bluuebunny/crossref_metadata_2025 huggingface dataset:
Driver of Innovation
Authors: Willetts David
Published: November 2020

We saw in Chapter Four that the UK can be proud of the quality of the research conducted in its universities. But we need to be clear what this success is. Success means relentless pressure on academics to produce papers that are going to be assessed by fellow academics as of the highest quality and frequently cited. For most academics today that means getting published in the most prestigious peer-reviewed journals which is what matters for promotion, even though the assessment of their research excellence in the REF is supposed to be independent of the status of the journal in which their work appears. That drives competition in research performance whose logic is as obvious as rewarding a football team for scoring goals. The sure way for a university to move up the rankings and boost its prestige is to promote or hire hot-shot academics with strong publishing records. In science as in football we run the most open and most competitive league in the world—and hope to continue to do so even outside the EU. It has projected our universities high up the rankings, alongside the US. (There is one important difference from football—under the rules of the REF, academics could take their publications with them when they moved. It as if when you buy a star striker you get the goals he scored in the previous season as well. The logic is that it is part of their personal research performance that is being assessed. It has driven up the pay of the academic stars but also provided opportunities to younger post-docs after they get something published. Nicholas Stern’s review of the REF in 2016 proposed that such portability should end.) The high rankings of our research-intensive universities are a real achievement. But that is not the same as having the best national R&D system or contributing to tackling big global challenges or successfully commercializing new technologies or making a region a lively innovation cluster. We might hope that our research strengths contribute to these wider goals. But we may have been forced to make trade-offs to achieve research excellence which can actually make it harder to achieve other objectives.
The University in the Marketplace
Authors: Willetts David
Published: November 2020

The opening chapters of this book were a story of expansion, in which more and more universities were created after progressive reformers finally broke the Oxbridge duopoly. And, just as important, in the second part of the book we have seen it is also a story of personal growth and advance as more people have their lives transformed by higher education. In the previous two chapters we have then seen how useful this institution has become—broadening its role in professional training and promoting growth and innovation by working with business and government. The university is one of the key institutions of the twenty-first century and finds itself deeply embedded in the market economy. But there are doubters who are wary of this very success because it is changing the character of the university. One of my main objectives as universities minister was to create a more open and diverse higher education system which would work better for students. That meant more choice and competition between universities and easier entry for new providers as well as removing the number controls which limited the scope for universities to grow in response to student demand. I believed these changes would ensure students were better served and make British universities stronger in a higher education market which is increasingly global. In effect our funding reforms gave students an education voucher to be spent at the university of their choice if they met its admission requirements, to be repaid when they were graduates if they could afford to. We replaced funding via a Government agency providing grants to universities with funding via the fees (funded by loans) which students brought with them. Many people in higher education are suspicious of this wider agenda. They worry about ‘marketization’ and, just as bad, ‘consumerism’. Those market values pervade the wider environment within which Western universities operate. All these changes open up a key question: to what extent should universities themselves absorb these values or should they deliberately hold themselves apart? There are sceptics who fear that as universities grow bigger and more economically significant they betray their distinctive values.
Function
Authors: Swift Ellen
Published: November 2020

The relationship between design, function, and behaviour is explored in this chapter by assessing design features and their affordances against firstly, evidence of use drawn from wear studies of the artefacts that indicate the way they have been used; secondly, both experimental recreations, and the end-products the tools were used to create; and thirdly, archaeological context. In this way, we can examine both the potential of an approach focusing on design features, and also any limitations. I hope to show that affordances are an important source of evidence and provide insights that cannot be gained fromother sources, but that it is important not to take potential affordances at face value, and to interrogate their relationship to likely uses by comparison with other types of evidence. The first method through which possible affordances can be evaluated is through comparison with use-wear. In this way, it is possible to see how ‘proper function’ uses, suggested by practical affordances, compare to evidence of actual use as represented by use-wear. In a previous study, I investigated use-wear in relation to the functional features of Roman spoons (principally cochlear spoons with pointed handles), which I will briefly summarize here. Two principal affordances were evaluated: firstly, the shape of the spoon bowl, and secondly, the capacity of the bowl to hold varying amounts of liquid. I also investigated some other features such as the handle shape. The data, studied through personal inspection of museum objects, were drawn mainly from south-east Britain with some comparative material from the Roman site at Augst in Switzerland which has a very large collection of Roman spoons. Roman cochlear spoons occur in a wide range of well-dated forms, with different bowl shapes broadly succeeding one another chronologically (with some inevitable overlap). Round-bowled spoons are the earliest, found in the first and second centuries AD. Forms with a pear-shaped bowl are found from towards the end of the first century AD to the end of the second century, and forms with a fig-shaped bowl from the mid-second into the third century AD.
Safeguarding children
Authors: Harris J C , Welbury R
Published: November 2020

