bluuebunny/crossref_metadata_2025 huggingface dataset:
Sedation for refractory symptoms
Authors: Knight Patti , Espinosa Laura A. , Freeman Bonnie
Published: November 2017

This chapter explores the use of palliative sedation in the hospital setting. It presents case studies involving palliative sedation, discusses several definitions of palliative sedation, frequency of palliative sedation, reasons for palliative sedation, medications used, guidelines for nursing care, time-to-death issues, ethical considerations, informed consent, and the role of the nurse-caregiver.
Withdrawal of life-sustaining therapies
Authors: Campbell Margaret L. , Gorman Linda M.
Published: November 2017

Withdrawal of mechanical ventilation (MV), discontinuation of dialysis, and deactivation of cardiac devices are procedures that occur with relative frequency. The benefits of these therapies, when initiated, are to replace failing organs, extend life, and improve quality of life by relieving symptom distress associated with organ failure. When the burdens exceed the benefits, or when the patient is near death or unresponsive, decisions may be made to cease these therapies. In some cases, such as implantable cardioverter defibrillator (ICD) deactivation, no distress is anticipated. In others, such as discontinuing dialysis or withdrawing MV, measures to palliate anticipated distress must be applied. A peaceful death after cessation of life-prolonging therapies can be provided.
Supporting families in palliative care
Authors: Steele Rose , Davies Betty
Published: November 2017

Family-centered care is a basic tenet of palliative care philosophy, which recognizes that terminally ill patients exist within the family system. The patient’s illness affects the whole family, and, in turn, the family’s responses affect the patient. Supporting families in palliative care means that nurses must plan their care with an understanding not only of the individual patient’s needs but also of the family system within which the patient functions. Families with a member who requires palliative care are in a “transition of fading away,” characterized by seven dimensions that help nurses to understand families’ experiences and to support them. Level of family functioning also plays a role in family experience and serves to guide nursing interventions for families with varying levels of functioning.
Spiritual care intervention
Authors: Baird Rev. Pamela
Published: November 2017

Recognizing and addressing patients’ spiritual needs is fundamental to palliative care. Spiritual care addresses issues of religion, existential suffering and humanity. Nurses provide spiritual care through deep listening, presence, bearing witness, and compassion.
Meaning in illness
Authors: Borneman Tami , Brown-Saltzman Katherine
Published: November 2017

Finding meaning in illness is an important issue when facing the end of life. The process of finding meaning in illness involves a journey through sometimes very difficult transitions. A terminal illness can greatly impact the patient-caregiver relationship. It is essential for nurses to experience their own journey regarding the dying process and bring with them a willingness to be transformed by it.
Poor, homeless, and underserved populations
Authors: Hughes Anne
Published: November 2017

The purpose of this chapter is to consider characteristics of the poor as an underserved population that place them at risk when seriously ill and when palliative care is indicated. In particular, this chapter looks at a subset of the poor who are homeless. This chapter focuses on persons whose “membership” in this group is more long term and not the result of an identifiable global economic crisis; similarly, this chapter does not address the experiences of persons living in extreme poverty in resource-limited countries around the globe.
Patients with acquired immunodeficiency syndrome
Authors: Kirton Carl A. , Witt Sherman Deborah
Published: November 2017

This chapter provides an overview and update of the comprehensive care related to HIV/AIDS and addresses the palliative care needs of individuals and families living with and dying from this illness. With this information, nurses and other health-care professionals will gain the knowledge to provide effective and compassionate care, recognizing the need for both curative and aggressive care as well as supportive and palliative therapies to maximize the quality of life of patients and their family caregivers.
Long-term care
Authors: Carpenter Joan G. , Ersek Mary
Published: November 2017

Over 25% of older adults and almost 70% of persons with advanced dementia live out their final days in nursing homes. While the number of hospice patients living in nursing homes has increased dramatically over the past decade, other comprehensive palliative care models have not been widely adopted or tested in nursing homes. Palliative care nurses play critical roles in collaborating with nursing home staff to enhance end-of-life care and outcomes for older persons.
Home care and hospice home care
Authors: Milone-Nuzzo Paula , Ercolano Elizabeth , McCorkle Ruth
Published: November 2017

This chapter discusses home care as an environment that provides unique opportunities to promote palliative care for patients and families throughout their illnesses. The chapter gives background information on what home care is, its historical roots, the types of providers available to give services, the regulatory policies controlling its use, examples of models of palliative home care programs, and recommendations to professionals for facilitating the use of home care in palliative care, concluding with a case study illustrating key elements of palliative care provision in the home.
Palliative care nursing in the outpatient setting
Authors: Davies Pamela Stitzlein
Published: November 2017

