Books on the topic '200310 Primary care'

With the Lisbon 2000 Strategy, the focus of education systems has shifted from contents to competencies and due to the constant update of new technologies, education has to be considered as a lifelong process. In this context, online technologies play an increasingly crucial role. While research on learning software has mainly focused on the contents and digital medium in teaching, this study examines aspects of the digital artifacts that have been rarely investigated but are fundamental to increase the learner’s motivation, including system, interface, navigation, and graphics. Specifically, this work develops a new framework to analyse user experience and sustainability strategies that have been implemented in the case study JaLea. The analysis of primary data, collected with surveys and interviews, allows determining whether these strategies are effective for the creation of e-learning systems that are useful for the learner’s personal study, as well as investigate possible developments for teaching environments.

This chapter considers the Great African War of 1998-2003. The first section sets out the factual context of the interventions of Uganda, Rwanda and (on a much lower scale) Burundi in the territory of the Democratic Republic of Congo (DRC). It also considers the counter-force employed by the DRC and other states acting in support of the DRC’s government. The second section considers the positions of the main state protagonists on both sides, as well as of international organisations and states not involved in the conflict. The third section analyses the legality of the actions of the various states involved, including – but not limited to – a consideration of the 2005 International Court of Justice merits decision in the Armed Activities (DRC v Uganda) case. The ad bellum implications of the conflict stretch beyond that decision, but the proceedings at the Court have become its primary legacy in this context.

This book explains and analyses the unprecedented rise in visibility of ‘cult’ Asian cinema in the UK, especially between the years 2000 and 2005. Considering multiple factors behind the cultural, critical and economic success of Asia cinema in the West, this book focuses specifically on the hugely influential and pioneering (if deeply problematic) Tartan Films (formerly Metro-Tartan) Asia Extreme brand. This book is structured as a series of case studies, examining different films, filmmakers and distribution events in order to sketch an historical overview of this developing film cycle, paying attention primarily to the marketing and critical reception of these films. The Asia Extreme brand incorporated multiple genres – primarily horror, action, and erotic thrillers – and also elided the differences between various national cinemas. The role of Orientalism in both the marketing and reception of films from Hong Kong, Japan, and South Korea is also examined in detail.

Narrative medicine is a clinical practice fortified by complex narrative skills that equip healthcare professionals to recognize, absorb, interpret, and be moved to action by patients’ and colleagues’ stories of illness. Founded in 2000 at Columbia University by the authors of this volume, narrative medicine provides rigorous conceptual frameworks and practical clinical methods to increase the accuracy and scope of clinicians’ knowledge of their patients and to deepen their therapeutic partnerships. This book presents the authors’ views, enriched by collaboration with a worldwide network of colleagues, of the workings of the narrative, relational, and reflexive processes of healthcare. Literary theory, narratology, continental philosophies, aesthetic theory, and cultural studies provide the intellectual foundations of narrative medicine, while primary care practice, patient-centered care, psychoanalysis, and interprofessional practice supply the clinical foundations.The book provides both principles and practices of the central tenets of the discipline—relationality and emotion, the philosophies of embodiment, ethicality, participatory pedagogy, close reading, creativity, and clinical practice. Each Part of this volume explains the conceptual foundations of its subject and demonstrates the pedagogic or clinical methods of putting those principles into action. Narrative medicine has grown since its inception into an international movement including many health professional disciplines, patients, families, and institutions.The overarching goal of narrative medicine is to improve the effectiveness of healthcare. This volume provides the standards of the field’s theory and practice as a guide to all who are now joining in this creative commitment to improve healthcare for all.

The book’s point of departure is Dipesh Chakrabarty’s (2000) claim that the analytical tools of our mainstream historicism are irredeemably Eurocentrist, thereby causing us to lose the experiences of non-western peoples in translation. It aims to build on this postcolonial critique of historicism in three ways. First, our conventional historicist devices are not just Eurocentrist but essentially modernist. They cause us to lose in translation the experiences of all non-modern peoples, non-western and western alike. Second, this modernism is problematic specifically because it authorizes us to align non-modern realities with our own peculiarly modern ontological commitments, fundamentally altering the contents of those realities in the process. Third, to produce histories that are more ethically defensible, philosophically robust, and historically meaningful, we need to take an ontological turn in our practice. We need to analyse each non-modern lifeworld on its own ontological terms, in its own metaphysical conjuncture, according to its own particular standards of truth and realness. To support these three claims, the book uses the proverbially western lifeworld of classical Athens (ca. 480-320 BC) as its primary case study.

