To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The Art of Child and Adolescent Psychiatry is an engaging and authoritative account of the essential skills required to practice child and adolescent psychiatry for all those working in children's mental health, from trainees to experienced professionals in paediatrics, psychiatry, psychology, and psychotherapy. The practical tasks of meeting the child and family, planning treatments, and working with colleagues are all covered, building on existing texts that mainly focus on diagnostic criteria, protocols, and laws. This book respects the evidence base, while also pointing out its limitations, and suggests ways in which to deal with these. Psychiatry is placed within broader frameworks including strategy, learning, management, philosophy, ethics, and interpersonal relations. With over 200 educational vignettes of the authors' vast experience in the field, the book is also highly illustrated. The Art of Child and Adolescent Psychiatry is an indispensable guide to thoughtful practice in children's mental health.
Wellness is often intimidating. Pursuing it requires significant commitment and carries emotional risk/vulnerability . While fear can be a strong motivator, it can also be the reason one may not try or follow-through with a plan. In most cases, fear prevents us from being able to accomplish what we wish to. In the case of wellness, we found that due to the commitment many were challenged by the fear of not being able to achieve the results and goals they had set for themselves. For example, if one was never taught, or had modeled, how to live a life full of joy, love, and wellness, they will fear a life different than what they were taught, whether by observation or directly. Occasionally it can be more difficult and painful to break a pattern than to live in it . The path to wellness will likely be unique for each and every one of us.
We evaluated the safety and feasibility of high-intensity interval training via a novel telemedicine ergometer (MedBIKE™) in children with Fontan physiology.
The MedBIKE™ is a custom telemedicine ergometer, incorporating a video game platform and live feed of patient video/audio, electrocardiography, pulse oximetry, and power output, for remote medical supervision and modulation of work. There were three study phases: (I) exercise workload comparison between the MedBIKE™ and a standard cardiopulmonary exercise ergometer in 10 healthy adults. (II) In-hospital safety, feasibility, and user experience (via questionnaire) assessment of a MedBIKE™ high-intensity interval training protocol in children with Fontan physiology. (III) Eight-week home-based high-intensity interval trial programme in two participants with Fontan physiology.
There was good agreement in oxygen consumption during graded exercise at matched work rates between the cardiopulmonary exercise ergometer and MedBIKE™ (1.1 ± 0.5 L/minute versus 1.1 ± 0.5 L/minute, p = 0.44). Ten youth with Fontan physiology (11.5 ± 1.8 years old) completed a MedBIKE™ high-intensity interval training session with no adverse events. The participants found the MedBIKE™ to be enjoyable and easy to navigate. In two participants, the 8-week home-based protocol was tolerated well with completion of 23/24 (96%) and 24/24 (100%) of sessions, respectively, and no adverse events across the 47 sessions in total.
The MedBIKE™ resulted in similar physiological responses as compared to a cardiopulmonary exercise test ergometer and the high-intensity interval training protocol was safe, feasible, and enjoyable in youth with Fontan physiology. A randomised-controlled trial of a home-based high-intensity interval training exercise intervention using the MedBIKE™ will next be undertaken.
Pain management for patients with chest trauma in aeromedical prehospital and retrieval medicine is important in order to maintain respiratory function. However, it can be challenging to achieve with opioids alone due to side effects including sedation, respiratory depression, and nausea.
Reported are two trauma patients with uncontrolled pain despite multiple doses of opioids managed with a single-injection erector spinae plane block (ESB).
The sono-anatomy and performance of the block, indications, and possible complications associated with the ESB are described.
An ultrasound-guided ESB is useful for multimodal pain therapy following chest trauma in aeromedical retrieval medicine.
There is a substantial proportion of patients who drop out of treatment before they receive minimally adequate care. They tend to have worse health outcomes than those who complete treatment. Our main goal is to describe the frequency and determinants of dropout from treatment for mental disorders in low-, middle-, and high-income countries.
Respondents from 13 low- or middle-income countries (N = 60 224) and 15 in high-income countries (N = 77 303) were screened for mental and substance use disorders. Cross-tabulations were used to examine the distribution of treatment and dropout rates for those who screened positive. The timing of dropout was examined using Kaplan–Meier curves. Predictors of dropout were examined with survival analysis using a logistic link function.
Dropout rates are high, both in high-income (30%) and low/middle-income (45%) countries. Dropout mostly occurs during the first two visits. It is higher in general medical rather than in specialist settings (nearly 60% v. 20% in lower income settings). It is also higher for mild and moderate than for severe presentations. The lack of financial protection for mental health services is associated with overall increased dropout from care.
Extending financial protection and coverage for mental disorders may reduce dropout. Efficiency can be improved by managing the milder clinical presentations at the entry point to the mental health system, providing adequate training, support and specialist supervision for non-specialists, and streamlining referral to psychiatrists for more severe cases.
Jamie Gundry’s dramatic image of a white-tailed eagle (Haliaeetus albicilla) on the cover of this book reflects the twisting changes in fortune experienced by this species, with a revival that can be attributed to a successful interplay of science, policy and practice. White-tailed eagles were historically much more widely distributed than they are today (Yalden, 2007), once breeding across much of Europe, but by the early twentieth century the species was extinct across much of western and southern Europe. The main cause of its decline was persecution by farmers and shepherds, who considered the eagles a threat to their livestock, but, along with other raptors, white-tailed eagles were also seriously affected by DDT in the 1960s and 1970s, which had disastrous effects on the breeding success of remaining populations.
In the Anthropocene, when our environment is changing rapidly and the windows of opportunity for action to prevent further biodiversity loss are narrow, conservation researchers are increasingly encouraged to think and operate beyond the traditional approaches of producing peer-reviewed papers and presenting results to other members of the research community. Indeed, the perception that researchers belong in their ivory tower, from which they deliver evidence for others to interpret, disseminate and use in decision-making, is thankfully now widely recognised as outdated. The rise of fake news, a deliberate lack of consideration for scientific evidence, and changes to the ways of assessing the value of researchers’ work probably all play a role in supporting this shift in perception. Moreover, for many researchers, the prospect of their work ‘making a difference’ and having an impact on wider society is at least as great a motivation for doing research as generating new knowledge, however interesting that may be.
Conservation research is essential for advancing knowledge but to make an impact scientific evidence must influence conservation policies, decision making and practice. This raises a multitude of challenges. How should evidence be collated and presented to policymakers to maximise its impact? How can effective collaboration between conservation scientists and decision-makers be established? How can the resulting messages be communicated to bring about change? Emerging from a successful international symposium organised by the British Ecological Society and the Cambridge Conservation Initiative, this is the first book to practically address these questions across a wide range of conservation topics. Well-renowned experts guide readers through global case studies and their own experiences. A must-read for practitioners, researchers, graduate students and policymakers wishing to enhance the prospect of their work 'making a difference'. This title is also available as Open Access on Cambridge Core.