bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case 9
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 32-year-old woman presented to the Emergency Department with shortness of breath 3 weeks after the birth of her first child. The pregnancy had been uneventful, and she had an uncomplicated vaginal birth after spontaneous labour at 40 weeks of gestation. She was discharged the day following birth. She described worsening short of breath over the preceding week. This was worse on exertion, and she was unable to walk up the stairs. She also felt occasionally short of breath at rest. She did not wake up at night feeling breathless but was sleeping on four pillows as she felt short of breath lying flatter than this. She also suffered from palpitations for the last 3 days but did not have any chest pain. She had no other significant past medical history or family history. She was on no regular medications and did not smoke.
Case 10
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 25-year-old woman had a history of end-stage renal failure (ESRF) secondary to focal segmental glomerulosclerosis and was having regular haemodialysis via tunnelled catheter. She had been on the transplant list for a year, but no match had been identified. She attended the Emergency Department with abdominal pain, fever, vomiting, and concern about sepsis. She still passed small volumes of urine and did not have any symptoms of urine infection. She had no other past medical history. She was taking alfacalcidol three times a week, erythropoietin injections twice a week, ramipril daily, and intermittently received intravenous iron whilst on haemodialysis. She had no family history of any illnesses and had never smoked.
Case 12
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 20-year-old woman presented at 28 weeks of gestation in her first pregnancy with a 2-week history of palpitations. They were occurring daily, lasting for 10–15 minutes, and usually occurred at rest. There was no associated chest pain, shortness of breath, or syncope. She had had no previous episodes and was otherwise fit and well, with no significant past medical history. She was not on any regular medication, and she had never smoked. Her booking BP was 100/70 mmHg and BMI was 24 kg/m2. On examination observations were normal apart from a heart rate of 110 bpm.
Case 20
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 37-year-old woman was pregnant for the first time with DCDA twins. She had an uncomplicated pregnancy and elective caesarean delivery was undertaken at 37 weeks of gestation. The twins were born in good condition with normal birthweight. Birth was complicated by postpartum haemorrhage; the mother lost approximately 400 ml of blood. She had no significant past medical history and her only regular medication in pregnancy was vitamin D and aspirin 150 mg daily (pre-eclampsia prophylaxis).
Immediately postpartum she had a single episode of hypertension (150/95 mmHg) that was normal when repeated. The day after birth it was noted that her urine output reduced significantly. The day after this, she complained of feeling generally unwell, with blurred vision and dizziness. She did not have a headache and had no altered level of consciousness.
Case 22
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 37-year-old woman attended the Maternity Assessment Unit at 26 weeks of gestation, reporting a 4-day history of itchy feet and arms which was so severe that she could sleep. There was no associated rash. She initially thought she had been bitten by an insect but there was no evidence of any bites. She reported dark urine but was uncertain about whether her stool was paler in colour than normal. She was in her first pregnancy, and at booking her BP, BMI, and routine bloods were normal. She had no significant past medical history. She was taking vitamin D supplements and had not taken any new medications or supplements in the weeks preceding this presentation. She described allergies to penicillin and peanuts. She did try some chlorphenamine which helped her sleep but did not improve the itch. She worked as a teacher and had never smoked.
Case 29
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 35-year-old woman was pregnant for the first time. She had no significant past medical history. When she booked with her midwife, she had a normal blood pressure (105/70 mmHg), and a urine sample was sent for culture. No dipstick results were documented. Her BMI was 42 kg/m2. At her 16-week antenatal visit she was noted to have 2+ proteinuria on dipstick, which was confirmed by a urinary protein:creatinine ratio of 100 mg/mmol. Her blood pressure remained normal, she had no symptoms of urinary tract infection, and she was entirely well in herself. There were no abnormal findings on examination.
Case 38
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 37-year-old woman was re-admitted 5 days after birth having developed shortness of breath and wheeze. Her pregnancy had been uncomplicated, and she had required an emergency caesarean section for a failed induction of labour (post-dates). She was discharged 2 days after birth with non-steroidal analgesia and the remainder of a 10-day course of prophylactic LMWH. Daily midwifery review after discharge had not identified any abnormalities except peripheral oedema. She had no other past medical history and no allergies. She was exclusively breastfeeding her infant. On examination, she was unwell, oxygen saturations were 70%, blood pressure was 170/100 mmHg and respiratory rate 28 breaths/min.
Case 46
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 26-year-old woman in her second pregnancy attended the Maternity Assessment Unit at 30 weeks of gestation. She had felt unwell for 1 week, with nausea, malaise, vomiting, transient diarrhoea, mild fever, and non-specific abdominal pain. She also complained of itch on her arms. She had been well in her pregnancy up to that point. She had no other significant past medical history and was on no regular medication except pregnancy multivitamins. She had been taking paracetamol for the last week to help with her symptoms. She did not drink alcohol and had never smoked. She had not had any unwell contacts. She had spent 1 month in India from 21 weeks of gestation visiting family in both the city and countryside.
Case 53
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry 
Published: January 2023

