bluuebunny/crossref_metadata_2025 huggingface dataset:
Invariances in the architecture of pride across small-scale societies
Authors: Sznycer Daniel , Xygalatas Dimitris , Alami Sarah , An Xiao-Fen , Ananyeva Kristina I. , Fukushima Shintaro , Hitokoto Hidefumi , Kharitonov Alexander N. , Koster Jeremy M. , Onyishi Charity N. , Onyishi Ike E. , Romero Pedro P. , Takemura Kosuke , Zhuang Jin-Ying , Cosmides Leda , Tooby John
Published: August 2018

Significance

It has been proposed that one key function of pride is to guide behavior in ways that would increase others’ valuation of the individual. To incline choice, the pride system must compute for a potential action an anticipated pride intensity that tracks the magnitude of the approval or deference that the action would generate among local audiences. Data from industrial mass societies support this expectation. However, it is presently not known whether those data reflect cultural evolutionary processes or a panhuman adaptation. Experiments conducted in 10 traditional small-scale societies with widely varying cultures and subsistence modes replicate the pattern observed in mass societies. This suggests that pride is a universal system that is part of our species’ cooperative biology.
Effect of hook characteristics on the fracture behaviour of dissimilar friction stir welded aluminium alloy and mild steel sheets
Authors: Wang Tianhao , Sidhar Harpreet , Mishra Rajiv S. , Hovanski Yuri , Upadhyay Piyush , Carlson Blair
Published: August 2018

Under tensile shear loading, fracture modes of dissimilar lap welds produced by friction stir scribe technology were studied. Three fracture modes were observed. For zone A fracture, the initial crack was restrained, and the joint ultimately fractured in the base mild steel. For zone B fracture, the initial crack progressed through the aluminium sheet just above the Al/steel interface. For zone C fracture, the initial crack proceeded along the steel hook to the aluminium sheet surface. Fracture mode and joint strength were greatly influenced by steel hook size, and the steel hook size was affected by welding parameters and tool scribe height. In this study, the experimental joint strength achieved the calculated joint load limit.
HPV: CIB1 is for EVER and EVER
Authors: Notarangelo Luigi D.
Published: August 2018

In this issue, de Jong et al. (https://doi.org/10.1084/jem.20170308) identify bi-allelic loss-of-expression, loss-of-function mutations of the calcium- and integrin-binding protein 1 (CIB1) gene as a new cause of epidermodysplasia verruciformis (EV) and demonstrate that the CIB1 interacts with the EVER1 and EVER2 proteins to form a complex involved in keratinocyte-intrinsic immune response to human β-papillomaviruses (β-HPVs).
Locally conformally flat manifolds with constant scalar curvature
Authors: He Huiya , Li Haizhong
Published: August 2018

Let

(

M
n

,
g
)

(M^n,g)

be an

n
n

-dimensional

(
n
≥
4
)

(n\geq 4)

compact locally conformally flat Riemannian manifold with constant scalar curvature and constant squared norm of Ricci curvature. Applying the moving frame method, we prove that such a Riemannian manifold does not exist if its Ricci curvature tensor has three distinct eigenvalues.
Life Space in Older Adults
Authors: Wettstein Markus , Wahl Hans-Werner , Schwenk Michael
Published: August 2018

When referring to life space, researchers usually mean the area in which individuals move in their everyday lives. Life space can be measured based on different approaches, by means of self-reports (i.e., questionnaires or diaries) or by more recent approaches of technology-based objective assessment (e.g., via Global Positioning System [GPS] devices or smartphones). Life space is an important indicator of older adults’ out-of-home mobility and is meaningfully associated with autonomy, well-being, and quality of life. Substantial relationships between life space and socio-demographic indicators, health, and cognitive abilities have been reported in previous research. Future research on life space in old age will benefit from a more comprehensive and stronger interdisciplinary perspective, from taking into account different time scales (i.e., short- and long-term variability), and from considering life space as a multidimensional measure that can be best assessed based on multi-method approaches with multiple indicators.
Universal Influenza Vaccines: Progress in Achieving Broad Cross-Protection In Vivo
Authors: Epstein Suzanne L
Published: August 2018

Despite all we have learned since 1918 about influenza virus and immunity, available influenza vaccines remain inadequate to control outbreaks of unexpected strains. Universal vaccines not requiring strain matching would be a major improvement. Their composition would be independent of predicting circulating viruses and thus potentially effective against unexpected drift or pandemic strains. This commentary explores progress with candidate universal vaccines based on various target antigens. Candidates include vaccines based on conserved viral proteins such as nucleoprotein and matrix, on the conserved hemagglutinin (HA) stem, and various combinations. Discussion covers the differing evidence for each candidate vaccine demonstrating protection in animals against influenza viruses of widely divergent HA subtypes and groups; durability of protection; routes of administration, including mucosal, providing local immunity; and reduction of transmission. Human trials of some candidate universal vaccines have been completed or are underway. Interestingly, the HA stem, like nucleoprotein and matrix, induces immunity that permits some virus replication and emergence of escape mutants fit enough to cause disease. Vaccination with multiple target antigens will thus have advantages over use of single antigens. Ultimately, a universal vaccine providing long-term protection against all influenza virus strains might contribute to pandemic control and routine vaccination.
13. Understanding and using feedback
Authors: Moore Imogen , Newbery-Jones Craig
Published: August 2018

