bluuebunny/crossref_metadata_2025 huggingface dataset:
The “Tibet question”: Tibetan, Chinese and Western perspectives
Authors: Crowe David M.
Published: May 2013

The historical conflict between Tibet and China goes back almost a thousand years. Both sides use history to argue their point about the core issues in this dispute – Tibet's claim of independence and autonomy, and China's of suzerainty. This article looks at the historical roots of this conflict, particularly since 1949, when China began its gradual takeover of Tibet. Chinese policies toward Tibet, which have been driven by a desire to communize and sinicize Tibet, has been met by stiff resistance from the Tibetans, who see Han Chinese dominance as a force that will, over time, destroy Tibet's unique religion, language, culture, and history. This resistance has drawn the attention of the West, who see Chinese policies in Tibet as a symbol of the failings of Beijing's rulers to embrace a strong commitment to human rights at the same time that China is becoming a global economic power. The 14th Dalai Lama, a key figure in this conflict, and his government-in-exile have served as bridges to Western efforts to try to force Beijing to embrace more open, humane policies toward Tibetans throughout China. His retirement as political head of the exile government in 2011, coupled with China's growing economic and strategic power globally, raises serious questions about the willingness of the USA, and other democratic powers to risk their relationships with Beijing to continue to promote true human rights and autonomy throughout the Tibetan Plateau.
Improved image alignment method in application to X-ray images and biological images
Authors: Wang Ching-Wei , Chen Hsiang-Chou
Published: May 2013

Motivation: Alignment of medical images is a vital component of a large number of applications throughout the clinical track of events; not only within clinical diagnostic settings, but prominently so in the area of planning, consummation and evaluation of surgical and radiotherapeutical procedures. However, image registration of medical images is challenging because of variations on data appearance, imaging artifacts and complex data deformation problems. Hence, the aim of this study is to develop a robust image alignment method for medical images.

Results: An improved image registration method is proposed, and the method is evaluated with two types of medical data, including biological microscopic tissue images and dental X-ray images and compared with five state-of-the-art image registration techniques. The experimental results show that the presented method consistently performs well on both types of medical images, achieving 88.44 and 88.93% averaged registration accuracies for biological tissue images and X-ray images, respectively, and outperforms the benchmark methods. Based on the Tukey’s honestly significant difference test and Fisher’s least square difference test tests, the presented method performs significantly better than all existing methods (P ≤ 0.001) for tissue image alignment, and for the X-ray image registration, the proposed method performs significantly better than the two benchmark b-spline approaches (P < 0.001).

Availability: The software implementation of the presented method and the data used in this study are made publicly available for scientific communities to use (http://www-o.ntust.edu.tw/∼cweiwang/ImprovedImageRegistration/).

Contact:  cweiwang@mail.ntust.edu.tw
1. Introduction
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This introductory chapter first reviews the current state of the law of tort. It discusses the increase in tort claims due to our greater ability to cause more and greater harm and our reduced willingness to put up with the normal vicissitudes of life. It considers the law of individual responsibility. It suggests that tort law is becoming by the day a more complex set of rules than it ever was, where national law mixes with legal ideas emanating from foreign jurisdictions. Tort law rules are also becoming intermingled with those from other branches of English law. The second part of the chapter discusses the relationship between tort and contract.
3. Establishing Liability in Principle: Duty of Care
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter discusses the following: the duty concept and the elements of the tort of negligence; formulating the duty of care; kinds of damage; the manner of infliction; and the way in which the notion of duty confines liability by reference to the nature of the parties involved.
11. Interference With Chattels
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter discusses trespass to goods, conversion, and negligence. The present law of trespass to chattels is governed by the Torts (Interference with Goods) Act 1977, which introduces a collective term ‘wrongful interference with goods’ to cover trespass, conversion, negligence, and any other tort resulting in damage to goods or to an interest in goods. The Act abolishes the tort of detinue, but otherwise has little or no impact on the principles of liability developed by the common law: thus, the nomenclature and substantive scope of the common law claims remain significant to this day in understanding the legal rules in this area.
17. Liability for Animals
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter examines the special rules of strict liability under the Act under three headings: liability for straying livestock, liability for ‘dangerous animals’, and liability for dogs. This is followed by discussions of defences, remoteness of damage and strict liability, and liability for dogs.
22. The Protection of Human Privacy
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter discusses violations of human privacy by private individuals and organisations. It is divided as follows: (1) the difficulties of defining privacy; (2) the casuistic protection afforded by English law; (3) the protection afforded in the most important types of cases; (4) the growth of breach of confidence after the entry into force of the Human Rights Act 1998; (5) Europe and beyond.
24. Damages1
Authors: Deakin Simon , Johnston Angus , Markesinis Basil
Published: May 2013

This chapter discusses the monetary consequences of a proven tort. It covers the notions of damage and damages; types of damages; the principle of full compensation; the interrelationship of tort and other compensation systems; pecuniary and non-pecuniary losses; death in relation to tort; and damage to property.
Land Law
Authors: Gray Kevin , Gray Susan Francis
Published: May 2013

