DOCSLIB.ORG

Children's Palliative Care in Africa

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Children's Palliative Care in Africa Children’s Palliative Care in Africa Edited by Dr Justin Amery Supported by The Diana, Princess of Wales Memorial Fund 1 1 Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offi ces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press Inc., New York © Oxford University Press, 2009 The moral rights of the author have been asserted Database right Oxford University Press (maker) First published by Oxford University Press 2009 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose the same condition on any acquirer British Library Cataloguing in Publication Data Data available Library of Congress Cataloging in Publication Data Data available Typeset in Minion by Cepha Imaging Private Ltd., Bangalore, India Printed in Great Britain on acid-free paper by The MPG Books Group, London, UK ISBN 978–0–19–956–7966 1 3 5 7 9 10 8 6 4 2 Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. There can be no keener revelation of a society’s soul than the way in which it treats its children. Nelson Mandela This book is dedicated to my wonderful family: Karen, Mikey, Mair, Rhiannon, Florence and Tende Foreword by Elton John In 1990, an 18-year-old American haemophiliac named Ryan White died of an AIDS-related illness. He had been diagnosed with HIV aged 11. At the time, AIDS was seen as a deeply stig- matised ‘gay disease’. Ryan and his family were regularly subjected to abuse and excluded from community life. Their astounding acceptance, even forgiveness of this treatment was truly hum- bling. Because of Ryan, I realised there was so much more I could and should be doing in the fight against AIDS and this was the inspiration behind establishing The Elton John AIDS Foundation. We have come a long way since then. Ryan White became a national icon in America and the Ryan White Care Act is still responsible for the largest number of HIV/AIDS programmes in the USA. My Foundation has become one of the twenty largest HIV/AIDS charities in the world. Last year alone, we supported nearly 30,000 children to go on antiretroviral treatment. If Ryan were sick today, we would know so much more about how to help him – medically and emotionally. However, we still could not ‘cure’ Ryan’s HIV/AIDS and that is why this book is so important. Of course health promotion, disease prevention and curative approaches remain our goal, but this cannot be at the expense of palliative care. Indeed in my view, the two are largely insepa- rable, and the need is truly mind-boggling. Worldwide, nearly 11 million under-fives are dying every year. Most of them are living in developing countries, with more than four million of these deaths in sub-Saharan Africa, where child mortality rates are running at an average rate of 172 deaths per 1,000 babies born (compared with 9 per 1,000 in developed regions). For many economic, political, cultural and sociological reasons, palliation and symptom relief remain the only realistic treatment options for the majority of these children. Our duty is to make sure it is as good as it can be. One of the things Ryan’s illness taught me is that sick children are not simply ‘small sick adults’, and children’s palliative care needs to reflect this. Helping very sick or dying children to understand what is happening to them, and working with them to overcome the physical, psychological, social and spiritual challenges that come with impending death, is achievable, easily affordable, and highly rewarding even in the poorest settings with the least resources. However, to practice children’s palliative care, health workers do need to gain some additional knowledge, skills, support and confidence. Unfortunately, in resource-poor settings, it is very rare for health workers to receive any training in children’s palliative care. Research has shown that, not surprisingly, health workers feel particularly lacking in confidence and competence in children’s palliative care and tend to avoid these issues in practice – to the significant detriment of children who continue to suffer