bluuebunny/crossref_metadata_2025 huggingface dataset:
Seeding Techniques
Authors: Stura E. A.
Published: November 2020

A seed provides a template for the assembly of molecules to form a crystal with the same characteristics as the crystal from which it originated. Seeding has often been used as a method of last resort, rather than a standard practice. Recently, these techniques have gained popularity, in particular, macroseeding, used to enlarge the size of crystals. Seeding has many more applications, and the use of seeding in crystallization can simplify the task of the crystallographer even when crystals can be obtained without it. We will explore the various seeding techniques, and their applications, in the growth of large single crystals and the methods by which we may attempt to obtain crystals that diffract to higher resolution. Crystallogenesis can be divided into two separate phases. The first being the screening of crystallization conditions to obtain the first crystals, the second consisting of the optimization of these conditions to improve crystal size and quality. Seeding can be used advantageously in both these situations. The first stage in crystallogenesis consists of the discovery of initial crystals, crystalline aggregates, or microcrystalline precipitate. This may result from a standardized screening method (1, 2), a systematic method (3), an incomplete factorial search (see Chapter 4 and refs 4 and 5), or by extensive screening of many conditions. This may be bypassed by starting with seeds from crystals of a related molecule that has been previously crystallized. Molecules that have been obtained by genetic or molecular engineering of a previously crystallized macromolecule fall in this category. This method is termed cross-seeding. It has been used to obtain crystals of pig aspartate aminotransferase starting with crystal from the chicken enzyme (6) and between native and complexed Fab molecules (7). Whatever the method used to obtain the initial crystals, seeding may provide a fast and effective way to facilitate the optimization of growth conditions without the uncertainty which is intrinsic in the process of spontaneous nucleation. The streak seeding technique can be used to carry out a search quickly and efficiently over a wide range of growth conditions.
Learning from Decision Making
Authors: Roberts Deborah , Holland Karen
Published: November 2020

This chapter explores the concept of learning from your experience in clinical practice, and is designed to help you to use reflection as a means of learning both to make decisions in practice and to learn from the decisions that you have made. The use and value of reflective practice will be explored in many of the chapters to come; it is considered to be essential in the development of decision-making skills as a student nurse, and for your ongoing personal and professional development as a qualified registered nurse. Learning from experience is often referred to as ‘experiential learning’ and one of its key skills is reflection. In other words, reflection is the key to helping you to use experiences as a student and a person in order to learn from them. This chapter will provide some definitions of reflection and will introduce some commonly used frameworks or models that can help you to develop the underpinning skills required if you are to be a reflective practitioner. There are also activities for you to complete, so that you can begin to use a range of different frameworks that are appropriate to different situations. To place reflection in the context of your learning to become a nurse and therefore to achieve the appropriate competencies, the Nursing and Midwifery Council (NMC) states that: We can see from this statement that there appear to be some key assumptions and activities that are seen as working together, including reflection, and these will be explored particularly in this chapter. Reflection on practice, and subsequently for learning from this practice, will be two of the most important aspects that will be addressed. To begin with, however, we need to consider some of the underlying principles in which reflection and reflective practice are embedded. Learning from our experiences means that we can either use what we have learned to develop and to enhance future experiences, or alternatively that we can learn from any mistakes that we may have made in the anticipation that we will not make the same ones again.
Decision Making in Children’s and Young People’s Nursing Practice
Authors: Lunat Aatefa , Major Denise
Published: November 2020

The purpose of this chapter is to address decision making in the field of children’s and young people’s nursing practice in relation to the field-specific competencies outlined by the Nursing and Midwifery Council (NMC) in the Standards for Pre-Registration Nursing Education (NMC 2010). In order to explore these competencies further, we will consider examples from practice, and links will be made between the various examples from practice and the competencies in order to demonstrate their importance. To allow an in-depth exploration of the examples from practice, we will use Johns’ (1994) model of reflection. ‘Reflection’ is described as a means by which nurses can closely examine their theoretical knowledge along with their nursing practice (Johns 2000). The process of reflection has been found to have great benefits for nurses, because it allows them the opportunity to change and develop practice in order to carry out improved care practices (O’Regan and Fawcett 2006). In this chapter, the evidence of decision making has been interlinked with critical evidence-based reflective practice, and demonstrates its integration and development in the role of the newly qualified nurse. The chapter will begin by discussing examples derived from practice, and key aspects from these examples will be taken and related to the NMC Standards (NMC 2010). The chapter will then go on to discuss key elements required to make decisions in clinical practice. The evidence base for many of the decisions taken in the case study is interwoven throughout the narrative, thus enabling you see how they link together in nursing practice. Centred on a newly qualified staff nurse on the neonatal unit, the single case study around which this chapter is structured considers the care of a sick neonate whose parents were adolescents. This example was chosen because it illustrates many aspects of caring decisions that have to be made for patients from birth through adolescence, because the parents themselves were still in the later stages of childhood. The case study itself appears as dialogue, and the Standards and competencies referred to are those generic and field-specific competencies that a student pursuing a children’s nursing field-of-practice pathway is required to achieve, found under the heading ‘Competencies for entry to the register: Children’s nursing’ in the NMC Standards (NMC 2010).
Fire and Brimstone
Authors: Wothers Peter
Published: November 2020

