bluuebunny/crossref_metadata_2025 huggingface dataset:
How to Benefit from Received Ideas (2001)
Authors: Stoczkowski Wiktor
Published: November 2020

Like Gulliver, the intrepid explorer depicted in Samuel Butler’s novella Erewhon visits an odd country whose image, inverted as its name, is evidently that of the Western world. Throughout his travels, the adventurer converses with the eccentric scholars of Erewhon who devote themselves to singular enterprises, such as the formation of the ‘Society for the Suppression of Useless Knowledge’ (Butler 1985). If somebody were to suppress useless knowledge in this day and age, there could be a substantial number of victims. Fortunately, no one finds it necessary to question the raison d’être of institutionally established knowledge, provided that sufficient funds are available to ensure its survival. The question of usefulness is only raised where marginal knowledge is concerned. The fact that we question whether the history of archaeology is useful or not testifies to its marginality. For it is marginal, despite belonging to the history of science, a domain in which all disciplines should theoretically inspire historians’ interest to the same extent. This, however, is not the case. Historians seem to prefer studying either sciences considered as the greatest conquests of Western rationality (such as modern physics, Darwinism, molecular genetics, etc.) or theories supposed to be excessively irrational (such as Renaissance medicine, Stalinist genetics, Nazi biology, astrology, etc.). It is commonly believed that archaeology does not belong to either of these categories. The history of archaeology is as marginal to archaeologists as it is to historians. This is particularly apparent in France, where most archaeologists would not hesitate to respond in the negative to the question of whether disciplinary history matters to current scientific practices. Since the nineteenth century, certain French archaeologists and prehistorians have indeed written on the history of their discipline, but this activity was a task usually reserved for emeritus scholars who took it up in a somewhat nonchalant manner, as if to crown their archaeological œuvre, and probably motivated by the same reasons which prompt certain people, at the same point in their lives, to write their memoirs. There are some notable exceptions, of which are the works of Alain Schnapp, particularly his monumental The Discovery of the Past (Schnapp 1996).
Historiography (2001)
Authors: Trigger Bruce
Published: November 2020

Historical works dealing with archaeology have been written to entertain the public, commemorate important archaeologists and research projects, instruct students in the basic concepts of the discipline, justify particular programmes or ideas, disparage the work of rivals, and, most recently, try to resolve theoretical problems. These studies have taken the form of autobiographies, biographies, accounts of the development of the discipline as a whole, investigations of specific institutions or projects, and examinations of particular theories and approaches. They have used the analytical techniques of intellectual and social history and sought to treat their subject objectively, critically, hermeneutically, and polemically. Over time, historical studies have become more numerous, diversified, and sophisticated. Histories of archaeology are being written for all parts of the world, and in a growing number of countries, a large amount of material is being produced at local as well as national levels. There is no end in sight to the growing interest in this form of research. The history of archaeology has been written mainly by professional archaeologists, who have no training in history or the history of science, and by popularizers. Only a small number of these studies have been produced by professional historians. Archaeology has attracted little attention from historians of science, despite its considerable interest to philosophers of science. This lack of interest is hard to understand since the difficulties inherent in inferring human behaviour from archaeological evidence make archaeology an ideal discipline for addressing many of the issues of objectivity that are currently of interest to historians of science. The earliest use of the history of archaeology appears to have been for
didactic purposes. In the mid-nineteenth century, the physicist
Joseph Henry, the first secretary of the Smithsonian Institution,
sought to purge American archaeology of useless speculation and
to encourage an interest in factual research. To do this, he commissioned
Samuel F. Haven, the librarian of the American Antiquarian
Society, to write a critical historical review of studies of American
prehistory titled Archaeology of the United States (1856). To improve
the quality of American archaeology, Henry also published reports
on developments in the discipline in the Annual Report of the Smithsonian
Institution, which was widely distributed in North America.
Consent and legal/ethical matters
Authors: McLoughlin Moira , King Carole
Published: November 2020

