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1
Ivanishchev, Viktor (Victor). Molecular biology. ru: Publishing Center RIOR, 2020. http://dx.doi.org/10.29039/01857-6.
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The textbook presents the main range of issues in molecular biology — the most rapidly developing area of biological science. The logic of the presentation of the material includes sequential coverage of the structural organization and functions of DNA, RNA, proteins. Important attention is paid to the mechanisms of signal transmission in living systems, the problems of creating and using genetically engineered organisms. Each chapter ends with control questions and assignments for independent work. The textbook includes a set of laboratory and practical works that do not require specialized equipment and materials. The new edition has been supplemented and clarified, reflecting the current state of science. The content of the textbook corresponds to a number of competencies, the development of which is provided for by the Federal State Educational Standard of Higher Education in the preparation of bachelors in the fields of "Pedagogical Education" (profiles "Biology" and "Chemistry"), "Biology". Certain topics can be used in the preparation of masters in the fields of "Biology", "Chemistry", "Natural Science Education". The book is intended for students studying in natural sciences, and will also be useful for teachers of biology and chemistry of high school.
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Beuningen, Cor, and Kees Buitendijk, eds. Finance and the Common Good. NL Amsterdam: Amsterdam University Press, 2019. http://dx.doi.org/10.5117/9789463727914.
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Over the past fifty years, (financial) capitalism has brought about an enormous growth in wealth. Millions around the world have been lifted out of poverty. However, the downsides of the present global economic constitution are rapidly becoming evident as well. Rising inequality, soaring debt levels, and repeated cycles of boom and bust have proven to be some of its key characteristics. After the 2008 crisis brought the financial system to the brink of collapse, new regulations, stricter supervision, higher capital requirements, and ethical codes were introduced to the sector. Today we find ourselves in the middle of another economic boom. Yet one pressing question remains: has anything changed? Have the (necessary) repairs fixed the flaws in the system? Or do we require even more fundamental reforms? This volume builds on the observation that society has co-evolved with the financial sector. We cannot simply claim that 'finance' was the sole instigator of the 2008 crisis. Society itself has become financialized; the process of replacing relations, structures of trust and reciprocity, by anonymous and systemic transactions. The volume poses vital questions with regard to this societal development. How did this happen? And more importantly: is change possible? If yes, how? This volume contains 21 essays on the themes mentioned above. Authors include Jan Peter Balkenende, Wouter Bos, Lans Bovenberg, Govert Buijs, and Herman Van Rompuy. A recommendation by Dutch Minister of Finance Wopke Hoekstra is also included.
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To establish policies and procedures in the Peace Corps to provide for the safety and security of volunteers from rape and sexual assault, and for other purposes; and to amend the Peace Corps Act to require sexual assault risk-reduction and response training, the development of sexual assault protocol and guidelines, the establishment of victims advocates, the establishment of a sexual assault advisory council, and for other purposes: Markup before the Committee on Foreign Affairs, House of Representatives, One Hundred Twelfth Congress, first session, on H.R. 2699 and H.R. 2337, September 21, 2011. Washington: U.S. G.P.O., 2011.
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Fountoulakis, Konstantinos N., and Dimos Dimellis. The treatment of rapid cycling bipolar disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198748625.003.0006.
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Rapid cycling may complicate the course of a significant proportion of patients with bipolar disorder (BD). It is defined in DSM-5 by the occurrence of at least four distinct mood episodes in 12 months. Rapid cycling BD has been consistently associated with worse outcomes compared with non-rapid cycling BD. Thus, rapid cycling BD may require specific treatment strategies. Antidepressants, antipsychotics, and mood stabilizers/anticonvulsants have been studied either as monotherapy or in combination treatments. Concerning the treatment of acute mood episodes, the best available data exist for atypical antipsychotics. On the other hand, maintenance or relapse-prevention treatment, and newer-generation antipsychotics and anticonvulsants seem to be efficacious for rapid cycling BD. Lithium may also be efficacious. Treatment with antidepressants should be avoided in this subpopulation of patients. Overall, few randomized controlled trials have been conducted, and many have been underpowered. Therefore, a significant gap remains in evidence-based treatment of rapid cycling BD.
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Paddock, LeRoy, and Karyan San Martano. Energy Supply Planning in a Distributed Energy Resources World. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198822080.003.0021.
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Traditional electricity planning in the United States has typically been focused on forecasting future demand and identifying the need for new large generating facilities that involve one-way flows from central power plants to customers. However, legal innovation has incentivized the deployment of more energy resources at the customer end of the electricity network and technological innovation has facilitated rapid expansion in the number and capacity of these distributed energy resources. These changes now require innovation in the type of planning for future energy resources that must be employed to ensure an efficient and reliable electric energy network. Deployment of the rapidly growing number of distributed energy resources —solar and wind generation, combined heat and power, fuel cells, battery storage, demand response and energy efficiency—is facilitated by an increasingly smart grid. This chapter proposes a new, distributed resource-planning process to better integrate all of these distributed resources into the grid.
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Mitchell, John D., and Marek Brzezinski. Introduction to Pulmonary Urgencies and Emergencies. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0013.
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The lungs exchange gases and also provide for some metabolic functions. Respiratory failure can be grouped into types I-IV. Type I (hypoxemic) and type II (hypercapnic) are the most prominent; type III is perioperative and often considered a subset of type I, while type IV is due to shock. Pulmonary urgencies and emergencies require rapid diagnosis and treatment in order to avoid morbidity and mortality. Identification of risk factors for desaturation and the application of an appropriate management algorithm can facilitate diagnosis and management. The ABCD-A SWIFT CHECK algorithm and its subalgorithms represent a logical approach to rapid diagnosis and management.
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Phillips, Dennis, and Joshua Knight. The Difficult Airway (DRAFT). Edited by Raghavan Murugan and Joseph M. Darby. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190612474.003.0018.
