bluuebunny/crossref_metadata_2025 huggingface dataset:
Notes for a Theory of Memory
Authors: Papanicolaou Andrew c.
Published: November 2023

Our primary aim in this book has been to identify and segregate the symptoms and the signs of amnesia into distinct syndromes in order to create a practical guide for the clinician. A secondary aim was to provide a service to the theorists who would have to accommodate such facts into any model of memory if the latter were to be complete. But the construction of such a model was never in the blueprints of this work—which is one of the reasons for the rather vague and noncommittal title of this concluding chapter. A second reason for it is the incompleteness of the factual record as it now stands; the many gaps in our understanding of the nature of the phenomena of memory and of the amnesias. And, to the degree that theories must be about phenomena, a theory of memory at this point would be, in all probability, a precarious one, having to rest at least partially on the quicksands of conjecture rather than on solid factual foundations.
The Role of the Genome in the Initiation of Meiotic Recombination
Authors: Borts Rhona H , Kirkpatrick David T
Published: November 2023

Initiation of recombination is an essential and highly regulated process. Recombination during meiosis is important for enabling exchange of information between the paternal and maternal contributions to a genome. In addition, in most organisms, the absence of meiotic crossovers causes homologous chromosomes to segregate aberrantly. Recombination is not randomly distributed along or between chromosomes. Rather, the genomes of many species contain regions that have an elevated level of recombination (“hotspots”) or a decreased level (“coldspots”). Factors that determine the level of recombination at a specific site are the primary sequence, the configuration of the chromatin, and the nature and function of the DNA sequence. Also, prior recombination initiations repress additional events in their vicinity. The probability of recombination within a region of the genome is very context dependent. It can be modulated by factors that include the nutritional state of the cell, the base composition of the region, and the level of primary sequence variation present between the maternally and paternally inherited chromosomes, as well as the action of DNA repair proteins on sequence mismatches occurring in regions of recombination between maternal and paternal chromosomes. Thus, initiation of meiotic recombination is tightly controlled. Due to the importance of the DNA sequences themselves and their interaction with meiotic proteins, there are regions where the probability of meiotic recombination can be considered to be encoded implicitly in the DNA sequences as a result of interactions with the meiotic protein complement.
Transcendence without God: On Atheism and Invisibility
Authors: Laden Anthony Simon
Published: November 2023

This essay is about seeing, about what to look for, and what difference that might make. I start, however, with a story that helps explain the nature of my own atheism. At the heart of Aristotle’s Nicomachean Ethics lies a puzzle that no one who wishes to teach it can ignore. Aristotle tells us that the aim of his book is to investigate what form of life is the “best for man.” He then devotes almost the entire book to a discussion of the life of moral virtue, seemingly arguing that such a life is the best life. In the final sections of the book, however, he appears to change his mind and very quickly concludes that a life of contemplation, of the exercise of intellectual virtue, is in fact the best life, better than the active life of moral virtue. The puzzle, then, is how to make sense of these final pages. Were they a mistake, not meant to appear in a text that, after all, was assembled by his students and has had a complex and not unbroken history? Was it a merely self-serving but essentially ad hoc addition that allows the author to put himself at the top of the heap, claiming with satisfaction that the philosopher leads the best life? Or can one find hints that this is what was coming all along, so that the discussion of moral virtue is, after all, merely a preparation and a prelude to the final conclusion in favor of philosophy? Clearly, this final alternative would make the text more coherent, not to mention more interesting, but it can be hard work figuring out how to make that case. It was not until I was in the middle of teaching the Ethics for the third time that I came upon a strategy that I liked for solving this problem.
Without the Net of Providence: Atheism and the Human Adventure
Authors: Taylor Kenneth A
Published: November 2023

At first glance, it may appear that those who believe in divine providence have a happier lot and are much less prone to despair than those who reject god and divine providence altogether. That alone may seem to give us good reason to prefer belief to non-belief. I shall argue in this essay that there is almost nothing to be said for either the view that belief in providence provides invincible armor against despair or for the view that the atheist who rejects providence need surrender to a paralyzing despair. Many theists evidently do take comfort in the belief that there exists a god who both loves humanity and who guarantees, through divine providence, that human history will ultimately culminate in an unqualifiedly good outcome. Such comfort is not entirely unreasonable. If history is guided by divine providence, then whatever apparent ills may befall us along the way, we may be assured that moral darkness will not ultimately triumph over light and that the innocent are not destined to suffer injustice at the hands of their persecutors for eternity.
Disenchantment
Authors: Owens David
Published: November 2023

