bluuebunny/crossref_metadata_2025 huggingface dataset:
Does money talk, and do languages have price tags? Economic perspectives on English as a global language
Authors: Mair Christian
Published: August 2014

The rise of English to its present position of the world’s undisputed lingua franca and the role of Global English in a multilingual world are core topics of World Englishes research. However, this does not mean that they have not been of interest to researchers in other disciplines, as well – for example in history, sociology and economics. The present contribution reviews a sample of recent analyses of English in multilingual settings written by economists, arguing that in spite of their methodological blindness to some phenomena important to (socio)linguists they have important things to say to the World Englishes research community. Conversely, taking account of the results of linguistic research on World Englishes would greatly help in refining the econometric models.
Language variation and education
Authors: Mahboob Ahmar
Published: August 2014

Studies on World Englishes focus on variations in the use, meanings and structures of Englishes as they have evolved in different parts of the world. However, World Englishes is not the only framework used by linguists to study variations in the English language. This chapter introduces a three-dimensional framework of language variation that allows us to place the various traditions of studying language variation in relation to each other. The chapter then considers the implications of studying language variation in educational contexts, using the three-dimensional model. In doing so, the chapter examines how language variation operates in Pakistani English language textbooks at a discursive level and discusses the implications of these variations.
Non-standard or new standards or errors?
Authors: Kirkpatrick Andy , Subhan Sophiaan
Published: August 2014

Using data of speakers whose first language is a variety of Malay, a language that does not mark for tense, this article will investigate the hypothesis that speakers of second language (L2) varieties of English whose first languages (L1s) do not mark for tense, will use tense marking less frequently than those speakers of L2 varieties of English whose L2s do mark for tense. The article will also review other possible motivations for the presence of non-standard forms in the English, bearing in mind Thomason’s caution “that multiple causes are responsible for a particular change” (2010: 31). It is hoped that the study will contribute to our knowledge of contact-induced change in English worldwide (Schneider 2007, 2012).
The evolutionary trajectory of Cameroonian Creole and its varying sociolinguistic statuses
Authors: Ngefac Aloysius
Published: August 2014

The different names the contact language spoken in Cameroon has had at different historical points significantly reveal the complex evolutionary itinerary of the language and its varying sociolinguistic statuses. After the Portuguese era (ca. 1469 – 1600), which had Pidgin Portuguese as the main lingua franca, the language has had such names as “Pidgin English”, “Neger Englisch”, “Cameroons Creole”, “Cameroonian”, “Cameroon Pidgin English”, “Kumba English”, “Kamtok”, and “Cameroonian Creole”. This article makes an appraisal of these names in terms of how they reveal sociolinguistic information about the language (history, functions and status) and information about the country where it is spoken.
Lexical creativity reconsidered
Authors: Fischer Roswitha
Published: August 2014

The present study complements and modifies Fischer (1998), who analyzed creative neologisms in the British newspaper The Guardian 1991–1996 and established a general model of lexical institutionalization. First, we will present and discuss relevant research in cognitive linguistics. Secondly, we will consider various corpus-based studies about neologisms published from the 1990s onwards, particularly about meaning cues and the life-cycle of neologisms. In an empirical part, we will then investigate novel coinages and constituents in the London Guardian from the 1980s until 2012, including the combining forms techno- and cyber-, whose productivity will be measured and compared as well. The findings allow a re-evaluation of the factors involved in the institutionalization process.
A New Old English? The chances of an Anglo-Saxon revival on the Internet
Authors: Neuland Christina , Schleburg Florian
Published: August 2014

By facilitating the contact between smaller groups of people living in widely separated places, the new media stimulate the use of minority languages, including constructed and historical languages. This article looks at the international community of users of Old English as a living language on the Internet. It analyses the linguistic competence behind the modest Anglo-Saxon revival and the strategies applied to deal with the modern world. As a sample of online texts, especially from Wikipedia, shows, not only does neo-Old English suffer from haphazard grammar and pervasive interference from Modern English, but it also depends too essentially on lexical innovation to have much of a future.
The Effects and Value of a Resistant Perennial Variety: An Application to Pudrición del Cogollo Disease
Authors: Grogan Kelly A. , Mosquera Mauricio
Published: August 2014