This chapter will explore contemporary child protection issues including safeguarding policies and laws currently in place for children, in order to provide a framework to guide your understanding and practice as a nursing student. We will also highlight the influence of other agencies in fulfilling their statutory responsibility for safeguarding children and the importance of inter-professional work. It is important that student nurses can recognize the presentation of children who may have suffered abuse and so common scenarios are explored and discussed. Examples of the nature and range of abuse will be outlined as will the skills used for both recognition and identification. You may find some of the content disturbing, and it may be useful for you to seek support and guidance when reading the chapter. The chapter commences with a discussion of the background literature in this area, which provides a definition and explanation of abuse and outlines related contributory factors. In order to provide a discussion of the legislation related to this topic, examples from the United Kingdom (UK) will be outlined. Legislation in this area varies between countries; therefore it is not possible to provide information on the scope of the law in individual countries. It may be useful to refer to your own country’s legislation when considering the chapter content. By reading this chapter and engaging with the various activities, you will have: ● A basic understanding of several aspects of child protection and safeguarding policy and law (examples are drawn from the UK and Ireland). ● An understanding of the nature of presenting abuse in children. ● An understanding of child protection/safeguarding guidelines that would enable you to act if you have concerns. ● An awareness of accountability and responsibility issues in relation to your role in nursing children. From preceding chapters you will have developed an understanding that children need to grow up in a nurturing environment that encourages their physical and emotional development.
Essential skills
Authors: Nevin Mary , Mulkerrins James
Published: November 2020

Children present to the health services with a variety of health needs. The Department of Health (DH) National Service Framework (2004) in the United Kingdom (UK) identifies that children with health needs should receive good quality care. Furthermore this care needs to be provided by staff that have adequate preparation to work with children and families (DH, 2004). In order to provide such care, the nursing student needs to develop and acquire the necessary knowledge and skills to gain an understanding and appreciation of the common needs of both family and child on hospitalization. This chapter aims to equip you with the knowledge and background skills to enable you to provide this quality care. After reading this chapter you should be able to: ● Identify and outline the essential skills that are required during the child’s admission to hospital. ● Understand the essential clinical observations that are performed upon the child’s admission to hospital. ● Develop a further understanding of the basic elements of admission and discharge planning, including the nursing process and care planning. ● Understand the importance of good record keeping during care. ● Identify the means of transmission of infection and the specific precautions and practices that the nursing student can utilize to prevent such transmission. ● Understand the principles of distraction therapy. ● Understand the situations in which restraint may be required. ● Comprehend the principles of last offices and the nurse’s role in providing bereavement care. This chapter assists with your understanding of your nursing care by helping you to understand the skills that can be used during the child’s admission to hospital. These skills develop with experience and education and enable you to develop a caring, family centred approach that makes the transition from home to hospital and vice versa a smooth one for both family and child. Crucially, the assessment process, in the initial phase, helps to set the scene in your relationship with both child and family and communication skills are vital. At the same time essential physical observations of the child are carried out and documented to support your overall assessment and these will be outlined in this chapter.
Essential care
Authors: Jonas Denise , Muldowney Yvonne
Published: November 2020

This chapter examines the principal skills of assessment and management of pain and wounds. It provides information on the assessment of a child’s skin and the management of eye and ear care, skin care, and mouth care. It also provides information on mobility and the moving and handling care of children. The care discussed is applicable to a variety of nursing settings such as the hospital or in the community and family participation and cultural needs are incorporated in keeping with the philosophy of family centred care (Chapter Two). It is anticipated that you will be able to do the following after you have read and studied this chapter: ● Discuss the importance of pain assessment to the child’s overall pain management. ● Understand different pain relief medications used to manage pain in children. ● Identify the factors affecting wound healing and discuss assessment of a wound. ● Develop an awareness of the importance of cleaning eyes and ears in children. ● Understand the general principles of maintaining mouth care in the child. ● Appreciate differences in the child’s care and needs at different developmental stages. ● Be aware of general principles of maintaining skin care for the child, including: relating anatomy and physiology of skin to skin care; carrying out an assessment of child and skin; and ensuring child safety and dignity. ● Develop a greater understanding of parent participation and cultural needs of the child in skin care. ● Understand the principles of moving and handling, describing the carrying and supporting of infants and children. You can review your knowledge in some of these areas using the online resource feature that accompanies this book. Pain assessment is an essential first step in the relief of pain. It forms a major part of overall pain management and provides a foundation on which future care is based. Prior to considering pain assessment for the child you should be familiar with the related anatomy and physiology of the child’s condition, an outline of which you should find in a chapter of this book. Revision of your core textbook in anatomy and physiology would also be useful.
Musculo-skeletal system
Authors: McDermott Siobhan , Nolan Liz
Published: November 2020

