bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring and record keeping
Authors: Olsen Jørn , Merletti Franco , Snashall David , Vuylsteek Karel
Published: November 2023

Epidemiology has an important role to play in occupational medicine, but there are limitations to epidemiological studies. In studying the effect of occupational exposure on the health of the workers you look at those events which you would want to have prevented. On the other hand, not all effects on health can be foreseen and no matter how cautious you are, some exposures or some combination of exposures will turn out to be dangerous for the health of workers. When that happens, they should be detected as soon as possible in order to reduce the damage to a minimum. Epidemiology has a role to play in this process. It is unsatisfactory that occupational causes of diseases are often recognized in a haphazard way. Too many dangerous chemicals had been around for too many years before anyone studied what happened to the exposed. This is where the idea of monitoring comes in.
Maternal illness and drug use in pregnancy
Authors: Elwood Mark , Little Julian , Elwood Harold
Published: November 2023

If neural tube defects, or even a small proportion of them, were caused either by illness in the mother, or by drugs used in pregnancy, identification of such hazards could be followed rapidly by preventive actions. Studies on both these topics have been difficult: they consist of observations of associations in time and place between such exposures and the occurrence of defects (particularly prone to difficulties of other, confounding, effects); retrospective studies comparing mothers of affected and of unaffected infants (prone to recall bias); and prospective studies comparing exposed with unexposed mothers (a strong design, but one requiring very large numbers of pregnancies to give reliable information). When an association is seen, it is very difficult to separate the effects of an illness from those of drugs used to treat that illness. Moreover, many studies are not powerful enough to show or to exclude an association specific to neural tube defects, and information on major congenital defects in aggregate must be used. As well as the problems inherent to individual studies, assessing the evidence on reproductive hazards is made more difficult by publication bias, i.e. the information which is published may not be representative of all that is available. This has been demonstrated in regard to the reproductive effects of cocaine; Koren et al. (1989) have shown that abstracts on this topic showing adverse effects were more often accepted by a major paediatric society than those showing no such effects, although in terms of size and detail, the negative studies were better.
Ethical and legal issues
Authors: Campbell Alastair
Published: November 2023

A quite remarkable array of both moral and legal issues is raised by the subject matter of this book. The most obvious are termination of pregnancy for fetal abnormality and selective non-treatment of handicapped neonates. But in addition, questions are raised concerning the allocation of resources, the ethics of research into primary prevention, parental rights in both the reproduction and the treatment of their offspring, social versus individual benefit in screening programmes, and ethical dilemmas in organ transplantation. In many of these topic areas there is an absence of clear and agreed guidelines. Perhaps for this reason, debate about the moral values at stake may seem inconclusive, if not futile. Yet, without such debate, decisions may be taken in a haphazard fashion, without a proper regard for their effects on the health and welfare of individuals, families, and the society as a whole. A survey of the ethical and legal debate must inevitably reveal a diversity of opinion and will provide few, if any, simple answers. On the other hand, it can serve to delineate the options for both legislative controls and ethical guidelines, and may assist the decisions taken by parents and their professional helpers. The topics discussed in this chapter will be dealt with in a roughly sequential fashion, beginning with the prenatal dilemmas involved in prevention prior to conception, screening, prenatal diagnosis, and genetic counselling, moving on to the debate about selective termination of pregnancy, and concluding with the postnatal dilemmas raised by non-treatment of affected neonates and the use of anencephalic infants as organ sources. A concluding section of the chapter will give a more general overview of the ethical and legal debate.
Conclusions
Authors: Elwood Mark , Little Julian , Elwood Harold
Published: November 2023

A great deal of progress into the control of neural tube defects has been made in the last decade. Antenatal diagnosis, with the choice of an induced abortion being given, is now routinely offered to high risk mothers in many countries, and is provided as a population based screening service in many moderate and high risk areas, particularly in the UK. Antenatal diagnosis in the UK has dramatically reduced the prevalence at birth of anencephalus, and very considerably reduced that of open spina bifida. Screening using a combination of alpha-fetoprotein measurements and ultrasound can lead to very high detection rates with very few false positives.
Cigarette smoking and the risk of age-related fractures
Authors: Cooper Cyrus , Wickham Carol
Published: November 2023

Age-related fractures constitute a major public health problem. Their incidence depends on osteoporosis and the risk of falling. Evidence exists to support an association between cigarette smoking and fracture risk. The strength of this association, however, varies with type of fracture, being stronger for vertebral than hip fracture. A clear understanding of the relationship between smoking and these fractures is fundamental to the design of preventive strategies.
The sky is the limit—prospects for the future
Authors: Ellencweig Avi Yacar
Published: November 2023