Nurses and advanced practice nurses (APNs), with their extensive psychosocial training, and in collaboration with a multidisciplinary team, play an important role in helping ambulatory clinic patients and caregivers navigate concerns that arise as the end of life approaches. This chapter addresses the provision of palliative care in the adult outpatient setting, with a focus on the role of nurses and APNs.
Rehabilitation and palliative care
Authors: Wilson Donna J. , Michael Kathleen
Published: November 2017

This chapter applies the concept of physical activity to palliative care across settings. A physical activity program for each patient should be presented at the time of diagnosis and extend to end-of-life care. Even when it is not possible to cure or reverse a disease process, or to restore a previous level of functioning and independence, a rehabilitative approach to nursing care adds quality to the experience of living until life’s completion. The language of rehabilitation nursing is a language shared with those who practice palliative care. Feelings of self-confidence, independence, hope, human dignity, and autonomy are all influenced by an individually tailored program of rehabilitation.
The emergency department
Authors: Bowman Mary
Published: November 2017

Palliative care can be provided to all patients who present to the emergency department (ED). The growing number of patients presenting to the ED at the end of life means an increase in the proportion of patients for whom the default resuscitation approach is less applicable. Rapid identification of treatment goals with the terminally ill patient or surrogate prevents unwanted resuscitation and application of burdensome life-prolonging therapies. Unrestricted access of the family to the dying patient can be successfully implemented in the ED.
End-of-life decision-making in pediatric oncology
Authors: Hinds Pamela S. , Oakes Linda L. , Furman Wayne L.
Published: November 2017

The purposes of this chapter are to offer a review of the current literature (both clinical and research-based) on end-of-life decision-making in pediatrics, with a special emphasis on pediatric oncology, and to offer guidelines for the use of health-care professionals in assisting children, adolescents, their parents, and other healthcare professionals in making such decisions.
Nursing research
Authors: Ferrell Betty R. , Grant Marcia , Sun Virginia
Published: November 2017

The goal of nursing research is to improve care for patients and caregivers. Palliative nursing research includes many sensitive topics such as suffering, quality of life, and life meaning. Nurse researchers face many obstacles in conducting research, such as obtaining informed consent, dealing with high subject attrition, and openly discussing end-of-life issues with patients and families. Palliative nursing research also addresses the experiences of nurses and the need for self-care. Palliative nursing research should use an interdisciplinary model that includes all supportive care disciplines.
Enhancing team effectiveness
Authors: Otis-Green Shirley , Fineberg Iris Cohen
Published: November 2017

The National Consensus Project (NCP) Guidelines for Quality Palliative Care, the National Quality Forum (NQF), and multiple Institute of Medicine reports all recommend a team approach as the optimal way to provide patient-and-family-focused care, yet our current socialization of professionals remains discipline-specific. This chapter will provide readers an opportunity to consider various strategies useful in increasing team effectiveness. The use of family meetings is highlighted as an important palliative care team intervention.
Palliative care in Africa
Authors: Mwangi-Powell Faith N. , Downing Julia , Powell Richard A. , Kiyange Fatia , Ddungu Henry
Published: November 2017

The agenda for palliative care in Africa the coming years is significant, encompassing the need to overcome government indifference and effect high-level policy change, training for its primarily volunteer cadre as well as orthodox preservice and inservice health workers (to include recruitment, training, and retention issues), improving societal and medical understanding and use of opioids for effective pain management, building effective linkages between relevant stakeholders (e.g. academics, oncologists, pediatricians, those working with the aged, etc.), and developing and utilizing a methodologically rigorous research base to inform service development, policy development, and, ultimately, maximize the quality of patients‘ lives.
Palliative care in Japan
Authors: Takenouchi Sayaka , Tamura Keiko
Published: November 2017

In Japan, the palliative care approach to patients and families differs from the approach provided by other departments, especially the consideration of patients‘ families and cultural backgrounds, which plays a significant role in planning their care. Even if palliative care at home becomes well developed, there will always be patients who will choose to spend the last days of their lives in the general hospitals. It is therefore essential to offer chances for any medical professionals who provide care to patients and families facing life-threatening illness to be educated so that they can offer high quality palliative care for those in need.
Palliative care in Eastern Europe
Authors: Mitrea Nicoleta , Mosoiu Daniela
Published: November 2017

This chapter on palliative care in Eastern Europe is divided into several sections, including a general perspective, in which demographic data, cultural aspects, common characteristics of countries in Eastern Europe are presented, and a review of individual countries in the region with examples of success stories presented by leaders from those countries.
Palliative care in the Philippines
Authors: Nambayan Ayda G. , Lu Henry U.
Published: November 2017

Culture, traditions, beliefs, and religion play an important part in every Filipino‘s life and death. In addition, the family is central and carries a significant importance especially in healthcare decisions. Families are generally very involved in caring for their loved ones who are dying and equally expect healthcare providers to do the same. These are the hospice/palliative care activists who, against all odds, continuously try to improve their patients‘ quality of life and provide them with elements of dignity.
The role of nursing in caring for patients undergoing palliative surgery for advanced disease
Authors: Williams Anna Cathy , Ferrell Betty R. , Juarez Gloria , Borneman Tami
Published: November 2017

