bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Narrative-Crisis Model of Suicide
Authors: Galynker Igor 
Published: March 2023

Abstract
The narrative-crisis model of suicide (NCM) is a multistage diathesis-stress model of suicide that integrates empirically validated long- and short-term risk factors to explain the mental processes that lead to suicide. As a preface to a detailed discussion of the NCM, the chapter outlines key differences between trait and state risk factors, as well as between static and dynamic risk factors. The primary focus of the chapter is to expound on the NCM and its theoretical basis: when individuals with heightened baseline vulnerability for suicide (i.e., long-term risks factors) encounter stressful life events, they may develop distorted views of themselves and others, culminating in a perception of their having no future and increasing the likelihood of their developing a suicidal crisis. The NCM’s three components, which are discussed throughout the chapter, are: (1) long-term risk factors, which are relatively stable over time and incur heightened vulnerability for suicide; (2) the suicidal narrative, a subacute suicidal state whereby individuals develop maladaptive views of themselves and the world that result in the perception of an intolerable present and a future that is unimaginable; and (3) suicide crisis syndrome, an acute suicidal state characterized by cognitive and affective dysregulation that signals imminent risk for suicidal behavior. The result of SCS is a suicide attempt, made in a desperate urge to end the intolerable mental pain of SCS. Empirical support for the NCM, as well as the model’s flexibility in explaining several types of suicidal behaviors, are also discussed.
Stressful Life Events
Authors: Lawrence Olivia C. , Goncearenco Inna , Ziafat Kimia 
Published: March 2023

Abstract
Stressful life events are critical precipitants of suicidal thoughts and behaviors and play a central role in triggering the onset of acute suicidal states. This chapter reviews the evidence to date for various types of stressors that have been linked to suicidal thoughts and behaviors. Six broad categories of stressful life events are examined: work and financial hardship, relationship conflict, serious medical illness, serious mental illness, recent substance misuse, Internet and social media use, and the COVID-19 pandemic. While the literature discussed in the chapter largely includes adult samples, stressful life events shown to be uniquely related to suicide in adolescents, such as conflict with parents, ongoing childhood neglect, and bullying, are also examined throughout the text. Case examples are provided throughout the chapter to illustrate the role of stressful life events in conferring increased suicide risk.
Suicide Crisis Syndrome
Authors: Galynker Igor 
Published: March 2023

Abstract
This chapter provides an in-depth review of the suicide crisis syndrome (SCS), an acute pre-suicidal mental state associated with imminent suicidal behavior. The chapter opens with a brief overview of the increasing empirical focus on understanding short-term risk factors for suicide, following an introduction to SCS, the rationale for its development, and its empirical basis. The next sections examine the proposed DSM diagnostic criteria for SCS and the research supporting the validity, reliability, and clinical utility of SCS and its symptomology. The first key symptom of SCS is a frantic hopelessness/entrapment, defined as a persistent or recurring overwhelming feeling of urgency to escape or avoid an unbearable life situation that is perceived to be impossible to escape, avoid, or endure (Criterion A). Additional diagnostic criteria include affective disturbances, loss of cognitive control, hyperarousal, and acute social withdrawal (Criteria B). Structured according to the proposed SCS DSM criteria, the SCS assessment algorithm provided in this chapter does not rely on self-disclosure of suicidal ideation. Additionally, the One-minute Assessment, which targets core symptoms of SCS, is suggested for use in high-volume and high-pressure clinical settings, such as the emergency department. An in-depth analysis of three clinical cases, representing the high risk of imminent suicide, moderate risk of imminent suicide, and low risk of imminent suicide, is included to illustrate the SCS interview assessment algorithm.
Emotional Response to Suicidal Patients in the Assessment of Imminent Suicide Risk
Authors: Imbastaro Benedetta , Lawrence Olivia C. , Goncearenco Inna , Ziafat Kimia 
Published: March 2023