For those looking for ways to simplify the study of health systems and to benefit from easy comparisons, this book brings no salvation. Perhaps a typology classifying health systems into a few prototypes would be more appealing. However, as we noted before, in our view the application of such typology is not realistic. Health systems simply are not adaptable to simplistic presentations based on a small number of descriptive dimensions. Based on our understanding that there is little sense in comparing health systems as such, we have suggested that modules be compared instead, since—according to our model—the modules make up the health system. Now, a crucial question remains unanswered: Can we still predict the future development of a health system based on our partial knowledge of these components called modules? Well, the answer is definitely yes. In this concluding chapter, we shall examine the effects of trends in health systems and seek to understand their implications for the future of these systems. We shall discuss these trends in relation to each separate module of our model and in the order dictated by our discussion in previous chapters.
Treatment of hypochondriasis
Authors: Warwick Hilary M C
Published: November 2023

This chapter concentrates on patients who fulfil the criteria for a particular sub category of somatoform disorder, hypochondriasis. It focuses especially on hypochondrias unaccompanied by other major psychiatric disorder, so-called primary hypochondriasis. The status of this category as a distinct syndrome subgroup remains controversial (Barsky, et al. 1992).
Chlamydia-induced arthritis
Authors: Zeidler Henning K , Schumacher H Ralph
Published: November 2023

An aetiological connection between urogenital infections with Chlamydia trachomatis and arthritis has long been presumed, but chlamydia! antigen in synovium and synovial fluid was only recently identified in patients with Reiter’s syndrome, sexually acquired reactive arthritis, and undifferentiated seronegative oligoarthritis (Ishikawa et al. 1986; Keat et al. 1987; Schumacher et al. 1988; Taylor-Robinson et al. 1988). Meanwhile, an increasing number of investigations have confirmed the presence of chlamydia! antigens, nucleic acid, and chlamydia-like particles in arthritic joints, which has led to the present view of an intraarticular inapparent infection with viable, non-culturable or difficult to culture Chlamydia (Bas et al. 1995; Beutler et al. 1994; Hammer et al. 1992; Mascia et al. 1992, Rahman et al. 1992a; Taylor-Robinson et al. 1992).
Spondyloarthropathies in children and adolescents
Authors: Rosenberg Alan M , Petty Ross E
Published: November 2023

With the emergence of rheumatology as an established paediatric subspecialty, it has become increasingly apparent that a wide spectrum of rheumatic diseases afflict children more frequently than had been appreciated previously. The spondyloarthropathies, once believed to occur almost exclusively in adults, are now recognized as frequently having their onsets during childhood and adolescence. In this chapter the clinical characteristics of childhood spondyloarthropathies are discussed and advances in diagnosis and management are considered.
Urinary Tract Defects and Chromosomal Disorders
Authors: Amor David J , Crespigny Lachlan De , Gardner R J Mckinlay
Published: November 2023

Chromosomal abnormality may be constitutional or acquired. A constitutional abnormality is present at conception (or at least from embryogenesis), and typically affects the morphogenesis of organs. An acquired abnormality arises somatically, in a person whose constitutional karyotype may be normal or (more rarely) abnormal, and cancer is the classical example. In this chapter, we focus largely on the constitutional case, but do not ignore acquired abnormalities.
Cystic Renal Diseases
Authors: Saggar-Malik Anand K
Published: November 2023

Renal cysts may result from a variety of causes. Table 11.1 shows a simple classification of renal cystic kidney disease. A diagnosis of multiple renal cysts is often confused with autosomal dominant polycystic kidney disease (ADPKD) which is a very common inherited cystic renal disease (Chapter 11). The clinical picture together with the location of the cyst may help in the differential diagnosis (see Table 10.1).
Trial-based economic evaluations: an overview of design and analysis
Authors: Glick Henry A , Polsky Daniel P , Schulman Kevin A
Published: November 2023

In response to increasing health care costs, countries around the world have been exploring methods for their control. At the more macro level, responses have included greater risk sharing between payers, providers, and patients as well as a greater reliance on market-oriented incentives. At the more micro-level, government regulators, health care providers, members of managed care formulary committees, payers, and patients have begun to evaluate the value for the cost of individual medical therapies.
Handling uncertainty in economic evaluation and presenting the results
Authors: Briggs Andrew H
Published: November 2023

Economic evaluations of health care interventions are increasingly common, with the growth of the economic evaluation literature now widely documented (Pritchard 1998; Briggs and Gray 1999; Stone et al.2000). Uncertainty in economic evaluation is pervasive, entering the evaluative process at every stage. It is useful to distinguish uncertainty related to the data requirements of a study (the resource use and health outcome consequences of a particular intervention and the data required to value those consequences) from uncertainty related to the process of evaluation.
Molecular basis of macrophage activation: from gene expression to phenotypic diversity
Authors: Hamilton T A
Published: November 2023

Mononuclear phagocytes represent a host-wide system of cells which provide a broad range of physiologically important services (Adams and Hamilton, 1984, 1992a; Nathan and Cohn. 1995: Van Rooijen et al., 1996; Bosque et al., 1997; Gordon. 1998). Not surprisingly, members of this cell system can exhibit a diverse array of characteristics. The mononuclear phagocyte lineage develops in the bone marrow and, following entry into the circulation, seeds essentially all tissues. Thus, under resting conditions, the differences between macrophages in different organ locations are likely to result from developmental signals encountered within individual tissue sites. Such differences are not the consequence of ‘activation’ as they reflect the specific physiology of each tissue and are stable over time. Examples of such developmentally distinct mononuclear phagocyte populations include microglia. Kupffer cells, splenic macrophages and the spectrum of myeloid dendritic cells.
Macrophages in bacterial infection
Authors: Heale J -P , Speert D P
Published: November 2023

