bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generalized infections
Authors: Southgate Lesley , Lockie Cameron , Heard Shelley , Wood Martin 
Published: November 2023

Abstract
This chapter includes infections that affect several or most of the body systems and which do not therefore fit naturally into other Chapters of this book. The immunization of children has substantially modified the pattern of childhood viral illnesses. Nevertheless, these infections, which also may occur infrequently in adults, still comprise an important part of general practice and they will be discussed in some detail here.
Principles of patient management
Authors: Lawrence Martin , Neil Andrew , Mant, David , Fowler Godfrey 
Published: November 2023

Abstract
In developing guidelines for clinical management, any recommendation should be based, so far as possible, on evidence. The first two parts of this book provide the evidence for and against intervention in the prevention of cardiovascular disease. This chapter lists recommendations for activity in practice, referencing back to Parts I & II of the book where appropriate. External recommendations or guidelines are not appropriate for direct incorporation into practice (see Chapter 22, page 313-4), but need to be adapted by practices according to their particular clinical circumstances. The statements in this chapter, and the evidence in the book which supports them, are intended to help practices formulate their own policies and protocols for the prevention of cardiovascular disease.
Nerve injury
Authors: Guly H R 
Published: November 2023

Abstract
Nerve injuries occur within the spinal cord, at nerve roots, in the plexuses, and in peripheral nerves; and the examination is different for suspected injuries at each level. Thus to exclude a nerve root lesion in a patient with neck pain one needs to examine at least one muscle group supplied by each root from C5 to T1 and the sensation within each dermatome (see Chapter 18). The neurological examination for a peripheral nerve injury should look at the motor power and sensation in the areas supplied by any nerve which could be injured. Between the roots and the nerves is the brachial plexus where an injury will produce a different pattern of signs.
Chronic pain and its medical and surgical management in renal cystic diseases
Authors: Segura Joseph W , King Bernard F , Jowsey Sheila G , Martin Patricia , Zincke Horst 
Published: November 2023

Abstract
Pain, located in the abdomen, flank, or back is the most common initial com plaint in autosomal dominant polycystic kidney disease (ADPKD) and, at some point in the course of the disease, affects the majority of patients (Dalgaard 1957; Iglesias et al. 1983, Gabow et al. 1984). The pain can be caused by cyst enlargement; bleeding (either confined to inside a cyst or leading to gross haematuria with passage of clots, or to a perinephric haematoma); urinary tract infection (acute pyelonephritis, infected cyst, perinephric abscess); nephrolithia sis and renal colic; rarely a coincidental renal cell carcinoma.
What happens in a head injury
Authors: Gronwall Dorothy , Wrightson, Philip , Waddel Peter 
Published: November 2023

Abstract
In this chapter we will try to explain the ways in which the brain may be damaged in an accident, and the effects that this damage can cause. We have found that most families and injured people want to know more about this, and that it seems to help them both in the early days after the accident and in dealing with the problems that come later. You should remember that we are describing a wide range of possibilities, and that the person that you are concerned with may have been affected in only one or two of the ways we will be talking about. If you are in doubt about anything, or if what we say worries you, talk it over with the doctor who has been your contact at the hospital or clinic, or with your family doctor.
The continuing effects of head injury
Authors: Gronwall Dorothy , Wrightson, Philip , Waddel Peter 
Published: November 2023

Abstract
When the staff at the hospital talked to you about what the future might hold for your relative or friend they probably used the terms ‘brain damage’ or ‘brain injury’. Obviously the outcome depends on the amount of damage but the words suggest a gloomy outlook to most people. The amount of recovery that you have seen up until the time the head-injured person is ready to leave hospital will have been a great source of reassurance to you, and you are right to assume that it will continue. You need to realize, however, that although the patient is well enough to leave hospital, there are many problems still to be faced. If you know about these in advance then you will be better prepared to deal with them.
Suggestions for further reading
Authors: Gronwall Dorothy , Wrightson, Philip , Waddel Peter 
Published: November 2023

Abstract
Bryant, Beverley (1992) In search of wings: A journey back from traumatic brain injury. Wings Press, South Paris, Maine Weiss, L., Thatch, D., and Thatch, J. with Gray, L. (1983). I wasn’t finished with life. E. Hart Press, Dallas, Texas. Levin, H. S., Eisenberg, H. M., and Benton, A. L. (ed) (1989) Mild head injury. Oxford University Press, New York. Lezak, Muriel, D. (ed) (1989) Assessment of the Behavioural consequences of head injury. Alan R. Liss, New York. Ponsford, Jennie (1995) Traumatic brain injury: Rehabilitation for everyday adaptive living. Lawrence Erlbaum Associates, East Sussex
Introduction: a story of stories
Authors: Roberts Glenn 
Published: November 2023

