This case summarizes the management of a patient who presented for counseling 2 weeks after a stillbirth at 34 weeks’ gestation. Her pregnancy was uncomplicated until she developed prelabor rupture of membranes, leading to fetal demise. Placental pathology revealed findings suggestive of high-grade fetal vascular malperfusion, maternal vascular malperfusion, and severe ascending intrauterine infection. The most common placental abnormalities and their causes and associations are discussed as well as recommendations for further testing and future pregnancy management. Understanding placental histology following stillbirth allows for better support and preparation for future pregnancies.

This chapter provides an introduction to dementia and mild cognitive impairment (MCI). It covers the incidence and prevalence of the most common forms of dementia, and explains the underlying causes in terms of different types of proteinopathy. Risk factors for development of dementia are reviewed, along with protective factors. The role of age is also considered as different subtypes of dementia peak during different age ranges. The contribution of genetics and epigenetics is reviewed, along with the importance of blood supply, sleep, and inflammation. The theory of cognitive and neuronal reserve is introduced as one of the factors which can predict which people are more or less likely to develop dementia and MCI. Connectomics and the arrangement of the brain into circuits is covered, along with developments in neuro-imaging.

This chapter examines the origins and legacy of sexology – the scientific study of sexuality – in the modern world. First consolidated into a coherent programme in the late nineteenth century, sexology has its roots in the re-organization of knowledge about nature in the frameworks of taxonomy, evolutionism, and race. A pervasive preoccupation with heredity gave rise to powerful eugenics movements around the world. The interest in controlling variability and unlocking the secrets of the soul generated parallel developments in biomedicine, especially psychoanalysis and endocrinology. Sex experts worldwide converged in diagnosing cultural signs of homosexuality for the purpose of national modernization. As the centre of gravity in sexual science began to shift from Europe to North America, researchers gave growing support to the sex/gender distinction and redefined the meanings of normality. In the waning days of hereditarian theories, the rise of cultural anthropology coupled with a renewed scientific investment of colonial powers to reverse hierarchical templates of sexual practices and norms emanating from the metropoles. A public health crisis (HIV/AIDS), social movements (gender and sexual minority rights), and the systematization of research protocols (bioethics) shaped a comeback of biological sexology in the closing decades of the twentieth century.

Abundant moments of indecision and delay shape George Eliot’s last novel Daniel Deronda (1876), which treats uncertainty as a recursive movement between interior and exterior, potentiality and activity. This chapter shows how Eliot explores action’s convoluted antecedents, drawing on intellectual trends in mid-century comparative method and physiological psychology, especially the latter’s portrait of embodied willing and pathologies of volition. These contexts frame a reading of the novel’s twin stances of practical experience and intellectual reflection: hesitation, the bewildering experience of having a “will which is and yet is not yet,” and its rational cousin, comparison, “our precious guide.” Formal fluctuations and portrayals of mental caprice would seem at cross-purposes with Eliot’s narrative control and moral coherence. Yet in discovering a “kinship” between certainty and doubt, she reinvigorates her novelistic ethics and recasts sympathy as guaranteed by “closer comparison between the knowledge which we call rational & the experience which we call emotional.” Her characters set store by irresolute stances of hesitation and comparison, and predictive affects like trust and hope.

This chapter provides an overview of the components of the evolving conceptual model since the 1988 Spitak earthquake that guided the intervention and research arms of our work in Armenia. With the concept of traumatic stress as the gateway to post-trauma sequelae and recovery, we recognized the important contributions made by post-trauma adversities and the pervasiveness of trauma and loss reminders in the aftermath. Individual and ecological factors were seen as making powerful contributions to the impact and course of recovery, especially in terms of factors associated with resistance, resilience, vulnerability, adjustment, maladjustment, and pathology. The traumatic stress pathway is embedded in a developmental perspective, with the understanding that child, adolescent, and adult development plays an overarching role across all aspects of the conceptual framework. In addition, cultural and religious factors are also seen as integral. Implications of the conceptual model for data collection metrics and methodology, as well as intervention strategies are also discussed.

Hirsutism is a common endocrine disorder affecting 5–10% of women of reproductive age. A thorough history, physical examination and selected laboratory tests will confirm the underlying cause. This chapter reviews various causes and clinical management of hirsutism. Counselling, lifestyle modifications, mechanical hair removal and selected medical therapies can be used to reduce the degree of hirsutism and to improve self-esteem. Combined oral contraceptive pill is the first-line therapy for hirsutism, provided there has been no contraindication. At least 6–9 months of treatment may be necessary before an effect can be observed.

Imaging is an indispensable diagnostic tool in gynaecological practice. Transvaginal ultrasound (TVS) is most often used in an office environment as an adjunct to clinical examination. Transabdominal ultrasound is employed in specific applications and often as a first step before TVS by non-gynaecologists, while MRI and CT are used selectively as secondary tests for specific indications. Perioperative imaging is increasingly popular in clinical practice. In the first section, the essentials of the ultrasound technique and image optimization skills will be described as well as professional attributes necessary for safe ultrasound practice. In the clinical section, the prescribed approach was based on presenting symptoms as is the case in clinical practice where patients are referred or present themselves with a complaint. It is critical for ultrasound practitioners to accurately recognize normal features easily and, likewise, in the differential diagnosis of abnormal findings, they should master the salient features that will ultimately establish a diagnosis.