This article develops a forestry model to obtain the optimal control strategy and optimal rotation length after a disease attacks in a perennial variety. Three cases are considered: a benchmark consisting of a disease‐free field, an identical field with the disease present but no resistant variety with which to replant, and an identical field with the disease present and a resistant variety with which to replant. We determine general decision rules and then apply the model to the case of Pudrición del Cogollo, a major disease threat to the Colombian oil palm industry. In the application, we compare the optimal rotation length between the three scenarios and determine the optimal level of control in each period for the disease scenarios. The singular solution involves complete control of the disease, and in the absence of a resistant variety, the presence of the disease increases the rotation length. With these solutions, we then determine the value of developing a resistant variety. This value depends heavily on the age distribution of the current trees and decreases as the average tree age decreases. The value further declines when the resistance variety has negative attributes such as higher replanting and maintenance costs than the original variety.
VSEAMS: a pipeline for variant set enrichment analysis using summary GWAS data identifies IKZF3, BATF and ESRRA as key transcription factors in type 1 diabetes
Authors: Burren Oliver S. , Guo Hui , Wallace Chris
Published: August 2014

Motivation: Genome-wide association studies (GWAS) have identified many loci implicated in disease susceptibility. Integration of GWAS summary statistics (P-values) and functional genomic datasets should help to elucidate mechanisms.

Results: We extended a non-parametric SNP set enrichment method to test for enrichment of GWAS signals in functionally defined loci to a situation where only GWAS P-values are available. The approach is implemented in VSEAMS, a freely available software pipeline. We use VSEAMS to identify enrichment of type 1 diabetes (T1D) GWAS associations near genes that are targets for the transcription factors IKZF3, BATF and ESRRA. IKZF3 lies in a known T1D susceptibility region, while BATF and ESRRA overlap other immune disease susceptibility regions, validating our approach and suggesting novel avenues of research for T1D.

Availability and implementation: VSEAMS is available for download (http://github.com/ollyburren/vseams).

Contact: chris.wallace@cimr.cam.ac.uk

Supplementary information: Supplementary data are available at Bioinformatics online.
Chronic cough and a normal CXR
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Those people with chronic persistent cough and a normal CXR are increasingly being referred to specialist respiratory clinics. Definitions of acute and chronic cough are included, along with the introduction of the term cough hypersensitivity syndrome. Different cough measures are listed. Cough syncope is also described, with specific driving rules following this. The main causes of chronic cough with normal CXR are gastro-oesophageal reflux disease, cough variant asthma, and post-nasal drip (or upper airway cough syndrome), which account for over 90% of cases. Features of the history and suitable investigations for these are described. Ultimately, most diagnosis is made by a positive response to a trial of treatment, usually at high dose and given for an adequate amount of time. Possible approaches to this, based on the NICE guidelines, are described in detail, for each of the common causes. Symptomatic cough remedies are listed, although many of these have little evidence of a specific pharmacological effect, along with stronger possible options and novel treatments. ACE inhibitor-associated cough is highlighted.
Critically ill patient with respiratory disease
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter considers the patient who may present critically ill with either an exacerbation of known respiratory disease, a first presentation of respiratory disease, or respiratory involvement of a systemic disease. An approach to the initial assessment is suggested, including ways to consider the possible underlying cause and with practical guidance regarding airway management, assessment of breathing, circulation, and disability. Determining the treatment options for the different possible causes is discussed in general terms, including assessment of prior disease extent, baseline function, patient wishes. Organ support on the intensive care unit or non-invasive ventilation may be appropriate, and these should certainly be considered in the patient who is deteriorating, in whom a full assessment is not possible or in whom full information is not available. There are links to specific conditions and their presentations in other chapters, along with specific treatment links.
Diffuse lung disease
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter starts with a description of the basic lung anatomy, often discussed in the context of diffuse lung disease. The secondary pulmonary lobule is described, which is important in the understanding of the pathophysiology and radiological appearances of these conditions. A helpful table of possible causes of diffuse lung disease, categorized by speed of onset, is provided, giving a structure with which to approach these conditions. Considered clinical assessment, with attention to drug history, occupation, hobbies, travel, relevant family history, is highlighted. Imaging with CXR and HRCT is discussed, in particular, the range of patterns that can be found on the HRCT in diffuse lung disease, e.g. ground glass, reticular, nodular, cystic, interlobular septal thickening. Possible distribution of these patterns of abnormality and possible causes are described. Further investigations, including bronchoscopy, biopsy, pulmonary function tests, sputum, urine, and blood tests are described. There is a final section on diffuse lung disease presenting with acute respiratory failure, with a list of differential diagnoses and key points for assessment and treatment.
Haemoptysis
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The clinical assessment of the patient presenting with haemoptysis is discussed, along with a diagnostic approach and a list of possible causes. These include common causes, such as a bronchial tumour, bronchiectasis, pneumonia, and tuberculosis, and rare causes such as lung abscess, mycetoma, foreign body, arteriovenous malformation, pulmonary hypertension, and pulmonary haemosiderosis. Investigation of the patient with haemoptysis is considered, conveniently divided into first-line (blood tests, sputum, CXR, CT, transbronchial biopsy) and second-line investigations which are performed if a cause has not been found, such as CTPA, bronchial angiogram, bronchial artery embolization. The emergency management of massive haemoptysis is discussed in some detail with practical advice.
Post-operative breathlessness
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