Abstract
The significance of stories in psychiatry and psychotherapy is paradoxical and contradictory. They are at once ephemeral, ‘only a story’, flimsy remnants of an anecdote-based medicine, the stuff of propaganda and inculcation, arising from a flabby subjectivism, and seductive dissimulations, and at the same time rich, iconic evocations of meaning, foundational and inescapable, accessing all that is unique and personal, containers of our origins, our tribal tales, and the myths we live by.
The psychodynamic narrative
Authors: Phillips James 
Published: November 2023

Abstract
An account of the role of narrative in psychoanalysis and the psychodynamic therapies must begin with a recognition of the role of narrative and narrative identity in our lives in general. Considerations of narrative identity do not begin, after all, in the consulting room. They are with us, implicitly or explicitly, throughout our lives. We live in and through the stories we tell and imagine about ourselves. The narrative ‘I’ is that story-spinning self that tells stories about itself, exists in those stories, and conceives its identity in terms of those stories. To quote the literary critic Peter Brooks (1984) on this theme:
Defensive and creative uses of narrative in psychotherapy: an attachment perspective
Authors: Holmes Jeremy 
Published: November 2023

Abstract
Joseph Conrad’s Heart of darkness begins and ends on a packet ship moored on the River Thames, with the narrator Marlow sucking at his guttering pipe. In between the reader has been taken on a compelling and horrific journey into the interior. The book is a story within a story, framed by the river itself, whose reaches, unlike stories, are unpunctuated: stretching in a spacial continuum from London across the oceans to the heart of the Congo, and in time from the present day back to the Roman invasion of Britain. This contrast between the structure and boundedness of the story, and the fluidity and formlessness of reality, forms the background to this chapter. There is also an opposition between artifice and nature, which can be expressed psychoanalytically as a contrast between the apparent actuality of the dream narrative and the patchwork of fragmented associations and ‘day’s residues’ that a dream evokes. Bollas (1995) takes this as a general paradigm for the activity of the unconscious, which he sees as continuously fashioning lived life into stories, and then dismantling and dispersing those stories in the light of further experience.
Holding on to the story: older people, narrative, and dementia
Authors: Bruce Errollyn 
Published: November 2023

Abstract
In this chapter I put forward some attempts to weave together ideas about attachment through out the life course, and narratives in dementia. However, for the vast majority of people, the backdrop to dementia is ageing, and to set dementia in context I begin with a discussion of the place of older people’s narratives, in particular their reminiscence stories. Older people have a place in fairy stories as tellers of wonderful tales. Other parts of children’s literature offer a multiplicity of images for older people, from the evil killjoys of Dahl, through the wildly eccentric, good-fun grannies, to the supportive older person who, often unexpectedly, comes up trumps when all other adults seem to be against the young. Over a period of time, social change and the communication revolution have eroded the traditional role of elders as repositories of culture, passing on customs and tribal wisdom to younger generations. Increasingly, younger people have been able to turn to other sources to access the accumulated know ledge of humankind, and old customs have been challenged as irrelevant to a fast-changing world.
Prognosis: luck and judgement
Authors: Dickenson Donna , Fulford Bill (Kwm) 
Published: November 2023

Abstract
Many of the most pressing problems of current clinical practice turn on questions of risk — balancing care and control in the management of suicide, maintaining unstable patients in the community, steering a path between taking advantage of new treatments and waiting for the benefits of hindsight, stepping into the unknown with research. In all these and a host of related ways, psychiatry is a risky business. As we put it in the introduction to this book, in psychiatry uncertainty is the norm.
In this chapter, we explore two of the more common ethical problems arising directly from the uncertainty of prognostic judgements of dangerousness, concerned respectively with confidentiality and clinical practice guidelines.
The prevalence and characteristics of male sexual assault
Authors: King Michael , Coxell Adrian , Mezey Gill 
Published: November 2023

Abstract
Until recently there was little acknowledgement that men could suffer sexual molestation. Although sexual assault was recognized as a problem in prisons (Sagarin 1976; Anderson 1982) and other all male institutions (Goyer and Eddleman 1984), sexual assault of men in the community was thought to be an unusual event. Statistics on male sexual molestation were rare and encouraged the belief that the phenomenon itself was rare. This was due in part to a narrow legal definition of rape in English law and in the legal systems of many states in the USA. In English law the term ‘rape’ was restricted to forced penile penetration of the vagina and thus could not apply to sexual assaults against men. In 1994 the offence of rape was extended to include anal or vaginal penetration by a penis. This change in the law arose because of increasing recognition that sexual attacks on men were more common than previously believed. Recorded annual statistics show that large numbers of men are victims of sexual crime. In 1996 there were 3142 indecent assaults and 227 rapes of men (HMSO 1996). The figure for rape represents an increase of 51 per cent from 1995 (HMSO 1996). Very few sexual crimes, however, are reported to the police (Mayhew et al. 1989) and research is required to assess more accurately their prevalence and effects on victims.
Male children and adolescents as victims: a review of current lcnowledge
Authors: Watkins Bill , Bentovim Arnon 
Published: November 2023

