bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental health nursing in a rehabilitation and recovery context
Authors: Lloyd Marjorie
Published: November 2020

In this chapter we return to the story of Anthony and his brother David, who we originally met in Chapter 4, and Joyce, who first appears in Chapter 5. Previously we considered the role of the mental health nurse in working with people experiencing acute mental health crisis. This chapter seeks to consider how as mental health nurses we might go on to work with these people to support their rehabilitation and reintegration into the community. The chapter opens by outlining some key principles of recovery and proceeds to demonstrate how these ideas might be implemented in working with both Anthony and Joyce. “The way I was feeling my sadness was mine. When I was in hospital staff rarely took time to find out what this was like for me. Not taking the time often fuelled what I was thinking: ‘I’m not worth finding out about.’ Nigel Short (2007: 23)” This service user describes how it feels to live with mental illness continuously throughout their lives, not just while they are in hospital. Professional staff may contribute to this feeling if care planning becomes too focused upon symptoms and treatment rather than person-centred care and recovery. In this context, recovery should not be seen as a new concept; rather it can be traced back at least 200 years to one of the earliest asylums, the Tuke Retreat in Yorkshire. “For it was a critical appraisal of psychiatric practice that inspired the Tuke at York to establish a clinical philosophy and therapeutic practice based on kindness, compassion, respect and hope of recovery. Roberts and Wolfson (2004: 37).” Later, during the 1960s, The Vermont Project (an American psychiatric facility) also published research on successful rehabilitative practice that was based upon ‘faith, hope and love’ (Eldred et al. 1962: 45). However, much of the current focus upon recovery practices is based on longitudinal studies in America, services in Ohio, service users were asked to identify what was important to them. This resulted in the Emerging Best Practices document that is recommended guidance in the UK today (NIMHE 2004).
Additional skills for complex cases in mental health nursing
Authors: Clarke Nicola , Clarke Victoria
Published: November 2020

In this chapter we will focus on some service users and mental health nursing skills that are more specialized than many students may experience. However, in introducing these concepts it is hoped that the chapter will help to prepare students and encourage exposure to such areas. You will meet four different service users from four different areas of mental health: child and adolescent mental health (Sarah, who has the additional complexities of an eating disorder, p. 224), substance misuse issues (Charlie, p. 231), forensic involvement and personality disorder issues (Tracy, p. 237), and post-traumatic stress in a person seeking political asylum (Feodor, p. 246). It is important to state at the outset that using the term ‘areas’ of mental health may lead students to believe that these are specialisms within the field of mental health nursing. The reality is the opposite. These issues and concerns are common for many service users that mental health nurses encounter in practice. While you may find that during your education you receive little formal teaching or experience in these areas, you will find some knowledge of these issues appropriate when, after-qualification, you are working with service users who are experiencing related problems. It is important to understand the context from which many of these issues may emerge. There is recognition of the structured inequalities in Britain’s health and social system, including for example substance misuse, ageism, unemployment, homelessness, poverty, sexism, and racism. For a variety of reasons, mental health service users may find themselves in situations of social disadvantage and economic hardship. The social effects of mental health problems can lead to individuals being effectively disabled, often with greater challenges than the mental health problem itself. The National Service Framework for mental health (NSF) (Department of Health 1999) encourages all mental health professionals to promote social inclusion. But how do we promote social inclusion of individuals who are ultimately excluded from services, potentially because of our lack of skills in these ‘specialist areas’?
Introduction
Authors: Harrison Rodney , Schofield John
Published: November 2020

How can we use the methods of archaeology to explore contemporary social phenomena? In what ways can the approaches of a discipline that has been developed to explore the distant past be used to understand the present, and should we even try? How can the ‘excavation’ of the recent past bring to light new insights into what it means to be ‘us’? These are the questions that have absorbed a new generation of scholars who seek to draw on the skills of archaeology to study an increasingly contemporary past and attempt to make the familiar past ‘unfamiliar’ (cf. Graves-Brown 2000a) by exploring its hidden, forgotten, and abject qualities and utilizing the powerful rhetoric of archaeological recovery in the retrieval of recent memories through the study of present-day material culture. This book aims to explore what happens if we take an archaeological approach to contemporary, late modern, post-industrial societies. It acts as an introduction both to the ways in which archaeologists approach the study of the recent and contemporary past, and to the interdisciplinary field of modern material culture studies more generally. We hope it will be of interest not only to students and practitioners of archaeology, but also to scholars who work within the broad interdisciplinary field of modern material culture studies— anthropologists, sociologists, historians of technology and science, and psychologists—in developing a new agenda for the study of the materiality of late modern societies. Because knowing more about our own society and how it functions is an issue of broad public concern, we have also tried to write this book in such a way that the reader who is not a specialist, but who has a casual interest in the manner in which archaeologists and others study contemporary material culture, will also be engaged by it. The book’s principal focus is the archaeology of developed, postindustrial societies during the second half of the twentieth century and the beginning of the twenty-first. Our emphasis is the period after about 1950, though the examples in Part II deliberately focus on the years after c.1970, a time which for us is literally the contemporary past, the period of our own lives and experiences.
Field Methods
Authors: Harrison Rodney , Schofield John
Published: November 2020