Titles in the Core Text series take the reader straight to the heart of the subject, providing focused, concise, and reliable guides for students at all levels.
Land Law provides a reliable explanation of the key elements of this subject, making it an invaluable guide. The book sets land law in its socio-political and economic context, enabling students to examine this subject in depth. The topics it covers include fundamental concepts, possession and title, freehold and leasehold ownership, and easements and profits à prendre. The book also looks at security interests, beneficial ownership, dealings, modes of acquisition, privacy, and public regulation of land.
1. Fundamental concepts
Authors: Gray Kevin , Francis Gray Susan
Published: May 2013

Titles in the Core Text series take the reader straight to the heart of the subject, providing focused, concise, and reliable guides for students at all levels.
This chapter introduces a number of concepts that are fundamental to an understanding of the contemporary law of land in England and Wales. It discusses: definition of ‘land’ as physical reality; the notion of abstract ‘estates’ in land as the medium of ownership; the relationship between law and equity; the meaning of ‘property’ in land; the impact of human rights on property concepts; the ambivalence of common law perspectives on ‘land’; the statutory organisation of proprietary rights in land; and the underlying policy motivations that drive the contemporary law of land.
7. Beneficial ownership
Authors: Gray Kevin , Francis Gray Susan
Published: May 2013

Titles in the Core Text series take the reader straight to the heart of the subject, providing focused, concise, and reliable guides for students at all levels.
This chapter, which explores the nature and operation of beneficial ownership under various kinds of trust device relating to land, describes the respective roles of trustees and beneficiaries under a trust of land, and how a disposition by trustees can overreach (or clear off) the beneficial interests that exist behind the trust. It focuses on the following: the constitution and classification of beneficial interests in land; express trusts; resulting trusts; constructive trusts; co-ownership; trusts of land; and successive interests.
9. Other modes of acquisition
Authors: Gray Kevin , Francis Gray Susan
Published: May 2013

Titles in the Core Text series take the reader straight to the heart of the subject, providing focused, concise, and reliable guides for students at all levels.
This chapter examines other ways by which interests in land may be acquired, which include adverse possession; proprietary estoppel; and succession and donatio mortis causa.
10. Privacy, access and exclusion
Authors: Gray Kevin , Francis Gray Susan
Published: May 2013

Titles in the Core Text series take the reader straight to the heart of the subject, providing focused, concise, and reliable guides for students at all levels.
This chapter examines the legal concept of trespass upon land and describes the most common forms of licence known to English law, which include bare licences, contractual licenses, and licenses coupled with an equity or the grant of an interest. It concludes with a review of various other entitlements to enter another's land – rights which are exercisable by anyone merely by virtue of the fact that he or she is a member of the public (or of a section of the public).
Headache and Facial Pain
Authors: Newman, MD Lawrence C , Levin, MD Morris
Published: May 2013

This resource presents a representative set of 33 ‘mini-cases’ of headache and facial pain, and is divided into three sections that cover the typical ground for head/face pain consultation: (1) Diagnostic Questions, (2) Treatment Considerations, and (3) Prognostic, Social and Legal Issues. Recommendations are based on the most current evidence available, and diagnostic thinking is presented along the lines of the International Classification of Headache Disorders, second edition (ICHD-II).
Headaches in Pregnancy
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

While some women with migraine note an improvement during pregnancy (especially the last two trimesters), many continue to experience headaches, and some suffer an increase in attack frequency and/or severity. These can be intractable, in part due to the restricted choices in pharmacotherapy. The clinical approach to diagnosis and effective management of migraine and other headaches during pregnancy is discussed in this chapter.
Occipital Neuralgia
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Occipital neuralgia (ON) presents with lancinating (often mixed with more aching) occipital pain, which can be very disabling. There are a number of conditions which present, like ON, with posterior pain; but tenderness of the greater occipital nerve and response to greater occipital nerve anesthetic blockade are essentially pathognomonic.
Postconcussive Headache
Authors: Newman Lawrence C. , Levin Morris
Published: May 2013

Determining when to allow an athlete to return to competition following a concussion is often a challenge. This chapter reviews the clinical features of the postconcussive syndrome and outlines the return-to-play guidelines that have been established.
Basics of Neurophysiology
Authors: Daube Jasper R. , Stead Squire M.
Published: May 2013

The transmission of information in the nervous system depends on the generation of a resting potential that acts as a reserve of energy poised for release when the valve is turned on. Ionic channels act as the valve, controlling the energy in the ionic concentration gradient. The release of energy is seen either as local graded potentials or as propagated action potentials that arise when local potentials reach threshold. Information is moved from one area to another as action potentials conducted by single cells. The information is integrated in neurons by the interaction of local potentials generated in response to the neurotransmitters released from depolarized nerve terminals. In this system, information can be coded either as the rate of discharge in individual cells or axons or as the number and combination of active cells. Both of these are important mechanisms, for although the activity of the nervous system can be conveniently described in terms of the electrical activity of single cells, the combined activity of large numbers of cells and axons determines the behavior of the organism.
Ambulatory Electroencephalography
Authors: Buchhalter Jeffrey R.
Published: May 2013