The tension between religion and intellectual knowledge definitely comes to the fore wherever rational, empirical knowledge has consistently worked through to the disenchantment of the world and its transformation into a causal mechanism. For then science encounters the claims of the ethical postulate that the world is a God-ordained, and hence somehow a meaningfully and ethically oriented cosmos. Weber speaks of a tension, but for many, science’s disenchantment of the world is instead a liberation. Science empowers us; it gets us what we want. Two things stand in the way of our getting what we want: technical obstacles and superstitions. Science eliminates them both. It removes the technical obstacles by giving us a technology, a recipe for constructing machines that help us get what we want. Beyond that, science conquers superstitions; it gives us a picture of the world, a theory of how the world works, which disenchants that world. The scientific picture of the world leaves out much that used to prevent us from doing what we want. It excludes from reality all sorts of imaginary beings, forces, and powers that used to constrain us. Once these mind-forged manacles are broken, we can take advantage of the technology science provides.
Science, Society, and Mental Retardation: A History
Authors: Smith Moyra
Published: November 2023

In this chapter, we trace a history of societal attitudes to mental retardation during the period when it was becoming evident that mental retardation is due to biological factors. We will discuss the history of the study of mental retardation beginning in the second half of the nineteenth century, when interest in brain structure and function intensified. In addition, we will consider a number of scientific developments in the fields of biochemistry and genetics that were, in due course, to impact our understanding of the causes of mental retardation.
Mental Retardation Associated with Other Neurological Defects
Authors: Smith Moyra
Published: November 2023

In this chapter, we discuss disorders that are due to a specific gene defect and where mental retardation occurs along with a striking neurological deficit. The neurological deficits described include epilepsy, episodes of acute illness, seizures and/or coma, movement disorders, and sensorineural abnormalities such as blindness, deafness, and muscle defects.
Mental Retardation That Develops after a Period of Normal Cognition
Authors: Smith Moyra
Published: November 2023

In this chapter, we will review disorders that disrupt development and the maturation of cognition in children with no previous evidence of delay. We will focus primarily on genetic diseases that are associated with abnormal storage of normal substances, i.e., lysosomal storage diseases, peroxisomal disorders, and copper storage disease. We include a discussion of Rett syndrome since in this condition girls who have developed normally for I or more years undergo regressive changes. There are also environmental conditions that lead to disruption of normal development. We will review neurodevelopmental effects of malnutrition in early childhood and neurocognitive deficits in children exposed to certain pesticides and heavy metals.
Mannose-Binding Lectin Genes
Authors: Bellamy Richard
Published: November 2023

Mannose-binding lectin (MBL) is an important component of the innate immune system. MBL belongs to the family of proteins called collectins, which contain both collagen-like domains and C-type lectin domains. The human collectin family includes MBL and lung surfactant proteins A and D (Holmskov et al., 1994; Lu, 1997; Lu et al., 2002).
Complement Genes
Authors: Crawford Keith D , Alper Chester A
Published: November 2023

This chapter provides a broad overview of the human complement system, its component proteins and interactions, and the functions generated by its activation. We broadly outline the genetics of complement proteins with special emphasis on inherited deficiencies. We seek thereby to explain some of the clinical consequences of genetic defects in the system. For more details on the complement system and its components, see the comprehensive reviews in Muller-Eberhard (1988) and Volanakis and Arlaud (1998).
Tuberculosis, Leprosy, and Other Mycobacterial Diseases
Authors: Cooke Graham , Hill Adrian V S
Published: November 2023

Mycobacteria are slow-growing, gram-positive organisms protected by a complex outer cell wall. In common with gram-positive bacteria, this wall contains peptidoglycan (PG). Unlike gram-positive organisms, this PG is linked to arabinogalactan (AG), which in turn is covalently linked to long chain mycolic acids. These and other lipids, including liparabinomannan (LAM), phosphoinositol mannosides found within the cell wall (figure 22.1.) contribute to the organisms’ environmental resilience. Despite similar biochemical characteristics, mycobacteria cause diverse human diseases. Mycobacterium tuberculosis alone is responsible for most of the 1.8 million deaths annually attributed to clinical tuberculosis (WHO 2003), while M. leprae continues to be responsible for enormous morbidity, causing 700,000 cases of leprosy (WHO 2002) (see table 22.1). Many other mycobacteria are found in environmental sources, including soil and water, and rarely cause disease except in an immunocompromised host. Such immune compromise can be acquired (e.g., due to HIV infection) or genetic. The rare examples of genetic susceptibility to these ‘‘atypical’’ mycobacteria are discussed below and of interest, not only in the treatment of affected individuals but also because the lessons they can teach are relevant to the major mycobacterial killer, tuberculosis.
Genuine and Sham Effects
Authors: Schenker Heinrich
Published: November 2023

Body, time, unfolding in space and time, goal setting, the pleasure of the journey, protraction of that pleasure, remembrance, repetition, contrast, expectation, striving, fulfilling, deception, and similarly fundamental experiences of the human soul, to name only the most essential, are also repeated in music as a human art. Nothing human is foreign to it, only genius—and genius alone— adds synthesis. The non-genius is not familiar with the genius’s experience and does not attain the genius’s success, not in art, not in life.
Elucidations
Authors: Schenker Heinrich
Published: November 2023

The fundamental chord in nature (Der Klang in der Natur) is a triad: Because of the inherently narrow compass of the human voice, art—a human activity—can avail itself only of the shortened form of the chord of nature, which when sounded successively defines tonal space: The Urlinie measures out the tonal spaces within the chord, and thereby articulates the chord for the first time, bringing it to consciousness.
Miscellanea
Authors: Schenker Heinrich
Published: November 2023