Although newer in the traditional setting, palliative care and surgeries are emerging at a very rapid pace. As the path of the surgeon, the patient‘s disease trajectory, and the path of palliative intervention overlap, it is possible for professional and personal conflicts to arise, with negotiations needing to take place. Surgeons and palliative care colleagues, along with other health team members and patients, will need to collaborate on a very intimate level, and often.
Symptom management in pediatric palliative care
Authors: Hellsten Melody Brown , Berg Stacey
Published: November 2017

This chapter focuses on issues related to the assessment and management of common non-pain symptoms in children and adolescents with complex medical conditions in the advanced and terminal stages. Suffering from uncontrolled symptoms can be prevented by knowledge of the child‘s underlying disease process, thorough assessment of the child and family for sources of suffering, advocacy for child and family needs, and the use of an interdisciplinary approach to management that includes appropriate pharmacological and nonpharmacological interventions.
Accounts of Self: Exploring Relationality Through Literature
Authors: Spiegel Maura , Spencer Danielle
Published: November 2017

Literature offers the opportunity to study relationality in many different forms and contexts. This chapter discusses relationality in creative works—Colm Toíbín’s “One Minus One”, Dostoevsky’s Notes from Underground, Alison Bechdel’s Fun Home, and Kazuo Ishiguro’s Never Let Me Go—in combination with selected criticism and theory, exemplifying one approach to the narrative medicine classroom. In these texts characters offer an account of self in contrasting ways—from the vexed, distrustful address of Dostoevsky’s Underground Man to the richly inviting tapestry of Bechdel’s graphic memoir—provoking different readerly experiences. Critical perspectives such as Bakhtin’s analysis of the dialogic nature of the Underground Man’s apparent soliloquy, Rita Felski’s conception of readerly recognition, Michael White’s description of Narrative Therapy, and Judith Butler’s discussion of the ethics of giving an account of self—all enrich our experience of these works and deepen our understanding of relationality, particularly as it relates to clinical practice.
This Is What We Do, and These Things Happen: Literature, Experience, Emotion, and Relationality in the Classroom
Authors: Spiegel Maura , Spencer Danielle
Published: November 2017

The role of emotion in clinical education and practice is discussed, drawing upon thinkers such as Derald Wing Sue, John Dewey, Joanna Shapiro, and others. Focusing on Alice Munro’s short story “The Floating Bridge,” different themes of classroom discussion are described, as well as an in-class writing exercise including examples of participant responses. Several questions and themes are explored: How does exploration of judgment in readers’ response to a literary text offer insight into the role of judgment in a clinical context? What is the effect of hearing the various emotional responses of other readers in enhancing an appreciation of diverse perspectives? How might we understand this classroom/workshop in light of John Dewey’s description of an aesthetic “experience” of particular clarity and intensity? And finally, what are the consequences of such pedagogical approaches integrating attentiveness to emotion for healthcare training and practice?
Dualism and Its Discontents I: Philosophy, Literature, and Medicine
Authors: Irvine Craig , Spencer Danielle
Published: November 2017

Part I of II: Beginning with several literary and nonfiction patient accounts elaborating alienating healthcare experiences, this chapter offers a brief overview of 20th-century attitudes and movements informing medical pedagogy and practice in the U.S., citing such figures as Abraham Flexner, Francis Peabody, Eric Cassell and others. Seeking an understanding of the dissociative underpinnings of medical practice, the chapter turns to the Western philosophical lineage, with particular emphasis on mind–body dualism. Beginning with Plato, key passages in The Republic and The Symposium are examined, exploring Plato’s influential conception of the hierarchy between the physical and intelligible realms. Descartes’ Enlightenment philosophy and his approach to knowledge—with thought abstracted from the physical realm—is discussed in detail, alongside the connections between such thought and medical practice. The chapter closes with a question, to be addressed in Part II: Might philosophy offer more salutary approaches to understanding healthcare?
Dualism and Its Discontents II: Philosophical Tinctures
Authors: Irvine Craig , Spencer Danielle
Published: November 2017

Part II of II: This chapter explores philosophical responses to Cartesian dualism—notably Maurice Merleau-Ponty’s elaboration of phenomenology—and its relevance to medicine. With close reading of Merleau-Ponty’s Phenomenology of Perception, phenomenology’s attentiveness to lived experience and to embodiment is described. Next, discussion of the work of philosophers, clinicians, ethicists and patients—including Havi Carel, S. Kay Toombs, Richard Baron, Edmund Pellegrino, Richard Zaner, and Fredrik Svenaeus—demonstrates the influence of phenomenological perspectives in healthcare, addressing the dissociation and alienation often experienced by clinicians and patients alike. Counter-examples to the philosophical narrative presented here are then offered, demonstrating the rich complexity of philosophical enquiry. The chapter closes with a brief discussion of the poem “Soul” by David Ferry, which offers a means of approaching the age-old issue of the relationship between body, mind, and spirit. Thus the authors argue that philosophical understanding—particularly in combination with literature—offers particular insight into the challenges and possibilities of healthcare today.
Close Reading: The Signature Method of Narrative Medicine
Authors: Charon Rita
Published: November 2017