Ambulatory EEG (AEEG) can provide a cost-efficient means of recording prolonged, continuous EEG in the outpatient setting. The quality of digital systems is comparable to in-lab recording—number of available channels, sampling rate, frequency bandwidth, sharp transient/seizure detection algorithms, and the ability to reformat studies. AEEG is an effective technology to distinguish epileptic from non-epileptic events in addition to classification, quantification, and localization of seizures. Limitations of the technique are the inability to immediately secure loose electrodes and to decrease antiepileptic drugs without direct observation by EEG technologists and nursing personnel.
Electroencephalography in the Surgical Evaluation of Epilepsy
Authors: Drazkowski Joseph F.
Published: May 2013

As technology advances, the availability and use of minute microprocessors may change the way we evaluate the patient with epilepsy. Currently trials are ongoing using permanently implanted electronic devices that are capable of recording limited but chronic EEG from depth or grid leads.65 The device has been shown to be able to analyze ongoing EEG and detect the onset of seizures by various algorithms and in response provide a small electrical shock in an attempt to abort the ictal activity, while other permanent devices stimulate at scheduled intervals.66 Trending data, brief samples, and seizures may be easily downloaded for analysis via the Internet. The ability to safely record and detect seizures on a chronic basis may change future treatment strategies. The current study and use of such devices is limited to patients felt not to be resective surgical candidates and are able to be participants in ongoing clinical studies.
Brain Stem Auditory Evoked Potentials in Central Disorders
Authors: Carter Jonathan L.
Published: May 2013

BAEPs are performed primarily in patients with suspected neurologic disorders to determine whether there is evidence of a brain stem lesion. BAEPs are highly sensitive to auditory conduction defects, but the findings are not pathologically specific. BAEPs provide data that are highly reproducible and objective and lend themselves to sequential studies for comparison. BAEPs are noninvasive and can be performed not only in the clinical neurophysiology laboratory but also in a hospital room or the intensive care unit. Patient cooperation is not critical, and BAEP waveforms are resistant to the effects of drugs or anesthesia. Important factors that need to be considered for accurate interpretation of BAEPs include the patient’s age, sex, and auditory acuity. The diagnostic yield of BAEPs has been confirmed in patients with acoustic neuromas, MS, or intra-axial brain stem lesions involving the auditory pathways. BAEPs appear to be complementary to structural neuroimaging studies such as MRI.
Motor Evoked Potentials
Authors: Strommen Jeffrey A.
Published: May 2013

MEP recordings are a safe and effective means of assessing conduction along the central and peripheral motor pathways in a variety of clinical settings. MEP is proven to be effective in monitoring central motor pathways that are at risk during surgical procedures and is finding usefulness in the diagnosis and prognosis of several central nervous system disorders such as multiple sclerosis, stroke, and spinal cord injury. The responses can be elicited by a variety of stimulation techniques using either magnetic or electrical stimulation to the cortex, spinal cord, or peripheral nerve. Recordings can be obtained from several structures including the spinal cord, peripheral nerve, or muscle dependent on the clinical application. The clinical neurophysiologist should have a basic understanding of the techniques as well as the potential physiologic and technical factors that need to be accounted for in the interpretation of these studies.
H Reflexes
Authors: Laughlin Ruple S.
Published: May 2013

Technically, the H-reflex test is relatively simple to perform in a clinical neurophysiology laboratory. A thorough understanding of the physiologic basis, sources of error, and clinical applications and limitations enhances the usefulness of the H reflex.
Movement Disorders
Authors: Caviness John N.
Published: May 2013

Surface EMG, EEG, and elicited response results provide a simple and noninvasive means of studying movement disorders. These techniques are particularly helpful in classifying involuntary movements such as tremor and myoclonus. In addition, EMG can assist with designing and performing botulinum toxin injections.
Autonomic Physiology
Authors: Cheshire William P.
Published: May 2013

The autonomic nervous system consists of three divisions: the sympathetic (thoracolumbar), parasympathetic (craniosacral), and enteric nervous systems. The sympathetic and parasympathetic autonomic outflows involve a two-neuron pathway with a synapse in an autonomic ganglion. Preganglionic sympathetic neurons are organized into various functional units that control specific targets and include skin vasomotor, muscle vasomotor, visceromotor, pilomotor, and sudomotor units. Microneurographic techniques allow recording of postganglionic sympathetic nerve activity in humans. Skin sympathetic activity is a mixture of sudomotor and vasoconstrictor impulses and is regulated mainly by environmental temperature and emotional influences. Muscle sympathetic activity is composed of vasoconstrictor impulses that are strongly modulated by arterial baroreceptors. Heart rate is controlled by vagal parasympathetic and thoracic sympathetic inputs. Vagal influence on the heart rate is strongly modulated by respiration; it is more marked during expiration and is absent during inspiration. This is the basis for the so-called respiratory sinus arrhythmia, which is an important index of vagal innervation of the heart. Power spectral analysis of heart rate fluctuations allows noninvasive assessment of beat-to-beat modulation of neuronal activity affecting the heart. Arterial baroreflex, cardiopulmonary reflexes, venoarteriolar reflex, and ergoreflexes control sympathetic and parasympathetic influences on cardiovascular effectors. The main regulatory mechanism that prevents orthostatic hypotension is reflex arterial vasoconstriction in the splanchnic, renal, and muscular beds triggered by a decrease in transmural pressure at the level of carotid sinus baroreceptors.
Evaluation of Adrenergic function
Authors: Low Phillip A.
Published: May 2013

