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38670 results in Cambridge Textbooks

Page 1248 of 1934

  • Preface

  • Andrew G. Webb
  • Book:
    Principles of Biomedical Instrumentation
    Published online:
    11 August 2019
    Print publication:
    11 January 2018, pp xi-xv

  • Summary

    The main aim of this textbook is to provide the tools to understand the function and design of different biomedical instruments and devices, and for the reader to be able to use these tools to envision new and improved future technology and designs. Throughout the book the terms medical and biomedical are used interchangeably, and similarly with the terms device and instrument. With several thousand instruments and devices on the market it is clearly impossible to consider more than a handful in detail. Instead, this book concentrates on the following general approach.

  • (i) What is the clinically relevant measurement that needs to be made?

  • (ii) What are the pathophysiological mechanisms that give rise to the clinical condition?

  • (iii) What are the characteristics (e.g. magnitude, frequency, bandwidth) of the signal to be measured? How accurate and reproducible does the measurement have to be? What are the interfering signals that have to be suppressed?

  • (iv) What are the recommended instrumental specifications for the particular device? How does one design the device to meet these specifications?

  • (v) How does one test the biocompatibility and electrical safety of such a device, whether it is external or implanted, so that it can operate safely for a number of years?

    • Traditionally, most of these instruments and devices have been located in a hospital, and patients travel to the clinics for the measurements to be performed by trained personnel. However, this model is changing and nowadays there is an increasing role for what is termed mobile health (m-health), which involves a much greater degree of healthcare being performed by the patients themselves at home. This means that a biomedical device must operate in the patient's home environment without specialized training, as well as transmit the data wirelessly and securely to the physician. This model of continuous patient monitoring not only provides a much more complete assessment of the patient's health, but also reduces the number of visits that a patient has to make to the hospital.

    The main areas of technological development that have enabled the rapid incorporation of m-health into the healthcare infrastructure are wearable and implantable devices that can transmit data to the physician via mobile phone networks.

  • 9 - Safety of Biomedical Instruments and Devices

  • Andrew G. Webb
  • Book:
    Principles of Biomedical Instrumentation
    Published online:
    11 August 2019
    Print publication:
    11 January 2018, pp 271-307

  • Summary

    Introduction

    Every year many thousands of patients receive some form of electrical shock from medical devices and instruments. These are typically not fatal and do not cause serious injury, but rather result in significant discomfort to the patient and may cause effects such as ventricular fibrillation. There are many incidents of physicians and nurses also receiving electric shocks. These events occur despite strict regulations to ensure the electrical safety of all medical devices. Although some events occur due to a design flaw in a particular device, the most common situation in which electrical shocks occur is one in which a patient is hooked up to many different devices in the operating room (OR), as shown in Figure 9.1. These devices might include defibrillators, pacemakers, ultrasound scanning equipment, cardiac catheters and EEG equipment to monitor anaesthesia. In addition, there are a number of ancillary devices such as high intensity lights and intravenous lines, which are attached to, or close to, the patient. Conductive body fluids also result in unintended conduction paths close to the patient or in the medical device itself if these fluids come into contact with the equipment. In general, medical equipment, and particularly the power cords and power cables feeding the equipment, see many years of use, and it is estimated that over 70% of electrical ‘incidents’ occur due to wear and tear on the power cords, which are regularly run over or mechanically stressed. The electrical insulation around equipment also becomes damaged over time during normal operation. In order to govern the design of medical equipment, regulatory bodies have produced documents to safeguard patients, and the IEC has produced a standard, the IEC 60601 Medical Electrical Equipment – Part 1: General Requirements for Safety and Essential Performance. A brief description of the tests that must be performed before installation, and for regular maintenance, is covered in section 9.5 of this chapter.

    One can analyze the different potential danger points in terms of the possibility that multiples of these are present, and can cause a potential electrical shock to the patient or physician, as shown in Figure 9.2.