Bacterial pathogens must breach normal host defenses to establish invasive infections. The macrophage stands guard at potential portals of entry to discourage such intruders and to maintain sterility of deep tissues. Despite the rich panoply of antimicrobial devices available to the macrophage, many bacterial species have developed means of resisting these normal tidal mechanisms. Some bacteria are able to persist within macrophages and some are even dependent upon this intracellular haven for their survival. This chapter will provide an overview of the macrophage’s antibacterial activities and will describe some of the strategies used by intra- and extracellular pathogens to overcome these normal host defense mechanisms.
Macrophages in the central nervous system
Authors: Matyszak M K , Perry V H
Published: November 2023

A dominant theme in studies of the central nervous system (CNS) is the relationship between structure and function. The wide diversity of neuronal forms is believed to reflect differences in their functions. With the use of immunocytochemistry and antibodies directed against components of the plasma membrane of macrophages, it has become clear that tissue macrophages also have a wide diversity of forms (Figure 13.1). These morphological differences reflect not only adaptations of the monocyte to the local microenvironment, but also heterogeneity in functional capabilities, expression of membrane receptors and biosynthetic capacity (Gordon et al., 1988). The adaptation of a monocyte appears to reach its greatest degree of morphological specialization in the microglia, the resident tissue macrophages of the CNS.
Use of mathematical models to simulate and predict macrophage activity in diseased tissues
Authors: Byrne H M , Owen M R
Published: November 2023

The key role played by macrophages in developmental biology, normal physiology and the progression of many diseases is now well accepted, and is underlined by the range of subjects already discussed in this book. Whilst the involvement of macrophages in, for example, angiogenesis (Bennet and Schulz, 1993; Polverini et al., 1977), bacterial and parasitic infections (see Chapters 5 and 6) and human immunodeficiency virus (HIV) infection (see Chapter 4, and Wodarz et al., 1999) is undisputed, their precise function is not always well understood. For example, on the basis of current, experimental evidence, it is not clear whether the presence of macrophages within solid tumors is a good prognostic indicator: in breast carcinoma, extensive macrophage infiltration is significantly associated with poor prognosis (Leek et al., 1996), whereas in other cancers the association between infiltration and prognosis has not been established. The difficulty in making general predictions about macrophage behavior is undoubtedly linked to their multifaceted nature: an individual macrophage is capable of performing a large repertoire of functions, with a combination of its location, activation status and the stimuli to which it is being subjected controlling the action that is undertaken. Faced with such a complex cell, the prospect of using mathematical techniques to provide additional insight into the role that macrophages play in human biology may appear alternately naive and infeasible. However, closer inspection of the phenomena in which macrophages are implicated reveals several common features that can, and should, be exploited when developing mathematical models. For example, the preferential (or chemotactic) migration of macrophages to hypoxic sites at which they are activated to express angiogenic factors such as vascular endothelial growth factor (VEGF) is characteristic of not only wound healing but also tumor angiogenesis and rheumatoid arthritis. Equally, the ability of macrophages to engulf and destroy foreign bodies is integral to the immune system’s ability to combat bacterial and parasitic infections and is often compromised by HIV infection.
expression in human vasculature
Authors: Mosley Michael , Mansfield Roy , McHarg Aileen
Published: November 2023

Triptans are 5-HT1 receptor agonists with high affinity and selectivity for 5-HT1B, 5-HT1D, and 5-HT1F receptors, and have been shown to be effective as acute treatments of migraine. Although the pathophysiology of migraine is uncertain, it is believed that pain-associated migraine arises from excessive dilation of intracranial blood vessels and the resulting increased neurosecretory activity within the trigeminovascular system. Selective 5-HT1 receptor subtype agonists and antagonists have indicated that the vasomotor dysfunction associated with migraine is mediated by 5-HT1B receptors.
Comparison of triptan-induced contractions in human cerebral versus coronary arteries
Authors: Uddman Erik , Edvinsson Lars
Published: November 2023

The effect of triptan treatment in migraine headache is believed to be mediated through several pathways, one of which is the activation of contractile 5-HT1B/1D receptors on cerebral arteries. Immunocytochemistry and mRNA studies have shown expression of 5-HT1B but not 5-HT1D receptors in human cerebral and middle meningeal arteries, respectively.
The relevance of hepatic intrinsic clearance and brain penetration on the doses used for 5-HT1B/1D agonists (triptans) in the treatment of migraine
Authors: Morgan Paul , McCleverty Paul , McHarg Aileen , Milton K Ashley
Published: November 2023

