bluuebunny/crossref_metadata_2025 huggingface dataset:
A Unit Root Test in the Presence of Structural Changes in 1(1) and 1(0) Models
Authors: Hatanaka Michio , Yamada Kazuo
Published: November 2023

In the unit root literature on structural changes of deterministic trends the changes are admitted either in 1(0) models only, as in Zivot and Andrews (1992), orin both 1(1) and 1(0) models, as in Perron (1989). However, in Perron (1989) the break fractions ( Tb/ T) are specified outside the inference on the unit root, while the fractions are regarded as unknown parameters inside the inference in Zivot and Andrews (1992). Vogelsang and Perron (1994) compare the correctly and incorrectly specified break fractions that enter into both I(l) and 1(0) models, and point out the inapplicability of Zivot and Andrews’ procedure to such models. In the present paper we shall admit the structural changes in both I(l) and 1(0) models, while incorporating the inference on the break fractions within the unit root test.
Actor-Network Theory and Information Infrastucture
Authors: Monteiro Eric
Published: November 2023

The study of the economics of infrastructure has already begun to show how the development, introduction, and use of an information infrastructure are an involved socio-technical process of negotiation. The open-ended character of this process—the stumbling, the compromises, the way non-technical interests get dressed up in technical disguise—calls for an analytic vehicle that helps tease out interesting and relevant issues related to the ‘management’ of such processes. This chapter introduces, outlines, and illustrates one such vehicle—namely, actor-network theory (ANT). We introduce ANT by briefly positioning it within the broader landscape of conceptualizations of technology and society. This exercise is intended to be neither comprehensive nor systematic. It is aimed at spelling out those underlying aspects of an information infrastructure towards which ANT makes us sensitive.
Post face: From Infrastructure to Networking
Authors: Dahlbom Bo
Published: November 2023

The Internet is often described as an infrastructure for information society, but it is not immediately obvious that the notion of infrastructure, originally introduced to describe the foundation of industrial society, is useful in an analysis of the role of information technology. In this final chapter we will question the idea of information technology as foundational infrastructure, and suggest that this technology is best understood as a flexible medium by which social structures are formed, reformed, and dissolved, in a continuous process of networking.
Central Control and Provincial Discretion during Decollectivization: System-Level Analyses
Authors: Chung Jae Ho
Published: November 2023

This study utilizes an intergovernmental perspective with which the operational effects of post-Mao administrative decentralization on provincial discretion in the implementation of the household responsibility reform are investigated. The household responsibility reform refers to a set of policy measures that brought about fundamental changes in the incentive structure and the size of the primary unit of agricultural production in 1978-84? While there were a variety of responsibility systems based upon the production brigade, the production team, the work group, the individual labourer, or the household, this study concentrates on the last form as it was the system that the overwhelming majority of peasants in China eventually settled with. More specifically, two types of household-based responsibility systems are the focus of this study: baochan daohu and baogan daohu.
Managing the Corporate Story
Authors: Larsen Mogens Holten
Published: November 2023

Managers are increasingly broadening their perspective from the strictly rational, to include more emotional and imaginative aspects of doing business. In my opinion, one of the most important implications of this shift is the potential for ownership of words and images in the minds of stakeholders. Ownership of words and images relates to those (often emotional) associations that occur in one’s mind when a company name is mentioned. Associations that are meaningful and relate to long-term corporate strategy create differentiation of the organization from its competitors in the eyes of its customers and a sense of belonging for employees and other constituencies.
The Communication Advantage: A Constituency-Focused Approach to Formulating and Implementing Strategy
Authors: Argenti Paul A , Forman* Janis
Published: November 2023

Since the 1970s, numerous studies have identified how organizations develop their strategies and, in some instances, how they succeed or fail as they attempt to move from a formulated strategy to its implementation. These studies include Collins and Porras’s book Built to Last (1994) on the long-term corporate success of eighteen visionary companies; Prahalad and Hamel’s (1990) work on core competence, as well as the Hamel and Prahalad (1989) article on strategic intent; and D’Aveni’s (1994) work on hypercompetition. Some of these studies also discuss the importance of communication to the process of implementing strategy, but none of them considers communication to be a central focus.
Identity Lost or Identity Found? Celebration and Lamentation over the Postmodern View of Identity in Social Science and Fiction
Authors: Czarniawska Barbara
Published: November 2023

One persistent topic in the recent wave of so-called postmodernist thinking is that of individual identity. The insertion of the problematizing adjective ‘so called’ suggests at the outset that there is some doubt as to the kind of thinking that may be called ‘postmodern’. Indeed, the adjectives ‘postmodern’ and ‘postmodernist’ are frequently used in social science and humanities writing nowadays. Sometimes they stand contrasted to ‘modern’ and ‘modernist’, sometimes not; sometimes they are used synonymously, sometimes not. I have no ambition to sort out various semantic confusions once and for all, but I wish to propose a temporary order for the purposes of this chapter. I shall use the word ‘postmodern’ to denote a special kind of attitude, a sensibility that has its roots in one or another kind of disenchantment with what Lyotard (1979/1987) calls ‘The Modern Project’. It often comes in one of two versions: despairing or celebratory.
Global City-Regions Trends, Theory, Policy
Authors: Scott Allen J
Published: November 2023

