bluuebunny/crossref_metadata_2025 huggingface dataset:
Quasi-one-dimensional cyano-phenylene aggregates: Uniform molecule alignment contrasts varying electrostatic surface potential
Authors: Balzer Frank , Resel Roland , Lützen Arne , Schiek Manuela
Published: April 2017

The epitaxial growth of the mono-functionalized para-quaterphenylene molecule CNHP4 on muscovite mica is investigated. The vacuum deposited molecules aggregate into nanofibers of varying morphology. Due to muscovite’s cm symmetry, almost mutually parallel fibers grow. Polarized light microscopy together with X-ray diffraction resolves the projected orientation of the molecules on the substrate surface and within the fibers. Several different contact planes with the substrate are detected. For all of them, the molecules orient with their long molecule axis approximately perpendicular to the grooved muscovite direction, so that the alignment of the molecules on the substrate is uniform. Kelvin probe force microscopy finds vastly different electrostatic properties of different fiber types and facets.
Self-assembly of magnetic nanoclusters in diamond-like carbon by diffusion processes enhanced by collision cascades
Authors: Gupta P. , Williams G. V. M. , Hübner R. , Vajandar S. , Osipowicz T. , Heinig K-H. , Becker H-W. , Markwitz A.
Published: April 2017

Mono-energetic cobalt implantation into hydrogenated diamond-like carbon at room temperature results in a bimodal distribution of implanted atoms without any thermal treatment. The ∼100 nm thin films were synthesised by mass selective ion beam deposition. The films were implanted with cobalt at an energy of 30 keV and an ion current density of ∼5 μA cm−2. Simulations suggest the implantation profile to be single Gaussian with a projected range of ∼37 nm. High resolution Rutherford backscattering measurements reveal that a bimodal distribution evolves from a single near-Gaussian distribution as the fluence increases from 1.2 to 7 × 1016 cm−2. Cross-sectional transmission electron microscopy further reveals that the implanted atoms cluster into nanoparticles. At high implantation doses, the nanoparticles assemble primarily in two bands: one near the surface with nanoparticle diameters of up to 5 nm and the other beyond the projected range with ∼2 nm nanoparticles. The bimodal distribution along with the nanoparticle formation is explained with diffusion enhanced by energy deposited during collision cascades, relaxation of thermal spikes, and defects formed during ion implantation. This unique distribution of magnetic nanoparticles with the bimodal size and range is of significant interest to magnetic semiconductor and sensor applications.
Monolithic echo-less photoconductive switches as a high-resolution detector for terahertz time-domain spectroscopy
Authors: Maussang K. , Palomo J. , Manceau J.-M. , Colombelli R. , Sagnes I. , Li L. H. , Linfield E. H. , Davies A. G. , Mangeney J. , Tignon J. , Dhillon S. S.
Published: April 2017

Interdigitated photoconductive (iPC) switches are powerful and convenient devices for time-resolved spectroscopy, with the ability to operate both as sources and detectors of terahertz (THz) frequency pulses. However, reflection of the emitted or detected radiation within the device substrate itself can lead to echoes that inherently limit the spectroscopic resolution achievable for their use in time-domain spectroscopy (TDS) systems. In this work, we demonstrate a design of low-temperature-grown-GaAs (LT-GaAs) iPC switches for THz pulse detection that suppresses such unwanted echoes. This is realized through the growth of a buried multilayer LT-GaAs structure that retains its ultrafast properties, which, after wafer bonding to a metal-coated host substrate, results in an iPC switch with a metal plane buried at a subwavelength depth below the LT-GaAs surface. Using this device as a detector, and coupling it to an echo-less iPC source, enables echo-free THz-TDS and high-resolution spectroscopy, with a resolution limited only by the temporal length of the measurement governed by the mechanical delay line used. As a proof-of-principle, the 212-221 and the 101-212 rotational lines of water vapor have been spectrally resolved, demonstrating a spectral resolution below 10 GHz.
Generation of strong cylindrical vector pulses via stimulated Brillouin amplification
Authors: Zhu Zhi-Han , Chen Peng , Sheng Li-Wen , Wang Yu-Lei , Hu Wei , Lu Yan-Qing , Gao Wei
Published: April 2017

Light with transverse polarization structures, such as radial and azimuthal polarization, enables and revives lots of applications based on a light-matter interaction due to its unique focal properties. To date, studies referring to this topic mainly concentrate on a weak-light domain, yet it should have gained more attention in a high-energy domain. Here, we demonstrate the generation of strong single-longitudinal-mode (SLM) cylindrical vector (CV) short pulses via stimulated Brillouin amplification. As a proof-of-principle work, the energy is transferred from a pair of 700 ps pumps to a 300 ps Stokes pulse via parametrically exciting coherent phonons in fluorocarbon liquid. After amplification, a 100 mJ-level SLM CV pulse light with 300 ps duration is obtained. Meanwhile, the phase and polarization structures are high fidelity maintained. This result provides a practicable way to generate strong CV light, and by further extending this mechanism into the beam combination system, even an ultra-high intensity CV light can be expected.
Magneto-optical manifestation of bilayer silicene
Authors: Da Haixia , Ding Weiqiang , Yan Xiaohong
Published: April 2017