It is essential that everyone who provides dental care for children has an understanding of other factors that affect children’s lives. This includes non-dental aspects of their health and wider issues that affect children’s development and well-being. Child maltreatment is one such issue. Abuse and neglect are forms of maltreatment of a child. Child maltreatment involves acts of commission or omission which result in harm to a child. When health professionals work with others to take action to protect children who are suffering, or are at risk of suffering, significant harm as a result of maltreatment, this is known as ‘child protection’. Child protection sits within the context of a wider agenda to ‘safeguard’ children. Safeguarding measures are actions taken to minimize the risks of harm to children and young people. These include: • protecting children from maltreatment • preventing impairment of children’s health or development • ensuring that children are growing up in a safe and caring environment. This should enable children to have optimal life chances and to enter adulthood successfully. The foundation for the success of such work is an acceptance and understanding of children’s internationally agreed human rights. In this context the term ‘child’ includes children and young people up to the age of 18. Violence towards children has been noted between cultures and at different times within the same culture since early civilization. Infanticide has been documented in almost every culture, and ritualistic killing, maiming, and severe punishment of children in an attempt to educate them, exploit them, or rid them of evil spirits has been reported since early times. Ritualistic surgery or mutilation of children has been recorded as part of religious and ethnic traditions. In the seventeenth century values started to change and incest was seen as a crime under church law, but until the eighteenth century society viewed children as possessions of their parents who were at liberty to treat them in any way they wished. In fact, legislation to protect animals was introduced before children were afforded the same ‘privilege’.
Oral medicine and oral surgery in children
Authors: Crighton A , Meechan J G
Published: November 2020

Children experience a variety of oral medicine and oral surgical problems, of which some last into adulthood and some resolve with or without intervention by the dentist or doctor. Even where the same pathology is found in both adults and children the approach to management and the issues of delivering dental care may be very different in each group. This Chapter reviews conditions of the orofacial region, oral soft tissues, and bone that are frequently found in children or require a particular approach to their management in a paediatric population. The examination of the child starts as soon as the dentist and the child meet. Observations about a child’s weight, height, and development for his/her age, the attachment to the parent or siblings, and even the clothing worn by the child can be important. Apart from being a good starter to a conversation, the child’s new clothes or shoes can suggest a period of growth. Facial and perioral observation is best completed when seeing the child initially, as first impressions of swelling or asymmetry can be investigated later during the standard clinical examination. Although the history will elicit the findings needed to diagnose dental as well as non-dental conditions, the information needed for non-dental conditions and the impact that these conditions have on the child need particular exploration. When at all possible the child should be the source of the information—usually supported by the views of a parent—but it is important to have the child as the focus for initial information gathering. Be careful not to interpret the language used too literally—not every ‘ulcer’ turns out to be such, and always ask ‘What do you mean by …’ if the child or parent uses a word with a particular meaning to the dentist. Many ulcers subsequently turn out to be ‘sore bits’ with questioning—let the child use language with which they are comfortable. Always ask the child for permission before starting an extra- or intraoral examination of the soft tissues and explain what is going to happen.
Childhood impairment and disability
Authors: Nunn J H , Wright G
Published: November 2020

An impairment becomes a disability for a child only if he/she is unable to carry out the normal activities of his/her peer group. For example, a child who has broken an arm is temporarily ‘disabled’ by not being able to eat and write in the normal way. However, impairment is a permanent feature in the lives of some children, although it may become a disability only if they are unable to take part in everyday activities, such as communicating with others, climbing stairs, and toothbrushing. A more contemporary view is one that moves away from the medicalization of impairment to a consideration of ability and functioning, enshrined in the World Health Organization’s International Classification of Functioning, Disability, and Impairment (ICF). In this definition, a number of domains are classified from body, individual, and societal perspectives. This approach is less stigmatizing and more enabling of children with impairments. There are a number of reasons why children with impairments merit special consideration for dental care. 1. The oral health of some children with disabilities is different from that of their healthy peers—for example, the greater prevalence of periodontal disease in people with Down syndrome and of tooth-wear in those with cerebral palsy. 2. The prevention of dental disease in disabled children needs to be a higher priority than for so-called normal peers because dental disease, its sequelae, or its treatment may be life-threatening—for example, the risk of infective endocarditis from oral organisms in children with significant congenital heart defects. 3. Treatment planning and the provision of dental care may need to be modified in view of the patient’s capabilities, likely future cooperation, and home care—for example, the feasibility of providing a resin-bonded bridge for a teenager with cerebral palsy, poorly controlled epilepsy, and inadequate home oral care. In the light of these considerations, do such children need special dental care? Most of the studies that have been undertaken on disabled children have indicated that the majority can in fact be treated in a dental surgery in the normal way, together with the rest of their family.
The Development and Character of Urban Communities in Prehistoric Crete in their Regional Context: A Preliminary Study
Authors: Whitelaw Todd
Published: November 2020

