bluuebunny/crossref_metadata_2025 huggingface dataset:
The perception of pain
Authors: Coniam S W , Diamond A W
Published: November 2023

Pain is unlike any of the other sensory modalities. It is not a single measurable sensation like light and sound; it is an experience, the nature of which depends not only on the nature of the stimulus, but on the programming of pain perception mechanisms and their cerebral interpretation. There is no single pathway in the nervous system which is responsible for the perception of pain. The integrated response of many physiological mechanisms may be interpreted as pain.
Acute pain
Authors: Coniam S W , Diamond A W
Published: November 2023

‘Acute’ in medicine means of short duration and coming to a crisis. This applies to the initial pain of an incision, a fracture or a bum. It also applies to the pain of trigeminal neuralgia, the initial overwhelming onset of acute back pain, and even some migraine headaches. There has been a recent surge of interest in the important topic of pain following surgery. This follows publication of a report by the Royal Colleges of Anaesthetists and Surgeons demonstrating that pain after surgery was very poorly managed and that simple measures would relieve a lot of unnecessary suffering.
Pain as a long-term problem
Authors: Coniam S W , Diamond A W
Published: November 2023

Pain is useful. It tells us that we have injured ourselves. We can ignore pain that is not severe enough to affect our enjoyment or quality of life when we are assured that it is not caused by a disease or injury. Hit is caused by a disease or injury and it goes when the cause is cured, the pain is now no longer of any significance. All other pains are significant. They generate suffering, they cause anxiety and then depression. They interfere with the ability to live a normal life. They cause invalidity. These pains are part of chronic disease. In the absence of a causative disease, the pain becomes a disease.
Neurogenic pain
Authors: Coniam S W , Diamond A W
Published: November 2023

The nervous system acts as a whole, from the upper motor neuron to the endplate on flexor digiti minimi, and from the sensory receptor in the little toe to the sensory cortex. Among its vital functions is damage detection and avoidance. This intricate and integrated function is the reason for pain perception.
Great auricular nerve block
Authors: Mather S J
Published: November 2023

Apart from local infiltration and the dental blocks, the great auricular block is the only frequently performed block of the head and neck in children.AnatomyThe nerve pierces the fascia to become superficial over the sternomastoid muscle. Branches run up toward the mastoid process.
Regional anaesthesia in awake babies
Authors: Peutrell J M
Published: November 2023

Babies born before 37 weeks’ gestation are at risk of postoperative apnoea, and regional anaesthetic techniques have been recommended to reduce this risk. Apnoea is usually defined as either:(1) the cessation of breathing for 15 seconds or longer; or(2) the cessation of breathing for a shorter period if associated with bradycardia or cyanosis.Postoperative apnoea in ex-premature babies has several clinical characteristics:
Circulatory Support
Authors: Millar K J
Published: November 2023

Restoration or maintenance of a normal circulation is one of the cornerstones of intensive care. The circulatory system exists primarily to carry oxygen and nutrients to the tissues and to carry carbon dioxide and products of metabolism to their sites of excretion.
Some problems of adolescents
Authors: Modell Michael , Mughal Zulf , Boyd Robert
Published: November 2023

A group practice of 10 000 patients will contain on average 1500 between the ages of 10 and 20. In this chapter we discuss some of the features of consultations with adolescents, and some of their common problems not covered elsewhere in the book. Practice leaflets can usefully include a paragraph describing special services provided for adolescents plus reassurance that the under-16s can see their GP or other member of the team for a confidential consultation. This right has been firmly endorsed by the BMA, the GMSC, and the RCGP. Rare exceptions are if the young person is considered to be too immature to understand what is going on or to consent to treatment, or if the safety and welfare of a third person are at risk.
The skin
Authors: Modell Michael , Mughal Zulf , Boyd Robert
Published: November 2023

The epidermis, which is about 0.1 mm thick, is completely replaced every month through the mitotic division of cells in its basal layer. These cells gradually migrate towards the surface, become flattened, lose their nuclei and become filled with keratin. As well as the squamous cells or keratinocytes, which form the bulk of the final layer or stratum corneum, the epidermis contains other cell types including the pigment producing melanocytes. In diseases such as psoriasis, where there is an accelerated turnover of the epidermis, the more rapid movement of the keratinocytes to the surface prevents production of the usual well formed protective layer of dead cells. This surface layer is then an ineffective barrier and is more easily breached.
Bones, joints, and limbs
Authors: Modell Michael , Mughal Zulf , Boyd Robert
Published: November 2023

Parents frequently consult about their toddlers’ posture or gait. Fortunately most children’s legs and feet are normal, even if they point in slightly unusual directions. The best advice is, with few exceptions, to do nothing. Important but rarer deformities, such as congenital dislocation of the hip, which do require prompt attention, or club feet, may result from exposure to an abnormal pressure in utero. For example, they are slightly more common after amniocentesis, presumably from oligohydramnios associated with continued loss of amniotic fluid. Abnormal intrauterine moulding also underlies some of the milder abnormalities of posture.
Chronic disease, malignancy, and death
Authors: Modell Michael , Mughal Zulf , Boyd Robert
Published: November 2023

