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In aprotic solvents, the radical anion, RX , for aryl halides has been detected as intermediate. In cyclic voltammetry of aryl halides, though an irreversible twoelectron reduction occurs at low scan rate, a reversible one-electron reduction occurs at high scan rate. Thus, it is possible to get the values of the standard potential (E0) for the RX/RX couple and the rate constant (k) for RX R (therefore, the lifetime of RX ). In Fig. 8.18, the relation between E0 and log k for aryl bromides in DMF is linear with a slope of * 0.5 [51 f ]. It is apparent that the lifetime of RX , obtained by 1/k, increases with the positive shift of E0. In contrast, the existence of RX for alkyl monohalides has never been confirmed. With these compounds, it is difficult to say whether the two processes, i.e. electron transfer and bond cleavage, are step-wise or concerted (RX + e R + X ). According to Sav ant [51e], the smaller the bond dissociation energy, the larger the tendency for the concerted mechanism to prevail over the step-wise mechanism. Studying the electrochemical reduction of halogenated organic compounds has practical importance, especially related to organic syntheses [62]. Moreover, the reductive cleavage of the C X bond is applicable as a method to convert hazardous chlorinated compound; for example, polychlorinated biphenyls (PCBs) to biphenyl by reducing in DMF at 2.8 V vs SCE [63].



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practiced (McDaniel et al, 1992, 1997) Medical family therapy is based on a biopsychosocial systems theory (Engel, 1980; McDaniel et al, 1992) This theory, unlike traditional biotechnical medicine, is expressly systemic and sensitive to the effects on health and illness of context, including such variables as gender, race, culture, and class The goals of medical family therapy are to optimize agency and communion for the patient, the family, and the health professionals involved (Bakan, 1966) Agency refers to a sense of self-efficacy in the face of challenge Communion refers to a sense of connection with family, friends, health professionals, community, and spiritual communionity Taken together, agency and communion are the foundations of individual effectiveness within a relational context.

Fig. 8.1 Ensemble-averaged value of the performance index for uncorrelated measurement noise in the rst example: dotted line represents the original algorithm (8.8) with noise, dashed line represents the bias removal algorithm (8.10) with noise, solid line represents the original algorithm (8.8) without noise [404].

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The main role of the primary care physician is to be aware of the risk factors for development of VAIN and to evaluate patients appropriately. Once abnormal cytology is obtained, the physician should proceed with colposcopy or refer the patient for colposcopic exam by another provider.

Vicki Hegelson (1994), in a review of the research on agency and communion, concludes that both agency and communion are required for optimal health, but that the effects on health are curvilinear She found that both unmitigated agency and unmitigated communion are associated with negative health outcomes The goal is to find a balance between these extremes Medical family therapy emphasizes the development of a collaborative (rather than hierarchical) relationship between the health professional, the patient, and the spouse or partner; this is a necessary corrective to the welldescribed power problems that can occur in the doctor-patient relationship (McDaniel & Hepworth, 2004; McDaniel et al, 1992) This collaborative stance involves respecting the patient s and family s agendas, supporting their goals, and providing care from a consultative rather than authoritarian position.

Techniques for helping couples and families in medical family therapy include the following: (1) recognize the biological dimension along with the psychological, (2) solicit the illness story, (3) respect defenses, (4) remove blame and accept unacceptable feelings, (5) attend to developmental issues, (6) increase sense of agency, (7) facilitate communication, and (8) remain available The first technique is to attend to the biological dimension of any problem This is fundamental to a biopsychosocial approach Historically, various approaches to family therapy have looked askance on biological explanations of human functioning, in part out of an understandable concern with the reductionism of traditional biomedical approaches In working with couples facing illness, however, it is critical to recognize the importance of biology and its profound impact on the life of the couple.

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