bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive therapy formulations and interventions for treating distress in dementia
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
Cognitive therapy’s Lamarckian progress is generally attributed to three key writers: Beck (1967), Ellis (rational-emotive therapy: Ellis and Whitley 1970) and Meichenbaum (self-instructional training: Meichenbaum 1977). Over recent years, the terms cognitive therapy (CT) and cognitive behavioural therapy (CBT) have become synonymous, with the addition of the term ‘behavioural’ emphasizing the importance of the behavioural component within the treatment.
Alternative therapies: other non-pharmacological therapies
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
Whether or not a person has cognitive impairment, he/she will have needs. These will include physiological (food, water, shelter) and psychological features (security, activity, companionship, stimulation). It is suggested that people with dementia retain their desire to have needs fulfilled, but become less able to communicate and obtain them. Therefore it is not unusual for a person with dementia to be energized by a need and to become distressed when it is not met. In such circumstances, the energy may be expressed in terms of feelings and emotionally driven activities (shouting, aggression), and thus trigger a challenging behaviour.
Pharmacological treatment of psychosis
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
This chapter focuses on the pharmacological management of psychotic symptoms in dementia. Issues are discussed to facilitate treatment decisions, such as whether a pharmacological treatment may be appropriate, and the evidence of efficacy from clinical trials for different pharmacological treatment is reviewed. This information is then summarized and illustrative vignettes are given to examine some potential clinical scenarios.
Managing behavioural and psychological symptoms in residential and nursing home care
Authors: Ballard Clive , O’Brien John , James Ian , Swann Alan 
Published: October 2023

Abstract
The expanding elderly population inevitably means that the number of people with dementia will continue to increase well into the twenty-first century (Melzer et al. 1997), with enormous implications for care provision (Knapp et al. 1998). Residential and nursing homes form an integral part of the care network for these individuals, particularly during the later stages of the disease process (Bannister et al. 1998) or when concurrent psychiatric morbidity or behavioural problems arise (Steele et al. 1990).
Ethical issues and evidence-based patient choice
Authors: Ashcroft Richard , Hope Tony , Parker Michael 
Published: October 2023

Abstract
The concept of ‘evidence-based patient choice’ (EBPC) brings together two important movements in modern medicine. The first of these, ‘evidence-based medicine’, has been described as a ‘paradigm shift’ in medical practice (Hope 1996). It is an approach to medicine based on the claim that clinical interventions are to be justified on the existence of evidence for the effectiveness of the intervention rather than on other grounds such as, for example, the authority of the clinician or of tradition. ‘Patient-centred medicine’ too has arisen out of a concern with and a critical response to traditional medical practice and the traditional overemphasis on the authority of the health care professional. Advocates of patient-centred medicine argue that the best protection for patients from excessive paternalism is to be gained by emphasizing the point that patients should play a central role in decision making about their clinical care. Like evidence-based medicine, patient-centred medicine has been described as marking a fundamental shift in medical practice, a ‘Copernican revolution’ (Battista 1993).
Humane judgement
Authors: Downie R S , Macnaughton Jane , Randall Fiona 
Published: October 2023

Abstract
The doctor-patient relationship is commonly seen as the central feature of medical practice: it is by means of this relationship that a doctor exercises professional skills and pursues the aims of medicine. The analysis of this relationship is the main concern of this section, since it is the key to the idea of humane judgement. It will emerge that, in addition to the need for the doctor to interpret and show insight into the symptoms and words of the patient—which are necessary also for the technical aspects of judgement—the humane doctor has ethical sensitivity and a broad educated perspective. The analysis of these factors will begin in this chapter and be completed in Chapter 6.
Judgement and resource management
Authors: Randall Fiona 
Published: October 2023