Sulfur has long been associated with the fiery domain of hell, and with its god. In the fifteenth-century poem The Assembly of Gods, after describing Othea, the goddess of wisdom, the anonymous author continues with an account of the god of the underworld: . . . And next to her was god Pluto set Wyth a derke myst envyroned all aboute His clothynge was made of a smoky net His colour was both wythin & wythoute Full derke & dӯme his eyen grete & stoute Of fyre & sulphure all his odour waas That wo was me while I behelde his faas . . . Even more terrifying is the account from the Vatican Mythographers, in which Pluto is described as ‘an intimidating personage sitting on a throne of sulphur, holding the sceptre of his realm in his right hand, and with his left strangling a soul’. This association between sulfur and the fiery underworld is perhaps understandable given that the element is often found in the vicinity of volcanoes. In Mundus Subterraneus, one of many books written by the seventeenth-century polymath Athanasius Kircher (1602–80), the author describes a night-time visit to Vesuvius in the year 1638—just seven years after the great eruption of 1631. He tells us that after arriving at the crater, ‘I saw what is horrible to be expressed, I saw it all over of a light fire, with an horrible combustion, and stench of Sulphur and burning Bitumen. Here forthwith being astonished at the unusual sight of the thing; Methoughts I beheld the habitation of Hell; wherein nothing else seemed to be much wanting, besides the horrid fantasms and apparitions of Devils.’ Kircher believed that the volcanoes were fed by massive fires deep underground, as he tells us in the opening of his book: . . . That there are Subterraneous Conservatories, and Treasuries of Fire (even as well, as there are of Water, and Air, &c.) and vast Abysses, and bottomless Gulphs in the Bowels and very Entrals of the Earth, stored therewith, no sober Philosopher can deny; If he do but consider the prodigious Vulcano’s, or fire-belching Mountains; the eruptions of sulphurous fires not only out of the Earth, but also out of the very Sea; the multitude and variety of hot Baths every where occurring. . . .
North-West Frontier: Kohistan, Hindu Kush, Pamirs
Authors: Searle Mike
Published: November 2020

The Hindu Kush Mountains run along the Afghan border with the North-West Frontier Province of Pakistan. Following the First Anglo-Afghan war of 1839– 42 the British government in Simla decided that the North-West Frontier of British India had to have an accurate delineation. Sir Mortimer Durand mapped the border between what is now Pakistan and Afghanistan in 1893 and this frontier is known as the Durand Line. Unfortunately it is a political frontier and one that splits the Pathan or Pushtun-speaking lands into two, with the North-West Frontier Province and Waziristan in Pakistan to the east and the Afghan provinces of Kunar, Nangahar, Khost, Paktiya, and Kandahar to the west. The border regions north of Baluchistan in Quetta and Waziristan are strong tribal areas and ones that have never come under the direct rule of the Pakistani government. Warlords run their drug and arms businesses from well-fortified mud-walled hilltop fortresses. During the period that Lord Curzon was Viceroy of India from 1899 to 1905 the entire border regions of British India were mapped out along the Karakoram, Kashmir, Ladakh, and south Tibetan Ranges. During Partition, in 1947, once again an artificial border was established separating mostly Muslim Pakistan from India. Lord Mountbatten, the last Viceroy, gave Sir Cyril Radcliffe the invidious task of delineating the border in haste to avoid a civil war that would surely have come, and on 17 August 1947 Pakistan inherited all the territory between the Durand Line and the new Indian frontier, the Radcliffe Line. In the north, the disputed Kashmir region still remained unresolved and the northern boundary of Pakistan ran north to the main watershed along the Hindu Kush, Hindu Raj, and Karakoram Ranges. To the west, Afghanistan was a completely artificial country created by the amalgamation of the Pathans of the east, Hazaras of the central region, the Uzbeks in the Mazar-i-Sharif area, and the Tadjiks of the Panjshir Valley along the border with Pakistan’s North-West Frontier Province. The British lost three wars trying to invade this mountainous land between 1839 and 1919, and the Soviet Union which occupied Afghanistan for ten years from 1979 also withdrew across the Oxus River in failure in February 1989.
Faces of Everest
Authors: Searle Mike
Published: November 2020