As the respiratory physician is often asked to see patients post-operatively who have become dyspnoeic following an operative procedure, this chapter deals with the assessment and management of these patients. Points to consider when assessing these patients, such as speed of onset of dyspnoea and type of surgery, are included, along with appropriate investigations. A useful comprehensive table, detailing possible causes of post-operative dyspnoea and suitable specific management, is included.
Pulmonary disease in the immunocompromised (non-HIV)
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter discusses different aspects of pulmonary disease in the non-HIV immunocompromised host, due to reasons such as cytotoxic chemotherapy, haematological malignancy, immunosupression post-transplant, prolonged corticosteroid use. The difficulty in making a precise diagnosis is discussed, as clinical presentation can be non-specific and there are a large number of possible causes. An approach to these patients is therefore provided, including clinical assessment, points to look for on examination, appropriate initial and later investigations. The role of immediate empirical antibiotics, prior to confirmation of the definitive cause, is discussed. Possible causes are discussed, divided into infectious and non-infectious, whilst accepting that some people will have multiple causes. A further subdivision by the speed of onset of symptoms is provided. Specifically, causes of pulmonary disease following solid organ transplantation are listed, according to time since transplant. Treatment possibilities, including antibiotics, steroids, surgery, and supportive therapy, are listed.
Sleep and ventilation
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Sleep-disordered breathing and other problems of sleep are increasingly common reasons for referral to the respiratory physician. This chapter discusses possible clinical scenarios which may lead to referral, including obstructive sleep apnoea (OSA) and obesity hypoventilation syndrome. Pertinent points in the sleep history are described, including sleepiness and how to quantify it and how to differentiate it from tiredness, OSA symptoms, the significance of previous ENT surgery, assessing the impact of work patterns, alcohol, etc. on sleep. A useful box lists possible alternative diagnoses for excessive daytime sleepiness. The examination and investigation for a person with suspected OSA are described, along with which blood tests to perform in the clinic and in whom arterial blood gas assessment is warranted. A discussion of points to consider regarding commencing CPAP is given, which is expanded further in the subsequent chapter on obstructive sleep apnoea. Finally, the Epworth Sleepiness Score is replicated, which may prove useful in the clinic.
Acute respiratory distress syndrome
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter discusses the pathophysiology, diagnosis, management, and complications of ARDS. This is a common finding, affecting up to 20% of patients on intensive care units. Key causes are sepsis and pneumonia, gastric aspiration, trauma, and burns. Recent work has clarified some of the inflammatory pathways and thus better ways to prevent and manage the condition. The use of steroids and timing of these is now clearer and how to avoid complications better established. Future developments that may further improve the care of patients are also highlighted.
Asthma
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

A comprehensive review of all aspects of modern asthma care, including diagnosis, epidemiology, pathophysiology, and appropriate investigations. This chapter covers both acute and chronic disease, including the specific areas of refractory asthma, occupational asthma, and asthma in pregnancy. The emergency management of acute severe asthma is covered, including the latest British Thoracic Society guidelines. The tricky area of vocal cord dysfunction and other conditions often confused with asthma is discussed. New methods of monitoring asthma with biomarkers to aid exacerbation management are covered (exhaled nitric oxide, sputum and blood eosinophil measurement).
Bronchiectasis
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Epidemiology, pathophysiology, and causes of this respiratory condition are discussed. A multiplicity of causes is now recognized. All aspects of management are highlighted, particularly the appropriate investigations and the management of haemoptysis and Aspergillus. Therapies are detailed, including: antibiotics, long-term macrolides, physiotherapy, hypertonic saline, N-acetylcysteine, immunoglobulin replacement therapy, NIV, surgery, self-management plans. Management of exacerbations and how to manage the finding of Pseudomonas aeruginosa is fully covered, including the use of nebulized antibiotics.
Chronic obstructive pulmonary disease (COPD)
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

COPD continues to be a common condition, seen often by the respiratory and general physician. Although mostly associated with smoking, other causes are recognized. Making the diagnosis, along with severity stratification and management, according to recent BTS, NICE, and GOLD guidelines, is covered. Tips for the doctor seeing a patient with COPD in the outpatient clinic are included, along with how to manage the acute exacerbation of COPD. The role of NIV, home care in exacerbations, and pulmonary rehabilitation are discussed, along with when surgery may be an option (lung volume reduction, bullectomy, lung transplant). The specific area of alpha-1 antitrypsin deficiency is considered.
Cor pulmonale
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Cor pulmonale is the end result of many hypoxic conditions, especially when associated with hypercapnia, and is poorly understood by many clinicians. Cor pulmonale is a particular accompaniment of hypercapnic COPD, hypoventilation syndromes, and much less commonly seen when there is no associated rise in PaCO2 to accompany the hypoxia. This chapter explains the pathophysiology behind cor pulmonale, its specific features, appropriate investigations, and current management strategies.
Eosinophilic lung disease
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