Feedback is an essential part of the learning process. It enables the student to learn from experiences, to identify strengths and weaknesses, and ensures that they can build on hard work and continually improve performance to achieve potential. This chapter look further at feedback — what it is and where it can be found — and how the student can make the most of the feedback that is available to them to enhance their chances of success. It focuses on feedback within legal studies. However, it should be noted that the general principles of finding and using feedback — taking opportunities, identifying strengths and weaknesses, building on experience, and absorbing the advice and experience of others — have relevance to all aspects of a successful life and career.
14. Dissertations and research projects
Authors: Moore Imogen , Newbery-Jones Craig
Published: August 2018

A dissertation or research project is often an important part of legal studies. It can be viewed as the culmination of three or four years of hard work because it is usually completed in the last year of the degree. This chapter explores the nature of legal research projects and dissertations. It considers how to complete them successfully, taking a broadly chronological approach to the issues arising. While the approach here may not follow precisely the guidelines set out by the law school, it can still provide markers to guide the student through the process, from constructing and refining the project proposal, to writing and rewriting, all the way through to final submission. The chapter also discusses further the use of relevant resources, drawing upon the earlier discussion of research in Chapter 8, and the important relationship with the dissertation or project supervisor.
How to Write Law Essays & Exams
Authors: Strong S I
Published: August 2018

How to Write Law Essays and Exams provides a practical and proven method of analysing and answering essay and exam questions. Using the techniques in this book will not only help students write more powerful and responsive essays and exams but will also improve their appreciation of how to undertake critical legal thinking. Furthermore, the suggestions in this text will help students manage their time better, allowing them to write top essays despite time pressures. The book focuses on those questions that give students the most trouble, namely problem questions, but its techniques are equally applicable to other types of essays. In addition to providing a framework for analysing and writing law essays, the book teaches how to identify relevant legal authorities, distinguish and harmonise conflicting legal precedents and evaluate the applicability of the law to the facts of the question at hand. The book also contains specific law-related revision techniques and general writing tips.
4. Step two in the IRAC method: the rule
Authors: Strong S I
Published: August 2018

This chapter presents techniques and tips for identifying and discussing the rules, the second step in the IRAC method of legal essay writing. Many students worry that they will not know enough ‘law’ to do well on their exams and essays, but this chapter provides key tips on how to maximise the effectiveness of each student’s knowledge. The discussion identifies the steps involved in writing a first-class essay in law: the purpose of supporting authority (‘rules’) in legal writing; what constitutes supporting authority in legal writing; how to compile the relevant supporting legal authority; and how to communicate the relevant supporting authority in the essay. Writing tips are provided throughout the chapter. A worked example is also given.
4. Shaping the legal system: the role of government
Authors: Partington Martin
Published: August 2018

This chapter considers the principal government departments that have been shaping and will continue to shape the English legal system. The leading department is the Ministry of Justice which is responsible for running and developing the courts and tribunals system. The chapter provides an overview of its functions. It also considers the Judicial Office, the Judicial College, and the Law Commission. The Home Office is responsible for many aspects of criminal justice policy. Mention is also made of the Department for Exiting the European Union, the Department for Business, Energy and Industrial Strategy, and other central government departments whose work impacts on the legal system.
6. American foreign policy during the Cold War
Authors: Saull Richard
Published: August 2018

This chapter examines US foreign policy during the Cold War, beginning with an overview of the main historical developments in US policy. It first considers the origins of the Cold War and containment, focusing on the breakdown of the wartime alliance between the United States and the USSR, the emergence of US–Soviet diplomatic hostility and geopolitical confrontation, and how the Cold War spread beyond Europe. It then explains how the communist revolution in China in 1949 and the outbreak of the Korean War in June 1950 propelled the US towards a much bolder and more ambitious containment policy. It also looks at US military interventions in the third world, the US role in the ending of the Cold War, and the geopolitical, ideational, and/or socio-economic factors that influenced American foreign policy during the Cold War. The chapter concludes with an assessment of the dual concerns of US foreign policy.
8. The twenty-first century and smart power
Authors: Nye Joseph S.
Published: August 2018