  • 8 - Mobile Health, Wearable Health Technology and Wireless Implanted Devices

  • Andrew G. Webb
  • Book:
    Principles of Biomedical Instrumentation
    Published online:
    11 August 2019
    Print publication:
    11 January 2018, pp 235-270

  • Summary

    Introduction

    The standard model of healthcare is that a patient with disease symptoms visits a general practitioner, who refers the case to a specialized physician at a hospital. The patient then visits the specialist who orders a battery of tests and scans. Some time later, when the results of the tests and scans have been interpreted, the patient revisits the hospital and the appropriate therapeutic course is prescribed. At regular periods the patient may be asked to revisit the hospital, whereupon updated tests are performed, progress assessed and any necessary changes to the medication are implemented.

    There are several obvious inefficiencies in this process. First is the lack of any prior information that can be transmitted to the general practitioner before the patient's initial visit. Second is the requirement for the patient to visit the hospital multiple times. Perhaps the most important limitation is the lack of continuous monitoring of the patient's situation after therapy has started. Infrequent visits to the hospital provide only a snapshot of the entire treatment process. While the process may merely be inconvenient in the developed world, the entire concept breaks down in many developing countries.

    This chapter considers the design of software and hardware that can be used to provide continuous information from a patient to a physician and vice versa, as well as from a device to the patient and the physician, all without the patient being required to be physically present at the hospital. Figure 8.1 schematically represents different ways in which information transfer can be achieved. In order of increasing complexity, the general areas covered are:

  • (i) the use of mobile/smartphone utilities for information dissemination and patient reminders: this comes under the general description of mobile health

  • (ii) the design of wearable activity monitors that can wirelessly upload data to the patient and physician

  • (iii) the application of physical patches that can be attached to the skin and record heart rate, blood pressure, sweat, temperature etc. and can wirelessly send data to the hospital

  • (iv) the design and operation of implanted monitoring devices such as continuous glucose monitors, which can wirelessly transmit data through the body to a recording device that provides feedback to the patient and the physician, and

  • Chapter 10 - Quasi-Experimental Designs

  • Wendy Heath, Rider University, New Jersey
  • Book:
    Psychology Research Methods
    Published online:
    01 July 2021
    Print publication:
    11 January 2018, pp 241-262

  • Summary

    Would you be more likely to lie for a friend than a stranger? That was one of the questions asked recently by Marion and Burke (2015). They had pairs of friends and pairs of strangers come to their lab to work on a series of tasks. Shortly after their arrival, the two participants were separated and one was recruited to be a confederate (the other remained naïve to the true purpose of the study). Then the two participants came together to work on a task. The researcher left them alone while they were working, saying she was briefly leaving the building. Before completing the collaborative task, the confederate briefly left the testing room “to use the restroom.” The confederate returned and the two participants finished the task.

    The researcher returned shortly thereafter and said some money had been taken from an adjoining room. She asked the participants whether they had seen or heard anyone enter that room. As pre-arranged, the confederate claimed they were both in the testing room with the door closed during the entire session. This, of course, was a lie. The confederate had left the room. Each naïve participant was later questioned separately about whether they had both been in the room the whole time. The question of interest was: Would naïve participants be equally likely to lie for a friend as for a stranger? Would the naïve participant say the other participant had never left the room?

    Marion and Burke found that those who were friends with the confederate were significantly more likely to lie (41%) than those who were not (18%). They cannot conclude that the reason for this result was solely friendship however. As Marion and Burke acknowledge, what is missing from their design is random assignment to groups. They chose to work with students who were already friends and with students who had never met. They did not randomly assign people to groups and say, “Forget whether you know each other or not; for the purpose of this research, you will be friends” or “you will be strangers.” The independent variable of relationship (friends, strangers) was out of the researchers’ control. Thus, Marion and Burke needed to use a quasi-experimental design. Since the groups are not considered equivalent, something inherently different about the groups (beyond the independent variable) could be responsible for the results.