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The difficult airway invariably presents itself to all airway managers and is mostly unpredictable in the context of rapid response team (RRT) calls. A multiprofessional difficult airway team (DAT) that could be called for airway emergencies is likely to reduce complications and death. The DAT is organized with predefined roles for each member so that rapid intervention occurs during the emergency. Priority is given to oxygenation throughout the airway response. The anticipated and unanticipated difficult airways should be approached differently and often require medication adjuncts that should be carefully chosen. Airway devices such as the video laryngoscope and the laryngeal mask airway (LMA) have dramatically improved the ability to secure an airway quickly. Finally, it is important to recognize when a surgical airway is needed in the setting of the RRT calls.
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Akhtar, Shamsuddin. Hyperglycemic Hyperosmolar State. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0031.
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The incidence of diabetes mellitus has rapidly increased in recent years. Perioperative care of patients with diabetes presents challenges of glycemic control and management of associated cardiovascular disease. Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are life-threatening complications of diabetes that require emergent therapy. Although elective surgery in patients with DKA or HHS is contraindicated, there are times when an emergent surgical condition may require anesthesia in the presence of DKA or HHS. There are many different factors that may precipitate these disorders and an understanding of the underlying pathophysiology and treatment is important for successful management of anesthesia.
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Colebourn, Claire, and Jim Newton. Field guide to critical care echocardiography. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757160.003.0008.
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This chapter is intended as a summary or reference for clinician echocardiographers at the bedside. It gives step-by-step algorithms which address both commonly asked questions and clinical situations which require rapid decision-making using echocardiography in the critically ill. These algorithms cover fluid status and fluid responsiveness, cardiovascular parameters, assessment of the shocked and breathless patient including trauma, assessment of the patient with a clinical diagnosis of pulmonary embolism, and assessment of the unwell obstetric patient and patients who are weaning from mechanical ventilatory support.
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Sevransky, Jon. Management of sepsis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0296.
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Sepsis is triggered by an infection, and treatment of sepsis requires timely identification of the patient, and rapid treatment with antibiotics, source control, and fluids. The site of infection, patient’s phenotype, and location of the patient will help drive decisions about initial antibiotic therapy. Patients with sepsis should be treated to ensure adequate cardiac output and organ perfusion, which usually requires infusion of intravenous fluids. In addition to haemodynamic and fluid support, some patients require infection source control. Many sepsis patients require additional supportive therapy with vasoactive agents, mechanical ventilation, renal replacement therapy, and nutritional therapy.. When using these supportive therapies, the clinician should attempt to minimize the complications of the therapies, including withdrawal of therapies that are no longer necessary.. Patients who do not respond to initial therapy should be evaluated for resistant organisms, persistent sources, or alternate diagnoses.
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Abatzis, Vaia T., and Edward C. Nemergut. Transsphenoidal/Pituitary Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0004.
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Patients with tumors of the pituitary gland represent a heterogeneous yet commonly encountered neurosurgical population. Optimal anesthetic care requires an understanding of the complex pathophysiology secondary to each patient’s endocrine disease. Although patients presenting with Cushing’s disease and acromegaly have unique manifestations of endocrine dysfunction, all patients with tumors of the pituitary gland require meticulous preoperative evaluation and screening. There are many acceptable strategies for optimal intraoperative anesthetic management; however, the selection of anesthetic agents should be tailored to facilitate surgical exposure, preserve cerebral perfusion and oxygenation, and provide for rapid emergence and neurological assessment. Postoperatively, careful monitoring of fluid balance and serum sodium is essential to the early diagnosis of diabetes insipidus (DI). DI is most often transient but can require medical therapy. A thorough understanding of the preoperative assessment, intraoperative management, and potential complications are fundamental to successful perioperative patient care and avoidance of morbidity and mortality.
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Lee, Daeyeol. Birth of Intelligence. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780190908324.001.0001.
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What is intelligence? How did it begin and evolve to human intelligence? Does a high level of biological intelligence require a complex brain? Can man-made machines be truly intelligent? Is artificial intelligence (AI) fundamentally different from human intelligence? Rapid expansion of AI applications has made these questions pressing. To better prepare for the future society and its technology, including how the use of AI will impact our lives, it is essential to understand the biological root and limits of human intelligence. After systematically reviewing biological and computational underpinnings of decision-making and intelligent behaviors, this book proposes that true intelligence requires life.
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Hooper, Timothy, and David Lockey. Assessment and management of ballistic trauma. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0340.
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The severity of ballistic trauma is dependent upon multiple factors including bullet type, velocity, tissue type penetrated, and energy transfer. Patient management needs a considered approach with careful assessment, appropriate imaging and directed treatment of the wounds found. Triage, treatment and transport form the framework of effective prehospital care. In the emergency department a rapid primary survey is essential to reveal any injuries that need immediate intervention. The decision to operate and nature of surgery is determined by the patient’s suspected injuries, physiological condition and expertise available with some patients benefiting from damage control resuscitation and surgery. Indications for intensive care admission include the need for ongoing organ support, cardiovascular instability, and injuries that require close observation. Attention should be paid to cardiovascular status, coagulation, nutrition, thromboprophylaxis, infective issues, and management of specific injuries. Patients may require protracted hospital stays and extensive reconstructive surgery. The psychological and social impact of these injuries should not be underestimated.
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Emlet, Lillian L., and James M. Dargin. Airway Equipment (DRAFT). Edited by Raghavan Murugan and Joseph M. Darby. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190612474.003.0029.
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Patients frequently require airway management during rapid response team (RRT) activations. Airway management during RRT activations frequently occurs in locations that are not well equipped or prepared to perform airway procedures. Therefore, it is important that RRTs arrive with the proper equipment and medications to safely secure the airway whenever necessary. An “airway bag” that is stocked by a hospital’s central supply department and carried by RRTs ensures the availability of functioning equipment and helps to standardize the process of airway management during RRT activation. In this chapter, we will review recommendations for equipment required in emergency airway management, including portable routine and difficult airway equipment and medications.
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Aguasca, Gerard Martí, Bruno Garcia del Blanco, and Jaume Sagristà Sauleda. Pericardiocentesis. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0027.