This chapter examines US foreign policy as ‘smart power’, a combnation of hard and soft power, in the twenty-first century. The beginning of the twenty-first century saw George W. Bush place a strong emphasis on hard power, as exemplifed by the invasion and occupation of Iraq. This was evident after 9/11. While the war in Iraq showcased America’s hard military power that removed a tyrant, it failed to resolve US vulnerability to terrorism; on the contrary, it may have increased it. The chapter first considers the Obama administration’s reference to its foreign policy as ‘smart power’ before discussing Donald Trump’s ‘America First’ policy, the role of power in a global information age, soft power in US foreign policy, and how public diplomacy has been incorporated into US foreign policy.
7. The Ideal State
Authors: Ferdinand Peter , Garner Robert , Lawson Stephanie
Published: August 2018

This chapter examines the basics of political philosophy, focusing in particular on what makes the state legitimate, or what is the ideal state we should be striving for. It first considers the use of normative analysis by political philosophers — that is, they are concerned with asking how the state ought to be organized and how much freedom ought individuals be granted. It then discusses the issues of consent and democracy, social contract, and the general will, along with utilitarianism as an account of state legitimacy. It also explores liberalism and liberty in relation to the state, Marxism and communitarianism, the idea of a just state, and how the traditional state focus of political theory has been challenged by globalization. Finally, it describes the influence of anarchism on modern politics and the position of anarchists with respect to the ideal state.
8. Ideologies
Authors: Ferdinand Peter , Garner Robert , Lawson Stephanie
Published: August 2018

This chapter considers a range of traditional and contemporary ideologies. Traditional ideologies are associated with the Enlightenment and have had a significant impact on the development of world politics in the last 200 years. The claims of the traditional ideologies are challenged by more contemporary ideologies; the latter should therefore be seen in the context of growing scepticism about the utility of Enlightenment ideologies. The chapter first describes the general characteristics of an ideology before discussing traditional ideologies such as liberalism, socialism, conservatism, and fascism. It also examines contemporary ideologies, namely: feminism, environmentalism, multiculturalism, and religious fundamentalism. The chapter argues that contemporary ideologies represent a challenge to the state, as seen in the greater emphasis on the supranational dimension observed, in particular, in multiculturalism, environmentalism, and religious fundamentalism.
12. Votes, Elections, Legislatures, and Legislators
Authors: Ferdinand Peter , Garner Robert , Lawson Stephanie
Published: August 2018

This chapter explores the interrelationships among votes, elections, legislatures, and legislators in the context of politics. It first considers the two basic paradoxes of voting before discussing elections and their outcomes, which tend to have different virtues: stronger government versus more representative government. It then describes the functions of legislatures as well as measures for establishing quotas to increase gender equality in legislative recruitment. It also introduces a classification of legislatures based upon their capability to stand up to the executive branch of government before concluding with an analysis of the internal structure of legislatures as well as the backgrounds of members of parliament in various countries, focusing in particular on the criticism that lawmakers constitute a ‘political class’.
13. Political Parties
Authors: Ferdinand Peter , Garner Robert , Lawson Stephanie
Published: August 2018

This chapter deals with political parties, focusing on why they emerged, how they can be classified, what functions they perform, and how they interact. It identifies two phases in the development of political parties. The first parties were intended to structure the work of legislatures, and later evolved into mass parties to structure the votes of electors, catch-all parties to win more votes irrespective of ideological appeal, and cartel parties more dominated by party professionals. The chapter also considers seven functions typically carried out by a political party, irrespective of whether they operate in democracies or authoritarian regimes: legitimation of the political system, integration and mobilization of citizens, representation, structuring the popular vote, aggregation of diverse interests, recruitment of leaders for public office, and formulation of public policy. Finally, it discusses various types of party outside the West, party systems, and some of the challenges facing political parties today.
14. Executives, Bureaucracies, Policy Studies, and Governance
Authors: Ferdinand Peter , Garner Robert , Lawson Stephanie
Published: August 2018

This chapter examines how executives, bureaucracies, and policy studies influence governance. It first provides an overview of the relations between the legislature and the executive, with emphasis on the competing claims of presidentialism versus parliamentarianism, before discussing the civil service and its traditional role in building up the effective power of the state. Using examples from economic policy-making, it argues that embedded autonomy is an appropriate way of characterizing the civil service's relationship with the rest of society. The chapter goes on to consider theories of bureaucratic policy-making, focusing in particular on policy innovation, public administration, and New Public Management, the more recent proliferation of agencies in government, and the concept of good governance. Issue networks, the notion of iron triangles, and policy communities are also explored. The chapter concludes with an analysis of the ‘network state’ and its implications for civil servants.
18. Governance and Organizations in Global Politics
Authors: Ferdinand Peter , Garner Robert , Lawson Stephanie
Published: August 2018