There are now more than three hundred city-regions around the world with populations greater than one million. These city-regions are expanding vigorously, and they present many new and deep challenges to researchers and policy-makers in both the more developed and less developed parts of the world. The processes of global economic integration and accelerated urban growth make traditional planning and policy strategies in these regions increasingly inadequate, while more effective approaches remain largely in various stages of hypothesis and experimentation. 'Global City-Regions' represents a multifaceted effort to deal with the many different issues raised by these developments. It seeks at once to define the question of global city-regions and to describe the internal and external dynamics that shape them; it proposes a theorization of global city-regions based on their economic and political responses to intensifying levels of globalization; and it offers a number of policy insights into the severe social problems that confront global city-regions as they come face to face with an economically and politically neoliberal world. At a moment when globalization is increasingly subject to critical scrutiny in many different quarters, this book provides a timely overview of its effects on urban and regional development, one of its most important (but perhaps least understood) corollaries. The book also offers a series of nuanced visions of alternative possible futures.
Istanbul’s Confiicting Paths to Citizenship: Islarnization and Globalization
Authors: Isin Engin f.
Published: November 2023

Any discussion of citizenship inevitably involves related issues of modernization and postmodernization and economic, cultural, and political globalization (Isin and Wood 1999). If we define postmodernization as both a process of fragmentation through which various group identities have been formed and discourses through which “difference” has become a dominant ideology, its effect on citizenship has been twofold. On the one hand, various groups that have been marginalized and excluded from modern citizenship have been able to seek recognition (Fraser 1997; Young 1990). Groups based upon ethnic, “racial;’ ecological, and sexual concerns have articulated claims for citizenship to include group-differentiated rights. Women have fought to expand their citizenship rights to include social rights such as access to childcare, pay equity, and rights to safe cities; ethnic and racialized minorities have sought recognition and representation; aboriginal peoples have sought rep resentation and self-government rights; gays and lesbians have struggled to claim rights that are already extended to heterosexual couples, such as spousal benefits and common-law arrangements; immigrants have struggled for naturalization and political rights; and various ability groups have demanded recognition of their needs to become fully functional citizens of their polities.
Introduction: The Intern Ional Law Commission 1949-1998
Authors: Watts Sir Arthur
Published: November 2023

Broadly speaking, the International Law Commission is the latest stage in a process which began as an intellectual aspiration in the late eighteenth century, made progress through non-governmental initiatives in the nineteenth century, dcvdopcd through ad hoc inter-governmental action in the late nineteenth and first part of the twentieth century, and led finally to its establishment in 1947 as a permanent international institution.
Special Missions
Authors: Watts Sir Arthur
Published: November 2023

In modern times, and indeed for the past two or three centuries, permanent diplomatic and consular missions have been the principal forms of a State’s representation for the pursuit of its interests in foreign countries. Yet before the fifteenth and sixteenth centuries diplomatic relations were primarily a matter for ad hoc missions, special envoys being sent as occasion demanded for the conduct of official business on a particular matter (such as the negotiation of a treaty or the resolution of some particular bilateral dispute), or to participate in some ceremonial function (such as attendance at a coronation or a State wedding or funeral).
Non-Navigational Uses Of International Watercourses
Authors: Arthur Watts
Published: November 2023

For a long time international rivers have been a source of legal concern. Nearly two hundred years ago navigation on European international rivers was the subject of regulation at the Congress of Vienna in 1815. In 1868 the Convention of Mannheim laid the foundation for the navigational regime on the River Rhine. In those earlier times interest concentrated almost exclusively on the use of rivers for navigational purposes, although in a different context their function as geographical frontiers between States was also important.
Diplomatic Couriers
Authors: Kcmg,Qc Sir Arthur Watts
Published: November 2023

The immunity and inviolability of diplomats is usually thought of as one of the well-established cornerstones of the law of diplomatic relations, just as, also, is the absolute protection due to diplomatic communications, in particular the diplomatic courier and the diplomatic bag which he accompanies: the former is necessary if the diplomat is to be able to do his job in the receiving State, while the latter is necessary if there is to be free communication between an embassy and its home State.
An ‘Ever Closer Union’ in Need of a Human Rights Policy: The European Union and Human Rights
Authors: Alston Philip , Weiler J H H
Published: November 2023