Forgive me, if an unknown person and a mere musical amateur does not wish to deny himself the opportunity to express his most heartfelt thanks to you for your splendid and seminal work toward the understanding of the Ninth. After a long, long epoch of the most shameless barbarism, you have succeeded in enabling those who have been led so contemptibly astray to understand and appreciate again the strict and serious art. And in your thoroughly painstaking and equally valuable work, as destroyer and creator at the same time, you have succeeded magnificently. Even if the consequences and success may not follow immediately but can only take place in the course of time, perhaps as we move into a somewhat nobler age, you will come to enjoy the respect that you deserve as the first to have mightily promoted the sort of renaissance we have hoped for.
The Opening Chorus (First Chorale Fantasy) from Bach’s St. Matthew Passion
Authors: Schenker Heinrich
Published: November 2023

That Bach was guided by the image of a particular musical form, among other things, in composing the opening chorus of the St. Matthew Passion—the graph of the Urlinie is given on p. 128—cannot be doubted. But with respect to this form, which of course is at the same time the content of the piece, alas, every performance is a failure, as, no less, is all the literature (discussed later). The St. Matthew Passion’s opening chorus itself is incontrovertible evidence that the art of our geniuses stands too high to be the collective property of humanity in any serious sense. The common understanding of music is by its nature too feeble to raise itself to such heights, and no illusion, no yearning, will build a bridge to them. And to overstep the limits of nature, to underestimate God’s grace, election, vocation and occupation, gathering and deepening in the highest dedication of an entire life, because one hopes for more blessings, more fruits, from a wider dissemination, from the artificial gathering together of humanity and its compulsory cultivation—this is assuredly not the way that leads to the high art of genius.
Mendelssohn’s Song without Words, Op67, No. 6
Authors: Schenker Heinrich
Published: November 2023

Since 3 is placed directly above the tonic chord, this tonal space is filled in by the descending third-progression of the Urlinie, 3 2 1 (g –f –e). In the breadth of this narrative, 3 turns twice toward 2 before setting out once more and finally continuing to 1. In the language of form, the first two statements of 3 –2, bars 1–12 and bars 13 – 27, signify antecedent and consequent of a first section. We then recognize in the fifth-progression divided at the third, B–(G –)E, the outline of a middle section, bars 1-12– 61, which is followed by the return appearance of 3 at the beginning of the third section.
Schumann’s Scenes of Childhood, Op. 15, No. 1 “Träumerei”
Authors: Schenker Heinrich
Published: November 2023

Fig. 1a shows how the Urlinie rises from 1 to 3, only to fall back again to 1; it climbs there a second time, and indeed all the way to 4, only to sink back again to 1. Finally, it repeats its first motion, ascending a third time to 3 and falling back to 1. Thus the Urlinie also clearly illustrates the form, the small three-part song form, whose middle section is highlighted by 4.
Introduction to Palliative Nursing Care
Authors: Coyle Nessa
Published: November 2023

“I failed to care for him properly because I was ignorant”— these are haunting words, and they are as true today as they were several decades earlier. Clinicians cannot practice what they do not know. However, the opposite is also true: Individuals and their families, struggling to live in the face of progressive, symptomatic, and debilitating disease, can be well cared for and supported throughout this process and find meaning and peace in the face of death. This is the essence of skilled palliative nursing care—to facilitate the “caring” process through a combination of science, presence, openness, compassion, mindful attention to detail, and teamwork. Although we have both the knowledge and the art to control the majority of symptoms that occur during the last months, weeks, and days of life, we still have much to learn about how to alleviate the psychological and spiritual distress that comes with life-threatening illness.
Pain at the End of Life
Authors: Paice Judith A , Fine Perry G
Published: November 2023

Of the many symptoms experienced by those at the end of life, pain is one of the most common and most feared. However, this fear is largely unfounded because the majority of patients with terminal illness can obtain relief. Nurses are critical members of the palliative care team, particularly in providing pain management. The nurse’s role begins with assessment and continues through the development of a plan of care and its implementation. During this process, the nurse provides education and counsel to the patient, family, and other team members. Nurses also are critical for developing institutional policies and monitoring outcomes that ensure good pain management for all patients within their palliative care program. To provide optimal pain control, all health care professionals must understand the frequency of pain at the end of life, the barriers that prevent good management, the assessment of this syndrome, and the treatments used to provide relief.
Dysphagia, Xerostomia, and Hiccups
Authors: Dahlin Constance M , Goldsmith Tessa
Published: November 2023

Dysphagia and dry mouth are disturbing symptoms that occur frequently in progressive terminal illness. Hiccups, while less frequent, can be as distressing, adversely affecting quality of life. These problems impact the essence of pleasurable activities such as food, communication, intimacy, social interaction, as well as nutrition.
Hydration, Thirst, and Nutrition
Authors: Kedziera Pamela , Coyle Nessa
Published: November 2023