This chapter aims to highlight the principles of orthopaedic nursing and the skills required to perform effective musculoskeletal care of orthopaedic injury in children. Musculo-skeletal injury is one of the most frequently encountered problems in children’s nursing. Almost 20% of children who present with injury have sustained a fracture (Hart et al., 2006). When children have fractures, they are generally brought to emergency departments. Whether the fractures are simple or complex, or they require surgical intervention or not, fractures produce a great deal of anxiety for children and their families. Children’s nurses are in an ideal situation to use their nursing knowledge to provide optimal care for children with musculo-skeletal injury. The initial assessment and immediate treatment of an injured extremity is fundamentally important in ensuring a good outcome. Delay in recognition of neurovascular compromise can lead to a condition known as compartment syndrome (CS). If ignored, a limb can become seriously compromised, which could eventually lead to amputation of the limb or even the death of the patient. However, having the foundation of knowledge regarding total neurovascular function can equip the nurse with accurate assessment skills and the knowledge of the need for immediate action. Neurovascular assessment used correctly provides the best patient care with the best possible outcome. Compartment syndrome is a possible complication for every patient with a fracture, sprain, or following orthopaedic surgery. Any deviation from the normal range of the neurovascular parameters should be highlighted immediately. Early identification of the symptoms will prompt immediate treatment and prevent any compromise of the limb. In addition the immature skeleton of children has unique properties that directly affect the management of fractures in children. By the end of this chapter you will be able to: ● Explain the nursing assessment you would undertake for an infant/child presenting with musculo-skeletal injury. ● Understand the principles of neurovascular assessment and complete all the aspects involved in assessing neurovascular status. ● Understand the rationale and purpose of the musculo-skeletal nursing skills outlined such as care of the child with a cast.
Gunpowder, Militarization, and Threshold Ecologies in Henry IV Part Two and Macbeth
Authors: Martin Randall
Published: November 2020

The disputed land-uses and cultivation practices represented in As You Like It responded to unprecedented changes in Elizabethan climate, population, and economic relations. Traditional modes of rural dwelling were no longer protected by virtue of their rural isolation or autonomy, but were becoming inescapably tied to national and global orders of competitive growth and resource exploitation. Perhaps the most disruptive of these modernizing turns was the development of gunpowder technologies and the armament industry. As in other western European countries, military culture became ubiquitous in England by the late sixteenth century as a result of innovations in gunpowder weapons and the formation of national armies. During the Middle Ages, low-tech weaponry and feudal mobilization had limited the social and environmental impacts of war. This situation began to change from the fifteenth century onwards with the development of far more deadly cannons, mines, and firearms. Influenced partly by the Erasmian ethics of his Humanist education (like Queen Elizabeth and King James in their attitudes to war), Shakespeare drew attention to gunpowder’s devastating effects on human and non-human animals and their environments in virtually all his history plays and several of his tragedies, even thoughmost of these references were anachronistic. By layering historical and contemporary viewpoints he registered changing material realities and cultural assumptions about the ecology of war: from self-regulating cycles of martial destruction and agrarian regeneration, to incremental technological mastery reliant on ever-increasing resource consumption. Traditional ideas about redeeming war through cultivation are captured by the Virgilian image of beating swords into ploughshares. It suggests that peacetime cultivation will heal wartime damage, and that periods of war and peace routinely alternate. The swordsinto-ploughshares trope also encodes temporal assumptions that the arc of catastrophe, in its political, ecological, and dramatic senses, is limited in scope and ultimately reversible. In this chapter I want to examine the emerging gunpowder regime putting pressure on this paradigm, and replacing it with modern structures of recoiling environmental risk and planetary push-back, represented in Henry IV Part Two and Macbeth respectively.
Biospheric Ecologies in Cymbeline
Authors: Martin Randall
Published: November 2020

Cymbeline makes a theatrical virtue of continually echoing dialogue and scenarios from Shakespeare’s previous plays. Earlier critics were doubtful about this recycling, wondering whether Shakespeare was not falling back on re-runs to make up for failing inventiveness towards the end of his career. These opinions tended to overlook his return to writers such as Boccaccio and Holinshed for fresh material, as well as his projection of personal conflict into new geographic contexts, in the manner of All’s Well That Ends Well and his other late romances. Modern stage productions have capitalized on these signs of imaginative vigour, however, by embracing Cymbeline’s retrospective recreation as cheeky, knowing humour, particularly in the final scene of over-packed revelations and entwining narratives. Cymbeline’s multiple storylines create a polygeneric experience characteristic of Shakespeare’s plays in general and his romances in particular. Steve Mentz has observed that Cymbeline and other ‘polyglot’ romances are well suited to staging modern narratives about the natural world’s tendencies to interdependence, adaptation, and biodiversity. Every main character in Cymbeline has his or her own environmental attachments (e.g. Innogen and Britain, Giacomo and Italy, Lucius and the Roman empire, Cymbeline and ‘Lud’s Town’, Belarius, Arviragus, Guiderius and Wales, Posthumus and Milford Haven). Each of these place-identities represents a different physical and cultural worldview, so when they shift and/or interweave, they suggest dynamic networks operating at multiple levels of planetary space and time. These webbed relations raise modern questions of environmental ethics and practice. Which plane of ecological relations suggests the best way of dwelling responsibly in the world? Which life-challenge might analogize a resolve to reduce excessive consumption and reverse human harm? (e.g. cultivating the local allotment garden? travelling to fewer conferences? preserving boreal forests?). Following trends in postmodern and postcolonial studies, ecotheorists observe that environmentalism has tended to privilege local attachments and modes of dwelling as the common ground for resistance to degrading forces of economic globalization. Pioneering ecocritic Jonathan Bate, for example, celebrated regional and village-focused writers such as William Wordsworth and John Clare.
Communication skills and ethics
Authors: Nandakumar Michael , Bessant Rupa
Published: November 2020