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Cardiac tamponade is a life-threatening condition that may require the urgent removal of pericardial fluid. Therefore, the pericardiocentesis procedure should be part of the skills of physicians treating critically ill patients. The pericardiocentesis technique has evolved from a blind and unguided procedure, prone to complications, to a safer and more effective guided technique by using echocardiography or fluoroscopy. However, as in any invasive procedure, complications still occur. Therefore, indications should be restricted to patients with cardiac tamponade or a high suspicion of specific aetiologies when performed for diagnostic purposes. Accurate indications, optimal imaging assessment, knowledge of materials required, familiarization with different techniques, and rapid recognition of complications are key for a successful procedure.
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Halle, Randall. Interzone Xperimental. University of Illinois Press, 2017. http://dx.doi.org/10.5406/illinois/9780252038457.003.0007.
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This chapter examines the rapid and accelerating technological transformations to film that have been happening in the last decade. These transformations make it anachronistic to speak solely of film and require the analysis of a more inclusive moving image. Moreover, these transformations have occurred simultaneously with the developments of globalization and transnationalism. Broadband, streaming video, and networked social relationships have been central to the formation of new communities and new forms of engagement with existing social conditions. The chapter seeks to highlight the interconnection between technology politics and economy by focusing on the question of moving-image experiments and migration. It focuses on the works of filmmakers who have worked in an experimental mode.
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Spevetz, Antoinette, and Joseph E. Parrillo. Diagnosis and management of shock in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0150.
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Sepsis is triggered by an infection and treatment of sepsis requires timely identification of the patient, and rapid treatment with antibiotics, source control, and fluids. In the absence of a true biomarker for sepsis, the clinician needs to recognize which patients are at risk, as well as the common signs and symptoms of infection. The site of infection, the patient’s phenotype, and the location of the patient will help drive decisions about initial antibiotic therapy. Patients with sepsis should be treated to ensure adequate cardiac output and organ perfusion, which usually requires infusion of intravenous fluids. Crystalloid fluids are most frequently infused, and patients will often require large doses in the first 6–24 hours of treatment. In addition to haemodynamic and fluid support, some patients require infection source control. Many sepsis patients require additional supportive therapy with vasoactive agents, mechanical ventilation, renal replacement therapy, and nutritional therapy. The use of these supportive therapies allows for a patients host defence system to work in conjunction with antibiotics to fight off the infection. When using these supportive therapies, the clinician should attempt to minimize the complications of the therapies and the causative infection. Once a patient starts to clinically improve, it is essential that therapies that are no longer necessary are withdrawn. Patients who do not respond to initial therapy should be evaluated for either resistant organisms, persistent sources, or alternate diagnoses.
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O'Brien, Patrick Karl. Industrialization. Edited by Jerry H. Bentley. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780199235810.013.0018.
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Industrialization refers to an economic transformation that is recent and different in scale and scope from the mere making of artifacts and has involved the rapid rise in the significance of manufacturing in relation to all other forms of production and work undertaken within national economies. This article discusses the many facets of industrialization: industrialization as a historical process; the present tendencies and future trends in global diffusion; inter-sectoral connections; international relations and the global context; and industrialization on a global scale over the very long run. In the twenty-first century success seems to require new and different political and social capabilities that are already shifting the concentrations of industrial activity away from Europe and North America and back to Asia.
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Crouch, Robert, Alan Charters, Mary Dawood, and Paula Bennett, eds. Mental health emergencies. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199688869.003.0019.
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It is common for patients with mental health problems to present to emergency and urgent care services at times of crisis. Patients with acute distress, agitation, or psychosis can be very difficult to manage in the acute phase of their illness. Emergency departments often have the support of mental health liaison nurses. However, nursing staff still require skills in assessment that enable them to rapidly identify patients with acute problems that may pose a risk to themselves or others. This chapter covers the assessment and management of common mental health emergencies and includes relevant sections within the Mental Health Act.
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Shankland, Gillian S. Microscopy and culture of fungal disease. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0039.
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The clinical mycological laboratory strives to provide an accurate and rapid diagnosis of suspected fungal disease, or exclude its possibility. The most common and most traditional methods for demonstrating fungi in tissue and body fluids are microscopy and culture. The techniques discussed in this chapter are not exhaustive but have proved to be efficient for the visualization and recovery of fungi from clinical samples. In general, these methods do not require expensive or specialist equipment. The clinician’s presumptive diagnosis may help with the selection of the most appropriate specimen and aid the laboratory in the method of processing and selection of the primary culture media. However, all too often there is scant clinical information provided to the laboratory, and indeed a fungal infection may initially not have been suspected.
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Kahn, S. Lowell. Use of a Buddy Wire to Facilitate Contralateral Gate Catheterization During Endovascular Aortic Aneurysm Repair. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0005.
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Catheterization of the contralateral gate during endovascular aortic aneurysm repair is typically of little difficulty. However, on occasion it proves challenging. With the exception of grafts such as Nellix (Endologix Inc., Irvine, CA), which utilizes parallel stents with polymer endobags, and those that employ a unibody concept, such as the AFX (Endologix Inc., Irvine, CA), all modular grafts require this step. A difficult catheterization can often be facilitated by using different catheters, such as the Cobra, Van Schie (Cook Medical Inc., Bloomington, IN), or Sos (AngioDynamics Inc., Latham, NY) designs. Alternatively, a wire advanced up and over through the contralateral gate from the ipsilateral side can be snared allowing catheterization of the gate. This chapter describes a simple alternative buddy wire technique that facilitates rapid contralateral gate catheterization.
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Lattman, Eaton E., Thomas D. Grant, and Edward H. Snell. Distinct Instrumental Approaches to SAXS. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199670871.003.0010.
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There are more specialized applications of SAXS and SANS which require specific experimental considerations. This chapter covers size exclusion chromatography which has proven to be useful to study both soluble and membrane bound proteins allowing the study of samples that show time and concentration dependent dynamics. It also describes iime-resolved techniques for SAXS and in a few cases, SANS. Finally, with improved X-ray sources, detectors, sample handling, and compute power, the ability to perform SAXS data in high-throughput is available. This is discussed in enabling the use of SAXS to study protein interactions, map macromolecular conformation, and rapidly characterize samples amongst other applications.