In Chapter 1 we suggested that the archaeology of the contemporary past is a critical inquiry into the present using archaeological approaches originally developed to look at the past. But how, precisely, does one undertake an archaeological study of the contemporary past, and what do practitioners more familiar with earlier periods bring with them to this particular type of archaeological enquiry? Is this archaeology of the very recent past so different to that of earlier periods? Is it simply a matter of transferring skills from more familiar grounds of the deeper past? We suggest that to large extent it is, though recognizing at least one key difference: the degree to which our diverse cultural backgrounds and life experiences will influence the way we think about and interpret material remains that often seem closely familiar. In this chapter we look particularly at the ways in which an archaeology of the contemporary past is informed by oral accounts and living memories, and at approaches to recording and analysing complex and multi-layered contemporary landscapes in which the past is manifest as an integral part of the present. Following the work of Michael Schiffer (1987), most archaeologists are used to thinking about the archaeological record as the cumulative product of both cultural and natural forces over the full course of human existence, from the Lower Palaeolithic until the moment just passed. But there are obvious differences with the way human behaviour is constructed and transformed into an archaeological record. When considering the archaeology of the contemporary past, for example, many of the natural processes that lead to the decay and deterioration of traditional archaeological sites are not present. And in many ways, the cultural site formation processes are more varied, resulting in archaeological sites of the recent past being either extremely well or very poorly preserved. Comparatively few modern buildings simply deteriorate for example, the more likely outcome being a decision to renovate, modernize, upgrade, or demolish and replace. Those buildings and places that are just abandoned to their fate are interesting because they are often adopted for truly alternative uses, sometimes becoming the characteristic places of those at the margins of contemporary society, as squats for example, or places for play, or where drugs are taken and alcohol consumed.
Landscape
Authors: Harrison Rodney , Schofield John
Published: November 2020

As we saw in the previous chapter, many close comparisons exist between the archaeology of the contemporary past and that of earlier periods, most obviously in the way we conceptualize and investigate sites as places or loci of human activity through the material traces left behind. We saw how this approach, this archaeological methodology, applies equally to prehistoric settlements and abandoned office spaces that we ourselves have occupied. Another comparison concerns the question of landscape, and the ways in which human activity occurs within and across landscape; how it can be influenced by the properties of landscape, whether physical or social; how the present landscape is the result of actions, activities, and attitudes in the past, and their collective and cumulative impact over time; and how we can helpfully study human activity at this broader scale. We are not talking here about particular landscapes that become fossilized at a certain time, coincident for example with their abandonment or some natural catastrophe: the Roman townscape of Pompeii for example; the Palaeolithic land surfaces at Boxgrove (West Sussex); or nuclear testing facilities of the western United States, closed or downgraded at the end of the Cold War. Rather, for the contemporary past, we are (or at least should be) referring to landscape in a more holistic sense: the everything, the everywhere, and of course—what makes it so interesting and so relevant that we examine this as archaeologists—the everyday. This scale of inquiry, the sheer amount of stuff within the contemporary landscape, and the new technologies that make it possible now to begin making sense of all this material, is one of the main challenges and benefits of exploring the archaeology of the late modern world. This chapter returns initially to the principles of historic landscape characterization or ‘HLC’, first discussed in Chapter 3, to think further about investigations of this kind, and how, for example, national and international patterns of change and use can be studied archaeologically.
Discussion and Conclusion
Authors: Harrison Rodney , Schofield John
Published: November 2020