Teaching healthcare professionals how to be close readers assures that they can listen with attention and empathy to what their patients tell them. The close reader pays attention to such narrative features as temporality, narrative situation, voice, metaphor, and mood. This chapter describes the origins of close reading in the 1920s and its subsequent contentious development within literary studies. It describes the salience of the skills learned from close reading for the practice of narrative medicine. The chapter examines such consequences of close reading as relationship-building among learners and individual awareness of the interior processes of the reader. Close reading helps narrative medicine to achieve its goals of justice in healthcare, participatory practice, egalitarian learning, and deep relationships in practice. With the benefit of the capacities learned in close reading, clinicians and their patients can face the unknown, tolerating the ambiguity that always surrounds illness.
From Fire Escapes to Qualitative Data: Pedagogical Urging, Embodied Research, and Narrative Medicine’s Ear of the Heart
Authors: Colón Edgar Rivera
Published: November 2017

The author begins with a lyrical and evocative description of a cilantro-green fire escape from which he observed the neighborhood of his childhood, explaining that the work of the ethnographer is rooted in experiences of observation and experience. Drawing upon these tools of social interaction, training in qualitative research methods can help students to discover and reframe their already practiced skills in the social observation and interpretation with which they, and all of us, traverse the world. The embodied and reflexive nature of this practice is emphasized, with attention to the observer’s own social positionality and identity. Citing William Stringfellow’s proposal that “listening…is a primitive act of love,” the author proposes that qualitative research and narrative medicine both offer frameworks for such listening, with implications of political and social liberation.
Clinical Contributions of Narrative Medicine
Authors: Charon Rita
Published: November 2017

This chapter summarizes the clinical practices that have been developed worldwide by those trained in narrative medicine. It describes innovations in interviewing techniques that improve the development of narratively fortified clinical relationships, including examples from clinical genetics and fetal cardiology. The chapter describes the increasing call for disciplined training in creative and reflective writing as a means to enrich and strengthen the clinical skills of individual practitioners. Interprofessional education and practice is a growing arena for the application of narrative medicine methods, as their collaborative nature helps to overcome divisive conflicts between specialized professions that can hamper effectiveness of care and threaten patient safety. Discoveries in clinical witnessing and clinical writing are presented, with descriptions of narrative medicine practices of including patients as readers and writers of the electronic medical record.
Errors and Violations
Authors: Merry Alan F.
Published: November 2017

Errors and violations are major contributors to iatrogenic harm in patients. Anesthesia is a complex process within the complex system that is healthcare. In complex systems, decisions need to be reviewed frequently and iteratively with reset baseline data. Errors are unintentional and cannot be avoided simply by trying harder or deterred by the threat of punishment; violations, on the other hand, are deliberate deviations from safe practice. Types of error are statistically predictable, and can be understood in relation to the cognitive processes involved in their generation: either System I thinking, or System II thinking. Safety depends on doing the right things correctly the first time, using a systems-based approach (drawing lessons from aviation and other high-reliability industries) within a just culture.
Deliberate Practice and the Acquisition of Expertise
Authors: Baker Keith
Published: November 2017

The American medical system has room for improvement in the area of quality. Many systems-level approaches have been tried, but most have not yielded significant improvements in healthcare quality. This chapter focuses on strategies that mediate individual-level expert performance in a variety of domains. A central strategy underlying expert performance is deliberate practice. Deliberate practice is supported by having a learning orientation and “grit,” which is defined as long-term perseverance and passion for a goal, even if the goal is arduous. A general approach to performance improvement for individuals is also discussed. A reinvestment model for performance improvement proposes that individuals invest their time, effort, and cognitive resources, such as working memory capacity, in the design and implementation of deliberate practice for performance improvement.
Creating a Culture of Safety
Authors: Chidester Thomas R.
Published: November 2017

Safety culture focuses on who is responsible in what ways for patient safety, ranging from individuals and teams performing critical duties on the front lines to the context within which work takes place, and high-level organizational priorities. Though it is a recent concept, it represents growth in the understanding of accident causation, and offers additional and potentially more broadly effective preventive actions. Key concepts include organizational commitment, operational interactions, formal and informal safety indicators, and safety behaviors and outcomes. Measurement can be accomplished through benchmarked surveys, case analysis, field observation, and examination of procedures, manuals, newsletters, brochures, and performance evaluation criteria for their safety focus. Intervening to improve safety culture requires assessing an organization’s current state, communicating safety and minimizing patient risk as a core value in a methodical and sustained manner, deploying and monitoring standardized procedures by workgroup, establishing feedback systems, and reporting progress in safety alongside economic progress.
Adverse Event Prevention and Management
Authors: Guffey Patrick J. , Culwick Martin
Published: November 2017