The twentieth century’s most important proclamation of human rights, the Universal Declaration of Human Rights, was adopted by the United Nations General Assembly on 10 December 1948.1 It provided not only the inspiration but also the basis for the drafting of the European Convention on Human Rights, which was adopted less than two years later. Between them, the two instruments enabled the work of building a European community to proceed without a separate human rights foundation.
The Internal and External ‘Other’ in the Union Legal Order: Racism, Religious Intolerance and Xenophobia in Europe
Authors: Gearty Conor A
Published: November 2023

At the centre of the plan for a new European landscape there is to be found a hard seed of hate. Though small, it has been carefully nurtured by the malevolent and has thrived on the past inattention of Europe’s master-gardeners. In the excitement of the march to unity, the push for the single currency, and the rejuvenation of our Euro-wide institutions, it has been tempting to ignore its venomous potential and to concentrate instead on the rekindled Renaissance that seems to beckon for the Europe of the New Millennium. This seed of hate is however more than a mere detail or the pedantic obsession of a gardener responsible for only a small part of the whole. It is the evil of racism and its associated negative passions of religious intolerance and general xenophobia.
Non-Communitarians: Refugee and Asylum Policies
Authors: Noll Gregor , Vedsted-Hansen Jens
Published: November 2023

While the internal dimension of immigration policies has been an integral part of EC co-operation ever since the 1957 Treaty of Rome, immigration policies vis-á-vis third-country nationals, and the related issue of asylum, became a serious EC concern only in the mid-1980s. Developing the single market and abandoning internal border controls were seen as conditioned upon the establishment of common control at the external borders. This resulted in the attempts to harmonize immigration policies with respect to non-EC citizens, and asylum policies as well. As it will emerge, there are important disparities in harmonization of the two policy areas.
Monetary movements, taxation, and the Treaty ‘freedoms’
Authors: Usher J A
Published: November 2023

Linkages were clearly made between monetary movements and taxation m Council Directive 88/361,1 which finally established the basic principle of free movement of capital as a matter of Community law, with effect for most Member States from 1 July 1990. With regard to tax harmonization, Directive 88/361 expressly envisaged in its art. 6(5) that the Commission would submit to the Council by 31 December 1988 proposals aimed at eliminating or reducing risks of distortion, tax evasion, and tax avoidance ‘linked to the diversity of national systems for the taxation of savings and for controlling the application of these systems’, and the Council was to take a position by 30 June 1989. As stated in the previous Chapter, this initiative failed. However, the start of the third stage of Economic and Monetary Union has led to the elimination of exchange risks and differential interest rates for the eleven participants and thus made the legal theory of moving money to other Member States a realistic proposition for ordinary taxpayers. No doubt this was one reason for the resuscitation in 1998 of a proposal for withholding taxes on investment income; however, legal problems and political initiatives may be observed with regard to tax incentives, tax competition, tax evasion, and tax discrimination. Furthermore, in the context of monetary movements, possible conflicts with other substantive provisions of the EC Treaty arise from the wording of art. 58(1) (a) (formerly art. 73d(1)(a)). This states that the provisions of art. 56 (i.e. the liberalization of capital movements and payments inside and outside the Community) ‘shall be without prejudice to the right of Member States: (a) to apply the relevant provision of their tax law which distinguish between tax-payers who are not in the same situation with regard to their place of residence or with regard to the place where their capital is invested; …’
The Role of Fault in the Law of Unjust Enrichment
Authors: Birks Peter
Published: November 2023

Fault can creep into the law of unjust enrichment on the plaintiff’s side or on the defendant’s. A plaintiff who would otherwise be entitled to a restitutionary claim may be denied restitution because he has been at fault. For example, in respect of payments made by mistake some jurisdictions have chosen to bar claims where the plaintiff’s mistake is judged to be inexcusable. More frequently it is the fault of the defendant which is made relevant. A system can go as far as to allow innocent defendants to escape restitutionary liability altogether. More selectively, the requirement of fault on the part of the defendant may be confined to particular causes of action in unjust enrichment.
Reforming Non-Compensatory Damages
Authors: Burrows Andrew
Published: November 2023

Lord Goff’s influence on the common law, through both his writings and his judgments, has been immense and is plain for all to see. What is less well known has been his contribution to legislative reform through the great help he has given over the years to the Law Commission. In my early weeks at Conquest House, I received a call from him offering me whatever assistance he could give; and over the past few years I have greatly benefited from discussions with him on a number of Law Commission projects, ranging from illegal transactions,2 through mistake of law, to liability for psychiatric illness.
Federalism and Takeover Law: The Race to Protect Managers from Takeovers
Authors: Bebchuk Lucian Arye , ferrell Allen
Published: November 2023

