bluuebunny/crossref_metadata_2025 huggingface dataset:
Soil and Climate Change
Authors: Bardgett Richard
Published: November 2020

The world’s climate is changing. Not only is it getting warmer, but also there are more extreme weather events, such as droughts, storms, and catastrophic floods. Humans are undoubtedly the cause of this change in climate, through the burning of fossil fuels, intensive farming, deforestation, and many other aspects of our industrious lives that increase the emission of greenhouse gases—carbon dioxide, methane, and nitrous oxide—to the atmosphere. In fact, over the past fifty years or so there has been an unprecedented increase in the release of greenhouse gases to the atmosphere, and, unless measures are put in place to cap emissions, this trend is likely to continue. So what have soils got to do with climate change? Put simply, soils play a pivotal role because they act as both a source and sink for greenhouse gases, and any disruption of this balance will affect the concentration of these gases in the atmosphere and hence the global climate, potentially making the situation either better or worse. Perhaps the most powerful illustration of this concerns the carbon cycle. Soil is the Earth’s third largest carbon store, next to the oceans and deep deposits of fossil fuels, and together with vegetation it contains at least three times more carbon than the atmosphere. Many worry that climate change will destabilize these carbon stores by stimulating the soil organisms that break down soil organic matter, releasing vast quantities of carbon dioxide to the atmosphere. This could shift soils from being sinks to sources of this greenhouse gas, thereby accelerating climate change. Scientists call this carbon-cycle feedback, and we will revisit it later. Let’s begin with the main actors of climate change, the greenhouse gases. The most abundant and well-known greenhouse gas is carbon dioxide. This gas is taken up from the atmosphere by plants through the process of photosynthesis, which occurs in the presence of light. Plants retain most of the carbon they take up and use it to grow and sustain their metabolism, but they also release a portion back to the atmosphere as carbon dioxide through respiration from both their shoots and roots.
Childhood and adolescent mental health as developmental predictors of the early caregiving of teenage mothers
Authors: Hipwell Alison E.
Published: November 2020

I first met Channi 25 years ago when I applied for a Research Assistant position on the Mother-Baby Unit (MBU) at the Bethlem Royal Hospital. The research project was to improve the process of collecting data on infant functioning and mother–infant interactions among inpatient dyads on the MBU in order to evaluate better the real and potential risks to the infant. Channi had noticed that, soon after an admission, MBU staff often had a hunch about which mothers could demonstrate sensitive and responsive caregiving once their florid psychotic episode had improved, and which mothers were likely to have ongoing difficulties. He had developed the Bethlem Mother-Infant Interaction Scale for completion by nurses on the unit to capture and quantify their observations in a more systematic manner. Although my primary responsibility was to test the psychometric properties of the scale, Channi encouraged my nascent interests in the transactional relationships between maternal postpartum psychopathology and infant development. During the next 5 years and beyond, I benefited greatly from his intellectual guidance and mentorship, his exceptional generosity and his visionary thinking. These highly formative experiences have contributed to my sustained interest in early prediction of both maternal caregiving and perinatal psychopathology. In this chapter, I describe results from a prospective study of adolescent mothers that combine both of these elements. A glance at the literature gives a very strong impression that adolescent mothers and their infants are a highly vulnerable group of dyads. Much has been written about adolescent motherhood as a life transition that is not yet normative, requiring teenagers to cope with the developmental demands of adolescence simultaneously with the new and, not insignificant, challenges of pregnancy and motherhood. Research has shown that adolescence is a period in life that is characterized by mood volatility (Brent and Birmaher 2002; Nolen-Hoeksema and Girgus 1994) as well as vulnerability for onset and escalation of a wide range of mental health problems, including depression (Lewinsohn et al. 1993), and behaviour problems (Steinberg et al. 2006). Combining this developmental window of risk for psychopathology with the possibility that adolescent mothers may be emotionally and practically unprepared to deal with their infant’s capacities and needs, certainly gives cause for concern.
The intergenerational transmission of stress: psychosocial and biological mechanisms
Authors: Pariante Carmine M.
Published: November 2020