Trekking to Everest from the Sola Khumbu in Nepal is most definitely one of life’s great treats. When Nepal first opened up to foreigners in 1950 there was only one road from India to Kathmandu via the border town of Raxaul. Early expeditions to Everest had to trek from the plains of India either from Jogbani or Jaynagar in south-eastern Nepal. For the purist, the trail nowadays starts in the Kathmandu Valley, whilst the road head at the village of Jiri is the normal starting point for overlanders. The first week’s walking goes from west to east towards the village of Junbesi, against the grain of the land, crossing three passes and several rivers draining south from the Rolwaling and Khumbu Himalaya. Once across the Dudh Kosi River and up the hill to Lukla, the trail heads north up into the high country. Many trekkers nowadays fly directly into Lukla, where the plane lands at the impressive and frighteningly tilted airstrip built by Edmund Hillary and his Sherpa friends high on the side of the Dudh Kosi. From Lukla, the trail winds through forests of blue pine, fir, silver birch, and the ubiquitous rhododendron. In spring the hills are a mass of red, pink, and white rhododendrons. Meadows are carpeted in wild flowers—gentians, primrose, edelweiss, and the magical Himalayan blue poppy. Small Sherpa villages with their sturdy homes built from slabs of schist and gneiss have expanded with new trekking lodges springing up annually. The terraced rice paddies of the lowlands are soon left behind and apple orchards are a mass of blooms in the spring. Clouds well up and float quietly down into the valleys. The forests with their hanging mosses become eerily quiet. The senses dwell on the serene beauty of the forests and streams, all green and full of life and sound. Suddenly one’s eye is caught by something higher up, way above the clouds. With amazement, one realizes that is no cloud up there: it is a mountain, five miles high, far above the peaceful green of the valley.
Constructing Science and Dealing with Denial
Authors: Dryzek John S. , Norgaard Richard B. , Schlosberg David
Published: November 2020

Climate science has a long history. The Swede Svante Arrhenius in 1896 recognized that the burning of fossil fuels could add CO2 to the atmosphere in sufficient quantities to warm the Earth, though he thought it would take millennia for that to become apparent. Arrhenius himself thought this would be beneficial to agriculture, anticipating some contemporary emphatic climate change deniers for whom CO2 is nothing more or less than “plant food.” The twentieth century saw anthropogenic (i.e. caused by humans) climate change gradually progress from a scientific curiosity likely to arise only in a very distant future to something more pressing (see Weart, 2008 for a history). Charles Keeling began monitoring atmospheric CO2 on Mount Mauna Loa in the middle of the Pacific Ocean in 1958, providing strong evidence that CO2 levels were rising. In 1965 the Science Advisory Committee to the US president raised the specter of changes in the climate appearing by 2000. Climate science gradually grew in extent and prominence, aided by advances in satellite monitoring and computing power. One watershed moment occurred in 1988, on a hot day in Washington DC, when James Hansen of NASA testified to the Energy and Natural Resources Committee of the US Senate that global warming had arrived. The same year British Prime Minister Margaret Thatcher (who had a degree in chemistry) announced in a speech to the scientists of the Royal Society that she was convinced of the need to act—embracing environmental concern she had until then derided. Since the 1980s climate research has exploded, exploring ever more facets of the issue. The role of the IPCC, established by the United Nations in 1988, has become crucial. The Panel does not actually conduct or sponsor research itself, but rather summarizes the weight of scientific opinion in periodic assessment reports aimed at policy makers, especially those participating in the negotiations of the UNFCCC. With literally thousands of scientists from diverse disciplines participating in the assessment, it has a significant impact on how scientists connect their subsequent research to discoveries by others and learn how to communicate with each other, building an ever greater capacity to both assess and synthesize climate science into a more cohesive whole (Edwards, 2010).
The Triumph of Emptiness
Authors: Alvesson Mats
Published: November 2020

In this book, Mats Alvesson aims to demystify some popular and upbeat claims about a range of phenomena, including the knowledge society, consumption, branding, higher education, organizational change, professionalization, and leadership. He contends that a culture of grandiosity is leading to numerous inflated claims. We no longer talk about plans but 'strategies'. Supervisors have been replaced by 'managers', managers are referred to as executives. Management is about 'leadership'. Giving advice is 'coaching'. Companies become 'knowledge-intensive firms'. The book views the contemporary economy as an economy of persuasion, where firms and other institutions increasingly assign talent, energy, and resources to rhetoric, image, branding, reputation, and visibility. Using a wide range of empirical examples to illuminate the realms of consumption, higher education, organization, and leadership, this provocative and engaging book challenges established assumptions and contributes to a critical understanding of society as a whole.
Consumption—the shortcomings of affluence
Authors: Alvesson Mats
Published: November 2020