AB stacking bilayer silicene is a two-dimensional material which is predicted to be a chiral topological superconductor. In contrast to monolayer silicene and bilayer graphene, bilayer silicene hosts more complexity due to the respective buckled nature of monolayer silicene, thus leading to a mechanism of optical manifestation. Here, we investigate Landau levels and magnetooptical absorption spectrum of bilayer silicene with different stacking sequences under the application of electric and magnetic fields. It is found that the Landau levels and magnetooptical absorption spectrum of bilayer silicene are sensitive to electric fields and exhibit the distinct profiles for different stacking sequences. Especially, there is a split of absorption peaks for bilayer silicene with different stacking sequences in the longitudinal magnetooptical conductivity, facilitating the possibility of identifying the stacking sequences of bilayer silicene. The manipulation of the magnetooptical absorption spectrum in AB stacking bilayer silicene might be crucial for enhancing the understandings of these materials as well as the possible applications.
Correlation between defect-related photoluminescence emission and anomalous Raman peaks in N-Al co-doped ZnO thin films
Authors: Hu Yu Min , Li Jung Yu , Chen Nai Yun , Chen Chih Yu , Han Tai Chun , Yu Chin Chung
Published: April 2017

The origins of defect-related photoluminescence (PL) and anomalous Raman peaks in N-doped ZnO are poorly understood. These features may be related to defects that control p-type conduction in N-doped and N-Al co-doped ZnO (AZO) films. In this study, we investigate the effects of introducing N2 gas during film deposition or a post-growth annealing process on crystallinity and defects in AZO films. A clear correlation between interstitial Zn (Zni)-related PL emissions and Raman features is found. X-ray diffraction and Hall results revealed that N was incorporated into AZO films deposited in the presence of N2 (N-doped AZO), whereas films annealed in N2 gas (N2-annealed AZO) had improved crystallinity with no substitution of N2 at O sites [(N2)O] or N at O sites (NO). The Raman scattering and PL spectra results indicated that Zni-related vibration and emission were dominant in the N-doped AZO films. X-ray photoelectron spectroscopy showed increases and decreases in the binding energies of Zn 2p and O 1s states in N2-annealed and N-doped AZO films, respectively. Together, these results demonstrate that the presence of Zni donor defects may be stabilized by the formation of small clusters and/or caused by the presence of NO acceptor defects, preventing p-type conduction in N-doped AZO films.
Platinum composite nanowires for ultrasensitive mass detection
Authors: Hao Tingting , Shen Tiehan H. , Li Wuxia , Song Chenzhi , Xu Zhi , Jin Aizi , Jin Ling , Li Junjie , Bai Xuedong , Gu Changzhi
Published: April 2017

Platinum (Pt) composite nanowires were grown on the tip of tungsten (W) microprobes by focused-electron-beam induced chemical vapor deposition (FEB-CVD). An electrical field was used to drive a transversal mechanical vibration of the nanowires. Such nanowire vibrations were found to display the first and second harmonic resonances with frequencies in the range of tens of MHz. The Young's modulus of the nanowires was estimated to be in the range of (1.4 ± 0.1) × 102 GPa to (4.7 ± 0.2) × 102 GPa, dependent on the wire size. A mass responsivity of 2.1 × 1021 Hz/kg was demonstrated with the minimum detectable mass of about 0.4 attogram. Our results indicated the potentials of FEB-CVD for the fabrication of nano-balances on any surface for ultra-sensitive mechanical applications.
Anisotropic thermal expansion in pentacene and perfluoropentacene: Effects of molecular packing motif and fixation at the interface
Authors: von Helden Leonard , Breuer Tobias , Witte Gregor
Published: April 2017

Thermal expansion coefficients of molecular solids are typically significantly larger than those of inorganic materials. Since they are furthermore highly anisotropic, the molecular arrangement and consequently the intermolecular orbital overlap strongly depend on temperature, hence also affecting the energetics of optoelectronic excitations and the efficiency of charge transfer processes. Here, we report on the precise determination of the anisotropic thermal expansion coefficients of the organic semiconductor pentacene in its solid state. We compare the thermal expansion coefficients of three different pentacene polymorphs and observe distinct differences between both pentacene bulk polymorphs and the interface-stabilized thin film phase. By comparing epitaxial films with films prepared on weakly interacting, amorphous substrates, we identify a notable influence of the substrate fixation on the thermal expansion in thin pentacene films. Furthermore, the results for pentacene are compared to the thermal expansion of perfluoropentacene, where an exceptionally large vertical thermal expansion coefficient is found in the substrate-mediated π-stacked polymorph. The present study underlines the importance of thermal expansion for the interpretation of temperature-dependent spectroscopic measurements and device characterizations since the notable changes in the unit cell geometries severely affect the intermolecular coupling and thus the excitonic energetics.
Room temperature synthesis of wurtzite phase nanostructured ZnS and accompanied enhancement in dielectric constant
Authors: Virpal  , Kumar J. , Singh G. , Singh M. , Sharma S. , Singh R. C.
Published: April 2017