The communication skills and ethics station aims to assess your ability to guide and organize an interview with a patient, relative or surrogate (such as a healthcare worker). The skills specifically tested in this station include: • Clinical communication skills • Managing patients’ concerns • Clinical judgement (including knowledge of ethics and law) • Managing patient welfare. Written instructions are provided for the scenario during the 5-minute interval before the station starts. 14 minutes are allowed for the patient interaction, followed by 1 minute for the candidate to reflect their thoughts. A 5-minute discussion with the 2 examiners will then take place after the patient has left the station. Each examiner has a structured marksheet for the case. • Approach the station as a 2-way discussion rather than a rigid ‘tick-box task’. • Set aside time each week to practise scenarios with colleagues under timed conditions. • Familiarize yourself with recent NICE guidance (especially with new or controversial or rationed treatments) and DVLA advice. • Remember that skills needed in this station are also particularly applicable to those required in station 2 (history taking) and station 5 (brief clinical consultations), and it is therefore essential that you spend adequate time practising these skills to maximize your performance in the examination. • Identify key issues that need to be addressed during the consultation (e.g. breaking bad news) as well as ‘hidden clues’ (e.g. a single parent may have concerns regarding childcare if she herself is admitted to hospital). • Make notes during this time, but avoid the temptation to make notes during the consultation itself, as it distracts from the flow of the discussion. • Start with open-ended questions and establish the patient’s understanding, knowledge and concerns at an early stage – these are all specifically mentioned in the clinical marksheet. • Use ‘2-way acting’ where appropriate – you can improvise within reason to aid the flow and realism of the consultation (e.g. ‘Are you feeling better since I saw you on the ward last week?’).
The derivation of trial structures. I. Analytical methods for direct phase determination
Authors: Glusker Jenny Pickworth , Trueblood Kenneth N.
Published: November 2020

As indicated at the start of Chapter 4, after the diffraction pattern has been recorded and measured, the next stage in a crystal structure determination is solving the structure—that is, finding a suitable “trial structure” that contains approximate positions for most of the atoms in the unit cell of known dimensions and space group. The term “trial structure” implies that the structure that has been found is only an approximation to the correct or “true” structure, while “suitable” implies that the trial structure is close enough to the true structure that it can be smoothly refined to give a good fit to the experimental data. Methods for finding suitable trial structures form the subject of this chapter and the next. In the early days of structure determination, trial and error methods were, of necessity, almost the only available way of solving structures. Structure factors for the suggested “trial structure” were calculated and compared with those that had been observed. When more productive methods for obtaining trial structures—the “Patterson function” and “direct methods”—were introduced, the manner of solving a crystal structure changed dramatically for the better. We begin with a discussion of so-called “direct methods.” These are analytical techniques for deriving an approximate set of phases from which a first approximation to the electron-density map can be calculated. Interpretation of this map may then give a suitable trial structure. Previous to direct methods, all phases were calculated (as described in Chapter 5) from a proposed trial structure. The search for other methods that did not require a trial structure led to these phaseprobability methods, that is, direct methods. A direct solution to the phase problem by algebraic methods began in the 1920s (Ott, 1927; Banerjee, 1933; Avrami, 1938) and progressed with work on inequalities by David Harker and John Kasper (Harker and Kasper, 1948). The latter authors used inequality relationships put forward by Augustin Louis Cauchy and Karl Hermann Amandus Schwarz that led to relations between the magnitudes of some structure factors.
Social Relations in Later Prehistory
Authors: Sharples Niall
Published: November 2020