Twenty-five years ago, William Cary (1974) published his most lasting contribution to corporate law: his Yale Law Journal article entitled ‘Federalism and Corporate Law: Reflections upon Delaware’ —one of the most well-known and widely cited articles in corporate law (Shapiro 1991: 1462). In the article, he argued that Delaware’s reliance on revenues generated from corporate charters had led it to favour corporate managers in crafting its corporate code. Cary believed that managers, often at the expense of shareholders, enjoyed unjustifiably lax constraints with regard to issues ranging from fiduciary obligations to a parent’s treatment of a corporate subsidiary. To stop this harmful ‘race to the bottom’, Cary proposed that Congress adopt ‘federal standards of corporate responsibility’ (1974: 701).
Environmental Federalism in the United States: The Risks of Devolution
Authors: Engel Kirsten , rose-Ackerman Susan
Published: November 2023

Federalism in the United States is currently characterized by two recent developments: the federal government is devolving regulatory policy making and enforcement to the states, and the federal courts are challenging long-held views of federal power. Both developments have important and problematic implications for environmental policy. Although there are indeed benefits from state involvement in environmental affairs, the current decentralizing trends should not obscure the risks associated with too great a reliance on lower-level governments.
Ever Decreasing Circles? The Crisis in Standards Setting in the Wake of US v. Microsoft
Authors: Lea* Gary
Published: November 2023

It is comparatively rare for competition law cases to attract mass media attention but there can be few members of the general public in any of the major industrialized nations who are unaware of the fact that Microsoft, one of the world’s largest companies and a leading software supplier, has been ‘in trouble’ over allegations of anticompetitive practices: when a company can slip from first to fifth largest in the world by market capitalization, wiping over 15 per cent ($81 billion) off its stock market valuation, even the most jaded observer will sit up and take notice.
New Bottles, but No Wine
Authors: Maniatis* Spyros
Published: November 2023

Intellectual property law is changing. Pressure for change comes from several sides. New technologies, the information economy’s potential for growth at the national and international level, international co-operation on intellectual property under the World Intellectual Property Organization and the World Trade Organization, lobbying from industries for more protection are all pushing for new developments that bring with them expectations, uncertainties, and risks. The world wide web is challenging notions of territoriality. Some commentators argue that the whole system of intellectual property needs a total overhaul; others, including this author, are more cautious. The intellectual property regime may be regarded as a form of regulation, whether national or international. Inevitably it collides with other forms of regulation.
Copyright Law in 1998–9: Developments in Substantive Copyright Law
Authors: Enser John , Moore Jane , clayton James
Published: November 2023

Once again, the period under review has given rise to a few profound developments in UK copyright law. This indicates that, despite the level of debate about the operation of copyright in a digital age, the substantive concept embodied in UK copyright law to date is not seriously under threat.
Review of Trade Mark and Passing off Cases
Authors: Maniatis* Spyros
Published: November 2023

Jeryl Lynn Trade Mark challenges the current belief that the system of registration has been liberalized to such an extent that, provided the applicant can produce evidence of distinctiveness acquired through use, it is possible to overcome the obstacle of section 3(1)(a) of the Trade Marks Act 1994 (the 1994 Act). The trade mark, registered since 1995, was ‘Jeryl Lynn’ for medicinal and pharmaceutical preparations and substances and sanitary substances in class 5. The name was chosen in honour of Jeryl Lynn Hilleman from whom the original mumps virus was extracted and used to produce a live attenuated mumps vaccine; the patent for the vaccine had expired in the mid-1980s. The applicant for invalidation of the registration had produced from the respondents’ own vaccine a new strain of attenuated mumps, RIT 4385; the vaccine was marketed under the trade mark ‘Priorix’ and in the accompanying literature there was a reference to RIT 4385 as being ‘derived from Jeryl Lynn mumps strain’.
Reporting Restrictions and Contempt
Authors: Andrew Nicol QC , Heather Rogersϯ
Published: November 2023

New reporting restrictions have been introduced by sections 44–52 of the Youth Justice and Criminal Evidence Act 1999 (YJCEA). They are principally concerned with the position of young people, but extend also to adult witnesses.
A Unified Approach to the Fundamental Freedoms
Authors: Jarass Hans D
Published: November 2023

The four fundamental freedoms of the EC Treaty have developed an importance far beyond what would have been expected. They encompass the free movement of goods in Article 28 EC, the free movement of workers in Article 39 EC, the freedom of establishment in Article 43 EC and free movement of services in Article 49 EC.2 This chapter outlines the theory and basic structure of the fundamental freedoms focusing on what they have in common.3
Judicially-Created Exceptions to the Free Provision of Services
Authors: O’Leary Siofra , Fernández-Martínf’ José M
Published: November 2023

Articles 45, 46 and 55 EC permit exceptions from the freedom to provide services in so far as the activity in question is related to the exercise of official authority, or on grounds of public policy, public security and public health. This chapter focuses on further exceptions to the prohibition on restrictions of the free provision of services which have been fashioned by the European Court of Justice. It first reviews developments in the Court’s case law which have led it, beyond direct and indirect discrimination, to prohibit, in addition, non-discriminatory national restrictions which are liable to impede the free provision of services. These indistinctly applicable restrictions are permissible if they can be justified with reference to imperative requirements of public interest. This open-ended category of justifications, created by the ECJ itself, is meant to reflect the social, moral and cultural diversity which still exists between the Member States and which, at least in the absence of further harmonization, may come into conflict with fundamental freedoms guaranteed by the EC Treaty. In order for indistinctly applicable national measures which restrict free movement to be justifiable, they must, in addition, comply with the principle of proportionality.
The Currency of Money
Authors: Fox David
Published: November 2023

