bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low intensity interventions for mental health problems in children with chronic physical illness
Authors: Catanzano Matteo , Bennett Sophie D. 
Published: August 2022

Abstract
Common chronic physical illnesses in children include asthma, eczema, and diabetes. Some chronic physical illnesses, particularly neurological conditions, are associated with increased rates of intellectual and/or neurodevelopmental disabilities such as autism spectrum disorder. Rates of mental health disorders are elevated in children with a chronic physical illness compared to children who are otherwise healthy. The most common mental health disorders in this group are the same as the most common in children without a chronic physical illness: anxiety disorders, depressive disorders, and disruptive behaviour disorders. This chapter describes how low intensity and/or brief interventions may be used to treat these common mental health disorders in the context of chronic physical illness.
A problem-solving self-help approach for family and friends of young people with first-episode psychosis
Authors: McCann Terence V. , Lubman Dan I. 
Published: August 2022

Abstract
This chapter describes a guided self-help programme focusing on carers of young people with first-episode psychosis, based on a problem-solving approach. Problem-solving bibliotherapy is an alternative, non-threatening, cost-effective, low intensity intervention for first-episode psychosis, with potentially good reach and penetration, in comparison to other more complex and resource-intensive family interventions. It can be used by carers more or less independently of healthcare professionals; however, it seems to work best when integrated with other therapeutic approaches. Bibliotherapy gives carers the chance to refamiliarize themselves with material at a later date. It increases access to support for carers whose caregiving and other commitments, and geographical, financial, and other constraints prevent them from accessing face-to-face family interventions.
Overview of training and implementation considerations
Authors: Parker Jonathan , Gallop Catherine 
Published: August 2022

Abstract
There are indications of a growing prevalence of mental health problems in children and young people. In England, the government has responded by targeting the expansion of the children and young people’s mental health workforce. Focusing on offering support at a stage of early intervention, the education mental health practitioner and the well-being practitioner for children and young people have been developed as new professional mental health roles. These new roles have required the development of specialist training in support of delivering low intensity, evidenced-based interventions for emerging mental health difficulties in children, young people, and families. These new roles are intended to improve access to early intervention mental health support through the effective implementation and integration into community-based (children and young people well-being practitioner) and education-facing (education mental health practitioner) settings.
Single-session interventions for children and adolescents
Authors: Ahuvia Isaac , Schleider Jessica L. 
Published: August 2022

Abstract‘Single-session interventions for children and adolescents’ provides an overview of single-session interventions (SSIs) designed to meet the needs of children and youth experiencing mental illness. A subset of low intensity interventions, SSIs are those designed to be completed in only one visit or encounter with a provider or programme. Many SSIs have been studied and show promising effects for a variety of disorders in youth. SSIs can be guided (requiring facilitation from a trained practitioner) or unguided; this chapter highlights some promising interventions in both categories as well as their evidence base. In addition, it provides a detailed look at an unguided SSI that has reduced depression in youth, and outline design principles for developing future SSIs. A weblink is included to this intervention, which is free and publicly available.
New ideas: one-at-a-time therapy
Authors: Dryden Windy 
Published: August 2022

Abstract
The terms ‘single-session therapy’ and ‘one-at-a-time therapy’ (OAATT) are used interchangeably in the literature; in this chapter, OAATT is referred to throughout. The chapter defines OAATT as a single session of therapy where therapist and client agree to meet to address the client’s most pressing concern in that session, but with the understanding that further help is available if the client needs it. This help may be another single session or whatever other support the therapist and client decide the client needs. There are no papers investigating the use of OAATT as defined in this chapter in child and adolescent services. Why then is it being including in a book about children and young people? Previous chapters have demonstrated a clear need for novel approaches within child and adolescent mental health services in order to cope with the current demands worldwide. There are numerous advantages of this innovative approach. While the approach is typically used and has been researched within adult services, the mindset and practice can and should be translated into mental health settings for children and young people.
Airway Obstruction, Bleeding, and Pain Control After Tonsillectomy
Authors: Johnson II Selby B. , Vail Emily Anne 
Published: August 2022