In this fully illustrated study, Niall Sharples examine the complex social relationships of the Wessex region of southern England in the first millennium BC. He considers the nature of the landscape and manner of its organization, the methods that bring people together into large communities, the role of the individual, and how the region relates to other regions of Britain and Europe. These thematic concerns cover a detailed analysis of the significance of hillforts, the development of coinage and other exchange processes, the character of houses, and the nature of burial practices. Sharples offers an exciting new picture of a period and a region which has considerable importance for British archaeology, and he also provides all archaeologists interested in prehistory with a model of how later prehistoric society can be interpreted.
The House as a Cosmology
Authors: Sharples Niall
Published: November 2020

One of the most popular sub-disciplines of archaeology is experimental archaeology, the re-creation of items, structures, and practices of past societies in the present day. This area of study has a long pedigree in Continental Europe, but was a relatively late development in Britain. One of the pioneers of this approach was Peter Reynolds, who created the Butser Ancient Farm Research Project to explore life in the Iron Age (Reynolds 1979). When it was set up, in the 1970s, experimental archaeology was undertaken with full scientific rigour. Important goals included the quantification of resources required to create a house, the management of ancient breeds of domestic animals, the productivity of Welds of ancient cereals, and the function of pits. All these tasks were carried out with a critical attention to detailed data recording and scientific rigour. More recently, experimental archaeology has become geared towards the general public, and though Butser Farm has retained a scientific core to its activities it also caters for a wider public, providing both knowledge and entertainment about past societies. I had a brief experience of this work in 1977 when I took part in a week-long Weld school at Butser Farm, organized by Glasgow University. This was a key period in the development of the Iron Age farm. The original farm had been created on a spur near the top of Butser, specifically away from easy public access and in a very exposed location. Public interest in the experiment had become difficult to manage and a new site had just been located in the Queen Elizabeth Country Park, a much more accessible location near the main road from Portsmouth to London. The new location was designed to be a public amenity that would attract visitors to the Country Park and represented a move from ‘Laboratory to Living Museum’ (Reynolds 1979: 93). The main job we were to undertake was to help with the construction of a large roundhouse that would form the centre of the new farm. Two previous timber houses had been built up on the hill, but both had been fairly modest affairs; one was based on a house plan from Wheeler’s excavation at Maiden Castle, the other was slightly larger and based on the excavation of a house in the Balksbury enclosure, Hampshire (Reynolds 1979).
Wessex in Context
Authors: Sharples Niall
Published: November 2020

In this book I have attempted to create a new agenda for the study of Britain in the last millennium BC. The book consciously sets out, in its structure and content, to direct attention away from the nature of the archaeological record towards the nature of past human societies. This does not mean I am not interested in the archaeological record, and readers will have noted there is a considerable amount of detail in the text, perhaps too much for some people; but the data has to be examined in relation to the people who lived in a particular place at a particular time: ‘the archaeologist is digging up, not things, but people’ (Wheeler 1954b: v). The objective has been to outline the overall constraints of place and time (Chapter 2) and to see how these created a distinctive archaeological record that differed not only from other areas of Britain, but which varied significantly within the region. I examine how people created communities (Chapter 3) and explore how the mechanisms used to organize human relationships, within that society, changed through time. These changes were partly brought about through events outside their control, but always in a way that was affected by their own particular circumstances. I consider how the most ubiquitous architectural form in later prehistory, the house, was used to structure social relationships on a daily basis in relation to the family, and how this provided a template for thinking about the world (Chapter 4). The analysis concludes with an examination of how these societies considered individual freedom and connectedness, and how the complex variability of individual agency provides an internal dynamic to social change that was influenced by external events, but not led by them (Chapter 5). When I originally conceived of this book the structure was reversed: I started with the individual and worked up to the organization of the larger landscapes. At first sight this may sound a more sensible way of presenting the evidence, moving from small-scale structures to large-scale processes, but during the writing of the book I found this did not seem to work.
How to prepare for the MRCPCH clinical examination
Authors: Zengeya Stanley Tamuka , Serane Tiroumourougane V
Published: November 2020