This chapter examines the ways in which governance and organizations influence global politics. It first provides an overview of what an international organization is, focusing on intergovernmental organizations and non-governmental organizations, before discussing the rise of organizations in the global sphere from the nineteenth century onwards. It then takes a look at the major intergovernmental institutions that emerged in the twentieth century and which have played a major role in shaping global order, including the League of Nations and its successor, the United Nations (UN). The chapter concludes with an analysis of ideas about social movements and civil society, along with their relationship to contemporary governance and organizations.
9. Committee Scrutiny of Legislation
Authors: Thompson Louise , McNulty Tony
Published: August 2018

This chapter deals with committee scrutiny of legislation, focusing on common perceptions of the committee stage and its role in bringing about changes to government legislation. In the UK Parliament, legislation which follows the normal passage of a bill will at some point have a committee stage, where Members of Parliament (MPs) or peers can review the text of the bill in detail. It is common for bills to receive their committee stage in public bill committees. The chapter first considers how the committee stage is planned before discussing the legislative, procedural, and political contexts in which bill committees work. It then examines traditional assumptions about committee scrutiny of bills, along with contemporary developments in parliamentary scrutiny of legislation. In particular, it looks at the benefits of evidence-taking, ministerial behaviour in committees, the impact of committees in the latter stages of the legislative process, and the wider function of the committee stage.
12. Private Members’ Bills
Authors: Hazell Robert , Reid Fergus
Published: August 2018

This chapter considers the ways in which backbench Members of Parliament (MPs) exploit their right to introduce legislation — known as private members' bills (PMBs). The PMB process has been criticized for allegedly being opaque, misleading, and virtually discredited inside and outside the UK Parliament. Yet, each session, more than 450 backbenchers enter the Commons PMB ballot for a priority slot. The chapter first explains the terms ‘hybrid bill’, ‘private bill’, and ‘public bill’ before discussing the difference between PMBs and government bills. It also examines the importance of time when considering PMBs, the three routes to a PMB in the House of Commons, a typical second reading Friday in the Commons, and the PMB ballot in the House of Lords. Finally, it analyses efforts to reform PMB procedures and why, despite flaws and frustrations, PMBs are seen by many MPs as a useful tool for advancing their agendas and campaigns.
15. Evidence from Outside
Authors: Defty Andrew , White Hannah
Published: August 2018

This chapter considers the UK Parliament's use of external evidence in the scrutiny of policy and legislation. Throughout the nineteenth and most of the twentieth century, Members of Parliament (MPs) drew on their professional experience outside of Parliament to provide informed scrutiny of government policy and legislation. Since the latter part of the twentieth century, however, there has been a significant increase in opportunities for Parliament to draw on external evidence. Today, external evidence occupies a central place in Parliament's scrutiny and legislative functions. The chapter first examines how select committees scrutinize policy and administration, making a distinction between written evidence and oral evidence, before discussing the impact of evidence-taking on the legislative process for draft bills that are subject to scrutiny by public bill committees. It also describes formal mechanisms by which evidence and expertise are drawn into Parliament.
16. Select Committees
Authors: Kelso Alexandra
Published: August 2018

This chapter examines the role of select committees in the UK Parliament, and more specifically how they enable lawmakers in the House of Commons to pool their scrutiny efforts by working together as a formally constituted team. Select committees are cross-party, with membership restricted to backbench Members of Parliament (MPs) and reflecting the party balance in the House. These committees determine their own work agendas and decide for themselves which topics to investigate. Committee work is structured around running focused inquiries into specific issues, ranging from antisemitism to foster care. The chapter first considers the effectiveness of select committees before discussing some major developments that the departmental select committee system has undergone over the last four decades with regard to elected committee chairs and membership, committee activity, addressing highly controversial topics, and developing policy expertise.
19. Scrutiny by the House of Lords
Authors: Milner Patrick
Published: August 2018

This chapter examines the scrutiny function of the House of Lords. It first provides an overview of conventions informing the scrutiny role of the House of Lords, including the Salisbury Convention and the financial privilege of the House of Commons which concerns its special right to decide levels of public taxation and public spending. It also considers the position of the House of Lords with respect to secondary legislation before discussing the many different ways in which the House of Lords fulfils its scrutiny function, such as scrutinizing draft primary legislation as part of the legislative process, as well as secondary legislation in committees; conducting in-depth inquiries; investigating matters of public policy in committees; questioning the government through oral and written questions; participating in debates on current issues and the findings of committees; and scrutinizing the government's actions in the Council of the European Union.
24. Whips and Rebels
Authors: Stuart Mark
Published: August 2018