This chapter is a preliminary sketch of an approach to analysing Minoan and Aegean urbanism in the Bronze Age. It comprises two sections, the first an outline of urban development, focusing particularly on the Cretan evidence but situating that in its southern Aegean context, on the far western fringe of Eurasian Bronze Age urban societies. The second section is a preliminary comparative exploration of the Cretan data in the context of Bronze Age urbanism in the broader East Mediterranean and Near East. This is aimed at assessing whether, despite its geographical remove, Minoan urbanism shares significant characteristics with other examples of Bronze Age, institutionfocused urbanism, and whether the diversity of the latter, with their more extensive textual documentation, may potentially provide models which can help us to analyse the Cretan evidence. Today, urban status tends to rely on bureaucratic and legal definitions, which vary arbitrarily between jurisdictions (Roberts 1996). They are usually based on population size, sometimes on areal extent, but the underlying idea is that the size of the population interacting in a community has an impact on the nature of those interactions, with larger communities being more complex, with individuals, through spatial propinquity, being able to interact with greater numbers of other individuals, interact in more complicated ways, and require more organization and infrastructure to facilitate these interactions (Bairoch 1988; Mumford 1966). This is well documented through recent analyses that explore the intensification of social interactions in larger cities (not just more, but more per person), whether positively, as measured through, for example, GDP or innovation rates, or negatively, through crime rates (Bettencourt et al. 2007, 2010). Moving away from modern industrial and post-industrial contexts, viewed cross-culturally, it has long been established that the largest community in a culture provides a general index of overall cultural complexity, measured in a variety of ways (Carneiro 1967; Tatje and Naroll 1970; McNett 1970).
Community Building/Building Community at Gournia
Authors: Buell D. Matthew , McEnroe John C.
Published: November 2020

For more than a century Gournia has been one of the key sites for understanding Minoan urbanism. Excavations by Harriet Boyd Hawes (1901–4), Jeffrey Soles and Costis Davaras (1971, 1972, and 1979), an intensive archaeology survey by Costis Davaras and L. Vance Watrous (1992–4), cleaning operations by Watrous near the shore (2008 and 2009), and the current Gournia Excavation Project (hereafter GEP) also directed by Watrous (2010–present) have resulted in one of the most extensively explored Bronze Age towns in the Eastern Mediterranean (Hall 1912; Boyd Hawes et al. 1908; Watrous et al. 2012; Watrous et al. 2015). By the end of the Neopalatial period the excavated section of the town covered some 1.68 ha, consisting of a number of interdependent components, including approximately sixty-four houses, a small palace, harbour facilities, a 500 m2 plateia, and a cobblestone street system with a total length of more than half a kilometre (Gomrée 2013: 850). When we began our work with the GEP we assumed that we would simply add the new excavations to the existing plan by Boyd. However, we quickly discovered it was not possible to make the old plan fit with our new survey points. Moreover as we looked more closely at the old plan we discovered a number of other problems. We noticed that walls, rooms, and even entire buildings had been omitted. In addition, the straight lines of the earlier plan had the effect of regularizing the architecture and masked the chronological complexity of the site. We decided, therefore, to make a new GIS-based plan of the entire site. When combined with excavation data, our new architectural analysis provides a rich dataset, which is useful for both interisland and cross-cultural comparisons of urban development and change. This dataset also provides us with the opportunity to examine how the various components of the town interacted from the time of its foundation in the Early Minoan period through to its final use in the Late Minoan III period.
From Life to Death: Dynamics of Personhood in Gallo-Roman Funerary Customs, Luxemburg Province, Belgium
Authors: Cerezo-Román Jessica I. , Deforce Koen
Published: November 2020