I met Channi for the first time when I was a senior house officer (trainee) in psychiatry at the Maudsley Hospital, and I worked under his supervision for 6 months, in 1998. At that time, Channi was the only Consultant Perinatal Psychiatrist at the Maudsley, covering the Liaison Services at King’s College Hospital, the outreach work, and the Mother and Baby Unit. And, of course, he was leading the academic section. It is perhaps the best tribute to his memory that it takes now three consultants and two academics to do the work that he was then doing all by himself! I was already interested in neuroendocrinology, and Channi was fascinated by the possibility that hormones might have a role in the mental health problems of the perinatal period. At that time, the notion that hormonal changes in pregnancy could have long-lasting effects on the offspring was still at its infancy, and I remember fondly the many discussions on this topic with Channi, sitting at his famous old desk. Channi was a pioneer in this field: he was the first to emphasize the dramatic impact of depression in pregnancy on the wellbeing of mothers and children. I am honoured to be able to continue this line of research today. The intergenerational transmission of stress has powerful clinical and social consequences, consolidating social adversity and psychopathology in future generations. The 2007 Policy Briefing by the World Health Organization Regional Office for Europe, ‘Preventing child maltreatment in Europe: a public health approach’ (WHO 2007), recognizes that ‘there is an association between maltreatment in childhood and the risk of later . . . becoming a perpetrator of violence or other antisocial behaviour as a teenager or adult’. The report also highlights that the costs are both overt (for example, medical care for victims, treatment of offenders, and legal costs for social care) and less obvious (for example, criminal justice and prosecution costs, specialist education, and mental health provision). In Europe, only the United Kingdom has calculated the total economic burden, estimated to be ￡735 million in 1996 (WHO 2007).
Child abuse in the United States
Authors: Spinelli Margaret
Published: November 2020

Child abuse is a major cause of morbidity and mortality in the United States and other countries. It is the second leading cause of death among children in the US. All 50 States, the District of Columbia, and the US Territories have mandatory child abuse and neglect reporting laws that require certain professionals and institutions to report suspected maltreatment to a child protective services (CPS) agency. Four major types of maltreatment are considered: neglect, physical abuse, psychological maltreatment, and sexual abuse (Centers for Disease Control and Prevention 2010). Once an allegation or referral of child abuse is received by a CPS agency, the majority of reports receive investigations to establish whether or not an intervention is needed. Some reports receive an alternative response in which safety and risk assessments are conducted, but the focus is on working with the family to address issues. Investigations involve gathering evidence to substantiate the alleged maltreatment. Data from reports on child abuse is derived from the National Child Abuse and Neglect Data System (NCANDS), which aggregates and publishes statistics from state child protection agencies. The first report from NCANDS was based on data for 1990. Case-level data include information about the characteristics of reports of abuse and neglect that are made to CPS agencies, the children involved, the types of maltreatment that are alleged, the dispositions of the CPS responses, the risk factors of the child and the caregivers, the services that are provided, and the perpetrators (Centers for Disease Control and Prevention 2010). During 2010, the NCANSDS reported that an estimated 3.3 million referrals estimated to include 5.9 million children were received by CPS agencies. Of the nearly 2 million reports that were screened and received a CPS response, 90.3% received an investigation response and 9.7% received an alternative response (Centers for Disease Control and Prevention 2010). Of the 1,793,724 reports that received an investigation in 2010, 436,321 were substantiated; 24,976 were found to be indicated (likely but unsubstantiated); and 1,262,118 were found to be unsubstantiated. Three-fifths of reports of alleged child abuse and neglect were made by professionals.
Trends in oral health
Authors: Daly Blánaid , Batchelor Paul , Treasure Elizabeth , Watt Richard
Published: November 2020

In the introduction to Chapter 1 it was stressed that in order to decide whether a disease is a public health problem it is important to be able to answer some key questions about it. Is the disease widespread? Is it on the increase? What individuals or groups appear to be susceptible? Do we know what causes it? Can it be prevented? What is the impact of the disease on the individual and society? The epidemiology of oral diseases can provide some detailed answers to these important questions. This chapter will present a brief overview of trends in oral diseases for children and adults in the UK. It will focus on periodontal disease, oral cancer, and dental caries, but there is also a brief section on dental trauma and erosion. Dentofacial anomalies, per se, are not diseases but will be included here, as their prevalence and incidence have implications for dental care because of the impact on social and psychological well-being. The impact on health will be presented. The problems of oral health inequality will be reviewed and the implications of trends in oral diseases for dental care in the UK will be discussed. There are many surveys describing the oral health of children and adults in the UK, with decennial national surveys of both groups since 1973. Scotland has not participated in the two most recent surveys, children in 2003 and adults in 2009. In these surveys all dental examiners are trained and calibrated, so that the diagnostic criteria are consistent and national trends can be identified. See Chapter 5 for a brief description of the importance of standardization of diagnostic criteria. In addition, the British Association for the Study of Community Dentistry (BASCD) undertakes surveys of the oral health of children within the districts of the UK; again, examiners are trained and calibrated and changes in trends in oral health across smaller areas can be monitored at shorter intervals than in the 10-yearly national surveys. Details of these surveys, including diagnostic criteria, can be found at http://www.bascd.org/oral-health-surveys. Current concepts in relation to periodontal disease have changed considerably in the last 20–30 years. The traditional ‘progressive’ disease model has been replaced by the ‘burst theory’. That is, periodontal diseases have short ‘bursts’ of activity followed by long periods of remission and healing (Goodson et al. 1982; Socransky et al . 1984).
Prevention and oral health education in dental practice settings
Authors: Daly Blánaid , Batchelor Paul , Treasure Elizabeth , Watt Richard
Published: November 2020