Abstract
The normally accepted definition of sexual abuse is ‘the involvement of dependent, developmentally immature children or adolescents in sexual activities they do not truly comprehend, and to which they are unable to give informed consent and that violate the sexual taboos of family roles’ (Schechter and Roberge 1976). Researchers usually define the age difference between abuser and victim as needing to be of 5 years or more. However, Johnson (1988, 1989) has proposed a 2-year age difference, along with other criteria, to define sexual activities that are clearly abusive. Cantwell (1988) has proposed a defini tion for child abusers without specifying an age criterion for the perpetrator and focused entirely on the behavioural element. Thus, subjecting a child to oral-genital contact or penetration of the vagina or anus with fingers or objects would be regarded as deviant and abusive.
Surviving sexual assault and sexual torture
Authors: Turner Stuart 
Published: November 2023

Abstract
Sexual violence may occur in many settings – in established relation ships or between strangers – but in its nature it is an attack which always challenges intimacy and trust. The specific psychological re actions, post-traumatic stress disorder (PTSD) and the other sequelae must be seen in the context of more pervasive and potentially more fundamental changes in which, for example, the nature of human relationships is laid bare for re-examination and re-evaluation. Although in this chapter, the basic reactions to psychological threat and trauma will be examined in more detail, the other personal sequelae should not be seen as less important.
Treatment of male victims of sexual assault
Authors: Mezey Gillian , King Michael 
Published: November 2023

Abstract
Sexual assault is a frightening and degrading experience that is pro foundly traumatic for the victim. Men experience rape as an aggressive attack on their sexuality and a violation of their physical and psychological boundaries. Although most men develop strategies that enable them, to a greater or lesser extent, to cope with the experience, a minority develop long-term psychological problems which may require professional help. The experience frequently results in pro found alterations to a person’s attitudes, behaviour, and perspective on life (Mezey and King 1989; McMullen 1990), including a shatter ing of basic assumptions about one’s vulnerability, the safety and predictability of the future, and the belief that disasters happen only to other people (Janoff Bulman 1992).
Vascular access in children
Authors: Polo José R 
Published: November 2023

Abstract
In the first five children who underwent haemodialysis, vascular access was obtained by means of plastic catheters placed in both the radial artery and the saphenous vein (Mateer 1955). Even 10 years later, only 37 children treated by haemodialysis had been reported in the literature (Anderson et al. 1965). During this period, nylon catheters placed in the inferior vena cava through the saphen¬ous veins were used as vascular access.
Describing Symptoms and Signs
Authors: Farmer Anne , McGuffin Peter , Williams Julie 
Published: November 2023

Abstract
The description of signs and symptoms is the first stage in the measurement of psychopathology. Signs and symptoms can be regarded as the basic building blocks from which diagnostic categories are constructed. Also, they often provide the basis for items used in constructing continuous measures such as clinical rating scales (see chapters I, 7 and 10). Traditionally, most emphasis hasbeen on symptoms, the things of which patients complain, and psychiatry has sometimes been described as ‘neurology without physical signs’ (Miller I961). This is not strictly true, because important parts of a mental state examination include direct observations of, for example, the individual’s behaviour, appearance and form of speech (signs). That said, most research, dating back to the introduction of structured or semistructured interviews (Wing et al. 1974) (see also chapter 5) shows that the rating of symptoms tends to more reliable than the rating of signs.
Validity, Reliability, and Utility
Authors: Farmer Anne , McGuffin Peter , Williams Julie 
Published: November 2023

Abstract
As we have already discussed, in much of the assessment of psychopathology the focus is on internal, unobservable processes of which there is only indirect evidence. In chapter 2, we described the signs and symptoms that comprise the main types of psychopathology. We mentioned that in addition to complaints of subjective distress (symptoms), evidence for the presence of psychopathology may also be shown in the form of abnormal behaviour, which may be self-reported by the subject or observed by a clinician/researcher or other informant (observational measures or signs). One such example of this type of evidence can be noted in the examination of children with suspected attention deficit hyperactivity disorder (ADHD). Evidence regarding a subject’s ADHD could consist of both the individual’s own description of their perceptions, cognitions and emotions and of observations by a clinician or, for that matter, by a parent or a teacher. Probably, the simplest way of measuring psychopathology is by the means of questionnaires. The subject or an informant/observer (such as a spouse, a close friend, parent or teacher) answers a series of questions about the subject’s behaviour and experiences, either in a written pencil and paper or computerized form. Some examples of the use of questionnaires are given in more detail elsewhere, particularly in chapters 7,8 and 9.
Consultation liaison geriatric psychiatry
Authors: Draper Brian 
Published: November 2023