This chapter examines the role of whips and rebellious Members of Parliament (MPs) in the UK Parliament. Whips are MPs or peers who are responsible for managing the Members of their party, and in particular for ensuring that party Members vote in line with their party's policy. The whips are often regarded as bullies and cajolers, whereas MPs are seen as spineless and overly loyal. The chapter first considers the myths and reality about whips before discussing the growing rebelliousness of MPs — that is, they vote against their party line in the division (voting) lobbies. It shows that these rebels have made the role of the whips much harder, citing as an example the case of the Coalition Government of 2010–2015, where the government whips had to try to satisfy the demands of two parties — Liberal Democrats and the Conservative Party.
27. Parliament and Devolution
Authors: Gormley-Heenan Cathy , Sandford Mark
Published: August 2018

This chapter examines the relationship between the UK Parliament and the devolved legislatures established in Wales, Scotland, and Northern Ireland. It first considers the impact of devolution on parliamentary sovereignty before discussing the establishment and development of the devolved parliaments in Wales, Scotland, and Northern Ireland. It then describes the key features of those devolved institutions and the way in which Parliament's interactions with them have evolved since their inception, as well as the division of powers between the United Kingdom and devolved governments. It shows that the influence of Parliament on devolution in the UK has so far been marginal, and that these subtle changes in practices at Westminster point to Parliament as an increasing reflection of wider shifts in public attitudes about the relationships between the territories of the United Kingdom, especially after the Brexit referendum.
29. Parliament and Public Engagement
Authors: Leston-Bandeira Cristina , Walker Aileen
Published: August 2018

This chapter examines why the UK Parliament has invested heavily in public engagement over the last decade. Since the 1960s, the UK Parliament has been facilitating public engagement through a variety of ways. However, it is also an institution which is far more vulnerable and criticized by both the public and media. The chapter first defines public engagement before discussing the importance of parliamentary public engagement today. Four key inter-related factors that explain the rise in the importance of public engagement for parliaments are highlighted: the steady trend of increasing scepticism towards politics; the improved access to education and information; the increased opportunities created by digital media; and the growing appeal of participatory democracy. The chapter goes on to analyse how public engagement developed in Parliament and asks whether this has led to changes in public attitudes towards the institution.
32. Conclusion: The Future of Parliamentary Politics
Authors: Judge David , Leston-Bandeira Cristina , Thompson Louise
Published: August 2018

This concluding chapter reflects on the future of parliamentary politics by identifying key puzzles implicit in previous discussions which raise fundamental questions about what Parliament is and why it exists. The goal is to determine the ‘predictable unknowns’ as starting points for exploring the future. Three principal puzzles that need ‘hard thinking’ in order to understand legislatures are considered: representation, collective decision-making, and their role in the political system. The chapter also examines the difficulties in reconciling ideas about popular sovereignty and direct public participation with notions of parliamentary sovereignty and indirect public participation in decision-making; the implications of the legislative task of disentangling UK law from EU law in the wake of Brexit for Parliament's recent strengthened scrutiny capacity; and how Parliament has integrated the core principles of representation, consent, and authorization into the legitimation of state policy-making processes and their outputs.
Microsimulation model to predict incremental value of biomarkers added to prognostic models
Authors: Pencina Karol M , D’Agostino Ralph B , Vasan Ramachandran S , Pencina Michael J
Published: August 2018

It is unclear to what extent simulated versions of real data can be used to assess potential value of new biomarkers added to prognostic risk models. Using data on 4522 women and 3969 men who contributed information to the Framingham CVD risk prediction tool, we develop a simulation model that allows assessment of the added contribution of new biomarkers. The simulated model matches closely the one obtained using real data: discrimination area under the curve (AUC) on simulated vs actual data is 0.800 vs 0.799 in women and 0.778 vs 0.776 in men. Positive correlation with standard risk factors decreases the impact of new biomarkers (ΔAUC 0.002-0.024), but negative correlation leads to stronger effects (ΔAUC 0.026-0.101) than no correlation (ΔAUC 0.003-0.051). We suggest that researchers construct simulation models similar to the one proposed here before embarking on larger, expensive biomarker studies based on actual data.
Sleep Disturbance in Palliative Care
Authors: Burke Rebecca , Yennurajalingam Sriram
Published: August 2018

Sleep disturbance is a persistent source of suffering in palliative care patients. Symptoms such as difficulty falling asleep, staying asleep, early awakening, or nonrestorative sleep are all indicative of sleep disorders. Poor sleep can have consequential effects on perception of pain, fatigue, mood, and quality of life. It is not only a prevalent symptom in the primary care population but also may in fact affect more than 60% of the palliative care population. In addition to the complexities of treatment, insomnia often serves as a red herring to alarm physicians of underlying conditions. Therefore, it is essential that palliative care physicians maintain a high index of suspicion for such confounding conditions as restless leg syndrome, sleep apnea, and delirium. This chapter highlights the intricacies of sleep disturbance and focuses on the most common patient presentations.
Pediatric Palliative Care
Authors: Madden Kevin
Published: August 2018