needlessly as a result. However, the research also suggests that health professionals in Africa (and across the world) see a great need for children’s palliative care, highly value further training in it and find it extremely rewarding, empowering and satisfying when they try it for themselves. x FOREWORD BY ELTON JOHN For these reasons I applaud the publication of this book, which sets out with understanding and tenderness the specific palliative care needs of children. It can support thousands of health workers to better care for children for whom there is no immediate cure; can give them pride and clarity in their role and can make life better for millions of children around the world. Ryan would have approved. Contents The authors xiii Acknowledgements xix List of abbreviations xxi 1 Introduction 1 Section 1: The basics of children’s palliative care 2 Communicating with children and their families 11 Justin Amery, Gillian Chowns, Julia Downing, Eunice Garanganga, Linda Ganca and Susie Lapwood 3 Play and development 37 Sue Boucher and Justin Amery 4 Assessment and management planning 79 Caroline Rose and Justin Amery Section 2: Symptom control in children’s palliative care 5 Pain 97 Justin Amery, Michelle Meiring, Renee Albertyn and Sat Jassal 6 Respiratory symptoms 125 Justin Amery and Michelle Meiring 7 Feeding and hydration problems 133 Justin Amery 8 Gastrointestinal symptoms 155 Justin Amery, Michelle Meiring and Caroline Rose 9 Neurological symptoms 171 Justin Amery, Susie Lapwood and Michelle Meiring 10 Skin problems 189 Justin Amery and Michelle Meiring 11 Urinary symptoms 201 Justin Amery and Michelle Meiring 12 HIV/AIDS 207 Justin Amery, Jenny Sengooba, Ivy Kasiyre and Michelle Meiring Section 3: Holistic care 13 Psychosocial and family care 227 Justin Amery, Nkosazana Ngidi, Caroline Rose, Collette Cunningham, Carla Horne and Linda Ganca xii CONTENTS 14 Pre-bereavement and bereavement 249 Justin Amery, Collette Cunningham, Nkosazana Ngidi, Eunice Garanganga, Carla Horne and Jenny Ssengooba 15 Spirituality 271 Justin Amery, Eunice Garanganga and Carla Horne 16 Palliative care for adolescents 289 Justin Amery, Julia Downing and Collette Cunningham 17 Ethics and law 305 Justin Amery, Joan Marston and Nkosazana Ngidi Section 4: Bringing it all together – caring at the end of life 18 Caring for children at the end of life 327 Michelle Meiring and Justin Amery Section 5: Caring for yourself 19 Caring for yourself 351 Justin Amery, Mary Bunn, Susie Lapwood and Gillian Chowns Section 6: Children’s palliative care formulary for Africa 20 Formulary 377 Justin Amery and Sat Jassal Further reading 411 Index 415 The authors Renee Albertyn is a researcher in the department of Paediatric Surgery at the Red Cross Children’s Hospital in Cape Town, South Africa. In addition, she is also clinically involved in the Pain Management Unit of hospital. In 2002, Renee obtained her PhD degree from the University of Cape Town Medical School in Pain Management and Assessment Strategies. She developed a Burn Pain and Anxiety Scale for children (BOPAS), which led to her PhD degree. Renee is involved in ongoing research and conducts weekly lectures on hospital palliative care to medical students. She regularly gives talks on her subject both locally and abroad. Renee has extensive experience and vast knowledge on the evaluation, assessment and management of pain in children. Justin Amery was Medical Director at Helen House (the world’s first children’s hospice) from 1995 until 2005. He also helped design and develop one of the world’s first hospices for young adults, Douglas House, where he was founding Medical Director. In 2006, he moved to Hospice Africa Uganda where he took over as Clinical Director, setting up a new Children’s Palliative Care service, coordinating the Distance Learning Diploma Course in Palliative Care and developing a new post-graduate certificate course in children’s palliative care. He has authored and contrib- uted widely to texts, original articles and reports in children’s palliative care. His research interest is education and training for health workers in children’s palliative care.