Prevention is a core element of the practice of dentistry in the 21st century. Of course the provision of evidence based dental treatment and surgical intervention are the main clinical roles for dentists, but, as health professionals, prevention is also a key responsibility (Department of Health 2012 ; Petersen 2009 ; Steele et al. 2009). Adopting a preventive orientation is relevant to all aspects of clinical care, from diagnosis and treatment planning to referral and monitoring procedures. Dentists and their team members have an important role in helping their patients prevent, control, and manage their oral health. Prevention is important for all patients, but support needs to be tailored to the needs and circumstances of each individual. It is also essential that any preventive advice and support is informed by scientific evidence to ensure maximum benefit is gained. Effectiveness reviews of preventive interventions have shown that many are ineffective and may increase oral health inequalities unless they are supported by broader health promotion interventions (Watt and Marinho 2005; Yehavloa and Satur 2009). Prevention in clinical settings therefore needs to be part of a more comprehensive oral health promotion strategy that addresses the underlying causes of dental disease through public health action, as well as helping patients and their families prevent oral diseases and maintain good oral health through self-care practices. Health education is defined as any educational activity that aims to achieve a health-related goal (WHO 1984). Activity can be directed at individuals, groups, or even populations. There are three main domains of learning (see also Chapter 9 ): . . . ● Cognitive: understanding factual knowledge (for example, knowledge that eating sugary snacks is linked to the development of dental decay). . . . . . . ● Affective: emotions, feelings, and beliefs associated with health (for example, belief that baby teeth are not important). . . . . . . ● Behavioural: skills development (for example, skills required to effectively floss teeth). . . . How do knowledge, attitudes, and behaviours relate to each other? For most people, in most instances, the relationship is complex, dynamic, and very personal; very rarely is it linear.
The European Union and dentistry
Authors: Daly Blánaid , Batchelor Paul , Treasure Elizabeth , Watt Richard
Published: November 2020

As the UK is part of the European Union it is important to understand the effect this has on the practice of dentistry. This chapter briefly reviews the European Union legislation as it relates to dentistry, and describes common features found in European states with regard to the practice of dentistry. The European Union consists of 28 member states with over 520 million citizens. Article 129 of the Treaty of Rome requires the European Union: . . . ● to contribute towards ensuring a high level of human health protection; . . . . . . ● to direct action towards the prevention of diseases, particularly of the major health scourges, including drug dependence, by promoting research into their causes and transmission, as well as health information and education. . . . One area in which the European Union works is by funding collaborative research between member states, for which major research schemes are available. It is not yet clear what the European Union’s role will be in public health, although there are developments in this area. In 1969, the principle of freedom of movement was established and aimed to ‘abolish any discrimination based on nationality between workers of the Member States as regards employment, remuneration and other conditions of work and employment’. This means that every worker who is a citizen of a member state has the right to: . . . ● accept offers of employment in any European Union country; . . . . . . ● move freely within the European Union for the purposes of employment; . . . . . . ● be employed in a country in accordance with the provisions governing the employment of nationals of that country; . . . . . . ● remain in the country after the employment ceases. . . . The freedom of movement has applied to dentists since 1980, if their education has met the requirements of the Dental Directives. The European Union Dental Directives (78/686 and 687 EEC) mean that any national of a member state who holds one of the recognized qualifications of dentistry may practice dentistry in any other member state.
The origin problem, invariants, and seminvariants
Authors: Giacovazzo Carmelo
Published: November 2020

In Section 1.6, the basic postulate of structural crystallography was formulated, according to which there is a biunique correspondence between the crystal structure and the set of experimental diffraction data: . . . crystal structure ⇔ {|Fh|} . . . . Can this property be extended to phases? In more simple terms, is the following logical relation valid? . . . crystal structure ⇔ {φh} ? (3.1) . . . If relation (3.1) is valid, only one set of phases should be compatible with a given crystal structure. We will show in Section 3.2 that relation (3.1) is false; there are more sets of phases that are compatible with the same crystal structure. It will also be shown that such behaviour arises due to the origin problem. The above conclusion suggests that there is no sense in declaring: the phase of the reflection h is 35°, without first specifying the origin with respect to which the phase is estimated. This conclusion presents a new basic question: since the origin is arbitrarily chosen by the crystallographer, how can we hope to directly derive phases from experimental amplitudes? This seems to be a contradiction in logic; indeed, the experimental amplitudes, which are invariant with respect to origin translations, cannot define the phases, since their values depend on the arbitrary origin chosen by the crystallographer. This contradiction may be overcome since combinations of phases exist whose values do not depend on the origin, but only on the structure. They may therefore be estimated from the diffraction amplitudes and are called structure invariants (shortened to s.i.; see Section 3.3). The reader should not be surprised that invariants are more than just necessary to our treatment of the phase problem. Indeed they will guide our approach, providing a general and simplified description of the properties of phase space. This situation is similar to that met in the study of mathematics, where we learn that the geometrical properties of curves may be more easily studied via invariant properties. The only difference here is that we are dealing with phases and with the invariant properties of phase space.
Isomorphous replacement techniques
Authors: Giacovazzo Carmelo
Published: November 2020

