Heavy Rain - the Video Game

Released in 2010 for the PlayStation 3, Heavy Rain is a ground-breaking computer game combing elements of film and video gaming. The game is really more of an 'interactive drama' and, as such, forms the spiritual sequel to 2005's similarly themed Fahrenheit. It combines truly open-ended gameplay with the film noir model, creating a playable movie in which the ending is altered by the player's actions. The game received much praise from critics, who seemed to particularly enjoy the game's gritty atmosphere and successful mixing of genres. The game follows the attempts of four playable characters to catch the Origami Killer and find his latest victim before time runs out.

Please note that this Entry contains some spoilers.

Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo is a condition of the inner ear, and causes a form of dizziness known as vertigo. To break it up into its constituent parts:

• Benign means it isn't a progressive disease.
• Paroxysmal means it comes and goes.
• Positional means it is triggered by certain positions.
• Vertigo means it causes the room to spin – the sufferer feels as if they are moving when they are not.

The Gomboc

The Gömböc (pronounced 'goemboets', from the Hungarian for dumpling¹) is a convex, homogeneous mono-monostatic object. In other words, it's a funny-looking curved object that will right itself regardless of which side you put it on. This Entry will try to explain what a Gömböc is, how it came to be and why such a thing should exist.

Pre-eclampsia and Eclampsia

Pre-eclampsia is a condition that only occurs in women who are at least 20 weeks pregnant, though it may occur a short while after childbirth. It is thought that some form of pre-eclampsia will occur in as many as 10% of all pregnancies, though severe pre-eclampsia affects only 0.5%. The condition is characterised by high blood pressure and protein in the urine, and is due to a reduction of maternal blood supply to the placenta¹. Other symptoms, ranging from excessive blood clotting to kidney or liver damage, may occur in the mother if the placenta is damaged by the lack of blood supply. Eclampsia is the name given to a state of convulsions, altered consciousness and eventually coma that may occur following pre-eclampsia, or in some cases entirely out of the blue². Severe pre-eclampsia and eclampsia are potentially life-threatening, and the only cure is to deliver the foetus and placenta.

Accident and Emergency Departments

The Accident and Emergency (A+E) department¹ is a common fixture in large hospitals and deals with acutely unwell individuals and those who have suffered trauma. Smaller hospitals and those that deal only with outpatients may not have an A+E, but this will be clearly indicated on signs at the hospital entrance. Also, road signs for hospitals with an A+E are red, whereas signs pointing to those without are blue. A+E departments generally operate continuously (24 hours per day throughout the year), though the staff do change on a regular basis.

Do Not Leave Unattended Luggage

Imagine you're travelling via British Rail to reach some sunny destination¹. You've left your suitcase/holdall/internal frame backpack in the luggage rack at the end of the carriage where you would imagine it to be safe – that is, until you hear an 'important announcement':

Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a condition affecting women that causes various symptoms including obesity, male pattern hair growth, a lack of periods and infertility. It is thought that a high level of insulin leads to the persistence of immature egg follicles¹ in the ovaries, leading to excess production of male hormones. It is these multiple follicles that give the disease its name – 'polycystic'² is, in a sense, a misnomer. The condition occurs in 5-10% of women in their reproductive years, though it does not always cause symptoms. Furthermore, one in five women who menstruate normally will have large numbers of follicles in their ovaries, but two thirds of these women will not have PCOS. Treatment depends on the individual case: some women have little in the way of symptoms whereas others are severely affected, and some seek to become pregnant and thus have treatment to increase their fertility.

Endometrial Cancer

Cancer of the endometrium (the inner lining of the uterus) is a common cancer affecting the female reproductive tract, and is diagnosed in around 6,000 women each year in the UK. The disease most commonly affects women between the ages of 55 and 65, and typically causes vaginal bleeding or a bloody discharge. More than three quarters of cases are diagnosed early, and the standard treatment is the removal of the uterus and both ovaries.

Stress Incontinence

Stress incontinence is the involuntary loss of urine upon coughing and sneezing, laughing, exercising or any other activity that puts stress on the bladder. The condition is also known as urethral sphincter incontinence, as it is due to an inability of this sphincter to match the pressure inside the bladder and thus prevent voiding of urine. While men may suffer from the condition, it affects half of all women at some time in their lives, especially in those who have given birth, and though it tends to occur in older women, around a quarter of sufferers are under the age of 30. A number of possible treatments exist, ranging from lifestyle changes and medication to surgical techniques.

Meningitis

Meningitis is the inflammation of the meninges¹, most commonly due to infection with a bacterium or virus – bacterial meningitis tends to be potentially life-threatening, whereas viral meningitis is usually relatively benign. The classic triad of symptoms seen in meningitis is headache, neck stiffness and photophobia², with other symptoms depending upon the microbe involved and the severity of the disease. Meningitis may also occur together with encephalitis³ – this is known as meningo-encephalitis. Meningitis is a notifiable disease in the UK, meaning that public health authorities are notified of all cases.