Abstract
A 45-year-old woman in her first pregnancy presented to the maternity day assessment unit at 22 weeks of gestation with 2 transient episodes of abnormal vision and difficulty speaking normally, associated with a headache. Each episode lasted for about 2 hours, had an acute onset and offset, and had fully resolved by the time she was assessed. She had no past medical history, however had been experiencing unilateral headaches throughout pregnancy. She was not taking any regular medications and had no known drug allergies. Her father had had a stroke aged 60 years. She had never smoked.
Integrating Psychiatry and Palliative Medicine
Authors: Kissane David W. 
Published: January 2023

Abstract
The biopsychosocial model is integral to the understanding of human suffering and well-espoused by consultation-liaison psychiatry, which has made a vital contribution to the development of palliative care. The research methodologies from psycho-oncology have contributed greatly through several interventions designed to preserve dignity and sustain meaning in the face of dying. Psychiatry has grappled with the existential challenges so prevalent at the end of life; helped in the recognition of maladaptive pathways that end in depression, anxiety, and demoralization; and aided with effective treatments that sustain well-being and quality of life. The psychiatrist has accumulated evidence for best practice treatment of depression, anxiety, delirium, and suicidal ideation while being recognized as the expert to assess decision-making capacity when this is needed in palliative care. Much of the art of the physician as a compassionate healer is derived from the integration of psychiatric practice into palliative medicine.
Palliative Care for People Who Experience Severe Persistent Mental Illness
Authors: Bates Alan , Nunez John-Jose , Farag Alexandra , Fudge David , O’Shea Timothy , Baba Willison Kathleen , Woods Anne 
Published: January 2023

Abstract
There are many complexities in psychiatric care of people with severe and persistent mental illness (SPMI) and care of people at end-of-life. The combination of the two can be particularly challenging with major issues including access to care, care planning, care setting, patient decision-making capacity and autonomy, medication interactions, and patient vulnerability. The significant diversity in SPMI requires a tailored approach to each syndrome and individual. With schizophrenia, there is likely to be greater focus on decision-making capacity. Patients with substance use disorders often require a trauma-informed approach to care, as do patients with personality disorders who also underline need for thoughtful communication between team members. With the highest mortality rate among psychiatric illnesses, anorexia nervosa often demonstrates the similarities between life-limiting psychiatric illness and life-limiting non-psychiatric illness. This chapter also addresses other areas of overlap between psychiatry and palliative care. SPMI can be mimicked by phenomena such as delirium and steroid-induced psychosis or mood lability in acute medical settings. As well, interactions between psychiatric and non-psychiatric medications can be a concern. The authors expect clinical training and provision of care models that combine mental health and palliative care expertise will continue to evolve, with future changes likely having as much to do with ethics and models of care as with more direct management of physical symptoms and mental status.
Cancer Caregivers
Authors: Applebaum Allison J. , Mitchell Hannah-Rose 
Published: January 2023

AbstractThis chapter provides an overview of who cancer caregivers are in the United States; the developmental, social, and cultural context which shapes the caregiving experience; and the burden of caregiving. The authors describe the psychological, physical, existential, and financial impact of caregiving and underscore this role as one that has the potential to impact multiple health outcomes. The chapter also describes several empirically supported interventions designed to address the unique needs of cancer caregivers and implications for clinical practice and policy to improve caregiver and patient health outcomes. The authors emphasize how the COVID-19 pandemic has highlighted the already existing caregiving crisis in the United States and the urgent need for the development and dissemination of policies that will support caregivers as they shoulder growing responsibilities for patients at home.
Psychiatric Aspects of Pain Management in Palliative Care
Authors: Key R. Garrett , Breitbart William S. 
Published: January 2023