The isomorphous replacement method is a very old technique, used incidentally by Bragg to solve NaCl and KCl structures: it was later formulated in a more general way by Robertson (1935, 1936) and by Robertson and Woodward (1937). Its modern formulation is essentially due to Green et al. (1954) and to Bragg and Perutz (1954), who applied the method to haemoglobin. The technique has made possible the determination of the first three macromolecular structures, myoglobin, haemoglobin, and lysozyme. The approach may be summarized as follows. Suppose that the target structure is difficult to solve (e.g. it is a medium-sized structure, resistant to any phasing attempt, or it is a protein with bad data resolution) and we want to adopt isomorphous replacement techniques. Then we should perform the following steps: (a) Collect the diffraction data of the target structure; in the following we will suppose that it is the native protein. (b) Crystallize a new compound in which one or more heavy atoms are incorporated into the target structure. This new compound is called derivative. (c) Check if the operations in (b) heavily disturb the target structure. If not, the derivative is called isomorphous; then, only local (in the near vicinity of the binding site) structural modifications are induced by the heavy atom addition. Non-isomorphous derivative data are useless. (d) Use the two sets of diffraction data, say set {|FP|} of the target structure and set {|Fd|} of the isomorphous derivative, to solve the target structure. The above case is referred to as SIR (single isomorphous replacement). The reader should notice that redundant experimental information is available; indeed, two experimental sets of diffraction data relative to two isomorphous structures may be simultaneously used for solving the native protein. The redundancy of the experimental information allows crystal structure solution even if data resolution is far from being atomic (e.g. also when RES is about 3 or 4 Å, and even more in lucky cases). Imperfect isomorphism may hinder crystal structure solution. Then, more derivatives may be prepared; their diffraction data may be used in a combined way and may more easily lead the phasing process to success.
Death and Burial in Iron Age Britain
Authors: Harding Dennis
Published: November 2020

Archaeologists have long acknowledged the absence of a regular and recurrent burial rite in the British Iron Age, and have looked to rites such as cremation and scattering of remains to explain the minimal impact of funerary practices on the archaeological record. Pit-burials or the deposit of disarticulated bones in settlements have been dismissed as casual disposal or the remains of social outcasts. In Death and Burial in Iron Age Britain, Harding examines the deposition of human and animal remains from the period - from whole skeletons to disarticulated fragments - and challenges the assumption that there should have been any regular form of cemetery in prehistory, arguing that the dead were more commonly integrated into settlements of the living than segregated into dedicated cemeteries. Even where cemeteries are known, they may yet represent no more than a minority of the total population, so that other forms of disposal must still have been practised. A further example of this can be found in hillforts which, in addition to domestic and agricultural settlements, evidently played an important role in funerary ritual, as secure community centres where excarnation and display of the dead may have made them a potent symbol of identity. The volume evaluates the evidence for violent death, sacrifice, and cannibalism, as well as age and gender distinctions, and associations with animal burials, and reveals that 'formal' cemetery burial or cremation was for most regions a minority practice in Britain until the eve of the Roman conquest.
Social and ritual violence and death
Authors: Harding Dennis
Published: November 2020

In recent years the issue of violence in Iron Age society has become polarized between those who believe that it was endemic and those who believe that it has been exaggerated, particularly by conventional stereotypes of ‘warrior Celts’ based on classical and Irish literary sources. Currently, the ‘postprocessual consensus that dominates academic archaeology in the United Kingdom retains, as its default position, a more or less pacifist view of the prehistoric past’ (Armit, 2011: 503). The conventional interpretation of ‘war cemeteries’ and ‘massacre sites’ in hillforts especially may have been unduly simplistic, and it is these therefore that we shall consider first. The archetypal Iron Age war cemetery was that excavated by Wheeler (1943) in the eastern entrance at Maiden Castle, Dorset, where several skeletons bore traces of physical trauma compatible with the sack of the hillfort by Vespasian’s Second Augustan legion. An adult male in grave P7A had an iron arrow-head buried in his spine, and another adult male in grave P7 had a small, square perforation through the left temporal bone, consistent with a Roman ballista bolt. In some instances there were multiple injuries, notably skeleton P12 whose skull bore at least nine sword cuts, a measure of ‘overkill’ that reflected either the ferocity of the attack or systematic degradation after death. In reviewing the physical evidence for warfare in Iron Age Britain Knüsel (2005) divided instances of weapon trauma into three principal categories, those inflicted with a sharp-bladed weapon, such as a sword, those resulting from crushing from a blunt instrument, and wounds from a weapon or missile that penetrated the skeleton. The first two are essentially the same classification as those offered by Wheeler (1943: 351) for the Maiden Castle war cemetery. He too had raised the question whether the peri-mortem injuries apparent on some of the victims were the cause of death, or were inflicted after death.
A Preliminary Remark: Water and Friends
Authors: Atkins Peter
Published: November 2020