To travel abroad would be said to buy currency from an exchange dealer. The second sense is the one developed in this chapter. It refers to a feature of the characteristic proprietary regime applying to money, and in particular to the way in which title to money is exempted from the full force of the general rule on derivative transfers of title expressed in the maxim nemo dat quod non habet. In this sense, ‘currency’ is often used interchangeably with ‘negotiability’, which reflects the common origin of the rules on transfer of title to money and money instruments in what would nowadays be identified as the law of negotiable instruments.
Some Restrictions in Linguistic Expressions of Spatial Movement
Authors: Nikanne Urpo
Published: November 2023

This chapter discusses the link between spatial cognition and language. The investigation supports the idea of Jackendoff (1983) that linking between these two representations is not direct; it is intermediated by a level of representation referred to as conceptual structure. The constraints that govern the form of conceptual structure are also the reason for some structural differences between spatial structures and the linguistic structures expressing them. The theoretical assumptions are based on the approach of Conceptual Semantics (Jackendoff 1983, 1987a, 1990; Nikanne 1990). The main focus is on the constraints of conceptual-structure formation and their effects on the linking between linguistic and spatial representations.
Preparing for dental practice
Authors: Trevor Burke F J , Freeman Ruth
Published: November 2023

This book prepares dental students and vocational dental practitioners for primary dental practice. It will also be helpful to general dental practitioners to enable them to undertake continuing professional development. The book provides a background to the holistic approach that dentists need to use when identifying treatment needs, and covers the integration of treatment and its planning, aspects of dental team building, practice selection and management matters. The first chapter examines issues in relation to career choices, the location of the practice together with the means by which access to dental care may be increased. Chapters 2 and 3 take the reader from outside to inside the dental practice to examine relationships within the practice. This includes those with the patient as well as the dental team. The fourth chapter describes clinical excellence in primary dental care by examining clinical decision-making, the need for referral as well as the place of prevention and restorative philosophies in treatment of patients. The last chapters examine the business of dental practice and suggest future pathways for the newly qualified dental practitioner.
Software Infrastructure for Computer-Assisted Orthopaedic Surgery
Authors: Jaramaz Branislav , Delp Scott L
Published: November 2023

Computer assisted surgery (CAS) systems are used in a variety of surgical specialities, including neurosurgery, craniofacial surgery, and orthopaedics. Although the clinical applications span several surgical disciplines, many of the software components are common. These common software components can facilitate the development of new systems and enable deployment into novel clinical applications if a robust software platform can be defined and developed.
Robotic Systems for Orthopaedic Surgery
Authors: Taylor R H
Published: November 2023

Robotic systems for orthopaedic surgery are Computer-Integrated Surgery (CIS) systems first, and ‘medical robots’ second. In other words, the robotic manipulator itself is just one element of a larger system that typically includes preoperative planning based on medical images, intra-operative registration to presurgical plans, a combination of robotic assist and manually controlled tools for carrying out the plan, and patient verification and follow-up.
Rationale for Computer-assisted Orthopaedic Knee Surgery
Authors: Rauh Michael A , Krackow Kenneth A
Published: November 2023

On any given day in our modern world we are intensely exposed to computer technology and methodology from computer assisted automobile wheel alignment to bar coding and inventory management at the store checkout counter. The medical field is no different. Our anesthesiologists utilize computerized electronics to monitor their tasks, while the nursing staff enter patient and case information into the hospital database. Yet, all of this sophistication happens while orthopaedic surgeons use nothing more than rulers, hammers, screwdrivers, goniometers and power saws.
Knee reconstructive surgery: preoperative model system
Authors: Picard F , Moody James E , DiGioia III Anthony M , Jaramaz Branislav , Plakseychuk Anton Y , Sell David
Published: November 2023

The first chapter has already reminded us of the rationale of Total Knee Replacement (TKR) and only a few important requirements for the standard TKR surgery have been listed in the following paragraph. The functional result of a TKR depends on preoperative management, the surgeon’s skills, knee kinematics properties, bone quality, soft tissue damages, implant design, and post-operative follow-up.
CRA hip and knee Reconstructive Surgery: Ligament Reconstructions in the Knee – intra-operative Model System (non-image based)
Authors: Sati Marwan , Stäubli Hans-U , Bourquin Yvan , Kunz Manvela , Nolte Lutz-Peter
Published: November 2023