There is lack of consensus either in society or among experts as to whether it is physically, psychologically, socially, or ethically appropriate to provide artificial hydration and nutrition to a terminally ill person. Do these therapies improve the way an individual feels physically and emotionally? Do they cause harm? Can an individual die comfortably without these interventions? Decisions are usually made on the basis of whether the intervention will make the patient more comfortable and whether it will honor his or her wishes. These elements are illustrated in the following two case reports.
Skin Disorders: Tumor Necrosis, Fistulas, and Stomas
Authors: Bates-Jensen Barbara M , Seaman, Susie , Early Lynne
Published: November 2023

Tumor necrosis, also known in the literature as fungating tumors, ulcerative malignant wounds, or malignant cutaneous wounds, presents both a physical and an emotional challenge for the patient and even the most experienced clinician. These wounds are frequently associated with pain, odor, bleeding, and an unsightly appearance. They may be a blow to self-esteem and may cause social isolation just when the patient needs more time with loved ones. The goals in the care of patients with tumor necrosis include pain management; control of exudate, odor, and bleeding; and prevention of infection.
Clinical Interventions, Economic Outcomes, and Palliative Care
Authors: Coyne Patrick J , Lyckholm, Laurie , Smith Thomas J
Published: November 2023

Health care spending and health care quality are major problems in the United States, with health care spending reaching $1.6 trillion, a number expected to triple in the next 10 years. In 2002, there was an annual increase of 9.3%. Drug costs and rising hospital expenses fueled much of this spending. The financial costs of cancer are great both for the individual and for society as a whole. The economic burden is likely to increase as the population ages, the absolute number of people treated for cancer increases, and newer technologies and expensive treatments are adopted as standards of care. Already in the year 2004, the National Institutes of Health estimated overall annual costs for cancer to be $189.8 billion, with direct medical costs totaling $69.4 million, and indirect costs from lost productivity to be $16.9 billion due to illness and $103.5 billion due to premature death. Lack of health insurance and other barriers to health care prevent many Americans from receiving optimal medical care. According to the 2003 National Health Interview Survey data, nearly 27% of Americans between the ages of 18 and 24 and 20% of Americans between the ages of 25 and 44 reported not having a regular source of health care.4 Additionally, 17% of Americans under age 65 have no health insurance, and about one third of older individuals only have Medicare coverage. Nearly one third of all Medicare spending is on patients in their last year of life5,6; we are spending a significant amount on high-technology care for the elderly, and those funds cannot be spent on preventive services or chronic disease conditions for the same population. The pressure on health care funds will increase due to heightened demands for care from an educated elderly population, more elderly long-term survivors, new and expensive technologies, new diseases, and demands for cost cutting.
in Palliative Care
Authors: Berenson Susan
Published: November 2023

Mary was a 64-year-old vivacious, beautiful woman with a zest for life, a wonderful sense of humor, and a terrific Welsh accent. She appeared much younger than her stated age. She was born in Wales and immigrated to the United States at the age of 23. She was happily married for 29 years and had a 23-year-old son, whom she adored. Mary was a strong woman who had managed to stay sober in Alcoholics Anonymous one day at a time for 10 years, and who was able to stop smoking after 35 to 40 years of smoking. She had numerous friends and was cherished by many.
Spiritual Assessment
Authors: Taylor Elizabeth Johnston
Published: November 2023

To solve any problem, one must first assess what the problem is. Consequently, the nursing process dictates that the nurse begin care with an assessment of the patient’s health needs. Although palliative nurses are accustomed to assessing patients’ pain experiences, hydration status, and so forth, they less frequently participate in assessing patients’ and family members’ spirituality. Because spirituality is an inherent and integrating, and often extremely valued, dimension for those who receive palliative nursing care, it is essential that palliative care nurses know to some degree how to conduct a spiritual assessment. This chapter reviews models for spiritual assessment, presents general guidelines on how to conduct a spiritual assessment, and discusses what the nurse ought to do with data from a spiritual assessment. These topics are prefaced by arguments supporting the need for spiritual assessments, descriptions of what spirituality “looks like” among the terminally ill, and risk factors for those who are likely to experience spiritual distress. But first, a description of spirituality is in order.
Cultural Considerations in Palliative Care
Authors: Mazanec Polly , Panke Joan T
Published: November 2023

This chapter defines culture and its components as they relates to palliative care. It addresses cultural competence and the importance of recognizing how one’s own values, practices, and beliefs impact care. Finally, selected palliative care issues influenced by culture are discussed. This chapter is not intended to be a “cookbook” approach to describing behaviors and practices of different cultures as they relate to palliative care, but, rather, a guide to raising awareness of the significance of cultural considerations in palliative care.
Patients with Acquired Immunodeficiency Syndrome
Authors: Sherman Deborah Witt
Published: November 2023