We report the room temperature synthesis of ZnS in the wurtzite phase by using ethylenediamine, which acts as a template as well as a capping agent. With the addition of ethylenediamine, structural transformation in ZnS from cubic to wurtzite phase is observed. This is accompanied by an increase in the real permittivity by an order of 2, and reduction in dielectric loss by a factor of 6 as compared to a sample without ethylenediamine. Thus, suggesting that ethylenediamine capped wurtzite ZnS is more suitable for miniaturied capactive devices.
Indium segregation in N-polar InGaN quantum wells evidenced by energy dispersive X-ray spectroscopy and atom probe tomography
Authors: Bonef Bastien , Catalano Massimo , Lund Cory , Denbaars Steven P. , Nakamura Shuji , Mishra Umesh K. , Kim Moon J. , Keller Stacia
Published: April 2017

Energy dispersive X-ray spectroscopy (EDX) in scanning transmission electron microscopy and atom probe tomography are used to characterize N-polar InGaN/GaN quantum wells at the nanometer scale. Both techniques first evidence the incorporation of indium in the initial stage of the barrier layer growth and its suppression by the introduction of H2 during the growth of the barrier layer. Accumulation of indium at step edges on the vicinal N-polar surface is also observed by both techniques with an accurate quantification obtained by atom probe tomography (APT) and its 3D reconstruction ability. The use of EDX allows for a very accurate interpretation of the APT results complementing the limitations of both techniques.
Sugarcane yield gap: can it be determined at national level with a simple agrometeorological model?
Authors: Monteiro Leonardo A. , Sentelhas Paulo C.
Published: April 2017

Brazilian sugarcane yield is below its physiological potential, which has compromised the crop’s profitability. This, together with the expansion of the crop to marginal areas with limiting climatic conditions, requires studies to quantify crop yield gaps (YG) and to identify their main causes (i.e. droughts and/or crop management). One way to determine YG is through crop simulation models, which vary in complexity, mainly in terms of input data requirements. This study evaluated whether a simple agrometeorological crop yield model could be suitable for estimating sugarcane YG at a national level, in order to consider and suggest practices to mitigate yield losses. The model was calibrated and evaluated for different conditions across the country. The calibrated model was used to estimate plant and ratoon sugarcane potential (Yp) and best farmer (Ybf) yields for 259 locations representing all regions of the country where sugarcane is grown. Weather data from 1984 to 2013 and general local soil information were used as inputs. The Yp and Ybf simulations were performed for 30 growing cycles, with the final yields being weighted by the proportion of plant (20%) and ratoon (80%) canes in each area. These data were compared with actual average yields (Yavg), obtained from official surveys. Sugarcane yields varied considerably across the country: Yp range was 68.5–232.7 t ha–1, Ybf 61.7–123.3 t ha–1, and Yavg 11.2–101.1 t ha–1. These yields resulted in an average total YG of 133.2 t ha–1. The main source of YG was water deficit, accounting for 75.6% of total losses, while crop management was responsible for 24.4%. Considering the main sources of YG for sugarcane in Brazil, the use of drought-tolerant cultivars, irrigation, and deep soil preparation seems the best strategy to mitigate the risks, improving yields. Based on these results, the simple agrometeorological crop yield model proved suitable to estimate sugarcane YG at national level.
Photosynthetic acclimation to elevated CO2 concentration in a sweet pepper (Capsicum annuum) crop under Mediterranean greenhouse conditions: influence of the nitrogen source and salinity
Authors: Porras Manuel E. , Lorenzo Pilar , Medrano Evangelina , Sánchez-González María J. , Otálora-Alcón Ginés , Piñero María C. , del Amor Francisco M. , Sánchez-Guerrero M. Cruz
Published: April 2017

In many plant species, long-term exposure to elevated CO2 concentration results in a reduction in photosynthetic capacity, known as acclimation. This process is mainly explained by a feedback inhibition mechanism. The supply of a fraction of the nitrogen (N) in the nutrient solution as NH4+ can play an important role in the maintenance of photosynthetic activity and could mitigate the acclimation process. The aims of the present work were to study the photosynthetic response of sweet pepper (Capsicum annuum L.) to CO2 enrichment in Mediterranean greenhouse conditions, throughout the crop growth cycle and to evaluate the supply of NH4+ in the nutrient solution as a strategy to enhance the long-term response to CO2 at different levels of salinity. The experiment was conducted in two identical greenhouses: one with CO2 enrichment according to the ventilation, maintaining a high concentration when the vents were closed and a near-atmospheric level when the vents were open and one without. Sweet pepper plants were grown in both greenhouses, being irrigated with two levels of water salinity and two N sources: (i) NO3– and (ii) NO3– plus NH4+. A reduction in the response of photosynthesis to high CO2 concentration was found in the enriched plants after 135 days of CO2 supply, with respect to the reference plants. The leaf photosynthesis rate measured at high CO2 concentration showed a closer relationship with the leaf N concentration than the non-structural carbohydrate concentration. The relative yield gain of the CO2-enriched plants progressively decreased after reaching a maximum value; this was probably associated with the photosynthetic acclimation process. This decrease was delayed by the use of NH4+ in the nutrient solution at low salinity. Knowledge of the crop phase when acclimation to high CO2 concentration occurs can be the basis for deciding when to impose an early cessation of CO2 application, as a strategy to improve the economic efficiency of CO2 supply in Mediterranean conditions.
Melatonin potentially acts directly on swine ovary by modulating granulosa cell function and angiogenesis
Authors: Basini Giuseppina , Bussolati Simona , Ciccimarra Roberta , Grasselli Francesca
Published: April 2017

