bluuebunny/crossref_metadata_2025_split huggingface dataset:
The 4Rs of Culturally Responsive Practice
Authors: Goforth Anisa N. , Pham Andy V. 
Published: January 2023

Abstract
Culturally responsive practice includes the intentional practice of critical reflexivity, relationships, responsiveness, and relational empowerment. The concepts of reflexivity and cultural humility come together as the result of trust between a practitioner and the students, families, and communities they serve. Relatedly, relationships (specifically family–school relationships) can serve as a keystone in fostering communication and trust. When building these relationships, however, it is important to consider making connections through cultural knowledge and by understanding another culture’s perceptions of mental health. Throughout all this, it is important to adapt practices as needed given the complexity and individuality of culturally and linguistically diverse students. The combination of using evidence-based practices and a strengths-based approach will highlight student strengths and bring empowerment to those involved in the intervention.
Session 10: Review and Relapse Prevention
Authors: Woods Douglas W. , Twohig Michael P. 
Published: January 2023

Abstract
This chapter provides a review of the overall treatment and discusses relapse prevention. Monitoring and checking in help prevent hair-pulling tendencies from returning. Lapses may occur during certain situations after treatment ends, and continued practice of the skills learned during treatment can prevent lapses. Relapse refers to a full and persistent return to old behaviors of hair pulling. The patient must be vigilant when practicing habit reduction training and trigger reduction strategies to prevent lapses or relapses. The chapter reviews the processes covered during treatment that relate to controlling urges and practicing skills within and outside of therapy sessions.
Sessions 6 and 7: Defusion from Your Inner Experiences: You Are Not Your Urges to Pull
Authors: Woods Douglas W. , Twohig Michael P. 
Published: January 2023