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Munar, Myrna Y., and Ali J. Olyaei. The effect of renal failure on drug handling in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0217.
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The kidneys play an important role in the elimination of many drugs. In chronic kidney disease and acute kidney injury several pharmacokinetic processes are altered. Thus, patients with impaired renal function require adjustment of medication dosing. Many drugs require a loading dose to rapidly achieve therapeutic plasma concentrations. Subsequently, the dose or dosing interval may have to be adjusted as appropriate for the degree for renal function. The most common method to estimate renal function is use of the Cockcroft–Gault (CG) equation. It has been well validated, is easy to remember, and is fairly accurate in estimating kidney function. Most drugs are dosed based on the patient’s weight (mg/kg), which makes the CG method easier to use for most estimates. Other methods are available and a patient’s renal function should always be estimated based on the best available evidence for that specific patient. Patients with chronic kidney disease are at great risk of developing kidney injury from drugs or diagnostic agents. Exposure to nephrotoxins should be avoided as much as possible.
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Mueller, Christian. Acute dyspnoea in the emergency department. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0009.
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Acute dyspnoea is a very common symptom in the acute cardiac care setting. In contrast to current beliefs, acute dyspnoea, as the leading symptom in the emergency department, is associated with about twice the mortality risk, compared to acute chest pain. Rapid and accurate identification of the cause of dyspnoea is critical to the initiation of specific and effective treatment. In most patients, a rapid and accurate diagnosis in the emergency department can be achieved by a combination of vital signs, including pulse oximetry, detailed patient history, physical examination, blood tests (including natriuretic peptides—BNP, NT-proBNP, or MR-proANP), venous blood gases, and C-reactive protein in all patients, and D-dimers in selected patients, electrocardiograms, and chest X-ray. It is key to remember that the prevalence of acute heart failure in unselected patients with acute dyspnoea is about 50%. Therefore, a high awareness for the presence of acute heart failure is mandatory. Acute heart failure, pneumonia, obstructive pulmonary diseases (chronic obstructive pulmonary disease and asthma), pulmonary embolism, and anxiety disorders represent more than 90% of all cases with acute dyspnoea in the emergency department. In about 10–15%, two acute causes (e.g. acute heart failure and pneumonia) may be present and require combined treatment. Transthoracic echocardiography should be immediately performed in all patients with acute dyspnoea and shock, and in those patients in whom the diagnosis remains uncertain, even after initial work-up.
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Mueller, Christian. Acute dyspnoea in the emergency department. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0009_update_001.
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Acute dyspnoea is a very common symptom in the acute cardiac care setting. In contrast to current beliefs, acute dyspnoea, as the leading symptom in the emergency department, is associated with about twice the mortality risk, compared to acute chest pain. Rapid and accurate identification of the cause of dyspnoea is critical to the initiation of specific and effective treatment. In most patients, a rapid and accurate diagnosis in the emergency department can be achieved by a combination of vital signs, including pulse oximetry, detailed patient history, physical examination, blood tests (including natriuretic peptides—BNP, NT-proBNP, or MR-proANP), venous blood gases, and C-reactive protein in all patients, and D-dimers in selected patients, electrocardiograms, chest X-ray, and more recently also lung ultrasound. It is key to remember that the prevalence of acute heart failure in unselected patients with acute dyspnoea is about 50%. Therefore, a high awareness for the presence of acute heart failure is mandatory. Acute heart failure, pneumonia, obstructive pulmonary diseases (chronic obstructive pulmonary disease and asthma), pulmonary embolism, and anxiety disorders represent more than 90% of all cases with acute dyspnoea in the emergency department. In about 10–15%, two acute causes (e.g. acute heart failure and pneumonia) may be present and require combined treatment. Transthoracic echocardiography should be immediately performed in all patients with acute dyspnoea and shock, and in those patients in whom the diagnosis remains uncertain, even after initial work-up.
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Yennurajalingam, Sriram, and Eduardo Bruera, eds. Hospice and Palliative Medicine and Supportive Care Flashcards. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190633066.001.0001.
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In the United States, the subspecialty of hospice and palliative medicine has seen rapid growth since it was recognized by the American Board of Medical Specialties. During the past decade, there has been a dramatic increase in the number of palliative care programs and improved access to palliative and hospice for patients with life-limiting illness. There has also been an increase in the educational opportunities as well as growth of fellowship programs to train palliative care fellows. Unfortunately, there are limited study aids available for learning and retaining essential concepts in palliative care. Hospice and Palliative Medicine and Supportive Care Flashcards is a comprehensive, evidence-based book of flashcards for clinicians caring for patients who require hospice and palliative care and supportive care. Written in a clinical scenario/vignette, question-and-answer format by experts with first-hand experience in the field, the flashcards are highly readable and serve as a source of fast answers to clinical questions in the field. A total of 300 flashcards are organized into chapters by disease and provide readers with up-to-date information that follows the core curriculum of American Board of Hospice and Palliative Medicine for ease of use and rapid review for exams. This book will equip care professionals with key concepts related to the assessment and management of palliative care, making it an ideal point-of-care quick reference for physicians, nurse practitioners, fellows, residents, and students.
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Hermans, Hubert J. M. The Dynamics of Society-in-the-Self. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190687793.003.0002.
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In the field of tension between globalization and localization, a set of new phenomena is emerging showing that society is not simply a social environment of self and identity but works in their deepest regions: self-radicalization, self-government, self-cure, self-nationalization, self-internationalization, and even self-marriage. The consequence is that the self is faced with an unprecedented density of self-parts, called I-positions in this theory. In the field of tension between boundary-crossing developments in the world and the search for an identity in a local niche, a self emerges that is characterized by a great variety of contradicting and heterogeneous I-positions and by large and unexpected jumps between different positions as the result of rapid and unexpected changes in the world. The chapter argues that such developments require a new vision of the relationship between self and society.
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Barkley, Thomas. Energy Risk Management. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190656010.003.0024.