The use of non-prescription drugs is widespread and has a major impact on the health of the individual user and society. In 2006, the British Crime Survey reported that 10% of adults had used one or more illicit drugs in the preceding year, with 3% reporting using a Class A drug. Over 11 million people in the UK are estimated to have used an illicit drug at least once in their lifetime (35%). Drugs abused vary in their intrinsic potential to cause addiction and, with it, more regular and harmful use. Drug users are influenced by trends and fashions, adopting new compounds such as crack cocaine and experimenting with routes of ingestion. Some drugs may become less popular over time, such as LSD, while others, such as cannabis, experience a revival as more potent strains (e.g. Skunk) are developed. A problem drug user is best defined as a person whose drug taking is no longer controlled or undertaken for recreational purposes and where drugs have become a more essential element of the individual’s life. The true economic and social cost of drug use is likely to be substantially greater than the published figures, which are derived from a variety of health and crime surveys which may overlook vulnerable groups such as the homeless. The majority of non-prescription drugs used in the UK are illegal and covered by the Misuse of Drugs Act 1971. The drugs most commonly abused gave rise in 2003–4 to an estimated financial cost in England and Wales of 15.4 billion pounds to the economy, with Class A drugs such as heroin and cocaine accounting for the majority of this. Some 90% of the cost is due to drug-related crime, with only 3% (£488 million) due to health service expenditure, which is mainly spent on inpatient care episodes. This still represents a major health pressure, which in 2006–7 amounted to 38 000 admissions, in England, for primary and secondary drug-related mental or behavioural problems, and over 10 000 admissions recorded for drug poisoning. Clinicians in all specialities can expect to encounter harmful drug use, especially those working in primary care, A & E, and psychiatric services. Presenting problems are protean, ranging from mood disorders, delirium, and psychosis to sepsis, malnutrition, and hepatitis. Blood-borne infections such as hepatitis C and HIV are widespread, as contaminated needles and syringes are shared by up to a quarter of problem drug users. Even smoking drugs such as crack cocaine can lead to increased transmission of hepatitis C through oral ulceration and contact with hot contaminated smoking pipes. Amongst the UK population, over half of IV drug users have hepatitis C, a quarter have antibodies to hepatitis B, and, by 2006, 4662 had been diagnosed with HIV. Non-prescription drug abuse is a leading cause of death and morbidity amongst the young adult population (those aged 16–35). In 2006 there were 1573 deaths where the underlying cause was poisoning, drug abuse, or dependence on substances controlled under the Misuse of Drugs Act. The vast majority (79%) were male. Young men, in particular, are at greater risk of violent death through associated criminal activity such as drug supplying and from deliberate and accidental overdose. The male-to-female ratio for deaths associated with mental and behavioural disorder is 6:1.

This chapter describes the appropriate clinical approach to take when presented with a patient reporting a neurological symptom. Just under 10 per cent of the population consult their general practitioner about a neurological symptom each year in the United Kingdom. About 10 per cent of these are referred for a specialist opinion, usually to a neurologist. Nine conditions account for roughly 75 per cent of general neurological referrals and are diagnosed initially on purely clinical grounds, with the other 25 per cent representing the full range of other, potentially very rare, neurological disorders.This chapter underlines the importance of a thorough and informative history to achieve successful diagnosis. Crucial facets for a good history include information on the time course of symptom development, whether symptoms are negative or positive, previous neurological history (both personal and familial), as well as other potentially contributory general medical disorders. The general neurological examination is also described, as are specific examination manoeuvres that may be added to the general neurological examination in specific clinical circumstances.Reflexes play an important role in diagnostic neurology because they reflect the integrity of, or alterations in, the neural structures responsible for their arc. Loss of a reflex may be due to interruption of the afferent path by a lesion involving the first sensory neurone in the peripheral nerves, plexuses, spinal nerves, or dorsal roots, by damage to the central paths of the arc in the brainstem or spinal cord, by lesions of the lower motor neurone at any point between the anterior horn cells and the muscles, of the muscles themselves, or by the neural depression produced by neural shock. In clinical practice, the most useful and oft-elicited reflexes are the tendon reflexes of the limbs, the jaw jerk, the plantar response, the superficial abdominal reflexes, the pupil-light response, and in infants, the Moro reflex. The place of these particular reflexes in the routine neurological examination is outlined, and the elicitation and significance of these reflexes and of a wide variety of others which are used occasionally are described.Examinations that allow localization lesions that are responsible for muscle weaknesses and the assessment of somatosensory abnormalities are described, as are neurological disorders that result in identifiable gait disorders. The clinical signs and examinations relevant to autonomic disorders are also discussed.Intensive care may be required for patients critically ill either as a result of primary neurological disease, or in those in whom a neurological disorder is a component of, or secondary to, a general medical disorder. Indications for admission to neurological intensive care have been defined (Howard et al. 2003): impaired consciousness, bulbar muscle failure, severe ventilatory respiratory failure, uncontrolled seizures, severely raised intracranial pressure, some monitoring and interventional treatments, and unforeseen general medical complications. Naturally specific treatments indicated for the particular diagnosis should be instituted along with general intensive care measures.Finally, the discussion of diagnoses of chronic or terminal conditions with patients is discussed, with particular focus on the best way to present the diagnosis to the patient.