Most GPs look after several families with chronically unwell children. The range of sickness is wide and includes severe asthma, epilepsy, diabetes, congenital heart disease, and malignancy. A patient may also suffer from one or another of the vast range of rarer disorders. There are many important factors common to the care of these children, although details of management will, of course, vary according to the disease they suffer from. Many professionals are involved in their care: nurses, doctors, social workers, health visitors, physiotherapists, and teachers. These families must have medical advisers who are easily available and who will negotiate an approach to management with the family.
Miscellaneous information
Authors: Modell Michael , Mughal Zulf , Boyd Robert
Published: November 2023

The practice needs a couple of sizes of paediatric sphygmomanometer cuffs. The rubber bag inside the cuff should be long enough to go right round the arm and wide enough to cover two-thirds of the arm between shoulder and elbow. Too small a cuff will produce an abnormally high blood pressure reading-the commonest cause for alleged childhood hypertension. Too large a cuff may have the opposite effect.
True transsexualism
Authors: Volkan Vamik D , Greer William F
Published: November 2023

Among the anomalies of human sexual development, few, if any, seem more enigmatic than that of men and women who claim that they are the victims of cruel trick of nature and are imprisoned in the bodies of the wrong sex. Although they have normal anatomies for their biological sex, they, nonetheless, aver that they are ‘really’ a woman trapped in a man’s body or a man trapped in a woman’s body. So desperate are they to correct nature’s alleged mistake that they often make clamorous demands for surgical and endocrinological treatments.
Rapidly progressive glomcrulonephritis: resolution and scarring
Authors: Wiggins Roger C
Published: November 2023

Scarring takes place in glomeruli and interstitium in patients with the clinical syndrome of rapidly progressive glomerulonephritis (RPGN). The extent of scarring determines outcome, and depends on the balance of pro-and anti-sclerotic forces at particular sites and at particular times during the inflammatory event. In this chapter, two factors affecting this balance will be emphasized: (1) the importance of maintenance of the normal architecture of the kidney (the barrier hypothesis); and (2) the identification of collagen-producing cells in the interstitial compartment and the communication between inflamed glomeruli and these interstitial cells (glomerulointerstitial signals).
Developing an experimental parallel- track medical course: the Cambridge Community-based Clinical Course
Authors: Oswald Nigel
Published: November 2023

The main reasons for this innovation were a wish to explore the extent of the unused medical teaching resources outside hospitals and to seek way1, of developing co-operative teaching between specialist and generalist teachers in medical education. The innovation is about looking for ways to enhance education and not about coping with the difficulties experienced in traditional courses. The essential elements in this programme are that students are attached as a stable, small group to a single practice for 15 months out of the total clinical course of 27 months. This is intended to enable students to focus on patients’ problems, to maintain long-term contact with patients where appropriate, and to develop the skills and attitudes required for effective self-directed learning.
Single-photon emission-computed tomography (SPECT)
Authors: Gemmell Howard G , Staff Roger T
Published: November 2023

Although the principles of single-photon ennssioncomputed tomography (SPECT) have been well understood for many years and several centres were using SPECT clinically in the late 1960s and early 1970s, there has been a dramatic increase in the number of SPECT installations in recent years. In the early 1980s, however, SPECT was a technique in search of a clinical application and, since the rather stringent quality control requirements were not initially appreciated, the image quality from the early gamma-camera systems was often poor. Progress has been made on both fronts. A state-of-the-art gamma camera which is well maintained should produce high-quality SPECT images consistently, and even older cameras can produce acceptable images if care is taken.
Setting the scene
Authors: Heather Nick , Robertson Ian
Published: November 2023

Our task in the second part of this book is to present a credible alternative to the disease perspective through which to understand and respond to problem drinking. This chapter sets the scene for the three remaining in Part 2. This is achieved by an attempt to define the nature of problem drinking and by an outline of the approach known as social-learning theory which will serve as the basis for the alternative paradigm of problem drinking to be described later. We begin, however, with two thoroughly typical case histories.
The shoulder joint
Authors: Wardrope Jim. , English Bryan
Published: November 2023

Normal range of movement—flexion 160 degrees, extension50 degrees, abduction 170 degrees, adduction 50 degrees, internal/external rotation 70 degrees;Capsular pattern—limitation in abduction/external rotation and internal rotation in extension (arm up behind back);Very mobile units with lax capsule—main factors maintaining stability are the rotator cuff muscles;Acromioclavicular joint injury—common, may be a total dislocation of the joint;Supraspintous tear—is a common injury, may need operative repair in young person;Anterior dislocation—usually easily diagnosed and treated, but exclude major fractures and nerve/vascular injury;
Endocrinology and metabolic disease
Authors: Round Jonathan
Published: November 2023

