bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical abuse
Authors: Hobbs Chris 
Published: November 2023

Abstract
Research has shown that physical methods of controlling children remain popular. In community studies, for example the work of Marjorie Smith from the Institute of Child Health in London, confirmed that 14% of all children suffered severe experiences of physical punishment. Many children including babies suffered regular physical chastisement in the form of hitting (9 out of 10 children are hit at some time), physical restraint or being tied and bound. In the severe group the possibility of permanent physical or psychological harm was present.Although the usual picture of the disciplinarian father using physical force to discipline the children is ingrained in our thinking, this research revealed that it was the mothers who were responsible for more of this behaviour even when their greater contact with the children was taken into account.
Child sexual abuse
Authors: Mott Alison 
Published: November 2023

Abstract
General practitioners and health visitors, as a result of their close relationship with families in their communities, have an important role to play in the diagnosis and initial management of the child who has been sexually abused. Since the child and alleged perpetrator may both be registered with the practice, suspicion of abuse has to be handled carefully and it may be difficult to judge when concerns about abuse are sufficient for action to be taken. However, all members of the primary health care team are legally and ethically required to report all types of suspected abuse. General practitioners are not responsible for making the diagnosis of sexual abuse, but are obliged to identify children suspected of being abused and to refer them to social services.
Ethics and the child protection process
Authors: Slowther Anne-Marie 
Published: November 2023

Abstract
The area of child protection is challenging, and at times disturbing, for the general practitioner. The evidence on which to base a diagnosis, or suspicion of child abuse is often not as clear-cut as that involved in physical or even psychological disorders. The doctor ‘s core relationship with her individual patient may be in conflict with her role as a member of a multi-agency team in which she is not the principal decision-maker. Her role as a family doctor means that she may have conflicting responsibilities to different members of the same family, all of whom are her patients. In addition, her duties to the wider public, and her legal duties, may be in conflict with what her individual patients ‘ want, and indeed with what she feels would be in their best interests. Although these issues occur in many aspects of a GP ‘s work, they are thrown into sharp relief in all stages of the child protection process: prevention, diagnosis, reporting and management.
The health needs of looked after children and the role of the primary care team
Authors: Mather Mary 
Published: November 2023

Abstract
A young care leaver, speaking at a seminar, was asked by a member of the audience what had made him a ‘success ‘ despite the difficulties he had experienced growing up in care. He cited as an example someone who had listened to him, a doctor who had seen him as a child. He asked the doctor ‘Do you sometimes give people drugs just to keep them quiet? ‘ The doctor replied that he didn ‘t, but that it was an interesting question and he should keep on asking questions. This single remark by a doctor had made him feel valued, had given him positive encouragement and made him feel that he could make a contribution to society.All general practitioners, often without appreciating the significance, will encounter looked after children during their working lives. Interested and compassionate general practitioners can make a real difference in the lives of young people in the care system.
The child protection process: an international perspective
Authors: Hetherington Rachael 
Published: November 2023

Abstract
First there was child welfare; then the ‘battered baby ‘ syndrome; then child abuse; and then child protection. This is roughly how the response of services in this country has developed since the major shifts in structures and services that followed the wartime experiences of the evacuation of children and the subsequent creation of the National Health Service and the welfare state. During the 1950s and 1960s, while the post-war child welfare services were being developed in the UK, research in the US was beginning to establish the knowledge which led to the definition of child abuse (followed by child sexual abuse). This knowledge swiftly became available in the UK and in other European countries, and everywhere began to affect policies and practice in state interventions in families. Development was not uniform in the speed at which it took place, and the nature of developments depended on the systems that already existed. In the UK we have tended to look to the US rather than other European countries for new ideas and approaches and for this reason and because of a shared language, child abuse became a focus of concern earlier in this country than else- where. However, by the second half of the 1980s, new legislation on child welfare and child protection was being debated not only in this country, but in most other European countries.
The clinical assessment of the patient with gastrointestinal symptoms
Authors: Mazuryk Mary-Ellen 
Published: November 2023

Abstract
Gastrointestinal symptoms are a common source of distress in advanced cancer patients. A survey of 1000 palliative care patients has revealed that four of the 10 most frequently observed symptoms were gastrointestinal in nature. These included anorexia, weight loss, constipation, and early satiety (1). Other common gastrointestinal symptoms included in the 21 overall most common symptoms were nausea, vomiting, taste change, and dysphagia. Furthermore, these symptoms were rated as clinically significant in 60%–80% of cases. Symptom severity tended to vary according to tumour type for some symptoms. For example, dysphagia was most prevalent in patients with oesophageal or head and neck tumours and nausea and vomiting was most prevalent in patients with gynaecological malignancies. The median number of symptoms experienced at a given time was 10–12, implying that the majority of patients will be suffering with several different gastrointestinal symptoms.
Cancer anorexia/cachexia syndrome: epidemiology, pathogenesis, and assessment
Authors: Strasser Florian , Bruera Eduardo 
Published: November 2023

