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1
Brown, Lily A., David Yusko, Hallie Tannahill, and Edna B. Foa. Prolonged Exposure Therapy for Post-Traumatic Stress Disorder. Edited by Charles B. Nemeroff and Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0030.
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This chapter presents an overview of prolonged exposure therapy (PE), a highly efficacious and effective treatment for post-traumatic stress disorder (PTSD). First, emotional processing theory is reviewed, which provides the theoretical basis for PE and the key mechanisms underlying PTSD symptom reduction. Next, a synthesis of the robust evidence for the efficacy and effectiveness of PE is provided. The chapter reviews evidence that in addition to ameliorating PTSD symptoms, PE reduces secondary symptoms such as depression, suicidal ideation, anger, and substance use disorders. The chapter describes evidence supporting the extension of PE with unique samples, including individuals with psychosis, persons with self-injurious behavior, and war veterans. The chapter concludes with a review of the status of PE dissemination and implementation efforts.
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Newberg, Andrew B., and David B. Yaden. The Neurobiology of Meditation and Stress Reduction. Edited by Anthony J. Bazzan and Daniel A. Monti. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190690557.003.0004.
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Meditation is a complex mental process that involves changes in cognition, sensory perception, emotions, hormones, and autonomic activity. Several brain regions are involved in these practices, particularly as they relate to improvements in brain function and psychological parameters, including the thalamus, frontal lobes, limbic system, and parietal lobes. Additionally, many different neurotransmitter systems are likely affected by meditation practices. Meditation programs have become widely used, either alone or combined with other therapies, for stress reduction depression, anxiety, and posttraumatic stress disorder. There has been an increasing understanding of the overall biological mechanism of meditation practices in terms of their effects on both the brain and body. Recent studies using clinical tools and functional neuroimaging have substantially augmented the knowledge of the biology of meditative practices. This chapter reviews current understanding regarding the physiological and neurophysiological effects of meditation practices as they pertain to brain health.
3
Foa, Edna, Elizabeth A. Hembree, Barbara Olasov Rothbaum, and Sheila Rauch. Prolonged Exposure Therapy for PTSD. Oxford University Press, 2019. http://dx.doi.org/10.1093/med-psych/9780190926939.001.0001.
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This therapist guide of prolonged exposure (PE) treatment is accompanied by the patient workbook, Reclaiming Your Life from a Traumatic Experience. The treatment and manuals are designed for use by a therapist who is familiar with cognitive behavioral therapy (CBT) and who has undergone an intensive training workshop for prolonged exposure by experts in this therapy. The therapist guide instructs therapists to implement this brief CBT program that targets individuals who are diagnosed with posttraumatic stress disorder (PTSD) or who manifest PTSD symptoms that cause distress and/or dysfunction following various types of trauma. The overall aim of the treatment is to help trauma survivors emotionally process their traumatic experiences to diminish or eliminate PTSD and other trauma-related symptoms. The term prolonged exposure (PE) reflects the fact that the treatment program emerged from the long tradition of exposure therapy for anxiety disorders in which patients are helped to confront safe but anxiety-evoking situations to overcome their unrealistic, excessive fear and anxiety. At the same time, PE has emerged from the adaption and extension of Emotional Processing Theory (EPT) to PTSD, which emphasizes the central role of successfully processing the traumatic memory in the amelioration of PTSD symptoms. Throughout this guide, the authors highlight that emotional processing is the mechanism underlying successful reduction of PTSD symptoms.
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Bitzer, Johannes. Teaching psychosomatic obstetrics and gynaecology. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749547.003.0002.
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Gynaecologists and obstetricians are confronted with many tasks that require biopsychosocial competence, as explained in Chapter 2. Care for patients with unexplained physical symptoms, and patients with chronic incurable diseases, in various phases of their lives, require patient education, health promotion, counselling, and management of psychosocial problems. To obtain this competency, a curriculum is needed, which, besides gynaecology and obstetrics, includes elements of psychology, psycho-social medicine, and psychiatry, adapted to the specific needs of gynaecologists and obstetricians in their everyday work. A basic part of Chapter 2 shows the curriculum consists of teaching the knowledge, and skills derived from communication theory and practice including physician, and patient-centred communication with active listening, responding to emotions and information exchange as well as breaking bad news, risk-counselling, and shared decision-making. Building on these skills, trainees are introduced into the biopsychosocial process of diagnosis, establishing a 9-field comprehensive work-up using the ABCDEFG guideline (Affect, Behaviour, Conflict, Distress, Early life Experiences, False beliefs, Generalised frustration). The therapeutic interventions are based on a working alliance between the physician and the patient, and are taught as basic elements, which have to be combined according to the individual patient and the presenting situation. The overall technique for gynaecologists and obstetricians can be summarised as supportive counselling/psychotherapy. This includes elements such as catharsis, clarifying conflicts and conflict resolution, cognitive reframing, insight and understanding, stress reduction techniques, and helping in behavioural change (CCRISH).