Endocrinology is often lumped together with metabolic disease because they have common features—both often present with multisystem dysfunction and both require understanding of biosynthetic pathways. This does not mean that a student must know all of the steps or enzymes, just the overall mechanism of the pathway with more detail of the critical and clinically important sections.
Glomerulosclerosis: Insights into Pathogenesis and Treatment
Authors: Anderson Sharon
Published: November 2023

Loss of renal function is progressive; once the glomerular filtration rate (GFR) falls below about 25ml/min, regardless of etiology, most patients will progress to end-stage renal disease (ESRD) [l-3]. Recent investigations have focused on the elucidation of risk factors for progression, and the mechanisms which promote the process. It has long been known that contributing factors include poorly controlled hypertension, urinary tract infection, obstruction, administration of nephrotoxic drugs, and episodes of acute renal failure. More newly validated risk factors include hyperlipidemia, cigarette smoking, poor metabolic control (in diabetes), advancing age, and genetic factors, as are detailed elsewhere in this volume.
Proteinuria: Implications for Progression and Management
Authors: Harris Kevin P G
Published: November 2023

It is a well established observation from both human and animal studies of renal disease, that once a degree of renal damage has occurred then the progression of kidney failure is inexorable, even if the original injurious process has resolved [1]. Such observations have led to the hypothesis that following renal damage of any aetiology a maladaptive response occurs in the remaining nephrons which results in their eventual destruction by a common pathogenic mechanism. In support of this, the histological appearance of the kidney in end-stage renal disease is similar whatever the initial cause of the renal injury; within the glomerulus there are localised areas of cellular proliferation, deposition of excess extracellular matrix (ECM) and there is collapse of the glomerular capillary. Within the interstitium there is tubular cell atrophy, a mononuclear cell infiltrate, fibroblast proliferation, and ECl\:1 deposition. These events lead to the replacement of the functioning renal tissue by scar tissue, and affects both the glomeruli and the tubulo-interstitium, culminating in glomerulosclerosis and tubulo-interstitial fibrosis, respectively.
Diabetic nephropathy: natural history and management
Authors: Mogensen Carl Erik
Published: November 2023

Persistently good metabolic control is of major importance for the prevention and postponement of renal disease [1,2], as well as other microvascular complications in patients with type 1 [3] as well as type 2 diabetes mellitus (DM) [4]. Later, several factors appear to affect progression of renal disease of which hypertension seems the most important [5,6]. Similarly, in type 2 DM, hypertension, along with dyslipidemia and hyperglycemia appear to be risk factors for the development of macro vascular complications [7]. Incipient renal disease in diabetes, as judged by the occurrence of microalbuminuria, is frequently characterized by elevation or at least progressively increasing blood pressure. The increase, however, is often subtle and may only be detectable by careful monitoring, e.g. 24 h ambulatory recordings [8-11]. Elevation of blood pressure is found in both types of diabetes, but there appear to be several distinctions between type 1 and type 2 diabetes; some of these are clearly explained by the different aetiology and nature of the diabetic state. In type 2 diabetic patients, higher age, increased body weight, as well as insulin resistance and hyperinsulinemia related to syndrome X [12,13] are important factors. Although hypertension secondary to renal impairment is also frequently seen in type 2 diabetic patients, the renal genesis of hypertension is much more common in the relatively younger type 1 diabetic patients [14], where parental predisposition to hypertension seems to play some part [15,16]. However, differences between type 1 and type 2 regarding the nephropathy are less pronounced than originally thought [17]. Dietary protein intake may also be a modulating factor [18,19], but further studies on intervention are needed [20,21]. Thus, metabolic control, blood pressure elevation and to some extent dietary proteins, and the possibility of modification by treatment [22,23], will be the main issues addressed in this chapter.
Chronic tubulo-interstitial nephropathy
Authors: Smith R M , Tomson C R V
Published: November 2023

It has long been known that histological changes in the tubulo-interstitial compartment of the kidney are far more predictive of subsequent changes in renal function than glomerular changes [l-6]. These findings have focused attention on the importance of the interstitial compartment in the progression of glomerular disease. Paradoxically, however, in diseases in which the pathogenesis is largely within the interstitium, glomerular changes and the accompanying proteinuria appear to be more predictive of outcome-for instance, in reflux nephropathy. Tubulointerstitial diseases also pose challenges for the hyperfiltration theory of progression-why, for instance, is proteinuria so rare in polycystic kidney disease despite progressive loss of functioning nephrons?-and why is progressive renal failure so rare after relief of obstruction, even in patients who are left with severe renal impairment? Perhaps the type of scarring, rather than simply the number of nephrons lost, is a determinant of progression. This disparate group of diseases teach us that there are numerous contributing factors to progressive renal disease, many of which remain ill understood.
A new direction?
Authors: Iliffe Steve , Drennan Vari
Published: November 2023