Water is the most miraculous of fluids. As well as being ubiquitous on Earth and essential for life as we know it, it has remarkable properties which at first sight don’t seem to be consistent with its almost laughably simple chemical composition. Each molecule of water consists of a single oxygen atom (O) and two hydrogen atoms (H); its chemical formula is therefore, as just about everyone already knows, H2O. Here is one odd but hugely important anomalous property. A water molecule is only slightly heavier than a methane molecule (CH4; C denotes a carbon atom) and an ammonia molecule (NH3, N denotes a nitrogen atom). However, whereas methane and ammonia are gases, water is a liquid at room temperature. Water is also nearly unique in so far as its solid form, ice, is less dense than its liquid form, so ice floats on water. Icebergs float in water; methanebergs and ammoniabergs would both sink in their respective liquids in an extraterrestrial alien world, rendering their Titanics but not their Nautiluses safer than ours. Another very important property is that water is an excellent solvent, being able to dissolve gases and many solids. One consequence of this ability is that water is a common medium for chemical reactions. Once substances are dissolved in it, their molecules can move reasonably freely, meet other dissolved substances, and react with them. As a result, water will figure large in this book and this preliminary comment is important for understanding what is to come. You need to get to know the H2O molecule intimately, for from it spring all the properties that make water so miraculous and, more prosaically, so useful. The molecule also figures frequently in the illustrations, usually looking like 1, where the red sphere denotes an O atom and the pale grey spheres represent H atoms. Actual molecules are not coloured and are not made up of discrete spheres; maybe 2 is a better depiction, but it is less informative. I shall use the latter representation only when I want to draw your attention to the way that electrons spread over the atoms and bind them together.
Stringing Along: Radical Polymerization
Authors: Atkins Peter
Published: November 2020

Perhaps the most striking observable change brought about by chemistry as applied to the everyday world is in the texture of objects. Until the early twentieth century objects were manufactured from metal, wood, and animal and plant fibres. Today, synthetic polymers, in the vernacular ‘plastics’, are ubiquitous and have changed not only the appearance of the world but also its feel. Polymers (from the Greek words for ‘many parts’) are made by stringing together small molecules, the ‘monomers’, into long chains or extensive networks. Thus, polyethylene (less formally polythene) is a chain of linked ethylene molecules, and polystyrene is a chain of linked styrene molecules. In some instances, two or more different types of monomer molecules are used to form the polymer. Thus, one form of nylon is a chain in which the alternating links are of two different compounds. There are two main ways of linking molecules together, one involving radicals (Reaction 12) and the other not. In this section I shall introduce you to radical polymerization and treat the other kind in Reaction 14. Polyethylene and its cousins are made by the radical method, and I start with them. An ethylene molecule (1, formally, ethene) is written H2C=CH2, the double bar denoting a ‘double bond’. This is the first time I have needed to introduce you to a double bond, but it will turn out to be a crucial feature of all the monomers in this section. A double bond consists of two ordinary bonds linking the same two atoms. Because each bond consists of a shared pair of electrons acting as glue between two atoms, a double bond consists of two such pairs. Although a double bond between two C atoms is stronger than a single bond between C atoms, it is not twice as strong because the two pairs of electrons struggle for the best position and tend to push each other out of the ideal location for bonding. One consequence is that a molecule can acquire lower energy by giving up one of the pairs of electrons in the double bond and forming more single bonds with other atoms.
Fasteners: Acid Catalysis
Authors: Atkins Peter
Published: November 2020