Abstract
Clinicians’ emotional responses to suicidal patients can be a clinically useful source of information when determining a patient’s level of suicide risk. Although clinicians’ emotional responses to suicidal patients have been largely overlooked in research and practice, a growing body of evidence suggests that clinicians exhibit unique patterns of emotional reactions to suicidal patients that are linked to clinician decision-making and prospective suicidal outcomes. This chapter reviews the extant literature on the association between clinicians’ emotional responses in interaction with suicidal patients and patients’ future suicidal behavior. Underlying mechanisms of clinicians’ emotional responses, common defense mechanisms in psychotherapy with suicidal patients, and the meaning of different patterns of clinician emotional responses are discussed and illustrated by clinical cases. Additionally, the use of clinicians’ emotions as diagnostic tools for assessing imminent suicide risk is described. The chapter outlines a self-assessment framework, which includes guidelines for appraising one’s subjective emotional response and incorporating it into formulating a patient’s suicide risk. A practical method for assessing one’s emotional response is provided with relevant clinical cases illustrating its implementation in clinical assessment.
Orthopedic Surgery
Authors: Lazar Alina 
Published: March 2023

Abstract
Orthopedic surgery is frequently performed in children for traumatic fractures, developmental disorders of the skeleton, and bone neoplasms. The main anesthetic considerations are bleeding, sequelae of abnormal neurodevelopment or prematurity, and pain management. Multimodal analgesia, including regional anesthesia, is recommended. When performing neuraxial and peripheral nerve blocks proper patient selection and postoperative monitoring are essential to avoid complications. Scoliosis correction is done via either rod placement or spinal fixation. Bleeding and difficulties with neuromonitoring are of particular concern in patients with neuromuscular scoliosis. Spinal cord injury and severe postoperative pain are other important risks associated with scoliosis surgery. Antifibrinolytics and blood salvage techniques decrease blood loss, while multimodal analgesia, including opioids, adjuvants, and regional anesthesia, ensure adequate postoperative pain management.
Pediatric Ambulatory Surgery
Authors: McCormick Megan Rodgers 
Published: March 2023

Abstract
Children are often excellent candidates for outpatient surgery since they are generally healthy individuals undergoing brief surgeries with few complications. This chapter focuses on a brief overview of managing an outpatient pediatric anesthesia patient from preoperative to postoperative care. It reviews preoperative fasting guidelines, preoperative anxiolysis and premedication, and parental presence for induction. Inclusion and exclusion criteria for appropriate candidates are outlined, including postconceptual age and apnea concerns. Different types of induction techniques and intraoperative management and monitoring are reviewed. Common postoperative complications such as postoperative nausea and vomiting (PONV) are mentioned. Postoperative discharge criteria and the scales used to evaluate patients are described.
Cesarean Section
Authors: Al-Jindi Piotr , Attali Ami 
Published: March 2023

Abstract
Cesarean delivery is the most common surgical procedure performed worldwide. There are various indications related to maternal, fetal, uterus, or placental pathology. Preoperative evaluation includes review of past medical and obstetric history, including physical examination of airway, heart, and lungs. A blood type and crossmatch, intravenous access, aspiration prophylaxis, postoperative nausea and vomiting (PONV) management, and prophylactic antibiotics are integrals part of a preoperative plan. Neuraxial anesthesia is the preferred method of anesthesia for caesarian section unless there is an absolute contraindication. Advantages of neuraxial anesthesia include decreasing maternal mortality, limited neonatal drug transfer, ability of the parents to be awake and take part in the delivery during the birth of their child, and avoiding airway manipulation in patients who have both a potentially difficult airway and an aspiration risk. Different neuraxial techniques used for caesarian section include epidural, single-shot spinal, combined spinal-epidural, and spinal catheter. In case of general anesthesia, all equipment should be readily available with standard American Society of Anesthesiologist monitoring, including pulse oximetry, electrocardiography (ECG), capnography, and noninvasive blood pressure (NIBP). Rapid sequence induction and intubation with cricoid pressure are preferred after preoxygenation. All airway instruments should be available for a potential difficult airway, including an awake intubation plan if indicated. Anesthetic complications include intraoperative awareness and recall, dyspnea following neuraxial anesthesia, hypotension, failure of neuraxial blockade, high neuraxial blockade, difficult airway/trauma to the airway, and nausea and vomiting. Some of the important aspects of postoperative management include postoperative pain, pruritus, hypothermia, hemorrhage, and thromboembolic events.
Anesthesia for Cerclage or Nonobstetric Surgery
Authors: Ibrahim Rowaa , Attali Ami 
Published: March 2023