This book has been written at a time when late modern societies are experiencing a period of enormous social and economic upheaval. Some commentators have suggested that late modern societies should be seen as defunct, or at best in decline. This forecast of the end of late modern societies looms larger than it has ever done before. But, in what ways will this influence the archaeology of the contemporary past as a discipline, and its agenda as we have charted it in this book? In many ways, the need for an archaeology of the late modern period has become even more urgent in the light of these changes. Any discipline that allows us to look at the nature of late modern societies from a different perspective will help us to understand the critical points at which societies change, and to put this information into practice in the future. But what if we are in a period that heralds the onset of a new form of society? Will the archaeology of the contemporary past simply become another period study, like the archaeology of the Neolithic for example? Although we have focused much of our discussion on the nature of late modern societies, we argue that we need an archaeology of ‘now’ as much as we need one that explores social responses to the very recent past that got us here. The central theme of this book is the need to develop an archaeology that allows us to be more self-aware and critically reflexive by understanding the nature of contemporary society and its engagement with the material world, as well as our recent and deeper past. It is this single point that is at the core of our argument—that we need to use the approaches of archaeology not only to study the roots of our society, but also to understand our present lives. Thus archaeology becomes not only a discipline for recording objects, places, and practices that are extinct or have fallen into ruin, but develops a series of tools alongside its more conventional ones for scrutinizing objects, places, and practices within our own society that are still in use.
Why Species?
Authors: Sherratt Thomas N. , Wilkinson David M.
Published: November 2020

In this chapter, we will attempt to address several interrelated questions about species and species formation. First we ask what, if anything, is a species? As we shall see, while most scientists are happy to agree on the essentials, the answer to this question is far from straightforward. We then briefly discuss the range of ways new species can evolve, and provide evidence for these different pathways. Finally, following from our opening quotations, we ask a somewhat more abstract and philosophical question that brings together many of the separate threads we have introduced: why is life not composed of a single species? . . . What is a species? . . . The classification of organisms into species is so familiar that it is easy to accept without much critical thought. On reading ‘Tiger, tiger burning bright’, or headlines such as ‘Man bites Dog’, we have no problem envisaging who the main protagonists are. Mention a tiger, and one immediately thinks of a large cat with stripes. To most people, species are simply a collection of organisms with a given set of physical traits. All classification systems include elements of personal preference as to how one chooses to classify any group of objects (e.g. by shape, size, or colour). However, there is evidence that ‘species’ represent categories that are more consistent between observers than the various ways of sorting out one’s stamp collection. The Fore, a highland people of New Guinea, are perhaps best known in the western world for the devastating prion-based disease ‘Kuru’ that afflicted their population as a result of ritualized consumption of dead family members. However, the people have close links to their natural environment and a remarkably detailed system of classifying the larger animals they see around them. In an early study to test the degree to which species assignations are consistent among peoples with different backgrounds, Jared Diamond compared the Fore nomenclature with that developed by European taxonomists. Birds found regularly in the Fore territory were divided by the Fore into 110 distinct types, and by zoologists into 120 types, with an almost exact one-to-one correspondence between Fore ‘species’ and taxonomists’ ‘species’.
Why is the World Green?
Authors: Sherratt Thomas N. , Wilkinson David M.
Published: November 2020

Viewed from space by human eyes, the predominant colours of our planet are the blue of the oceans and the white of the clouds. The blue of the oceans forms the subject of another of our chapters. However, if one focuses on the land masses other colours dominate. On land the white colour still features prominently in the polar areas covered with snow and ice, but zoom in on lower latitudes and much of the land is a mix of the green of vegetation and the brown of more arid areas. Green dominates large areas of land, so unless you are reading this in a desert, during the high-latitude winter, or in a highly urban area, then green will probably feature prominently in your surrounding landscape. One answer to the question that heads this chapter is that the climate (often rainfall) allows some parts of the land to be green with plant life, while making other areas arid and brown. However, this green of extensive plant life is still a puzzle—plants are food for a wide range of animals, so why is so much food left unused? Swarms of locusts, destroying most plants in their path (be they biblical plagues or modern day outbreaks), are the exception not the rule. But why is this so? Why are so many parts of our world green in the face of this threat from herbivores? As we will see, if herbivores are the key to our question, then what starts as a question in plant ecology ends up being a question about factors that limit the size of herbivore populations. In effect, we need to understand why herbivore populations do not increase in density to such a level that they destroy all the available plants, giving a land that is brown rather than green. Until the middle of the twentieth century if you had put the green world question to biologists, many of them would probably have suggested that it was not in the interests of a species to consume all of its food reserves.
Identifying the Context of the Presentation
Authors: Issever Cigdem , Peach Ken
Published: November 2020