My first main theme is consumption, which is the focus of this chapter and the next. However, since consumer culture also has a clear imprint on the other themes covered in this book—education, working life, and organizations— consumption orientations and logics make themselves felt throughout. Consumption development is strongly characterized by zero-sum games and the cultivation of grandiose notions and illusion tricks. And maybe such features are typically most marked in the consumption area (in its more restricted, traditional sense). Consumption is about the satisfaction of needs, desires, and wishes, but of course also about the generation of those orientations. All this involves complicated construction processes. Given the enormous increase in consumption, at least in economically advanced countries, one would expect people to have become more and more satisfied. And perhaps feel saturation. But this is simply not the case. An interesting question is whether economic growth and increased consumption are satisfaction-creating projects? If they are not, and many indicators suggest they are only marginally so, the meaning of increased consumption in the world’s most affluent societies and groups deserves exploration. I start with a discussion of consumer culture, the increasing scope of consumption, and the apparently insatiable demand for additional goods and services, even in the richest countries. Subsequently, I examine some common views about consumption and consumers. The consumer may be regarded as everything from a heroic political figure to an undiscerning fool, from an active creator of meaning to a passive victim of market ideologies, fashion trends, and consumer manipulation. Next, I demonstrate that a massive increase in consumption is paralleled by a continual growth in demand, without any corresponding increase in satisfaction. The question then arises as to whether consumerism can be viewed as a major failure or at least a somewhat unsuccessful political and individual project. This chapter also addresses the significance and effectiveness of efforts to control consumers and consumption. The analysis of consumption continues in Chapter 3, addressing how consumption involves so many aspects and logics other than meeting needs, demands, and wishes, and can only, to a limited degree, be viewed as an ultimately satisfaction-raising enterprise.
Graphite Valley: IT in the Eighteenth-Century Lake District
Authors: Öhrström Lars
Published: November 2020

Lake Windermere in the north-west of England perhaps makes you think of poets, or of adolescent adventures less concerned with wizards and vampires and more with Swallows and Amazons if you have grown up with English children’s books. Anyhow, people who lived by their pencil. Or should that perhaps be the pen? We don’t see the serious author in her study hard at work with a pencil. Pencils are generally considered to be mostly for children doing their homework, or others who frequently need to erase their mistakes. There has never been a lack of ink, traditionally a mixture of iron salts, water, and tannins—the bitter tasting compounds in tea and red wine. Always plenty of the black stuff to write poems and sign death sentences with. But the pencil, that is a different story. Far from being just for children, it was, and is, an essential tool for artists, engineers, carpenters, and architects. At engineering school in the late 1980s we still made (some of us did anyway) beautifully crafted pencil drawings of double-mantled stainless steel reactors. And in the army, close to the polar circle four years earlier, did we write out orders and decipher incoming radio messages with ballpoint pens? We certainly did not—in fact, this was forbidden because the ink in a pen may easily freeze. The ‘lead’ in the pencil (which is obviously not lead as in the element 82, but something else) brings us to these green valleys of the Lake District and Cumbria, England—as unlikely a place for an information technology hub as the orange orchards around Palo Alto. The different is that in California in the 1970s it was the dedicated people that mattered, not any local silicon mines. In Borrowdale in the late sixteenth century, it was the inside of the mountain itself that made the difference, for there you find the stuff from which to make pencil lead. Not that the people were unimportant. Entrepreneurship thrived in different forms. ‘Black Sal’, for example, working out of the small town of Keswick close to Borrowdale, was allegedly running a pencil-lead smuggling network in the early eighteenth century.
War and Vanity
Authors: Öhrström Lars
Published: November 2020

In my childhood, visits to Gothenburg would always include a long (it seemed at the time) tram ride with my mother, from the centre of town to the north-eastern districts, past the old, red brick, ball-bearing factory of SKF to the vast Kviberg Cemetery to put flowers on my grandmother’s grave. I never ventured on any longer excursions among the neat flower-decorated graves on these well-kept lawns, but had I done so I would perhaps have discovered a different, more uniform, part of the cemetery that relatives seldom visited: the war graves. War graves form a somewhat unexpected discovery in the suburbs of a country that was neutral in both world wars, but there it is. Among the mostly German, American, and British graves we find, in the Commonwealth section, that of Arthur Cownden who, at 17, was probably the youngest to be buried there. He was boy telegraphist on a Royal Navy destroyer, and on the morning of 1 June 1916 his body was washed ashore close to the small fishing village of Fiskebäckskil on the Swedish west coast. His ship, the HMS Shark , was one of many British losses during the preceding day’s Battle of Jutland—the only clash between the main forces of the Royal Navy and the German Hochseeflotte during World War I. By all accounts this was a terrible battle, with loss of lives in the thousands on both sides, and one of the largest naval battles ever fought. The Battle of Jutland remains somewhat controversial for two reasons: the enduring argument between the two British commanders, David Beatty and his superior John Jellicoe, and the purported role of the Royal Navy’s smokeless gunpowder cordite in the sinking of a number of its own ships. We have no business with naval tactics, but the cordite question is related to one of the lesser-known supply problems of World War I, that of acetone. You may be familiar with this molecule as nail varnish remover, but perhaps you also know the disastrous effect it has on the glossy surface of cars.
I Told You So, Said Marcus Vitruvius Pollio
Authors: Öhrström Lars
Published: November 2020