Melatonin exerts well-known reproductive effects, mainly acting on hypothalamic gonadotrophin-releasing hormone release. More recent data suggest that melatonin acts directly at the ovarian level, even if, at present, these aspects have been only partly investigated. Swine follicular fluid contains melatonin and its concentration is significantly reduced during follicular growth. Therefore, the present study was undertaken to examine the effects of melatonin, used at physiological concentrations, on cultured swine granulosa cells collected from small (<3 mm) and large (>5 mm) follicles on the main parameters of granulosa cell function such as proliferation and steroidogenesis, namely oestradiol 17β and progesterone (P4) production. Moreover, the effects of melatonin on superoxide anion and nitric oxide (NO) generation by swine granulosa cells were also investigated. Finally, since angiogenesis is crucial for follicle growth, the effects of melatonin on new vessel growth were studied. Collected data indicate that melatonin interferes with cultured granulosa cell proliferation and steroidogenesis, specifically in terms of P4 production and NO output. In addition, the events of physiological follicular angiogenesis were stimulated by melatonin as evidenced by angiogenesis bioassay. Therefore, we suggest that physiological melatonin concentrations could potentially be involved in local modulation of swine ovarian follicle function.
Three-tier regulation of cell number plasticity by neurotrophins and Tolls in Drosophila
Authors: Foldi Istvan , Anthoney Niki , Harrison Neale , Gangloff Monique , Verstak Brett , Nallasivan Mohanakarthik Ponnadai , AlAhmed Samaher , Zhu Bangfu , Phizacklea Mark , Losada-Perez Maria , Moreira Marta , Gay Nicholas J. , Hidalgo Alicia
Published: April 2017

Cell number plasticity is coupled to circuitry in the nervous system, adjusting cell mass to functional requirements. In mammals, this is achieved by neurotrophin (NT) ligands, which promote cell survival via their Trk and p75NTR receptors and cell death via p75NTR and Sortilin. Drosophila NTs (DNTs) bind Toll receptors instead to promote neuronal survival, but whether they can also regulate cell death is unknown. In this study, we show that DNTs and Tolls can switch from promoting cell survival to death in the central nervous system (CNS) via a three-tier mechanism. First, DNT cleavage patterns result in alternative signaling outcomes. Second, different Tolls can preferentially promote cell survival or death. Third, distinct adaptors downstream of Tolls can drive either apoptosis or cell survival. Toll-6 promotes cell survival via MyD88–NF-κB and cell death via Wek-Sarm-JNK. The distribution of adaptors changes in space and time and may segregate to distinct neural circuits. This novel mechanism for CNS cell plasticity may operate in wider contexts.
Magnetic Transport Properties of Fe-Phthalocyanine Dimer with Carbon Nanotube Electrodes*
Authors: Lv Yu-Zhuo , Zhao Peng , Liu De-Sheng
Published: April 2017

Based on the non-equilibrium Green’s method and density functional theory, the magnetic transport of Fe-phthalocyanine dimers with two armchair single-walled carbon nanotube electrodes is investigated. The results show that the system can present high-performance spin filtering, magnetoresistance, and low-bias spin negative differential resistance effects by tuning the external magnetic field. These results show that the Fe-phthalocyanine dimer has the potential to design future molecular spintronic devices.
Introduction to the Nervous System
Authors: Mason Peggy
Published: April 2017

The primary regions and principal functions of the central nervous system are introduced through the story of Jean-Dominique Bauby who became locked in after suffering a brainstem stroke. Bauby blinked out his story of locked-in syndrome one letter at a time. The primary deficit of locked-in syndrome is in voluntary movement because pathways from the brain to motoneurons in the brainstem and spinal cord are interrupted. Perception is also disturbed as pathways responsible for transforming sensory stimuli into conscious awareness are interrupted as they ascend through the brainstem into the forebrain. Homeostasis, through which the brain keeps the body alive, is also adversely affected in locked-in syndrome because it depends on the brain, spinal cord and autonomic nervous system. Abstract functions such as memory, language, and emotion depend fully on the forebrain and are intact in locked-in syndrome, as clearly evidenced by Bauby’s eloquent words.
Neurotransmitter Release
Authors: Mason Peggy
Published: April 2017