The context of a presentation determines, or should determine, how you approach its preparation. The context includes many things, the audience, the purpose of the presentation, the occasion, what precedes the presentation and what follows from it. It will define what you expect from the audience, and will influence how you prepare yourself for the talk. A simple example. Suppose that you have been invited to give a series of lectures at a summer school. What more do you need to know, other than the topic? Here are a few of the questions that you need to have answered before you can start planning the course. 1. Is it an introductory course aimed at graduate students in their first year, or is it an advanced course more suited to graduates in their final year and young postdoctoral researchers? 2. Are the participants expected to ask questions during the lecture, or wait until the end? 3. Will there be any problem classes or discussion sessions? 4. Will lecture notes be handed out to participants before or after the lecture? 5. Will the proceedings be published, and if so, when? 6. What are the other lecture courses going to cover? 7. Will the basic theory already have been covered, or are they expected to know it already, or should you spend half of the first lecture going over it, just in case some have not seen it before? 8. If it is your job to give the basic introductory lectures, should you follow the standard approach in the usual text books, or should you assume that they have already covered that ground and try to give them more insight into the subject? 9. Will any of the lectures that come later in the school make any assumptions about what they have learned in your lectures? 10. Is there a social programme? If so, are you expected to participate in the activities and discuss the subject informally with the participants (which, from our experience, is always much appreciated), or can you spend most of the time in your room writing the next lecture?
Preparation and Presentation
Authors: Issever Cigdem , Peach Ken
Published: November 2020

Horace was clearly being critical. We need to ensure that we take our audience with us on the journey. In this chapter, we will discuss some of the ways in which you can try to achieve that happy outcome, once you have mastered your brief and mustered your material. Presenting scientific results is a serious business, but this does not mean that it has to be dull and boring. Of course, a lot depends upon personality; not everyone is outgoing and extrovert, or witty and erudite, and it can be quite difficult to follow someone who is. Nevertheless, like many things, it is a skill that can be acquired with practice. The point is that presenting scientific results is one of your professional duties, and it should be done professionally. It is likely to be some time in the development of your career before you are invited to give a major address to a large audience at a major event, which is when all of your oratorical and theatrical skills will be needed, but it is a good idea to start to practise them sooner rather than later. There is a trend towards giving younger scientists an opportunity to present their work at a major conference—if you are offered the chance, take it, but prepare well. In any case, many wise group leaders know that an enthusiastic graduate student or postdoc always makes a very good impression on visiting committees and suchlike, and so you might find yourself giving a keynote presentation quite early in your career. This is where self-awareness is vital. You need to assess your own strengths and weaknesses. Are you extroverted or introverted? Are you confident or timid? Is your voice strong, projecting well to the back of the hall, or do you speak with quiet authority? Are your nerves steady, or do you perspire and shake? In reality, most of us are somewhere in the middle most of the time. Even an experienced communicator is likely to be a little nervous if there are several Nobel Laureates in the audience.
Archaeology against the State: Roots of Internationalism (1995)
Authors: Evans Christopher
Published: November 2020

From World Heritage Sites to World Systems, global perspectives have come to play a dominant role in archaeology. The proliferation of variously ‘world’ entitled journals and the publication of the many volumes that are the proceedings of the 1986 World Archaeological Congress (One World Archaeology) attest to the prominence of the idea of a world archaeology/prehistory. There is a tendency to place the birth of this highly influential concept some time in the 1960s, the decade of emotive satellite imagery of the planet and McLuhan’s ‘global village’. Capturing the public spirit, ‘world’ projects featured in United Nations/UNESCO and environmental initiatives of the 1980s. Interrelating the global and local, the very big and small, by transcending or bringing pressure to bear upon the ‘middle’—the nation—‘One World’ is a compelling and apt contemporary ideology. It has come to supersede ‘united nations’, whatever the basis of their unity, inasmuch as it suggests the possibility of a world without borders. This chapter explores the roots of this recent archaeological internationalism, postulating that its origins, at least in part, lie in late/ post-Second World War reactions to nationalist archaeologies of the 1930s. Marking a watershed for the discipline, this reorientation was largely determined by the question of the role of the state and encouraged by the promise of objective archaeological science. The ‘state’ issue, much to the fore in the 1930s and 1940s, is still of relevance. It reflects, for example, upon recent declarations of politically motivated archaeologies and the awareness of practice in relation to local/indigenous, national, and international concerns. ‘The world’ and its many pasts is a (too) vast arena. This study is concerned only with the formulation of an international perspective in British archaeology. Narrowing the focus even further, it specifically considers the ‘announcement’ of this concept within a conference held in London in the late war years by Grahame Clark and his subsequent fostering of a global archaeological programme in the decades preceding the publication of World Prehistory in 1961. Finally, comparison is made between Clark’s ‘project’ and the avowedly political agenda of latter-day (One) World Archaeology.
Introduction
Authors: Palaniyappan Lena , Krishnadas Rajeev
Published: November 2020