Pediatric palliative care shares similarities with adult palliative care, but there are significant differences as well. Whereas the preponderance of adults receiving palliative care have cancer, 80% of children who receive pediatric palliative care in the United States have either a congenital/genetic or a neuromuscular complex chronic condition. Given the uncertainty of prognosis for these medical conditions, it is not unusual for pediatric palliative care providers to have years-long relationships with children and their families. The nature of the relationship is rooted in helping families think through whether medical or surgical interventions would be beneficial for their child at different points in the disease trajectory. As such, communication is the cornerstone skill that a provider of pediatric palliative care must possess. This chapter illustrates fundamental learning points about how to communicate with children and their families.
Palliative Care in End-Stage Heart Failure
Authors: Nguyen Linh My Thi
Published: August 2018

Heart failure (HF) is the most common cause of death. The acute syndrome of HF, better known as congestive heart failure, accounts for at least 20% of medical admissions to all hospitals for patients older than age 65 years. HF tends to have a high symptom burden (dyspnea, fatigue, edema, pain, nausea, anxiety, and depression) and periods of decompensation often requiring hospitalization. There is a high level of prognostic uncertainty, leading to significant psychosocial distress for both patients and their caregivers. Advance care planning and complex shared decision-making become increasingly important as HF progresses, particularly when patients are faced with options such as transplant and mechanical circulatory support, which may not align well with their overall goals or preferences. This chapter discusses the key issues related to end-stage HF, including diagnosis, symptom management, and prognosis.
Epilogue
Authors: Krauter Cheryl
Published: August 2018

We have come full circle to the importance of the human relationship as it relates to the multiple layers of healing involved in cancer survivorship care. The epilogue validates the need for survivorship care plans that are more tailored to the individual and the importance of coordinated care in survivorship care and asserts that best practices need to be disseminated and implemented in “real-world settings.” The recognition and naming of these points in cancer survivorship are a call to action in response to the need for communication and coordination between survivors, clinicians, formal and informal caregivers, and all others who attend to the needs of those in post-treatment as well as those who are living with cancer.
Fundamentals of Anesthetic Care
Authors: Clavijo Claudia F. , Riveros-Perez Efrain
Published: August 2018

This chapter focuses on the anesthesia process which can be divided into phases, from the preoperative assessment to induction, maintenance, emergence and finally to discharge. Throughout the whole process, patient safety is of paramount importance. This chapter focuses on safety measures such as surgical time-out, use of checklists, and prevention of intraoperative awareness. Fluid management, and intraoperative complications such as hypoxemia, electrolyte imbalances, and hypotension and hypertension are also discussed. The chapter discusses specific circumstances regarding anesthesia interventions including the difficult airway algorithm, extubation criteria and delayed emergence, the prevention of postoperative nausea and vomiting which has a huge impact on patient satisfaction, transfusion therapy, regional analgesia and anesthesia rational opioid use, as well as multiorgan support during anesthesia.
Continuous Quality Improvement
Authors: Cartwright Sarah M. I.
Published: August 2018

For the anesthesia provider early in his or her career, the concept of continuous quality improvement (CQI) seems far-reaching in daily practice. CQI is a concept that crosses multiple disciplines focusing on improving the provision of care from one episode to the next. Unlike traditional performance improvement or quality improvement initiatives that initiate change for a specific issue, CQI challenges system thinking with cyclic re-evaluation of processes for both improvement and sustainability. Data driven, CQI concepts are approached using a systematic methodology that supports inquiry, change management, and process development. The American Society of Anesthesiologists, American Medical Association, Centers for Medicare and Medicaid Services, and multiple regulatory agencies support CQI. This approach engages evidence-based medicine and promotes improved patient and provider outcomes.
Juvenile idiopathic arthritis
Authors: Clunie Gavin , Wilkinson Nick , Nikiphorou Elena , Jadon Deepak R.
Published: August 2018

The presentation and natural history of juvenile idiopathic arthritis (JIA) differs from that of the adult inflammatory arthritides and this chapter describes the key features and differentials that need to be considered. In making a diagnosis, this chapter should be used in association with Part I of the Handbook. The chapter conveys information useful for explaining JIA to parents, national guidelines and other routine therapeutic practices, analysis of subtypes of JIA, and uveitis commonly associated with JIA. The description of systemic-onset JIA includes its differential and association with macrophage activation syndrome. As an archetypal long-term musculoskeletal condition, the key features of transition and age-appropriate care are also discussed here.
Chronic pain syndromes
Authors: Clunie Gavin , Wilkinson Nick , Nikiphorou Elena , Jadon Deepak R.
Published: August 2018