The clinical examination for the MRCPCH is a major hurdle that every aspiring paediatrician has to face in their career. As the exam is designed to differentiate between the prepared and unprepared candidates, it is important to be well trained. To pass the MRCPCH exam, the candidate needs to demonstrate that they have the clinical skills expected of a newly appointed specialist registrar. According to the Royal College of Paediatrics and Child Health, the aim of the examination is to ‘improve the standard of medical care, educate and examine doctors and provide information to the public on the health care of children’. Competence is expected in various aspects of paediatric medicine, including history taking, communication, establishment of rapport, physical examination, clinical judgement, professional behaviour, and ethical practice. On the Royal College of Paediatrics and Child Health website, www.rcpch.ac.uk, a lot of information is provided for candidates. Every candidate is encouraged to visit this website before sitting the exam. Conventionally, the MRCPCH clinical exam consisted of a long case, a short cases, and a viva. However, concerns were raised about the validity of the traditional system, as it focused mainly on knowledge rather than competence. According to George Miller, who proposed a pyramidal framework for assessing clinical competence, the lowest level of the pyramid of assessment is the evaluation of knowledge. This is tested by written examinations. At the second level, the assessment tests not only the theoretical knowledge but also the application of this knowledge. At the third level, the individual has knowledge, knows how to do it, and shows how it is done. This is the level of ‘true competence’ and the MRCPCH clinical examination tests at this level (figure 1.1). In 2004, a major change was brought about in the clinical examination, in which competency-based ‘objective structured clinical examination’ replaced the traditional system. In the new MRCPCH clinical examination, the candidate goes through a ‘circuit’ of clinical stations. Competency-based assessments provide a measure of the subject’s skills in controlled representations of clinical practice and are regarded by both candidates and examiners as a fairer evaluation method. Candidates are given instructions either by the examiner or in written format with a predetermined ‘opening statement’.
Examination of the central nervous system
Authors: Zengeya Stanley Tamuka , Serane Tiroumourougane V
Published: November 2020

Due to the complexity of the diseases and the number of tests involved, examination of the central nervous system (CNS) is relatively difficult in the exam setting. Candidates should realize that an attempt to carry out every aspect of the physical examination of the CNS will take too long and is obviously impractical. Appropriate signs need to be elicited quickly to identify the existence of a lesion, its anatomical localization, and likely pathology. Hence, the examination of this system requires plenty of practise and a polished technique. In the exam, you may be asked to examine, for example, just the motor system, or the upper or the lower limb, rather than an examination of the whole central nervous system. Prepare yourself for a screening examination, which will uncover most signs in a relatively short time. Remember, a detailed assessment of complex disorders is never a part of the MRCPCH Clinical Exam. In this chapter, some areas have been explored extensively, keeping in mind the possibility of a ‘small area’ being examined. As the focus is mainly on examination technique and not theoretical aspects, basic neuroanatomy which has not been dealt with here should be read about elsewhere. Key competence skills required in the neurological examination are given in table 8.1. Neurological assessment begins with the first contact with the child, that is the moment you enter the room. It is necessary to have a predetermined, systematic order of examination so that important signs are not overlooked. However, you should be ready to adapt the examination technique, depending on the child’s age and the level of cooperation (e.g. compliant teenager, difficult toddler). Candidates should realize that a great deal can be learned by inspection before touching the child. Integration of observations with specific findings gathered during the neurological examination will fetch much credit. Candidates are often not expected to reach a diagnosis in a short case. They are expected to define the deficit, decide on the anatomical level, if possible, and then consider the likely causes. Abnormalities commonly seen in the exam include cerebral palsy, hemiplegia, quadriplegia, diplegia, primary myopathy, and hereditary motor sensory neuropathies. It is productive to have a pattern recognition approach to neurological disorders.
The Role of Agricultural and Environmental History in East African Developmental Discourse
Authors: Stump Daryl
Published: November 2020

The past, or the perception of the past, plays a pivotal role in the formation of modern policies on land-use, since the rhetoric of conservation favours the protection of ‘ancient’ or ‘pristine’ landscapes, whilst the focus on economic or environmental sustainability has led to the endorsement of apparently long-lived ‘indigenous’ practices, especially where these appear to have permitted extended periods of cultivation whilst conserving local soil, water, and forest resources. Focusing on examples of locally developed intensive agriculture from Kenya and northern Tanzania, this chapter aims to highlight how the history of landscape management in these areas—although still poorly understood—continues to be cited within developmental and conservationist debates. It will outline how a combination of archaeological, historical, and palaeoenvironmental research might be employed to produce a more complete understanding of these agronomies, and argues that work of this kind is essential to qualify the historical assumptions that have been used to justify external intervention. The invocation of historical arguments in support of either economic intervention or wildlife conservation is not a recent phenomenon, but the critical appraisal of such arguments has gained momentum over the last two to three decades. It is by no means a coincidence that this is also the period that has seen a rise in interest in the precepts of ‘historical ecology’ (e.g. Balée 2006; Crumley 1994) and in resilience theory (e.g. Walker et al. 2004), both of which emphasize the need to study social, economic, and environmental factors from a long-term historical perspective in order to fully understand the relationships between them in any given place or time, and both stress the importance of seeing modern landscapes and resource exploitation strategies as legacies of former periods of land-use. More recently, a resurgence in interest in world systems theory—itself formerly influential on developmental thinking via dependency theory (e.g. Frank 1969)—raises similar themes through the notion that most if not all local economies have been influenced by their interaction with broader webs of trade relations at regional and global scales for several centuries (e.g. Hornberg and Crumley 2007).
Specialty-Specific Interviews
Authors: Watkin Sara , Vincent Andrew
Published: November 2020