Anterior Cruciate Ligament (ACL) rupture is a very common sports-related injury. Endoscopic or minimally invasive ACL reconstruction with an autogenous graft has become a standard due to the reduced trauma involved and the possibility to perform the procedure on an out-patient basis. There was a recent consensus within the International Knee Society1 that, according to state of the art knowledge on proper ACL placement, approximately 40% of ACL ligaments are currently being misplaced! An advanced arthroscopy course held by the society tested the misplacement rate of ligament placement in 24 cadaver knee following intensive instruction and practice on plastic model.
Hip Trauma
Authors: Phillips Roger , Mohsen Amr M , Viant Warren , Sherman Kevin
Published: November 2023

Fractures of the proximal femur, hip and pelvis are among the most frequent dealt with by orthopaedic surgeons. This chapter focuses on the proximal femur where the fracture sites may be classified as shown in Fig. 23.1.
Accuracy and Validation
Authors: Mor Andrew B , Jaramaz Branislav , DiGioia III Anthony M
Published: November 2023

Validation of a system’s performance is very important to users of CAOS systems, and is an area in which no standardization has yet occurred. While all CAOS systems promise increased accuracy, and the possibility of less invasive surgery, the surgeon’s reliance on the system, especially when coupled with reduced exposure, requires that the CAOS system be thoroughly characterized and tested to ensure that it achieves its advertised accuracy under operating room conditions. The characterization of system performance must be tested at all steps of a procedure in which the CAOS system is utilized, from preoperative imaging to surgical intervention.
Future Challenges
Authors: Troccaz Jocelyne , Merloz Philippe
Published: November 2023

Two major populations of patients use orthopaedic surgery: those who have suffered trauma, and those who require correction of mechanical disorders. Orthopaedic surgery is a real public health issue: for instance, in Europe it concerns about 1,000,000 patients a year, and costs about 3,000,000,000 Euros. These populations are mostly young people (the average age is 40 and the median is 50), who will live for many years following the intervention.
The search for better dialysis membranes: the peritoneum and the beginnings of peritoneal dialysis
Authors: Cameron J Stewart
Published: November 2023

For a while Europe, and then the whole world, was occupied by the First World War. Nevertheless in the United States a further paper—besides that of Hess and McGuigan—employing in vivo dialysis appeared: Alice Rhode, a pupil of Abel’s, used in vivo dialysis to quantify ammonia in the blood [1]. After the end of the war this work in Baltimore continued to attract a good deal of attention. Clearly there was the possibility of a useful treatment, but the technical problems were formidable. Apart from the hirudin problem, if dialysis was ever to become successful in humans, another difficulty of the Abel–Rowntree–Turner dialyser had to be resolved: the relative fragility of the collodion membranes, and the tedium of their manufacture.
Hypertension and stroke
Authors: Hammersley Louise
Published: November 2023

Hypertension is common among almost all populations. It is a major risk factor for stroke, which is an extremely important cause of disability and death in all ethnic minority populations. However, these conditions warrant particular attention in people of black or African-Caribbean origin. This chapter outlines aspects of screening and health promotion, and emphasizes important practical issues in the clinical management of hypertension in this group.
24-hour availability and extended services
Authors: Burns Tom , Firn Mike
Published: November 2023

Availability seven days a week, round the clock (‘24/7’), is one of the rallying cries of assertive outreach purists (Hoult 1986; Marshall and Lockwood 1998; Smyth and Hoult 2000). Like the team approach it is a central tenet of the assertive outreach ideology and was heavily stressed in early studies. Hoult’s service in Sydney is the one where such crisis intervention, round the clock, is promoted in most detail. Interestingly, it is not known how often the original Madison service, while stressing the importance of 24-hour availability, actually made contact out of hours. Careful reading of the service details (Stein and Test 1978) indicates that this was on-call availability from home and very much a safety net rather than an active provision.
Engagement
Authors: Burns Tom , Firn Mike
Published: November 2023

Engagement is the most overused and under-defined term in the assertive outreach vocabulary. Definitions range from the ability of teams to retain patients in the service, to attempts to describe the qualities required of the patient/worker relationship. Table 10.1 classifies the varied activities and strategies that together can help build regular contact, promote a therapeutic alliance, and maximize our ability to provide long-term continuity of care to those patients who have come to be known as ‘hard to engage’. The selected vignettes and discussion of the strategies in this chapter should equip the reader with a working definition and a toolbox for practice.
Bipolar affective disorder
Authors: Burns Tom , Firn Mike
Published: November 2023

Bipolar affective disorder is the term currently used for what was originally called ‘manic–depressive psychosis’. Manic–depressive psychosis was one of the major mental illnesses that Kraepelin distinguished in his original studies (Kraepelin 1919) and it affects just under 0.7% of the adult population (Weissman et al. 1996). He distinguished it from schizophrenia (then called ‘dementia praecox’) not so much on the grounds of the symptoms as on the course of the illness. Dementia praecox was characterized by a gradual decline in functioning punctuated by episodes of severe disturbance, but manic–depressive patients often showed full recovery between episodes, although the disturbed periods could be equally severe. French psychiatrists called it ‘folie circulaire’ (Falret 1854).
Housing and homelessness
Authors: Burns Tom , Firn Mike
Published: November 2023