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The backdrop of rapid growth of worldwide energy consumption and increasing concerns about global energy sustainability and environment protection, as well as an increasing uncertainty of commodity prices, require energy companies to use derivatives to hedge against risks related to energy trading. Over time, this situation has led to a more important role for energy risk management as part of a company’s core business operation. This chapter discusses the primary financial instruments used in the energy sector and risk management for energy companies. It reviews the application of several important quantitative methodologies, including Value at Risk and its variant risk metrics, to measure market risk. The chapter also examines credit risk measures and credit risk migration. Lastly, it discusses liquidity risk, operational risk, and legal risk. Overall, the chapter focuses more on the risk the commodity producer/deliverer faces and less on the end user.
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Kennish, Steven. Interventional radiology. Edited by Michael Weston. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0135.
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Advances in imaging technology allow ever more complex yet minimally invasive diagnostic and therapeutic interventions to take place in the genitourinary tract. Imaging provides precise targeting for tissue biopsy to facilitate rapid and accurate diagnosis—the basis of all subsequent treatment regimes. Percutaneous renal intervention is invaluable in the treatment of complex stone disease and for renal preservation in the patient with malignant or benign urinary tract obstruction. Antegrade ureteric procedures allow strictures, stones, and tumours to be tackled, often with much greater ease than an alternative retrograde approach. Although interventional radiological procedures are generally safe, they do come with risks such as bleeding and sepsis, as well as the longer-term complications related to indwelling drains, catheters, and stents. It is important for the urological surgeon to be familiar with interventional uroradiological techniques so as to appropriately counsel and care for patients who require these procedures.
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Abhishek, Abhishek, and Michael Doherty. Clinical features of calcium pyrophosphate crystal deposition. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0050.
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Calcium pyrophosphate deposition (CPPD) occurs in the elderly, and is commonly asymptomatic. However, it can cause acute calcium pyrophosphate (CPP) crystal arthritis, chronic CPP crystal inflammatory arthritis, and is frequently present in joints with osteoarthritis (OA). Acute CPP crystal arthritis presents with rapid onset of acute synovitis, which frequently affects the knees, wrists, shoulders, and elbows. It can mimic sepsis in the elderly, and may require hospital admission. Patients with CPPD plus OA may have more inflammatory signs and symptoms (e.g. joint swelling, stiffness) than those with OA alone. Additionally, patients with CPPD plus OA may also have intermittent attacks of acute CPP crystal arthritis. Some patients with CPPD may have more chronic inflammatory joint involvement and are classified as chronic CPP crystal inflammatory arthritis. This chapter describes the clinical features and differential diagnosis of common clinical manifestations of CPPD and outlines some of its rarer manifestations.
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Pagnini, Francesco, and Zachary Simmons. Providing holistic care for the individual with ALS: Research gaps and future directions. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757726.003.0017.
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Much progress has been made in understanding, measuring, and managing quality of life and psychological well-being in individuals with ALS, but there are gaps. Anxiety and depression have been carefully explored in the ALS literature, but coping, resilience, sexuality, intimacy, and end-of-life concerns require more attention. Psychological interventions have been under-explored. Further research on mindfulness, hypnosis, and on complementary and alternative medicines is needed, with particular attention to early evidence that psychological interventions may lead to physical as well as psychological benefits. Attention to the psychological consequences of cognitive dysfunction in ALS would greatly benefits patients and caregivers. The impact of technology needs further study. Rapid advances in genetics, brain-computer interfaces, and new treatments, communicated virtually instantaneously via the internet, will inevitably contrast with the slower pace of implementation, resulting in surges of hope and disappointment. Optimal care is holistic, incorporating both physical and psychological assessment and management.
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Holloway, Frank, and Tony Davies. The Community Mental Health Team and the mentally disordered offender. Edited by Alec Buchanan and Lisa Wootton. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198738664.003.0016.
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There is a long-standing policy of diversion of mentally disordered offenders (MDOs) from the criminal justice system to care by mental health services. Care of the MDO presents specific challenges to the non-forensic practitioner. These include the need to understand the workings of the criminal justice system and the specific legal issues presented by an offender, the salience of risk, and its management in the mind of the courts and novel additional ethical dilemmas that arise. The importance of substance misuse as a factor in offending behaviour is emphasized, and its implications are explored. In addition, the MDO may present with clinical problems that are unfamiliar. Key principles of management are set out. These include developing a clear understanding of the patient and their world, excellent communication between all those involved, and rapid intervention when there is cause for concern. Staff working with an MDO require adequate supervision and support.
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Eseonu, Chikezie I., Jordina Rincon-Torroella, and Alfredo Quiñones-Hinojosa. Unusual Gliomas. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.003.0002.
Full textAbstract:
Patients with intra-axial brain tumors often present with neurologic symptoms based on the anatomic location of their tumor. Workup for a brain tumor includes cranial imaging such as magnetic resonance imaging and computed tomography, as well as systemic imaging to assess for primary tumor if metastasis is suspected. Maximal safe resection optimizes outcomes including overall survival. Surgical decisions are based on variables such as medical comorbidities and anatomic location of the tumor. Gliomas in eloquent areas may require intraoperative cortical and subcortical mapping of motor and/or language areas to optimize safety and help maximize resection. Adjuvant chemotherapy and radiation lead to a median survival of 14.6 months for patients with glioblastoma. Rapidly recurring glioblastoma after surgery has a poor prognosis.
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Osborn, Irene P., and Liang Huang. Interventional Neuroradiology. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0008.
Full textAbstract:
Interventional neuroradiology is one of the rapidly evolving specialties in medicine that provides minimally invasive and percutaneous treatment of diseases of the brain and spine. The new paradigm for management of a cerebral aneurysm begins with a detailed study of the anatomy and architecture of the lesion. Following this, decisions are made and devices are employed to treat the lesion in the event of a rupture or to prevent a future rupture. The anesthetic implications are different from intracranial clipping and require a different set of priorities. The procedure is performed in the radiology suite with unique concerns such as patient access, lack of movement, and radiation exposure. This discussion will focus on the safe management of endovascular coiling procedures.