I explained the general basis of catalysis in Reaction 11, where I showed that it accelerated a reaction by opening a new, faster route from reactants to products. One of the ways to achieve catalysis in organic chemistry is to carry out a reaction in an acidic or basic (alkaline) environment, and that is what I explore here. In Reaction 27 you will see the enormous importance of processes like this, not just for keeping organic chemists productive but also for keeping us all alive; I give a first glimpse of that later in this section too. Various kinds of acid and base catalysis, sometimes both simultaneously, are going on throughout the cells of our body and ensuring that all the processes of life are maintained; in fact they are the very processes of life. I deal with acid catalysis in this section and base catalysis in the next. The point to remember throughout this section is that an acid is a proton donor (Reaction 2) and a proton is an aggressive, nutty little centre of positive charge. If a proton gets itself attached to a molecule, it can draw electrons towards itself and so expose the nuclei that they formerly surrounded. That is, a proton can cause the appearance of positive charge elsewhere in the molecule where the nuclei shine through the depleted fog of electrons. Because positive charge is attracted to negative charge, one outcome is that a molecule may be converted into a powerful electron-sniffing electrophile (Reaction 16). Another way of looking at the outcome of adding a proton is to note that a C atom with a positive charge is a target for nucleophilic missile attack (Reaction 15). Therefore, if a proton draws the electron cloud away from a nearby atom, then its presence is like a fifth-column agent preparing a target for later attack. Let’s shrink and watch as some acid is added to a molecule that contains a –CO– group, such as acetic acid. The protons provided by the added acid are riding on water molecules, as H3O+ ions, and arrive in the vicinity of the acetic acid molecule.
Function 2: Social, Economic, Ritual
Authors: Harding Dennis
Published: November 2020

In southern England, in terms of prevailing environmental conditions most hillforts could have been occupied or used on a permanent rather than seasonal basis. With the exception of Exmoor and Dartmoor in the far south-west, none are located above the 300m contour and therefore could potentially have sustained a mixed agricultural regime. In northern England, Wales, and Scotland, on the other hand, there are hillforts at altitudes that make seasonal use more likely, although even with some of the larger hillforts in southern Scotland and Northumberland, like Eildon Hill, Hownam Law, and Yeavering Bell, higher altitude may not have precluded occupation on a significant scale. We have already seen that some hillforts in southern Scotland and the Cheviots show ample evidence of occupation in the form of house stances, so that a residential function as a primary purpose is hardly in doubt. Sites like Hayhope Knowe or Camp Tops may be categorized as protected villages, and though some might seem scarcely to qualify as hillforts at all (Frodsham et al. 2007), others like Sundhope Kipp boast defensive earthworks, which seem almost disproportionate in scale to the area of the internal settlement. Sometimes the houses are so densely arranged within the interior as to exclude the possibility of division into different activity zones, unless some of these seemingly identical roundhouses actually served as workshops or stores rather than just for domestic occupation. Despite their relatively high altitude and exposed locations, there is every reason to believe that some sites were permanently occupied, since evidence of cord-rig agriculture often lies in immediate proximity to the enclosure. Even so, these cultivation plots must have been on the margins of viability in the Iron Age, and it is possible that these Borders upland sites by the later first millennium BC were used only seasonally. Indeed, progressive environmental deterioration may be a reason why the earthwork phase of enclosure at Hayhope Knowe was never completed. Archaeologically it is hard to point to evidence that might distinguish seasonal from permanent occupation. The number of buildings may be indicative of the intensity of use, but might stake-wall construction with numerous episodes of rebuilding indicate seasonal construction, as opposed to more permanent post-built houses? On the other hand, stone foundations could have been renovated seasonally in a manner than might be hard to distinguish archaeologically from permanent use.
Documentary Sources
Authors: Harding Dennis
Published: November 2020

Prehistorians like to think of prehistoric archaeology as the ‘purest’ branch of the discipline, in that interpretation and reconstruction of prehistoric societies is solely dependent upon the principles and techniques of archaeology, untainted by the predisposition of history. The unfortunate polarization of attitudes was only too evident at a recent International Congress of Celtic Studies, at which some younger archaeologists were utterly dismissive of any argument that was based upon classical sources, an intolerance that was only comprehensible in the face of the equally irrational faith placed in these sources, irrespective of context or chronology, by some of their senior colleagues. This kind of uncritical use of texts doubtless underlies Hill's (1989) exhortation that Iron Age archaeological studies should become more like the Neolithic. For others, the present writer included, the challenge of the Iron Age derives largely from the fact that it does span the threshold of history, and that Britain and Europe are therefore populated by named individuals and known communities, not just by inanimate pots and stone artefacts. The age of hillforts is substantially protohistoric, though Christopher Hawkes’ (1954) term parahistoric is probably more accurate for much of the British Iron Age, for which the relevant texts derive from literate neighbours rather than from even a minority literate group among the native community. Archaeologists since Hawkes have sometimes talked about such periods as text-aided, as opposed to prehistoric periods that were text-free. It may be arguable whether the presence of textual sources is an aid or a complication, but the phrase text-free implies a measure of relief that for these periods at least the archaeologist is free to interpret the evidence uninhibited by possible contradiction from historical records. The problem with text-aided archaeology, of course, was that it tended to be text-led; that is, that archaeology was seen as a means of ‘proving’ or at least illuminating history. The subordination of archaeology to history that was implicit in this approach is well illustrated by the way that Sir Leonard Woolley's excavations at Ur were popularly heralded as proving the flood of Genesis, or Kathleen Kenyon's excavations at Jericho were presented as discovering the walls destroyed by Joshua, notwithstanding the fact that the Neolithic town with which she was primarily concerned pre-dated Iron Age Joshua by several millennia.
Upper gastrointestinal surgery
Authors: Wood James
Published: November 2020