MRCPsych exams are the most important exams a psychiatry trainee in the UK will sit during his or her career. Passing the MRCPsych is the most perceptible of the criteria that demonstrate the achievement of a number of competencies during the training. The details are clearly given in the Royal College website. They are summarized below for quick reference. Please note that these are subject to change and so we recommend checking with information at http://www.rcpsych.ac.uk before you apply. Candidates must have completed the mandatory training period of 12 months of post foundation training in psychiatry by the date of sitting the written exams. The recommended time frame for attempting Paper 2 is when the candidate is 18 to 24 months into his or her training. Posts must be part of a programme of training approved by PMETB or recognized by the Hospital or Trusts as having specific time, programme (journal clubs, grand rounds, teaching, supervision, etc.) and funds allocated for training. Individual posts can be of either 4 or 6 months’ duration. In addition, the college also has placed emphasis on successful completion of the annual review of competency progression (ARCP) and other work place based assessments (WPBA) to be eligible for training. The exact details need be confirmed from the college website as they are subject to regular reviews. The MRCPsych Paper 2 is 3 hours long and contains 200 questions. The paper consists of multiple choice questions (MCQ = 75%) and extended matching items (EMI = 25%). MCQs are in the ‘best of five’ (BOF) format. A best of five MCQ comprises a question stem of varying length, followed by a list of five options. Candidates should choose the single best option that answers the question. The college has retained the EMI format from the previous pattern in the new format. An EMI comprises a specific theme (sometimes with a short description), followed by a set of answer choices (often in an alphabetical order) and a lead-in statement explaining what the candidate is being asked to do. This lead-in statement is then followed by a question list, set out in a logical order. The questions may be asked in form of clinical vignettes.
Introduction to core principles in children’s nursing
Authors: Coyne Imelda , Livesley Joan
Published: November 2020

The aim of this chapter is to discuss the core principles in children’s nursing and the application of these principles in everyday practice for nurses working with children and families. These essential principles are fundamental in the delivery of high quality care and as such will be evident throughout this textbook. This chapter will explain these principles in the context of community and hospital care and illustrate how nurses can use this knowledge in their clinical practice. There is no doubt that clinical skills are an essential component of high quality healthcare, but they are on their own insufficient to ensure that the needs of children and their families are met. Clinical skills need to be embedded in children’s services that are child centred and clearly focused around the needs of children and their families; but how is this possible? To ensure high quality care for children in hospital and the community you need to incorporate the core principles of family centred care into your everyday nursing practice and interventions. It is essential to understand the principles of family centred care and the importance of partnership and negotiation in the delivery of clinical skills. Knowing where to begin can be difficult, but we think that you can start with the concept of attachment and loss. Understanding this in relation to children’s separation from their family and home will help you to understand the impact of hospitalization on children, particularly those younger than five years old. The adverse aspects of hospitalization have been a substantial driving force in delivering more nursing services to children at home. However, it is also important to remain aware of the ongoing impact of lifelong illness on children and their families and why it is essential to use effective communication skills, maintain safe environments, and incorporate play into your practice. Together with evidence-based clinical skills, these facets of practice will enable you to maintain and promote children’s and families’ health and well-being. Specific learning outcomes are as follows. At the end of this chapter you will: ● Understand the basic elements of attachment and loss theory.
Child development
Authors: Barron Carol
Published: November 2020