Adverse events are an unfortunate reality of caring for patients in our current healthcare system. Preventing and mitigating these events are an important part of quality improvement. First, an understanding of what events occur and how often they are occurring is critical to planning improvements. Incident reporting systems are one way of gathering this information. Then, events should be categorized and analyzed for improvement. The failure mode and effects analysis (FMEA) and bow-tie diagram are two tools for this purpose. Once an event has occurred, consideration should be given to the caregivers as well as the patient when managing and resolving adverse events. Prevention requires strong analysis of events and recognition of both latent (system) and human causes. Interventions have different degrees of effectiveness, ranging from highly effective forcing functions, to marginally effective encouraging statements. There are four steps to event management: mitigation, immediate management, refractory management, and follow-up.
Quality in Medical Education
Authors: Kurup Viji
Published: November 2017

Staying current with latest developments in the field of patient care is now universally considered to be a standard of care. The same standards have not been adopted in medical education, however, and many educational techniques used to train physicians are now outdated. This chapter reviews the evidence in medical education with respect to quality of three critical elements: the teacher, the process, and the learner. Students and faculty have different perceptions regarding the characteristics of effective teachers. Modern teaching methods no longer stress lecture-based sessions, but include techniques such as interactive learning and blended learning. Simulation is also an effective tool for learning technical skills, and for crisis and team training. When technological tools are used, they should be designed to enhance the learning experience. A number of studies show that learner engagement is the key factor in the learning process.
Creating a Quality Management Program
Authors: Dutton Richard P.
Published: November 2017

This chapter provides an overview of how to create a quality improvement (QI) program. It is intended as a high-level reference guide for a department, division or practice quality improvement officer. It covers the topics of recruiting allies; finding, aggregating and creating data; basic analytic techniques; mechanisms for feedback of QI data to healthcare providers; implementing cyclical QI activities; managing individual adverse events and complications; and benchmarking to outside data sources. A template quality capture form for an anesthesia practice is included, and examples of reporting graphics and strategies are included. Woven throughout the chapter are specific thoughts on how the QI officer can create a “culture of safety” within the group, such that practitioners feel safe in reporting adverse outcomes and expect to see continuous improvement efforts within their systems.
Safety in Remote Locations
Authors: Grodofsky Samuel , Lane-Fall Meghan , Weiss Mark S.
Published: November 2017

Non-operating room anesthesia (NORA) is increasingly prevalent and presents unique challenges to the anesthesiologist. NORA includes procedures performed by gastroenterologists, interventional cardiologists, interventional pulmonologists, radiologists, and surgeons. Members of the anesthesia team must maintain a level of vigilance in the specialized areas where these procedures are performed that is equal to that in a traditional operating room while making accommodations for specialized equipment and rapid turnover. Anesthetic techniques must be chosen so as not to interfere with the proceduralist’s ability to diagnose and treat the underlying problem. In order to ensure optimal safety standards in NORA settings, anesthesiologists should maintain open channels of communication with procedural staff and should become involved in the design and outfitting of NORA locations.
Disruptive Behavior
Authors: Keitz Sheri A. , Birnbach David J.
Published: November 2017

Misbehavior and disruption in the operating room are an all too common problem. Disruptive behaviors have been observed and experienced by all members of the operating room team, and these behaviors need to be addressed in a timely and appropriate fashion. Sometimes, hospital administrators and hospital leadership know about these problems but do not act, and thus they may be complicit in allowing these problems to continue. This chapter reviews the potential reasons for disruptive behavior among nurses and physicians and provides explanations for organizational reluctance to deal with disruptive behaviors, as well as recommendations to address these issues effectively.
The intervertebral disc and the spine
Authors: Roberts Sally , Trivedi Jai , Duance Victor
Published: November 2017

Back problems are common in the general population, affecting approximately 80% of individuals at some time in their lives. It used to be thought that loading, activity levels, or certain types of activities (e.g. driving tractors or heavy goods vehicles) greatly influenced the incidence of back pain (Pope and Hansson 1992). However, the over-riding ‘risk factor’ for back pain in the general population is now known to be genetic (...
Bone
Authors: Saxon Leanne
Published: November 2017

Sports participation has numerous positive health benefits; however, it is also associated with an increased risk of injury. While bone injuries in sport are less frequent than ligament tears, contusions, or surface wounds, they can be debilitating for an athlete because of the time needed for recovery. In this chapter I describe the incidence and cost of bone injuries in sport, fundamentals of bone biology and repair, risk factors associated with fractures, stress fractures, and periostitis, and review both current and possible future recommendations for the treatment of bone-related injuries....
Principles of biomechanics and their use in the analysis of injuries and technique
Authors: Dixon Sharon
Published: November 2017