Diseases of the upper gastrointestinal tract (GI) have changed a great deal both in their aetiology and presentations as well as their manage­ment in the last three decades. Modern students and junior doctors need to understand the range of upper GI conditions which now present, especially the increasing issues of upper GI malignancy and the impact of morbid obesity on medical and surgical practice. Old text books full of operations for benign peptic ulcer disease have been replaced with texts on the constantly advancing treatment of oesophagogastric cancer and operations for obesity management. Symptoms and signs in upper GI disease are often subtle and non-specific so a sound knowledge of clinical findings and the choices for appropriate investigations are extremely important and are covered in this chapter. Lastly, some of the most urgent and life-threatening surgical emergen­cies can occur due to upper GI disease and the management of these conditions is a vital area of knowledge for all junior doctors.
Urological surgery
Authors: Fisher Simon
Published: November 2020

When the student contemplates potential causes of urinary tract obstruction, considering the anatomy of the drainage system from renal pelvis to urethral meatus and appreciation of potential causes of block­age will provide a useful diagnostic screen and will help one to review the breadth of conditions which may affect the renal tract. These include extrinsic compression, (for instance, due to retroperitoneal fibrosis or prostatic hypertrophy), mural involvement (infection, inflammation and transitional cell carcinoma), or luminal obstruction, (blood clot, stone, or valve). A firm grasp of appropriate investigations for urinary tract disease will aid diagnostic accuracy. Urological surgery encompasses various aspects of neoplasia and developmental conditions. This chapter will test your knowledge of the presentation, diagnosis, management, and pathology of common urological malignancies including renal adenocarcinoma, transitional cell tumours, testicular tumours, and carcinoma of the prostate. Urological conditions often occur in patients who may have other co-morbidities. Understanding the causes, investigation, and management of renal failure, appreciating the significance of haematuria, and knowing how to deal with an urological emergency of acute urinary obstruction will add to the medical student’s or trainee surgeon’s breadth of compe­tence in general surgical practice.
Trauma surgery
Authors: Dawson-Bowling Sebastian , Ledwidge Serena
Published: November 2020

Appreciation of the ‘golden hour’ for resuscitation, and adoption of prin­ciples of the advanced trauma life support (ATLS) system are key factors in improving outcome for the patient with major injuries. Adherence to the strict protocols of the ABCDEs of the primary survey enables the trauma team to identify and deal with life-threatening conditions, prior to definitive treatment of problems with lesser immediacy. The clinician who understands the mechanism of injury will main­tain heightened levels of suspicion for clinical signs which point to well-recognized conditions resulting in early mortality and morbidity, for instance, tension pneumothorax, cardiac tamponade, and rising intrac­ranial pressure. This chapter will probe your grasp of the principles of trauma manage­ment. You will also be tested on common patterns of thoracic, abdomi­nal, vascular, and cranial injuries. Whilst clinical presentations of civilian trauma have remained consist­ent in recent years, the impact of military trauma in worldwide theatres of conflict has stimulated numerous advances in the management of trauma. The current impetus for reorganization of trauma services in the UK is tacit acknowledgement of the improvement in outcomes that can be achieved by adherence to recognized protocols in this challenging and demanding field of surgery.
Plastic surgery
Authors: Branford Olivier
Published: November 2020

Principles of plastic surgery are integral to all surgical specialties. An understanding of wound healing, suture selection, skin closure, skin cover, and scar management forms an essential component of all mod­ern surgical practice. Appropriate assessment of burns and competent early management of the burned patient are prerequisite skills for all surgeons who work in emergency departments. However, transfer to and management in a specialist burns unit will ultimately result in the best outcome for these unfortunate patients. This forms one aspect of specialist plastic surgical practice. The management of these and other conditions including soft tissue hand injuries, infections, and extensive skin loss through necrosis, whilst often requiring the skills of the specialist plastic surgeon, still form part of the broad general surgical curriculum. This chapter will explore your understanding of the basic principles of plastic surgery which underpin the vast breadth of more specialist practice. The latter encompasses the complex multidisciplinary arenas of correction of birth defects and deformities, management of extensive traumatic injuries, cosmetic, and oncoplastic surgery.
Understanding Skin Conditions
Authors: Ersser Steven J
Published: November 2020