This chapter explores the identification of, and changes in, aspects of personhood through the study and interpretation of funerary customs. The geographical and temporal foci are the Luxembourg province of south-eastern Belgium from AD 1–150 where variations in social and political organization are well documented but cremation funeral customs are not. This research explores one overarching question: how did the personhood of the deceased change throughout the different stages of cremation customs within and between two contemporary Gallo-Roman sites located in the Belgian province of Luxembourg? The sites selected are Weyler (Henrotay 2011; Henrotay and Bossicard 1999), located in Arlon, and Houffalize, located in Houffalize/Mont (Henrotay 2012) (Fig. 9.1). Two primary datasets were utilized: 1) biological profiles of the human skeletal remains, and, 2) posthumous treatments of bodies inferred from analysis of the remains within their burial contexts. In this chapter, we also contrast these findings with historical accounts of cremation customs among ancient Roman populations.We argue that Gallo-Roman mortuary practices mediated the dead from biological death through a liminal state where personhood was transformed from subject to object/subject before final burial. The concept of personhood is employed in identity research across the social sciences, and in recent years also has been applied in archaeology (e.g. Fowler 2005; Jones 2005). Our research employs the notion of personhood—what constituted the state or condition of being a person—to elucidate the portrayal of individuals in the past. This definition follows previous research in the concept (e.g. Brück 2006a, 2006b; Fowler 2010; Williams 2004a). Throughout an individual’s life social relationships change and new ones are formed. These also are dependent on the individual’s age, sex, class, race, disabilities, and particular group affiliations, among other factors. Mauss (1985) posited that frames of reference for personhood changed through time and space, according to distinct cultural ideologies. Building on this idea Meyer Fortes (1987) added that personhood also was negotiated and dependent upon social relationships and in light of specific moral codes. These ideas suggest that personhood is a social category, that it is inherently dynamic and relational and that it only takes on meaning through the enactment of relationships.
The Host-Parasite (Microbe) Relationship
Authors: Rosmarin Caryn
Published: November 2020

No and yes. The skin, oropharynx, upper airways, gastrointestinal tract, and lower female genital tract are full of bacteria, with the highest concentration being in the colon and in dental plaque. Overall, humans are made up of slightly more bacterial cells than human cells; about 40 versus 30 trillion respectively. Although much less prominent, fungi and viruses are also present. In addition to these endogenous microbes, humans come into contact with numerous others on a daily basis—they are inhaled, ingested with food and drink, and picked up on the skin from the environment. Some of these remain in and on the human body for periods of time, while others slough off or die. In contrast to this, there are certain areas of the body where microbial agents are not expected to occur under normal circumstances. These are called sterile sites and include: major organs and their surrounding fluids and capsules; blood and body fluids other than faeces and saliva (yes, including urine!); bone, bone marrow, and joint fluid; subcutaneous tissue, fat, muscle, and tendons; the lower respiratory tract; and some of the genital tract. Microbes only enter these protected sterile sites through various breaches in physical and immunological defences. Again— no and yes. This is a question that has posed much debate over the centuries and seems to evolve as understanding of both humans and microbes expands. Early understanding of infectious diseases was based on the idea that the microbe was an aggressor and the host a passive victim. Currently there is a better understanding of the relationship between microbe and host, which is more of a dance than a war. In order to express an understanding of the relationships between host humans and microbes, a language is required that describes this confusing and complex interaction, especially considering that knowledge in this field is still evolving. The bacteria that reside in or on human bodies on a semi- permanent basis are called normal flora, or indigenous microbiome. Each person has a relatively unique set of fairly stable microbes likely determined by early experience, and continued exposures and diets.
Tuberculosis and Other Mycobacterial Infections
Authors: Tiberi Simon
Published: November 2020

Mycobacterium tuberculosis (MTB) is a thin, aerobic, non-spore forming, slow-growing (doubling time twelve hours) non-motile rod-shaped bacteria, belonging to the family Mycobacteriaceae. Mycobacterium tuberculosis complex is made up of several species, including M. tuberculosis, M. bovis, Bacillus Calmette-Guerin (BCG), M. africanum, M. canetii, M.caprae, M. microti, and others. Transmission is via inhalation of aerosolized respiratory secretions. After inhalation, majority of bacilli are captured in the upper respiratory tract by mucus and removed through a process called clearance, although bacteria in small droplets can reach the alveoli where the bacilli are ingested by macrophages. If clearance is not effective infection may result. With the involvement of CD4 lymphocytes, interferon-γ and tumour necrosis factor-α, a granuloma is formed, and bacilli may be destroyed. In many cases, the bacilli are not destroyed and can spread into lymphatics or via blood to other sites (any organs) where it can lie dormant for years. This asymptomatic situation is called latent TB infection (LTBI). It may reactivate in 10% of people throughout their lifetime; this increases with immunosuppression and HIV infection. The course of illness is chronic and indolent. However, rapid progression to fulminant disease may result if the host is immunocompromised. Pulmonary TB is the most common and important form of TB because it is the infectious form of the disease. In areas where reactivation predominates (like the UK), there is a higher proportion of extrapulmonary TB. Tuberculosis bacilli resist destaining with acid alcohol treatment hence the term. This retention is due to complexing of the carbolfuschin Ziehl-Neelsen stain with mycolic acids present in the waxy cell wall, including lipoarabinomannan (which facilitates survival in macrophages). Microscopy will diagnose TB in 80% of smear-positive patients with a first sputum sample, a further 15% with the second, and 5% with a third. In endemic areas finding acid-fast bacilli in sputum has a 98% specificity, but this is not the case in the UK, a low-prevalence setting, where atypical mycobacteria can have a similar prevalence. In the best settings only 60% of culture-positive patients are also sputum smear-positive as liquid culture, the gold standard, and most sensitive test.
Bone and Joint Infections
Authors: Dave Jayshree , Ghani Rohma
Published: November 2020