This chapter is designed to provide a brief insight into the differences between specialties and how they approach the interview process. It should be read in conjunction with Chapters 4 and 6. The specialties covered are: • Anaesthesia • Emergency medicine • Medicine • Psychiatry • Obstetrics and gynaecology • Paediatrics and neonatal specialities • Pathology and laboratory-based specialities • Radiology • Surgery Each of these sections has been written by a guest author from within that specialty. Across the board, they are all experienced, senior clinicians with many years’ experience in interviewing for consultants. However, it is also important to remember that they are individuals and each individual has their own unique way of thinking too. We have done comparatively little editing and given relatively free rein to those individuals in deciding what’s important. Each was provided with the broad section titles for some consistency. The content is very much their own and we have left it largely untouched so that you may get a feeling for style, psychology and focus, accepting that they are also unique too. As a consequence, although the section structure is consistent, you will find a considerable variation in what authors have chosen to focus on. In each specialty, we have provided a perspective on the likely psychology of the individuals you may come across. This is written by us, not the guest authors, who we can’t expect to have sufficient understanding of psychological difference. However, what we have written must never be taken as gospel. There is no substitute for being a good detective and finding out exactly who is on your panel and exactly how they are wired as individuals. Dr Helga Becker, Consultant Anaesthetist, Dudley Group of Hospitals NHS Foundation Trust. In terms of number of consultants, anaesthetics is often the single largest department in a Trust and so the interview panel will not be particularly representative of the department as a whole. Besides the usual suspects like Chief Executive and Medical Director, the panel will probably have the Clinical Director and maybe another consultant from the department.
New Ways of Interviewing
Authors: Watkin Sara , Vincent Andrew
Published: November 2020

Over recent years there has been a significant move away from the traditional interview format for junior doctor appointments with the increasing use of either competency based interviews (also known as criteria-based interviewing, behavioural interviewing and situational interviews) or assessment centres. Both of these approaches are labour intensive but are felt to ensure a more objective, rather than subjective, approach to choosing the right candidate. Additionally, assessment centres give candidates an opportunity to reinvent themselves between ‘stations’ and a new set of assessors. Assessment centres also give those candidates who naturally struggle with the interview format more opportunities to shine, and for the assessment team to get to the underlying person in more ways. These two approaches are now being explored and utilized in some consultant interviews. Behavioural or competency-based interviews are often being done back-to-back with a traditional interview. Assessment centres are being used more and more for senior appointments, e.g. Medical Director posts, advertised externally. Finally, it is even possible today to find yourself subject to Objective Structured Clinical Examination (OSCE) in an interview situation. However, this is rare but may become more prominent as different colleges take differing approaches to exit exams and final CCT attainment. However, preparation for this, besides what has already been covered in preparing yourself, developing confidence, etc., is beyond the scope of this book. If you find yourself in the unusual position of undertaking an OSCE, then it must be considered in the same light as any other clinical exam, with preparation accordingly. It is likely that new techniques and combinations will be adopted in interviews, as the requirements of consultants evolve and so too do the methods of assessing them. It is important to always find out exactly what will happen to you so that you can be appropriately prepared. These are also known as criteria-based interviewing, behavioural interviewing and situational interviews. They are increasingly used in StR interviews and there have been some trials at consultant interview level.
Life-Threatening Emergencies
Authors: Gupta Pawan
Published: November 2020

When a ‘43-year-old male with a cardiac arrest’ or a ‘63-year-old hypotensive with tachycardia and shortness of breath’ message flies through the red phone from the ambulance control, it is normal for junior doctors to get a bit apprehensive in the first few days of their clinical life. However, knowledge of and following the few basic steps for a rapid assessment and management of the airway, breathing, circulation, disability, and exposure (ABCDE) that are discussed in this chapter may alleviate some of their nervousness and give them the requisite confidence to face such life-threatening emergencies with energy and vigour. The routine practice of taking a history and performing a physical examination, followed by investigations and treatment, is not applicable in emergency situations as time is of the essence. Brief assessment is followed by treatment. A brief history may be collected from the paramedics as often the patient is not in a condition to talk. In the event of a cardiac arrest, protocols are always available in almost all the EDs in the UK and you should follow these. In today’s training climate, a new FY1 will never be left on his or her own to face a situation which is beyond their competence. Help is always available in the form of senior doctors, nurses, and other staff. It is important to first manage the basic ABCDE and, then not missing any of the simple clinical observations such as respiratory rate, capillary refill time, and capillary blood glucose testing. A short but succinct systematic physical examination is important for nailing the main problems and treating them immediately. Most of the time, the underlying cause of acute symptoms is obvious from the outset; at other times, you may need to request some additional tests later to establish the diagnosis. Sticking to ABCDE in the first instance will support the patient and buy time, allowing the doctor to get to the root of the problem, and do what is necessary to help the patient. This chapter has scenarios relating to life-threatening clinical presentations such as anaphylaxis and hoarseness to help ascertain the diagnosis and initiate appropriate treatment immediately.
Houses into Tombs
Authors: Bradley Richard
Published: November 2020