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Abramowitz, Sharone. Mindfulness as a Component of Addiction Treatment (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0021.
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This compact chapter addresses patient selection and general principles of mindfulness-based interventions, specifically mindfulness-based stress reduction (MBSR). It describes mindfulness-oriented recovery enhancement (MORE) as a combination of mindfulness intervention and cognitive behavioral therapy, suggesting its effectiveness in reducing the perception of pain in more than half of the participants who complete training. While focusing principally on the patient, the chapter argues for the utility of mindfulness-based interventions in preserving the serenity and enhancing the effectiveness of the therapist. It also notes that while the therapeutic outcome may be modest, there is generally little cost and very little risk to initiation of mindfulness meditation and similar interventions. A text box is given with additional resources.
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Shabazz, Rashad. Epilogue. University of Illinois Press, 2017. http://dx.doi.org/10.5406/illinois/9780252039645.003.0007.
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This epilogue focuses on Chicago's changing racial geography, arguing that this change is creating not only gentrification in parts of the city, but also openings for Black Chicagoans to augment their geography. Since the mid-1990s abandoned lots all over Chicago have been turned into spaces of agricultural production. Not limited to middle-class white neighborhoods, urban gardens have sprung up in poor and working-class communities on the South and West Sides of the city. This is not the first time Chicagoans have performed agriculture in the city. The city has a long history of urban agriculture. This epilogue shows that green spaces can undo the consequences of carceral space by enabling Black Chicagoans to eat fresh fruits and vegetables in places with little retail access to them and creating environments of stress reduction for the entire community. It also demonstrates that the poor and the working class can be architects and planners, that they can augment their geographies in ways that produce healthy people and vital, vibrant communities—on their own terms.
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Magnuson, Doug, Mikael Jansson, and Cecilia Benoit. The Experience of Emerging Adulthood Among Street-Involved Youth. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780190624934.001.0001.
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The Experience of Emerging Adulthood Among Street-Involved Youth tells the story of young people who were street-involved from their early to middle teens and into their 20s, particularly their experiences of emerging adulthood while struggling toward young adulthood and independence. These youth experienced emerging and early adulthood earlier than other youth while living independently of guardians, detached from formal education, and working in the underground economy. After leaving their guardians they were choosing how to be different than their family, learning to cope with instability, and enjoying and protecting their independence, and they experienced some satisfaction with their ability to manage. As one youth stated, “away from my family, I learned that I was not stupid.” Their success was facilitated by harm reduction services, like access to shelter and food, that gave them time to experiment with living independently and to practice being responsible for themselves and others. Later they began to prefer nonstreet identities, and they began to think about their desires for the future. The distance between their current lives and those aspirations was the experience of feeling “in-between,” and progress toward their aspirations was often complicated by past experiences of trauma, current experiences of exclusion, coping with substances, and the mismatch between their needs and available services.
8
Lipman, Meegan, Jacqueline Calderone, Joel Yager, and Maryann Waugh. Wellness. Edited by Robert E. Feinstein, Joseph V. Connelly, and Marilyn S. Feinstein. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.003.0022.
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Lifestyle behaviors that contribute to wellness, specifically those involving physical exercise, healthy nutrition and weight management, healthy sleep patterns, and stress reduction, are of significant concern to clinicians and patients. Attending to these areas is critical, not only to prevent illness but also to reduce the deleterious impacts of existing chronic diseases on morbidity and mortality. Integrated primary care practices can readily establish and employ protocols for systematically addressing these important areas of overall physical and emotional functioning. This chapter discusses ways that primary care practices and team members can emphasize wellness in their integrated care services. The discussion covers assessing patients’ lifestyle choices, providing advice for improving health behaviors, developing agreed-upon interventions, assisting patients with related health behavior modifications and alterations, and arranging for improved patient access to and engagement with resources and programs that promote overall wellness.