Without affordable housing for the mentally ill we have little foundation for care in the community. Yet housing, or the lack of it, is a source of frustration to professionals working in the field of mental health and contributes to the debate about shortcomings in this policy. In the past, the responsibility for seeking out this scarce resource lay with social workers and local authority departments. Nowadays, this is seldom the case, and generic working means that regardless of our profession we need to assist our patients when they find themselves in a housing crisis. Housing is high on the patient’s agenda, and also because homelessness causes major difficulties, frequently leading to admission. These may have to be extensively prolonged despite patients being clinically ready to leave hospital.
Physical health care
Authors: Burns Tom , Firn Mike
Published: November 2023

People with severe mental illnesses suffer worse physical health than the general population. They are significantly more likely to die early: the ‘standardized mortality’ of schizophrenia is 1.6, which means that for any given age, their risk of dying is raised by 60% (Harris and Barraclough 1998). Their overall life expectancy is correspondingly lower than the norm. Some of this increased mortality and lowered life expectancy is due to suicide—but not all. The main causes of this increased mortality are respiratory and cardiovascular deaths. Kendrick (1996) found that a quarter of 101 severely mentally ill patients, studied in 16 general practices, were significantly obese, over half were regular smokers, 11 were hypertensive, 21 had persistent cough or sputum, and 24 suffered shortness of breath! Changes in lifestyle or earlier and better treatment could prevent much of this. Working closely with this patient group means that we need to understand more about why their health is so poor and what we can do about it.
Origins of the label “borderline personality disorder”
Authors: Krawitz Roy , Watson Christine
Published: November 2023

The term “borderline personality disorder” arose out of the experiences of psychoanalysts. They identified a cluster of clients who responded differently in treatment to clients categorised at the time as “neurotic)) or “psychotic)). The presentation was initially similar to those who were “neurotic” but response to treatment was very different. The term “borderline)) referred to the belief that these people were on the “border” between neurosis and psychosis. Whilst some clients do have psychotic or psychotic-like experiences, the notion that clients meeting diagnostic criteria for borderline personality disorder are on the border between neurosis and psychosis is no longer held.
History of treatment
Authors: Krawitz Roy , Watson Christine
Published: November 2023

History of treatment had psychoanalysts finding a poor response to treatments available at the time. They concluded that treatment was not possible and stopped engaging these clients in treatment. Cognitive-behaviourists were focusing their treatment on clients who had well-defined target problems and who were more cooperative with treatment suggestions. There was little interest in the treatment of people meeting diagnostic criteria for borderline personality disorder. After a number of decades both groups modified their practices and began to successfully treat people meeting diagnostic criteria for borderline personality disorder with the area becoming increasingly a focus of research and treatment (see “Outcome studies” section). The belief that these clients were untreatable, whilst understandable at the time, has had far-reaching and long-lasting effects. It has been used to support individual and institutional policies of not providing resources and treatment; policies no longer tenable.
Morbidity and mortality
Authors: Krawitz Roy , Watson Christine
Published: November 2023

The high frequency of self-harm, substance abuse, anxiety disorders, depressive disorders and suicide are markers of the high morbidity that exists (see “Comorbidity” section). Clients’ histories indicate a marked vulnerability to adult abuse, with 46% becoming victims of violence (rape -31%; physically abusive partner 33%) (Zanarini et al. 1999). Possible reasons for this include impulsivity, substance use, and limited capacity for self-protection (Zanarini et al. 1999). Koons et al.’s (2001) small study of women war veterans meeting diagnostic criteria for borderline personality disorder reported an even higher rate of adult abuse with 65% reported being battered by a partner and 85% being raped.
Different treatment models
Authors: Krawitz Roy , Watson Christine
Published: November 2023

Psychodynamic theorists view the client as having a poorly formed or fragmented identity due to incomplete or disrupted psychological developmental in childhood. Normal development involves the early establishment of a secure attached relationship. From this solid base, the child can develop a sense of self whilst psychologically separating and individuating. Problems developing a secure attachment, or with separation and individuation, can lead to insecure ambivalent attachments and problems with development of identity and sense of self. If these problems progress into adulthood, there will be a poor sense of self, poorly formed identity and associated problems with self-esteem. Relationships may be associated with avoidance, intense ambivalence, or with loss of identity and individuality.
Commonalities between different models
Authors: Krawitz Roy , Watson Christine
Published: November 2023