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Rahimi, Rod. Atypical Pulmonary Infections. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0027.
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Legionellosis or Legionnaires’ disease (LD) is a common cause of community-acquired pneumonia and can cause rapidly progressive respiratory failure and septic shock. Respiratory symptoms generally predominate; nonspecific symptoms include fever, malaise, myalgias, anorexia, and headache. There are no characteristic presenting clinical or radiological features, and the severity of illness can range from mild to severe. Although erythromycin was initially used to treat LD, trials have demonstrated that the newer macrolides and the respiratory fluoroquinolones are the antimicrobial agents of choice. Given the potential for outbreaks of LD, documented cases should be reported to the local or state health department. Along with LD, Legionella may cause Pontiac Fever, an influenza-like illness without pneumonia, which is self-limiting and does not require treatment.
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Albert, Tyler J., and Erik R. Swenson. The blood cells and blood count. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0265.
Full textAbstract:
Blood is a dynamic fluid consisting of cellular and plasma components undergoing constant regeneration and recycling. Like most physiological systems, the concentrations of these components are tightly regulated within narrow limits under normal conditions. In the critically-ill population, however, haematological abnormalities frequently occur and are largely due to non-haematological single- or multiple-organ pathology. Haematopoiesis originates from the pluripotent stem cell, which undergoes replication, proliferation, and differentiation, giving rise to cells of the erythroid, myeloid, and lymphoid series, as well as megakaryocytes, the precursors to platelets. The haemostatic system is responsible for maintaining blood fluidity and, at the same time, prevents blood loss by initiating rapid, localized, and appropriate blood clotting at sites of vascular damage. This system is complex, comprising both cellular and plasma elements, i.e. platelets, coagulation and fibrinolytic cascades, the natural intrinsic and extrinsic pathways of anticoagulation, and the vascular endothelium. A rapid, reliable, and inexpensive method of examining haematological disorders is the peripheral blood smear, which allows practitioners to assess the functional status of the bone marrow during cytopenic states. Red blood cells, which are primarily concerned with oxygen and carbon dioxide transport, have a normal lifespan of only 120 days and require constant erythropoiesis. White blood cells represent a summation of several circulating cell types, each deriving from the hematopoietic stem cell, together forming the critical components of both the innate and adaptive immune systems. Platelets are integral to haemostasis, and also aid our inflammatory and immune responses, help maintain vascular integrity, and contribute to wound healing.
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Harris, Kate Lockwood. Beyond the Rapist. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190876920.001.0001.
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In the United States, approximately one in five women experiences rape during college, and lesbian, gay, bisexual, transgender, and queer (LGBTQ) students experience sexual violence at higher rates than their peers. Given this context, many colleges are working to better prevent and address these assaults. This book takes up this social problem—how organizations talk about and respond to sexual violence—and considers it in proximity to a persistent theoretical dilemma in the academic field of organizational communication: How are organization and violence related, and what does that relationship have to do with communication? Guided by feminist new materialist and intersectional theories, the book examines one public U.S. university known for responding well to sexual violence. It focuses on the processes and policies that require most faculty and administrators, along with student–employees, to report sexual violence to designated campus offices, per federal laws Title IX, the Clery Act, and the Violence Against Women Act. Unfortunately, the university’s interventions in sexual violence reinforce other violent systems. The book illustrates the negative consequences of considering communication to be either separate from the physical world or indistinguishable from it. It also details problems with the notion that only individuals enact violence. Through its focus on two core ideas—communication and agency—the book encourages scholars to avoid wholly constructivist or realist arguments, and it shows the importance of questions about power and difference in organizational scholarship on posthumanism and materiality. The book concludes with suggestions for how U.S. universities can look “beyond the rapist” to generate more robust interventions in sexual violence.
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Weisang, Guillaume. Risk Measurement and Management for Hedge Funds. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190607371.003.0016.
Full textAbstract:
Risk measurement and management is an important and complex subject for hedge fund stakeholders, managers, and investors. Given that hedge funds dynamically trade a wide range of financial instruments, their returns show tail risk and nonlinear characteristics with respect to many financial markets that require advanced downside risk measures, such as value-at-risk, expected shortfall, and tail risk, to capture risk adequately. This chapter reviews the nature of these risks and presents the measurement tools needed, focusing on fixed-income instruments, derivative securities, and equity risk measurement, and stressing the importance of frequent assessment to capture the possibly rapidly changing risk profiles of hedge funds. This chapter also provides an overview of the linear factor models that investors often use to measure hedge fund risk exposures along many risk factors.
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Kennel, Victoria, Katherine Jones, and Roni Reiter-Palmon. Team Innovation in Healthcare. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190222093.003.0012.
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This chapter explores team innovation in the context of healthcare by integrating literature and empirical evidence from the organizational, social, and medical sciences on team innovation. Innovation encompasses the activities that transform the intentional decision to adopt and implement a new idea, process, product, or procedure into regular and sustained practice. The healthcare industry needs innovation to adapt to and manage complexity within a rapidly changing healthcare system. Interdisciplinary teams have been adopted as innovations to solve certain problems in healthcare that require coordinated interdependent action and complementary knowledge and skills, such as chronic conditions and disease management, patient safety concerns, and cancer treatment and care. Teams may also be employed to manage healthcare innovation adoption and implementation efforts, and the industry must leverage team composition and team process factors to help these healthcare teams innovate.
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Zahn, Roland, and Alistair Burns. Dementia disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198779803.003.0001.
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This chapter provides a brief overview of the different forms of dementia syndromes and provides a simple algorithm for initial differential diagnosis. Rapidly progressive dementias have to be excluded which require specific investigations to detect Creutzfeldt–Jakob as well as inflammatory and autoimmune diseases. A lead symptom-based approach in patients with slowly progressive cognitive and behavioural impairments without neurological symptoms is applied: progressive and primary impairments in recent memory are characteristic of typical Alzheimer’s dementia, primary behavioural changes point to the behavioural variant of frontotemporal dementia, primary impairments of language or speech are distinctive for progressive aphasias, fluctuating impairments of attention are a hallmark of Lewy body dementia, whereas primary visuospatial impairments suggest a posterior cortical atrophy. The chapter further discusses updated vascular dementia guidelines and DSM-5 revisions of defining dementia. Current diagnostic criteria for the different dementias are referenced and the role of neuroimaging is illustrated.