Abstract
This chapter describes the sixth and seventh sessions of the Acceptance and Commitment Therapy (ACT) Enhanced Behavior Therapy for Trichotillomania (AEBT-T) treatment package. Defusion is described as a therapeutic context that challenges the literality of language. The purpose of defusion exercises is not to change the client’s thinking from something that is illogical to something that is logical; rather, it is to change the context of language from something that supports inner experiences as literal events to something that looks at inner experiences as something to simply be experienced. One part of defusion is the ability to see that a person has thoughts that are separate from themselves and that thoughts and feelings affect the way the world is experienced. The chapter shows the therapist how to help a client see that their mind does not stop, that it always has something to say.
Oxford Case Histories in Obstetric Medicine
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
Obstetric Medicine provides the reader with 55 cases of different clinical presentations in obstetric medicine. Each case is presented with a background to the subject area, a summary of the history, and examination findings, and relevant investigation results. This is followed by several questions on clinically important aspects of the case with answers and detailed discussion, particularly of the differential management options. Each topic is mapped on to both the curriculum for physicians undertaking obstetric medicine, and for obstetric trainees studying for membership exams, the Advance Training Skills Module in maternal medicine, and speciality training in maternal and fetal medicine. Providing an ideal self-assessment tool, this new title is of interest to all doctors working in obstetrics, midwives, physicians who may encounter pregnant women in their clinical practice, and students revising for exams.
Case 4
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 33-year-old woman in her second pregnancy presented to the maternity assessment unit at 37 weeks of gestation with a 3-day history of itching and a new rash. She initially noticed the rash on the right side of her abdomen. It then spread across her abdomen, to involve both arms and legs, and neck. The rash was very itchy. She had had a cough and coryzal symptoms a week previously, but symptoms had resolved, and she had no temperature or other symptoms at that time. Oral antihistamines had not relieved the itching. She had a history of eczema, but this normally only affected her hands. She has tried her normal emollient, but this did not help.
Case 6
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 45-year-old woman with no past medical history presented with a painful left thigh, 4 weeks after the birth of her first child. The pain started 3 days prior to presentation on the medial aspect of the thigh, and subsequently radiated down the leg. It was associated with erythema, mild swelling, and pain on palpation. There was no history of trauma, no associated pain elsewhere, and she had never experienced anything similar in the past. Her pregnancy had been uncomplicated, but she had required an emergency caesarean section for a failed induction of labour. She had received 10 days of LMWH as VTE prophylaxis and had taken all the doses as prescribed. She had tried paracetamol with limited effect. She was not on any regular medications and had no significant family history. She had never smoked.
Case 13
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 39-year-old woman presented at 34 weeks of gestation with a tonic-clonic seizure. She had noticed a headache in the preceding few days. This was her first pregnancy, and her booking blood pressure was 100/70 mmHg and BMI was 23.5 kg/m2. There was no history of previous seizures, head injury, or high blood pressure. She had no past medical history and had never smoked. Her family history included hypertension in both her mother and sister. On examination she was drowsy, hypertension (175/105 mmHg) and had 2+ proteinuria. She had mild epigastric tenderness on abdominal examination and was hyperreflexic with five beats of clonus.
Case 17
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 32-year-old woman presented to the Emergency Department at 26 weeks of gestation with a vague constellation of worsening symptoms. She had a 4-week history of intractable nausea and was unable to tolerate oral fluids, despite treatment with cyclizine, metoclopramide, and ondansetron. She had also been experiencing intermittent generalized abdominal cramps, associated with loose stool, which was occasionally streaked with blood. She had been feeling increasingly tired, light-headed, and short of breath on minimal exertion. This was her first pregnancy, and she had no past medical history. In addition to the antiemetics, she was taking ferrous sulphate 200 mg on alternate days, as anaemia was identified on her booking bloods. Her father had a history of colonic polyps. She was an ex-smoker (10–15 a day for 12 years) and had drunk 25 units of alcohol per week prior to pregnancy. There was no history of recent overseas travel.
Case 24
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 32-year-old woman called the maternity advice line when she was 26 weeks pregnant. She was concerned as she worked as a primary school teacher and one of the children in her class had developed a rash which looked like chickenpox. The patient had not had chickenpox as a child and had not been vaccinated. She had been feeling well throughout pregnancy and had no similar symptoms. This was her second pregnancy; her first pregnancy had been uncomplicated, and she had delivered vaginally at term. She was taking pregnancy multivitamins but no regular medication. She was a non-smoker and did not drink alcohol.
Case 27
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 19-year-old woman in her first pregnancy was seen urgently in the antenatal clinic. She was approximately 12 weeks pregnant. Nine months prior to conception she had been diagnosed with moderate pulmonary arterial hypertension after extensive investigation and assessment. She had been started on a calcium channel blocker. She was able to walk up one flight of stairs without stopping but would be short of breath at the top. She became breathless when walking fast. She was World Health Organization (WHO) functional class II. She did not have any orthopnoea or paroxysmal dyspnoea, and no cough. She reported ankle swelling, particularly at night. She complained of worsening fatigue and dull substernal chest discomfort and occasional light-headedness.
Case 35
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 32-year-old woman was brought into the Emergency Department at 32 weeks of gestation. She was unwell and described severe left-sided chest pain and shortness of breath. The pain had started quite suddenly about an hour previously. It was severe, worse on inspiration, and on coughing she could feel the pain radiate to her back. She had noticed some mild right leg swelling and discomfort over the preceding two days but had otherwise been well. This was her first pregnancy and it has been uneventful until this point. She had no significant past medical history and was only taking pregnancy vitamins regularly. Her family history was notable for a pulmonary embolism in her mother after a hip replacement. She worked as a secondary school teacher, lived with her husband, and did not smoke.
Case 42
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 34-year-old woman underwent IVF treatment and became pregnant with DCDA twins. At booking her BP was 117/70 mmHg and her BMI was 28 kg/m2. Her pregnancy had been uncomplicated until the diagnosis of gestational diabetes, diagnosed on oral glucose tolerance test at 28 weeks. She was managing her blood glucose levels by dietary changes alone. She presented to the assessment unit at 34 weeks of gestation feeling generally unwell, with symptoms of nausea, alongside new-onset polyuria and polydipsia. She had no past medical history and was not on any regular medication. She was a non-smoker.
Case 45
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 32-year-old woman attended the obstetric medicine clinic at 30 weeks of gestation in her first pregnancy. Over the previous 10 weeks, she had been seen 3 times in the Emergency Department with collapse. She reported that her legs simply gave way and she fell to the ground. She did not lose consciousness, she had no headache, chest pain, palpitations, or any other symptoms. Her arms also felt heavy. Her symptoms improved each time after approximately 30 minutes rest. She had been feeling increasingly fatigued during her pregnancy, particularly in the afternoons, and often had to lie down. In the afternoons, her exercise tolerance had reduced so she could only walk for 10 minutes before feeling completely exhausted and having to rest. She had reduced her oral intake as she felt tired when eating.
Case 47
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 38-year-old woman was found to have low platelets on her booking blood tests in her first pregnancy. This abnormality was confirmed on repeat testing, and she was referred to the specialist clinic for review, where she was seen at 14 weeks of gestation. Her pregnancy had been otherwise uncomplicated. She had no significant past medical history and was taking pregnancy multivitamins. She had never smoked or taken recreational drugs. Examination was normal.
Case 49
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 41-year-old woman in her first pregnancy was seen in the maternity assessment unit at 34 weeks of gestation. She reports reduced fetal movement for the last 24 hours. She states that she has attended 2 other times for reduced fetal movements in pregnancy, but the CTG has been reassuring each time. She had been visiting her sister for the last 2 days and her normal antenatal care was in a different hospital. She does not have her maternity notes with her. She is HIV positive and has been taking highly active anti-retroviral therapy throughout her pregnancy. She reports having an undetectable viral load. She has no other medical conditions and states her HIV has been well managed since diagnosis. She is also taking pregnancy multivitamins. She has no allergies, smoked 10 cigarettes per day prior to pregnancy, but gave up when she found she was pregnant.
Case 51
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 30-year-old woman was referred urgently by her GP following a positive pregnancy test. She was originally from Somalia and had previously undergone replacement of her mitral and aortic valves for severe rheumatic heart disease. Following the surgery 4 years previously she had been anticoagulated on warfarin, with a stable INR (target 3.0, range 2.5–3.5) on 10 mg warfarin daily. She had been told that she could not conceive on warfarin but had understood that to mean she would be unable to get pregnant, rather than that she should not become pregnant. There had never been concern about valve function. There was no other past medical history, and she was not on any other regular medication. Her BMI was 35 kg/m2. She did not smoke or drink alcohol.
Case 52
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 36-year-old woman was seen in a routine antenatal clinic at 28 weeks of gestation in her first pregnancy. She described breathlessness on exertion but not on lying flat, extreme fatigue, falling asleep watching TV or reading in a chair, and she had reduced her driving as she is worried about feeling sleepy. She also mentioned that she is concerned her sleep has been poor for a long time (including prior to pregnancy) but had worsened during the second trimester. She described her husband frequently complaining that she snores heavily, and sometimes was concerned as he noticed her breathing is sometimes erratic, and sometimes there are big pauses in her breathing. She had no chest pain, cough, or wheeze. She had mild swelling of her ankles bilaterally but no pain or swelling in her calves.
How to request a test: A clinician's guide to the interpretation and evaluation of medical tests
Authors: Boyles Tom 
Published: January 2023