Load more

Recommended publications
  • The Functional Parasitic Worm Secretome: Mapping the Place of Onchocerca Volvulus Excretory Secretory Products
    pathogens Review The Functional Parasitic Worm Secretome: Mapping the Place of Onchocerca volvulus Excretory Secretory Products Luc Vanhamme 1,*, Jacob Souopgui 1 , Stephen Ghogomu 2 and Ferdinand Ngale Njume 1,2 1 Department of Molecular Biology, Institute of Biology and Molecular Medicine, IBMM, Université Libre de Bruxelles, Rue des Professeurs Jeener et Brachet 12, 6041 Gosselies, Belgium; [email protected] (J.S.); [email protected] (F.N.N.) 2 Molecular and Cell Biology Laboratory, Biotechnology Unit, University of Buea, Buea P.O Box 63, Cameroon; [email protected] * Correspondence: [email protected] Received: 28 October 2020; Accepted: 18 November 2020; Published: 23 November 2020 Abstract: Nematodes constitute a very successful phylum, especially in terms of parasitism. Inside their mammalian hosts, parasitic nematodes mainly dwell in the digestive tract (geohelminths) or in the vascular system (filariae). One of their main characteristics is their long sojourn inside the body where they are accessible to the immune system. Several strategies are used by parasites in order to counteract the immune attacks. One of them is the expression of molecules interfering with the function of the immune system. Excretory-secretory products (ESPs) pertain to this category. This is, however, not their only biological function, as they seem also involved in other mechanisms such as pathogenicity or parasitic cycle (molting, for example). Wewill mainly focus on filariae ESPs with an emphasis on data available regarding Onchocerca volvulus, but we will also refer to a few relevant/illustrative examples related to other worm categories when necessary (geohelminth nematodes, trematodes or cestodes).
    [Show full text]
  • Whatyourdrmaynottellyouabou
    What Your Doctor May Not Tell You About Parasites First published in Great Britain in 2015 by Health For The People Ltd. Tel: 0800 310 21 21 [email protected] www.hompes-method.com www.h-pylori-symptoms.com Copyright © 2015 David Hompes, Health For The People Ltd. David Hompes asserts the moral right to be identified as the author of this work. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of the publishers. HEALTH DISCLAIMER The information in this book is not intended to diagnose, treat, cure or prevent any disease, nor should it replace a one-to-one relationship with your physician. You should always seek consultation with a qualified medical practitioner before commencing any protocol contained herein. This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold, hired out or otherwise circulated without the publisher’s prior consent in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed upon the subsequent purchaser. British Library Cataloguing in Publication Data. 2 What Your Doctor May Not Tell You About Parasites Contents Introduction 5-13 1 What is a Parasite? 14-26 2 Where are Parasites to be found? 27-33 3 Why doesn’t the Medical System fully acknowledge 34-38 Parasites? 4 How on earth do you acquire Parasites?
    [Show full text]
  • American Dolorologies
    American Dolorologies Item Type Book Authors Strick, Simon DOI 10.1353/book.28834 Publisher SUNY Press Rights Attribution-NonCommercial-NoDerivatives 4.0 International Download date 29/09/2021 04:15:19 Item License http://creativecommons.org/licenses/by-nc-nd/4.0/ Link to Item https://www.sunypress.edu/p-5822-american-dolorologies.aspx AMERICAN DOLOROLOGIES AMERICAN DOLOROLOGIES Pain, Sentimentalism, Biopolitics SIMON STRICK State University of New York Press Published by State University of New York Press, Albany © 2014 State University of New York All rights reserved Printed in the United States of America No part of this book may be used or reproduced in any manner whatsoever without written permission. No part of this book may be stored in a retrieval system or transmitted in any form or by any means including electronic, electrostatic, magnetic tape, mechanical, photocopying, recording, or otherwise without the prior permission in writing of the publisher. For information, contact State University of New York Press, Albany, NY www.sunypress.edu Production, Laurie Searl Marketing, Anne M. Valentine Library of Congress Cataloging-in-Publication Data Strick, Simon, 1974– American dolorologies : pain, sentimentalism, biopolitics / Simon Strick. pages cm Includes bibliographical references and index. ISBN 978-1-4384-5021-6 (hardcover : alk. paper) 1. Pain—Social aspects—United States. 2. Suffering—Social aspects—United States. 3. United States—Civilization. 4. Sentimentalism. I. Title. BJ1409.S85 2014 306.4—dc23 2013014434 10 9 8 7 6 5 4 3 2 1 CONTENTS LIST OF ILLUSTRATIONS vii ACKNOWLEDGMENTS ix CHAPTER ONE What Is Dolorology? 1 CHAPTER TWO Sublime Pain and the Subject of Sentimentalism 19 CHAPTER THREE Anesthesia, Birthpain, and Civilization 51 CHAPTER FOUR Picturing Racial Pain 93 CHAPTER FIVE Late Modern Pain 147 NOTES 169 WORKS CITED 199 INDEX 219 ILLUSTRATIONS Figure 4.1 gordon: The Scourged Back/Escaped slave displays wounds from torture.