A systematic approach to the functional and health assessment of older people in the community is needed, but as we have shown the 1990 contractual obligation as presently configured does not appear to meet this need. The appraisal carried out in 1996 for the NHS Executive’ showed how little progress had been made in developing a preventive and proactive approach to primary care for older people after the phase of innovation was interrupted by the imposition of the new contract. The findings of this appraisal make disappointing reading, but they do indicate some ways forward for primary health care . Similar attempts to overcome the problems of reorganized social care, in favour of joint working, have produced interesting innovations that might become models for the future.
Establishing the infrastructure for quality health care
Authors: Iliffe Steve , Drennan Vari
Published: November 2023

This chapter considers the elements in the organization of primary health care which significantly contribute to the quality of health care. We will argue that organizational and professional cultures play a significant role in the way that health and social care is delivered. Attention to recognizing the current differences will assist in developing a culture of integrated working which gives the prime focus to the older person rather than individual professional roles. The chapter considers issues in collaboration and team working, communication and networking, and team effectiveness and quality.
Disability, functional loss, and falls
Authors: Iliffe Steve , Drennan Vari
Published: November 2023

Mr and Mrs H were woken up not long after midnight by the Remote Monitoring Centre linked to Mrs H.’s 82-years-old mother’s alarm systems. Mrs H.’s mother, Ivy, had fallen over in her bathroom an hour or so before, and had only just reached the alarm pull to get help, having left her alarm pendant beside her bed. She had taken her sleeping tablets at 8 o’clock but then decided not to go to bed, but to watch television instead. When she finally got up to use the lavatory before sleeping, she had lost her balance turning in the bathroom. It was her third fall in the same number of months.
Peritoneal dialysis methods
Authors: Cancarini Giovanni C , Maiorca Rosario
Published: November 2023

Until the introduction of hemodialysis, peritoneal dialysis (PD) was the only method used for the treament of end-stage renal disease (ESRD). Performed intermittently (IPD), in an inadequate and unstandardized way, it gave, however, unsatisfactory results, so that the introduction of hemodialysis (HD) led to its decline.
Treatment of patients with hereditary and congenital disorders
Authors: Pirson Yves , Cochat Pierre , Coffin Eric
Published: November 2023

A variety of inherited kidney disorders lead to end-stage renal failure (ESRF), at an age ranging from the newborn (such as in the nephrotic syndrome of the Finnish type) to the elderly (such as in type 2 autosomal-dominant polycystic kidney disease). In each instance, the best therapeutic option, maximizing rehabilitation and life-style, is renal transplantation. In most of these disorders, the 5-year graft survival does not differ from transplanted controls, and recurrence of the primary disease in the grafted kidney does not occur (Table 9.1). Unfortunately, it should be emphasized that in most of them the kidney is only one of the affected organs, so that extra-renal involvement continues to progress after renal transplantation.
Disorders of the pancreas, biliary tree, liver, and jaundice
Authors: Stonebridge Peter , Smith David , Duncan Lesley , Thompson Alastair
Published: November 2023

Pancreatitis usually presents with sudden onset of upper abdominal pain radiating through to the back and associated with nausea and vomiting.

The history of recurrent hospital admissions coupled with a heavy alcohol intake should make you think of acute pancreatitis as a possible diagnosis. All patients presenting with upper abdominal pain should have their serum amylase checked to exclude acute pancreatitis.

Having established that the airway is not blocked and putting an oxygen mask on the patient to assist breathing (remember ill patients need oxygen), venous access is established using a wide bore cannula and blood drawn for baseline FBC and biochemistry. IV fluid resuscitation should begin while a full assessment of the patient takes place.
Lumps in the neck and thyroid gland
Authors: Stonebridge Peter , Smith David , Duncan Lesley , Thompson Alastair
Published: November 2023

The commonest cause of a lump in the neck is lymphadenopathy (85%). A painful lymph node usually denotes an inflammatory reaction (i.e. an infective cause).

Ask about general symptoms including dyspnoea, cough, hoarseness, and any systemic upset, such as malaise, cachexia, and weight loss. These symptoms may point to a primary cause of the lymphadenopathy.