Child development can be described as the biological and psychological changes that occur in human beings between birth and the end of adolescence. There are many different factors that influence child development, such as biology/ genetics, the personal experiences we undergo throughout our childhood, and the influence of the environment. Child development is often categorized into five domains: cognitive (development of the ability to think and reason); social/psychosocial (the process by which a child learns to interact with others); emotional (the child has to learn how to recognize and control their own differing emotional states and to recognize emotions in others); language (how children acquire language); and finally physical development (the physical changes that occur from birth to adolescence). It is important to remember that development occurs simultaneously in all domains and that they are interrelated and interdependent, for example a delay in physical development may hamper the child’s social and emotional development. It is imperative that nurses have a sound understanding of ‘normal’ child development before they can begin to appreciate deviations in any aspect of development. On completion of reading this chapter you will begin to link your knowledge of child development to the preparation, implementation, and aftercare involved in clinical nursing procedures such as measuring a baby’s head circumference, as outlined later on in the chapter. It is anticipated that you will be able to do the following once you have read and studied this chapter: ● Understand the main influences on child development and the nature versus nurture debate. ● Understand normal child development so you can apply this knowledge to the key nursing skills required to care for a child and their family. ● Understand the importance of developmental assessment throughout childhood, such as the development checks undertaken by health visitors/ public health nurses, as a means to assess ‘normal development’ as well as delays in the achievement of expected developmental milestones. Child development refers to the biological and psychological changes that occur in human beings between birth and the end of adolescence, as the individual progresses from dependency to increasing autonomy.
The renal system
Authors: Hollywood Eleanor , Costello Paul
Published: November 2020

The focus of this chapter is the renal system and the clinical skills that are associated with renal dysfunction. By the end of this chapter you will be knowledgeable in relation to these skills and your new knowledge will be underpinned by up-to-date evidence-based best practice. It is anticipated that you will be able to do the following once you have read and studied this chapter: ● Understand urine sampling techniques and urine testing methods and their significance in clinical practice. ● Understand the various procedures and investigations that the infant, child, or young person may have to endure for renal system evaluation. The urinary system is important in maintaining the correct water and electrolyte concentrations in the body. Waste products and excess water and ions are eliminated from the body in the urine. The kidneys are situated on either side of the vertebral column in the abdomen. The ureter, renal blood vessels, nerves, and lymphatics enter the kidney at a cleft on the medial side called the hilum. The adrenal gland lies on top of the kidney. The outside of each kidney is lined by: ● The renal capsule—a layer of collagen fibres. ● The adipose capsule—a layer of fat. ● The renal fascia—a layer of dense connective tissue. These three layers of tissue protect and support the kidney. The inside of each kidney contains an outer area (the cortex) and an inner area (the medulla). The cortex is lighter in colour compared to the dark reddish-brown medulla. The medulla contains cone-shaped areas of tissue called the medullary pyramids, which point towards the hilum. The cortex extends in between the medullary pyramids forming the renal columns. Urine forms at the tip of the pyramids (papillae) and drains into the minor calyx, then into a larger major calyx. Two or three major calyces join together to form the renal pelvis, a funnel-shaped chamber that leads into the ureter. Nephrons are the functional units of the kidney, the structures where urine is formed.
Gastrointestinal system
Authors: Clynes Mary , O’connor Caroline
Published: November 2020

The aim of this chapter is to provide you with knowledge and understanding of the skills required in providing care to the child with a gastrointestinal disorder. This chapter will focus primarily on the most frequently encountered procedures both in the hospital and in the community setting. In addition, the importance of family centred care and a multicultural approach to care will be discussed. Some of the skills outlined in this chapter may be classified as advanced skills, for example, caring for a child on parenteral nutrition, and therefore you should seek appropriate guidance/ supervision when undertaking these practices. Moreover, it is essential that the student follows appropriate care plans, works within his/her scope of professional practice, and adheres to local policy in relation to carrying out nursing care (Nursing and Midwifery Council (NMC), 2007). This chapter will enable you to: ● Briefly describe the anatomy and physiology of the gastrointestinal system. ● Understand the procedures outlined in the chapter. ● Explain the rationale for the care you provide. ● Understand the importance of the holistic needs of the child when carrying out procedures. ● Understand the importance of family centred care and a multicultural approach to care. Knowledge of national and local policies and guidelines are recommended to enhance learning, e.g. National Institute of Health and Clinical Excellence (NICE) guidelines. Where reference is made to national guidelines, students are advised to refer to them for more detailed information. It is important that the student has a comprehensive knowledge of the anatomy and physiology of the gastrointestinal system to support understanding of many of the clinical skills described in this chapter. The following section will briefly outline the structure and function of the gastrointestinal tract. Knowledge of the changes that occur in the gastrointestinal tract as the child grows and develops is paramount to providing appropriate care and these will be signposted as they relate to skills throughout this chapter. For more detailed information refer to an anatomy and physiology textbook.
Integumentary system
Authors: Kelly Jacinta , Simons Joan
Published: November 2020