Various 5-hydroxytryptamine (5-HT1B/1D) agonists (triptans) have been shown to be effective in the treatment of migraine with a range of doses required to achieve efficacy, despite similar in vitro potency. Recent papers have speculated that limited brain penetration of eletriptan is the main reason for its higher dose requirement. However, these studies only considered total drug concentrations in brain and plasma which has no pharmacological relevance. In fact a fundamental tenet in linking pharmacokinetic and pharmacodynamic phases is that only free drug in the systemic circulation and tissues is available for clearance, distribution, and to exert pharmacological effects.
Consistency of pain relief over multiple migraine attacks following treatment with rizatriptan
Authors: Dahlöf Carl G H , Lipton Richard B , Lines Christopher R , Kramer Mark S , Reines Scott A , Polis Adam B , Ferrari Michel D
Published: November 2023

Migraine is a chronic disorder which is characterized by episodic attacks with a median frequency of one to two per month. Having a treatment which is consistently effective over multiple attacks is an important priority for migraine patients. The efficacy of antimigraine medications over a series of attacks has usually been evaluated in longterm, open-label studies which were primarily designed to assess safety. These studies generally lack a placebo control, for ethical reasons and to optimize patient compliance. Randomized, blinded, placebo-controlled clinical trials (RBCTs), which are the gold standard for determining treatment effects, have typically only assessed efficacy during treatment of a single migraine attack. There have been a small number of RBCTs looking at response to treatment in up to four attacks.
Naratriptan: the gentle triptan
Authors: Salonen Reijo
Published: November 2023

Naratriptan, the second selective 5-HT1B/1D agonist to be introduced for the acute treatment of migraine, was developed by the maker of the inaugural 5-HT1B/1D agonist sumatriptan. Sumatriptan transformed migraine therapy by promptly relieving migraine pain in the majority of patients and rapidly returning them to normal daily functioning. While sumatriptan revolutionized migraine therapy, it is not devoid of limitations. Naratriptan was developed with the aim of providing a sumatriptan complement with a placebo-like tolerability profile and a lower recurrence rate.
Almotriptan
Authors: Pascual Julio
Published: November 2023

Currently available triptans are not ideal for at least for 20–30% of patients due to side-effects and/or response failure. Almotriptan is a new selective 5-HT1B/1D receptor agonist developed by Almirall-Prodesfarma, Lundbeck, and Pharmacia-Upjohn for the symptomatic treatment of migraine. In this manuscript the fundamental basic properties and the clinical experience with oral almotriptan will be reviewed.
are unaffected during a migraine attack
Authors: Buchan P , Ward C , Zeig S
Published: November 2023

Frovatriptan is a potent, cerebroselective 5-HT1B/1D agonist for use in the acute treatment of migraine. This study investigated the pharmacokinetics and tolerability of frovatriptan during and outside a migraine attack.
The triptan threshold score: a score to help patients identify the best moment to take triptans
Authors: Göbel Harmut , Heinze Axel , Heinze-Kuhn Katja , Austermann K , Chryssafopoulos D , Keil R
Published: November 2023

When using triptans to treat migraine attacks it is important to ensure accurate timing of triptan intake. Early intake and late intake of triptans will both result in unsatisfactory treatment results. If the triptan is taken too early it may be unnecessary or inefficient, because the headache might show a spontaneous remission or might only develop into a tension-type headache. Patients with frequent migraine attacks may develop drug-induced headache as a result of overfrequent intake. On the other hand, if the triptan is taken too late it may not act fast enough or the results may be unsatisfactory1–3. Many patients with frequent headaches suffer both from migraine and from tension-type headaches; here, too, it is important to know the right time to take the triptan.
Tobacco advertising and promotion
Authors: Saffer Henry
Published: November 2023

If tobacco advertising and promotion increase cigarette consumption, they are issues for public health policy. Although public health advocates assert that tobacco advertising does increase cigarette consumption, there is a significant empirical literature that finds little or no effect of tobacco advertising on smoking. In this chapter, these empirical studies are examined more closely with several important insights emerging from the analysis. The chapter also provides new empirical research from 102 countries on the effect of tobacco advertising. The primary conclusion of this research is that a comprehensive set of tobacco advertising bans can reduce tobacco consumption and that a limited set of advertising bans will have little or no effect.
Clean indoor-air laws and youth access restrictions
Authors: Woollery Trevor , Asma Samira , Sharp Donald
Published: November 2023

The development of public policy on tobacco is incomplete without the consideration of clean indoor air and youth access policies. Clean indoor-air laws protect non-smokers from the dangers of environmental tobacco smoke and implicitly transfer property rights to ambient air from smokers to non-smokers, but also have economic costs for individuals and businesses. Numerous studies conclude that comprehensive clean indoor-air policies lead to significant reductions in smoking prevalence and average cigarette consumption among continuing smokers. Youth access laws limit the supply of tobacco products to adolescents, who are deemed too young to fully comprehend the risks of consuming tobacco products. The existing empirical evidence on the impact of limits on youth smoking is mixed. For both clean-air laws and youth access restrictions, economic theory justifies government intervention in an inefficient tobacco market. The laws work best when drafted comprehensively without pre-emptive provisions. Clean indoor-air policies can, in some instances, be self-enforcing, while youth access policies depend crucially on aggressive enforcement to ensure compliance. Overall, the global coverage of clean indoor air and youth access policies is minimal. While high-income countries as a group have histories of clean indoor air and, to a lesser extent, youth access laws, low-income and middle-income countries are in the nascent stages of developing such policies.
Experimental models of vascular dementia: a focus on white matter disease and incomplete infarction
Authors: Sarti Cristina , Pantoni Leonardo
Published: November 2023