Abstract
Resource management, or prioritizing, or rationing in health care is an imposed distribution system that has two goals: first, to ensure the best use of resources by using the most cost-effective treatments; and second, to ensure a just or fair distribution of treatment benefits. Rationing takes place at two levels: macro-allocation, where budgets are allocated for the treatments of different diseases, and for medical and nursing care; and micro-allocation, where discrimination between individual patients is necessary because it is not possible to give the most beneficial care or treatment to every patient. Obviously major moral and practical problems arise at both levels. Nevertheless, it will be the contention of this chapter that a rationing system is required now and will continue to be required in the future. To maintain such a position with any hope of plausibility, we must examine both the evidence on which a system of rationing might be based, and the sorts of judgement necessary to implement it. The ways in which rationing can be implemented will obviously vary to some extent, depending on the particular system of health-care delivery and financing that is operative. But many of the broad principles are the same, so while my discussion is centred on the UK National Health Service (NHS), I hope that my arguments will be more widely applicable. It should also be noted that some writers in this area, and all politicians, prefer the terms ‘resource management’ or ‘prioritizing’ to the term ‘rationing’. I do not distinguish between them, and will now move to outlining the bearing of evidence on rationing.
Oral codeine in acute postoperative pain
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Clinical bottom line. Codeine 60 mg is not an effective analgesic for postoperative pain. A 60-mg oral dose of codeine had an NNT of 16.7 (11–48) for at least 50% pain relief over 4–6 h compared with placebo in pain of moderate to severe intensity. Codeine is an opium alkaloid, with activity similar to, but weaker than morphine. It is also widely available in combination with aspirin or paracetamol.
Dextropropoxyphene alone and with paracetamol in postoperative pain
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Clinical bottom line. 65 mg of dextropropoxyphene is not an effective analgesic. Dextropropoxyphene is a relatively weak opioid analgesic that has been widely available since the 1950s. It is used alone and in combination with paracetamol or aspirin. Inclusion criteria were full journal publication, single oral dose, randomised, placebo-controlled, double-blind trials of dextropropoxyphene in acute postoperative pain, baseline pain moderate to severe. Mean TOTPAR and SPID values for each trial were converted to %maxTOTPAR and %maxSPID, and then the proportion of patients achieving at least 50%maxTOTPAR were calculated. This information was used to calculate the NNT and relative benefit. Adverse effects frequency data were used to calculate NNH and relative risk.
Diagnosing headache and Migraine
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
In 1988 the IHS published criteria for the diagnosis of a number of different headache types [1]. Those for some of the common headaches are reproduced below for migraine with and without aura, cluster headache, tension-type headache, and cervicogenic headache. A meta-analysis [2] tells us what clinical features are important, and what irrelevant, in diagnosing migraine. The review used a MEDLINE search up to May 1999 for English language papers with sensitivity and specificity of historical features in patients with primary headaches of migraine, tension-type headaches, or cluster headaches. Headaches caused by other underlying clinical conditions were not examined. Information from studies was pooled to generate overall sensitivity, specificity and likelihood ratios of migraine compared with tension-type headache.
Migraine: league tables of relative efficacy
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
There are a number of treatments available for acute migraine. Choices have to be made about which to prescribe, or even about formularies. Those choices will be influenced by a large number of issues with different resonance in different parts of the world. Policy, patient choice, prescriber preference, cost and experience will all play a part. These league tables allow us to see what is on offer, and make our choices informed by the evidence. The league tables are not there to tell us what to prescribe, or to limit prescribing choice (because there is some evidence that limiting choice is bad for patients and healthcare systems).
Aspirin plus metoclopramide for acute migraine
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
Clinical bottom line. Oral aspirin 900 mg plus metoclopramide 10 mg has been fully tested in three randomised trials with about 750 patients. The NNT for two hour headache response was 3.2 (2.6–4.0). The NNT for 2-h pain free was 8.6 (6.2–14). There was no information for sustained outcomes. Oral aspirin alone has no information yet published in full, though studies have been published in abstract form.
Anticonvulsants for diabetic neuropathy and postherpetic neuralgia
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
For over 30 years the management of neuropathic pain has involved the use of both antidepressants and anticonvulsants, but which drug class should be first line choice remains unclear. The dogma that the character of the pain was predictive of the response, burning pain responding to antidepressants and shooting pain to anticonvulsants, was shown to be incorrect in diabetic neuropathy, where patients experiencing both burning and shooting pain responded to tricyclic antidepressants. Most studies on neuropathic pain have involved diabetic neuropathy and postherpetic neuralgia, because these conditions represent the majority of patients with neuropathic pain.
Fibromyalgia
Authors: Moore Andrew , Edwards Jayne , Barden Jodie , McQuay Henry 
Published: October 2023