Examine the neck for lymphadenopathy (submental, submandibular, cervical). If present, examine for generalized lymphadenopathy (axillary, inguinal) and splenomegaly. This is because we want to know whether the lymph node is caused by a haematological disorder (when there is a problem that affects many lymph nodes, i.e. generalized lymphadenopathy) or whether the nodes are only located in the neck, when they are far more likely to be caused by a local or regional problem, i.e. localized/regional lymphadenopathy.
The design of experiments
Authors: Bland Martin , Peacock Janet
Published: November 2023

In an experiment or trial we carry out a treatment and observe the outcome. We need a control group who receive no treatment or a different treatment, but are otherwise similar to the group receiving the treatment of interest. The groups of patients should be comparable in every respect except treatment. We achieve this by random allocation, where subjects are allocated to treatments without the subject’s own characteristics influencing the choice. Each subject has the same chance of receiving each treatment. Methods to do this include tossing a coin and random number tables.
Determination of sample size
Authors: Bland Martin , Peacock Janet
Published: November 2023

For the comparison of means or proportions, as in a clinical trial or epidemiological study, we plan a significance test. The power of a test is the probability that the study will give a significant difference if the difference in the whole population is some chosen value. We might choose this value to be the smallest difference which would be clinically important, or the difference which two treatments might plausibly produce. The power depends on the sample size, so we can calculate the sample size required to achieve any given power of getting a significant difference in our study if the postulated population difference is correct.
Antenatal care
Authors: Neuberg Roger
Published: November 2023

There is no doubt that it is more dangerous for a woman to be pregnant than non-pregnant. Therefore, the aim of antenatal care must be to ensure that she emerges from pregnancy safely and has a happy outcome in the form of a live and healthy baby. How can this desirable result be achieved?
The newborn baby
Authors: Neuberg Roger
Published: November 2023

Most babies are delivered in good condition and do not need to be resuscitated. But unexpected neonatal emergencies frequently occur.
Perinatal and maternal death
Authors: Neuberg Roger
Published: November 2023

A perinatal death is one which occurs between the 24th week of gestation and the end of the first week after birth. It therefore includes all stillbirths and early neonatal deaths. The reason for grouping these deaths together is because their aetiology is often the same. The perinatal mortality rate is the number of such deaths per thousand total births (stillbirths and live births).
Rett Disorder and the Developing Brain
Authors: Kerr Alison , Engerström lngegerd Witt
Published: November 2023

Rett disorder, first described by Andreas Rett in 1966, is a condition which involves the functions on which intelligence and expression depend. It is probably the most common genetic disorder encountered in profoundly intellectually disabled females. Its many manifestations include epilepsy, scoliosis, nutritional difficulties, and disorders of mood and movement. This book provides an up-to-date account of current research into the disorder at a time when the causative mutations have just been discovered on the MeCP2 gene. The first section of the book presents the clinical signs and the latest research into the genetic, neuro- anatomical and neuro-chemical aspects of Rett disorder. The second section moves on to deal with the neuro-physiological research, concentrating on the autonomic system, which is deeply implicated in the disease mechanisms. The final section of the book examines the behavioural and psychological features of Rett disorder and discusses issues relating to communication. The chapters are written by a distinguished, international team of experts, all currently active in research. The contributions bring our understanding of the Rett disorder right up-to-date, as the study of the condition moves from an era of description into a time when there are real possibilities for beneficial interventions.
Cortical development in Rett syndrome: molecular, neurochemical, and anatomical aspects
Authors: Kaufmann Walter E
Published: November 2023

The cerebral cortex is probably the brain region studied in greatest detail in Rett syndrome (RS) (Chapter 3 of this volume presents an overview of RS neurons pathology). The interest in the cerebral cortex in RS is due to both the prominent role that the neocortex seems to play in the RS neurologic phenotype (cognitive and motor dysfunction) and the relative accessibility of this structure. This chapter presents a comprehensive overview of the changes affecting the cerebral cortex in RS, ranging from molecular to macroscopic levels. Interestingly RS is one.
Genetics of mental retardation
Authors: Thapar Anita , Clayton-Smith Jill
Published: November 2023

Mental retardation, known as learning disability in the UK, is defined as early onset intellectual deficit (IQ test scores of below 70), accompanied by impairment of functioning. Although this is a widely accepted definition, the term mental retardation describes a group of individuals who show an extremely wide range of abilities and adaptive skills and who differ enormously in terms of clinical presentation. Given that mental retardation represents such a broad category, it is not surprising that there have been many attempts to subdivide the group at a phenotypic and aetiological level.
Genetic Counselling
Authors: Scourfield Jane , Owen Michael J
Published: November 2023

Genetic counselling is a process which aims to facilitate informed and autonomous decision making, appreciation of the inheritance of a genetic condition, and improvement in the emotional well-being of those affected or their family members (Biesecker et al. 1999). Harper (1993) has defined it as: Currently, most genetic counselling is focused on rare Mendelian diseases; however, advances are likely to mean that in years to come genetic counselling will include improved empirical risk predictions for common diseases, such as the majority of psychiatric disorders, which are only partly genetic in origin. Despite this hoped-for improvement in risk prediction, considerable uncertainty will remain. For most common diseases it is likely that the proportion of cases attributable to any particular susceptibility genotype will be small (as in the case of breast cancer and BRCA1 and 2).
Ethical considerations in psychiatric genetics
Authors: Farmer Anne
Published: November 2023