  • Chapter 12 - External Validity

  • Wendy Heath, Rider University, New Jersey
  • Book:
    Psychology Research Methods
    Published online:
    01 July 2021
    Print publication:
    11 January 2018, pp 283-304

  • Summary

    I'd like to start this chapter by describing an experiment designed to investigate whether drinking alcohol affects self-disclosure. To do this Sayette (1994) brought male social drinkers to his lab and, given their informed consent, gave them either enough alcohol to be legally drunk or just a placebo (those who drank the placebo thought they were drinking alcohol). Then he asked each participant to speak for 3 minutes on the following topic: “What I like and dislike about my body and physical appearance” (p. 129). After that, undergraduates working for the experimenter listened to audiotapes of these speeches. They counted the number of negative, positive, and neutral items in each speech as well as the amount of time each speaker spent presenting each type of information.

    What did Sayette find? The participants who were intoxicated disclosed fewer negative pieces of information about themselves than those who were sober. The intoxicated participants also spent marginally less time disclosing negative information than those who were sober. On the other hand, there was no difference in the amount of positive information participants in the two groups disclosed about themselves.

    So what does this mean? Does Sayette's research suggest that a drunk person you meet in a bar is likely to disclose less negative information than a sober person? In other words, “Do people behave in real life as they behave in our experimental laboratories?” (Bem & Lord, 1979, p. 833). This question is an example of those we ask when we are concerned with external validity, and that's the topic of this chapter.

    What Is External Validity?

    When we want to assess external validity, we ask, “Will the results generalize?” More specifically, as noted in Chapter 1, external validity is the extent to which results of a study (experimental or non-experimental research) can be generalized to other people, places, and times. Considering the issue of external validity is often but not always important. It depends on what your goals are for your research (Mook, 1983).

  • Chapter 7 - Survey Research

  • Wendy Heath, Rider University, New Jersey
  • Book:
    Psychology Research Methods
    Published online:
    01 July 2021
    Print publication:
    11 January 2018, pp 157-182

  • Summary

    It may not surprise you to learn that researchers have recently reported that a substantial percentage of college students do not sleep well. How do we know this? Lund, Reider, Whiting, and Prichard (2010) conducted a survey; they asked over a thousand students at a midwestern university questions about their sleep habits.

    When you conduct a survey, you are attempting to estimate the opinions, characteristics, and/ or behaviors of a particular population by asking a sample to respond to questions. A population (sometimes called a target population or a population of interest) is a defined group of individuals, and it can be very large (such as all American adults) or it can be more specific (such as all female Democrats in the Princeton, NJ area). A sample is a subset of individuals chosen from a population.

    Many of us have been exposed to surveys. For example, during political campaigns, you may have been asked for your views on the candidates. According to one Gallup poll, shortly before the 2008 election, almost 40% of 18-to 29-year-olds had been contacted by either the Obama or the McCain campaign (Newport, Jones, & Saad, 2008).

    The same Gallup poll asked respondents whether they were registered to vote, whether they were giving a lot of thought to the election, and what was their chance of voting. These measures were used as voter turn-out indicators. With these numbers in hand, researchers were able to predict the likely turn-out of the youngest US voters on election day.

    To survey a population, you need to know what kinds of questions to ask, how to write effective ones, and how to obtain and contact your participant sample. These topics will each be covered in this chapter.

    Survey Questions

    In this section we will discuss different types of question content (demographic versus topical) as well as different types of question formats (openversus closed-ended questions).

  • 9 - The WTO Dispute Settlement System

  • from PART II - INTERNATIONAL DISPUTE SETTLEMENT IN PARTICULAR FIELDS
  • Yoshifumi Tanaka, University of Copenhagen
  • Book:
    The Peaceful Settlement of International Disputes
    Published online:
    21 June 2018
    Print publication:
    11 January 2018, pp 275-310

  • Summary

    Main Issues

    The WTO dispute settlement system is characterised by some particular features, such as the ‘reverse consensus’ decision-making procedure, appellate review procedure and surveillance of the implementation of recommendations and rulings. Owing to its unique features, the dispute settlement system of the WTO provides a useful insight into development of the international law of peaceful settlement of international disputes. This chapter will seek to examine the key issues of the WTO dispute settlement system. In particular, the following issues will be discussed:

  • (i) What are the principal features of the WTO dispute settlement system?