9
Zaret, Barry L. Nuclear Cardiology. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0001.
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Nuclear cardiology is generally considered a clinical phenomenon of the past four decades. However, the field has its roots in earlier times. This chapter focuses on these historical roots as they have evolved into the present era. The initial application of radioisotopes to cardiac studies occurred in the mid-1920s. Ventricular function was evaluated in the 1960s and 1970s by first pass and equilibrium techniques. Myocardial stress perfusion imaging was first performed using potassium-43 and exercise in 1973. Stress imaging rapidly evolved thereafter with new tracers (thallium-201 and technetium-labeled agents) and from planar to SPECT approaches. Perfusion imaging rapidly proved its value diagnostically and in assessing prognosis. Infarct imaging reached its peak use in the 1970s but is now no longer employed. Advances in hybrid imaging, combining CT with radionuclide imaging has recently allowed attenuation correction as well as providing the combination of anatomic and physiologic data. PET myocardial perfusion studies have recently become a standard approach for evaluating perfusion, absolute coronary blood flow and coronary reserve. PET FDG studies of cardiac sarcoidosis have recently been established as a new approach for defining myocardial inflammation. New SPECT systems provide high sensitivity, high resolution studies, allowing for radiation dose reduction and high quality imaging studies.
10
Nelson, Paul. The Millennium Development Goals and the Politics of Global Poverty. Oxford University Press, 2018. http://dx.doi.org/10.1093/acrefore/9780190846626.013.340.
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The Millennium Development Goals (MDGs), endorsed by 189 governments at the Millennium Summit, propose a concerted global effort to reduce the incidence of severe poverty and many of its most serious manifestations over a twenty-five-year period. The MDGs offer crucial insights into the politics of poverty and poverty reduction in international affairs. Their political dimensions can be analyzed in terms of agency, the nature and limits of accountability, the use and manipulation of quantitative goals for political ends, the dangerous illusion that MDG objectives can be accomplished in large part by mobilizing more development assistance, and the MDGs’ distinctly apolitical approach to the structural causes of poverty. The MDG initiative should be situated in three ongoing streams of debate and discussion: the debate over the relative priority of growth and of human development for poverty reduction; the tension between the assertion of rights and the enunciation of donor-driven goals as the political engine of poverty reduction; and the debate over the roles of markets and of state direction and regulation. While the MDGs concentrate on increasing aid flows to reduce the incidence of poverty and its manifestations, international trade and finance arrangements too often impede rapid progress. This is evident in water privatization, trade rules, and anti-retroviral medicines for HIV/AIDS patients. A way forward is to integrate the MDGs more deeply with human rights guarantees. Donors, for example, must take seriously the 2002 Draft Guidelines for the application of human rights to poverty reduction strategies.
11
van Lier, Felix, and Robert Jan Stolker. Preoperative assessment and optimization. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0040.
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Perioperative cardiovascular complications (including myocardial ischaemia and myocardial infarction) are the predominant cause of morbidity and mortality in patients undergoing non-cardiac surgery. The pathophysiology of perioperative myocardial infarction is complex. Prolonged myocardial ischaemia due to the stress of surgery in the presence of a haemodynamically significant coronary lesion, leading to subendocardial ischaemia, and acute coronary artery occlusion after plaque rupture and thrombus formation contribute equally to these devastating events. Perioperative management aims at optimizing the patient’s condition by identification and modification of underlying cardiac risk factors and diseases. The first part of this chapter covers current knowledge on preoperative risk assessment. Current risk indices, the value of additional testing, and new preoperative cardiac risk makers are investigated. During recent decades there has been a shift from the assessment and treatment of the underlying culprit coronary lesion towards a systemic medical therapy aiming at prevention of myocardial oxygen supply–demand mismatch and coronary plaque stabilization. In the second part of this chapter, risk-reduction strategies are discussed, including β-blocker therapy, statins, and aspirins. A central theme in this chapter will focus on long-term cardiovascular risk reduction. Patients who undergo non-cardiac (vascular) surgery are particularly prone to long-term adverse cardiac outcomes. The goal of perioperative cardiovascular risk identification and modification should not be limited to the perioperative period, but should extend well into the postoperative period.
12
Goligorsky, Michael S., Julien Maizel, Radovan Vasko, May M. Rabadi, and Brian B. Ratliff. Pathophysiology of acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0221.