The inclusion of a chapter on the ethical aspects of genetic research into mental disorders and behavioural traits, not only in this, but also in other recent textbooks (Crusio and Gerlai 1999), indicates the importance of ethical concerns in this rapidly developing branch of neuroscience. However the debate into the ethical aspects of genetic research is not one that should only take place within the research community. Accounts of recent technological advances and genetic discoveries described in the lay press have suddenly and sometimes sensationally captured the public imagination. The cloning of Dolly the sheep (Wilmut et al. 1997) was greeted in the Independent newspaper of 26 February 1997, with the statement ‘In the past few days we have been through a change in our condition as momentous as the Copernican revolution, or the splitting of the atom’.
The future and post-genomic psychiatry
Authors: Owen Michael J , McGuffin Peter , Gottesman Irving I
Published: November 2023

Research in psychiatric genetics is not for the fainthearted. Mental disorders pose great challenges to genetic analyses because, in the majority of cases, they result from the predisposing effects of alleles at an unknown number of different genes, as well as environmental influences. Further complexities include the likelihood of non-additive genetic effects, including gene–gene interactions (epistasis), and potential gene–environment (physical and experiential) interactions. Genetic complexity is compounded by possible epigenetic factors (Gottesman 2001; Petronis 2001), stochastic effects (McGuffin et al. 1994; Woolf 1997) and nosological complexity and uncertainty.
Genetics of affective disorders
Authors: Jones Ian , Craddock Lindsey Kent,Nick
Published: November 2023

It has long been noted that episodes of psychological distress tend to run in families, but recent advances in molecular genetics now provide the tools needed to identify genes influencing susceptibility. Although psychiatric and behavioural traits represent, perhaps, the greatest challenge to molecular investigation of complex genetic disorders, they also offer arguably the greatest potential reward. Identifying susceptibility genes for psychiatric disorders will pinpoint biochemical pathways involved in pathogenesis, facilitate development of more effective, better targeted treatments and offer opportunities for improving the validity of diagnosis and classification. This is likely to have important public health implications, given that the recent review by the World Bank identified mood disorder as second only to ischaemic heart disease as a cause of global health burden in 2020 (Murray and Lopez 1996).
Measuring things
Authors: Armstrong David , Grace John
Published: November 2023

This chapter describes how you will measure the things that you have decided need measuring from your research question and associated design. In her clinical work Dr Melanie Warm hands has observed that relationships in the families of asthmatic children do not seem very good. How should she go about exploring this question? Let us briefly summarize the process covered so far.
Collecting data
Authors: Armstrong David , Grace John
Published: November 2023

The last chapter dealt with deciding how you might go about measuring things. Having made those decisions you are almost ready to go ‘into the field’ to measure things in practice. But before you do so you have to give some thought to how you are going to collect your data. ‘Data’ are ‘out there’. You will need some sort of ‘net’ to bring data in: the net must be the right size and its mesh dimensions appropriate for the data you want to capture. This chapter deals with designing this ‘net’ for collecting data.
Getting ready
Authors: Armstrong David , Grace John
Published: November 2023

Previous chapters have described the basic principles of setting up a research project. Of course, in practice it is rarely as clear and logical - all sorts of things can, and do, go wrong. This chapter tries to give some ideas about the practical difficulties that can arise while you are ‘out there’ collecting data or trying to get the whole project underway. That said, the best way of learning about problems like this is actually to meet them when doing your own research: there is no substitute for getting hands-on experience.
Planning research
Authors: Armstrong David , Grace John
Published: November 2023

If you have not already started, now is the time to think about doing your own research. The previous chapters have covered a number of different skills you may require, though in the first instance you might like to start with something fairly straightforward such as a review of your workload. Then, when you see that research is not something restricted to ivory towers, you can be more ambitious. For any research, even the most elementary, it is wise to prepare a statement about what you intend to do and how. This is more formally known as a research protocol. For a simple study it need be no longer than a page; it would start with a single sentence statement of the aim of the study and be followed by a paragraph or two on the precise method that will be used to achieve the aim. For a relatively simple study, such as establishing your prescribing rate over one week,
Pancreas transplantation: long-term aspects and effect on quality of life
Authors: Stratta Robert J
Published: November 2023

Diabetes mellitus afflicts approximately 6 per cent of the population and is the third most common disease and the fourth leading cause of death by disease in the United States. Of the estimated 16 million diabetic patients in the United States, about 10 million are diagnosed, 4 million take insulin, and 1 million have insulin-dependent diabetes mellitus (IDDM) [1]. Nearly 30 000 new cases of IDDM are diagnosed each year, and the incidence is increasing. The syndrome of IDDM includes not only abnormal glucose metabolism but also specific long-term complications such as retinopathy, nephropathy, and neuropathy. Although some patients escape the problems associated with IDDM, many patients develop symptomatic complications within an average of 15 to 20 years following diagnosis and may manifest several complications concurrently. Diabetes mellitus is currently the leading cause of blindness in adults, the principle disease cause of amputations and impotence, and ranks among the leading chronic diseases of childhood.
Exercise and the muscletendon unit
Authors: Stanish William D , Curwin Sandra , Mandel Scott
Published: November 2023