    [Show full text]
  • Introduction: Phylum Nematoda
    INTRODUCTION: PHYLUM NEMATODA Outline: I. General morphology and physiology of nematodes. A. Movement by sinusoidal (“S” shaped) undulation requiring elevated pressure of fluid in body cavity or pseudocoelom. 1. Greater than external atmospheric pressure. 2. Keeps worm rigid until muscles (longitudinal) contract to bend it. a. muscles extend from hypodermal lateral cords. b. muscles form dorsal and ventral fields. c. muscles innervated from dorsal and ventral cords. 3. Nerve function essential to life: target of many anthelmintics. B. Feeding requires ingestion at anterior end and forcing nutrient into collapsed intestine. 1. Buccal cavity with or without teeth. 2. Esophagus of various configurations. a. rhabditiform b. strongyliform c. filariform d. stichosome esophagus or trichurid 3. Intestine 4. Anus or cloaca near posterior end. C. Excretion at mid ventral pore near anterior end. 1. Excretory glands 2. Excretory ducts running in lateral cords D. Reproduction - for almost all species of nematodes only sexual replication. 1. Males smaller than females. a. males have prominent to vestigial copulatory bursa - often characteristic of genus. b. male copulatory spicules are cuticular folds of the cloaca used to open the vulva of the female - also characteristic of genus. c. testis, seminal vesicle and vas deferens are one long continuous tube ending at the ejaculatory duct in the cloaca. 2. Females also have a tubular reproductive tract that is usually composed of two branches. a. Ovary, oviduct, uterus and vagina make up a continuous tube that opens to the outside at the vulva on the ventral surface near posterior or anterior ends or at midbody. b. Eggs in the uterus are released to the outside through the vulva.
    [Show full text]
  • Disseminated Strongyloidiasis in an Immunocompromised Host: a Case Report
    Asian Pac J Trop Biomed 2017; 7(6): 587–590 587 Contents lists available at ScienceDirect Asian Pacific Journal of Tropical Biomedicine journal homepage: www.elsevier.com/locate/apjtb Case report http://dx.doi.org/10.1016/j.apjtb.2017.05.004 Disseminated strongyloidiasis in an immunocompromised host: A case report Nurul Suhaiza Hassanudin1, Zubaidah Abdul Wahab1, Khalid Ibrahim2, Fadzilah Mohd Nor3,4* 1Microbiology Unit, Department of Pathology, Hospital Sg. Buloh, 47100, Sg. Buloh, Selangor, Malaysia 2Director Office, Hospital Sg. Buloh, 47100, Sg. Buloh, Selangor, Malaysia 3Microbiology Discipline, Faculty of Medicine, Universiti Teknologi MARA, Sg. Buloh Campus, Jalan Hospital, 47000, Sg. Buloh, Selangor, Malaysia 4Integrative Pharmacogenomics Institute (iPROMISE), Level 7, FF3, Universiti Teknologi MARA, Puncak Alam Campus, 42300, Bandar Puncak Alam, Selangor, Malaysia ARTICLE INFO ABSTRACT Article history: Infections caused by Strongyloides stercoralis (S. stercoralis) in human are generally Received 28 Oct 2016 asymptomatic, however in immunocompromised individual, hyperinfection may develop Accepted 12 Feb 2017 with dissemination of larvae to extra-intestinal organs. The diagnosis could be easily Available online 25 May 2017 missed due to asymptomatic presentation and insufficient exposure towards the infection itself, which may lead to low index of suspicion as a consequence. In this report, a case of a Malaysian male with underlying diabetes mellitus, hypertension, cerebrovascular ac- Keywords: cident, bullous pemphigus and syndrome of inappropriate antidiuretic hormone secretion Disseminated strongyloidiasis who initially complained of generalized body weakness and poor appetite without any Immunocompromised host history suggestive of sepsis is presented. However, he developed septicemic shock later, Hyperinfection and S. stercoralis larvae was incidentally found in the tracheal aspirate that was sent to Strongyloides stercoralis look for acid fast bacilli.