Rural Massachusetts is delightful at the end of summer. The classic New England architecture blends with the lawns, gardens, and green forests into a picture of perfect harmony. It is sunny, and the right time in the afternoon for a stroll around the college town of Amherst. However, after a few blocks a distinct crack appears in this idyll: a traditional white wooden house is being renovated and a skull and crossbones sign on the lawn is telling us to keep out due to danger of lead poisoning. It turns out that the customary white colour of the houses around here was oft en due to lead-based pigments. The use of lead in paints was phased out in 1978, but it is still an issue judging from the 16-page pamphlet available in six languages from the US Environmental Protection Agency, and the criminal cases brought against real estate companies and landlords failing to inform tenants and buyers of the lead status of their homes. Marcus Vitruvius Pollio would probably have agreed with this pamphlet and legislation, and so most certainly would Alice Hamilton. Although almost two millennia separate the Roman engineer from the first woman on the faculty of Harvard Medical School, they are united in the fight against the dangers of lead to the workforce and to the public. We do not know much about the life of the first century BC architect and engineer Marcus Vitruvius Pollio, otherwise known as Vitruvius, except what can be inferred from his famous work The Ten Books on Architecture. This magnum opus, written in the days of the Emperor Augustus, probably represents the summary of the professional experience of an old man. The title is slightly misleading, as architecture in Roman times would cover a much broader area than today. So Vitruvius tells us a great deal about engineering in general, about the chemistry of pigments and, to the benefit of this story, about aqueducts and the proper treatment of water. He is also clearly a conservative man, lashing out against ‘decadent frescos’ and ‘these days of bad taste’.
Of Pea-Soup, Dangers of Coffee in the Morning, and the Test of Mr Marsh
Authors: Öhrström Lars
Published: November 2020

Friday the thirteenth is supposed to be the unlucky day, but for ex-King Eric XIV of Sweden it must have been a Thursday, because Thursdays are pea-soup days, at least in Sweden and Finland. It may only be a persistent myth that the arsenic trioxide (As2O3), which probably killed him, was put in his pea-soup on the order of his half-brother John III. That is, the pea-soup bit may be a myth, not that his brother John was the instigator. He had already held his schizophrenic older brother Eric prisoner for nine years, and a number of incriminating documents have been preserved. Eric died in 1577, and his fate mirrors that of Mary Stuart, who was sentenced to a more conventional execution by her cousin Elizabeth I ten years later. Oddly enough Eric had, with a certain hubris one must say, tried to negotiate marriages with both these distinguished ladies, and was only a few days from sailing off to meet Elizabeth in person when his father Gustav Wasa died in 1560 distracting him with other matters for a while. In 1577 there was no good way to analyse arsenic and establish murder by poison, but in 1829 the situation was different. When John Bodle was tried for having murdered his grandfather, octogenarian George Bodle, on his farm in Plumstead near Woolwich, the prosecution could provide an expert witness, James Marsh, inventor and (among other things) assistant to Michael Faraday. Marsh, through the foresight of the local police, who were already suspicious, and had preserved both the last coffee George Bodle had drunk and his stomach contents, analysed both for arsenic. This he did by adding hydrogen sulphide (H2S), a foul-smelling, flammable, and poisonous gas that used to haunt undergraduate chemistry labs when I was young. Dangerous as it may be, rather elementary precautions make it safe to handle H2S even for first-year students, and it was used in much the same way as by Marsh—for hunting down metal ions.
Setting up a Travel Clinic
Authors: Colbert Dom
Published: November 2020

Setting up a travel medical service involves time, money, patience, and continual updating of information. Ultimately such a service cannot be viable unless there is a sufficient throughput of patients to warrant its existence. It is likely that in a multipractice clinic one practitioner will be very interested in travel medicine. Other members of the group should refer all travellers to him or her. In many countries, particularly in the UK, the practice nurse is the one who does most pre-travel consultations. However, this should be a shared responsibility between nurse and doctor so that maximum benefit is provided for both the patient and the clinic.
Special Groups
Authors: Colbert Dom
Published: November 2020

It is convenient to separate those who differ from the general travelling population into easily identifiable categories or special groups. Each of these groups will require advice, medication, or vaccines that are tailored for their specific needs. Thus, the pregnant traveller must be warned of the increased risk of air-travel-related venous thrombosis, the diabetic of the danger of poor glycaemic control, and the young (male) traveller of the risks of casual sex. While there are very few people for whom overseas travel is absolutely contraindicated, common sense should always be heeded.
Soil and War
Authors: Bardgett Richard
Published: November 2020