The basis for movement and exercise is muscle contraction. Characteristically we tend to regard contraction as a shortening of the muscle that occurs as the thick (myosin) and thin (actin) filaments slide past one another. Yet during many activities the overall muscle length does not change, and in some cases it may actually lengthen. These differences in muscle behavior during activity have led to the classification of muscle contraction (or exercise) as concentric, eccentric, or is truly isometric, since some shortening must occur at the muscle fibre level. However, no change in the overall length of the muscle takes place. As a result, this type of contraction is referred to as static.
Jumper’s knee
Authors: Stanish William D , Curwin Sandra , Mandel Scott
Published: November 2023

The quadriceps femoris covers most of the front and sides of the femur and is the great extensor muscle of the leg. It is divided into four parts, hence its name. The rectus femoris and vastus intermedius, the most central portions of the muscle, jointly form the quadriceps tendon (Fig. 5.1). The vastus lateralis, the largest part of the quadriceps, contracts into a flat tendon attached to the lateral border of the patella and the quadriceps The tendons of the different portions of the quadriceps unite in the lower thigh to form a single strong tendon attached to the base of the patella.
Lord Rayleigh
Authors: Tanford Charles
Published: November 2023

The word “amateur ” has two different meanings. The first refers to someone who does what he does out of love, and not for profit. It implies no lack of professional skills or dedication. The second meaning, the more usual one today, is more explicitly the antithesis of “professional. ” It calls forth the image of a “dabbler, ” who does lack the skills and educational background of the professional. The two “amateurs ” we shall meet in this and the following chapter are opposites in this respect. Lord Rayleigh, a “gentleman scientist, ” wealthy by virtue of inheritance, has all the advantages of education and of association with equally educated peers.
Meticulous Miss Pockels
Authors: Tanford Charles
Published: November 2023

They all call her “Miss Pockels, ” never just use her last name. Rayleigh does this and so does Langmuir, even in reviews written many years later. It was done out of natural gallantry, I suppose. Even among servants, only the maids were “Smith ” or “Jones, ” but the cook was entitled to “Mrs. Bridges. ” Men, on the other hand, addressed each other by their surnames alone, even if they were close friends. Given names were never used among adults.
‘Subtle is the Lord … ’
Authors: Pais Abraham
Published: November 2023

Subtle is the Lord is widely recognized as the definitive scientific biography of Albert Einstein. The late Abraham Pais was a distinguished physicist turned historian who knew Einstein both professionally and personally in the last years of his life. His biography combines a profound understanding of Einstein’s work with personal recollections from their years of acquaintance, illuminating the man through the development of his scientific thought. Pais examines the formulation of Einstein’s theories of relativity, his work on Brownian motion, and his response to quantum theory with authority and precision. The profound transformation Einstein’s ideas effected on the physics of the turn of the century is here laid out for the serious reader. Pais also fills many gaps in what we know of Einstein’s life — his interest in philosophy, his concern with Jewish destiny, and his opinions of great figures from Newton to Freud. This remarkable volume, written by a physicist who mingled in Einstein’s scientific circle, forms a timeless and classic biography of the towering figure of twentieth-century science.
William Wordsworth
Authors: Gill Stephen
Published: November 2023

Based on intimate knowledge of the poet's manuscripts, on a fresh look at contemporary records, and on a study of the mass of material that has appeared since the last serious biography, a quarter-century ago, this new account of Wordsworth focuses on what was most important to him - his life as a writer. The common notion is that the older Wordsworth betrayed his youthful, radical self to become a prosy Tory bore. By contrast, this intelligent and authoritative biography demonstrates that once the poet had returned to the Lake District, determined to live dedicated to poetry at whatever cost, his life took on a unity and purpose it had previously lacked. His politics certainly changed, and his poetic power waned, but from 1799 almost until his death in 1850, Wordsworth single-mindedly shaped his own life in submission to an imaginative possession whose importance he never doubted. It was, in its way, a heroic life. Wordsworth suffered numbing blows from the death of friends and family, including three of his own children. Critics reviled his poetry for over twenty years, and he never made enough money by his pen to live on - unlike his dear friend Scott. Yet his dedication to his art did not waver. In middle age he knew that contemporaries valued him as a moral sage; in old age he suffered the embarrassment of being a cultural icon. The lucid narrative that Stephen Gill draws out is the story of that hard-won triumph: its purpose is to bring readers back freshly to poetry that is full of human understanding and experience, and a tested, sober faith in 'Man's unconquerable mind'.
The Strange Case of the Spotted Mice and other classic essays on science
Authors: Medawar Peter
Published: November 2023