For noninvasive evaluation of autonomic function, tests of peripheral adrenergic function have recently been developed so that it is possible to separately evaluate the vagal and adrenergic components of baroreflex sensitivity. The vagal component is derived from the heart period response to BP change and the adrenergic component by the PRT in response to the preceding fall in BP, induced by the VM.
Cardiovagal Reflexes
Authors: Cheshire William P.
Published: May 2013

Noninvasive cardiovascular tests are reliable and reproducible and are widely used to evaluate autonomic function in human subjects. The heart rate response to deep breathing is probably the most reliable test for assessing the integrity of the vagal afferent and efferent pathways to the heart. This is because respiratory sinus arrhythmia is a relatively pure test of cardiovagal function, whereas many other conditions, such as plasma volume, antecedent rest, and cardiac and peripheral sympathetic functions, factor into the Valsalva response. Heart rate variability to deep breathing is usually tested at a breathing frequency of 5 or 6 respirations per minute and decreases linearly with age. The Valsalva maneuver consists of a forced expiratory effort against resistance and produces mechanical (phases I and III) and reflex (phases II and IV) changes in arterial pressure and heart rate. When performed under continuous arterial pressure monitoring with a noninvasive technique, the Valsalva maneuver provides valuable information about the integrity of the cardiac parasympathetic, cardiac sympathetic, and sympathetic vasomotor outputs. The responses to the Valsalva maneuver are affected by the position of the subject and the magnitude and duration of the expiratory effort. In general, it is performed at an expiratory pressure of 40 mm Hg sustained for 15 seconds. The Valsalva ratio, the relationship between the maximal heart rate response during phase II (straining) and phase IV (after release of straining), has been considered a test of cardiac parasympathetic function. However, without simultaneous recording of arterial pressure, this may be misleading. An exaggerated decrease in arterial pressure during phase II suggests sympathetic vasomotor failure, whereas an absence of overshoot during phase IV indicates the inability to increase cardiac output and cardiac adrenergic failure.
Electrophysiology of Pain
Authors: Dotson Rose M. , Sandroni Paola
Published: May 2013

Pain is a subjective experience in which the patient’s emotional state has a major role, contributing to the challenge pain clinicians have in quantifying and objectively evaluating this common complaint. The multiplicity and complexity of the neural mechanisms that produce chronic pain make the clinician’s task even more challenging. During the last 20 years, research in the assessment of the nociceptive and autonomic systems has provided useful tools for the diagnosis, treatment, and scientific investigation of neuropathic pain. QSTs provide an accurate, reproducible assessment of the sensory response to well-delineated controlled stimuli for evaluating the function of small myelinated and unmyelinated fibers. These tests can be useful for documenting sensory disturbances that may occur in patients with neuropathy who experience hypalgesia, hyperalgesia, or allodynia. The inclusion of autonomic tests in the evaluation of some patients with neuropathic pain may provide objective evidence of increased sympathetic tone, heightened somatosympathetic reflexes, or sympathetic denervation. This information may help the clinician to diagnose more accurately the particular type of pain syndrome the patient has so that the treatment may be better directed at the underlying mechanism. MCNG, primarily a research tool, is a powerful method for directly studying primary afferent and sympathetic efferent neural activity in patients with pain caused by lesions of the nervous system. LEPs allow clinicians and researchers to investigate objectively function of the peripheral and central nociceptive pathways in patients with neuropathic pain.
Peripheral Nervous System Monitoring
Authors: Harper C. Michel
Published: May 2013

Electrophysiological monitoring of the peripheral nervous system provides useful information that supplements and complements preoperative assessment. Monitoring improves localization and understanding of the underlying pathophysiology of peripheral nerve lesions leading to more rational treatment decisions and potentially improved outcomes. Monitoring is accomplished by adaptation of routine electrodiagnostic techniques (i.e., nerve conduction studies, evoked potentials, and electromyography) with special attention to technical factors including electrical and movement artifact. These techniques have been successfully applied during surgery for entrapment neuropathies, traumatic nerve injury and repair, and during procedures that risk peripheral nerve injury.
Application of Clinical Neurophysiology: Assessing Peripheral Neuromuscular Symptom Complexes
Authors: Rubin Devon I. , Daube Jasper R.
Published: May 2013

The major value and primary application of clinical neurophysiology is in the assessment and characterization of neurologic disease. Selection of appropriate studies for the problem of an individual patient requires a careful clinical evaluation to determine possible causes of the patient’s symptoms. The nature of the symptoms and the conclusions of the clinical evaluation are the best guides to appropriate use of clinical neurophysiologic testing.
Disorders of Higher Visual Function
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