My first visit to a battleground was during a family holiday to Scotland. We were staying in Applecross, a small, isolated village on the west coast of the Scottish Highlands that looks over the sea towards the Island of Raasay. On the way back we passed through Inverness, the most northerly city in Scotland. To break the long journey we decided to stop off at Culloden Moor, the site of the Battle of Culloden in 1746, between the Government forces, which were mainly English, and the Jacobite army, made up of Scottish Highlanders led by Bonnie Prince Charlie. I had never visited the site before, but I recall thinking that it was an odd place for a battle; it is exposed moorland and the ground is rough and boggy, which would be difficult ground on which to go to war. I later learned that Bonnie Prince Charlie’s choice of this site for battle was catastrophic; not only did the exposed ground leave the Jacobite forces vulnerable to the superior artillery of the Government forces, but also the boggy soil hampered their attack, rendering them even more exposed. These factors led to the slaughter of the Jacobite forces and the collapse of the Jacobite campaign. I don’t know exactly how much the boggy soil contributed to the outcome of this war but it certainly played a part. For centuries, soil has played an enormous, and often unexpected, role in the outcome of war. War can also leave lasting and often irreversible scars on soil, leaving it churned, riddled with battle debris and bodies, polluted with heavy metals, toxic dioxins, oil and radioactivity. In many cases, it is left unusable. War can also indirectly affect the soil, for example through the need in Britain, during the Second World War, to cultivate gardens and city parkland for food. And the current growing demand for food, coupled with environmental pressures related to climate change, will place increasing pressure on soil, potentially leading to future wars. This chapter will look at how war is affected by and how it affects soil.
The psychoses of childbearing
Authors: Brockington Ian
Published: November 2020

It is 50 years since the late Ralph Paffenbarger (1961) wrote a famous article on ‘the picture puzzle of postpartum psychosis. In order to solve this puzzle, it is necessary to clarify the term ‘postpartum psychosis’. One must first exclude a wide variety of disorders, occurring after childbirth, which are not ‘psychoses’. This may seem obvious, but, at one time, some psychoanalysts included disorders of the mother-infant relationship under ‘postpartum schizophrenia’ (Zilboorg 1929). One must then draw a clear boundary between organic and non-organic psychoses. The birth process is so complex, and has so many complications, that there are (depending on definition) 15–18 distinct organic psychoses occurring in pregnancy, parturition or the puerperium (Brockington 2006). Nineteenth century alienists found it difficult to distinguish these from puerperal mania, and this was not finally achieved until the work of Chaslin (1895) & Bonhöffer (1910) at the turn of the twentieth century. Even the most common of these organic psychoses—eclamptic psychosis and infective delirium—are now rare in Europe, North America, and Japan; but these nations, where most of the research is done, contribute less than 10% of the world’s births. In the rest of the world they may be important, and they may still interfere with epidemiological, genetic, and neuroscientific studies of non-organic psychoses. As for the non-organic psychoses, a few are psychogenic, but most have manic depressive features. The term ‘puerperal affective psychosis’, however, does not suffice, because there is an extensive literature on ‘atypical psychoses’, under names like hallucinatorische Irresein der Wochnerinnen (Furstner 1875), amentia, cycloid psychosis, and acute polymorphic psychosis. That is why some psychiatrists still claim that ‘puerperal psychosis’ is a specific disorder, with its own clinical features—those ‘specific features’ are the polymorphic symptoms found in ‘atypical psychoses’, and occur in women at other times, and in men. Ralph Paffenbarger’s ‘picture puzzle’, therefore, applies to the combined group of puerperal bipolar and acute polymorphic psychoses.
Young motherhood, perinatal depression, and children’s development
Authors: Waters Cerith S. , Pawlby Susan
Published: November 2020

The aim of this chapter is to examine young women’s experience of mental health problems during the perinatal period. We shall argue that women who were young at the time of their transition to parenthood are at elevated risk for perinatal depression, in their first and subsequent pregnancies. Evidence for the impact of perinatal depression on children’s development will be outlined, and we propose that the elevated rates of mental health problems among young mothers may partly account for the increased prevalence of adverse outcomes often seen among their children. However, for these young women and their offspring, the impact of perinatal depression may be compounded by many other social, psychological, and biological risk factors, and young women’s circumstances may exacerbate their own and their children’s difficulties. Therefore any clinical strategies regarding the identification and treatment of depression during the antenatal and postnatal months may need to take into account the age of women, with women bearing children earlier and later than the average presenting different challenges for health professionals. Across the industrialized nations the demographics of parenthood are changing, with both men and women first becoming parents at increasingly older ages (Bosch 1998; Martin et al. 2005; Ventura et al. 2001). In the UK for example, the average maternal age at first birth in 1971 was 23.7 years, compared to the present figure of 29.5 years (ONS 2012). Correspondingly, over the last four decades, birth rates for women aged 30 and over have increased extensively, whilst those for women in their teenage years and early twenties have declined (ONS 2012, 2007). Since the 1970s, the proportion of children born to women aged 20–24 in the UK has been decreasing, with women aged 30–34 years now displaying the highest birth rates (ONS 2010). These changes in the demography of parenthood are not confined to the UK with similar trends toward delayed first births observed across Western Europe (Ventura et al. 2001), the United States (Mirowsky 2002), New Zealand (Woodward et al. 2006) and Australia (Barnes 2003). Thus, a transition to parenthood during adolescence and the early 20s is non-normative for Western women, and the implications of this ‘off-time’ transition (Elder 1997, 1998) for the mother’s and the child’s mental health warrants attention.
The biology of postpartum psychosis: A hypothetical model
Authors: Dazzan Paola
Published: November 2020