There are a variety of causes of eosinophilic lung disease, with very different presentation and prognoses. These include: asthma with bronchopulmonary aspergillosis, Löeffler’s syndrome, tropical pulmonary eosinophilia, acute and chronic eosinophilic pneumonias, hypereosinophilic syndrome, Churg-Strauss syndrome, and several different drug-induced pulmonary eosinophilias. Their specific characteristics, clinical and laboratory findings, along with appropriate treatments, are covered.
Extreme environments—flying, altitude, diving
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Clinicians are increasingly asked to give advice over the health issues which may occur in the pursuit of work and leisure activities producing physiological challenges. The hypoxia and changes in barometric pressure associated with flying produce particular complications that are extensively discussed. The value of pre-flight assessment is covered. High-altitude complications, such as pulmonary oedema and cerebral oedema, including their management, are also covered. The useful role of acetazolamide, temazepam, nifedipine, dexamethasone, and the Gamow bag are debated. The peculiar problems related to diving and pre-existing lung disease, including the British Sub-Aqua Club recommendations, are included.
Lung cancer
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Management of lung cancer represents a very large proportion of the work of a respiratory physician. Slow progress in both the diagnosis and management of all forms of lung cancer (most commonly squamous, adeno, large cell, and small cell carcinoma) is being made, with increasing consensus amongst respiratory physicians, pathologists, radiologists, oncologists, thoracic surgeons, and palliative care specialists, who make up the multidisciplinary team. This extensive and detailed chapter covers the epidemiology, protean clinical features (including the non-respiratory complications such as superior vena caval obstruction, hypercalcaemia, inappropriate ADH secretion, hypercalcaemia, and spinal cord compression), appropriate investigations (standard, as well as the newer endobronchial ultrasound, thoracoscopy, and PET scanning), staging, and both surgical and non-surgical management. The emerging areas of lung cancer screening and the management of incidental pulmonary nodules are fully covered.
Mediastinal abnormalities
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Mediastinal masses often present as an incidental finding, with no clinical clues as to the cause. This chapter provides precise anatomical descriptions and classification and covers the causes and investigations, thus allowing a correct diagnosis to be made from the extensive differential diagnostic possibilities detailed in the text. Other mediastinal abnormalities, such as mediastinitis, mediastinal fibrosis, and pneumomediastinum, are covered.
Paediatric lung disorders pertinent to adult patients
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Chronic lung disease of prematurity produces abnormalities persisting into adulthood and are becoming more common, as more and more children survive premature birth. The pathophysiology of the initial damage and the long-term findings are described, particularly the persisting airway narrowing, hyperreactivity, pulmonary artery hypertension, and diffuse radiological abnormalities. It remains controversial as to whether early wheeze related to viral infections influence the subsequent development of asthma. Some congenital abnormalities may not present until adulthood such as diaphragmatic hernias, MacLeod’s syndrome (underdevelopment of part, or all, of one lung), and sequestered lobes; these are all covered in this chapter.
Pneumoconioses
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The pneumoconioses result from an inflammatory reaction in the lung to inhaled mineral dusts. The more common agents include coal dust, silica, asbestos, beryllium, iron oxide, barium sulfate, tin oxide, and aluminium. Increasing recognition is leading to a reduced prevalence through better worker protection. Lung damage varies from asymptomatic radiographic changes to death from ventilatory failure. This chapter describes the varying presentations and complications such as simple pneumoconiosis, progressive massive fibrosis, fibrotic lung disease, and sarcoid-like histology.
Pneumothorax
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter covers the clinical features, relevant investigations, variety of initial and longer-term management, including the recent BTS guidelines, of both primary and secondary pneumothoraces. The indications for chest drainage are covered in detail. Chest drain insertion can be dangerous, and the chapter rightly emphasizes watchful waiting, simple aspiration, and a more limited use of intercostal drainage than has occurred in the past. There is clear advice and guidance on the management of complications and issues, such as tension pneumothorax, surgical emphysema, continuing air leak, chemical and surgical pleurodesis, specific disease-related pneumothoraces, and what to advise patients regarding flying and diving.
Pulmonary hypertension
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Pulmonary hypertension occurs in a number of pulmonary and non-pulmonary diseases; the resulting classification is covered in detail in this chapter. Pulmonary arterial hypertension itself has many causes such as certain connective tissue disorders, drugs, heritable (two well-described genetic abnormalities), as well as the larger idiopathic group, pulmonary veno-occlusive disease, pulmonary hypertension due to left heart disease (systolic and diastolic dysfunction, and valvular disease), pulmonary hypertension due to lung disease (usually COPD, interstitial lung disease, other hypoxic lung diseases), chronic thromboembolic, and other rarer entities. The role of the UK pulmonary hypertension service and the specific management, including targeted drug therapy (calcium channel blockers, phosphodiesterase type-5 inhibitors, prostanoids, endothelin receptor antagonists), anticoagulation, and long-term oxygen therapy, of the different types of pulmonary hypertension are highlighted.
Respiratory infection—bacterial
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter covers all aspects of the diagnosis and management of community and hospital acquired pneumonia. Community-acquired pneumonia represents the commonest infectious cause of death in the UK and USA. Up to 10% require ITU admission where mortality remains at 50%. The predisposing conditions are discussed. This chapter includes guidance on community-acquired pneumonia severity scores and antibiotic choice, based on the recent British Thoracic Society guidelines. Strategies for patients who may need ITU care, who fail to respond to initial antibiotics, and who need follow-up after pneumonia are discussed. Other forms of respiratory infection are covered, including their aetiology and their management. These include ventilator-acquired pneumonia (VAP), aspiration pneumonia, lung abscess (including Lemierre’s syndrome), nocardiosis, actinomycosis, anthrax, tularaemia, melioidosis, and leptospirosis. The differential diagnosis of fever and CXR infiltrates in a patient on ITU is highlighted.
Respiratory infection—mycobacterial
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter discusses all aspects of Mycobacterium tuberculosis management, including pulmonary and extrapulmonary disease, appropriate investigations, and the various antibiotic regimes that may be applicable in different situations. Drug resistance and multidrug resistance, adverse drug reactions, and the problem of TB in pregnancy are all covered. Latent TB screening, contact tracing, and BCG vaccination are detailed. A guide for assessing risk of TB reactivation in people starting anti-TNF-? therapy is included. Non-tuberculous mycobacterial infection (NTM) is more common in people with chronic lung disease (cystic fibrosis, bronchiectasis, COPD, lung cavities) and immunodeficiency (including anti-TNF-? therapy). Lady Windermere syndrome is mentioned! The problems of non-tuberculous mycobacterial infection are discussed, in particular, the possibility of contamination of samples, the need for multiple diagnostic samples, considerations of treatment, and long-term follow-up.
Respiratory infection—parasitic
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Diseases included in this chapter are hydatid, amoebic, ascariasis, strongyloidiasis, toxocariasis, dirofilariasis, schistosomiasis, paragonimiasis, and tropical pulmonary eosinophilia. Although rare in the UK, they are an important possible cause of lung disease in the traveller or people coming from endemic regions. Detailed descriptions of presentation will help recognition when experience of these is inevitably low. Guidance for management is also included.
Respiratory infection—viral
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