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McLean, Donald, and Claire-Louise Chapple. CT dosimetry. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199655212.003.0015.
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The computed tomography (CT) medical examination is the highest single source of radiation to the general public in the developed world. Its use is rapidly growing, as is its technical complexity. The primary dosimetry formalism is based on the computed tomography dose index (CTDI), which can be measured in air or in standard phantoms using a calibrated pencil ionization chamber with adaptations for wide beam scanners. Displayed dose parameters can be used with caution to estimate patient organ doses, effective dose, and risk, using a variety of models and software. An understanding of automatic exposure control and the influence of patient size is essential when interpreting dosimetry results. CT examination protocols require optimisation, including the appropriate use of newly available dose reduction features. Particular consideration needs to be given to paediatric CT and to specialist applications such as radiotherapy planning, cardiac CT and volume imaging.
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Crowley, Stephen. Putin's Labor Dilemma. Cornell University Press, 2021. http://dx.doi.org/10.7591/cornell/9781501756276.001.0001.
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This book investigates how the fear of labor protest has inhibited substantial economic transformation in Russia. Vladimir Putin boasts he has the backing of workers in the country's industrial heartland, but as economic growth slows in Russia, reviving the economy will require restructuring the country's industrial landscape. At the same time, doing so threatens to generate protest and instability from a key regime constituency. However, continuing to prop up Russia's Soviet-era workplaces, the book suggests, could lead to declining wages and economic stagnation, threatening protest and instability. The book explores the dynamics of a Russian labor market that generally avoids mass unemployment, the potentially explosive role of Russia's monotowns, conflicts generated by massive downsizing in “Russia's Detroit” (Tol'yatti), and the rapid politicization of the truck drivers movement. Labor protests currently show little sign of threatening Putin's hold on power, but the manner in which they are being conducted point to substantial chronic problems that will be difficult to resolve. The book demonstrates that the Russian economy must either find new sources of economic growth or face stagnation. Either scenario — market reforms or economic stagnation — raises the possibility, even probability, of destabilizing social unrest.
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Chance, Kelly, and Randall V. Martin. Spectroscopy and Radiative Transfer of Planetary Atmospheres. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780199662104.001.0001.
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This book develops both spectroscopy and radiative transfer for planetary atmospheric composition in a rigorous and quantitative sense for students of atmospheric and/or planetary science. Spectroscopic field measurements including satellite remote sensing have advanced rapidly in recent years, and are being increasingly applied to provide information about planetary atmospheres. Examples include systematic observation of the atmospheric constituents that affect weather, climate, biogeochemical cycles, air quality on Earth, as well as the physics and evolution of planetary atmospheres in our solar system and beyond. Understanding atmospheric spectroscopy and radiative transfer is important throughout the disciplines of atmospheric science and planetary atmospheres to understand principles of remote sensing of atmospheric composition and the effects of atmospheric composition on climate. Atmospheric scientists need an understanding of the details, strength and weaknesses of the spectroscopic measurement sources. Those in remote sensing require an understanding of the information content of the measured spectra that are needed for the design of retrieval algorithms and for developing new instrumentation.
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Inglehart, Ronald F. Religion's Sudden Decline. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780197547045.001.0001.
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Secularization has accelerated. From 1981 to 2007, most countries became more religious, but from 2007 to 2020, the overwhelming majority became less religious. For centuries, all major religions encouraged norms that limit women to producing as many children as possible and discourage any sexual behavior not linked with reproduction. These norms were needed when facing high infant mortality and low life expectancy but require suppressing strong drives and are rapidly eroding. These norms are so strongly linked with religion that abandoning them undermines religiosity. Religion became pervasive because it was conducive to survival, encouraged sharing when there was no social security system, and is conducive to mental health and coping with insecure conditions. People need coherent belief systems, but religion is declining. What comes next? The Nordic countries have consistently been at the cutting edge of cultural change. Protestantism left an enduring imprint, but 20th-century welfare added universal health coverage; high levels of state support for education, welfare spending, child care, and pensions; and an ethos of social solidarity. These countries are also characterized by rapidly declining religiosity. Does this portend corruption and nihilism? Apparently not. These countries lead the world on numerous indicators of a well-functioning society, including economic equality, gender equality, low homicide rates, subjective well-being, environmental protection, and democracy. They have become less religious, but their people have high levels of interpersonal trust, tolerance, honesty, social solidarity, and commitment to democratic norms. The decline of religiosity has far-reaching implications. This book explores what comes next.
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Krzesinski, Jean-Marie, and Eric P. Cohen. Approach to the patient with oedema. Edited by Robert Unwin. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0030_update_001.
Full textAbstract:
Generalized oedema reflects retention of salt and water that can be triggered by disease of several organs, but notably kidneys, heart and liver. Management is based on salt restriction and the use of diuretics. Diuretics have greatly improved its management, but in severe cases, ultrafiltration or dialysis may be needed for its treatment. In congestive heart failure, the nephrotic syndrome, or primary sodium retention, one proceeds rapidly, using mainly loop diuretics. Weight loss of 1 kg/day is a typical goal. Fluid removal in patients with cirrhosis and ascites, but without peripheral oedema, must proceed more slowly, often only 0.5 kg/day or less. For other causes of generalized oedema, loop diuretics are usually preferred, and higher split doses may be required. Patients with resistant oedema from any cause may require high-dose loop diuretics frequently in combination with a diuretic acting at a more distal site in the nephron, typically a thiazide diuretic but also sometimes potassium sparing drugs. A high-salt diet and use of non-steroidal anti-inflammatory drugs should be ruled out.
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Macdougall, Iain C. Iron management in renal anaemia. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0126.