Abstract
Pediatric patients frequently undergo adenotonsillectomy (T&A). Complications, when they occur, can be delayed and life-threatening. In patients with uncontrolled pain, inadequate oral intake can lead to dehydration and malnutrition. Prevention of this complication requires multimodal analgesic treatment throughout the perioperative period. Post-tonsillectomy airway obstruction and bleeding are surgical emergencies and clinical challenges for both the anesthesiologist and surgeon. Resultant hypovolemia, difficult intubation, or aspiration significantly increase risks of morbidity and mortality. This chapter reviews complications related to T&A and discusses the need for adequate pain treatment, including education of caregivers at time of discharge, to prevent patient discomfort, dehydration and malnutrition.
Pulmonary Hypertension and Hemorrhage Requiring Lung Isolation
Authors: Shin Hannah , Eng Tracey , Teo Elrond 
Published: August 2022

Abstract
Pulmonary arterial hypertension is a progressive disease that results from sustained increases in pulmonary vascular resistance and is caused by several different and diverse processes. Treatment requires a detailed understanding of the pathophysiology. A case of a patient with suprasystemic pulmonary arterial hypertension is discussed including diagnosis, pathophysiology, and complications. A comprehensive assessment of medical and surgical options is presented in the setting of intraparenchymal bleeding resulting in a hemorrhagic pleural effusion and diffuse unilateral airway bleeding requiring emergent intervention. Management and mitigation strategies to stabilize the patient are discussed including medical, non-surgical, and surgical options.
Ventilator and Chest Tube Management for Pneumothorax in a Patient With Bullous Emphysema
Authors: Thompson Shaun L. , Sullivan James N. 
Published: August 2022

Abstract
A pneumothorax can be a life-threatening condition for patients that have underlying lung disease such as chronic obstructive pulmonary disease. Rapid diagnosis and treatment can avoid a potentially poor outcome. Following diagnosis, treatment of the pneumothorax with tube thoracostomy may be indicated, especially for a large pneumothorax. These patients may also require mechanical ventilation for significant respiratory or hemodynamic compromise. Appropriate mechanical ventilator settings are necessary to avoid an increase in size of the pneumothorax and further injury to the lungs. Positive pressure ventilation can still be utilized in patients with pneumothorax with a chest tube in place to evacuate air that may still be escaping from damaged airways.
Ruptured Esophageal Varices and Complications of Massive Blood Transfusion
Authors: Mucci Joti Juneja , McNamara Connor 
Published: August 2022

Abstract
Ruptured esophageal varices can lead to extreme hemodynamic instability due to rapid blood loss. Esophageal varices are commonly seen in patients with portal hypertension and thus often seen in cirrhotics. Because of rapid and large volume blood loss, massive blood transfusion may be necessary. The large amount of blood products can lead to many complications, but can be attenuated if anticipated by the diligent clinician.
Treatment for Hemorrhagic CVA/Aneurysm with Cerebral Arterial Vasospasm
Authors: Coleman Matthew D. , Roldan Oscar 
Published: August 2022

Abstract
Subarachnoid hemorrhage (SAH) describes a category of strokes that involve hemorrhage between the pia and the arachnoid mater of the brain. Spontaneous SAH accounts for 5% to 10% of all strokes. Although SAH is most commonly seen in the traumatic brain injury patient, spontaneous rupture of an aneurysm resulting in subarachnoid hemorrhage (aSAH) occurs in approximately 80% of nontraumatic SAH. aSAH carries a very high morbidity and mortality profile that can be greatly improved by timely and diligent management. Successful management requires coordinated, multidisciplinary care between intensivists, neurosurgeons, neurologists, emergency medicine providers, and the many layers of team members in these categories and beyond.
Motor Vehicle Accident With Skull Fracture and C-Spine Compromise, Elevated ICP, and Spinal Shock—A Case Presentation
Authors: Fried Eric , Zimick Nicholas C. 
Published: August 2022