A disorder of higher visual function should be considered when visual complaints are out of proportion to examination findings. Such disorders can remain undiagnosed until other cognitive deficits develop. In this chapter, we review common disorders of higher visual function, with specific reference to the visual (posterior) variant of Alzheimer’s disease.
Downbeat Nystagmus
Authors: Thurtell Matthew J. , Tomsak Robert L. , Daroff Robert B.
Published: May 2013

Downbeat nystagmus is a common type of central vestibular nystagmus that often produces oscillopsia or blurred vision. We review the signs, causes, and investigation of downbeat nystagmus. We also discuss available treatment options.
Measurement in psychiatry
Authors: Prince Martin
Published: May 2013

The science of the measurement of mental phenomena (psychometrics) is central to quantitative research in psychiatry. Without appropriate, accurate, stable, and unbiased measures, our research is doomed from the outset. Much effort has been expended over the last 40 years in the development of a bewildering array of assessments. Most of our measurement strategies are based on eliciting symptoms, either by asking the participant to complete a self-report questionnaire, or by using an interviewer to question the participant. Some are long, detailed, and comprehensive clinical diagnostic assessments. Others are much briefer, designed either to screen for probable cases, or as scalable measures in their own right, of a trait or dimension such as depression, neuroticism or cognitive function or as measures of an exposure to a possible risk factor for a disease.

Researchers in other medical disciplines sometimes criticise psychiatric measures for being vague or woolly, because they are not based on biological markers of pathology. For this very reason, psychiatry was among the first medical disciplines to develop internationally recognized operationalized diagnostic criteria. At the same time the research interview has become progressively refined, such that the processes of eliciting, recording, and distilling symptoms into diagnoses or scalable traits are now also highly standardized. These criticisms are therefore largely misplaced. Thanks to the careful construction and extensive validation of the better established measures in psychiatric research we can now afford to be slightly more confident of their appropriateness, accuracy, and stability than would be the case even for some biological measurements. This confidence is based on our understanding of the validity and reliability of our measures.
Introduction to epidemiological study designs
Authors: Ford Tamsin
Published: May 2013

Epidemiologists must have a sound understanding of the principles of study design. Ethical considerations naturally prevent us from allocating potentially harmful exposures on an experimental basis in human populations. Observational studies are inherently more vulnerable to the effect of bias and confounding. However, these problems can be minimized by good study design.

The design (and analysis) of a study aspires to maximize the precision and validity of its findings. The precision of an estimate of the prevalence of depression in a population will be reduced by sampling and measurement error. These errors are generally random, that is equally likely to deviate from the truth in either direction. Precision can be improved with larger sample sizes and more accurate measures. Confounding and bias lead to non-random error; that is the effect of the bias or confounder is systematic, tending mainly in one direction, thus reducing the validity of a finding. Choices of study design and measurement strategy are key factors in minimizing non-random error and maximizing the validity of the results.

Although the conduct and analysis of epidemiological studies has become increasing sophisticated over time, there are a limited number of basic designs, each with their own advantages and disadvantages. This chapter will provide an overview of study design, illustrated with examples from psychiatric epidemiological studies, while individual types of study will be discussed in greater depth in subsequent chapters.
Cross-sectional surveys
Authors: Prince Martin
Published: May 2013

This chapter considers the strengths and limitations, and the uses and abuses of cross-sectional surveys in psychiatric epidemiology. Certain basic aspects of research methodology; the concept of the base population, sampling strategies, representativeness, the problem of non-response and the practical logistics of population-based research are introduced here, although they are in practice equally relevant to other study designs. The chapter also introduces the problem of bias, arising both from non-response and misclassification. In conclusion, we review major surveys of psychiatric morbidity in a historical context, highlighting methodological developments and discussing the yield of information to be gleaned from them.
Statistical methods in psychiatric epidemiology 2: an epidemiologist’ s perspective
Authors: Prince Martin
Published: May 2013

We hope that these two chapters, while providing students with greater confidence in approaching the analysis of their data sets, will also have raised as many questions as they have provided answers. It should by now be evident that there is no single, set, correct way to analyse a given data set; many will argue with some of the approaches advocated in these chapters. The important thing is for students to be aware of the diversity of methods currently available, and to proceed judiciously in the analysis and inferencing of their data, constantly aware of the strengths and limitations of the techniques that they are using. Also, it is important to recognize that biostatistics is a constantly and rapidly evolving discipline. The introduction of logistic regression in the 1970s revolutionized modern epidemiology, influencing the design of our studies as well as the methods used to analyse them. The more recent development of multi-level modelling is likely to have a similarly profound effect upon the type of research questions that we formulate, as well as the designs that we use to test these new hypotheses. Statistical methods are therefore not just the tools that statisticians, working with epidemiologists use to analyse data. They also, as they develop drive the research agenda and influence all aspects of methodology. Ever increasing collaboration between biostatisticians, epidemiologists, and clinical researchers is therefore essential if the full creative potential of this momentum is to be realized.
Gynaecological cancers
Authors: Burkill Guy , Lankester Kate
Published: May 2013