Abstract
Nearly 50% of general hospital inpatients are over 65 years of age and they comprise an increasing proportion of referrals to consultation liaison (CL) services. Between 27 and 95% of older patients in general hospitals have mental disorders, particularly organic disorders and depression. Service delivery models for CL geriatric psychiatry vary according to the type of service provider and the style of service delivery. A literature review of psychiatric service delivery to the elderly in general hospitals found that there were few differences in outcomes according to service type, though geriatric psychiatry is more likely than CL psychiatry to consider post- discharge issues.
Introduction
Authors: Mason Malcolm , Moffat Leslie 
Published: November 2023

Abstract
The seminal vesicles lie alongside the prostate and look like small bunches of grapes. They produce over half the volume of the ejaculate, producing substances such as sugars that nourish the sperm and activate them prior to ejaculation. They drain into the lower area of the prostate. They are usually removed by the operation termed a radical prostatectomy, and irradiated if necessary during treatment by radical radiotherapy.
Death and dying
Authors: Taylor Ross J , Smith Blair H , Teijlingen Edwin R van 
Published: November 2023

Abstract
In the twentieth century with changes in culture, religion, public health, and medical advances, death became seen as the enemy of the doctor. No longer was it the clergy wrestling with the one dying to prepare for an afterlife, but rather the doctor actively intervening to prevent early and premature death. Along with the reduction in infant and maternal mortalities, the change in the pattern of mortality, increased life expectancy, and developments in modern medicine, death became removed from the community. Although most of the last year of life is still spent at home, death commonly occurs in an institutional setting and within a medical context. Many adults will never have seen a relative die and may not experience a close bereavement until their 30s or later. Although the twentieth century saw an unparalleled increase in human-induced and violent death, such as the concentration camps, world wars, and atomic bombs, doctors practise in a death-denying culture. Death is the modern taboo.
The child protection process
Authors: Pace Melanie 
Published: November 2023

Abstract
This chapter will guide health professionals through the child protection process in steps from identification, reporting, investigation and intervention. At each stage in the process the law/guidance available will be outlined, and the anxieties/dilemmas for health professionals explored. The chapter will focus on the personal/professional responses to the child protection systems and the perspective of the child/young person. It is aimed at facilitating reflection on how we respond to child protection concerns and why it may be that a mandate to respond of itself cannot be relied upon to ensure multi-agency cooperation.Detailed information about child abuse, signs and indicators, roles and responsibilities etc. is contained elsewhere in this book. This chapter will, therefore, focus on the process of child protection systems, the potential blocks to implementation and the requirement that, above all else, professionals keep the welfare of the child above all other consideration.
Domestic violence and child protection: Issues for the primary care team
Authors: Davidson Leslie L , Lynch Margaret A 
Published: November 2023

Abstract
All professionals who provide care for children and their families must acknowledge the vulnerability of children living in families where domestic violence is present. If a member of the primary care health team (PCHT) identifies domestic violence within a family, then the adverse impact on child welfare must be actively considered. In particular, the co-occurrence of physical and emotional child abuse with domestic violence must be borne in mind and referral to Social Services may be necessary. Even when children are not as yet suffering demonstrable significant harm, they may well meet the criteria for Children in Needas defined in the Children Act of 1989, and subsequently benefit from an assessment following the new Framework for Assessment of Children and their Families (Department of Health 2000a). Conversely, in situations where child protection is being considered (such as a child protection case conference), domestic violence is often not recognized. Furthermore, when recognized, the implications of domestic conflict upon child welfare are infrequently addressed during the assessment of risk process or following definition of child protection plans (Farmer and Owen 1995).
Information, learning and new technologies
Authors: Jamieson Alex , Rennison Tony 
Published: November 2023

Abstract
Alex Jamieson is a GP with 12 years’ experience in Continuing Education for GPs both as a GP Tutor and as an Associate Dean of Postgraduate GP Education. Tony Rennison is an Information Technology specialist who has considerable experience as a teacher in the use of primary care computer systems by health-care professionals. He is also the author of a book on the subject, and is a non-GP who is an Associate Dean of Postgraduate GP Education.
Higher degrees: their role in education and training for primary care
Authors: Howe Amanda 
Published: November 2023

Abstract
‘Higher degrees’ are all postgraduate qualifications that involve a substantive piece of original research work: this definition covers Masters (MMedSci, MSc, MPhil) and doctorates (PhD, or MD for those with a previous medical qualification). They range from taught courses to independently completed single theme projects, usually span 1–6 years of study depending on whether full-or part-time, and can be undertaken at any point in one’s adult life. Holding such a qualification is regarded as an essential step to an academic career, but also by many as evidence of serious scholarship and intellectual attainment.