Abstract
Anesthetic management of pregnant women can be challenging, with multiple factors affecting the decision-making process, especially when considering nonobstetric surgery. The well-being of the mother and the fetus are a priority; therefore, clear communication between the multidisciplinary team is crucial. Guidelines have been recommended by both the American College of Obstetricians and Gynecologists and American Society of Anesthesiologists for management in both elective and emergent scenarios. A thorough preoperative assessment is needed and can help mitigate the risks associated with anesthesia for both the mother and baby. Intraoperative management must consider the physiological changes, fetal gestational age, as well as concomitant surgical risks that occur with pregnancy. The recovery period postoperatively focuses on multimodal management as well as avoiding possible complications of surgery. With a comprehensive perioperative plan, the gestation can return to its natural course.
Gestational Trophoblastic Disease
Authors: Younger Joshua D. 
Published: March 2023

Abstract
Gestational trophoblastic disease (GTD) is a spectrum of diseases that arise from the maldevelopment of trophoblastic tissue. Trophoblastic tissue develops as early as 4 days after fertilization. The tissue serves to feed and nourish the developing embryo. GTD can range from benign to lethal consequences. Included in this disease spectrum is a partial hydatiform molar pregnancy, complete molar pregnancy, invasive molar pregnancy, placental site trophoblastic tumor, and gestational choriocarcinoma. There can be multiple medical and specific anesthetic considerations that need to be appreciated. A thorough understanding of the disease processes and their complications allows for optimal anesthetic preparation and administration.
Autoimmune Disorders
Authors: Bhatia Anuschka , Chung Kevin W. 
Published: March 2023

Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by autoantibody formation, multisystem immune complex deposition, and organ inflammation. Overall prevalence is approximately 50 per 100,000, and approximately 1 in every 1200 deliveries in the United States is affected. Pregnancy in patients with SLE is associated with a higher incidence of lupus-associated complications, as well as adverse maternal and obstetrical outcomes, such as preterm labor, unplanned cesarean delivery, maternal hypertension, preeclampsia, and eclampsia. Antiphospholipid syndrome (APS) is an acquired hypercoagulable state common among patients with SLE. Both SLE and APS require a multidisciplinary approach and specific anesthetic considerations in the peripartum period.
Hypertension
Authors: Ahmed Muhammad Fayyaz , Kamel Ihab 
Published: March 2023

Abstract
Hypertension complicates 5% to 10% of all pregnancies, and it is a major cause of maternal morbidity and mortality worldwide. Hypertensive disorders complicate pregnancy and can lead to significant maternal and fetal complications. Hypertensive disorders are classified into clinical classes that include chronic hypertension, gestational hypertension, hypertension with superimposed preeclampsia, and preeclampsia. During treatment of hypertensive disorders, attention should be given to fetal effects of antihypertensive medications and to maintenance of adequate uteroplacental perfusion. Intense sympathetic stimulation due to labor pain or direct laryngoscopy and intubation may lead to acute severe hypertension, which can then lead to life-threatening maternal complications.
Embolic Disorders
Authors: Ahmed Muhammad Fayyaz , Kamel Ihab 
Published: March 2023

Abstract
Embolic disorders are a major cause of maternal mortality in the United States, accounting for approximately 20% of all maternal deaths. It comprises mainly amniotic fluid embolism, venous thromboembolism, and venous air embolism. Each of the disorders has a different clinical course and management. Early recognition and management are necessary to reduce morbidity and mortality. High-risk patients with history of thrombosis, acquired or inherited thrombophilias, or patients with a mechanical heart valve should be anticoagulated during pregnancy as well as the postpartum period. Anesthetic considerations of the embolic disorders include preoperative assessment of high-risk patients for safe neuraxial anesthesia administration and management of intraoperative cardiovascular collapse that may result from massive embolism.
Retained Placenta
Authors: Ahmed Muhammad Fayyaz , Kamel Ihab 
Published: March 2023