Patients with bone and joint infections can present with native joint septic arthritis, osteomyelitis, or implant-associated bone and joint infections. Patients often present with an acute onset of hot, swollen, painful joint with restricted function in one or more joints over a couple of weeks. On examination the affected joint is painful with a limited range of movement, and fever is present. Risk factors for septic arthritis include an abnormal joint architecture due to pre-existing joint disease, e.g. patients with rheumatoid arthritis, or patients on haemodialysis, with diabetes mellitus, or older than 80 years of age. The differential diagnosis includes reactive arthritis, pre-patellar bursitis, gout, Lyme disease, brucellosis, and Whipples disease. Staphylococcus aureus is the most common cause of septic arthritis, followed by Group A streptococcus and other haemolytic streptococci including B, C and G. Gram-negative rods such as Escherichia coli are implicated in the elderly, immunosuppressed, or patients with comorbidities. Pseudomonas aeruginosa is implicated in intravenous (IV) drug users and patients post-surgery or intra-articular injections. Kingella kingae causes septic arthritis in children younger than four years of age. Neisseria gonorrhoeae, Neisseria meningitidis, and Salmonella species can also cause septic arthritis as part of a disseminated infection. Septic monoarthritis commonly occurs in patients with disseminated gonococcal infection. Blood cultures, white blood cell count, C reactive protein (CRP), electrolytes, and liver function tests are indicated. Serial CRP is useful in monitoring response to treatment. If there is a history of unprotected sexual intercourse, gonococcal testing is recommended. Brucella serology and Tropheryma whippei serology may be considered based on the clinical history. Joint fluid aspiration should be performed by a specialist within the hospital. Joint fluid aspirate is processed in the laboratory for microscopy, culture, and sensitivity. Gram stain can show an increase in neutrophils and presence of bacteria. The guidelines provided by the British Society for Rheumatology on the management of hot swollen joints in adults has provided advice for empirical treatment for suspected septic arthritis, but the local antibiotic policy should also be considered. Initial treatment is with intravenous flucloxacillin 2g four times daily, or 450– 600mg four times daily of intravenous clindamycin to cover S. aureus.
Zoonotic Infections
Authors: Sanz Marta Gonzalez , Fhogartaigh Caoimhe Nic
Published: November 2020

The term zoonosis comes from the Greek: ζῷον (zoon) ‘animal’ and νόσος (nosos) ‘sickness’, and means an infection transmissible from animals to humans. Infected animals can be symptomatic or asymptomatic, and humans usually become accidental hosts through close contact with the reservoir animal. Six out of ten infections in humans globally are spread from animals, and 75% of emerging infections are zoonotic. Some occur worldwide e.g. E. coli O157:H7, whereas some are more restricted geographically, e.g. Ebola virus. The highest burden is in developing countries. There are various classifications of zoonoses. ● Causative pathogen: bacterial (anthrax, non-typhoidal Salmonelloses); viral (rabies, Yellow Fever, hantaviruses); parasitic (hookworm, Giardia, toxoplasmosis); fungal (dermatophytes, histoplasmosis); or prion (new-variant Creutzfeldt-Jakob disease). ● Mode of transmission (see Section 35.3 and Table 35.1 below) ● Distribution: endemic zoonoses are continually present in a population (e.g. leptospirosis, brucellosis); epidemic zoonoses occur intermittently (e.g. anthrax, Rift Valley Fever); emerging zoonoses are new infections, or existing infections that are increasing in incidence or geographical range (e.g. Nipah virus, Middle East Respiratory Syndrome coronavirus). ● Direct contact: infectious particles are present on an infected animal, in its body fluids, and in its excreta. Q fever, caused by Coxiella burnetii, and brucellosis may be acquired by direct contact with infected animals, particularly during parturition; cat-scratch disease caused by Bartonella henselae, and Pasteurella spp. may be acquired by bites or scratches from cats, and rabies from canine bites. Many zoonoses are also transmitted via indirect animal contact through exposure to soil or water contaminated by infectious material, e.g. leptospirosis may be acquired when water contaminated with infected rats’ urine comes into contact with broken skin or mucous membranes. ● Ingestion: infection occurs by ingesting contaminated food or water, e.g. unpasteurized milk, poorly processed or undercooked meat, or by eating/ drinking after handling animals without handwashing. Listeria, bovine tuberculosis, and brucellosis may be transmitted by unpasteurized milk and dairy produce; Hepatitis E through processed pork, and Ebola and Marburg through bushmeat. ● Vector-borne: infection is transmitted through a biting arthropod vector. Examples include West Nile Virus and Japanese encephalitis from mosquitoes, Lyme disease, tick-borne encephalitis, and Rocky Mountain Spotted Fever from ticks, and Rickettsia typhi from rat fleas.
Infections in Neonates and Young Children
Authors: Millar Michael , Kempley Steve
Published: November 2020