Biomechanics, defined literally, is the mechanics of living systems. Human biomechanics involves the study of mechanical aspects of human movement. It is the science studying the internal and external forces experienced by the human and the effects of such forces. Nigg and Herzog (2007) highlight that forces may result in movement of body segments, deformation of biological materials, or biological changes in the tissue(s) on which they act. Thus biomechanics can involve the study of human movement and factors that affect this movement, deformation of biological structures and factors that influence this, and the biological effects of locally acting forces on living tissue (e.g. effects on growth development or injuries)....
Assessment and management
Authors: Hutson Mike
Published: November 2017

Individuals undertaking exercise include those engaged in aerobic activities as part of a healthy lifestyle, those engaged in an active fitness or rehabilitation programme relevant to acute or chronic conditions such as cardiovascular disease, respiratory problems, and musculoskeletal disorders, and the committed competitive athlete with high performance targets. Accordingly, those injured as a consequence of exercise or sport attend medical practitioners in diverse circumstances. Urgency of assessment of the full impact of injury clearly varies across the spectrum from the life-threatening situation on the field of play (or other sports/recreational exercise location, for instance poolside or roadside) to one in which a chronic condition can be evaluated in the relative comfort of the clinician’s consulting room. Irrespective of the circumstances, the primary requirement is the establishment of an accurate diagnosis. The process of assessment is aided when relevant by an appropriate index of suspicion with respect to those injuries that are not often seen outside sporting and recreational activity (e.g. throwers’ elbow and shin splints). Diagnosis of tissue injury is followed by a full assessment of its impact on the function of the surrounding structures, and subsequently assessment of impairment of sporting capacity in general. Evaluation is made of the aetiological factors associated with the development of injury, the behavioural responses, including motivation and health prioritization, and the individual’s standard of performance (actual and potential). Clinical assessment (and reassessment) is a constant theme throughout the text....
Neurophysiological investigation of injuries sustained in sport
Authors: Mullins Gerard , Ray Julian
Published: November 2017

The continued growth of recreational and competitive sports has been accompanied by an increased incidence of nerve injuries that have been traditionally associated with other types of occupational injury (Krivickas and Wilbourn 1998). Peripheral nerves are susceptible to injury in the athlete because of excessive physiological demands (...
Therapeutic modalities
Authors: Speed Cathy
Published: November 2017

Therapeutic modalities can be defined as thermal, mechanical, electrical, or electromagnetic energies used for the treatment of medical complaints. A range of such modalities is used in the treatment of sports injuries, particularly soft tissue injuries (Table 2.4.1). These include thermal agents, ultrasound, and electrical agents. The basis for the use of specific modalities and the existing evidence relating to their clinical effects are outlined in this chapter....
Surgical issues in sports medicine
Authors: Finlayson Craig , Hutchinson Mark
Published: November 2017

Surgical management of the athlete refers not just to the performance of a surgical procedure, but rather to the global perioperative period as a whole. The approach to the surgical patient requires a multidisciplinary team with interaction between the injured athlete, the surgeon, trainers, therapists, coaches, and other physicians in order to achieve an optimal outcome for the patient (...
Ocular sports injuries
Authors: Galloway Nick
Published: November 2017

Injuries to the eyes in sport are sufficiently common to have a significant economic impact in terms of loss of working time and cost of treatment, and they are largely preventable. Sometimes the serious nature of an eye injury is not apparent at first glance and it is important that, if damage to the eye is suspected, a proper microscopic examination is arranged without delay. One must not overlook the devastating effect such an injury can have on an individual. Despite the remarkable advances in surgical techniques the results of the treatment of severe injuries are not always satisfactory and prevention is the best approach....
Head injuries
Authors: Firth John
Published: November 2017

With the exception of pugilism, head injury is not an intended objective in sport. ‘Man is his brain’, so deliberate brain injury cannot reasonably be described as ‘sport’. Head injury in sport is unnecessary. Avoidable head injury is unacceptable. Therefore a primary objective in sport has to be to eliminate or minimize the opportunities for head injury. This does not have to detract from the excitement and enjoyment of sport. Both can be enhanced (...
Injuries to the shoulder
Authors: Speed Cathy , Wallace Andrew
Published: November 2017

The vast majority of shoulder complaints are due to soft tissue lesions, and rotator cuff disorders represent the largest diagnostic category of these. Many shoulder complaints are multifactorial in origin, and articular and extra-articular disorders can coexist. Instability also plays a major role; the shoulder is the most mobile joint of the body, achieving this mobility at the expense of its stability. Loss of the fine balance between optimal mobility of the joint and its stability is a common, albeit frequently subtle, feature of shoulder complaints....
Ankle injuries
Authors: Ribbans Bill , Speed Cathy
Published: November 2017

The ankle is the most common region of the body to be injured in sport. However, injuries sustained at this site are commonly neglected, resulting in potentially significant long-term functional and structural sequelae.