Abstract
The American College of Rheumatology has produced diagnostic guidelines. The historical feature of fibromyalgia is widespread pain of three months duration or more affecting the axial skeleton and at least two contralateral quadrants of the body. To this definition of widespread pain, for a diagnosis of fibromyalgia patients have to feel pain in 11 of 18 trigger points when they are palpated with the amount of pressure sufficient to blanch a finger nail.
The ethics of economic evaluation in priority setting
Authors: Dolan Paul , Olsen Jan Abel 
Published: October 2023

Abstract
Economic evaluation techniques have been criticized for being too narrow, focusing on ‘efficiency solutions’ only and ignoring other priority-relevant considerations. This chapter considers additional issues related to equity and ethics, and how they might possibly be incorporated into a societal economic evaluation. Again, the rationale is to help in ‘distributing health care’-but in an ethically preferred way.
Founding the common cold research unit
Authors: Tyrrell David , Fielder Michael 
Published: October 2023

Abstract
Britain in 1946 was a place of stark contrasts. The war was over. Army, navy, and airforce personnel were being demobilised. Men and quite a number of women were coming home to families they had hardly seen through- out the conflict. They were to find a way of life that had changed out of all recognition. Towns were in ruins; factories and equipment were worn out; and food, clothing, and furniture were severely rationed. People were grieving over their personal losses, the friends who were gone for ever. But, in spite of this, there was a feeling of optimism and the sense of a new beginning.
Hunting for treatments
Authors: Tyrrell David , Fielder Michael 
Published: October 2023

Abstract
‘We can land a man on the moon, but we can’t cure a common cold.’ Those involved with research into the common cold are familiar with the jibe. We all hoped that our work would bring a cure nearer, and of course it almost certainly has. But not to the point where something concrete has appeared. In fact no radically new medicines for colds have appeared in the shops since serious scientific research started about a century ago. Not surprisingly, the average person thinks that this is intolerably slow. But that is to misunderstand the nature of the problem and the way in which research and discovery take place.
The use of investigations and imaging in the evaluation of arthritis
Authors: Szer Ilona S 
Published: October 2023

Abstract
The aim of this chapter is to describe the laboratory and imaging evalu-ation for the child who is suspected of having Juvenile Idiopathic Arthritis. Laboratory tests are not usually helpful in positively establishing the diagnosis of Juvenile Idiopathic Arthritis (JIA) but they are helpful in excluding other disorders and providing evidence for the presence and extent of other chronic rheumatic conditions. Laboratory studies may help in determining the type of JIA such as Rheumatoid Factor (RF) Positive Polyarthritis, or HLA B27 associated arthritis.
Classification of childhood arthritis
Authors: Southwood Taunton R 
Published: October 2023

Abstract
The aims of this chapter are to discuss the historical and philosophical background giving rise to the ILAR classification of Juvenile Idiopathic Arthritis (JIA) and to outline the classification itself. The future evaluation of the classification is also discussed. Juvenile Idiopathic Arthritis (JIA) is a diagnosis of exclusion (see Part 1, Chapter 1.3). JIA refers to those forms of arthritis which begin before the 16th birthday, are persistent for longer than 6 weeks, and for which no cause is currently known [1]. Part 1 of this book gives an overview of the multitude of conditions which may be confused with JIA.
The Forty-Five Days, July to September 1943
Authors: Morgan Philip 
Published: October 2023