Abstract
Retained placenta is a failure to deliver the placenta completely within 30 minutes (active management of labor) or 60 minutes (physiologic management of labor) after the delivery of the fetus. Reported incidence ranges from 0.01% to 6.3% of vaginal deliveries. The retained placenta can lead to various complications, including life-threatening postpartum hemorrhage. Treatment involves early extraction of the retained placenta while preparing for resuscitation if hemodynamic instability ensues. General and neuraxial anesthesia can be considered for the extraction procedure, bearing in mind that neuraxial anesthesia is best suited for hemodynamically stable patients. Uterine relaxation with pharmacological means is usually required to facilitate extraction.
Patient Selection and Preoperative Management
Authors: Moskal Anna 
Published: March 2023

Abstract
The development of minimally invasive surgery, improvement in surgical technique and pain control, as well as better patient selection and preoperative management contribute to significant expansion of ambulatory anesthesia. Nearly two-thirds of all operations are performed in outpatient facilities according to the Centers for Disease Control and Prevention. The surgical procedures suitable for same-day surgery are characterized by modest surgical trauma, no likelihood of continuing blood loss or large perioperative fluid shifts, or no need for complex postoperative care. Ambulatory surgery is being offered to a variety of patients with significant coexistent diseases. The suitability of ambulatory surgery in patients with obstructive sleep apnea (OSA) remains controversial; therefore, the Society for Ambulatory Anesthesia (SAMBA) developed a consensus statement. The recommendations include the use of the STOP-Bang questionnaire for preoperative OSA screening and considering patients’ comorbid conditions in the selection process. Ambulatory surgery is very safe, with low perioperative mortality. Predictors for morbidity and mortality are obesity, prolonged operative time, prior cardiac surgical intervention, hypertension, and a history of transient ischemic attack or stroke. In elderly patients, the presence of comorbidities, disability, and frailty are associated with postoperative complications.
Discharge Criteria and Postoperative Follow-up
Authors: Connolly Matthew T. , Abd-Elsayed Alaa 
Published: March 2023

Abstract
The objective of this chapter is to provide a concise overview of high-yield requirements and associated relevant topics for discharge from the postanesthesia care unit (PACU), phase II, and discharge home as well as home follow-up. The Modified Aldrete Scoring System and Post-Anesthetic Discharge Scoring System (PADSS) are the two most common criteria used for PACU discharge; both include the general principles based on updated American Society of Anesthesiologists guidelines that should serve as a supplement to the individual anesthesia providers’ overall evaluation of discharge readiness. Specialty topics related to anesthesia discharge and follow-up addressed include fast tracking and discharge/follow-up in the pediatric population.
Office-Based Anesthesia (OBA)
Authors: Heidari Afshin , Aquino Ben 
Published: March 2023

Abstract
Office-based anesthesia (OBA) examines one of the most significant changes in medicine and surgery in recent years. This has been driven by new medical knowledge about inpatient and outpatient medicine, improvement in surgical and anesthetic techniques, and the administrative need to maximize efficiency and minimize cost. Cholecystectomy, for example, an operation once done open with a weeklong hospital stay, is now done laparoscopically and, in some centers, as an outpatient procedure. Procedures that were previously done at an outpatient surgery center are now given in office-based settings. As more complex and invasive procedures are being done on patients with more comorbidities, it is essential for the anesthesia provider to understand the need and importance of safe OBA.
Malpractice
Authors: Ghosh Priyanka 
Published: March 2023

Abstract
Malpractice is an important concept in every physician’s practice, including the anesthesiologist. Malpractice broadly refers to medical negligence that was caused directly by the physician’s actions. Malpractice lawsuits must prove direct damages to the patient. In order to prove negligence, the situation must include four discrete elements, often referred to as “the four D’s” of medical negligence: duty, dereliction, direct causation, and damage. Over time, anesthesiology has become increasingly safe for patients, with a decrease in overall severity and number of malpractice claims. However, there continue to be malpractice claims made in anesthesiology; this is discussed in depth in this chapter.
Initial Certification, Recertification, Maintenance of Certification, and Related Issues
Authors: Chiong Katya H. , Abouhassan Soozan S. 
Published: March 2023