I had the pleasure of meeting Channi Kumar as a junior psychiatry trainee at the Maudsley Hospital, when I elected to work in his clinical service as part of my rotation. It is therefore for me an honour to contribute to a book that celebrates his legacy. While working with him, I had the opportunity to seeing him in both the clinical and the academic settings. I came to know Channi as a gentle and charismatic clinician with patients, and an inspiring scientist. Channi was fascinated by the predictability of postpartum psychosis, which he used to discuss extensively with his patients, and he led seminal work on the biology of this disorder. I have been stimulated by this work and motivated to advance what remains a largely unexplored area of psychiatry. This chapter will discuss evidence on how biological factors relevant to the pathophysiology of psychoses and the perinatal period could interact in explaining the vulnerability and onset of postpartum psychosis. The role of genetic factors is extensively covered in Chapter 18, and will therefore not be discussed here. Psychiatric disorders contribute to 12% of all maternal deaths (UK Confidential Enquiry into Maternal Deaths; RCPG 2002), and puerperal (or postpartum) psychosis is the most severe psychiatric disorder associated with childbirth, with an estimated suicide rate of 2 per 1,000 sufferers (Oates 2003), and an incidence of 1–2/1,000 deliveries (Munk-Olsen et al. 2006). Although the last few decades have seen a fall in mortality and morbidity from childbirth, this has not been paralleled by a fall in the incidence of postpartum psychosis, which has remained remarkably stable at 0.5–1.0 per 1,000 deliveries (Munk-Olsen et al. 2006). Postpartum psychosis can have dramatic clinical and social consequences: child separation from the mother; lack of emotional bonding between mother and child; impaired child cognitive, physical, and psychological development; and, in some cases, suicide, infanticide, or both. This devastating impact is remarkable, especially considering that postpartum psychosis is highly predictable: in fact, between 30 and 50% of women with a history of bipolar affective disorder, or of schizoaffective disorder, will suffer postpartum psychosis after giving birth (Jones and Cradock 2001); and up to 50–70% of women with a previous history of postpartum psychosis (Jones and Craddock 2001).
Prevention for people with disabilities and vulnerable groups
Authors: Daly Blánaid , Batchelor Paul , Treasure Elizabeth , Watt Richard
Published: November 2020

In this chapter we will look briefly at the prevention needs of people with disabilities and people who are vulnerable and require special care dental services for reasons that may be social. Within this group there will be a spectrum of people with needs and dependencies. Not everyone described as belonging to a vulnerable group in this chapter would identify themselves as disabled; nevertheless, what they have in common are a range of factors that put their oral health at risk, make accessing dental care complicated, or make the provision of dental care complicated. These factors may include a ‘physical, sensory, intellectual, mental, medical, emotional or social impairment or disability, or more often a combination of these factors’ (GDC 2012). People with disabilities have fewer teeth, more untreated disease, and more periodontal disease when compared to the general population in the UK (Department of Health 2007). Good oral health can contribute to better communication, nutrition, self-esteem, and reduction in pain and discomfort, while poor oral health can lead to pain, discomfort, communication difficulties, nutritional problems, and social exclusion (Department of Health 2007). As discussed in previous chapters, the important risk factors for oral diseases include: high-sugar diets, poor oral hygiene, smoking, and alcohol misuse. They are also shared risk factors for chronic non-communicable diseases such as respiratory diseases, cardiovascular diseases, diabetes, and cancers. The basic principles and approaches for the prevention of oral diseases in disabled people and vulnerable groups are similar to those described in previous chapters; however, there is a need to recognize that the context, the circumstances, the settings, and the opportunities for prevention will be slightly different, depending on the groups. For example, some disabled people (e.g. people with learning disabilities) may be reliant on others, such as family, carers, health care workers, to support basic self-care and to access health services. Other vulnerable groups such as homeless people live independent lives but lack access to basic facilities such as drinking water, and a place to store toothbrushes and toothpaste.
Planning dental services
Authors: Daly Blánaid , Batchelor Paul , Treasure Elizabeth , Watt Richard
Published: November 2020