Abstract
Pain is one of the most prevalent and impairing symptoms in the realm of palliative care. Although opioids remain at the center of most pain management strategies, it is critical to employ adjuvant analgesics effectively and to understand the impact of psychosocial variables on a person’s overall pain experience. Many psychotropics can be employed as analgesics and also leveraged for secondary benefits to sleep, nausea, appetite, depression, anxiety, and fatigue. A number of promising nonpharmacologic approaches to pain also exist. Practitioners with a clear picture of physiologic and psychosocial components of the pain experience will be able to optimally manage pain and help their patients enjoy the best possible quality of life.
Dignity Therapy
Authors: Mari Schoppee Tasha , Max Chochinov Harvey 
Published: January 2023

Abstract
Despite significant advancement in medical interventions, patients often struggle with not feeling valued or worthy. While loss of dignity can be a significant struggle for patients nearing death, the concept of “death with dignity” has become entwined with euthanasia and physician-assisted suicide. This chapter has documented the state of the science regarding efforts to define dignity based on patient perspectives and the development of dignity therapy. A literature search was implemented in four databases (PubMed, CINAHL, PsychINFO, and Academic Search Premier) using the terms “Dignity Therapy” and “Chochinov.” Also, articles were identified from bibliographies of the initial evidence set, and additional references known to the authors of this chapter were included. Extensive review of the dignity therapy literature was synthesized to identify the populations of application, common findings, and areas of opportunity for future research. Sixty-seven articles were identified for inclusion in this review. Evidence has demonstrated dignity therapy to have application across various cultures, ages, and diagnoses; high satisfaction with patients and families; and ability to increase sense of meaning, purpose, and will to live. Areas for future research of dignity therapy include use with marginalized peoples, impact on family caregivers, implementation with diverse cultural groups, comparison of dignity therapy to other psychotherapeutic models, and exploration of the mechanisms of impact.
Managing Cancer and Living Meaningfully (CALM) Therapy
Authors: Malfitano Carmine , Hales Sarah , Rodin Gary 
Published: January 2023

AbstractManaging cancer and living meaningfully (CALM) is a brief, semi-structured individual and couple-based intervention designed to alleviate distress and promote well-being in individuals living with advanced cancer. CALM emerged from a longitudinal program of research and the theoretical traditions of relational, attachment, and existential theory. Through a therapeutic process that supports affect regulation, attachment security, and reflective functioning, CALM addresses four content domains: symptom management and communication with healthcare providers; changes in self and relations with close others; spiritual well-being, sense of meaning and purpose; and preparing for the future, sustaining hope, and facing mortality. Caregivers are invited to participate to provide an additional perspective and help address strains and strengths in the spousal relationship, the impact of the illness on the family, and planning for the future. Qualitative research demonstrates that CALM provides the experience of a safe place to explore fears, feel more fully seen in human terms, and face the challenges and threats of advancing disease. Quantitative research demonstrates that CALM is effective in reducing and preventing depressive symptoms, alleviating death anxiety, and facilitating communication of patients with healthcare providers, preparation for the end of life, and clarification of feelings and values. Healthcare providers from multiple disciplines in more than 20 countries have been successfully trained in CALM through didactic and experiential workshops and ongoing supervision. The semi-structured nature of CALM has allowed its adaptation and delivery in diverse cultural and clinical contexts.
Mindfulness-Based Interventions
Authors: Carlson Linda E. , Moran Chelsea , Baydoun Mohamad 
Published: January 2023

Abstract
For palliative care recipients, the psycho-emotional impacts of facing chronic progressive disease and end of life are significant, encompassing feelings such as fear, regret, anger, resentment, and depression. Informal caregivers and healthcare providers (HCPs) are also impacted by the psychological stress of managing patients requiring palliative and end-of-life care and, subsequently, the adverse effect that heightened distress has on their own health and patient quality of care. Over the past two decades, a growing number of studies have shown that mindfulness-based interventions (MBIs) can be a feasible, acceptable, and effective approach to reduce distress among patients in palliative care, their informal caregivers, and HCPs. By bringing one’s focused attention to experiences occurring in the present moment with an open, kind, and accepting attitude, MBIs may improve the quality of life of patients in palliative and end-of-life care, promoting stress reduction and pain and symptom management. MBIs may also be useful in addressing psychosocial issues faced by informal caregivers and HCPs to improve their well-being. Given their potential benefits, MBIs should be further explored by the healthcare community as adjuncts to conventional palliative care.
Acceptance and Commitment Therapy
Authors: Hulbert-Williams Nicholas J. , Hulbert-Williams Lee 
Published: January 2023