Abstract
The American Board of Anesthesiology (ABA) has transitioned to a new assessment of competency-based training and promotion mirroring the evaluation of anesthesia residents across the Accreditation Council of Graduate Medical Education (ACGME) system. Instead of the Traditional Part 1 (written) and Traditional Part 2 (Oral) Examination, candidates are now expected to complete a three-part examination: the BASIC, ADVANCED, and APPLIED Exams. The APPLIED Exam now includes elements of Objective Structured Clinical Examinations (OSCEs) in addition to the traditional Standardized Oral Examination (SOE) questions of the Traditional Part 2 (Oral) Examination. Candidates must satisfy all requirements for initial certification within 7 years of the last day of the year in which they completed their residency training. If a candidate does not satisfy all requirements for certification within the allotted time period, the candidate must reestablish eligibility with the ABA examination system. To maintain certification and meet recertification requirements, all newly certified diplomates participate in the ABA’s Maintenance of Certification in Anesthesiology™ (MOCA®) program, currently MOCA 2.0®. This program is designed to promote lifelong learning, maintain current medical knowledge, and promote patient safety.
Quality Improvement
Authors: McComb Joseph J. , Wong Corinne K. 
Published: March 2023

Abstract
Despite lagging other US industries, effective healthcare quality improvement (QI) programs are expected by patients, insurers, government agencies, and hospital leadership. Quality is important in any field, but even more so in medicine, where life and death are at stake. As the finances of medicine become more important, it is stressed more that we should look to produce quality medicine with fewer resources. The chapter looks at quality improvement projects to help streamline and provide better patient care while reducing expenses and increasing productivity. Anesthetists need to look at their culture, teamwork, current safety guidelines to help guide us and develop new methods for achieving quality and safe medicine.
The Greeks
Authors: Berman Carol W. 
Published: March 2023

Abstract
Starting from the ancient Greeks, plays have demonstrated basic psychiatric principles. For example, Sophocles’ Oedipus Rex shows Oedipus’s journey from marrying his mother to killing his father. Psychological studies revealed that boys of about three years old desire to be with their mothers and want to eliminate their fathers. We call this principle the Oedipus complex after Sophocles’s play. Similarly, girls at three yearn to be with their fathers and rid themselves of their mothers. Sophocles’s play Electra illustrates this psychiatric concept. Many other Greek plays portray fundamental truths in psychology. In Euripides’s Medea the extreme emotions of revenge of a woman betrayed by her husband are witnessed.
Reich’s Ideas
Authors: Berman Carol W. 
Published: March 2023

Abstract
Wilhelm Reich’s contributions to psychiatry include the study of character structure, studies of the psychology of fascism, and studies of sexuality. In opposition to Freud, Reich argued that every neurosis is the result of the damming up of sexual energy. He stressed character formation as a result of a human being dealing with instinctual conflicts. For him, the body armored itself in ways that therapists could read in body language and utilize for patients’ benefits. According to Reich, there are hysterical characters, compulsive characters, and impulsive ones. Blanche DuBois, in Tennessee Williams’s A Streetcar Named Desire is an example of a hysterical, impulsive character. When people watch this play, they usually empathize with Blanche and thereby achieve a catharsis.
Klein’s Positions
Authors: Berman Carol W. 
Published: March 2023

Abstract
Melanie Klein is famous for her work in object relations theory. Klein’s object relations theory is a variation of psychoanalytic theory. It places less emphasis on biological-based drives and more importance on interpersonal relationships. People are always dealing with relationships to objects (which can also be people). Her concepts of the “good breast” (mother providing nourishment) versus the “bad breast” (no nourishment from mother) established paranoid or depressed positions that patients could take. In Romeo and Juliet, the lovers become good and bad “breasts” to each other at different times and ultimately commit suicide when they feel the loss of each other as “objects.”