The biochemical and physiological processes of neurotransmitter release from an active zone, a specialized region of synaptic membrane, are examined. Synaptic vesicles containing neurotransmitters are docked at the active zone and then primed for release by SNARE complexes that bring them into extreme proximity to the plasma membrane. Entry of calcium ions through voltage-gated calcium channels triggers synaptic vesicle fusion with the synaptic terminal membrane and the consequent diffusion of neurotransmitter into the synaptic cleft. Release results when the fusion pore bridging the synaptic vesicle and plasma membrane widens and neurotransmitter from the inside of the synaptic vesicle diffuses into the synaptic cleft. Membrane from the active zone membrane is endocytosed, and synaptic vesicle proteins are then reassembled into recycled synaptic vesicles, allowing for more rounds of neurotransmitter release.
Receiving the Synaptic Message
Authors: Mason Peggy
Published: April 2017

Ionotropic and metabotropic receptors differ in their speed of action, the variety of effects produced after ligand-binding, and in the number of types present in the nervous system. The participation of two ionotropic glutamate receptors in synaptic plasticity is thought to be the cellular basis of learning. The actions of acetylcholine on nicotinic acetylcholine receptors present at the neuromuscular junction are described. The pharmacological profile of the GABAA receptor, central to most neural functions, is introduced. The properties of metabotropic receptors that are coupled to G proteins, termed G protein-coupled receptors (GPCRs), are detailed. Three canonical second-messenger systems through which GPCRs act are briefly described. An introduction to clinical pharmacology focused on how drugs acting on muscarinic and adrenergic receptors produce peripheral and central psychotropic effects is provided. Finally, the role of connexins and gap junctions in myelination and hearing is introduced.
The Brain in a Physician’s Life
Authors: Mason Peggy
Published: April 2017

With the knowledge acquired from this book, the brain regions responsible for each of the symptoms suffered by Jean-Dominique Bauby can be identified. It is also possible to understand why thought, language, and memory were unaffected in Bauby. Bauby’s narrative is used to launch a consideration of the role of embodiment in affective experience. The experience of Clive Wearing who, after a bout of encephalitis, was left without the ability to make new declarative memories is introduced to illustrate the highly personal and individual nature of people’s reactions to disease or clinical impairment. The impact of disease does not stop with the patient but extends to the patient’s loved ones and caregivers. This is particularly true of patients with dementia or those in an altered state of consciousness. Finally the reader is encouraged to use their understanding of the nervous system to provide compassionate care for patients.
Depression in Cancer Care
Authors: Fujisawa Daisuke , Uchitomi Yosuke
Published: April 2017

This chapter deals with depression as a common syndrome affecting 15% to 30% of cancer patients. It impairs patients’ well-being in multiple aspects, as well as being associated with shorter survival. A wide range of physical, neurological, and mental conditions are listed as key differentials. Cancer-related fatigue is one of the common differentials. Treatment of depression should be based on severity of illness and on patients’ preferences. Good communication between medical providers and patients, and holistic care based on comprehensive needs’ assessment, which is usually done by using screening tools, are fundamental to the treatment and prevention of depression. Psychotherapy (psychological treatment) is indicated for all levels of depression severity. Pharmacotherapy (e.g., antidepressants) is an option for mild to moderate depression and is a requirement for severe depression. All treatments should be tailored based on patients’ preference, their physical condition, and access to care.
Endocrinology
Authors: Fox Grenville , Hoque Nicholas , Watts Timothy
Published: April 2017

This chapter provides background information on fetal and neonatal renal development, physiology, and function. Detailed information is given on management of common, antenatally diagnosed, renal anomalies (renal pelvis dilatation/hydronephrosis); post-natal diagnoses (hypospadius, hydrocele); posterior urethral valves; polycystic kidney disease; and rarer diagnoses. There is a guideline on the management of acute renal failure in the newborn, and information on dialysis.
Practical procedures
Authors: Fox Grenville , Hoque Nicholas , Watts Timothy
Published: April 2017

This chapter provides detailed step-by-step descriptions of all the necessary practical procedures in neonatal care. It includes helpful hints and possible complications. Procedures covered include endotracheal intubation, blood sampling, vascular access, CSF sampling, exchange and dilutional transfusion, nasogastric and nasojejunal tube insertion, intercostal chest drain insertion, transurethral catheterization, and suprapubic aspiration of urine.
Journeys to the centre of empathy
Authors: Lim Renee , Dunn Stewart
Published: April 2017

As a species, we appear to be programmed to respond to the situations and emotions of others. However, there is wide variation in the ways doctors and other health professionals experience and express this capacity, and there is a need for effective training to enhance these skills. Unfortunately, systematic reviews suggest that many of our current training programmes do not improve the quality of communication in cancer and palliative care so as to limit the burden of professional burnout, and to improve patients’ mental or physical health and satisfaction. Our attempts to produce a generation of empathic clinical communicators are inconsistent and reviews of patient complaints reveal an increasing discontent with professional communication. So what is missing? How do we develop, sustain, and teach empathic communication? The answer, according to Lim and Dunn, is to shift the focus from empathy to authenticity.
Learner-centred communication training
Authors: Kurtz Suzanne M. , Cooke Lara J.
Published: April 2017