Full textAbstract:
Although erythropoiesis-stimulating agent therapy is the mainstay of renal anaemia management, maintenance of an adequate iron supply to the bone marrow is also pivotal in the process of erythropoiesis. Thus, it is important to be able to detect iron insufficiency, and to treat this appropriately. Iron deficiency may be absolute (when the total body iron stores are exhausted) or functional (when the total body iron stores are normal or increased, but there is an inability to release iron from the stores rapidly enough to provide a ready supply of iron to the bone marrow). Several markers of iron status have been tested, but those of the greatest utility are the serum ferritin, transferrin saturation, and percentage of hypochromic red cells. Measurement of serum hepcidin, which is the master regulator of iron homoeostasis, has to date proved disappointing as a means of detecting iron insufficiency, and none of the available iron markers reliably exclude the need for supplemental iron. Iron may be replaced by either the oral or the intravenous route. In the advanced stages of chronic kidney disease, however, hepcidin is upregulated, and this powerfully inhibits the absorption of iron from the gut. Thus, such patients often require intravenous iron, particularly those on dialysis. Several intravenous (IV) iron preparations are available, and they have in common a core containing an iron salt, surrounded by a carbohydrate shell. The IV iron preparations differ in their kinetics of iron release from the iron–carbohydrate complex. In recent times, several new IV iron preparations have become available, and these allow a greater amount of iron to be given more rapidly as a single administration, without the need for a test dose.
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Joyce, David L., and Lyle D. Joyce. Mechanical Circulatory Support. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190909291.001.0001.
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Mechanical circulatory support (MCS) offers life-saving treatment options for patients with advanced heart failure, cardiogenic shock, and acute cardiopulmonary failure. With the development of short-term, long-term, left-sided, right-sided, biventricular, and cardiopulmonary support options, the complexity surrounding this field has evolved substantially in the past decade. This textbook seeks to provide a logical and systematic framework for managing patients who require MCS therapies. In chapters 2–9, a comprehensive approach to selecting and preparing patients for MCS interventions is described. In chapters 10–23, the range of currently available devices is reviewed with updates on the most up-to-date clinical experiences based on recently published outcomes. Chapters 24–30 describe the current state of the art in perioperative strategies for achieving long-term success. Finally, chapters 31–46 outline the myriad of clinical challenges that often occur in the postoperative period, including some of the frequently encountered adverse events that are unique to the physiology associated with this technology. The fundamental principles included in this textbook will provide a framework for the MCS provider that can serve as a road map amidst the rapidly evolving landscape created by the technology pipeline within this industry.
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Bienvenu, O. Joseph, Ramona O. Hopkins, and Christina Jones, eds. Psychological and Cognitive Impact of Critical Illness. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199398690.001.0001.
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Neuropsychiatric problems, including posttraumatic stress disorders, depression, and anxiety, after critical illness are receiving increasing attention, particularly in the critical care medicine literature, but all clinicians should be interested in these common problems, given the growing number of critical illness survivors. Patients frequently come out of the intensive care unit (ICU) with horrifying distorted memories and don’t understand what has happened to them. Not only are patients debilitated with cognitive impairment and ICU-acquired weakness, they are traumatized by actual experiences (e.g., shortness of breath and pain) and distorted memories (of being tortured, raped, assaulted, or imprisoned) shaped by delirium. Patients’ family members are also frequently quite distressed, and children surviving critical illnesses appear to have similar experiences to those of adults. This book provides an overview of the nature and epidemiology of cognitive and other psychiatric problems in this growing population, and it addresses the small but growing literature on prevention and early intervention efforts. Addressing these problems successfully will require collaborative interventions, both in-ICU and post-ICU.
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Bornemann, Michel A. Cramer, and Mark R. Pressman. Violent parasomnias and sleep forensics. Edited by Sudhansu Chokroverty, Luigi Ferini-Strambi, and Christopher Kennard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682003.003.0052.
Full textAbstract:
Parasomnias are complex behaviors occurring out of or during sleep. Parasomnias are increasingly presented as proof of an automatism in criminal cases involving violence. The sleep forensics expert must have an up-to-date understanding of current sleep science and research, diagnostic and clinical techniques, and the legal requirements of expert testimony and scientific evidence. Sleepwalking and related disorders typically follow sudden, partial awakenings from deep sleep. Higher-level cognition is severely limited or absent, and complex behaviors often consist of “automatic” behaviors not initiated or guided by memory or planning. Sleepwalking and related disorders are noted to occur during deep sleep and often require a genetic predisposition or priming factors. Prior cases of sleepwalking violence find that the victim of sleepwalking violence—most often a family member—seeks out the sleepwalker. The history of sleepwalking includes reports of episodes and sometimes criminal court cases of murder, assault, and rape.
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Appelbaum, Kenneth L., Robert L. Trestman, and Jeffrey L. Metzner. The Future of Correctional Psychiatry. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0071.
Full textAbstract:
Recent decades have seen many advances in the knowledge base and practice standards for correctional psychiatry. In many ways, however, the field remains in the early stages of development. As it continues to mature in the coming years, we hope and expect to see further progress. Establishment of evidence-based clinical practices and a firm foundation for ethical standards has begun, and the momentum will continue to build. The questions and dilemmas that we present do not all lend themselves to easy consensus. They do, however, require attention and resolution. Custodial and clinical practices in correctional settings continue to evolve and change. Some of those changes may occur in a rapid and dramatic way. Psychiatry should stake-out a place in the forefront of the ongoing debate. By being proactive instead of reactive we will have a greater chance of influencing the outcomes and we will fulfill our responsibilities for the inmate patients who we serve. No one can predict with certainty what the future holds. We feel safe, however, in predicting that changes, incremental and perhaps revolutionary, will occur. In this chapter we identify opportunities to expand the evidence-base of correctional psychiatry, the need to refine practice guidelines, and the role that psychiatry might play in influencing the use of incarceration. As part of our review we describe what we believe the future may hold in store for our subspecialty. We hope that this textbook contributes to a picture of where things stand and a vision of where we need to go.