Abstract
The international consequences of Mussolini’s dismissal by the king on 25 July 1943 were signifiant but contained. The Italian ramifications of Mussolini’s fall were less immediately signifiant, but ultimately uncontainable. There has been so much controversy over the responsibility for and signifiance of the events from Mussolini’s removal in July 1943 to the signing and declaration of the armistice between Italy and the Allies in September 1943, that it becomes extremely diYcult for the historian to clear a path through the retrospective mutual recriminations and mud-slinging of the protagonists. The only place to start is with the announcement to the nation by the 72-year-old Marshal Pietro Badoglio, called out of military retirement by the king to head the new government after the dismissal and arrest of Mussolini on 25 July 1943.
The Invasion and Occupation of Italy, and the Kingdom of the South, 1943–1945
Authors: Morgan Philip 
Published: October 2023

Abstract
In spring 1943, General Sir Bernard Montgomery, commander of the British Eighth Army, gave an order to the head of MI9, the military intelligence service responsible for escaped prisoners of war in Axis-occupied Europe, which in turn was to be communicated secretly to the camps in northern and central Italy which were holding over 85,000 captured Allied servicemen. The instruction was to the effect that in the event of an Italian surrender, Allied POWs should ‘keep fit and stay put’ and await the arrival of Allied troops.1 In the actual event of the Italian armistice of 8 September 1943, and in light of what happened afterwards, this was rather stupid advice. But at the time it was made, the order reflected a condenser among Allied military commanders that Italy could be easily and rapidly conquered and occupied.
Confrontational Coexistence
Authors: Robbins Keith 
Published: October 2023

Abstract
In January 1965 great men, and just a few great women, including the Queen of Tonga, came to London to represent ‘the world’ at the funeral of Sir Winston Churchill, the last Englishman who would be truly a world figure. Churchill had not in fact been in office for a decade; nevertheless his death, twelve years after Stalin’s, had a certain symbolic significance: the Second World War was being buried. The congregation in St Paul’s cathedral represented states both great and small, old and new. Famous and familiar names mingled with newcomers to world politics: men moulded by their experience of wartime power, and a new generation only now coming into significant office. This mixture characterized political leadership in the world between the death of Stalin and the death of Churchill. Indeed, in the case of Churchill himself, during his last period as Prime Minister (1951–5) he was seeing the world as a man who had come of age politically half a century earlier. At the end of his life, he could no longer feel at home in what it had become. The transition to a new generation of leaders, not surprisingly, did not take place in every country at precisely the same time. As the following summaries demonstrate, it was their experience of war which still loomed large in the thinking of the Great Powers’ leadership between 1953 and 1965.
Belligerent Aims
Authors: Robbins Keith 
Published: October 2023

Abstract
Grey, the long-serving British foreign secretary, gloomily took the view in late 1914 that for the duration of the war there was little that the foreign office could do. Diplomacy would be entirely subservient to military events. States would be guided in their dealings with each other by the fluctuating fortunes of battle. He was, perhaps, a little too pessimistic. As far as Britain was concerned, the handling of initially non-belligerent states like Bulgaria or the United States, of neutrals like Denmark or the Netherlands, or an ally like Japan could be of very great significance and did not hinge entirely on military factors. Nevertheless, the scope of foreign policy was generally very limited, at least until a late stage in the conflict. Whether reluctantly or with a good grace, foreign secretaries and foreign offices lost some of their political standing and frequently found new agencies and advisers usurping their role.
Every state had to have war aims and traditional bureaucracies played their part in formulating them. The status of a ‘war aim’ is, however, difficult to determine. Particularly in the case of Germany, some writers have seen in the early formulation of territorial and economic objectives confirmation of the expansionary pressures which thrust the country into war. Others have been more cautious, suggesting that once war had begun it was only natural to attempt to define objectives. To have aims in war was not the same as going to war for certain aims. It can be confidently stated that the shape of Europe and the world in 1919 did not correspond to the ambitions of any state which went to war in 1914.
The Caesarian Party
Authors: Syme Ronald 
Published: October 2023