Abstract
This chapter discusses the case of a 43-year-old patient presenting with loss of consciousness after a motor vehicle accident. In a problem-oriented approach, the authors review the definition and calculation of the Glasgow Coma Scale, primary and secondary surveys for initial management of trauma patients, and the specific considerations for the presenting pathology including spinal shock and intracranial hypertension. Further discussion centers on the diagnosis, pathophysiology, management, and potential complications of each. Finally, they provide review questions for each learning objective to self-assess one’s knowledge at the conclusion of the discussion.
Management of Acute Ischemic Stroke With Interventional Clot Retrieval
Authors: Nadkarni Neil A. , Batra Ayush 
Published: August 2022

Abstract
The care of patients with acute ischemic stroke has rapidly changed in domains of diagnostic expediency and options for management. Coordinated multidisciplinary specialty care, improving technology, and favorable outcomes in clinical trials have increased the number of patients eligible for intervention by both systemic thrombolytic therapy and directed mechanical clot retrieval. The extended time window for reperfusion of cerebrovascular flow has subsequently increased salvage of the ischemic penumbra, decreasing overall infarct size and improving patient functional outcomes. The advances in mechanical thrombectomy, specifically in regards to the extended time windows for treatment eligibility, now offer hope to patients who were previously destined to severe morbidity and mortality. The authors of this chapter review indications for acute stroke therapy, methods for streamlining immediate care, key diagnostic imaging findings, results of the major thrombectomy trials, and complications for the post-interventional patient.
In-Hospital Acute Coronary Syndrome
Authors: Wells Dennis , Bennett Suzanne 
Published: August 2022

Abstract
In-hospital acute coronary syndrome (ACS) represents a complex problem generally occurring in a high-risk patient population. Diagnosis and intervention should be prompt but this process can be hindered by comorbid conditions in various ways including atypical presentations and potential contraindications to standard therapies. For patients with significant risk factors or known coronary artery disease, a high index of suspicion and well-developed protocols for assessment and intervention in the intensive care unit should lead to improved outcomes for patients with in-hospital ischemic events. This chapter will review principles for assessment, diagnosis, and intervention in acute coronary syndrome and particularly focus on an example of ACS presenting in a hospital patient with a history of known coronary artery disease and prior percutaneous coronary intervention with coronary stents.
Postpartum Hemorrhage
Authors: Miranda Haley Goucher 
Published: August 2022

Abstract
Postpartum hemorrhage (PPH) complicates 2% to 5% of all pregnancies and remains a leading cause of maternal morbidity and mortality. Multiple risk factors have been identified that allow for identification of high-risk patients. High-risk patients identified in the antepartum period should be referred to a tertiary care center for appropriate multidisciplinary consultation. However, up to 40% of cases of PPH occur in patients with no previously identifiable risk factors. Patients with severe PPH may develop disseminated intravascular coagulation (DIC), placing them at risk for exsanguination and death if left uncorrected. Critical care providers must thus be facile with the comprehensive management of PPH, including recognition and treatment of the DIC syndrome.
Amniotic Fluid Embolism
Authors: Zheng Xiwen , Ring Laurence 
Published: August 2022

Abstract
Amniotic fluid embolism (AFE) is a rare, life-threatening obstetric disorder that may occur at any time during labor and delivery. AFE has a reported incidence of 1.9 to 7.7 per 100,000 pregnancies and a mortality rate of up to 43%. While the name suggests a physical obstruction of the pulmonary circulation by amniotic fluid, the disease is better understood to be an abnormal maternal inflammatory response to fetal or amniotic material that has crossed the maternal–fetal barrier. This inflammatory response triggers activation of the coagulation cascade, leading to disseminated intravascular coagulation as well as profound pulmonary vasoconstriction, leading to hypoxia, pulmonary hypertension, right ventricular failure, and subsequent left ventricular failure. Treatment is supportive and usually includes mechanical ventilation, the administration of inotropes, vasopressors, and blood products. Many AFE patients suffer cardiac arrest and standard Advanced Cardiovascular Life Support protocol should be modified to account for lateral displacement of the gravid uterus and perimortem cesarean delivery. Successful rescue often utilizes mechanical cardiac support devices. Sequelae of AFE include acute respiratory distress syndrome and cardiogenic pulmonary edema, end organ failure, sepsis, and long-term neurologic deficits.
Complications of Bariatric Surgery Including Rhabdomyolysis with Acidosis and Acute Kidney Injury
Authors: Chae Floria E. , Satyapriya S. Veena 
Published: August 2022