Greek Cinema and Migration examines the ways in which the cinema of Greece has responded to the post-1990s phenomenon of becoming a host country for immigrants. The book focuses mainly on migration from Albania that dominated social discourse and cinematic representation in the 1990s and 2000s, but also sheds light on cinematic responses to the mid-2010s ‘refugee crisis’. Placing contemporary Greek cinema within the context of European film production and transnational cinema, the book explores the fascination of Greek filmmakers with migration, mobility, borders and identity between 1991 and 2016. With case studies such as The Suspended Step of the Stork (1991), The Way to the West (2003) and many more, Greek Cinema and Migration provides an in-depth understanding of contemporary Greek cinema and its direct correlation to the country’s struggles to implement European modernity. It tackles important questions on identity and representation, highlighting the role of migrants as constitutive ‘others’ who help to redefine national identity in times of encroaching globalization. The book raises in addition important questions on representations of migrants and refugees in film and mainstream media, focusing primarily on the role of migrant-related violence and its links to both humanitarianism and the agenda of the Far Right which gained a strong footing in crisis-era Greece. The author thus argues that migrants and refugees appear as either perpetrators or victims of violence in an intolerant host society, strengthening thus the role of stereotypes – both negative and positive.

Andean Truths: Transitional Justice, Ethnicity, and Cultural Production in Post-Shining Path Peru studies how literature, drama, film, and the visual arts contest the dominant narrative of national peace and reconciliation, as constructed by Peru’s Truth and Reconciliation Commission. Established in 2001, the Commission aimed to ‘investigate and make public the truth’ of the country’s twenty-year civil war, drawing upon homologous predecessors that provided a highly scripted model of truth-gathering and national healing. In this model, a predetermined collective mourning, catharsis, and reconciliation would move the nation forward in a consensually-determined fashion. Andean Truths shows that the Peruvian case proves internationally-endorsed models insufficient for arriving at the ‘truth’ of a national trauma that primarily affected disenfranchised ethnic groups, namely, the Andean Quechua speaking populations that accounted for the overwhelming majority of victims of the violence. Even as scholars recognize the importance of bringing multiple voices to the table in discussing post-Shining Path Peru, the question remains of what a more Andean-oriented transitional justice process might entail. Drawing on theories of decoloniality, intercultural communication and epistemological diversity (following scholars such as Enrique Dussel, Aníbal Quijano and Boaventura de Sousa Santos), this book analyzes cultural products, from the theater of Yuyachkani to the narrative of Oscar Colchado Lucio, the art of Edilberto Jiménez, and other popular artistic responses, that highlight Andean understandings of the conflict and its aftermath. These cultural products challenge dominant understandings of the conflict and question Peru’s ability to overcome its collective trauma without seriously reconsidering prevailing cultural paradigms.

Capillaria species are members of the superfamily Trichinelloidae. These worms have a filamentous thin anterior end and a slightly thicker oesophagus which is surrounded by glandular cells or stichocytes. This oesophageal pattern is called stichosomal oesophagus. Capillaria species are parasites which are found in many vertebrate animals. More than two hundred species have been reported in several vertebrate species, including fish, amphibians, reptiles, birds, and mammals (Cross 1992; Chitwood et al. 1968), but only three species infect humans. These are Capillaria hepatica , C. aerophila and C. philippinensis (McCarthy and Moore 2000). Of these intestinal capillariosis, a fish-borne parasitic zoonosis caused by C. philippinensis , is the most important. Humans acquire the parasite, C. philippinensis, by eating uncooked or raw freshwater fish (Cross and Basaca-Sevilla 1991). The disease is endemic mainly in Philippines and Thailand where there are many reported fatalities.Although C . hepatica is found in rodents worldwide, only a few cases of hepatic capillariosis have been reported in humans from Europe, Asia, Africa, North and South America. The infection is acquired by the ingestion of embryonated eggs from the soil. Female worms deposit eggs in the liver tissue and granulomas develop around the egg. The eggs are released after the rodent is eaten and the liver digested. Eggs pass in the faeces and are deposited in the soil where they embryonate. Avoidance of contaminated soil would prevent human infection and destruction of rodents would control animal infections.Only 12 cases of human infection caused by Capillaria aerophila have been reported, the majority from Russia. The parasite is found within tissue of the respiratory passages of canines and felines worldwide.Anatrichosoma cutaneum (Nematoda, Trichosomoididae), also included in this chapter, is primarily a subcutaneous parasite of monkeys, but there are two reports of cutaneous infections in humans resulting in serpiginous lesions in the skin of the soles, palms, and nasal passages. In addition there is a further suspected case isolated from a breast nodule and a possible case of mucosal lesions in the mouth reported. Whole monkey colonies can be infected with this parasite and control is difficult.