The skin is an organ that serves many functions in maintaining homeostasis in the body (Bryant, 2000). A wide range of diseases manifest in changes in the skin and its appendages, and because the skin is visible and its disorders are often disfiguring, skin disorders can cause emotional and psychological stress for children and their families (Ball & Bindler, 2007). Skin diseases affect 20–33% of the population at any one time, seriously interfering with activities in 10% (Byrant, 2000). Epidemiological evidence suggests that many cases of skin disease do not reach the general practitioner (GP) or even the local pharmacist; nevertheless, each year about 15% of the population consult their GPs about skin complaints (Bryant, 2000). Skin disorders are among the most common health problems in children (Butcher & White, 2005). The infant and child are possibly more vulnerable to the effects of skin disorders and breakdown due to their underdeveloped integumentary system. Understanding the normal condition of the skin can help in the identification of abnormal signs and prompt treatment of skin disorders (Butcher & White, 2005). This chapter will focus on the integumentary system of the child, with reference to the normal structure of the skin together with common alterations and injuries to the skin of the child and the skills required for their nursing management. At the end of this chapter you should be able to do the following: ● Understand the normal child skin anatomy and physiology. ● Understand the fundamentals of a skin assessment in a child. ● Develop an awareness of the management of common skin alterations. ● Understand the nature and treatment of a child with a skin injury. The skin of an infant or child is normally fundamentally the same as that of an adult, although the blood and nerve supplies are immature and the dermis thinner, with less collagen and fewer elastic fibres. This means that the skin is fragile and can be more easily damaged through physical and mechanical trauma (Turnball, 2007). The skin of a newborn is found to have lanugo, which is a very fine, soft, and unpigmented coat of hairs covering its body until it is shed about 14 days after birth.
Fish: exploring the sea as a taskscape
Authors: Van de Noort Robert
Published: November 2020

Food and social identities are closely connected. The idea that ‘to be Mesolithic is to be a fisher’, with all the connotations that differentiate the Mesolithic fisher from the Neolithic farmer, characterizes some of the debates that are ongoing (e.g. Thomas 2003). Food and social identities are connected, especially in the case of societies of fishermen, for example in the wearing of distinctive national dress by the female relatives of fishermen in the Netherlands in the 19th and first half of the 20th centuries (see chapter 2). However, we should not forget that fishing as a full-time occupation appears in the North Sea only around the 15th century AD, and that before that date fishing was only ever a part of people’s occupation and social identity (Kirby and Hinkkanen 2000; Fox 2001). Nevertheless, to be a successful fisher required skill, tools and knowledge of the tides and the movement of fish. All these created distinctive taskscapes where people’s daily engagement with the sea followed the rhythm of the tides, rather than that of the sun. This chapter considers the North Sea as a taskscape, focusing on the long history of fishing and fish consumption, and the current debates on the importance of fishing in our prehistoric and historic past. It presents a short overview of the role of fishing in the North Sea from the Mesolithic through to the 15th century AD, and the tools and craft used for this. Using anthropology and oral history research, the distinctive identities formed by fishing communities will be considered, and the chapter will ask whether this distinctiveness has a long heritage, or is of more recent date. The earliest indirect evidence for the use of marine resources in the North Sea basin goes, possibly, back to the tenth millennium cal BC. The zoo-archaeological evidence from the Galta peninsula in present-day south-west Norway, where flint points of the Ahrensburg complex have been discovered in redeposited beach sediments, has already been introduced (chapter 3; Prøsch-Danielsen and Høgestøl 1995). This evidence has been invoked to argue that south-west Norway was suited to reindeer hunting at the end of the Younger Dryas stadial, or very early Holocene.
Land-Uses and Convertible Husbandry in As You Like It
Authors: Martin Randall
Published: November 2020

