists, and public health professionals interested in viruses of vertebrate hosts.

                                                  

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Organic Structure Determination Using 2-D NMR Spectroscopy

Organic Structure Determination Using 2-D NMR Spectroscopy: A Problem-Based 

Approach, Second Edition, provides an introduction to the use of two-dimensional (2-D) 

nuclear magnetic resonance (NMR) spectroscopy to determine organic structure.

The book begins with a discussion of the NMR technique, while subsequent chapters cover 

instrumental considerations; data collection, processing, and plotting; chemical shifts; 

symmetry and topicity; through-bond effects; and through-space effects. The book also 

covers molecular dynamics; strategies for assigning resonances to atoms within a 

molecule; strategies for elucidating unknown molecular structures; simple and complex 

assignment problems; and simple and complex unknown problems. Each chapter includes 

problems that will enable readers to test their understanding of the material discussed.

• Presents strategies for assigning resonances to known structures and for deducing structures of unknown organic molecules based on their NMR spectra
• Contains 30 known and 30 unknown structure determination problems
• Features a supporting website from which instructors can download the structures of the unknowns in selected chapters, digital versions of all figures, and raw data sets for processing

                                              

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