These common infections are typically self-limiting and managed in the community but, in the immunocompromised, can be devastating (especially with suppressed T-cell function such as following organ transplant). Viral pathogens discussed include influenza, cytomegalovirus (CMV), adenovirus, measles, human metapneumovirus, parainfluenza, respiratory syncitial virus (RSV), varicella pneumonia, hantavirus. Severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS) are covered and reflect recent developments. The circumstances surrounding these infections and appropriate laboratory tests are discussed in detail, as imaging of the lung is rarely diagnostic.
Sickle cell disease—pulmonary complications
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Sickle cell anaemia is common in certain ethnic groups, with well-recognized systemic manifestations. In the lung, these include a higher incidence of pneumonia, asthma, pulmonary thromboembolism, and pulmonary hypertension. In addition, nocturnal oxygen desaturation is more common, and sickle cell chronic lung disease (progressive breathlessness, abnormal pulmonary function, pulmonary hypertension) is thought to follow recurrent lung infection and infarction. A more acute presentation, the acute chest syndrome, with new pulmonary infiltrates, associated with fever, chest pain, and breathlessness, is thought to represent acute lung injury and may progress to ARDS and is one of the leading causes of death in sickle cell disease.
Vasculitis and the lung
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Damage to the blood vessels supplying the lung accompanies several systemic disorders, and their classification can be confusing. This chapter clearly explains the different presentations, the different blood tests available, and the pathology (mainly based on size of vessel involved) associated with diseases such as granulomatosis with polyangiitis (Wegener’s), microscopic polyangiitis, Goodpasture’s disease, Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis), and the rarer arteritides such as Takayasu’s.
Ethical issues
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This novel chapter covers some of the inevitable ethical issues that face respiratory physicians looking after patients with severely disabling, and often fatal, diseases. The appropriateness of interventions is often questioned, and the basis upon which to try and make these difficult decisions is discussed. Issues, such as lasting power of attorney, advance decisions (living wills), and advance statements, are covered. The three specific areas covered in detail are chronic obstructive pulmonary disease, lung cancer, and neurological diseases that lead to ventilatory failure.
Financial entitlements
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