Having made jibes at Orlando’s love-verses and drawn defensive reactions from Rosalind, Touchstone gently reproves her by appealing to nature as a third party: ‘You have said; but whether wisely or no, let the forest judge’ (3.2.117–18). Thinking ecocritically, we might hear in his advice an anticipation of Aldo Leopold’s landmark book, A Sand County Almanac (1949). Leopold redefined ecological ethics by reading his local Wisconsin landscape for signs of its biodiversity, whose value he asserted independent of its economic and social utility. He also encouraged readers to think about reciprocity and fairness in their dealings with the environments and resources they share with non-human life. Jaques’s viewpoint in As You Like It is hardly as self-disinterested as that of a forest. Yet he captures the essence of Leopold’s biocentric principles by reminding Oliver that the trees into which he has thoughtlessly, if romantically, carved his verses are entitled to their own physical integrity (3.2.251–52). Leopold’s outlook inspired the later movement, bioregionalism, which looks to identification with a landscape’s terrain, climate, and biota, or collective plant and animal life, as the basis for resistance to environmental damage caused by distant political authorities and transnational economies. In conceiving environments as ‘life-territories’ with natural rights that extend beyond those of human culture, Leopold invited people to imagine cooperative attachments to regional modes of subsistence and dwelling. Arden and surrounding Warwickshire were the life-territory where Shakespeare learned to think bioregionally. Whereas his knowledge of Windsor in Merry Wives came from passing acquaintance, his sensitivity to Arden’s place-attachments was both deeply personal and critically detached, and he integrated both perspectives into As You Like It. Topographic and social contouring of Warwickshire’s historically changing terrains dramatically heightens the visibility of Arden’s early modern bio-relations. I’ll begin exploring these by considering how Shakespeare gave his dramatic adaptation of Thomas Lodge’s prose romance Rosalynde (1590) a distinctive environmental profile. In doing so, Shakespeare created an ecological meta-commentary on Lodge’s popular forest romance.
Distant lands
Authors: Zalasiewicz Jan
Published: November 2020

It was Avalonia, but it could as well have been Shangri-La, or Conan Doyle’s Lost World. The vanished nursery-ground of our pebble—the land-that-once-was—is now terribly distant from us. Epic journeys are needed to reach it, back into deep Earth time. It is not a physical journey, as such, to be taken using helicopter and dug-out canoe, by explorers in pith helmets, wielding machetes. Rather, it is a journey of the imagination, albeit one grounded in the physical reality of this lost continent, and the traces of it that remain. Touch the pebble, and you are touching Avalonia, in the form of the mineral grains that represent its destruction, a continuous dismantling accomplished by half a billion years of wind and rain and flood. It is through those grains that one needs to search back for the landscape that they once represented. Or rather, landscapes. Avalonia was not a single unchanging entity, which we can hope to picture in ever-more-faithfully captured detail as we study its ancient past. This lost continent ceaselessly changed, mutated, renewed itself. And the tiny mineral fragments that now form part of the pebble are not so much fragments of it, as fragments of them, of its many changing faces. One might, for comparison, take tiny relics from each of the seven successive cities of Troy (and sample, too, the modern buildings that now stand above their buried remains). Grind, then, those fragments into a fine powder. Then, give a handful of this dust to an archaeologist, and say ‘now, bring those cities back to life!’ Landscapes are transient. This is a concept that does not come easily to us. In our brief lifetimes we see the Earth’s landmasses as things of massive permanence, the bedrock of passing civilizations. And yet even in these human lifetimes we can see masses of rock debris piled up beneath mountain crags—and, as we walk nearby, hear the fall of new scree fragments, dislodged from rock faces by wind and water. We see sand move along a river floor, driven by the flowing water. Occasionally, we might see villages smashed by floodwaters, the wreckage littered with mud and boulders carried from miles up the valley.
To the rendezvous
Authors: Zalasiewicz Jan
Published: November 2020

Before any great expedition, there is a gathering of all of the forces—of the clans, the troops, the mercenaries—from near and far, by various routes. Once met, they will then travel en masse, their fortunes from then to be bound together, for good or ill. Sediment particles of the future pebble were gathering, around the shores of Avalonia, in the Silurian Period, for a journey that would take them to a resting place, one where they would not see the light of day for something over 400 million years. The grains of sand and flakes of mud, with all their variety and histories, were being washed into some long-vanished shoreline by Avalonian rivers, rivers that have not yet been discovered, or charted, or named, by modern-day explorer–geologists. Likely these rivers never will be charted, for in flowing they eroded themselves away, washing away their own tracks, as Avalonia was being dismantled, grain by grain, by the eternal, tireless action of the weather. All that is left is the freight they carried, the baggage of sand, mud and pebbles. The ancient shoreline lay not much more than 50 miles away from what is now our pebble beach in west Wales. It lay to the south, around what is now Pembrokeshire in South Wales. What did it look like, that ancient coastline? Well, it may even have resembled the rugged Pembrokeshire coastline of today, though it faced north rather than south, looking across an area of open sea that was later transformed into the Welsh mountains. For the pebble stuff, the passage across that coastline marked the entrance into a new realm. As the river waters entered the sea, their onrush slowed. The sediment grains, no longer driven by river flow, would have piled up around river mouths as deltas, or within silting-up estuaries. They would not have been stilled for long though, for coastlines are places where energy is exchanged. New forces acted on these sediment particles: wind and tides and waves, the forces that nowadays mariners need to respect, and understand, and predict.