Abstract
How to Request a Test: A Clinician’s Guide to the Interpretation and Evaluation of Medical Tests is a comprehensive overview of everything a doctor needs to know before performing a test. It fast-tracks learners to the level of experienced clinicians by providing insight into how they are able to use minimal tests to rapidly arrive at diagnoses. Illustrated throughout with real-life examples from multiple medical and surgical specialties, it begins with a simple definition of a test before moving on to explain the pros and cons of simple terms used to describe diagnostic accuracy, such as sensitivity, specificity, and predictive values. It continues with an introduction to Bayes’ theorem and explains how likelihood ratios are a possible solution to the drawbacks of simple measures of diagnostic accuracy. In light of this, the book evaluates the controversial case of prostate cancer screening with prostate-specific antigen. Drawing on classic papers from the 1970s, the book then introduces basic medical decision theory based on threshold values and explains their practicality in real-world scenarios. The book then turns from an individual to a public health approach, describing different methods of evaluating tests before they are introduced into healthcare systems, including the use of randomized controlled trials to determine their impact on patient outcomes. The example of a novel test for tuberculosis is used to illustrate how this works in practice and the book concludes with a simple four-point checklist for clinicians to consider before requesting a test.
Determining the Accuracy of a Test
Authors: Boyles Tom 
Published: January 2023