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In the intricate maze of proposed mechanisms, modifiers, modulators, and sensitizers for acute kidney injury (AKI) and diverse causes inducing it, this chapter focuses on several common and undisputable strands which do exist.Structurally, the loss of the brush border, desquamation of tubular epithelial cells, and obstruction of the tubular lumen are commonly observed, albeit to various degrees. These morphologic hallmarks of AKI are accompanied by functional defects, most consistently reflected in the decreased glomerular filtration rate and variable degree of reduction in renal blood flow, accompanied by changes in the microcirculation. Although all renal resident cells participate in AKI, the brunt falls on the epithelial and endothelial cells, the fact that underlies the development of tubular epithelial and vascular compromise.This chapter further summarizes the involvement of several cell organelles in AKI: mitochondrial involvement in perturbed energy metabolism, lysosomal involvement in degradation of misfolded proteins and damaged organelles, and peroxisomal involvement in the regulation of oxidative stress and metabolism, all of which become defective. Common molecular pathways are engaged in cellular stress response and their roles in cell death or survival. The diverse families of nephrotoxic medications and the respective mechanisms they induce AKI are discussed. The mechanisms of action of some nephrotoxins are analysed, and also of the preventive therapies of ischaemic or pharmacologic pre-conditioning.An emerging concept of the systemic inflammatory response triggered by AKI, which can potentially aggravate the local injury or tend to facilitate the repair of the kidney, is presented. Rational therapeutic strategies should be based on these well-established pathophysiological hallmarks of AKI.
13
Costa, Raquel, Miguel A. Serrano, and Alicia Salvador. Psychobiological Responses to Competition in Women. Edited by Maryanne L. Fisher. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199376377.013.21.
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From an evolutionary perspective, questions have been raised about whether women have a psychobiological pattern similar to that of men. In humans, hormonal effects of competition and its outcome have been investigated under the biosocial status hypothesis, which proposes that, after a competition, winners would show increases in testosterone whereas losers would show reductions, and the challenge hypothesis, which emphasizes the functional role of testosterone increases in the spring to promote agonistic behavior related to territoriality and access to females. Subsequently, the coping competition model has defended the study of competition within a more general stress model, considering the psychobiological responses as part of the coping response. This chapter shows that women investigations are increasing in number in recent years and that, in competitive situations, they present coping strategies with a psychobiological response pattern that can be enlightened by the coping competition model.
14
Haq, Khadija, ed. Development, Employment, and Income Distribution. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199474684.003.0009.
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In the chapter, Haq raises questions about the spurious relationship between GNP growth, employment and income distribution. Two decades of development experience of many developing countries suggested that high GNP growth did not guarantee elimination of unemployment or poverty reduction. He cites examples of development policies of India, Pakistan and Brazil to illustrate their preoccupation with GNP growth and their assumption that income distribution policies could be divorced from growth policies and could be added later to the equation. In this paper, Haq redefines the problem of development from GNP growth to a ‘selective attack on the worst form of poverty’. He also stresses on the need to treating employment as the primary objective of planning and using development and income redistribution policies in tandem, rather than thinking about redistribution after growth has materialized.
15
Benedetto, Chiara, Ilaria Castagnoli Gabellari, and Gianni Allais. Migraine and pregnancy-related hypertension. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749547.003.0005.
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Migraine is one of the most common, disabling neurological disorders in women of reproductive age. It is a disabling condition that can lead to a compromised health-related quality of life. Often `migraineurs' are unable to carry out everyday tasks due to a reduction in functioning and productivity. This burden impacts not only at work, but also on social and family life. Migraine affects not only the physical but also mental and social health. Chapter 5 discusses the available evidence of a correlation between migraine and pre-eclampsia. Pre-eclampsia complicates 3-5% of all pregnancies and remains a leading cause of maternal and perinatal morbidity, and mortality. Although the primary mechanisms of both migraine and pre-eclampsia are not yet well understood, they do share some common pathogenetic aspects. However, studies investigating the clinical association between migraine and pre-eclampsia are sparse. The majority suggest a close association between headaches and hypertensive disorders of pregnancy: gestational hypertension, pre-eclampsia, and eclampsia. There also appears to be a significant increase in the incidence of severe pre-eclampsia in women suffering from migraine. Clinical manifestations of both migraine and pre-eclampsia appear to result from an interaction of the mind and body. A relation with stress has been identified. Further robust research is needed to elucidate the psychosomatic contributions to the pathogenesis of migraine and pre-eclampsia, and the clinical application of their relationship in improving materno-fetal health.