This chapter covers infections in neonates and young children. In this chapter the term ‘young children’ indicates children under two years of age. For information on congenital infections interested readers are referred to Chapter 37. Early neonatal infection is variably defined as infection presenting up to a week after birth, but most infections present in the first seventy-two hours. Microbial invasion of the chorio-amniotic membranes or uterine cavity occur in a significant proportion of pregnancies before rupture of membranes (> 50% with preterm birth before thirty weeks gestation, 10% with term delivery), and in the majority of those with prolonged rupture of membranes (> 24 hours). It is likely that the majority of cases of early sepsis arise through ascending infection of the uterus (through the cervical canal). Ascending infection may be important in the pathogenesis of preterm birth and is more common in infants born preterm. Group B Streptococci (GBS) (Streptococcus agalactiae) and Escherichia coli are the most common agents of early neonatal infection. Infection with Listeria monocytogenes probably arises following ingestion of contaminated food by the mother, blood stream infection, and transplacental spread. Early infection with GBS usually presents with respiratory distress and can be difficult to differentiate from respiratory distress associated with other causes, particularly prematurity. The incidence of GBS blood stream infection in England and Wales has been 0.3–0.45/ 1000 live births over the last five years. Maternal genital herpes simplex infection can spread to the newborn infant and cause a wide range of serious clinical presentations, with skin, systemic, and central nervous system involvement. Maternal infection with Neisseria gonorrhoea or Chlamydia trachomatis can also infect the infant. Either can cause conjunctivitis which can sometimes be of sufficient severity to cause substantial damage to the eyes. Gonococcal conjunctivitis usually presents in the first few days of life. Infection with Chlamydia trachomatis (conjunctivitis or pneumonitis) tends to present later. Traditionally, penicillin and an aminoglycoside have been used to treat infants with suspected early sepsis (to cover GBS and Escherichia coli). Newborn infants are often empirically treated because it can be difficult to differentiate early bacterial sepsis from respiratory distress associated with prematurity, and death may ensue rapidly if the infection is not treated.
Introduction and Background
Authors: Hodgkinson Anna   K.
Published: November 2020

This book aims to establish knowledge of the infrastructure and organization of the excavated cities in Late Bronze Age (LBA), or New Kingdom Egypt (c.1550–1069 BC), and provide an understanding of the accessibility and control of the high-status products and the raw materials and tools used for their manufacture. This is done by analysing the distribution of the artefactual and structural evidence of the manufacture of high-status goods from three sites used as case-studies, namely Amarna, in Middle Egypt, Gurob, in the Faiyum region, and Malqata, in ancient Thebes (Chapters 2–5). It attempts to achieve some knowledge of the control and distribution of the finished goods, highlighting buildings and areas in the settlements that were involved in the production, and others that would be the consumers of high-status goods. By detecting some mutual patterns between the sites analysed, it has been possible to achieve an understanding of urban high-status manufacture throughout the New Kingdom and its influence on the internal organization and status of settlements. Moving inwards, the study then focuses on workshops, their layouts and functionality (Chapters 6 and 7). A number of research questions will be answered, which address the issues of settlement status, craft production and its social context, the character of workshops as well as their influence on LBA settlements. These questions are presented in Sections 1.1–1.6 together with the data and methods used to address them. In the discussion of the status of a larger settlement we have to take into account the work and opinions of previous scholars. Trigger, for instance, differentiates between two approaches to settlement archaeology as a whole: (a) one focusing on the location, size, spacing, material culture, and activities, as opposed to another (b) focusing on the interactions of their environmental, economic, and technological determinants. While much information concerning the first approach existed by this date, he states that at the time of publication (in the early 1970s) there was still a lack of understanding concerning the economic and technological interactions within the settlements.
Amarna: Urban Manufacture of Luxury Items
Authors: Hodgkinson Anna   K.
Published: November 2020

