This procedure is associated with a 66% survival rate of at least one fetus, with a 15% risk of cerebral palsy, and average delivery occurring at 29 weeks gestation. Septostomy, or iatrogenic disruption of the dividing membrane
This procedure involves the tearing of the dividing membrane between fetuses such that the amniotic fluid of both twins mixes, under the assumption that pressure is different in either amniotic sac and that its equilibration will ameliorate progression of the disease. It has not been proven that pressures are different in either amniotic sac. Use of this procedure can preclude use of other procedures as well as make difficult the monitoring of disease progression. In addition, tearing the dividing membrane has contributed to cord entanglement and demise of fetuses through physical complications. Adjustment of blood supply
Laser therapy
This procedure involves endoscopic surgery using laser to interrupt the vessels that allow exchange of blood between fetuses under the assumption that the unequal sharing of blood through these vascular communications leads to unequal levels of amniotic fluid. Each fetus remains connected to its primary source of blood and nutrition, the placenta, through the umbilical cord. This procedure is conducted once, with the exception of all vessels not having been found. The use of endoscopic instruments allows for short recovery time. This procedure has been associated with 85% survival rate of at least one fetus, with a 6–7% risk of cerebral palsy and average delivery occurring at 32–33 weeks gestation.Twin anemia–polycythemia sequence (TAPS) may occur after laser surgery for TTTS (post-laser form).
Culture shock is an experience a person may have when one moves to a cultural environment which is different from ones own; it is also the personal disorientation a person may feel when experiencing an unfamiliar way of life due to immigration or a visit to a new country, a move between social environments, or simply transition to another type of life. One of the most common causes of culture shock involves individuals in a foreign environment. Culture shock can be described as consisting of at least one of four distinct phases: honeymoon, negotiation, adjustment, and adaptation. Common problems include: information overload, language barrier, generation gap, technology gap, skill interdependence, formulation dependency, homesickness (cultural), boredom (job dependency), ethnicity, race, skin color, response ability (cultural skill set). There is no true way to entirely prevent culture shock, as individuals in any society are personally affected by cultural contrasts differently. Obergs four phases model
Kalervo Oberg first proposed his model of cultural adjustment in a talk to the Womens Club of Rio de Janeiro in 1954. Honeymoon
During this period, the differences between the old and new culture are seen in a romantic light. For example, in moving to a new country, an individual might love the new food, the pace of life, and the locals habits. During the first few weeks, most people are fascinated by the new culture. They associate with nationals who speak their language, and who are polite to the foreigners. Like most honeymoon periods, this stage eventually ends.