    [Show full text]
  • Methods in Infectious Disease Epidemiology
    1 P A R T Methods in Infectious Disease Epidemiology 1 95337_CH01_001–018.indd 1 2/1/13 11:56 PM 95337_CH01_001–018.indd 2 2/1/13 11:56 PM CHAPTER 1 Early History of Infectious Disease: Epidemiology and Control of Infectious Diseases Kenrad E. Nelson and Carolyn Masters Williams INTRODUCTION wrong theories or knowledge has hindered advances in understanding, one can also cite examples of Epidemics of infectious diseases have been docu- great creativity when scientists have successfully mented throughout history. In ancient Greece and pursued their theories beyond the knowledge of Egypt, accounts describe epidemics of smallpox, the time. leprosy, tuberculosis, meningococcal infections, and diphtheria. 1 The morbidity and mortality of in- fectious diseases profoundly shaped politics, com- THE ERA OF PLAGUES merce, and culture. In epidemics, no one was spared. Smallpox likely disfigured and killed Ramses V in The sheer magnitude and mortality of early epidemics 1157 BCE, although his mummy has a significant are difficult to imagine. Medicine and religion both head wound as well. 2 At times, political upheavals strove to console the sick and dying. However, before exacerbated the spread of disease. The Spartan wars advances in the underlying science of health, medi- caused massive dislocation of Greeks into Athens, cine lacked effective tools, and religious explana tions triggering the epidemic of 430–427 BCE that killed for disease dominated. As early communities con- up to half of the population of ancient Athens. 3 solidated people more closely, severe epidemics of Thucydides’ vivid descriptions of this epidemic make plague, smallpox, and syphilis occurred.
    [Show full text]
  • The Biology of Strongyloides Spp.* Mark E
    The biology of Strongyloides spp.* Mark E. Viney1§ and James B. Lok2 1School of Biological Sciences, University of Bristol, Bristol, BS8 1TQ, UK 2Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6008, USA Table of Contents 1. Strongyloides is a genus of parasitic nematodes ............................................................................. 1 2. Strongyloides infection of humans ............................................................................................... 2 3. Strongyloides in the wild ...........................................................................................................2 4. Phylogeny, morphology and taxonomy ........................................................................................ 4 5. The life-cycle ..........................................................................................................................6 6. Sex determination and genetics of the life-cycle ............................................................................. 8 7. Controlling the life-cycle ........................................................................................................... 9 8. Maintaining the life-cycle ........................................................................................................ 10 9. The parasitic phase of the life-cycle ........................................................................................... 10 10. Life-cycle plasticity .............................................................................................................
    [Show full text]
  • Parasites 1: Trematodes and Cestodes
    Learning Objectives • Be familiar with general prevalence of nematodes and life stages • Know most important soil-borne transmitted nematodes • Know basic attributes of intestinal nematodes and be able to distinguish these nematodes from each other and also from other Lecture 4: Emerging Parasitic types of nematodes • Understand life cycles of nematodes, noting similarities and significant differences Helminths part 2: Intestinal • Know infective stages, various hosts involved in a particular cycle • Be familiar with diagnostic criteria, epidemiology, pathogenicity, Nematodes &treatment • Identify locations in world where certain parasites exist Presented by Matt Tucker, M.S, MSPH • Note common drugs that are used to treat parasites • Describe factors of intestinal nematodes that can make them emerging [email protected] infectious diseases HSC4933 Emerging Infectious Diseases HSC4933. Emerging Infectious Diseases 2 Readings-Nematodes Monsters Inside Me • Ch. 11 (pp. 288-289, 289-90, 295 • Just for fun: • Baylisascariasis (Baylisascaris procyonis, raccoon zoonosis): Background: http://animal.discovery.com/invertebrates/monsters-inside-me/baylisascaris- [box 11.1], 298-99, 299-301, 304 raccoon-roundworm/ Video: http://animal.discovery.com/videos/monsters-inside-me-the-baylisascaris- [box 11.2]) parasite.html Strongyloidiasis (Strongyloides stercoralis, the threadworm): Background: http://animal.discovery.com/invertebrates/monsters-inside-me/strongyloides- • Ch. 14 (p. 365, 367 [table 14.1]) stercoralis-threadworm/ Videos: http://animal.discovery.com/videos/monsters-inside-me-the-threadworm.html http://animal.discovery.com/videos/monsters-inside-me-strongyloides-threadworm.html Angiostrongyliasis (Angiostrongylus cantonensis, the rat lungworm): Background: http://animal.discovery.com/invertebrates/monsters-inside- me/angiostrongyliasis-rat-lungworm/ Video: http://animal.discovery.com/videos/monsters-inside-me-the-rat-lungworm.html HSC4933.