Planning is an integral part of dental care provision that can operate at many different levels. At a national level, government NHS policy impacts upon dental services in different ways. For example, in the General Dental Service, patient charge bands in England are currently set by the government. In the future, at the national level, the National Health Service Commissioning Board (NHSCB) will determine national policy and national delivery requirements. The NHSCB will be responsible for commissioning primary dental services and contractual arrangements with dentists. At the Health and Wellbeing Board (HWB) level in England, planners (in conjunction with general medical practioner (GMP) consortia/clinical care commissioning groups (CCGs)) will make decisions over the priorities for local services, and the types and range of services offered locally. Within a dental practice, dental practitioners and their team members may develop a range of practice policies aimed at improving the services provided. Finally, every day clinicians develop treatment plans for individual patient care based upon their oral health needs. All these activities are planning in action. This chapter will examine the basic principles of planning, and review the different steps in the planning process. At the most basic level, planning aims to guide choices so that decisions are made in the best manner to reach the desired outcomes. Planning provides a guide and structure to the process of decision-making to maximize results within the limited resources available. Is planning really necessary when there are so many other demands on practitioners’ time? Planning can be justified for the following reasons: . . . ● It provides an opportunity to be proactive in decision-making rather than constantly reacting to pressures and demands. . . . . . . ● It enables priorities to be set. . . . . . . ● It identifies where resources can be directed to have the greatest impact. . . . Various planning models have been proposed to act as a guide to the different steps in the planning process. The rational planning model provides a basic guide to the process (McCarthy 1982), and involves the following steps: . . . 1 Assessment of need: e.g. identification of the oral health problems and concerns of the population. . . . . . . 2 Identifying priorities: agreeing the target areas for action. . . .
Focal and signal burials
Authors: Harding Dennis
Published: November 2020

The term ‘focal’ burial refers to burials that appear from spatial distribution within a cemetery to have acted as a focus for subsequent burials. They may be distinguished by their larger size or by the fact that they contain more lavish grave-goods. The term was used by Fitzpatrick (1997) to highlight certain larger or better-equipped graves at Westhampnett, though there was no unequivocal spatial relationship between the supposed ‘focal’ burials and others. At King Harry Lane, Verulamium (Fig. 3.18), Stead and Rigby (1989: 83) had identified several larger graves of phase 1 with more notable assemblages as central to ‘family’ clusters defined by their enclosure. The concept of family groups was challenged by Millett (1993), who nevertheless saw these ‘focal’ graves, whether enclosed or unenclosed, as potential ‘founders’ graves’ in socially allied units. There is no doubt that graves 241, 299, and 325 of phase 1, and possibly grave 148 of phase 2 and grave 41 of phase 3, stand out as candidates for founders’ graves within their compounds, whilst graves 272, 309, and possibly grave 93 could have been focal to unenclosed groups, or groups where the enclosure has not survived. It has to be acknowledged, however, that there are other larger or better-provided graves that stand in relative isolation and do not appear to have attracted subsequent satellite burials, though this hardly invalidates the concept in principle, especially in what must have been a period of social and political instability. The notion of a focal burial seems equally applicable to the late pre-Roman Iron Age cemetery at Owslebury (Fig. 5.1; Collis, 1968, 1994), where the burials were principally grouped within two adjacent enclosures. The central burial of the earlier of the two (grave 39) was the largest, and contained an extended inhumation with full warrior panoply of sword, spear, and shield, dating around the first half of the first century BC. The focal burial of the second enclosure (grave 10) was a cremation in an urn with lid and six accessory vessels.
Gender issues
Authors: Harding Dennis
Published: November 2020

Contemporary studies commonly stress the belief that, even if sex is biologically determined, gender by contrast is a social and cultural construct (Sofaer and Sørensen, 2012). Even biological sex entails varying degrees of male and female attributes in terms of chromosomes and DNA if not in terms of reproductive organs, so that, contrary to the bipolar model of sex, contemporary studies of gender tend to think in terms of a spectrum that includes composite gender or a third gender that is neither male nor female in what Arnold (2006: 155) described as ‘a suprabinary gender system’. In the case of the Byzantine eunuchs or the Indian hijra cited by Croucher (2012: 174–5), these could be regarded as socially constructed, and it is not here suggested that such categories existed in Iron Age Britain or Europe. It is important, however, to be clear that conventional western sexual stereotypes and conceptions of gender roles in child-rearing, food production, and warfare, for example, need not have pertained in non-classical societies in antiquity. Gender issues in the study of funerary archaeology have gained a prominence in the last twenty years not simply as a result of theoretical considerations but also because of more intensive interest in osteological research, as a result of which there has been a greater recognition of the fact that identifying sex may involve evaluation of a spectrum of criteria rather than simple bipolar options. Though pelvic bones remain crucial to assessing sex, the skull and other major bones can also be indicative, and not infrequently the evidence remains equivocal, even where the skeleton is reasonably well preserved. Accordingly, some of the skeletons from the eastern Yorkshire cemeteries were deemed to show ‘contra’ indications, that is male and female characteristics in equal measure, in a gradation of assessment that also included ‘definite’, ‘probable’, and ‘possible’ identifications (Stead, 1991). Furthermore, though sex is biologically determined, osteology may be affected by cultural factors such as the degree of physical exercise that the individual habitually engages in, so that the criteria observed by the osteologist may suggest a physique normally associated with the opposite sex.