Abstract
Bariatric surgery has become increasingly common. Current data suggest that 35.9% of the adult population in the United States fits the criteria for morbid obesity—typically defined as body mass index greater than 35, or weight 100% greater than ideal body weight. The morbidly obese patient can pose significant challenges in terms of perioperative airway and ventilation management, positioning, and cardiovascular risk factors. Infertility, obstructive sleep apnea, some types of cancer, osteoarthritis and gastro-esophageal reflux disease are all more prevalent in this patient population. In addition, these patients are at risk for postoperative surgical complications such as anastomotic leak and bleeding and medical complications such as venous thromboembolism, acute kidney injury, nephrolithiasis, and rhabdomyolysis.
Abdominal Compartment Syndrome
Authors: Woods Brian 
Published: August 2022

Abstract
Intra-abdominal hypertension (IAH) with new organ injury defines abdominal compartment syndrome (ACS). Common phenomena among the critically ill, IAH and ACS result from a wide range of medical and surgical disorders. ACS has devastating effects on multiple organ systems but is underrecognized with often misunderstood management. Complex interactions between the abdominopelvic organs, the chest, the cardiovascular, and the central nervous system occur with pathologic increases of abdominal pressure. Physical exam and usual measures of perfusion or hemodynamics require careful interpretation in IAH/ACS. Stepwise diagnosis and intervention permit a rational approach. Recognition, continued surveillance, and rapid treatment of IAH/ACS improve outcomes.
Atrial Fibrillation with Rapid Ventricular Response Post Mitral Valve Repair
Authors: Hance John , Mechlin Maggie , Grawe Erin S. 
Published: August 2022

Abstract
Atrial fibrillation is a common postoperative complication after cardiac surgery, especially mitral valve surgery. The cause is often multifactorial related to patient’s predisposing medical comorbidities, anatomical factors including size of the left atrium, and perioperative triggers including inflammatory response, autonomic stimulation, neurohormonal activation, and atrial stretch. The morbidity associated with postoperative is significant as it can affect hemodynamic outcome, length of stay, readmission rates, hospital cost, and even mortality. Treatment for postoperative atrial fibrillation is variable depending on hemodynamic circumstances. It is important to understand the incidence, risk factors, pathophysiology, and treatment options of atrial fibrillation to effectively manage this disease and minimize its impact on morbidity and mortality in the postoperative period.
Ventricular Fibrillation/Ventricular Tachycardia After Coronary Artery Bypass Grafting
Authors: Feduska Eric , Rock Kristen Carey 
Published: August 2022

AbstractMalignant ventricular arrhythmias (sustained ventricular tachycardia [VT] and ventricular fibrillation [VF]) are uncommon, but serious complications after coronary artery bypass grafting. Patient factors and surgery-related factors place post-operative CABG patients at higher risk for malignant ventricular arrhythmias. Although establishing the diagnosis in the immediate postoperative period is fairly straightforward in the era of continuous telemetry monitoring, establishing a cause of VT/VF is more challenging. Treatment options are varied, from pharmacologic to surgical to long-term prophylaxis. Patients may be candidates for electrophysiologic ablation or ICD therapy. As the cardiac surgical population becomes older with more comorbidities, skilled postoperative management of VT and VF will be essential to favorable outcomes.
An LVAD Patient Presenting With Intracranial Hemorrhage
Authors: Miranda Haley Goucher 
Published: August 2022

Abstract
Patients with implanted durable left ventricular assist devices (LVADs) are increasing in prevalence as expertise with surgical implantation and subsequent management continues to improve. LVAD patients require chronic anticoagulation due to the risk of thrombus formation in the pump motor. They are thus at risk of both hemorrhagic and thromboembolic events, which pose significant challenges for the intensivist. LVAD patients are at high risk for hemorrhagic expansion due to their multiple mechanisms of coagulopathy, but reversal of anticoagulation must be done cautiously due to the risk of LVAD pump thrombosis. Management may also be complicated due to reduced pulsatility associated with continuous-flow devices in addition to the lack of formal guidelines for blood pressure goals in the setting of acute stroke.
Vasoplegia Syndrome Management Post Cardiac Surgery
Authors: Tam Christopher 
Published: August 2022