  • (ii) What is the role of consultations in the WTO dispute settlement system?

  • (iii) What are the procedures of a panel and the Appellate Body?

  • (iv) How is it possible to secure the effective implementation of recommendations and ruling of WTO panels and the Appellate Body?

  • (v) What is the role of arbitration and how is it integrated into the WTO dispute settlement system?

  • (vi) What is the position of developing Members in the WTO dispute settlement system?

    • INTRODUCTION

    International Dispute Settlement in GATT

    In the blueprint for the post-war international order, economic development was considered as a prerequisite to establish international peace. Before the end of World War II, the United States already advanced the view that economic development on the basis of international free trade would provide an important mechanism for achieving world peace. In the 1941 Atlantic Charter, Franklin Roosevelt, the President of the United States, and Winston Churchill, the Prime Minister of the United Kingdom, stated that all of the nations of the world must come to the abandonment of the use of force to establish peace and that they would endeavour to further the enjoyment by all States of access to the trade and to the raw materials of the world which are needed for their economic prosperity. Furthermore, Article VII of the 1942 Anglo-American Mutual Aid Agreement provided that in return for aid furnished by the United States to the United Kingdom, the two governments took agreed action directed to the expansion of ‘production, employment, and the exchange and consumption of goods, which are the material foundations of the liberty and welfare of all peoples; to the elimination of all forms of discriminatory treatment in international commerce, and to the reduction of tariffs and other trade barriers’.

  • 19 - Cancer versus Regeneration: The Wrong versus Right Response to the Microenvironment

  • from Part III - Coordination of complex functions
  • Michael Sheetz, Columbia University, New York, Hanry Yu, National University of Singapore
  • Book:
    The Cell as a Machine
    Published online:
    06 August 2018
    Print publication:
    11 January 2018, pp 402-421

  • Summary

    Due to the presence of mechanisms that regenerate portions of tissue after disease or damage, it is possible that excessive or inappropriate growth may occur. In humans, when a portion of tissue grows excessively, it is often described as a cancer; however, there are many forms of excessive growth that are limited and not life-threatening. At the heart of a cancerous growth is the inappropriate response of the cell to its microenvironment. Sensory modules that determine mechanical aspects of the microenvironment contribute to cancerous growth. In particular, the depletion of rigidity-sensing modules enables cells to grow on soft surfaces, much in the way that loss of sensing in self-driving cars causes inappropriate movement. There are common features of inappropriate growth that are considered in the rubric of cancer biology and many books are written on the details. Here we consider growth in the context of cell states and the response of the cell to its microenvironment. By definition, cells in cancers have ignored normal growth controls and have grown excessively. Because tissue growths need vascularization to grow rapidly beyond millimeter dimensions, they are normally self-limiting. Further, telomere shortening will limit the number of divisions of cells. Thus, these two factors act as safeguards to keep most tumors small in size and benign. When cells move to states that continue growth, elongate telomeres and promote vascularization, they can be life-threatening. Even then, surgeons can remove the growths and the normal cells can often heal the area and restore function. What is life-threatening is the ability of inappropriately proliferating cells to disseminate to other parts of the body and to differentiate and grow in many different environments. Then, the surgeon cannot remove all of the tumors and the multiple, differentiated cells will not be killed by a single therapy. Furthermore, the act of killing the tumor cells often elicits a general repair response in the body that will promote further growth of tumors. The lessons of Cancer Biology can tell us a lot about biology in general.

    In the previous chapter, we discussed normal development and the process of differentiation. When a loss of cells occurs during normal development, neighboring cells typically divide to fill the gaps. This is important, because with the loss of cells in a tissue, both physical mass and functional performance are lost.