Abstract
Anorexia/cachexia is a frequent problem in patients with advanced cancer, and is distressing for both patients and families (1). However, since many cachexia-associated symptoms, such as anorexia and asthenia, are ‘silent’ symptoms, as compared with pain or shortness of breath, its importance is often underestimated and therefore underdiagnosed (2). Cachexia can be separated into primary (metabolic) and secondary (starvation) cachexia, which occur often together, and are often confused with each other (Table 4.1). Since treatments for them are frequently different, the paraneoplastic, metabolic cancer cachexia syndrome (the ‘primary cachexia’) needs to be distinguished from impaired nutritional intake secondary to obstacles in the gastrointestinal (GI) tract, and other causes for ‘secondary cachexia’ (Table 4.2). Anorexia is, besides weight loss, a leading symptom of the paraneoplastic, metabolic cachexia syndrome, therefore we use the term cancer anorexia/cachexia syndrome (ACS). ACS is one of the most important causes for the symptom complex of asthenia, weakness, and fatigue, which, beside pain, is the most common symptom in patients with advanced cancer (3). This chapter focuses on the three areas of epidemiology, pathogenesis, and assessment of ACS, providing a basis for understand actual and future treatments.
Hiccup
Authors: Walker Paul 
Published: November 2023

Abstract
Every person has experienced hiccups of a transient nature. These short spells are commonly experienced by healthy individuals and disappear spontaneously or with simple measures. Fortunately, prolonged episodes of hiccup are rare, but when they do occur, cause significant distress to the patient and caregiver. It has been reported to cause significant discomfort, fatigue, sleep deprivation, weight loss, and depression (1–3).
The known record for prolonged hiccup is held by an individual who hiccupped every 11/2 seconds for 69 years and 5 months (4). There is a paucity of scientific information related to this phenomenon with much of the literature consisting of case reports outlining specific etiologies or treatments. Launois et al. have written the most recent comprehensive review of this topic (1).
Gastrointestinal motility disorders
Authors: Davis Mellar P , Walsh Declan 
Published: November 2023

Abstract
A three-month prevalence survey from 10 international sites using 5581 face-to-face inter- views revealed that 46% of subjects experienced one or more of 14 different gastrointestinal symptoms (217). Upper gastrointestinal symptoms were experienced in 28%, reflux symptoms by 7.7%, ulcer-like dyspepsia in 4.1%, and dysmotility-like dyspepsia (nausea, bloating, and satiety) in 15.5% (217). Women experienced more reflux and dysmotility than men. Reflux symptoms increased and dysmotility decreased with age (217).
Chronic nausea and vomiting
Authors: Ripamonti Carla , Bruera Eduardo 
Published: November 2023

Abstract
There is no standard definition of chronic nausea in terms of duration in advanced cancer patients. According to Pereira et al. (1) the presence of nausea for more than one week in the absence of a well-identified and self-limiting cause, such as chemotherapy or radiation therapy, may be defined as chronic nausea. In advanced cancer patients, the frequency of nausea is higher than vomiting and varies from 6% to 98% (Table 8.1) (1–19). However, no study reports how long nausea is present. Nausea occurs both at an early stage of the unresectable disease (11,12), in advanced disease (1,2,4,6,7,9,11–14,20) as well as during the last weeks and days of life (5,16,18,20). Nausea is reported to be distressing for 33%–75% of patients (12,13,19). Bruera et al. (17) found a frequency of greater than 90% among patients admitted to a tertiary Palliative Care Unit. Although the frequency was extremely high, in this patient population managed with metoclopramide-based protocol the intensity was lower than other symptoms such as pain or asthenia.
Abdominal pain
Authors: Mercadante Sebastiano 
Published: November 2023

Abstract
Excluding pain directly originating from the abdominal wall, which has somatic characteristics, abdominal pain in cancer is due predominantly to a visceral involvement. Visceral cancer pain originates from a primary or metastatic lesion involving the abdominal or pelvic viscera. In a survey on prevalence, causes, and mechanisms of pain in advanced cancer patients followed at home, abdominal pain was found to have an incidence of 45%. Two-thirds of patients presented a visceral pain, although mixed pain syndromes were observed in more than half of these patients (1).
The viscera have a complex peripheral nervous system and different neurophysiological understandings of visceral pain have been reported. Unlike their cutaneous counterparts, visceral nociceptors appear not to be a simple acute warning system. Many viscera are innervated by receptors that do not evoke conscious perception. Visceral nociceptors, how- ever, have a wide range of response, and may be activated in the presence of inflammation or tissue injury. Therefore, visceral afferents are considered polymodal, giving excitatory responses to different stimuli, including inflammation, stretching, and distension (2).
Radiotherapy in treating gastrointestinal symptoms
Authors: Janjan Nora , Delclos Marc , Ballo Matthew , Crane Christopher 
Published: November 2023