The Oxford Handbook of Rheumatology 4th edition, has been extensively updated to thoroughly review aspects of musculoskeletal pain. Pain pathophysiology is reviewed. Chronic pain and fibromyalgia in adults and in children and adolescents is dealt with in detail. The reader is advised to cross reference from this chapter to Chapters 1–3 in the Handbook, where regional musculoskeletal pain conditions are listed and reviewed. In localized pain syndromes, the chapter has an overview of complex regional pain syndrome (CRPS), which is not infrequently encountered in rheumatology and musculoskeletal clinics. Included in detail for this edition, is the assessment and management of pain in children, which is a highly specialized clinical area of medicine and will be of use to the adult rheumatologist and general practitioner as well as paediatric specialists. Readers should cross reference to Chapter 23 on medications, for ‘pain medications’ in the Handbook
Day case surgery
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Day case surgery is of benefit to patients, clinicians, staff, and hospital trusts. Careful selection of appropriate patients and procedures is fundamental to providing a safe and effective service. Factors influencing suitability for day case surgery include the type of surgical procedure and anaesthetic planned as well as the fitness of the patient. Selection criteria should consider the availability of resources as well as the particular skill sets of the clinicians and be agreed by surgeons, anaesthetists, and nurses. Patients should be given clear verbal and written instructions regarding their preoperative, perioperative, and postoperative care and discharged with medication to control common postperative complaints, such as pain, nausea, and constipation.
Perioperative anticoagulation management
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Perioperative antithrombotic management is based on risk and benefits in the assessment for thromboembolism versus bleeding. It should be tailored to each patient. Patients with mechanical heart valves who are on warfarin need bridging therapy with heparin to reduce the risk of thrombosis. In addition, to reduce the risk of bleeding during the surgery, it should be managed accordingly prior to surgery. The target INR should be <1.5 on the day of surgery. High-risk patients should be considered for alternate prophylactic measures (e.g. low-molecular-weight heparin (LMWH)) when INR drops below 2. Low risk patients do not require bridging therapy or need prophylactic LMWH respectively. The new oral anticoagulation does not require frequent monitoring test but awareness of their pharmacokinetics critical in managing these patients prior to surgery.
Antibiotic prophylaxis in surgery
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Surgical site infection (SSI) is a common cause of nosocomial infection and prophylactic antibiotics are used to reduce post-operative wound infection. To identify risk factors for developing SSIs and to prescribe antibiotics for both prophylactic and therapeutic treatment according to local guidelines is very important. Beta lactams should be avoided in case of penicillin allergy and risk of multidrug resistance. C. diff infection should be considered with prolonged use of antibiotics.
Principles of nutritional support
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Malnutrition is a commonly found risk factor in hospitalized patients. All hospital patients, especially the high-risk ones, should be offered nutritional screening. Methods of screening include MUST (Malnutrition Universal Screening Tool) and the patient should have a thorough clinical assessment and investigations. The patient should meet adequate calorie requirement either by oral or enteral or parenteral nutrition. Malnourished patients receiving nutrition supplements demonstrated lower infection rates and shorter length of hospital stay compared to no supplements.
Barrett’s oesophagus
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Diagnosis of Barrett’s oesophagus leads to an ongoing clinical uncertainty thereafter as to strategy for surveillance, due to the risk of dysplasia and carcinoma. The endoscopic findings have to be accurately classified macroscopically and on biopsy. Management of associated gastro-oesophageal reflux (GORD) is essential, and the chapter discusses detailed strategies for surveillance and treatment according to recent guidelines.
Constipation in adults
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Constipation is often a multifactorial condition and requires careful history and examination. Definition is according to the Rome criteria. A holistic approach is required with attention to diet, lifestyle, and patient education, as well as laxative treatment. The latest medical treatments including prucalopride and lubiprostone are discussed with specific indications. Few patients will require formal investigation, but those who do need a structured approach which is covered in this chapter.
Chronic pancreatitis
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Management of chronic pancreatitis requires a multidisciplinary approach. Accurate diagnosis can be challenging, as initial tests may be inconclusive. MRCP/ERCP and CT scan are used in diagnosis. A plan for stepwise pain management is discussed including nerve plexus blocks. Therapy may involve endoscopic pancreatic duct decompression, and a small number may benefit from surgery such as pancreatectomy and pancreatico-jejunostomy or laparoscopic distal pancreatectomy
Gallstone disease
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Gallstone disease is common with clinical presentations including biliary colic, cholecystitis, and obstructive jaundice. Acute cholangitis and pancreatitis are other complications. Ultrasound scan and MRCP as well as endoscopic ultrasound are investigation modalities. Medical treatment of gallstones with ursodeoxycholic acid is discussed as well as laparoscopic cholecystectomy with its risks and benefits. The prevalence of bile duct stones is around 10–20%. Strategies for investigation and management are discussed, including ERCP and laparoscopic bile duct exploration.
Chronic venous insufficiency (CVI)
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Chronic venous insufficiency (CVI) can result in varicose veins or, if severe, may develop skin changes and leg ulcerations. This chapter details the classification and presentation of varicose veins and venous leg ulcers (CEAP classification). It outlines the recommended investigations for CVI such as handheld Doppler scan and venous duplex ultrasound scans. The management of CVI is to improve the venous and lymphatic flow thereby improving the skin oxygen transport through reducing oedema. This can be performed by graduated compression bandages.
Breast cancer
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Breast cancer is the most common cancer affecting women worldwide. Survival at time of detection is high. Clinical presentation ranges from a highly suspicious breast lesion to a completely asymptomatic screen-detected cancer. Triple assessment is the mainstay of diagnosis (clinical history and examination, breast imaging, and pathological assessment of biopsy). All lesions need careful MDT assessment, and a thorough assessment of patient fitness. Surgical excision is the treatment of choice for all operable cancers irrespective of age with consideration of patient factors. Breast reconstruction should be considered at the time of initial decision. Adjuvant, neoadjuvant, and other types of therapy (hormone, biological, etc.) should be planned at the multidisciplinary team meeting. Advanced cases should be considered for the most effective palliative therapy where needed.
Abdominal wall hernias
Authors: Jibawi Abdullah , Baguneid Mohamed , Bhowmick Arnab
Published: August 2018