The concept of vascular dementia has changed over the last few years (Desmond 1996). The use of both the words ‘dementia’ and ‘vascular’ has been criticized, and replacement by the term ‘vascular cognitive impairment’ proposed (Hachinski and Bowler 1993).
The Prevention of Oral Disease
Authors: CBE J J Murray , Nunn J H , Steele J G
Published: November 2023

The new edition of Prevention of Oral Disease remains the only comprehensive textbook covering all aspects of dental prevention. Chapters covering conventional preventive issues such as diet and fluorides are complemented by innovative new or revised material in a wide range of areas, including mucosal disease, the pulp and endodontics and periodontal disease. Generic subjects such as the social dimension of oral health and health promotion underpin the clinically based chapters. The book is relevant to anyone who has to provide or understand prevention, irrespective of their clinical discipline or interest. This is an essential text for undergraduates, but will be valuable for postgraduate students in many fields, and for dental practitioners and hygienists interested in current thinking on prevention. The material presented is concise, structured and well illustrated and is based on the most recent research evidence. For the first time, the book is presented in an attractive two-colour format and the use of summaries and key points throughout the book ensure that it is learner friendly.
Fluoride and dental caries
Authors: Murray John
Published: November 2023

The history of fluorides in dentistry is over 100 years old. Sir James Crichton Browne made an inspired guess about the importance of fluoride in the diet in 1892. Fluoride was isolated from water supplies in 1931 and has been incorporated into water, milk, salt, tablets, and drops. It has also been included as an active agent for the prevention of dental caries in toothpastes, professionally applied topical fluoride agents and mouth rinses. The purpose of this chapter is to summarize the information concerning the effect of fluorides in the prevention of dental caries.
Impairment—preventing a disability
Authors: Nunn June
Published: November 2023

The last five years have seen significant changes in the whole issue of disability; the reasons for this will be discussed in this chapter. It is important that we define what is meant by impairment, disability, and handicap before proceeding further. In the early nineties the term ‘handicapped’ was still in use in many countries and indeed, remains so today in places like Japan and Hong Kong. Pressure from the wider disability movement, and from advocates of people with disabilities persuaded those in health and social care, as well as a wider audience, that this term stigmatized people who were different. There has been a gradual move away from this medical model—describing people as ‘handicapped’—to the social model where the emphasis is more on the environment imposing disability on a person with impairment (Hutchison 1995).
The menopause and hormone replacement therapy
Authors: Barrett-Connor Elizabeth
Published: November 2023

Natural menopause is the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is confirmed after 12 consecutive months of amenorrhoea for which there is no other obvious cause. The average age at natural menopause, about 51 years, has been constant for centuries. A majority of women experience natural menopause between ages 45 and 55 years. Cigarette smoking, a vegetarian diet, and simple hysterectomy are each associated with an earlier (by 1–2 years) average age at menopause. Premature menopause (last menstrual period before age 40) can follow bilateral oophorectomy, chemotherapy, or radiation (i.e. induced menopause), or be caused by premature ovarian failure.
Cystitis
Authors: Hope Sally , Bowler Ian
Published: November 2023

When I makes tea I makes tea, as old mother Grogan said. And when I makes water I makes water . . . Begob, ma’am, says Mrs. Cahill, God send you don’t make them in the one pot. (James Joyce, Ulysses, 1922) Cystitis is an extremely common problem in women. Estimates vary but it is thought that between 10 and 20% of women are affected by a lower urinary tract infection (UTI) at some point during their lifetime. In the United Kingdom 1–3% of all consultations in general practice are for UTI.
Vulval disorders
Authors: Eva Lois
Published: November 2023

Vulval disease is a difficult area of women’s health, and as a result is often neglected or overlooked. Assessment of vulval disease is particularly difficult in general practice where specialist equipment or even decent lighting may not be available and all too frequently examination of this area is omitted entirely from the consultation. A combination of factors including patient embarrassment or the assumption by both the woman and the clinician that all vulval symptoms are attributable to thrush can often lead to serious and potentially avoidable pathologies being missed. Vulval disease affects women of all ages and the golden rule is that if a woman has persistent symptoms that are not responding to antifungal medication, then it probably is not candida and she needs a proper examination.
Chronic pelvic pain
Authors: Kennedy Stephen , Moore Jane
Published: November 2023