In 20 years, acquired immunodeficiency syndrome (AIDS) has escalated from a series of outbreaks in scattered communities in the United States and Europe to a global health crisis. Although the emerging biomedical paradigm of highly active antiretroviral therapy (HAART) has significantly reduced the mortality from human immunodeficiency virus (HIV) in the developed world and has transformed AIDS into a manageable chronic illness, the reality worldwide is that people are not “living with AIDS,” but, rather, “dying from AIDS” due to a lack of access to medications and appropriate health care. Even in developed countries, AIDS remains the leading cause of serious illness and death for young adults, and at this point in time, there is a false dichotomy created between disease-specific, curative therapies and symptom-specific palliative therapies.3 AIDS has stimulated the need to evaluate clinical practice when curative and palliative care interface and raises some interesting and interconnected issues about the care of individuals with life-threatening, progressive illnesses.4 Both the public and health professionals have been troubled by the reality of overtreatment and undertreatment of pain and symptoms in individuals with life-threatening illnesses, particularly at the end of life.5 Such concern extends to the care of patients with HIV and the resultant illness of AIDS because no cure has yet been found. The focus of care must, therefore, be on improving quality of life by providing palliative care for the management of pain and other physical symptoms while addressing the emotional, social, and spiritual needs of patients and their families throughout the illness trajectory. Even though current therapies have increased the life expectancy of people with HIV/AIDS, the chance of their experiencing symptoms related not only to the disease but to the effects of therapies also increases. Furthermore, palliative measures can be beneficial in ensuring tolerance of and adherence to difficult pharmacological regimens.
Caring for the Drug-Addicted Patient at the End of Life
Authors: Kirsh Kenneth L , Compton, Peggy , Passik Steven D
Published: November 2023

touches medically ill patients and can negatively influence how pain is treated. Because of these issues and despite the fact that national guidelines exist for the treatment of pain disorders such as cancer, pain continues to be undertreated, even at the end of life. In cancer, approximately 40% to 50% of patients with metastatic disease and 90% of patients with terminal cancer or other advanced diseases are reported to experience unrelieved pain. Furthermore, inadequate treatment of cancer pain is an even greater possibility if the patient is a member of an ethnic minority, female, elderly, a child, or a substance abuser.8 Thus, for multicultural patients, we sometimes have conflicting multiple biases in pain treatment that can lead to poor management, mutual suspicion and alienation, and suffering unless these biases are adequately addressed.
Improving the Quality of Care Across All Settings
Authors: Bookbinder Marilyn
Published: November 2023

One system for addressing health and end-of-life care is the inclusion of quality methodologies designed to improve education, streamline health care bureaucracies, help measure costs, and even address how people feel about their jobs. Whether or not your organization is accredited by the Joint Commission on Accreditation of Health Care Organizations (JCAHO), mandated to use a quality improvement (QI) methodology, a planned-change approach is needed to achieve positive outcomes and to cultivate an infrastructure that maintains optimal standards of care for those at the end of life.
Long-Term Care
Authors: Wilson Sarah A
Published: November 2023

Quality end-of-life care in nursing homes is becoming more important as the number of older adults increases, and managed care continues to minimize hospital stays. Nursing home residents are sicker today and have different care needs. Although nursing homes were not established as sites for terminal care, they are becoming the place where many people do die. Statistics on the place of death tell us little about the environment where someone lived and died. This chapter addresses nursing homes, the environment of nursing homes, the staff, the care of dying residents, and model programs to support dying residents.
The Intensive Care Unit
Authors: Puntillo Kathleen , Stannard Daphne
Published: November 2023

An intensive care unit (ICU) is, by tradition, the setting in which the most aggressive care is rendered to hospitalized patients. Patients are admitted to an ICU so that health professionals can perform minute-to-minute titration of care. The primary goals of this aggressive care are patient resuscitation, stabilization, and recovery from the acute phase of an illness or injury. However, many patients die in ICUs. It is estimated that 540,000 people die after admission to ICUs in the United States each year. Stated otherwise, almost one in five Americans receives ICU services before death. ICU deaths account for 59% of all hospital deaths and 80% of all terminal inpatient costs. One third of patients with metastatic cancer who die in hospitals do so in ICUs, as do 85% of patients with acute myocardial infarctions. Therefore, it is clear that management of the process of dying is common in ICUs.
The Outpatient Setting
Authors: Pen Anna R Du , Robison Jeanne
Published: November 2023

Dramatic changes over the last two decades have resulted in shorter and shorter hospital stays, longer survival with chronic debilitating disease, and smaller, fractured families—all of which have contributed greatly to increased use of outpatient services. Outpatient care is delivered in private practice offices, free-standing clinics, and hospital-based outpatient settings. Individuals with chronic and terminal illnesses receive care over time in the outpatient clinic or office setting. In these settings, significant long-term relationships develop among providers, patients, and families. As patients move toward the end of life, visits to the clinic provide an excellent opportunity to assess the patient’s and family’s needs, desires, struggles, and fears.
Rehabilitation and Palliative Care
Authors: Michael Kathleen
Published: November 2023