Sir Peter Medawar was not only a Nobel prize-winning immunologist but also a wonderful writer about science and scientists. Described by the Washington Post as a `genuinely brilliant popularizer' of science, his essays are remarkable for their clarity and wit. This entertaining selection presents the very best of his writing with a new Foreword by Stephen Jay Gould, one of his greatest admirers. The wide range of subjects include Howard Florey and penicillin, J. B. S. Haldane, whom he describes as a `with-knobs-on variant of us all', and, in the title essay, scientific fraud involving laboratory mice. There is Medawar's defence of James Watson against the storm of criticism that greeted the publication of The Double Helix. A merciless debunker of myths, he reveals the nonsense to be discovered in psychoanalytic interpretations of Darwin's illness and launches devastating attacks on Arthur Koestler, IQ psychologists, and, most notably, Teilhard de Chardin. He raises questions about the nature of scientific endeavour - he famously defined science as the art of the soluble - and a common theme is his desire to communicate the importance of science to the widest possible audience.
Lucky Jim
Authors: Medawar Peter
Published: November 2023

On 30 May 1953 James Watson and Francis Crick published in Nature a correct interpretation of the crystalline structure of deoxyribonucleic acid, DNA. It was a great discovery, one which went far beyond merely spelling out the spatial design of a large, complicated and important molecule. It explained how that molecule could serve genetic purposes-that is to say, how DNA, within the framework of a single common structure, could exist in forms various enough to encode the messages of heredity.
On ‘the effecting of all things possible’
Authors: Medawar Peter
Published: November 2023

My title, or, if you like, my motto, comes from Francis Bacon’s New Atlantis, published in 1627. The New Atlantis was Bacon’s dream of what the world might have been, and might still be come, if human knowledge were directed towards improving the worldly condition of man. It makes a rather strange impression nowadays, and very few people bother with it who are not interested either in Bacon himself, or in the flux of seventeenth century opinion or the ideology of Utopias.
Further comments on psychoanalysis
Authors: Medawar Peter
Published: November 2023

In my Romanes Lecture on science and literature I implied that a psychoanalytical explanation-structure answered pretty closely to Levi-Strauss’s description of a myth. By this I meant that a psychoanalytical interpretation weaves around the patient a well tailored personal myth within the plot of which the subject’s thoughts and behaviour seem only natural, and, indeed, only what is to be expected.
The question of the existence of God
Authors: Medawar Peter
Published: November 2023

Because of the especially important place he occupies in the philosophy of science, I gave Francis Bacon his say near the beginning of this essay.1 Now, at about the same distance from the end, I think he should be allowed to speak again. Francis Bacon was a simply reverent man, in spite of the traits in his thought that led Paolo Rossi to describe him as ‘a medieval philosopher haunted by a modern dream’.2 In his Confession of Faith, Bacon wrote thus: ‘I believe that nothing is without beginning but God; and no nature, no matter, no spirit, but one only and the same God, that God as He is eternally almighty, only wise, only good in His nature, and so He is eternally Father, Son and Spirit in persons.’
Eugenics and Genetic Manipulation
Authors: Ryan Alan
Published: November 2023

I shall begin this commentary on Professor Glover’s lecture with two thoughts about eugenics in general, then turn to the question of how much genetic manipulation we should welcome, in the hope of saying a little more about the so-called ‘yuk factor’ that Professor Glover mentions. The first thing I would wish to emphasize about eugenics is its origins in broadly progressive, and often in left-wing, thinking. Today when we think of eugenics, we think inevitably of the Nazis. We ought not to do so. Nor ought we to think of the Nazis when we discover that writers at the turn of the century-Bertrand Russell was among them-feared what they called ‘the degeneration of the · race’. We ought certainly to flinch at the lack of humanity with which Russell, like H. G. Wells, contemplated the disappearance of the aboriginal peoples of underdeveloped countries: something they thought was sad but inevitable. But the nonsense of Aryan supremacy was not what fuelled their views.
Tin Genes and Compensation
Authors: Wolff Jonathan
Published: November 2023

One highly prominent theme in libertarian thought is that of privatization. Libertarians wish to reduce the role of the state or society to a minimum and Hillel Steiner is no exception. However, as a libertarian who is also an egalitarian, the framework in which he operates is rather distinctive. Many egalitarians make a basic distinction between ‘choice’ and ‘circumstance’. On this view one is responsible for those results of one’s freely chosen actions or decisions, but should receive compensation (or pay tax) for the results of bad (good) luck. Compensation should be received from ‘society’ and society will receive the tax dividend from those who benefit from their good fortune. On such an egalitarian scheme those with genetic disadvantages should receive compensation from society for this disadvantage.