Chronic pelvic pain (CPP) is most commonly defined for research purposes as ‘constant or recurrent pain in the lower abdominal region lasting for at least 6 months, excluding pain related to pregnancy or malignancy, or pain that occurs only with menstruation or intercourse’. Clearly, however, women usually present with a much shorter history than 6 months and the causes described in this chapter must be considered from the time of first presentation. The major causes are endometriosis, irritable bowel syndrome (IBS), and pelvic inflammatory disease (PID), but CPP often appears to have no apparent cause despite extensive investigation.
Eating disorders
Authors: Waller Deborah , Fairburn Christopher
Published: November 2023

Eating disorders such as anorexia nervosa and bulimia nervosa are a common source of psychiatric and physical morbidity among young women in Western societies (van Hoeken et al. 1998). Eating disorders are often not detected and they have a reputation for being difficult to treat. The general practitioner (GP) is in a special position to offer help to sufferers and to intervene early in the development of their disorder. This chapter gives an overview of eating disorders and their management from a GP perspective, to help increase awareness and detection of eating problems and to outline evidence-based treatments for eating disorders, some of which are suitable for use in primary care.
The Tenth-Century Reformation
Authors: Stenton F M
Published: November 2023

There can be no question that the Danish invasions of the ninth century shattered the organization of the English church, destroyed monastic life in eastern England, and elsewhere caused distress and anxiety which made the pursuit of learning almost impossible.1 East Anglia, the eastern half of Mercia, and southern Northumbria were occupied and colonized by armies of heathen Danes. The bishoprics of Dunwich, Elmham, and Lindsey came to an end, and the see of York was reduced to a state of obscure poverty. Beyond the Tees, the sees of Hexham and Whithorn ceased to exist; the cathedral of Lindisfarne was abandoned, and for seven years its bishop with some of his younger clerks wandered from one insecure refuge to another, preserving the relics of St. Cuthbert from desecration until peace was so far re-established in the north that a new church could be built for them at Chester-leStreet.
The Last Years Of The Old English State
Authors: Stenton F M
Published: November 2023

The last sixteen years of the Confessor’s reign are often regarded as a prologue to the Norman Conquest. The initial Norman success was so conclusive, the victory of Norman ideas within the sphere of government was so rapid and complete, that to many historians the last phase of the Old English state has seemed the mere prelude to an inevitable collapse. The more obvious weaknesses of that state-the instability of its social organization, and the excessive power of a small group of wealthy families, have often been taken as signs of impending dissolution.
Nazi Policy Against the Jews
Authors: Carr William
Published: November 2023

For nearly twenty years after the collapse of Hitler’s Reich first revealed the full horrors of the Holocaust it was widely supposed that genocide on this enormous scale must have been the last stage ofa deliberate Nazi policy, a long-matured master plan which aimed all along at the physical annihilation of Euro pean Jewry. In the monolithic Nazi State where all power was allegedly concentrated in the Fiihrer’s hands, his vitriolic hatred of all things Jewish would have been sufficient on its own to explain the murder of six-and-a-half million Jews.
Mission to Tashkent
Authors: Bailey Lt.-Col. F M
Published: November 2023

‘one of the best books about secret intelligence work ever written‘ Peter Hopkirk. Colonel F. M. Bailey, whose extraordinary adventures are told here, was long accused by Moscow of being a British master-spy sent in 1918 to overthrow the Bolsheviks in Central Asia. As a result, he enjoyed many years after his death an almost legendary reputation there - that of half-hero, half-villain. In this remarkable book he tells of the perilous game of cat-and-mouse, lasting sixteen months, which he played with the Bolshevik secret police, the dreaded Cheka. At one point, using a false identity, he actually joined the ranks of the latter, who unsuspectingly sent him to Bokhara to arrest himself. Told with almost breathtaking understatement, Bailey's narrative - set in a region once more back in the headlines - reads like vintage Buchan.
Kashgar To Tashkent
Authors: Bailey Lt.-Col. F M
Published: November 2023

The position in Russian Turkestan was obscure. We knew that Bolsheviks were in control but no one quite knew what a Bolshevik was or what were his aims and objects. It seemed that it would be useful to go and see them, and find out what sort of people they were and to try to persuade them to continue the war against Germany, or at least not to help the Central Powers in the war against us.
Return To Tashkent
Authors: Bailey Lt.-Col. F M
Published: November 2023

While this was going on I was living at Troitskoe with Ivan. The family consisted of Ivan’s wife and a little girl of seven or eight. It was winter and the small room was sealed up. All windows had the cracks pasted over with newspaper and the door was bound with felt. Whenever the door was opened for anyone to enter, everyone in the room immediately shouted ‘Shut the door!’ We frequently had visitors; sometimes the neighbours would come in to gossip. On one occasion Ivan’s relative, the komissar from lskander, came in for the night with his wife. He was boasting about what he did to White Guards and how clever he was at spotting them, which made me feel uncomfortable. He said he could always tell White Guards by the white palms of their hands. His wife seized his hand and opened it, showed itto us and said: ‘You must then be a White Guard yourself for you have done no work since the revolution’. He and I had to share the same bowl for our dinner and slept on the floor under the same quilt. He asked me the number of my regiment and whether I was a Magyar.
Tashkent Again
Authors: Bailey Lt.-Col. F M
Published: November 2023