Abstract
Vasoplegia syndrome is a form of vasodilatory shock often seen in patients after cardiac surgery. It is characterized by profound vasodilation with low systemic vascular resistance resulting in high cardiac output and severe hypotension despite fluid resuscitation. It is associated with significant morbidity and mortality and is an important diagnosis to identify and manage accordingly. Although the exact mechanism is unclear, it is theorized that systemic inflammatory response via multiple mechanisms following cardiopulmonary bypass is the main cause of this syndrome. Initial treatment includes vasopressor support (i.e., norepinephrine, epinephrine, phenylephrine, high-dose dopamine) and vasopressin. Some patients may be vasopressin deficient and as a result may respond with improved results. Alternative treatment includes using methylene blue as an initial bolus dose and potentially an infusion. Angiotensin II receptor agonist can also be considered. Maintaining fluid and blood product resuscitation, avoiding acidosis and correcting hypocalcemia are also other mechanisms of treatment for vasoplegia syndrome. Recent studies have provided some evidence for treatment with methylene blue infusion and angiotensin.
Diagnosis of Brain Death and Management of the Brain Dead Patient
Authors: Bacon J. David , Hatton Kevin W. 
Published: August 2022

Abstract
Brain death, the irreversible cessation of all brain function, is a difficult diagnosis in patients with severe neurologic injury. The diagnosis is based, primarily, on physical examination findings and central reflex testing, after confounding factors have been excluded. When confounding factors cannot be eliminated or when clinical exam findings are equivocal, additional or ancillary testing may be necessary to confirm the diagnosis. Once the diagnosis of brain death has been made, a discussion of the potential for organ donation should occur with the family, and, if consent is given, the critical care management goals change to focus on optimization of transplantable organ function. Common problems in the brain dead patient include hemodynamic instability, endocrine gland dysfunction, coagulopathy, and nosocomial infections. Aggressive treatment of these problems has been associated with improved recovery and function of transplanted organs.
When the Loss Is Not Just Personal, but Is of One’s Self
Authors: Rowland Julia H. 
Published: August 2022

Abstract
This deeply personal account delves into the experience of loss of an adult child to suicide. No stranger to death professionally or personally, the author lays bare the profound shock, horror, and heartbreak she experienced in the wake of losing her thirty-three-year-old son, Ben, to bipolar disease. She examines the unique challenges posed by a loss where the one gone is both victim and perpetrator and the stigma attached to mental illness and self-harm that still runs deep in our culture. She lays bare her own struggles—shared by so many survivors of suicide—with at times overwhelming guilt, self-blame, anger and helplessness for which even a career as a psychological professional could not prepare her. What helps and harms and the unique hurdles to recovery, including the fundamental threat posed to her sense of self, are woven into the author’s story with compassion, courage, and self-discovery.
Speechless
Authors: Loscalzo Matthew 
Published: August 2022

Abstract
At the end, in my mother’s final moments, I was not with her, although the rest of my family was. I arrived at my mother’s bedside one hour after she died. In that moment, I also did not realize that she was dead: I thought she was sleeping. When my brother said, “Go say goodbye to your mother,” I was confused even further. After touching her, I felt the cold, reflexive shock and heard my internal dialogue: “My mother is gone.” I remember my father saying, “She held on as long as she could. Your mother kept looking around the room for you. She knew you were missing.” Concetta Greco Loscalzo died searching for another lost child. Until her last breath, my mother was reassured she would recover, all pain-wracked, dwindling seventy-five pounds of her. Yet we knew she was dying. We all knew that concentration camp look. We, the “courageous” men in her life, believed she was not able to handle the truth. But we were the ones too afraid to handle it. How could I have not remembered that secrecy is fertile ground for evil?