This chapter covers the practical aspects of financial benefits that patients (or their carers) with respiratory diseases may be entitled to, due to their disability and reduced ability to work. It includes areas that doctors may not have had much experience of such as statutory sick pay, employment and support allowance, personal independence payment, carer’s allowance, income support, as well as several other specific allowances and grants that a patient might be eligible for.
Non-invasive ventilation
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The use of non-invasive ventilation (NIV), via a close-fitting face mask (less commonly, just a nasal mask), has greatly increased in recent years, as its role in the management of both acute and chronic ventilatory failure has been appreciated. Terminology can be confusing, and this chapter clarifies many aspects of NIV use, particularly the indications, contraindications, practical aspects, and pitfalls. There have been new developments in the design and sophistication of non-invasive ventilators that may represent important advances and become standard. Acute exacerbations of COPD, cardiogenic pulmonary oedema, decompensated obstructive sleep apnoea, neuromuscular weakness, immunocompromised patients, and community-acquired pneumonia are all areas discussed in this chapter. Detailed guidance on the actual process of starting NIV is also given, including the problem of added oxygen.
Bronchoscopy
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Bronchoscopy is central to respiratory practice for both diagnostic and therapeutic purposes. This extensive chapter covers the indications and risks, problems with bleeding, patient preparation, important points to consider pre-procedure, sedation and local anaesthesia, the procedure itself, and sampling techniques. The newer technique of ultrasound (EBUS)-guided transbronchial needle aspiration is covered, with a useful diagram showing the various lymph node stations. The use of bronchoscopy to manage central airway obstruction is extensively discussed, along with endobronchial laser usage, electrocautery, cryotherapy, and tracheobronchial stent insertion.
Chest drains
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

The practice of chest drain insertion has radically changed in the last 10 years. The use of pleural ultrasound has greatly increased the safety and efficacy of chest drain insertion and has led to this procedure becoming a much more specialist procedure than previously. This extensive and very practical chapter covers all aspects of drain insertion: indications, drain types, complications, insertion techniques (Seldinger and blunt dissection), management (including the issue of clamping), and the recent introduction of indwelling pleural catheters.
Pleural biopsy
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

General points

Abrams’ pleural needle biopsy

Several techniques can be used to obtain a pleural biopsy.

• Using image guidance (either CT or USS), a cutting needle (e.g. 18G Temno® or Cook Quickcore®) takes several 1–2cm cores along the long axis of any parietal pleural pathology. FDG-PET CT may have a role guiding pleural biopsy in patients with diffuse pleural abnormality to increase sensitivity. Malignancy sensitivity >85%...
Safe sedation—general principles
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

Sedation is used in a number of procedures used by respiratory physicians for diagnosis and management. Sedation can be potentially hazardous, and a clear understanding of the drugs available, their doses, and side effects is required. This chapter covers all the aspects that need consideration before sedating a patient. Methods of administration and depth of sedation assessment tools are provided. A detailed discussion of the more common drugs (and their reversal agent) is included: benzodiazepines (flumazenil), opioids such as fentanyl and alfentanyl (naloxone), and propofol (not recommended for use other than by anaesthetists). Specific areas potentially liable to cause problems are discussed.
Thoracoscopy (medical)
Authors: Chapman Stephen , Robinson Grace , Stradling John , West Sophie , Wrightson John
Published: August 2014

General points

Indications and risks

Thoracoscopy technique

Thoracoscopy is the procedure of examining the parietal pleura, visceral pleura, and diaphragm with a thoracoscope and taking biopsies. Chemical pleurodesis can also be performed. Performed by chest physicians using conscious sedation and local anaesthetic. Either a rigid or a ‘semi-rigid’ flexible thoracoscope (similar to a bronchoscope) is used, dependent on local availability....
Psychiatric Assessment and Treatment Planning
Authors: Cutler Janis L.
Published: August 2014