Abstract
Within this decade 11 million cases of cancer were diagnosed and 5 million people have died from cancer. Over 70% of all cancer patients develop symptoms from either their primary or metastatic disease (1–4). Approximately half the patients diagnosed with cancer will develop metastatic disease. Cancer of the lung, prostate, breast, and rectum constitute more than 50% of all cancer deaths. There is a profound need for expertise in palliative care in oncology. Quality of life is now recognized as an endpoint of secondary importance only to survival (5,6).
Drug therapy for cancer-associated anorexia
Authors: Jatoi Aminah , Loprinzi Charles L 
Published: November 2023

Abstract
Anorexia is a distressing symptom for patients with advanced cancer. In The Death of Ivan IIych , Tolstoy alludes to the anguish and global sense of loss that accompanies loss of appetite (1):
… all foods became increasingly distasteful and disgusting to him … his mind went back to the raw… plums of his childhood, their peculiar flavor and the flow of saliva when he sucked their stones, and along with that taste came a whole series of memories of those days… .
Equally eloquent and equally troubling are observations from family members who served as care-givers during the later stages of their loved one’s illness. In a series of interviews among cancer patients and their care-givers, Holden quotes a husband as he cares for his wife who is losing both her appetite as well as her battle with cancer (2):
It is so frightening for me to see her lose weight. I knew something was drastically wrong. I blamed myself for not feeding her the right things.
Clinical governance and education and training
Authors: Pringle Mike , Southgate Dame Lesley 
Published: November 2023

Abstract
As we enter the third millennium, the accountability of medical practitioners is national news in the United Kingdom. The issues are complex, but we do well to remember that they are essentially unchanged in many respects from those that have been debated since the emergence of a recognizable medical profession. By the early part of the nineteenth century, advances in physiology, pathology, and chemistry were still not reflected in medical practice. In addition, there was widespread cynicism amongst the general public, many of whom considered doctors useless or dangerous, views based on observations of the outcomes of treatments such as bleeding or purging in the face of epidemics. In England there were opposing views about the solution. Some favoured control by mandatory licensing, others advocated complete freedom of choice for patients with anybody free to practise medicine. These advocates of a free market argued that regulation would lead to a self-serving restriction of others by the medical profession. Then, as now, these events concerned the profession, the public view of the effectiveness of medical practice and the trustworthiness of doctors, and the government of the day through its law-making powers.
Sepsis syndrome and infective complications of acute renal failure
Authors: Goddard Jane , Cumming Allan 
Published: November 2023

Abstract
The connection between sepsis and acute renal failure is a ‘two-way street’. Sepsis is a dominant cause of acute renal failure and renal dysfunction is a common and important component of the sepsis syndrome and consequent multiorgan failure. In turn, patients with acute renal failure are at increased risk of infective complications which at best prolong their illness and at worst may contribute to mortality. This chapter deals with both sides of this relationship in turn, beginning with the pathophysiology of the sepsis syndrome and the role of sepsis in the causation of acute renal failure.
Travel and vaccination in renal patients
Authors: Burns Aine 
Published: November 2023

Abstract
Patients suffering from renal failure, whether victims of pharmacologically inflicted and/or pathophysiologically mediated immunosupression (Chapter 2) are at greater risk of succumbing to and dying from infectious diseases. Preventive and treatment strategies used in the general population are not as effective in renal patients. The enormous success of renal replacement therapies and particularly renal transplantation over the past three to four decades has led to an explosion in the numbers of ‘at-risk’ renal patients. Improved patient well-being has also led to an expectancy by patients and their families of travel abroad despite the inherent added risk of infection that this brings. The more widespread use of ever more powerful immunosupressant drugs will be likely to further increase the susceptibility to infection in renal patients in the future.
Introduction to Judith Butler
Authors: Bowie Malcolm 
Published: November 2023

Abstract
Judith Butler’s lecture, delivered in the Sheldonian on 6 March 2002, was a deeply moving occasion. In that tiered and ornamented space, through which so many local speech-makers had already passed and in which so many grandiloquent lectures on matters of public concern had previously been delivered, Butler spoke with unerring directness about a matter that had seldom been addressed there, even obliquely. She spoke about the oppression of sexual minorities, and about the hope for humanity at large that an end to such oppression might bring. Inhumanity was her theme; and yet, as her successive propositions found their target, a new, enlarged and inclusive vision of what it is to be human began to emerge. The whole performance was compelling in its moral authority, and it is encouraging to know that the lecture will now reach a much wider audience by way of the printed page. Butler describes both the brutality and the subtle discriminatory practices to which gays, lesbians and transgendered people are exposed in Western and non Western societies, and the exemplary courage and lucidity with which she proceeds will be a source of inspiration to campaign groups and concerned individuals around the world.
On Being Beside Oneself: On the Limits of Sexual Autonomy
Authors: Butler Judith 
Published: November 2023