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with skin conditions in an evidence-based and person-centred way. The chapter will provide a comprehensive overview of the commonest skin diseases and their causes before exploring best practice to assess and help patients to manage skin conditions. Nursing priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with skin conditions can be found in Chapters 19, 20, 21, 24, 27, and 28 on skin care and the maintenance of skin hygiene, skin barrier integrity, the prevention of skin breakdown, and wound management, respectively. Skin care is a fundamental area of nursing responsibility. The skin, or integumentary system, is the largest organ of the body and has significant protective and thermoregulatory functions. Skin disease is common, accounting for approximately 24% of GP visits (Schofield et al., 2009). It may have a major psychosocial impact on a person’s quality of life through its influence on appearance, body image, and self-esteem. This chapter introduces you to the common skin diseases that you are likely to encounter when caring for adult patients and outlines the nursing problems that you will need to manage. The cause or aetiology of common skin conditions lies with the interaction between genetic and environmental factors. For example, a child’s eczema is influenced by his or her genotype and his or her exposure to environmental allergens. Within the UK population, 23舑25% have a skin problem at some time in their lives that can benefit from medical care (Schofield et al., 2009). Skin problems are the commonest reason for consulting a GP, with 6% referred for specialist advice. As such, all registered nurses should have the knowledge and skills to manage the common conditions. The commonest skin conditions in the Western hemisphere are chronic inflammatory skin diseases (CISDs), such as eczema. In developing countries, the common conditions are infections and infestations. The quality-of-life impact of CISDs can exceed that for life-threatening conditions such as cancer (Rapp et al., 1999; Kingman, 2005).
Managing Pain
Authors: Allcock Nick , Day Ruth
Published: November 2020

This chapter aims to provide you with the knowledge to be able to take an evidence-based approach to the nursing management of people who are experiencing pain. As a practising nurse, pain will be something that many of your patients will experience; however, one individual’s pain may be very different from another person’s. Pain can vary depending on the circumstances in which it is experienced and the individual characteristics of the person experiencing it. Understanding someone’s pain experience is therefore challenging because you cannot see someone’s pain or easily judge how bad it is, what it feels like, or how it affects him or her. This chapter provides you with knowledge and skills to recognize, assess, and manage the patient’s experience of pain effectively with evidence-based strategies. The variability of the experience of pain makes defining pain difficult. Pain is something that we have all experienced at some point in our lives and therefore, through these experiences, we have developed an understanding of what we consider to be pain. One of the most widely accepted definitions is that of the International Association for the Study of Pain (IASP), which defines pain as:…An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. (Merskey and Bogduk,1994)…Although this definition is often quoted, the difficulty in defining pain is illustrated by the fact that the IASP added a note (go to http://www.iasp-pain.org/ and search for ‘pain definitions’) to highlight the individual nature of pain and the fact that pain is a sensory experience with an emotional component. The individual nature of pain is also highlighted by another commonly used definition:…Pain is whatever the experiencing person says it is and happens whenever he/she says it does. (McCaffery, 1972)…This definition highlights the fact that pain is an individual experience and that measuring pain objectively is difficult. Therefore asking the person and actively listening to the self-report of the experience is the best way in which to understand another person’s pain. A common criticism of McCaffery’s definition is that some people cannot say what they are experiencing.
Managing Wounds
Authors: Grocott Patricia
Published: November 2020

This chapter addresses the vital area of wound care, including the impact that wounds can have upon patients and their families, and the nursing management challenges that they present. As a registered nurse caring for patients with wounds, you will be responsible for making a clinical assessment of the patient with a wound, making clinical decisions based on the most appropriate evidence-based, nurse-led interventions, and, crucially, measuring patient outcomes. The latter involves continuous monitoring of how both the patient and his or her wound is responding, or not, to the treatment and care that you give. This chapter presents a generic approach to wound management, and this should help you to deliver high-quality, safe wound care for patients with wounds of differing aetiologies. This includes core components of interventions for acute, chronic, and palliative wound care. Importantly, the chapter has been designed to help you to make the links between assessment, clinical decision-making, nursing interventions, and patient care. Nurses play a key role in the multidisciplinary team in the delivery of wound care, and frequently act as the ‘point of contact’ for the manufacturers and suppliers of wound care products. The approach advocated in this chapter will equip you to make informed assessments and clinical decisions. Wounds are injuries to the body, the skin in particular, causing a breach of the layers of skin (see Chapter 12 Understanding Skin Conditions) and the body boundary. The term ‘wound’ also defines the act of injuring a person’s skin. This may be deliberate, e.g. during a surgical procedure, or deliberate to cause harm, e.g. during warfare, terrorist attacks, or domestic and street violence. Wounding can also occur with accidents (a cut from a kitchen knife), natural disasters (earthquake), and exposure to environmental stresses such as extreme heat (burns, skin cancers), extreme cold (frostbite), excessive pressure, and excessive exposure to water and moisture (trench foot). Wounds also develop because of diseases and conditions such as diabetes, which disrupt the structures of the skin and the normal metabolic processes that maintain skin health (see Chapter 9 Understanding Diabetes Mellitus).