This chapter presents the elements of a psychiatric assessment. After hearing the patient’s chief complaint, the physician elicits the patient’s history of the present illness (a chronological, systematic description of the patient’s signs and symptoms) past psychiatric history, medical history, psychosocial history, family history, and review of systems. The physician also obtains the patient’s mental status examination, which is an objective description of his or her current mental state. Integration of the patient’s history and objective findings results in a comprehensive descriptive and diagnostic impression, which summarizes patterns of data, predicts prognosis, and suggests appropriate treatment options. Use of a biopsychosocial and cultural perspective produces a psychiatric assessment that considers the patient’s strengths and vulnerabilities in relation to his or her cultural group.
Anxiety, Obsessive-Compulsive, and Stress Disorders
Authors: Schneier Franklin R. , Vidair Hilary B. , Vogel Leslie R. , Muskin Philip R.
Published: August 2014

Patients with generalized anxiety disorder experience anxiety related to multiple areas, such as work, finances, and illness. Discrete, unexpected panic attacks and anticipatory anxiety characterize patients with panic disorder. Patients with social anxiety disorder have fear of embarrassment in social situations. Patients with obsessive-compulsive disorder are preoccupied with and distressed by inappropriate thoughts, urges, and images. The four cardinal features of posttraumatic stress disorder are intrusive reexperiencing of the initial trauma, avoidance, persistent negative alterations in cognitions and mood, and alterations in arousal and activity. One element common to patients suffering from most of the anxiety disorders is an elevated sensitivity to threat, which appears to involve brain systems identified to mediate “fear” responses, including the amygdala. The selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the first-line pharmacotherapy treatment for obsessive-compulsive disorder and most of the anxiety and stress disorders. Cognitive-behavioral therapy for anxiety, obsessive-compulsive, and stress disorders is an empirically validated time-limited treatment.
Child and Adolescent Psychiatry
Authors: Chrzanowski Daniel T. , Guthrie Elisabeth B. , Perkins Matthew B. , Rynn Moira A.
Published: August 2014

Common disorders of children and adolescents include neurodevelopmental disorders (e.g., intellectual disability, autistic spectrum disorder, and learning disorders), internalizing disorders (e.g., mood and anxiety disorders), and externalizing disorders (e.g., oppositional defiant disorder and conduct disorder). The assessment of a child or adolescent patient always includes multiple informants, the context in which the child’s difficulties occur, and a functional behavioral assessment. Patients with autism spectrum disorder tend to have persistent deficits in social communication and social interaction, a restricted repertoire of behaviors and interests, and abnormal cognitive functioning. Children with disruptive mood dysregulation disorder experience chronic and severe irritability and frequent temper outbursts. Attention deficit hyperactivity disorder is characterized by hyperactivity, impulsivity, and inattention before 12 years of age. Behavior therapy has been effectively used to treat children and adolescents with neurodevelopmental disorders, attention deficit hyperactivity disorder, tic disorders, feeding and elimination disorders, and externalizing disorders. Fluoxetine is approved for treatment of depression in children and escitalopram, for adolescents. Methylphenidate and amphetamine preparations are first-line treatment for children with attention deficit hyperactivity disorder.
Confidentiality and Privilege
Authors: Konrad S. Shane , Bath Eraka
Published: August 2014

Chapter 1 looks at legal cases relevant to some of the most important tenets of psychiatric practice—confidentiality and privilege. Both involve the protection, and limits to that protection, of information communicated during mental health treatment. Cases described here include In re Lifschutz, Doe v. Roe, Whalen v. Roe, In re Subpoena Served upon Zuniga, State v. Andring, Commonwealth v. Kobrin, Menendez v. Superior Court, and Jaffee v. Redmond.
Duty to Protect
Authors: Kopelman Andrew M.
Published: August 2014

Chapter 3 examines cases that relate to a mental health clinician’s legal responsibility to protect citizens from danger caused by patients. The duty can be at the individual or institutional level and varies from state to state. Tarasoff v. Regents, described in this section, is probably the most famous landmark case of all. Other cases included in this section are Lipari v. Sears, Petersen v. Washington, Jablonski v. U.S., and Naidu v. Laird.
Civil Commitment
Authors: Ford Elizabeth
Published: August 2014

Chapter 6 covers the major legal cases that have informed the laws governing the civil commitment—involuntary hospitalization—of individuals with mental illness. The cases highlight the evolution of the emphasis on dangerousness as a critical factor in decision-making and very clearly describe the tension between individual autonomy and police power. The cases included in this chapter are Lake v. Cameron, Baxstrom v. Herold, Lessard v. Schmidt, O’Connor v. Donaldson, Addington v. Texas, and a case involving children, Parham v. J.R.
Right to Die
Authors: Ford Elizabeth
Published: August 2014

Chapter 7 describes three cases that involve an individual’s right, in certain circumstances, to choose death. Cruzan v. Missouri Department of Health is more specifically about a right to refuse life-sustaining treatment and surrogate decision-making; Washington v. Glucksberg and Vacco v. Quill are physician-assisted suicide cases, both decided on the same day by the U.S. Supreme Court and both declaring the practice unconstitutional.
Child Custody and Parental Competencies
Authors: Ryan Eileen P.
Published: August 2014