Even when it is not reasonable to expect cure or reversal of disease processes, or to restore a previous level of functioning and independence, a rehabilitative approach to nursing care adds quality to the experience of life’s completion. Grounded in respect for each unique patient, rehabilitation nurses address palliative and end-of life care with concern for preserving hope, human dignity, and autonomy. They involve social, spiritual, and functional support systems. Rehabilitation nursing interventions are designed to help patients and families make the most out of each day in the context of the disease trajectory. The language of rehabilitation nursing is a language shared with those who practice palliative care.
End-of-Life Decision-Making in Pediatric Oncology
Authors: Hinds Pamela S , Oakes, Linda , Furman Wayne L
Published: November 2023

Deciding to end a child’s life, and involving a child in the decision to end his or her life, are startling phrases, but we in pediatric oncology participate in those considerations with parents, patients, and other members of the health care team as a part of providing the highest-quality care for the child or adolescent with incurable cancer. Participating in end-of-life decisions is life altering for the child or adolescent and for the family, but it can also be life altering for the health care provider. Clinical anecdotes suggest that the way in which patients, family members, and health care providers complete end-of-life decision-making can color all of their preceding treatment-related interactions, and may influence how well parents emotionally survive the dying and death of their child. The manner in which end-of-life decision-making processes are completed may also contribute to the survival of health care providers as compassionate and fully competent professionals.
Grief and Bereavement in Pediatric Palliative Caren
Authors: Davies Betty , Jin Juhye
Published: November 2023

Effective and compassionate care for children with life-threatening conditions and their families is an integral and important part of care from diagnosis through death and bereavement.1 This guiding principle, one of seven put forth by the Institute of Medicine report on the status of palliative and end-of-life care for children and their families, emphasizes that care continues for the family following the child’s death. Though medical science has contributed significantly to the treatment of children with life-limiting illnesses or conditions, children still die from cancer, cardiac disease, respiratory conditions, genetic conditions, and more. Moreover, thousands of neonates die each year and thousands more children of all ages, particularly toddlers and adolescents, die as a result of trauma. Approximately 55,000 children die annually in the United States.1 Regardless of the cause of death, the death of a child is a tragedy, an incomparable life event that has an impact on all family members, friends of the family, and the community in which the family lives. A child’s death also affects the physicians, nurses, social workers, and other health care personnel who provide care for the dying child. The purpose of this chapter is to define common words associated with grief; to describe factors that affect the grief of family members, the effects of grief upon them, and the nurse’s role in helping grieving individuals and their families; and to discuss the needs of nurses who work in pediatric palliative care.
Pediatric Pain: Knowing the Child Before You
Authors: Goldstein Mary Layman , Byrnes-Casey, Maura , Collins John J
Published: November 2023

Pain, a source of suffering, is present in many children—those who are facing a potentially life-threatening illness and those who are not. Expert pain management is a necessary part of pediatric palliative care. It is possible for very young children to feel and express pain. A child’s ability to communicate pain is influenced by age and cognitive level. Even a preverbal child can communicate pain. To effectively manage an individual child’s pain, the nurse first must be aware of the possibility of pain, sensitively observe the child, and use developmentally appropriate, objective assessments. Developmental factors (physical, emotional, and cognitive) play an important role in both pediatric pain assessment and pain management. Through knowledge of these factors and an awareness of how they affect an individual child, it is possible for nurses to effect better management of each child’s pain (Table 55–1). Despite a significant increase in interest and in the study of pediatric pain and its control over the last 20 years, there often remains a gap between what is technically possible and what is clinically practiced.
Ethical Considerations
Authors: Stanley Karen J , Zoloth-Dorfman Laurie
Published: November 2023

Technological advances in the diagnosis and treatment of chronic disease have resulted in longer lifespans and, in many cases, an extended period of dying. This ability to prolong life has been almost seamlessly integrated into the medical profession’s philosophical approach to treating disease as an adversary that can and must be conquered. The value of existence for its own sake, a false sense of security about technology’s ability to rescue, and the human need to maintain hope and delay the end of life have obscured and postponed the inevitable need to confront critical issues.
Project Safe Conduct
Authors: Pitorak Elizabeth Ford
Published: November 2023

The details of developing and implementing an integrative model of palliative care are discussed in this chapter. The concepts that contributed to the success of this program were having a well defined vision; obtaining support from top leadership; developing an extremely detailed step-by-step plan; creating an education plan; role modeling how to deliver “bad news” creating an environment conducive to family conferences for decision-making; and establishing outcome measures for evaluation.
Imaging Brain Function in Living Patients
Authors: Williamson Peter
Published: November 2023

Over the last 25 years remarkable advances have been made in quantifying brain chemistry and function in living patients. Beginning with primitive xenon techniques through to highly sophisticated positron emission tomography (PET) and functional MRI techniques, it has become possible to accurately determine cerebral blood flow changes in localized regions of the brain during performance of cognitive tasks. Other PET and single photon emission computed tomography (SPECT) techniques allow us to look at resting brain metabolism and receptor occupancy. The findings from these studies have changed the way we look at schizophrenia and have brought us much closer to understanding the neuronal circuits that could be involved.
Experiencing Still Photographs
Authors: Walton Kendall L
Published: November 2023