At the French site of Aillevans, not far from the border with Switzerland, there is a group of megalithic tombs (Pétrequin and Pinigre 1976). At first sight, these monuments conform to a wider tradition which is best represented at Sion on the Swiss side of the frontier, and at Aosta in Italy. In each case they feature massive stone cists associated with unburnt human bones (Mezzena 1998). These structures were sometimes located at one end of a low rubble platform or cairn, which could be either triangular or trapezoidal in plan. At Aosta and Sion they incorporated the remains of a series of anthropomorphic sculptures and, for that reason, the excavated evidence has played an important role in studies of statue menhirs. Dolmen 1 at Aillevans is equally remarkable but, in this case, the results of excavation have not attracted the attention they deserve (Pétrequin and Pinigre 1976: 325–49; Figure 25). In its original form, this structure consisted of a round mound six metres in diameter with a stone chamber and an antechamber. Again, it was associated with a quantity of disarticulated human bones. In a subsequent phase that construction was encased within a much larger trapezoidal cairn, seventeen metres in length. Although the circular monument was no longer a freestanding element, both its chamber and antechamber were retained. This was one of the latest megaliths in Europe, but sequences of this kind can be recognized at older tombs distributed across a much larger area. In its final phase, Dolmen 1 changed its character again. The chambered tomb was enclosed within a large wooden structure which had a similar outline to the cairn. The excavators concluded that it had been a roofed building. The stone chamber was located inside its eastern end, but the antechamber was left uncovered and acted as a kind of porch. Seen from a distance, the monument might have looked like a domestic dwelling. Indeed, Pétrequin and Pinigre (1976) specifically compare it with the well preserved buildings in the waterlogged Late Neolithic settlement at Clairvaux. According to their account, a megalithic tomb at Aillevans was almost completely concealed inside what appeared to be a house.
An Introduction to the Crystallogenesis of Biological Macromolecules
Authors: Giegé R. , Ducruix A.
Published: November 2020

The word ‘crystal’ is derived from the Greek root ‘krustallos’ meaning ‘clear ice’. Like ice, crystals are chemically well defined, and many among of them are of transparent and glittering appearance, like quartz, which was for a long time the archetype. Often they are beautiful geometrical solids with regular faces and sharp edges, which probably explains why crystallinity, even in the figurative meaning, is taken as a symbol of perfection and purity. From the physical point of view, crystals are regular three-dimensional arrays of atoms, ions, molecules, or molecular assemblies. Ideal crystals can be imagined as infinite and perfect arrays in which the building blocks (the asymmetric units) are arranged according to well-defined symmetries (forming the 230 space groups) into unit cells that are repeated in the three-dimensions by translations. Experimental crystals, however, have finite dimensions. An implicit consequence is that a macroscopic fragment from a crystal is still a crystal, because the orderly arrangement of molecules within such a fragment still extends at long distances. The practical consequence is that crystal fragments can be used as seeds (Chapter 7). In laboratory-grown crystals the periodicity is never perfect, due to different kinds of local disorders or long-range imperfections like dislocations. Also, these crystals are often of polycrystalline nature. The external forms of crystals are always manifestations of their internal structures and symmetries, even if in some cases these symmetries may be hidden at the macroscopic level, due to differential growth kinetics of the crystal faces. Periodicity in crystal architecture is also reflected in their macroscopic physical properties. The most straightforward example is given by the ability of crystals to diffract X-rays, neutrons, or electrons, the phenomenon underlying structural chemistry and biology (for introductory texts see refs 1 and 2), and the major aim of this book is to present the methods employed to produce three-dimensional crystals of biological macromolecules, but also two-dimensional crystals (Chapter 12), needed for diffraction studies. Other properties of invaluable practical applications should not be overlooked either, as is the case of optical and electronic properties which are at the basis of non-linear optics and modern electronics (for an introduction to physical properties of molecular crystals see ref. 3).