One of the first things I had to do after my retum to Tashkent was to consult a good Russian doctor 9-bout my leg. We had to choose a trustworthy man and to tell him who I really was. This was not difficult and a consultation was arranged. The doctor said that the Sart doctor who had treated me in the mountains had done very well indeed. He recommended massage. There was, he said, a good masseuse in the town. I said that in my peculiar position it was essential that I should see as few people as possible and that my acquaintances should be discreet. Could this masseuse be relied upon not to question me too much and to keep her mouth shut if she had any suspicions that I was not exactly what my papers showed. The doctor said that such people had nothing to do but to chatter when engaged in their work and that a silent and discreet masseuse did not exist, certainly in Russia. I, therefore, had to give up all idea of massage.
Bokhara
Authors: Bailey Lt.-Col. F M
Published: November 2023

Bokhara Sherif (The Noble) was a great centre of Moslem religion and scholarship. The mullahs of the mosques are chosen by the people much in the same way as ministers were chosen by competition-preaching in Scotland. It was not an uncommon thing to see mullahs, usually young men, preaching in a sing-song voice to their followers on the steps of the mosque in order to show what they could do. I once saw two rivals sitting some distance apart competing in their discourses, each surrounded by a crowd of admirers.
The People’s Decisions
Authors: Diamond Hanna
Published: November 2023

By placing refugees at the centre of his concerns, Pétain gave them hope that their suffering might soon come to an end. In underlining their plight, he also sent a clear message to communities swamped by these arrivals: their priority should be to reinforce their efforts to provide shelter and tend to their needs. As host communities attempted to rise to the challenge, stranded refugees halted their journeys and started to consider their next steps. Gradually, a series of alternative strategies opened up. Some followed the advice of the authorities and stayed where they were. Others chose to carry on, seeking less crowded areas with better food supplies. For those that believed that German occupation might put them at personal risk, and that this was a likely outcome of Pétain’s decision to negotiate, it became imperative for them to maintain their distance from the Nazis.Many now had to contemplate the option of leaving the country.
Sleepfaring
Authors: Horne Jim
Published: November 2023

What is sleep? Why do we sleep? How much do we normally need, and what happens if you don't get enough sleep? Are we modern people with busy lives suffering stress from 'sleep debt'? This book is about all aspects of sleep. It's a subject that interests and worries a lot of people. In recent years, the nature of sleep, our sleeping patterns, how much sleep we need, and the dangers of lack of sleep have become increasingly important, as people work longer hours, styles of working have altered, and the separation between workplace and home has been eroded by the mobile phone and the Internet. From drowsiness at the wheel, to stress and insomnia, this is a subject that matters to people. Jim Horne gives an engaging account of what science has found out about sleep, and problems related to sleep - from snoring to sleep apnoea. He brings in brain physiology, psychology, medicine, and social factors. The book highlights recent research and Horne does not shy away from areas of controversy, for instance regarding the amount of sleep we actually need. As a result, it is likely to provoke lively debate among sleep researchers, as well as fascinating the general reader. As well as being richly informative about the nature of sleep, this book may just help you to get a good night's rest.
Higher matters
Authors: Horne Jim
Published: November 2023

One problem with laboratory tests of sleepiness is that their relation- ship to real-world activities is not always evident. A good illustration concerns junior hospital doctors (interns) who suffer sleep loss and long working hours on a routine basis. Although there has been much research into the effects of sleepiness on these staff, it has tended to focus on simple tasks such as reaction time, which seem to have little to do with the true nature of their jobs. Sometimes the overall picture can be confusing, with no apparent decline in clinical skills, but with impaired reaction time and deterioration in other psychological per- formance tasks that are of unknown relevance to medical practice.
chapter XVIII
Authors: Burnaby Frederick
Published: November 2023

ON taking off our shoes at the entrance, we were at once admitted into a large building constructed in the form of a dome. Two vast circular halls, leading the one into the other, were beneath the lofty ceiling. Stained glass windows, with infinitesimally small panes, allowed but little light to penetrate to the interior, which was carpeted with rich Persian rugs of many hues and fashions. Chains, descending from the centre of the building, supported a huge circular hoop of iron. From this were suspended a hundred lamps of different-coloured crystal. Two enormous wax candles, each as thick as a man’s leg, and about seven feet high, were fixed in a corner of the building. They had been made to last a year, and had cost “tchok para”-a great many paras.

The attendant evidently thought that he should impress my mind with this announcement, and he uttered the word “tchok” in a way which no Englishman could imitate save when he is in the extreme agonies of sea-sickness. Forty or fifty Turks were lying on the floor, and seemed to be in no way disturbed by the entrance of Mr. Yankovitch and myself.
chapter XIX
Authors: Burnaby Frederick
Published: November 2023

I CALLED upon a Greek who had paid me a visit on the day of my arrival. Several of his compatriots were with him. They at once commenced conversing about what they suffered under the Turkish administration.