Abstract
This chapter describes the elements that must be included in any empirical study of test accuracy. It describes how the target condition must be clearly defined along with the reference standard against which the novel (or index) test will be measured. It explains that not all reference standards are 100% accurate in all circumstances and may be chosen as a compromise between simplicity and accuracy. It explains how case-controlled study designs are cheaper and faster but have limited value compared to prospective cohort studies and that results will be most valid if the population and setting (domain) of the study are the same as that in which the test will be used in practice. The chapter outlines how the output of a diagnostic accuracy study when the index test result is binary is a 2×2 table and when it is continuous it can be viewed as two frequency distributions and that the Standards for Reporting Diagnostic accuracy studies (STARD) guideline should be followed when reporting diagnostic accuracy studies.
Test Accuracy As Likelihood Ratios
Authors: Boyles Tom 
Published: January 2023

Abstract
This chapter introduces readers to the use of Bayes’ theorem as a potential way to address the drawbacks of sensitivity, specificity, and predictive values. It describes the process of updating the probability of a condition based on test results and that the principal statistics (Bayes’ factors) are the likelihood ratios which are calculated from all four squares of a 2×2 table. It explains how the application of Bayes’ theorem to medical testing begins with a calculation of the pre-test probability of a condition using intuition and experience or, where available, a data-driven approach. It continues with the method of combining pre-test probabilities with likelihood ratios to give post-test probabilities, which can be illustrated with a Fagan nomogram but is best performed with a smartphone app. It concludes with a discussion of screening tests which are typically performed at very low pre-test probability when tests with very high diagnostic accuracy are needed.
Evaluation of a Novel Test
Authors: Boyles Tom 
Published: January 2023

Abstract
This chapter draws together the whole book using the example of Xpert MTB/RIF, a novel test for tuberculosis (TB) that has recently been introduced and evaluated. It gives a brief history of TB diagnostics including difficulties encountered following the HIV pandemic then presents a seminal paper from 2010 describing the high diagnostic accuracy of Xpert MTB/RIF. The chapter then explains that appropriate diagnostic research was not carried out but instead researchers carried out diagnostic intervention research which failed to show any impact on patient-relevant outcomes and how, despite this, the World Health Organization has continued with the widespread roll-out of Xpert MTB/RIF. It explains the World Health Organization target product profiles for TB diagnostics and how these are inadequate to determine if a test will improve patient outcomes.
Hospice and Palliative Care
Authors: Higginson Irene J. , Gomes Barbara , Bone Anna E. 
Published: January 2023

Abstract
Hospice and palliative care have always embraced the “whole” person in the context of their family, encompassing physical, psychological, emotional, social, and spiritual aspects of care. Mental disorders and psychological distress are among the most common, overlooked, and troublesome complications of advanced illness, which highlights the important role of psychiatrists and psychologists, social workers, and all variety of psychosocial professionals in the multiprofessional care team. This chapter outlines the contributions of key multiprofessional individuals and groups to hospice and palliative care development over time, including current international initiatives that continue to grow and shape the field. The importance of holistic and systematic assessment of patients with advanced conditions and the development of validated assessment tools to support this are discussed. Barriers that interfere with recognition and treatment of the full range of problems in advanced illness include prognostic uncertainty, challenges in diagnosing mental disorders in the context of serious illness, and stigma surrounding mental disorders. In overcoming some of these barriers, the importance of recognizing the interface between the mind and body in approaches to care is illustrated using the example of breathlessness management among people with advanced disease. The holistic practice of hospice and palliative care provides an exciting opportunity for psychiatrists, psychologists, social workers, and other psychosocial professionals keen to work on the interface of mind and body.
Delirium in the Terminally Ill
Authors: Manschreck Christopher , Alici Yesne , Breitbart William 
Published: January 2023

Abstract
Delirium is one of the most common neuropsychiatric complications in the management of terminally ill patients. Delirium is characterized by an abrupt onset and fluctuating disturbance in arousal, attention, cognition, and perception. Delirium is a serious neuropsychiatric condition that is associated with increased morbidity and mortality, causing distress in patients, family members, and staff. Delirium signals a medical emergency. Emerging from significant physiologic disturbance, usually involving multiple medical etiologies, delirium requires prevention, early identification, and vigorous treatment. Unfortunately, delirium is often underrecognized, misdiagnosed, inappropriately treated, or untreated in the medical setting. Palliative care specialists and others who care for terminally ill patients must be able to diagnose delirium accurately, undertake appropriate assessment of etiologies, and understand the benefits and risks of pharmacologic and nonpharmacologic interventions currently available. This chapter presents a comprehensive overview of the epidemiology, pathophysiology, clinical features, assessment, and management of delirium in the terminally ill.