Chapter 14 covers gynaecological cancers, including ovarian, uterine, cervical, and vaginal and vulval cancers.
Head and neck cancers
Authors: Wong Wai-Lup , Kabala Julian , Saunders Michele
Published: May 2013

Chapter 15 covers head and neck cancers, including head and neck squamous cell carcinoma (HNSCC), salivary gland tumours, and thyroid cancer.
Central nervous system
Authors: Erridge Sara C. , Gibson Rod , Summers David
Published: May 2013

Chapter 16 discusses tumours of the central nervous system (CNS), and covers how to look at imaging of the CNS, treatment planning, new imaging techniques, intraparenchymal tumours, ependymoma, embryonal tumours, primary CNS lymphoma (PCNSL), and extra-axial tumours.
Skeletal tumours
Authors: James Steven , Spooner David
Published: May 2013

Chapter 19 discusses skeletal tumours, and how modern radiological imaging has transformed the ability to accurately locate and define the extent of primary and secondary skeletal tumours. Using information available from such imaging and the recent provision of computed tomography (CT) planning facilities, both the clinical target volume (CTV) and critical normal organs at risk (OAR) can be more reliably defined.
Central nervous system
Authors: Harrison Dr Mark
Published: May 2013

6.1 Overview, 129

6.2 Cerebral hemispheres, 129

6.3 Cerebral blood supply, 133

6.4 Cerebral venous drainage, 135

6.5 Brainstem, 135

6.6 Cerebrospinal fluid, 137

6.7 Cerebellum, 137

6.8 Spinal cord anatomy, 138

6.9 Division of the cord, 140

6.10 Cord blood supply, 141

•...
Legionella
Authors: Harrison Dr Mark
Published: May 2013

8.1 Background to infection, 186

8.2 Clinical features of infection, 186

8.3 Basis of diagnosis, 187

8.4 Medical management of infection and principles of prevention and public health, 187

• Legionella pneumophilia is the primary pathogen in human disease.

• Gram negative rod in nature but in clinical material appear cocco-bacillary....
Herpes simplex and zoster
Authors: Harrison Dr Mark
Published: May 2013

11.1 Herpes simplex, 193

11.2 Herpes zoster, 195

• Herpesviridae - enveloped double-stranded DNA virus.

• There are 8 strains of human herpes virus, including:

▪ Herpes simplex

▪ Varicella zoster

▪ Cytomegalovirus

▪ Epstein-Barr virus

• All have ability to enter a latent state following primary infection and be reactivated at a later time....
HIV
Authors: Harrison Dr Mark
Published: May 2013

12.1 Epidemiology, 197

12.2 Pathogenesis, 197

12.3 Clinical features, 198

12.4 Basis of diagnosis, 198

12.5 Basis of management, 199

• Human immunodeficiency virus

• Retrovirus. Single-stranded, positive sense, linear RNA. Contains reverse transcriptase

• Transmission:

▪ Sexual (present in semen and vaginal secretions)...
Respiratory physiology
Authors: Harrison Dr Mark
Published: May 2013

2.1 Lung volumes and pressures, 243

2.2 Lung epithelium, 245

2.3 Lung compliance, 245

2.4 Surfactant, 247

2.5 Airway resistance, 248

2.6 Gas transfer, 250

2.7 Gas transport within the circulation, 252

2.8 Control of respiration, 255

2.9 Ventilation-perfusion relationship, 257

• There are 2 different terms applied to lung physiology:...
Anaesthesia
Authors: Harrison Dr Mark
Published: May 2013

10.1 Intravenous agents, 424

10.2 Inhalational agents, 426

10.3 Sedatives and analgesics, 427

10.4 Muscle relaxants, 428

10.5 Antagonist agents, 430

10.6 Local anaesthesia, 431

• Induction profile:

▪ Barbiturate enhances effect of GABA

▪ Used for rapid sequence induction (5mg/kg), status epilepticus

▪...
Renal
Authors: Harrison Dr Mark
Published: May 2013

4.1 Uraemia, 475

4.2 Measurement of the glomerular filtration rate (GFR), 476

4.3 Tubular function, 476

4.4 Endocrine function, 476

4.5 Water balance, 477

4.6 Increased extracellular volume, 479

4.7 Decreased extracellular volume, 480

4.8 Disorders of sodium - hyponatraemia/hypernatraemia, 480

4.9 Disorders of potassium - hypokalaemia/hyperkalaemia, ...
Immune response
Authors: Harrison Dr Mark
Published: May 2013

2.1 Normal, 497

2.2 Abnormal, 499

• The normal immune response is divided into a layered response:

▪ A physical barrier

▪ Innate responses

▪ Adaptive responses

• A number of physical and mechanical barriers protect the body from invasion of foreign organisms:

▪...
Allergic disease
Authors: Spickett Gavin P
Published: May 2013

Introduction

Anaphylaxis

Management of anaphylaxis

Anaphylactoid reactions

Angioedema

Urticaria 1

Urticaria 2: treatment

Urticarial vasculitis

Mastocytosis

Histamine intolerance

Asthma 1

Asthma 2: treatment

Sulphite sensitivity

Aspirin sensitivity

Allergic rhinitis

Allergic conjunctivitis

Sinusitis

Secretory otitis media (glue ear)

Atopic eczema (dermatitis)

Contact dermatitis (hypersensitivity)

Itch (pruritus)...
Autoimmunity associated with cardiac, respiratory, and renal disease
Authors: Spickett Gavin P
Published: May 2013

Cardiac disease 1: myocarditis and cardiomyopathy

Cardiac disease 2: eosinophilic syndromes

Cardiac disease 3: recurrent pericarditis and Dressler’s syndrome

Cardiac disease 4: rheumatic fever

Respiratory disease 1: idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis)

Respiratory disease 2: pulmonary alveolar proteinosis (PAP)

Respiratory disease 3: lymphoid interstitial pneumonitis and sarcoidosis...
Autoimmune skin disorders
Authors: Spickett Gavin P
Published: May 2013

Overview

Bullous pemphigoid

Herpes gestationis and cicatricial pemphigoid

Pemphigus vulgaris

Pemphigus foliaceus

Paraneoplastic pemphigus

Epidermolysis bullosa acquisita

Dermatitis herpetiformis (DH) and linear IgA disease

Erythema multiforme (EM)

Stevens–Johnson syndrome (SJS); toxic epidermal necrolysis (TEN)

Sweet’s syndrome (acute febrile neutrophilic dermatosis)

Lichen planus (LP)

Alopecia areata...
Gastrointestinal and liver disorders
Authors: Madan Ira , Hellier Simon
Published: May 2013

Few disorders of the gastrointestinal systems, bar infections, are caused or exacerbated by the work environment. More commonly, gastrointestinal disorders and associated symptoms limit the capacity of individuals to undertake the duties required for their job. The symptoms and treatment of some disorders such as inflammatory bowel disease may lead to the employee requiring periods of long-term sickness absence, to recover from surgery for instance. Advances in investigation, medical treatment, and surgery should improve symptom control and prognosis in many individuals, enabling them to remain in employment. Conditions likely to cause employment problems or risks to individuals and the public include: Inflammatory bowel disease Ileostomy and ileo-anal pouch Irritable bowel disease Gastroenteritis and gastrointestinal infections Viral hepatitis Chronic liver disease Obesity. The Equality Act 20101 is likely to apply to disorders affecting the ability to control defecation. Therefore conditions that lead to regular minor faecal incontinence or to even infrequent loss of bowel control are likely to be defined as a disability under the Act. This will include many cases of ulcerative colitis and Crohn’s disease. The occupational health practitioner has a key role in supporting employees with this disability who understandably may wish the details of their symptoms to remain medically confidential. Liaison with the employer about the nature of any support or adjustments required will be a key aspect of assessment of fitness to work.
Diabetes mellitus and other endocrine disorders
Authors: Waclawski Eugene R. , Gill Geoff
Published: May 2013

A few studies of employment and diabetes in the UK indicate some increase in sickness absence. Recent research on the impact of hypoglycaemia at work indicated that severe hypoglycaemia was uncommon. Serious morbidity including accidents or injuries associated with hypoglycaemia at work was very uncommon. Information is still needed on the impact of particular work activities on diabetic control, especially shift work and vocational driving. Because of the paucity of definitive information, the advice given to diabetic workers is often arbitrary and employment decisions are taken with little supporting evidence. Physicians should take care to inform employers and potential employers factually about diabetes and to dispel any prejudice that might exist. The introduction of self-testing and modern systems of treatment have enabled those with diabetes to cope more easily with irregular work patterns. Careers officers and teachers need to know more about diabetes, so that they can give school-leavers accurate advice and enable them to make sensible career plans. A sustained effort is required to educate employers and persuade them to take a more objective view of diabetic workers. It is essential that each individual case be assessed on its own merits with full consultation between all medical advisers. Diabetes per se should not limit employment prospects, for the majority with diabetes have few, if any, problems arising from the condition and make perfectly satisfactory employees in a wide variety of occupations. Other endocrine diseases are less common than diabetes, and have less potential impact on employment. Decisions on this should be made on an individual basis. Once the specific endocrine disorder is either cured, or is stable on treatment, there are not usually any work-related issues. If the condition has caused an impairment it will be considered a disability even if treatment cures or stabilizes the condition. Where a cure occurs surgically, this may be considered a past disability, time limited from the start of impairment to the curative surgery. This chapter focuses on hyperthyroidism, hypothyroidism, thyroid eye disease, and pituitary disease.
Haematological disorders
Authors: Smedley Julia C. , Kaczmarski Richard S.
Published: May 2013