How often have we experienced a day when the light was so crystalline, when every object within our vision was etched with such clarity, that we longed for the moment to be preserved forever? The purpose of art since the days of the cave dwellers has been to arrest the passage of time in order that the moment may be contemplated at leisure.
The Subtle Princess Translated by Gilbert Adair
Authors: Villandon Marie-Jeanne L’Heritier De
Published: November 2023

In the time of the first Crusades, a certain king (as to where his kingdom lay I know no more than that it was in Europe) resolved to make war against the infidels in Palestine. Before undertaking a journey that promised to be long and perilous, he put the affairs of his kingdom in order, and appointed his ablest minister as regent, so that he might feel entirely easy on that account. What did concern this king, however, was the welfare of his own family. The queen had died, alas, not long before our story properly begins. She had left him no son, but three young princesses, all of marriageable age. My knowledge of the family doesn’t extend to their true names: I only know that, in those honest, uncomplicated times, it was the custom among ordinary folk to refer to eminent persons by nicknames chosen according to their good and bad qualities, a custom all the more appropriate to the princesses in that each was so very different from her two sisters it was as if the king had three only children.
A Note on “Restructuring” and Quantifier Climbing in French
Authors: Cinque Guglielmo
Published: November 2023

The fact that Modem French (as opposed to Italian) has no systematic Clitic Climbing (la), Long Object Preposing in se constructions (lb), or Auxiliary Change (le) was initially taken to suggest that it lacks “restructuring” altogether (see, e.g., Kayne 1978: fn. 7, 1980: 39--40, 1981: fn. 5, and Rochette 1988: sec. 2.3):1 It was soon realized, however, that some transparency effects exist in Modem French that point to the existence of “restructuring” in this language too.2 So, for example, taus ‘all’, tout ‘everything’, rien ‘nothing’ and other quantifiers) are known (since Kayne 1975) to extract out of the infinitival complement-and, for many, out of the subjunctive complement (if any)-of certain verbs (vouloir ‘want’, oser ‘dare’, devoir ‘have to’ ,pouvoir ‘be able to’ ,falloir ‘be necessary’ ,etc.; see[2]) but not of others (avouer ‘confess’ ,certifier ,jurer ‘swear’ ,croire ‘believe’ ,dire ‘say’ ,etc.: see[3]).
The Status of “Mobile” Suffixes
Authors: Cinque Guglielmo
Published: November 2023

Verbal suffixes that encode grammatical notions of mood, modality, tense, aspect, and voice have been found to obey a relative order that is largely consistent across languages (Bybee 1985).1 This order appears to reflect, in a mirror fashion, that of the corresponding free morphemes (auxiliaries and particles), in VO languages, suggesting the existence of a layered constitution of the clause (Foley/van Valin 1984, Dik 1989).2 In Cinque (1999), I have proposed that the layered structure of the clause is much richer than previously thought. Each of the ordered categories of mood, modality, tense, aspect, and voice break down into a number of distinct grammatical markers, which are also ordered among one another. If we put together these different orders, we reach some forty or so grammatical layers for the clause.3 Within this picture of a rigid and invariant universal structure for clauses, “mobile” suffixes constitute a particularly severe challenge, as they seem to point to an at least partially undetermined layered structure. On the basis of a number of representative cases, however, I will conclude that it is rational not to abandon the stronger assumption that the grammatical markers of mood, modality, tense, aspect, and voice enter an invariant and rigid universal order.
Introduction
Authors: Gill Stephen
Published: November 2023

The two g reat critics who defined the terms in which much of the debate about Wordsworth’s achievement has been conducted were in agreement about his stature. “In imaginative power,” Samuel Taylor Coleridge declared in Biographia Literaria (1817), “he stands nearest of all modern writers to Shakespeare and Milton.” “I firmly believe that the poetical performance of Wordsworth is, after that of Shakespeare and Milton... undoubtedly the most considerable in our language from the Elizabethan age to the present time,” Matthew Arnold echoed in 1879.1 As to the merits of The Prelude, however, they disagreed completely. Coleridge was so inspired by a private recitation of the poem that he wrote his own verse tribute, “To William Wordsworth.” In his judgment, Wordsworth’s “prophetic Lay,”
‘A Strong Confusion’ Coleridge’s Presence in The Prelude
Authors: Newlyn Lucy
Published: November 2023

Cole r idge ‘ s p r e s e n c e in The Prelude is deceptive, even at first sight. As an account of Wordsworth’s life, the poem does not come up to date, and is concerned with experiences the two poets never shared. Again and again, however, their friendship is introduced as part of the unfolding story: O friend, we had not seen thee at that time, And yet a power is on me and a strong Confusion, and I seem to plant thee there.
The Prelude and The Recluse Wordsworth’s Long Journey Home
Authors: Abrams M H
Published: November 2023