AbstractAcceptance and commitment therapy (ACT) is a type of psychological intervention that differs from some more dominant therapeutic approaches, such as cognitive behavior therapy in fundamental ways. Encompassing a number of third-wave psychological intervention components—including acceptance, mindfulness, and values-driven processes—ACT increases psychological flexibility which may, in turn, improve well-being outcomes. This chapter includes a detailed description of ACT and an account of how and why it might be especially suitable for people affected by life-limiting illness, drawing on both theory and the authors’ applied work with this client group. Though the overall evidence base for ACT is gaining strength, there are few studies which robustly test the benefits of integrating ACT into palliative care. Most of the work published to date focuses solely on those with advanced cancer and has not progressed beyond small-scale pilot and feasibility studies. This lack of evidence might be a fundamental barrier to widespread implementation of ACT despite its promising strengths and qualitatively reported acceptability.
Grief Interventions in Palliative Care
Authors: Lichtenthal Wendy G. , Roberts Kailey E. , Rogers Madeline , Fadalla Carol , Rosa William E. , Neimeyer Robert A. 
Published: January 2023

Abstract
Family members of patients receiving palliative care for life-limiting illness face grief both before and after the patient’s death. While many will adapt, others will develop mental health challenges that may benefit from psychosocial intervention to support them in their grief. This chapter provides an overview of grief interventions in palliative care, with a focus on intervention for family members (i.e., those individuals who are close to the patient). Interventions can be delivered before the patient dies to address pre-death grief and reduce risk for negative bereavement outcomes, immediately following the patient’s death to support continuity of care, and in the long term to treat bereavement-related mental disorders. Additional information is provided on supporting palliative care clinicians who are impacted by the multiple patient losses that inherently come with their work. The chapter concludes with recommendations for future research on grief interventions in palliative care.
Pain medicine and the medicalization of chronic pain
Authors: Sullivan Mark D. , Ballantyne Jane C. 
Published: January 2023

Abstract
This chapter examines how the ideal of managing complex chronic pain on a rehabilitation model was gradually eroded, particularly in the United States, as healthcare itself became increasingly focused on rapid results and short-term outcomes. Multidisciplinary management became hard to sustain, chronic pain management fell increasingly to primary care, and primary care became increasingly stressed by the burden of looking after intractable chronic conditions. The lure of opioids drew patients and their physicians into prescribing that promised much relief, but ultimately increased the burden of care. The framing of pain as a medical problem opened the floodgates for abuse of patients’ suffering based on profiteering and the offering of false hopes. Once the limitations of long-term opioid therapy became clear, the medical community turned back to the earlier recognition that over-reliance on medical solutions for chronic pain leaves the patient out of the recovery.
Carer, Partner, and Family-Centered Support
Authors: Mitchell Hannah-Rose , Applebaum Allison J. , Zaider Talia 
Published: January 2023

AbstractThe psychosocial experiences inherent to oncology and palliative care extend beyond the individual with cancer to the family members and friends tasked with serving them unpaid care (“caregivers”), and to the entire family system. Not only can cancer present distress directly to the patient, caregiver, and family, it can also disrupt relationships and family functioning. This chapter highlights how psycho-oncology and palliative care are optimized when families are considered, and clinicians take flexible, culturally sensitive approaches to identifying the individuals whom the patients wish to be involved in their units of care through the end-of-life phase. Guidance for routine and ongoing assessment of individual (e.g., burnout and subclinical/clinical psychiatric symptoms) and relational concerns (e.g., challenges in roles, communication, conflict, boundaries, and intimacy) is provided. Evidence-based treatments to support caregivers, couples, and families coping with cancer and receiving palliative care, which can be delivered at individual, dyadic, or group levels are also highlighted. Family-centered support throughout the care continuum and the palliative care phase is ever so more important given ongoing shifts to outpatient and home-based care. This chapter offers tools to encourage family participation and collaboration, while identifying and addressing the needs related to and consequences of caregiving and coping with cancer in each unique family system.
Community-Based Group Intervention to Reduce Fear of Falling and Activity Restriction
Authors: Schmid Arlene A. 
Published: January 2023

Abstract
Fear of falling is common in older adults and may lead to activity restriction. In the A Matter of Balance study, a standardized group intervention, focused on promoting activity by reducing fear of falling and addressing self-efficacy, was compared to a social contact control condition. Assessments were completed at baseline, 6 weeks, 6 months, and 12 months. Individuals randomized to the intervention reported increased “intended activity” and greater mobility control compared to those in the control condition. Improvements were enhanced for individuals considered compliant (completed five or more sessions); they demonstrated significantly greater falls efficacy, perceived falls management, and mobility control compared to the control group. Effects diminished over time, indicating a potential need for booster sessions.