This chapter provides an overview of core principles and key strategies for teaching communication skills using a learner-centred approach. Goals of communication teaching are summarized. Attitudes are important to be developed as a foundation to the masterful use of skills crossing several different communication issues. Communication should focus on mutual understanding. Effective strategies for teaching communication include experiential, learner-centred small-group work that uses observation, feedback, and repeated practice. The Calgary–Cambridge Model is used as an example of a skills-based approach to teaching communication. Following on, agenda-led outcome-based analysis (ALOBA) is presented as a model to for giving feedback and facilitating experiential, learner-centred, problem-based sessions. The authors close with commentary on modelling and the informal curriculum.
Talking about dying
Authors: Levin Tomer T. , Wiesenthal Alison
Published: April 2017

Talking intimately about a person’s death is a poignant conversation. The intensity of this is reduced by locating the discussion within a review of the goals of care and inviting consideration of natural forms of dying. A sequence of well-rehearsed strategies informed by patient-centredness and compassionate support serves the effective accomplishment of this task. Family support is an important related task, often calling for a family meeting to optimize outcomes. Withdrawal of life-prolonging therapies, handling requests for hastened death or futile care, and responding to misunderstanding and family conflict are common predicaments. The use of educational videos about end-of-life decision-making has improved understanding. Clinicians need to be able to comfortably discuss any potential mode of dying and assure the patient and their family of their continuing and committed care. Communication skills training with simulated patients helps optimize the ease with which clinicians can talk about death and dying.
Communication strategies and skills for optimum pain control
Authors: Lovell Melanie , Boyle Frances
Published: April 2017

Pain is a subjective experience and as such, communication regarding the experience is essential for the clinician to comprehensively assess and manage it. It is also the most feared complication of the most feared diagnosis. Effective communication creates an environment of trust, in which a patient is able to relate their experiences, in their entirety, including hopes and fears. This expression enables diagnosis of the aetiology, mechanism, and the myriad modulators of the pain by the clinician and is therapeutic in its own right as the patient makes meaning of the pain experience in the telling. The clinician is then able to explain the cause of the pain, the possible treatment strategies, and negotiate a management plan with the patient. There are many misconceptions associated with opioid analgesics and these can also be explored and corrected.
Communication and cancer-related infertility
Authors: Rosberger Zeev , Aubin Sylvie , Bultz Barry D. , Chan Peter
Published: April 2017

Cancer and cancer therapies (e.g. surgery, chemotherapy, radiation) may have a significant impact on fertility for both young men and women, resulting in distress regarding future parenting options. Fertility preservation (FP) is available through sperm cryopreservation and for women through oocyte or embryo cryopreservation. While normal fertility will occur after treatment for many patients in the survivorship phase, assisted reproductive therapy (ART) may be the only option for some. Because of this uncertainty, healthcare providers must discuss this challenge immediately after diagnosis to facilitate decision-making regarding FP, and at all points along the continuum with patients and their families to ensure that the right information and choices are clearly shared. Research has shown that timely communication can result in successful outcomes for patients wishing to have children after treatment completion.
Communication in non-surgical oncology
Authors: Yew Lai Cheng , Maher E. Jane
Published: April 2017

The non-surgical oncologist is involved in almost every patient’s cancer journey be it at diagnosis, during treatment, at follow-up, at recurrence, through survivorship, and even at the end of life. Communication issues will arise at all of these stages and will need to consider the complexities of the whole patient. There are key communication points when patients shift from different health states (e.g. diagnosis of cancer, completion of initial anti-cancer treatment, recurrence, each time treatment is no longer ‘working’ and disease is progressing, diagnosis of significant, irreversible, treatment-related effects, moving from living with incurable cancer, to dying with cancer). Effective communication is associated with better outcomes including adherence to advice, patient empowerment, quality of life, and survival.
Communication challenges with the elderly
Authors: Adelman Ronald D. , Greene Michele G. , Silva Milagros D.
Published: April 2017

The significant growth in the elderly population brings with it increased utilization of healthcare resources. Effective geriatric medical care requires effective communication and consideration of the challenges to communication in all stages of the continuum through health and disease. Given the often-negative perceptions of the elderly and the great heterogeneity of this population, it is imperative that health professionals assess each older patient as an individual. The impact of a cancer diagnosis and treatment, as well as a terminal illness, has a powerful effect on the lives of older people. Health professionals who care for the elderly with sensitivity to their personhood, their medical status, and psychosocial needs will have a profound influence on the quality of older patients’ lives.
The United Kingdom general practitioner and palliative care model
Authors: Noble Simon , Pease Nicola
Published: April 2017

Within the United Kingdom, the general practitioner (GP) will manage the care of the majority of patients with life-limiting and terminal disease. The need for effective communication is recognized in the general practice curriculum and college examinations. The opportunity to review and critique one’s own communication skills allows considerable opportunity for self-directed learning and reflection. The development of a reflective portfolio of learning has been developed as a user-friendly and cost-effective way for the general practitioner to commit to lifelong learning in the context of communicating with palliative care patients. This chapter describes several models that can help deliver an evidence-based template of training, supported by a simple toolkit with which to empower GPs to enhance their communication skills throughout their professional careers.
Understanding NCDs
Authors: Rayner Mike , Wickramasinghe Kremlin , Williams Julianne , McColl Karen , Mendis Shanthi
Published: April 2017