In t h e “ prospectus “ to his intended masterwork, The Recluse, Wordsworth announces that his “high argument” will be the capacity of the mind of man, “When wedded to this goodly universe In love and holy passion,” to transform the world into a paradise which will be “A simple produce of the common day.”1 He then goes on to pray to the “prophetic Spirit” that if with this I mix more lowly matter; with the thing Contemplated, describe the Mind and Man Contemplating; and who, and what he was— The transitory Being that beheld This Vision; when and where, and how he lived;— Be not this labour useless.
Writing the Self/Self Writing William Wordsworth’s Prelude
Authors: Mellor Anne K
Published: November 2023

Writing the Self Masculine romanticism has traditionally been identified with the assertion of a self that is unified, unique, enduring, capable of initiating activity, and above all aware of itself as a self. The construction of such self-consciousness was the project of one of the most influential literary autobiographies ever written, William Wordsworth’s The Prelude. Responding to Locke’s sceptical insistence that since human consciousness is mutable, constantly receiving new sensations and ideas, so also must human identity be discontinuous, Wordsworth attempted to represent a unitary self that is maintained over time by the activity of memory, and to show that this self or “soul” is defined, not by the body and its sensory experience, but by the human mind, by the growth of consciousness. In the last decade, however, deconstructive critics, most notably Paul de Man and those influenced by his work, have rightly argued that Wordsworth’s project was undercut by his own recognition that language can never be more than an alienating “garment,” can never be “the air we breathe.” They have tracked the way images of an achieved unitary self give way in The Prelude to figures of effacement and defacement, to images of a lost boy, a self “bewildered and engulfed,” and the “broken windings” of the poet’s path.
Alkyd Resins
Authors: Shelley Mee Y , Braun Jennifer L
Published: November 2023

Trade Names Plaskon, Durez, Glaskyd Class Thermoset polymers (polyesters modified with monobasic fatty acids) Principal Components Fatty acids and oils (e.g., lauric, palmitic, stearic, oleic, linoleic, linolenic, eleostearic, and licanic acids). Polyhydric alcohols (e.g., glycerol, pentaerythritol, ethylene glycol). Polybasic acids (e.g., phthalic acid/anhydride, maleic acid/anhydride, fumaric acid/anhydride). Major Applications Paints, brushing enamels, and clear varnish. Industrial coatings (spraying, dipping, flow coating, roller coating). Industrial baking finishes. Properties of Special Interest Rapid drying. Good adhesion. Flexibility. Mar resistance and durability. Ester groups can be hydrolyzed under alkaline conditions.
Polyesters, Unsaturated
Authors: Shelley Mee Y , Braun Jennifer L
Published: November 2023

Trade Names Dion, Hetron, Polylite, Advaco, Altek, Cargill, Cook, OCF, Pedigree, Pioester, etc. Class Thermoset polymers (mixtures of polyester prepolymers with aliphatic unsaturation and a vinyl monomer) Principal Components Prepolymers (oligomer): glycols (e.g., 1,3-propylene glycol), saturated acids (e.g., phthalic anhydride/acid), unsaturated acids (e.g., maleic anhydride/acid). Monomers: styrene, α-methylstyrene, methyl acrylate, methyl methacrylate, etc. Other Ingredients Inhibitors to prevent premature cross-linking and to allow a suitable shelf life (e.g., hydroquinone). Initiators (catalysts): methyl ethyl ketone peroxides, benzoyl peroxides, etc. Accelerators: cobalt naphthenate, cobalt octanoate, etc. Major Applications Laminates, coatings, art objects, insulation, construction (e.g., bath tubs, floor tiles, countertops, roofing, siding, skylights, fences, etc.), automobile parts, embedding of specimens (e.g., decorative, zoological), encapsulation of electronic assemblies, toys, playground equipment, furniture, pearl buttons, sports equipment (snow boards, skis, bowling balls, etc.), chemical storage tanks.
Poly(ethylene-2,6-naphthalate)
Authors: Iroh Jude O
Published: November 2023

Molecular Conformation Nearly planar Major Applications Films, rigid thermoplastic polyesters Properties of Special Interest Mostly synthesized as semi-crystalline thermoplastic. PEN is a clear and rigid polyester Preparative Techniques Synthesized by step growth polymerization of ethylene glycol and naphthalene-2,6-dicarboxylate(1)
Poly(glycolic acid)
Authors: Lu Lichun , Mikos Antonios G
Published: November 2023

Major Applications Sutures, drug delivery devices, and scaffolds for use in cell culture, transplantation, and organ regeneration. Properties of Special Interest Good biocompatibility; biodegradable mainly by simple hydrolysis; bioresorbable; good processability; a wide range of degradation rates, physical, mechanical, and other properties can be achieved by PGA of various molecular weights and its copolymers.
Polymeric Sulfur
Authors: Clarson Stephen J
Published: November 2023

Introduction The interesting color changes (yellow to orange to red to black) that are seen upon heating sulfur from its melting point up to its boiling point are fascinating. Elemental sulfur has been studied by mankind for many, many years—for example, the self-depression of the freezing point of sulfur was reported by Germez in 1876. According to Kelly, there are some 15 references to the element in the Bible.