Abstract
Caesar, who took his stand on honour and prestige, asserted that Pompeius was disloyal. Caesar had made enemies through Pompeius—and now Pompeius had joined them.1 A just complaint, but not integral truth: a Sullan partisan before turning popular is, Pompeius by his latest change of front came back to earlier alliances.
The Predominance Of Antonius
Authors: Syme Ronald 
Published: October 2023

Abstract
HE victor of Philippi proceeded eastwards in splendour to re-establish the rule of Rome and extort for the armies yet more money from the wealthy cities of Asia, the prey of both sides in Rome’s intestine wars. He exacted nine years’ tribute, to be paid in two. Antonius distributed fines and privileges over the East, rewarded friends and punished enemies, set up petty kings or deposed them. So did he spend the winter after Philippi. Then his peregrinations brought him to the city of Tarsus, in Cilicia. Through his envoy, the versatile Q.
Rome Under The Triumvirs
Authors: Syme Ronald 
Published: October 2023

Abstract
IT was ten years from the proscriptions, ten years of Trium J. viral despotism. Despite repeated disturbances, the lapse of time permitted the Revolution (for such it may with propriety be called) to acquire permanence and stability. The beneficiaries of that violent process, dominant in every order of society, were in no way disposed to share their new privileges or welcome intruders. In a Senate of a thousand members a preponderance of Caesarians owed status and office, if not wealth as well, to the Triumvirs; and a mass of Roman knights, by their incorporation in that order, reinforced the bond between the higher classes of the holders of property. Veterans by grant, and freedmen by purchase, had acquired estates, sometimes with improvement of social standing, actual or in prospect: after the Sicilian War Octavianus accorded to his centurions on discharge the rank of town-councillors in their municipia.I Hence certain symptoms of consolidation, political and social. There were to be no more proscriptions, no more expulsions of Italian gentry and farmers. Many of the exiles had returned, and some through influence or protection got restitution off roperty. But the government had many enemies, the victims o confiscation, rancorous and impotent at the moment, but a danger for the near future, should the Republicans and Pompeians come back from the East, should Antonius demand lands for the veterans of his legions, should the dynasts, fulfilling a solemn pledge, restore the Republic after the end of all the wars. Though a formidable body of interests was massed in defence of the new order, it lacked inner cohesion and community of sentiment.
Antonius In The East
Authors: Syme Ronald 
Published: October 2023

Abstract
AFTER Brundisium the prestige of Antonius stood high, and A his predominance was confirmed by the renewal of the Triumvirate at Tarentum—when that office lapsed, Antonian consuls would be in power at Rome. Antonius had already lost the better part of two years—not Ventidius but the victor of Philippi should have driven the Parthians out of Asia. When at last his hands were free he departed to Syria, summoning thither the most powerful and most wealthy of the Roman vassals, the Queen of Egypt: he had not seen her for nearly four years. Fonteius brought her to Antioch, where they spent the winter of the year 37-36 in counsel and carouse. The invasion of Media and Parthia was designed for the next summer.
Dux
Authors: Syme Ronald 
Published: October 2023

Abstract
HE adversary spent the winter in Greece, ready in his preparations of army and fleet, but not perhaps as resolute as he might appear. Antonius now had to stand beside Cleopatrathere could be no turning back. Patrae at the mouth of the Gulf of Corinth was his head-quarters. His forces, fed by corn-ships from Egypt, were strung out in a long line from Corcyra and Epirus to the south-western extremity of Peloponnesus. The land army under the command of Canidius comprised nineteen of his legions: the other eleven made up the garrison of Egypt, Cyrene, Syria and Macedonia.