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Vout, Caroline. The Error of Roman Aesthetics. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198803034.003.0002.
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Today, discussions of ancient art criticism privilege technical terms (akribeia [“accuracy”], aletheia [“truth”], decor [“fittingness”], symmetria [“symmetry”]). Discussions of Rome’s reception of Greek art, as revealed, for example, in Pliny the Elder, stress the need for elites to perform their artistic expertise, with Petronius’ Satyrica providing an elegant caricature. Yet this emphasis represents but one way of telling the story of Greek art’s naturalism and appropriation. In light of ancient accounts of famous artists, Gombrich’s language of “making and matching” can be rethought as “trial and error,” a formula that casts the problems of producing art that is similis veritati (“like to the truth”) in a new light. Indeed Rome’s entire appreciation of Greek art could be described as “one big error” and the Roman reception of Greek art taken as the paradigm for how art must be received. Seen like this, recent scholarship is radically reductive. Why privilege reason?
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Lee, Cheol-Sung, and In-Hoe Koo. The Welfare States and Poverty. Edited by David Brady and Linda M. Burton. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780199914050.013.32.
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This article examines the impact of welfare states on poverty reduction. It considers how different welfare regimes have reacted to help stressed populations, especially the poor, and how welfare states in developing countries protect their less capable populations under the pressures of globalization and postindustrial economic transformation. To address these questions, the article reviews existing theoretical and empirical literature on welfare states and poverty. It first describes three welfare state typologies in terms of skill and employment provisions before discussing the issues of targeting and encompassing welfare institutions. It then explores the redistributive policies of welfare states and how demographic transformations affect poverty. It also assesses the effects of two different types of welfare regimes observed in developing countries—productivist and protectionist welfare regimes—on poverty outcomes. Finally, it analyzes which configurations of social policies reduce poverty more effectively.
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Weil, Andrew. Integrative Environmental Medicine. Edited by Aly Cohen and Frederick S. vom Saal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190490911.001.0001.
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Integrative Environmental Medicine looks at the history and changing landscape of environmental issues in the United States, including water supply, air quality, extensive plastic pollution, harmful chemicals in cleaning and personal care products, radiofrequency radiation, food additives, pesticides, and medications. The unique properties of compounds such as endocrine-disrupting chemicals are explored along with their ability to disturb the body’s normal signaling pathways, genetic profile, and gut microbiome. Resulting molecular derangements promote thyroid and other autoimmune diseases, diabetes, cardiovascular disease, cancer, and influence developmental problems in children. Analysis of current research identifies ways to reduce exposures and health risks, improve regulations and appropriate testing for chemicals, remediate environmental pollution, and design healthier products for the future. Best practices are considered for clinicians to ascertain exposure history, test for toxins, and teach patients how to avoid harmful exposures. Patients will be prepared and empowered with information about healthier food choices and cooking practices, appropriate supplement use, water filtration, cleaning and personal care product selection, improved sleep, stress reduction, sauna, fasting, chelation, safe cell phone use, and other means of reducing harmful environmental exposures. Solutions at every level require interdisciplinary collaboration to advance assessment, design, stewardship, and regulation of chemicals to promote environmental and human health.
19
Hamilton, Matthew Lloyd. COMT genotypes in pain responses. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0080.
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The landmark study discussed in this chapter is ‘COMT val158met genotype affects μ-opioid neurotransmitter responses to a pain stressor’, published by Zubieta et al. in 2003. Catechol-O-methyl-transferase (COMT) is a key modulator of dopaminergic and noradrenergic neurotransmission. This study focused on a single nucleotide polymorphism of the COMT gene encoding the substitution of valine (val) by methionine (met) at Codon 158 (val158met), resulting in a three- to fourfold reduction in its activity. Individuals with the val/val genotype have the highest activity of COMT, val/met genotypes have intermediate activity, and met/met genotypes have the lowest activity of COMT. Using a mixture of PET imaging of the binding of μ-opioid receptors and correlation with clinical outcomes, this groundbreaking study provided evidence that confirmed their hypothesis and established the COMT val158met SNP as one of the first gene modifications with direct ramifications on human pain.