Chapter 12 contains only two cases, Painter v. Bannister and Santosky v. Kramer, but these cases are extremely important in having established the key principles of “best interest of the child” for determining child custody arrangements and terminating parental rights based on “clear and convincing evidence.” The former overturned the idea that parental preference should drive custody decisions, and the latter recognized the serious and potentially traumatic effects of removing a child from his or her parents.
Juvenile Rights
Authors: Ryan Eileen P. , Ford Elizabeth
Published: August 2014

Chapter 13 includes three cases that have shaped the way adolescents are treated in the justice system. In re Gault was a critical case in establishing due process rights for adolescents who have been charged with a juvenile offense. Graham v. Florida and Miller v. Alabama are recent Supreme Court cases that have defined the limits of punishment, specifically limiting life without parole, for adolescents charged in the adult system.
EAHCA (Education for All Handicapped Children Act); IDEA (Individuals with Disabilities Education Act)
Authors: Sidhu Shawn S.
Published: August 2014

Chapter 14 includes two cases involving the EAHCA, now called the Individuals with Disabilities Education Act (IDEA), that have heavily influenced the way public education is provided to schoolchildren with disabilities. Hendrick Hudson Board of Education v. Rowley helped to establish the requirements and limits of Individual Education Plans (IEP), a free academic service for any school child with a learning disability. Irving Independent School District v. Tatro, although specific to a child with spina bifida, helped to establish the medical care accommodations that a school must provide for a child with a physical disability.
Questions on Child and Adolescent Issues
Authors: Ford Elizabeth , Rotter Merrill
Published: August 2014

This chapter contains 20 questions on child and adolescent issues
Emotional Harm
Authors: Mehta Amar
Published: August 2014

Chapter 17 involves two California Supreme Court cases that relate to damages that can be recovered for emotional harm in negligence cases. Both cases involve the death of a child after being struck by a car and subsequent lawsuits filed by their mothers. The first, Dillon v. Legg, established that one need not be in the “zone of danger” to recover damages if emotional injury is “reasonably foreseeable.” The second case, more than twenty years later, Thing v. LaChusa, was an attempt to further broaden emotional injury damages, but the court prevented such action and even reversed the “foreseeability” standard as too broad.
Health Insurance
Authors: Shelby Bryan C. , Rotter Merrill , Ford Elizabeth
Published: August 2014

Chapter 18 includes cases that are probably the most challenging for clinicians to understand. These cases all involve health insurance plans, specifically what is covered, what kind of damages can be recovered in malpractice claims, and establishing the scope of permissible litigation for plans administered through the Employment Retirement Income Security Act (ERISA) of 1974. The cases included in this chapter are Aetna v. McCabe, Mazza v. Medical Mutual Insurance Company, Wickline v. State, Wilson v. Blue Cross of Southern California, Corcoran v. United Healthcare, Blue Cross/Blue Shield v. Travelers, Dukes v. U.S. Healthcare, and Aetna v. Davila.
Sexual Harassment
Authors: Levin Andrew P. , Rotter Merrill
Published: August 2014

Chapter 19 describes cases that involve sexual harassment in the workplace. As a group, they have defined and applied such important concepts as a “hostile work environment” and “quid pro quo” and have established standards that forensic practitioners need to know when conducting evaluations for cases involving sexual harassment. The cases in this chapter are Meritor Bank v. Vinson, Harris Forklift Systems, Inc., and Oncale v. Sundowner Offshore Services, Inc.
Sex
Authors: Rotter Merrill
Published: August 2014

Chapter 20 includes only one case, but that case was extremely influential for its time and established precedent for ethical guidelines in multiple mental health organizations. Roy v. Hartogs, in 1976, involved a psychiatrist who had sex with his patient as part of “therapy” and was subsequently found liable for malpractice. Although perhaps not very surprising in today’s clinical climate, this case was an important statement about the boundaries of psychiatric treatment.
Questions on Tort Law
Authors: Ford Elizabeth , Rotter Merrill
Published: August 2014

This chapter contains 24 questions on tort law
Criminal Procedure
Authors: Greenspan Michael , Mehta Amar , Rotter Merrill
Published: August 2014

Chapter 22 includes cases that have helped to define basic principles of criminal procedure. The cases do not all involve individuals with mental illness, but the opinions significantly affect how those individuals are processed in the criminal justice system. Robinson v. California and Powell v. Texas were critical in establishing the scope of prosecution permitted against individuals with substance use disorders. The other cases in the chapter are Miranda v. Arizona, North Carolina v. Alford, and Colorado v. Connelly.