Abstract
What makes for a liveable world is no idle question. It is not merely a question for philosophers. It is posed in various idioms all the time by people in various walks of life. If that makes them all philosophers, then that is a conclusion I am happy to embrace. It becomes a question for ethics, I think, not only when we ask the personal question, what makes my own life bearable, but when we ask, from a position of power, and from the point of view of distributive justice, what makes, or ought to make, the lives of others bearable? Somewhere in the answer we find ourselves not only committed to a certain view of what life is, and what it should be, but also of what constitutes the human, the distinctively human life, and what does not. There is always a risk of anthropocentrism here, if one assumes that the distinctively human life is valuable, or most valuable, or the only way to think of the problem of value. But perhaps to counter that tendency it is necessary to ask both the question of life, and the question of the human, and not to let them fully collapse into one another.
Who’s Sorry Now? Personal Stories, Public Apologies
Authors: Warner Marina 
Published: November 2023

Abstract
Apology is a kind of language, as well as an area of mentalitéand of sensibility embodied in discourse and in writings of different kinds, and today I am going to probe the apologetic state and the feelings associated with apology, in order to throw light, if possible, on the meaning of public apology in the many distempered areas of the past and the present where human rights are violated. As we go, we shall meet beckoning figures, as if on travelling on some allegorical map of a pilgrim’s progress: Vindication, Confession, Regret, Remorse, Recognition, Exculpation, Retraction, Responsibility, Repentance, and then towards the end of the journey, Expiation/Atonement, Placation, Reconciliation—flanked by two pairs of strong twins, Reform and Redress, Reparation and Restitution, with the angel of Redemption hovering overhead. The prefix that recurs so frequently in these words denotes that these states of mind arise in response to something that has occurred; they respond to a prior act or event and are made in relation to an object, which then bears back on the subject—an apology is in this sense an agreement, a compact between different parties, not a lone initiative. I will be coming back later to this recursive recombining and mutual self-fashioning.
Defence and Immunity: The Old Immune System
Authors: Playfair John 
Published: November 2023

Abstract
One can argue the correctness of this old Latin tag where military politics are concerned, but it is undoubtedly true for infectious disease. In the first chapter of this book I suggested that defending the body against pathogens was very much like defending a country against invasion, and now we are ready to pursue this analogy and see how far it holds good. We have met the enemy forces – viruses, bacteria, etc. – and we know that some of them, the pathogens, will cause damage, perhaps even kill us, if they get in.
Sharpening The focus: the new immune system
Authors: Playfair John 
Published: November 2023

Abstract
As we have seen, antibody formation, immunological memory, and the success of vaccines were well known before 1900, yet it was another half century before it was realized that they were all due to the properties of lymphocytes. Nowadays, even when a totally new infectious disease appears, the experience and the techniques are in place to identify the pathogen and work out how best to control it – drugs, a vaccine, or simple public health measures.
Communication and Collaboration
Authors: Playfair John 
Published: November 2023

Abstract
Like an anti-aircraft battery, immune defences could not function without collaboration and communication. In Chapter 3 I described the collaboration of phagocytes, antibody, and complement in dealing with a typical bacterium. In Chapter 4 I mentioned that helper T lymphocytes collaborated with B lymphocytes to make a larger antibody response, and T lymphocytes with macrophages to improve their handling of intracellular pathogens, while in the reverse direction, antigen-presenting cells were needed to start the process of lymphocyte activation.
The pathogens fight back
Authors: Playfair John 
Published: November 2023

Abstract
This cynical couplet could have been written with pathogens in mind. When attacked they defend themselves - not very sportif of them! But a pathogen with an efficient defence mechanism for survival is obviously more likely to cause disease than one without. It may be one of those pathogens that goes on to injure cells directly, or it may set off self-damaging responses by the host. All these properties of the pathogen that increase the chance of disease are often lumped together as virulence factors. In the next chapter we shall look at the virulence factors that actually cause damage, but first we shall consider the ones that allow survival.
Controlling Pathogens
Authors: Playfair John 
Published: November 2023

Abstract
We are the only animals that have consciously interfered with the balance between ourselves and our pathogens. Admittedly there are reports of chimpanzees eating the right parts of the right plants to get rid of their worm infections, but that is a far cry from draining swamps, building hospitals, designing vaccines, and synthesizing antibiotics. Nowadays, even when a totally new infectious disease appears, the experience and the techniques are in place to identify the pathogen and work out how best to control it – drugs, a vaccine, or simple public health measures.