This chapter helps readers understand about non-communicable diseases (NCDs). It explains the term NCDs in the context of this book, based on the 2011 Political Declaration of the High-Level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs. This chapter provides information to compare and contrast NCD burden in countries in different regions and with different development levels. This chapter also describes the inequalities in the NCD burden and shows how the socioeconomic status is linked to NCD outcomes. It explains how the unequal distribution of NCD outcomes is the result of a combination of poor social policies and programmes, unfair economic arrangements, and bad politics. It discusses the importance of addressing social determinants to reduce the NCD burden.
The sociopolitical landscape of NCDs, Part I
Authors: Rayner Mike , Wickramasinghe Kremlin , Williams Julianne , McColl Karen , Mendis Shanthi
Published: April 2017

The sociopolitical landscape of non-communicable diseases (NCDs) is presented in two chapters in this book. This is the first chapter which introduces the topic. It shows how the recent demographic shifts have changed the global landscape, creating a fertile ground for the rise in the NCD burden. It describes how changes in disease patterns in low- and middle-income countries and factors such as the ageing population, urbanization, globalization, and cultural and political changes have contributed to the problem. Importantly, this chapter sets the scene to introduce NCDs as a development problem, which requires a global political response as demonstrated with the sustainable development goals (SDGs; SDGs and NCDs are discussed in later chapters). This chapter also considers the ways that competing voices and vested interests impact on NCD prevention activities.
The sociopolitical landscape of NCDs, Part II
Authors: Rayner Mike , Wickramasinghe Kremlin , Williams Julianne , McColl Karen , Mendis Shanthi
Published: April 2017

This chapter provides additional explanation about the sociopolitical landscape of non-communicable diseases (NCDs), and focuses on global responses to change the sociopolitical landscape following the 2011 Political Declaration of the High-Level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs. It helps readers to understand agreed global targets related to NCDs set out in the World Health Organization’s global action plan for the prevention and control of NCDs 2013–20 and by the United Nation’s sustainable development goals. It explores why the NCD agenda should be linked with the undernutrition programmes and maternal and child health programmes. The chapter also provides case studies to elaborate the double burden of malnutrition, i.e. coexistence of undernutrition and obesity in the same population.
Edward Seguin and the Irony of Physiological Education
Authors: Trent James W.
Published: April 2017

“The apostle to the idiots,” Edward Seguin (né Edouard Seguin) developed the first method, physiological education, for the education of idiots. Around 1850 he emigrated from France to the United States where his method influenced the first leaders of American institutions for idiots. He despised large institutions, but his method was technologically successful, but provided only a limited vision of life beyond the school.
The Remaking of Intellectual Disability
Authors: Trent James W.
Published: April 2017

The 1950s began two decades of the greatest growth in the populations of institutions for intellectually disabled children and adults. During the time, physicians routinely told families to “put away” their young disabled children. The chapter considers books and articles written in the popular press by some of these parents—Peal Buck, Dale Evans Rogers, Eunice Shriver, and others. Out of these writings, parents formed a national association—the Association for Retarded Children. Despite greater public services for mentally retarded people, the public institutions continued to grow in size and numbers. By the late 1960s reports emerged about the terrible conditions in these facilities. Beginning in the 1970s, a new shift would occur in services for mentally retarded citizens—deinstitutionalization and community based programs. Using law suits, federal legislation, and the new ideology of “normalization,” advocates began a process that continues. Intellectually disabled were becoming, once again, members of communities. This direction has resulted a mixture of successes and failures.
The Current Status of Outpatient Approaches to Parent–Child Contact Problems
Authors: Polak Shely , Moran John A.
Published: April 2017

This chapter describes the status of outpatient clinical interventions for unjustified parent–child contact problems using an ecological systems approach. It starts with a review of the multiple factors found to be associated with the development of parent–child contact problems, which include parenting styles and skills, parental alienating behaviors, cognitive distortions, history of the parent–child relationship, parental psychopathology, interparental conflict, and court involvement. Next, the chapter considers the specific goals of reunification treatment for the alienated child, the rejected parent, and the favored parent. Finally, the chapter critically reviews the state of outcome evidence for a range of outpatient and intensive reintegration interventions. Key clinical and theoretical components of each intervention are highlighted, noting both components that the interventions share and those that distinguish them.
Overview of the Overcoming Barriers Approach
Authors: Ward Peggie , Deutsch Robin M. , Sullivan Matthew J.
Published: April 2017

This chapter summarizes an intervention model for parent–child contact problems known as Overcoming Barriers. After separation or divorce, children may resist contact with a parent for reasons including intimate-partner violence, child abuse, impaired parenting, and attempts by one parent to exclude the other from the child’s lives. Research is fairly clear in showing that children are harmed when caught in the middle of unremitting parental conflict. Overcoming Barriers is a novel family-based intervention implemented over several days in a neutral setting with highly trained clinicians and recreational counselors. This chapter explicates the key elements of this approach, including involvement of the entire family system, strategies for addressing each family member’s polarized stance, and interventions such as psychoeducational groups, coparent work, family interventions, and recreational activities. The authors emphasize the approach’s evolving nature. The importance of bridging families with effective aftercare teams following intensive family-based treatment is also discussed.
“Common Ground”
Authors: Deutsch Robin M. , Judge Abigail M. , Fidler Barbara J.
Published: April 2017