Few haematological disorders are caused or exacerbated by work. However, they may affect an employee’s capacity to work. Mild haematological derangements (e.g. iron deficiency anaemia, anticoagulant treatment) are common, but have only minor implications for employment. Conversely, genetic and malignant haematological diseases, although comparatively uncommon, are complex and affect young people of working age. Malignant disease has a profound impact on work capability during the treatment and early recovery phases. However, advances in clinical management achieve a much greater potential for return to work during treatment, and a growing population of survivors in whom it is important to address employment issues. The evidence base contains little research about fitness for work related to haematological disease, functional rehabilitation, or prevalence rates for specific disorders in the working population. The likelihood of an occupational physician encountering haematological disease in fitness for work assessments is therefore based on occurrence in the general population and this chapter relies primarily on traditional textbook teaching, and recent reviews of advances in clinical management. It contains brief summaries of the more common haematological disorders that an occupational physician might encounter when advising about fitness for work. The major determinants of functional capacity are similar for many haematological conditions. In order to avoid repetition the common treatments, complications and symptoms are covered under ‘Generic issues’.
Dermatological disorders
Authors: Ferriday Ursula T. , Foulds I. S.
Published: May 2013

The skin acts as a protective barrier against a number of hazards within our environment. These hazards can be: chemical, e.g. acids, alkalis, solvents, cutting, or soluble oils; biological, e.g. bacteria, plant allergens, or raw food; or physical, e.g. ultraviolet light, or mechanical shearing forces. In some situations the defensive properties of the skin are exceeded resulting in cuts, grazes, inflammation, ulceration, infection, and occasionally malignant change. The risk factors for breakdown of skin defences can be categorized as: (i) occupational—common at-risk groups are cleaners, food handlers, hairdressers, and workers in contact with cutting fluids; and (ii) non-occupational—where genetic predisposition to skin disorders is an important factor. Workers with non-occupational skin disorders can suffer exacerbations of their underlying dermatological condition in workplaces where the environment is hot and humid or extremely cold or dry.
Drugs and alcohol in the workplace
Authors: Brown David , Bowden-Jones Henrietta
Published: May 2013

Drug and alcohol misuse is present at all levels of society and throughout the world although the patterns of use, the substances involved, and the prevailing attitudes vary widely. However it presents, drug and alcohol misuse is a particularly challenging issue for employers, managers, and occupational physicians. These include the effects of drugs and alcohol on health and well-being and the direct and indirect effects on output, performance, and behaviour at work. There are legal implications if employees are under the influence of alcohol or drugs or in possession of illegal drugs where there may be a degree of vicarious liability for the employer. Management may have limited tolerance towards such individuals and there may be significant issues regarding public confidence towards those involved in safety critical industries. Whilst attitudes towards alcohol in society and the workplace appears to be hardening, the distinction between what is acceptable drinking and problem drinking is often blurred.
Managing and avoiding sickness absence
Authors: Preece Richard , Royles Dean
Published: May 2013

Sickness absence is an important issue for workers, managers, and occupational health services. Most employees suffer health problems at some time during their career and face decisions on fitness in relation to their work. All employers will occasionally be concerned about the fitness to work of absent employees and what actions they might take to address this. Advising on sickness absence management and the fitness to work of absentees, individually and collectively, is a major activity for occupational health specialists.
Viva 4
Authors: Davies Nev , Jackson Will , Price Andrew , Rees Jonathan , Lavy Chris
Published: May 2013

Viva 4 asks for the likely nature of this injury, how this patient would be assessed, and how this injury would be treated. It also asks which organisms commonly cause infection with this type of injury, and which antibiotics should be used to cover these organisms.
Viva 17
Authors: Davies Nev , Jackson Will , Price Andrew , Rees Jonathan , Lavy Chris
Published: May 2013

Viva 17 shows a child with cerebral palsy. Describe cerebral palsy and its different types, followed by a description of spasticity, and the different ways it can be managed. Ambulant children with cerebral palsy are assessed by gait analysis – what does that involve?
Viva 29
Authors: Davies Nev , Jackson Will , Price Andrew , Rees Jonathan , Lavy Chris
Published: May 2013

Viva 29 shows an image and asks what is shown, how it works, and what it is used for.
Viva 31
Authors: Davies Nev , Jackson Will , Price Andrew , Rees Jonathan , Lavy Chris
Published: May 2013

Viva 31 asks for identification of the bearing shown in the photo, followed by its advantages over a conventional bearing surface, what factors influence the type of lubrication achieved, and if there are any adverse effects with this type of bearing.
Viva 34
Authors: Davies Nev , Jackson Will , Price Andrew , Rees Jonathan , Lavy Chris
Published: May 2013

Viva 34 shows a stress–strain curve for a generic material. It then asks what Zone 1 represents, what Young's modulus is, what the first circle represents, what Zone 2 is, what the second and third circles represent, and what strain hardening is?
Viva 35
Authors: Davies Nev , Jackson Will , Price Andrew , Rees Jonathan , Lavy Chris
Published: May 2013

Viva 35 shows a screw from a basic small fragment set used in fracture fixation. Explain the different parts of the screw and their function, including its mechanical properties, how the small fragment screw differs mechanically from this locking bolt for an intramedullary nail, and what size drills would be used to insert the small fragment screw to act as a lag screw across a fracture?