Different models tend to have firm, explicit contracts, a high degree of clinician engagement and a proactive, disciplined approach to impulsive behaviour (Allen 1997; Milton, Dawson, Kazmierczak et al. I 999). All models highlight the importance of the clientclinician relationship, of the therapeutic alliance and of patterns of client behaviours manifesting in the client-clinician relationship (Allen 1997; Milton et al. 1999). All models require clinicians to remain relatively calm in crisis, be mindful of their feelings and to set limits to assist the clinician in maintaining warmth for the client, so essential for a positive outcome (Allen 1997; Milton et aL 1999). In exploring similarities in four different models, Allen (1997) notes the acceptance that therapists will make errors, which need to be acknowledged (perhaps with a brief apology) and used if possible to therapeutic advantage.
Outcome studies
Authors: Krawitz Roy , Watson Christine
Published: November 2023

The evidence-based research review organization, the Cochrane Collaboration has not done a systematic review on borderline personality. There is a growing literature base on evidenced-based outcome studies. In 1998 in “A guide to treatments that work”, a text focused on evidence-based research, Crits-Christoff (1998) named only two randomized controlJed trials published at the time. By the end of 2001 there have been a further four randomized controlled trials published making six randomized controlled trials published to date (Linehan et al. 1991; Linehan, Schmidt, Dimeff et al. 1999; Munroe-Blum and Marziali 1995; Bateman and Fonagy 1999; Turner 2000; Koons, Robins, Tweed et al. 2001). In addition there is one waiting list controlled study published (Stevenson and Meares 1992; Stevenson and Meares 1999). These studies are described below in order of date of publication.
In summary
Authors: Krawitz Roy , Watson Christine
Published: November 2023

The term “borderline personality disorder” is unsatisfactory Point prevalence is about 1.8% of 19-55-year-oldsPeople meeting criteria are well represented in mental health facilities, with estimates of 11% at community dinics and 20% in inpatient units High percentage of those attending drug and alcohol services meet criteria75% are female
Introduction
Authors: Krawitz Roy , Watson Christine
Published: November 2023

Effective treatment requires a skilled balance between encouraging client responsibility and autonomy, and offering clear supportive structures when needed. This section outlines how well-defined and well-supported roles for key clinicians and treatment teams can be developed in a system culture that minimizes burn-out and processes staff differences. Careful assessment, clinical plans and contracts encourage collaboration between dients and staff to improve dient outcomes. Clinician empathy, validation and containment are imbedded in dealing with inevitable crises, which for the client, are an essential opportunity to practice dealing with distress. To enable hospitalizations to be brief requires clear understandings of issues around acute versus chronic suicidality and short versus long-term risks/gains. Skills development offers clients alternatives to self-harm and suicidality as ways of relieving internal distress and communicating to others. The principles of effective treatment outlined in this section can provide a foundation to firm up current skilful practice and address hurdles to effective treatments.
Assessment
Authors: Krawitz Roy , Watson Christine
Published: November 2023

The assessment provides the foundation for the clinical plan on which treatment will be based. Assessment can be difficult given that interpersonal trust is damaged, but is crucial. An adequate assessment of a client’s problems and needs is required for clinician and client to engage in a mutually
Interventions
Authors: Krawitz Roy , Watson Christine
Published: November 2023

A desire for a solid, consistent, caring, enduring relationship is almost universal. People meeting diagnostic criteria for borderline personality disorder frequently have childhood and adult histories of relationships that have been notable for problems in attachment. Evidence-based treatments, and for that matter virtually all treatment schools, have a secure, firm, attached relationship with the therapist as central to the treatment. This firm, attached relationship is not easy to establish and maintain for clinician and client alike. Fear of abandonment and difficulty being alone have been named as core client feelings (Gunderson 1996). It is common for clients to want more from their clinicians than clinicians can provide. This threatens the therapeutic relationship because of associated feelings of hurt, anger, disappointment, rejection and abandonment.
Stigma and discrimination
Authors: Krawitz Roy , Watson Christine
Published: November 2023

Unlike the stigma the community puts on mental illness, the stigma associated with borderline personality disorder has been shown to come from within the mental health profession (Fraser and Gallop 1993; Gallop, Lancee and Garfinkel 1989; Lewis and Appleby 1988). Sometimes there is individual and institutional avoidance of treating people meeting diagnostic criteria for borderline personality disorder. When they are seen, it may be with ambivalence or annoyance. Linehan (1995) describes how clients who come to services with a diagnosis of borderline personality disorder may already be disliked before they have even been seen. Clients in treatment are often embroiled in clinician attitudes that are derogatory or deny the legitimacy of their right to access resources. Studies have demonstrated that clinicians have less empathy for people meeting diagnostic criteria for borderline personality disorder than other diagnostic groups and make more belittling comments (Fraser and Gallop 1993; Gallop, Lancee and Garfinkel 1989). Consumers have identified this stigma (Haswell and Graham 1996; Mazelis 1997; Mazelis 1998) and drawn parallels with the stigma associated with AIDS in the early 1980s (Mazelis 1998).