Hernias are abnormal protrusion of an organ through a weakness/defect in the body wall that contains it. Classifications include groin hernias, ventral abdominal wall hernias (umbilical, femoral), incisional, Spigelian, and lumbar hernias. Inguinal hernias are the commonest types of abdominal wall hernias (~75%). Male are affected 15-times more frequently. Hernias are more common in smokers, patients with underlying connective tissue disorders (Ehlers Danlos Syndrome, Marfan syndrome), and patients with increased intra-abdominal pressure (obesity, heavy lifting, chronic cough, and chronic straining during defecation and urination). Hernias present as incidental finding on imaging, asymptomatic lumps, painful lumps, or incarcerated or strangulated hernias. Clinical history and examination are the mainstay of diagnosis. Most hernias are treated with surgical repair (open or laparoscopic). Conservative wait and watch policy is indicated in some cases.
Frameworks, study designs, and guidance
Authors: O'Cathain Alicia
Published: August 2018

The use of frameworks and study designs can help researchers to plan their studies, communicate them to other researchers and wider stakeholders, and build up a methodological knowledge base to improve specific research designs. In this chapter, different frameworks and study designs are discussed in three contexts: describing evaluations or the whole study, describing the combination of qualitative research and RCTs, and describing the qualitative research when used alongside an RCT. The label ‘mixed methods evaluation’ is proposed for describing the whole study when qualitative research and RCTs are combined. Different labels for describing the relationship between qualitative research and RCTs within a mixed methods evaluation are then explored. Finally, researchers have started to produce guidance to help others to undertake qualitative research with RCTs. This guidance is briefly introduced here in relation to the frameworks introduced in the earlier parts of the chapter.
Theories underpinning the intervention
Authors: O'Cathain Alicia
Published: August 2018

Researchers have theories about how the interventions they are evaluating achieve effectiveness (mechanisms of action) and how best to implement them in complex environments. It is recommended that these theories are made explicit, either by drawing on existing theories from organizational, psychological, improvement science, or sociological research, or displaying programme theories specific to the intervention that show the proposed causal pathways from content of intervention to long term outcomes. These theories can shape the research questions, sampling, data collection, analysis, interpretation and reporting of any qualitative research undertaken with RCTs. Some relevant theories are introduced, with examples of how researchers have used them with qualitative research and RCTs.
Writing a proposal
Authors: O'Cathain Alicia
Published: August 2018

When researchers plan to undertake qualitative research with a pilot or full RCT they write a proposal to apply for funding, seek ethical approval, or as part of their PhD studies. These proposals can be published in journals. Guidance for writing a proposal for the qualitative research undertaken with RCTs has been published, and there is existing guidance for writing proposals in related areas such as mixed methods research. In this chapter, existing guidance is introduced and built upon to offer comprehensive and detailed guidance for writing a proposal for the qualitative research undertaken with an RCT. There are challenges to writing these proposals and these are discussed and potential solutions proposed.
Engaging with key stakeholders
Authors: O'Cathain Alicia
Published: August 2018

A range of stakeholders can interact with the qualitative research undertaken with RCTs. Some may be part of the evaluation team (public and patient involvement, possibly the intervention developers, clinical trials units), but most are external to the team (policy makers, and members of trial steering committees, ethics committees, or institutional review boards). It is important to think about these stakeholders and plan their interaction with the qualitative research to ensure that the most relevant and high-quality qualitative research is undertaken and acted upon.