    [Show full text]
  • Working with Parents and Caregivers to Support Children from Birth to Three Years
    DOCUMENT RESUME ED 473 839 PS 031 037 AUTHOR Hanssen, Elizabeth, Ed.; Zimanyi,Louise, Ed. Support for Families: Working with Parentsand Caregivers to TITLE Support Children from Birth toThree Years of Age. and Development, INSTITUTION Consultative Group on Early Childhood Care Haydenville, MA. SPONS AGENCY Bernard Van Leer Foundation, The Hague(Netherlands).; World Bank, Washington, DC.; High/ScopeEducational Research Foundation, Ypsilanti, MI.; ChristianChildren's Fund Inc., Richmond, VA. PUB DATE 2000-00-00 NOTE 84p.; Journal is subtitled "AnInternational Resource for Early Childhood Development."Additional support provided by UNICEF, UNESCO, USAID, InterAmericanDevelopment Bank (IDB), Radda Barnen, and Save the Children USA.The Coordinators' Notebook is published twice annually. AVAILABLE FROM For subscription information contact:Louise Zimanyi, Ryerson Polytechnic-University, School of ECE, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada. Tel:416-979-5000; Fax: 416-979-5239; e-mail: [email protected]; Website: http://www.ecdgroup.com. PUB TYPE Collected Works Serials (022) JOURNAL CIT Coordinators' Notebook; n24 2000 EDRS PRICE EDRS Price MF01/PC04 Plus Postage. Nations; Early DESCRIPTORS *Caregiver Child Relationship; Developing Childhood Education; Early Intervention;Family Programs; Family Support; Foreign Countries;*Infants; *Parent Caregiver Relationship; *Parent ChildRelationship; *Parent Education; *Toddlers IDENTIFIERS Early Childhood Development Programs;UNICEF ABSTRACT This theme issue of "Coordinators'Notebook" focuses on how early childhood care and development(ECCD) programs world-wide can work with parents and caregivers to supportchildren from birth to 3 years of age. Section 1 of the journal describesthe needs of parents and families and the development of parent programs aroundthe world. Section 2 highlights the needs of infants and toddlersand the importance of appropriate care.