Little is necessary in terms of an introduction, since Amarna is one of the best-known settlements of ancient Egypt. The city was founded by pharaoh Amenhotep IV, known from his fifth regal year as Akhenaten, on his move away from Thebes and Memphis to found a new religious and administrative capital city. Akhenaten reigned approximately between 1348 and 1331 BC, and his principal wife was Nefertiti. Akhenaten’s direct successor appears to have been a figure named Smenkhare (or Ankhkheperure) who was married to Akhenaten’s daughter Meritaten. Like Nefertiti, Smenkhare/Ankhkheperure held the throne name Nefernefruaten. For this reason it is uncertain whether this individual was Nefertiti, who may have reigned for some years after the death of Akhenaten, possibly even with a brief co-regency, or whether this was a son or younger brother of the latter. The rule of Smenkhare/Ankhkheperure was short, and he or she was eventually succeeded by Tutankhamun. The core city of Amarna was erected on a relatively flat desert plain surrounded by cliffs on the east bank of the Nile, in Middle Egypt, approximately 60km south of the modern city of Minia, surrounded by the villages et- Till to the north and el-Hagg Qandil to the south. The site was defined by at least sixteen boundary stelae, three of which actually stand on the western bank, past the edge of the modern cultivation. In total, the city measures 12.5km north–south on the east bank between stelae X and J, and c.8.2km west–east between the projected line between stelae X and J and stela S to the far east, which also indicates approximately the longitude of the royal tomb. The distance between stelae J and F, to the far south-west, measures c.20km, and between stelae X and A, to the far north-west 19.2km. The core city, which is the part of the settlement examined in this section, was erected along the Nile, on the east bank, and it is defined by the ‘Royal Road’, a major thoroughfare running through the entire core city north–south.
Conclusions
Authors: Hodgkinson Anna   K.
Published: November 2020

This final chapter addresses the individual research questions posed in the Introduction (Chapter 1), in the light of the data and discussion presented in Chapters 2–7. According to the range of settlement types defined by Troy (see Section 1.1), Amarna and Gurob may be regarded as cities, with a less specialized character and the presence of both a royal court and temples. While Amarna was not long-lived, it was specifically founded as a capital city with a large amount of urban planning. Gurob was certainly occupied for a long period, before and after the New Kingdom. Although Malqata can be defined as a royal city, it does not fulfil Troy’s definition of a city in that it was only very short-lived and served the sole purpose of a location for the festivities in honour of Amenhotep III, for which reason it should most likely be regarded a specialized settlement. In conclusion, it can be said that the presence of high-status goods and evidence of their manufacture enhances a settlement’s status. On the one hand, it proves that a strong demand existed for these types of objects, most of which were not for everyday use, and therefore implies the presence of either a consuming elite or royal court. On the other hand, should no royal court be present, it indicates at least the settlement’s dependence on the favours of royal personages acting as recipients of high-status goods. The presence of such personages would also enhance the settlement’s status. Hence, a developed infrastructure, together with a well-managed system of redistribution, as observed in all three case-studies discussed in this book, may very well be a factor determining a high-status settlement, such as a royal city. It can be stated that the analyses of the archaeological material from Amarna, Gurob, and Malqata have been successful in highlighting several areas of intensive industrial activity despite some issues regarding the nature of the data (see Section 1.4.3). In addition, it has been possible to further define the locations in which most of the finished products were found and, probably, used.
Making Music in Detroit: Archaeology, Popular Music, and Post-industrial Heritage
Authors: Ryzewski Krysta
Published: November 2020