Urge Incontinence

Urge incontinence is the urgent need to pass urine due to untimely contractions of the bladder muscle (detrusor). This occurs day and night, often leading to the passing of urine before the sufferer can reach a toilet. The condition affects women more often than men, and though urge incontinence is less common than stress incontinence, a number of older women suffer from both forms. Treatment ranges from retraining the bladder to medication to relax the bladder muscle and, in severe cases, surgery to increase the bladder's size.

The Human Herpes Viruses

The viruses of the family Herpesviridae are responsible for much woe among humans, chickens and certain species of monkey. This Entry makes the assumption that the latter two groups cannot read, and therefore only covers those viruses affecting humans – the 'human herpes viruses'. They number eight in total, and are as such rather unimaginatively numbered one to eight:

Ill-Fitting Bras - A Medical Perspective

The ill-fitting bra is thought to affect at least 70% of women regardless of their size, though the one in four who require a D cup or above are worst off. Assuming that the measurements are right – definitely not a given – the array of different sizes, designs, shapes and brands available creates plenty of room for confusion. A bad fit can lead to a painful back, neck and shoulders, red marks and irritation over the shoulder and on the chest, and unsightly bulging out from the top or sides, to the extent that some women eventually seek a surgical reduction in size. Ill-fitting sports bras can be even more of a problem, considering that a lack of tight fit completely negates their purpose.

AIDS HIV - Visible Features

In terms of its size, the human immunodeficiency virus (HIV) is like a pinhead upon a pinhead, being around 1/60th the size of the white blood cells it infects. However, both its effect on infected individuals and its rapid spread throughout the world have made the virus highly visible to humankind. Furthermore, the immune suppression that HIV causes can lead to several conditions that make the HIV infection itself visible to the outside world. The majority of these are not due to HIV infection itself, but are instead a result of 'opportunistic' infection with other diseases once the individual's immune system has become compromised. This entry looks at these so-called 'stigmata' of HIV infection. Curiously, many are caused by the human herpes viruses: you'll find mentions of herpes simplex, varicella-zoster, the Epstein-Barr virus, cytomegalovirus and human herpes virus 8.

Alcohol and Substance Misuse

The use of alcohol and other recreational drugs use can lead to a variety of problems, ranging from short and long term side effects of use to syndromes of dependence and withdrawal. Drugs can also produce a variety of substance-induced disorders including amnesia, dementia, psychosis, anxiety, depression, mania, insomnia and sexual dysfunction. This entry looks at the mental health issues surrounding alcohol consumption and provides an overview of substance use problems.

Obstetric Mental Health

This section is entitled 'obstetric' for want of a catch-all phrase, and covers mental health issues related to menstruation, menopause, pregnancy and the postnatal phase. Included are Premenstrual Syndrome, postnatal blues and depression, postnatal psychosis, and the effects of pregnancy and menopause on mental health.

Somatoform Disorders

While the aim of medicine is generally seen as being the search for a biological explanation of illness, some individuals will present to their doctors with symptoms for which no medical explanation is forthcoming. When these symptoms persist despite normal investigation and treatment, it is important to consider mental health as a possible cause. This entry looks at the somatoform disorders, in which real symptoms are produced by the mind, along with factitious disorder and malingering in which the symptoms are in some way fake.

Psychotic Disorders

The psychoses are often poorly understood by lay persons, with schizophrenia and 'split personality' being confused with one another. In fact, the symptoms experienced by schizophrenics are those we usually associate with madness: hearing voices, thinking that aliens are out to get them, or believing that they are the son of God. Schizophrenia often occurs during the late teens or early twenties, and affects no less than 1% of the population. This entry looks at the unusual symptoms that psychotic individuals experience, and also covers the causes, diagnosis, treatment and prognosis of schizophrenia.

Reactions to Stress and Bereavement

It is not unusual for a person to be affected by the death of a loved one or a traumatic incident involving themselves. These so-called 'life events' can precipitate a range of mental health problems ranging from depression to schizophrenia, and are recognized as being important factors in the development and course of such conditions. However, stressful events may also produce a 'reaction' that prevents the individual from functioning normally, and which may require treatment in order to help the person return to their normal way of life. This entry looks at stress, adjustment and bereavement reactions and also covers the dissociative disorders.

Child and Adolescent Mental Health

Child and adolescent mental health encompasses a wide range of disorders including learning disability, autism and ADHD as well as so-called 'adult' conditions that may also affect children. These disorders can have important effects on a child's development, and so their early detection is quite important. However, it is worth bearing in mind that behaviour such as tantrums and bed-wetting are normal in a two year-old and only become abnormal at an age where most children have stopped them. Children with mental health problems can present differently from adults, often having non-specific problems with their behaviour, and they may well present to a doctor after an adult notices that something is amiss. This entry covers those conditions that only occur during childhood, though some may persist for the rest of a person's life.