    [Show full text]
  • 48641Fbea0551a56d8f4efe0cb7
    cave The Earth series traces the historical significance and cultural history of natural phenomena. Written by experts who are passionate about their subject, titles in the series bring together science, art, literature, mythology, religion and popular culture, exploring and explaining the planet we inhabit in new and exciting ways. Series editor: Daniel Allen In the same series Air Peter Adey Cave Ralph Crane and Lisa Fletcher Desert Roslynn D. Haynes Earthquake Andrew Robinson Fire Stephen J. Pyne Flood John Withington Islands Stephen A. Royle Moon Edgar Williams Tsunami Richard Hamblyn Volcano James Hamilton Water Veronica Strang Waterfall Brian J. Hudson Cave Ralph Crane and Lisa Fletcher reaktion books For Joy Crane and Vasil Stojcevski Published by Reaktion Books Ltd 33 Great Sutton Street London ec1v 0dx, uk www.reaktionbooks.co.uk First published 2015 Copyright © Ralph Crane and Lisa Fletcher 2015 All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publishers Printed and bound in China by 1010 Printing International Ltd A catalogue record for this book is available from the British Library isbn 978 1 78023 431 1 contents Preface 7 1 What is a Cave? 9 2 Speaking of Speleology 26 3 Troglodytes and Troglobites: Living in the Dark Zone 45 4 Cavers, Potholers and Spelunkers: Exploring Caves 66 5 Monsters and Magic: Caves in Mythology and Folklore 90 6 Visually Rendered: The Art of Caves 108 7 ‘Caverns measureless to man’: Caves in Literature 125 8 Sacred Symbols: Holy Caves 147 9 Extraordinary to Behold: Spectacular Caves 159 notable caves 189 references 195 select bibliography 207 associations and websites 209 acknowledgements 211 photo acknowledgements 213 index 215 Preface ‘It’s not what you’d expect, down there,’ he had said.
    [Show full text]
  • 19022 Sedt.1998 Public Disclosure Authorized
    19022 SeDt.1998 Public Disclosure Authorized Early PARENTING IN THE EARLY YEARS: A REVIEW OF PROGRAMS FOR PARENTS OF Public Disclosure Authorized CHILDREN FROM BIRTH OF THREE YEARS OF AGE Judith L. Evans and Public Disclosure Authorized P. A. Stansbery September 1998 Public Disclosure Authorized EDUCATNkON T H E W 0 R L D B A N K THE CONSULTATIVEGROUP ON EARLY CHILDHOODI CARE AND DEVELOPMENT Parenting in the Early Years: A Review of Programs for Parents of Children from Birth to Three Years of Age by Judith L. Evans' P. A. Stansbery2 September 1998 1 Director,Consultative Group on Early childhoodCare and Development 2 HarvardGraduate School of Educationand Child DevelopmentUnit (Boston Children's Hospital) TABLE OF CONTENTS Background ................................................................. 2 What Young Children Need ................................................................. 3 Strengthening Care for Children through Parenting Support and Education ...................... 11 Principles in Creating Parenting Programs ................................................................ 13 Strategies of Programming for Children Under Three ............................................................ 20 Models of parent support and parent education ................................................................ 23 One-on-One Parent Support at a Point of Service Delivery .................................................... 27 One-on One Parent Support in the Home: Home Visiting .....................................................
    [Show full text]
  • Breastfeeding and Kangaroo Care: Biobehavioral
    BREASTFEEDING AND KANGAROO CARE: BIOBEHAVIORAL MEASURES OF DYADIC BONDING, INFANT CORTICAL MATURATION, AND INFANT HPA REACTIVITY by Jillian Hardin A Dissertation Submitted to the Faculty of The Charles E. Schmidt College of Science in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Florida Atlantic University Boca Raton, FL May 2014 Copyright by Jillian Hardin 2014 ii ACKNOWLEDGEMENTS Thank you to my family. I love you all and thank you for your unconditional support throughout this chapter of my life. Special thank you to Mom, Lisa, and Lila for babysitting Averie so I could work. I could never have finished this degree without you, thank you so much! Momma, my accomplishments are a reflection of your loving parenting and guidance. Nana, thank you for your encouragement and all the laughs! Rodney, my sweet husband. You fill my heart with joy each and every day. Thank you for being such a strong positive influence in my life. Thank you for the countless pep talks, helping me through my anxiety attacks, and being the strong foundation of our little family. I admire you more than you’ll ever know. Your mental fortitude, positive attitude, and loving soul are qualities that are unrivaled in anyone else I know. I couldn’t imagine a more fulfilling life. I love having you by my side! Nancy, thank you for everything—your mentorship and support have meant so much to me over the past five years. I can’t thank you enough for being so understanding and helpful when I became a new mom in the middle of my graduate school journey.
    [Show full text]