This chapter describes the characteristics of children who unreasonably resist or refuse a relationship with a parent and the components of psychoeducation for such children at Overcoming Barriers camp. Children who resist contact are often the target of ongoing litigation and conflict between their parents as well as the focus of treatment. The Overcoming Barriers approach to this problem is to intervene with the family system and provide specific targeted psychoeducation to each component, including each parent and child. Education and interventions that shift perceptions, reframe experiences, and build coping skills form the basis of children’s psychoeducation at Overcoming Barriers camp. This chapter also discusses the methods for overlaying the psychoeducational, recreational, and family intervention components of the camp.
Coparenting, Parenting, and Child-Focused Family Interventions
Authors: Sullivan Matthew J. , Deutsch Robin M. , Ward Peggie
Published: April 2017

This chapter describes the clinical work with individual families during the Overcoming Barriers camp program. Though the practical goal is to restore parent-child contact and relationships in a gradual progressive between rejected parents and their children, the focus of these interventions is on the individual and relationship issues within the family that entrench the resistance or refusal dynamics. The chapter addresses the goals, objectives, and specific techniques that make up the clinical work with the coparents, the favored parent and child, the rejected parent and child, and the whole family. Also described is the progression of this work from intake through the final session. The process culminates with the documentation of any agreements that have been reached and with the parents’ committing to a specific aftercare plan.
Conclusion
Authors: Johnston Janet R.
Published: April 2017

This chapter provides a brief historical context about how political controversies have limited professional writing about parent–child contact problems and describes the ways in which this volume provides a more nuanced and nonpartisan perspective on family-based interventions for these complex problems. The chapter first highlights the conceptual formulation of parent–child contact problems that underlies the treatment approach described throughout the book. It next suggests essential components of the Overcoming Barriers intervention model. This discussion is followed by comments on limitations of the empirical evidence available to inform policy and practice. Conundrums in clinical practice that involve risks of harming rather than helping families are then considered. Finally, the chapter explores how to practice ethically while awaiting more definitive direction from accumulated research on these matters.
Capgras and Other Misidentification Syndromes
Authors: Sinkman Arthur
Published: April 2017

Capgras is the delusional belief that people in the sufferer’s life are not who they seem to be, but are identical duplicates who have been substituted for the originals. The copy looks just like the original, although the patient may sometimes notice minor and imaginary differences between the original and the copy, differences that the patient cites as confirmatory evidence that the person is indeed an impostor. Although Capgras was initially thought to occur only during psychotic episodes, it has now been recognized to occur in patients suffering from certain brain conditions as well. Capgras is one of several misidentification syndromes. Other misidentification syndromes, such as the Fregoli delusion and delusion of intermetamorphosis, also are discussed.
Cotard’s Syndrome
Authors: Debruyne Hans
Published: April 2017

Cotard’s syndrome involves nihilistic delusions about the patient’s own body, such as believing that he or she is a walking corpse. The syndrome is named for Jules Cotard (1840–1889), a French neurologist who first described this condition in 1880. He formulated the syndrome as a new type of depression characterized by symptoms such as anxious melancholia, ideas of damnation or rejection, insensitivity to pain, delusions of nonexistence concerning one’s own body, and delusions of immortality. Along with discussing the typical progression of symptoms and associated features, this chapter situates Cotard’s syndrome within the context of several other disorders and well-known neuropsychological deficits.
Frotteurism
Authors: McAnulty Richard
Published: April 2017

Frotteurism, also known as forcible touching, is a paraphilia characterized by recurrent and persistent sexual arousal from touching or rubbing against a nonconsenting person, usually a stranger. When reports of such aberrant incidents were first published at the turn of the 19th century, these crimes were viewed as deviant and rare. Today, however, unwanted sexual “groping” or “grinding,” as it is known in the popular press, is rather commonly reported. This unwanted contact often occurs in congested areas and on crowded public transportation systems.The chapter discusses potential etiologies for frotteurism, along with potentially aggravating factors. Despite the anonymous nature of their crimes, frotteurs, when compared with other sex offenders, have some of the highest number of victims.
Autoerotic Asphyxia and Asphyxiophilia
Authors: Hucker Stephen
Published: April 2017

Deliberate self-hanging for sexual arousal has been variously termed sexual asphyxia, autoerotic asphyxia, asphyxiophilia, eroticized repetitive hangings, hypoxyphilia, and Kotzwarraism. Regardless of the term used and the safeguards that are often put in place, this widely practiced sexual behavior can be dangerous, and even deadly. In fact, given the secretive nature of this paraphilia, much of the research base derives from the study of fatalities. Our knowledge of what motivates those who asphyxiate themselves to achieve sexual arousal has until recently been dependent upon studying these death scenes, supplemented by the rare descriptions of those who have survived and described the experience. Specific challenges and impediments to treating individuals with this disorder are described.