Effective prophylactic strategies to minimize ankle injuries in specific sports should be developed. Addressing modifiable risk factors should be an important aspect of conditioning regimes for most sports, and early recognition and management of injuries is vital for preventing the development of chronic pathology limiting the attainment of an athlete’s full potential....
Sports injuries in older people
Authors: Speed Cathy
Published: November 2017

A generally enhanced health status in an increasingly ageing population allows many to maintain high physical activity levels, and competitive masters and seniors events are becoming progressively more popular. This, together with the recognition of the importance of exercise to mitigate or even reverse many age-related changes, means that the physician in sport and exercise medicine requires a high index of awareness of the specific issues that arise in relation to sporting injury in the ageing individual. These issues include not only recognition and management of sports injuries ...
Sports injuries in children
Authors: Sayana Murali , Shanmugam Chezhiyan , Maffulli Nicola
Published: November 2017

In the UK, 79% of children aged between 5 and 15 take part in organized sport, and 11% of them are involved in intensive training (Rowley 1989). As a competitive element is introduced, children train harder and longer and participate in sport throughout the whole year. As an undesirable but inevitable consequence, sports-related injuries have increased significantly in children. Approximately 3–11% of schoolchildren are injured annually whilst participating in sport. Twice as many boys as girls sustain sports-related injuries (...
Injuries in the female athlete
Authors: Speed Cathy
Published: November 2017

Women were banned from competing and even watching events in the ancient Olympics, and were excluded from the first modern Olympic Games. However, with changes in society, participation in sport at all levels has dramatically changed. This has heightened awareness of several important clinical issues relating to women and sport and exercise. In particular, exercise can have positive or deleterious effects on bone health, females are at greater risk of some musculoskeletal injuries, and there is a common need for guidance on exercise in pregnancy and at the menopause....
Emergency medical care of on-field injuries
Authors: Gillett Mark
Published: November 2017

The treatment of life- or limb-threatening injuries in the sporting arena constitutes one of the most intimidating challenges for any healthcare professional employed in sport. The skills required to cope with these scenarios decay very rapidly so that regular drills and scenario training are essential to maintain the competencies acquired from emergency training courses....
Injuries in netball and basketball
Authors: Gillett Mark
Published: November 2017

Basketball and netball are both physically demanding sports involving movements that are often performed at high speeds in a multitude of directions. Any reduction in a participant’s ability to control the forces generated while running, cutting, jumping, or stopping could lead to excessive stress upon the musculoskeletal system. This stress could be traumatic or repetitive in nature, with the potential outcome resulting in injury....
Rowing injuries
Authors: Budgett Richard
Published: November 2017

The sport of rowing (Figs 4.14.1 and 4.14.2) encompasses rowing with a single oar per competitor, sculling with two oars per competitor, and, increasingly, indoor rowing on a rowing ergometer. Rowing and sculling are under the auspices of the International Federation (FISA).

Rowing is a safe sport with very few reported traumatic injuries (...
Injuries in rugby union
Authors: Fuller Colin
Published: November 2017

Rugby union is the second most popular team sport in the world with over 100 countries affiliated to the International Rugby Board (IRB) and with the Rugby World Cup the third most popular televised sports event behind only the Olympic Games and the FIFA Football World Cup. Rugby is a full-contact sport played predominantly by men and boys. Although the 15-a-side game continues to be the most common form of rugby played, the faster seven-a-side game is increasing in popularity and is the format of rugby that the IOC adopted as an official Olympic sport (...
Tennis injuries
Authors: Speed Cathy
Published: November 2017

Tennis is a game of power and endurance, involving running, cutting, sprinting, stopping and starting, lunging, rotation, and smashing. It is played on different surfaces with rackets that can differ significantly in their characteristics and by individuals over a wide range of age and fitness. Injuries in tennis are common and can be related to one or more of these factors, which can be broadly divided into intrinsic and extrinsic types (...
Achieving behavioural changes in individuals and populations
Authors: Hill David , Dixon Helen
Published: November 2017

Chapter 3 considers how behavioural theory and research can be translated into successful cancer prevention programmes. Such programmes may be applied at the individual, group, community or national level. The agenda for behavioural interventions in cancer prevention is set by rigorous epidemiological analysis. The ultimate goal of behavioural interventions is to enable individuals to reduce their cancer risk by engaging in recommended preventive behaviours. To reach this goal, a thorough analysis of factors underpinning the behaviour in question is needed to identify possible targets for intervention. This foundation can be strengthened by consideration of key psychological principles known to be important drivers of health-related behaviour. Chapter 3 presents the Big Five Principles of Behaviour Change and suggest how they may be applied to promoting and evaluating change in cancer preventive behaviour.
Integrating science with service in cancer control: closing the gap between discovery and delivery
Authors: Kerner Jon
Published: November 2017