  • Introduction

  • Edited by David A. Rothery, The Open University, Milton Keynes, Neil McBride, The Open University, Milton Keynes, Iain Gilmour, The Open University, Milton Keynes
  • Open University
  • Book:
    An Introduction to the Solar System
    Published online:
    11 May 2019
    Print publication:
    11 January 2018, pp 1-2

  • Summary

    In astronomical terms, the Solar System is our backyard. Set against the vast number of stars in our Galaxy, the colossal number of other galaxies in the observable universe and the incredible distances involved, our Solar System is an extremely tiny part of the Universe. However, this is where we live. It is where life on Earth developed, and it gives us our only vantage point from which to view the rest of the Universe.

    Unlike other planetary systems, the objects in our Solar System are close enough to visit with space probes and to study long-term and (in some cases) in reasonable detail using telescopes. As well as revealing the splendour and diversity of the worlds that make up the Solar System, these studies allow us to try and understand ‘what makes the Solar System tick’. By doing this, we not only attempt to understand the system in which life evolved, but also gain an insight into the likely diversity of individual planetary bodies and their possible histories all over the Universe.

    One of the more fundamental questions often asked is, ‘why is the Solar System the way it is?’ In answering this question, we have to address more detailed questions such as, how were the planets made? What were the planets made from? Were all the planets made from the same material? Why do they look so different? Do all the planets have the same internal structure? Does their surface appearance change with time? The answers to these questions lie in the physical and chemical processes that act on the bodies within the Solar System. Understanding these processes allows us to appreciate how the planets and the other Solar System bodies have formed and have been changed over time, and hence why they look the way they do today. In this book, you will be looking at these processes in detail.

  • 11 - Peaceful Settlement of Disputes Involving Non-State Actors

  • from PART II - INTERNATIONAL DISPUTE SETTLEMENT IN PARTICULAR FIELDS
  • Yoshifumi Tanaka, University of Copenhagen
  • Book:
    The Peaceful Settlement of International Disputes
    Published online:
    21 June 2018
    Print publication:
    11 January 2018, pp 334-381

  • Summary

    Main Issue

    Peaceful settlement of disputes between two parties of which at least one party is a non-State actor is an increasingly important issue in international law. The settlement of these disputes necessitates particular procedures. As such procedures are diverse, this chapter will focus on some prototypical examples in this matter: the role of the United Nations in internal armed conflicts, intra-State arbitration, the International Centre for the Settlement of Investment Disputes (ICSID), the Iran–United States Claims Tribunal, the United Nations Compensation Commission, judicial review by the ICJ, the UN internal justice system and the World Bank Inspection Panel. In particular, the following issues will be examined:

  • (i) What is the role of the United Nations in the settlement of intra-State disputes?

  • (ii) What is the role of arbitration in the settlement of intra-State disputes?

  • (iii) What are the law and procedures of the ICSID and the Iran–United States Claims Tribunal?

  • (iv) What are the principal features of the United Nations Compensation Commission?

  • (v) Is it possible for the International Court of Justice to review the validity of UN Security Council resolutions?

  • (vi) What is the role of the World Bank Inspection Panel?

    • INTRODUCTION

    In light of increasing activities of non-State actors in international relations, growing attention is paid to the peaceful settlement of disputes between two parties of which at least one party is a non-State actor. As discussed in Chapter 1, section 3.4, four types of international disputes involving non-State actors can be identified:

  • (i) intra-State disputes

  • (ii) disputes between the State and juridical/natural persons

  • (iii) disputes between an international organisation and its Member States

  • (iv) disputes between an international organisation and individuals.

    • Relevant procedures of the settlement of international disputes involving non-State actors considerably differ according to the nature of disputes. Thus this chapter has only the modest aim of examining some prototypical examples concerning the settlement of the four types of disputes.

    Following the Introduction, this chapter examines the role of the United Nations and arbitration in the settlement of intra-State disputes (section 2). Next, it addresses mixed arbitration with specific focus on the ICSID and the Iran–United States Claims Tribunal (section 3). This chapter then discusses the United Nations Compensation Commission (UNCC) (section 4). It moves on to examine the potential of judicial review of UN Security Council resolutions by the ICJ (section 5).

Page 1248 of 1934