Detroit’s popular music-making legacy has remained a foundation for the city’s symbolic identity throughout the twentieth century and into the present. For over a century music production in Detroit has been part of a thriving local industry and global enterprise, with different genres and styles of music measuring the city’s changing composition over the years (Holt and Wergin 2014). The sounds emerging from the city, coupled with its built environment and physical landscape, tell the stories of a creative, shapeshifting industrial and post-industrial centre defined by melodies, artists, and sounds that are distinctly Detroit—The Hucklebuck, Martha and the Vandellas, Cybortron. Attention to the assemblages of buildings, landscapes, people, and the soulful sounds associated with them reveal the underlying power of the city’s creative accomplishments to unite disparate communities, call attention to issues affecting urban well-being, and preserve memories of Detroit’s rich musical heritage. In its expansive repertoire of recording history and in its vast contemporary terrain of decay and ruination, Detroit’s musical heritage holds tremendous potential for archaeological research and cultural heritage initiatives. Through creative documentation platforms and dissemination practices contemporary archaeological approaches are particularly well suited for engaging place-based and thematic heritage discourses about Detroit and other post-industrial cities. This chapter presents the ‘Making Music in Detroit’ project, a contemporary archaeology and digital storytelling exercise focused on popular music assemblages and their placemaking power in Detroit, a city that is simultaneously defined and encumbered by the traumatic and festering post-industrial wounds of poverty, mismanagement, and ruination. In a series of twenty-four videos and web texts, ‘Making Music in Detroit’ illustrates how archaeologists might use digital storytelling to involve music-making places and their physical remains (some ruined, others intact) in communicating present-day senses of place as they relate to urban histories of creativity. These stories are part of a substantially broader and more formal multidisciplinary digital humanities effort to map Detroit’s transformations over the course of the past century, as it transitioned first from a thriving, wealthy, and innovative centre of manufacturing industries to an epicentre of post-industrial struggle, and more recently, from a bankrupt city into a stage for selective, privatized, and creative revitalization efforts (Ethnic Layers of Detroit project 2016; on creative cities, see White and Seidenberg, Chapter 1).
Effective Communication
Authors: Metcalfe David , Dev Harveer
Published: November 2020

Communication is fundamental to the role of the doctor. It includes routine verbal communication (e.g. history taking, updating relatives, handovers, and requesting investigations from specialists), written communication (e.g. prescriptions, updating the clinical notes, and discharge summaries), breaking bad news, and ‘challenging’ interactions such as dealing with an angry relative. Questions within this section assess your ability to communicate effectively with patients and colleagues. Effective communication requires understanding and being understood. You will need to demonstrate an ability to negotiate with colleagues, to document information within the medical notes clearly and concisely, to gather information from patients, and to listen to angry relatives. As always, your responses must adapt to the needs and context of each situation, while always remembering to demonstrate empathy and compassion. ● Listen to patients, relatives, and colleagues. They are trying to tell you something. ● Explain your position carefully after listening to the other side. ● Adapt your style as far as possible to the person with whom you are communicating. ● However strongly you feel, poor manners will never get the job done faster. Foundation doctors should not usually be left to ‘break bad news’ in the classical sense of a new cancer diagnosis in clinic. However, bad news can take many forms and it is likely that you will find yourself going through the ‘breaking bad news’ sequence many times during the foundation programme. For example, the following scenarios are all bad news to varying degrees. Some patients will take such developments in their stride and others will rank them amongst other significant life events. ● An incidental ‘nodule’ found on a CT chest that might be benign but will require a follow- up scan in three months. ● An elderly man who has become very unwell and is unlikely to survive while you are on call. You have been assigned the task of calling his wife, providing an update, and suggesting she come to the hospital urgently. ● The fact that investigations have all been normal and they are being discharged without a diagnosis for their persistent debilitating abdominal pain.
Introduction
Authors: Lutz Wolfgang , Butz William P.
Published: November 2020

This book addresses systematically and quantitatively the role of educational attainment in global population trends and models. By adding education to the traditional demographic characteristics of age and sex, this distinguishing feature substantially alters the way we look at changes in populations and how we project them into the future. In most societies, particularly during the process of demographic transition, women with more education have fewer children, both because they want fewer and because they find better access to birth control. And better educated men and women in virtually all societies have lower mortality rates and their children have a better chance of survival. Migration flows also differ by level of education, and better educated migrants integrate more easily into receiving societies. These pervasive demographic differentials by level of education matter greatly for population dynamics. When we explicitly address this important source of population heterogeneity the projected future population trends are different from those based on the conventional stratifications that include only age and sex. In addition, the future educational attainment levels of the adult population are of great interest in their own right as a key determinant of outcomes ranging across economic growth, quality of governance, and adaptive capacity to environmental change. Traditionally in demography, the sex of a person is considered the most fundamental characteristic because it is essential for studying the process of reproduction. Mortality and migration also show significant variation by gender. Age is another key characteristic because it is the main driver of biological maturation at an early age and is directly related to school attendance, labour force entry, and retirement, all landmarks that are important for social institutions. Because there are distinct age-related patterns of fertility, mortality, and migration intensities, gender and age are considered the most fundamental demographic dimensions. In addition, demographers frequently take into account other biological, social, and economic characteristics, including place of residence (especially urban or rural), citizenship, marital status, race, migration status, employment status, health/disability status, and educational attainment. These additional characteristics are not systematically considered in every study, but tend to appear in corresponding topical studies.