Chapter 5 discusses the integration of science with service in cancer control to close the gap between discovery and delivery, and that to close the gap between scientific discovery and service delivery, if we want more evidence-based practise, we need more practice-based evidence.
The optimal provision of cancer treatment services
Authors: Barton Michael , Delaney Geoff
Published: November 2017

Chapter 9 describes an evidence-based approach to estimating the demand for cancer services and its application to different treatment modalities and different populations. The work was done mainly for Australia, but has been adapted and used in Europe and North America. Cancer services include all cancer control interventions such as screening, early detection, diagnosis, treatment, palliation, and rehabilitation. It also describes in detail the estimation of demand for radiotherapy and give examples of how this approach has been adapted to other modalities and other populations.
Managing the costs of new therapies: the challenge of funding new drugs
Authors: O’Reilly Susan E. , Venkatesh Jaya
Published: November 2017

Chapter 10 discusses managing the costs of new therapies and the challenge of funding new drugs, including opportunities and challenges, the scale of the problem, communication, purchasing contracts, monitoring developments, and further reasearch.
Patient-centred supportive and palliative care
Authors: Thompson Genevieve , Ens Carla , Chochinov Harvey
Published: November 2017

Chapter 14 expands on the role of palliative care within the framework of cancer control. In addition, the public health approach outlined by the WHO, including appropriate policy, adequate drug availability, education, and palliative care delivery at all levels of health care, will be discussed. Finally, the challenges in adapting these principles into high and low resource settings will be described.
Getting the public involved in cancer control – doing something besides worrying
Authors: Kelly Patricia , Friedman William , Addis Tara , Elwood Mark , Neal Claire , Sarner Mark , Sutcliffe Simon
Published: November 2017

Chapter 16 discusses how cancer control – with its greater emphasis on prevention and information prior to a cancer diagnosis – benefits from employing a public engagement/social mobilization model in many ways.
Strengthening the global community for cancer control
Authors: Sutcliffe Simon , Elwood Mark
Published: November 2017

Chapter 23 defends the principles of population-based cancer control for all, but recognize that opportunities, priorities, and the real-life context will determine which policies and practices are pursued with what vigour, when, and how, to fulfil these principles.
Examination of the gynaecological patient
Authors: Arulkumaran Sabaratnam , Farquharson David I. M. , Monga Ash , Papageorghiou Aris T. , Regan Lesley
Published: November 2017

Abstracts and keywords to be supplied.
Communication: confidentiality, breaking bad news, and obtaining consent
Authors: Arulkumaran Sabaratnam , Farquharson David I. M. , Monga Ash , Papageorghiou Aris T. , Regan Lesley
Published: November 2017

Abstracts and keywords to be supplied.
The history of muscular dystrophy: a unique story
Authors: Emery Alan E. H. , Emery Marcia L. H.
Published: November 2017

Chapter 1 discusses the history of Duchenne muscular dystrophy, a serious condition and the second most common genetic disorder in many countries. Its cause was unknown until relatively recently and there has been no effective treatment. However, the responsible gene and its protein product have now been identified and gene therapy is under serious consideration.
The life of Edward Meryon (1807–1880)
Authors: Emery Alan E. H. , Emery Marcia L. H.
Published: November 2017

Chapter 4 discusses the life of Edward Meryon (1807–1880).
Pathogenesis of Duchenne dystrophy
Authors: Emery Alan E. H. , Emery Marcia L. H.
Published: November 2017

Chapter 11 discusses ideas of pathogenesis and how at the beginning, the field of research of the disease was dominated by neurologists.
The search for the gene
Authors: Emery Alan E. H. , Emery Marcia L. H.
Published: November 2017

Chapter 12 discusses finding the basic biochemical defect in a disorder by first identifying the mutant gene itself, which was a quantum leap in the study and understanding of genetic disorders.
Phenomenology and psychopathology: in search of a method
Authors: Wiggins Osborne P. , Schwartz Michael Alan
Published: November 2017

We outline a phenomenological method for a science of psychopathology. Method is conceived as the mode of experiencing an object which can deliver the best direct evidence of the object available. Hence a main aim of our chapter is to sketch a method for the science of psychopathology that can establish this best evidence for claims about abnormal mental realities. The best source of evidentially grounded claims regarding psychopathological experiences is located in the clinical interview and dialogue. The method of hermeneutics adds needed detail. Our concept of hermeneutics goes back to Dilthey and up to Ricoeur. The need for the psychiatrist to “re-live” or “re-experience” of the patient’s experiences is stressed. We relate this to the phenomenological concept of quasi-experience or imaginative experience. Finally we discuss how conceptual generalization and the formation of scientific categories can follow from this phenomenological procedure.