“We are very badly treated,” said one. “Very badly indeed,” said another.

“Are the Christians here ever tortured?” I inquired. “No.”

“Have you ever heard of any of them being impaled?” The company began to laugh.

“No such things go on in Turkey,” said my host; “but the law is bad, that is what we mean. Just before you arrived, we were talking about a Turk who had borrowed some money from one of our countrymen and had given a gun as security for the debt. The Turk died, and the Christian, not being paid what he was owed, sold the gun to a friend. Ten years afterwards a son of the deceased Turk came and claimed the weapon, which he said was his father’s property, and consequently his own. There were no papers or witnesses to prove that the gun had been pledged, and the Cadi decided for the Mohammedan.”
chapter XX
Authors: Burnaby Frederick
Published: November 2023

SOME gipsy men now entered, and, squatting down on the carpet, began to tune their lutes. One of their party carried a fearful instrument. It was rather like the bagpipes. He at once commenced a wild and discordant blast. The musicians were followed by the dancers.

The chief of the gipsy women was provided with a tam - bourine. She was attired in a blue jacket; underneath this was a purple waistcoat, slashed with gold embroidery, a pair of very loose, yellow trousers covered her extremities. Massive gold earrings had stretched the lobes of her ears; they reached nearly to the shoulders, and, by way of making herself thoroughly beautiful and doing fit honour to the occasion, she had stained her teeth and finger-nails with some red dye. Her eyebrows had been made to meet by a line drawn with a piece of charcoal. Gold spangles were fastened to her black locks. Massive brass rings encircled her ankles, the metal jingling as she walked, or, rather, waddled round the room.
Chapter XXIV
Authors: Burnaby Frederick
Published: November 2023

SOON afterwards I met Osman Bey, my acquaintance of the previous day. He was on the point of leaving for a Circassian hamlet in the neighbourhood. It appeared that a feud had arisen between the people of this village and another one in its vicinity; the Bey was going there to calm, if possible, the angry feelings of the inhabitants.

He remarked that in the event of war breaking out between Turkey and Russia he should go to the Caucasus.

“Will there be a great rising in that country?” I inquired.

“It is very doubtful,” was the answer; “our people have risen several times;* no foreign power has assisted us, and the result is that we have been decimated by our enemy. My countrymen are afraid of doing anything, unless they feel certain that they will be aided in their attempt. If England were to help us,” he continued, “and could only capture one
chapter XXV
Authors: Burnaby Frederick
Published: November 2023

THE following morning, Mohammed arrived at an early hour, bringing with him his horse, a wretched brute to look at; he had not a particle of flesh on his bones, and was half blind with one eye.

“This is my horse, Effendi,” said Mohammed proudly; “is he not a magnificent animal? My having this horse will save the Effendi the expense of hiring or buying another one.”

“I hope that I shall get a baksheesh at Erzeroum,” he added. “Of course,” I said; “that is, if the brute reaches Erzeroum. But it strikes me that you have not been giving him anything to eat lately!”
chapter XXIX
Authors: Burnaby Frederick
Published: November 2023

ON leaving the monastery, we rode to the principal mosque of the town. I was struck by seeing a large ostrich egg suspended from the ceiling by a silver chain. On my asking the Turk who showed me over the building, why this egg was hung there, he replied,-

“Effendi, the ostrich always looks at the eggs which she lays; if one of them is bad, she breaks it. This egg is suspended here as a warning to men that, if they are bad, God will break them in the same way as the ostrich does her eggs.”

Mohammed met me as I was returning to my house. He was very much excited.
chapter XXXII
Authors: Burnaby Frederick
Published: November 2023

I WAS now to learn that the usury laws in Turkey are also used against the Christians. On returning to my house, a servant informed me that an Armenian was downstairs, and wished to see me.

He had been in Paris, and could speak a little French. This he so interlarded with Turkish that it was rather difficult to follow him. The man’s name was Hanistan Ereek. At length

I discovered that, twelve years ago, his father had borrowed 300 piastres from a Turk. Soon afterwards the father died, and the son, leaving Divriki without paying the debt, had gone to Europe. On his return the creditor had him arrested for the sum of 6000 piastres. This Hanistan Ereek refused to pay; he had been imprisoned for three months in consequence.
chapter XXXIV
Authors: Burnaby Frederick
Published: November 2023

FROM the barracks we rode to the Mohammedan school. Here there were about thirty boys, all squatting on the floor, and

engaged in spelling verses of the Koran. A few badly-drawn maps of the different quarters of the world were hung round the whitewashed walls. The governor accompanied me to the schoolroom. On his entrance the boys at once stood up and salaamed. The Hodja schoolmaster made a gesture, as if he too would rise; but then, seeing me, his countenance changed. He sank back into a sitting position.

“This is done to show his contempt of you as a giaour,” whispered an Armenian. “This is how he insults us Christians.”