The medical liability crisis continues to grow at an alarming rate and has particularly impacted perinatal and neonatal practice. This book focuses on issues which have a high vulnerability to claims of medical negligence. Its objective is the recognition of high-risk situations and the appropriate means to diagnose, treat, and document the response to such situations. Emphasis on record keeping, communication, and anticipatory behaviour is stressed. Chapters are accompanied by commentaries aimed at presenting alternative strategies. Authors have been chosen for their expertise in the subject and their abilities to communicate their points of view.

This unique text focuses on an aspect of medical and nursing practice which has become a major area of importance in the medico-legal arena. The editors have made a special effort to aid both the medical and legal sectors in understanding the important issues involved in medical negligence cases. This book will help remedy this situation by examining the "red flags" in several high risk situations to enable the development of a prospective approach to risk management. The contributors are internationally recognised experts from the field of obstetrics, neonatology, nursing and hospital administration, as well as the legal profession.

The editors believe that this book will serve to bring about changes in the behaviour of health care professionals which will ultimately improve the quality of care that they give to their patients. This text should be on the bookshelf of any individual involved in the medical care of the pregnant woman and her newborn.

This book presents new findings that deal with different facets of the well-being of children and their relevance to the proper treatment of children. The well-being of children is considered against the background of a wide variety of legal, political, medical, educational and familial perspectives. The book addresses diverse issues from a range of disciplinary perspectives using a variety of methods. It has three major sections with the essays in each section loosely organized about a common general theme. The first section focuses on issues concerning the relation between children’s well-being and autonomy or agency. The second section deals with child well-being insofar as the limits of parental authority are concerned. The third section has a more applied orientation and addresses a variety of public policy controversies involving the interpretation of children’s well-being.

This book analyses the reasons for relying on behavioural contraception methods among urban 'elites' in India and examines their efficacy in controlling fertility. It also traces variations in contraception choice over the reproductive cycle of women. Although researchers and policy makers generally equate reliance on behavioural contraceptive methods with low levels of education and awareness and lack of desire to control fertility, this perception has been questioned in recent years. The authors' analysis of the first three rounds of the National Family Health Survey (NFHS) data in India reveals that behavioural contraceptive methods are popular in eastern India. Moreover, it is urban educated women who rely on behavioural methods, and are apparently able to regulate fertility quite effectively with such methods. NFHS data, however, has some limitations and this motivates the authors to explore birth control methods through primary surveys of currently married graduate women in Kolkata. The use of behavioural contraception methods is a little researched area globally and this is the first book focusing on the topic in India.

This important book proposes revising the current informed consent protocol for predictive genetic testing to reflect the trend toward patient-centered medicine. Emphasizing the predictive aspect of testing, the author analyzes the state of informed consent procedure in terms of three components: comprehension of risk assessment, disclosure to select appropriate treatment, and voluntariness. The book's revised model revisits these cornerstones, restructuring the consent process to allow for expanded comprehension time, enhanced patient safety, greater patient involvement and autonomy, and reduced chance of coercion by family or others. A comparison of the current and revised versions and case studies showing the new model in real-world applications add extra usefulness to this resource. Included in the coverage: The science behind PGT. Understanding genetic risks and probability. The history of informed consent. Revised model of informed consent: comprehension, disclosure, voluntariness, patient safety. Applications of the model in DTC and pleiotropic genetic testing. Implementation of the revised model, and assessing its effectiveness. A milestone in the bioethics literature, Informed Consent in Predictive Genetic Testing will be of considerable interest to genetic counselors, medical and bioethicists, and public health professionals.

This sensible book draws on evidence-based data, provides updated evidence focusing on the impact of pregnancy complications on long-term morbidity of both mother and child and aims to give a clear and comprehensive set of tools for general practitioners counseling women in different stages of their lives. Chapters are contributed by a multidisciplinary team of obstetricians, oncologists, pediatricians, internal medicine specialists, and psychiatrists. The book may serve as a valuable resource for a broad spectrum of clinicians and healthcare professionals. Medical and nursing students as well as residents in family medicine, obstetrics, and pediatrics may derive great benefit from it in various stages of their training.

They are laborers, soldiers, refugees, and orphans. In areas of the world torn by poverty, disease, and war, millions of children are invisible victims, deprived of home, family, and basic human rights. Their chances for a stable adult life are extremely slim. The powerful interdisciplinary volume Vulnerable Children brings a global child-rights perspective to the lives of indigenous, refugee, and minority children in and from crisis-prone regions. Focusing on self-determination, education, security, health, and related issues, an international panel of scholars examines the structural and political sources of children's vulnerabilities and their effects on development. The book analyzes intervention programs currently in place and identifies challenges that must be met at both the community and larger policy levels. These chapters also go a long way to explain the often-blurred line between vulnerability and resilience. Included in the coverage: Dilemmas of rights-based approaches to child well-being in an African cultural context. Poverty and minority children's education in the U.S.: case study of a Sudanese refugee family. The heterogeneity of young children's experiences in Kenya and Brazil. A world tour of interventions for children of a parent with a psychiatric illness. An exploration of fosterage of Owambo orphans in Namibia. UNICEF in Colombia: defending and nurturing childhood in media, public, and policy discourses. Vulnerable Children is a must-have volume for researchers, graduate students, and clinicians/professionals/practitioners across a range of fields, including child and school psychology, social work, maternal and child health, developmental psychology, anthropology, sociology, social policy, and public health.

Multiauthored book dealing comprehensively with the various aspects of imaging of pediatric musculoskeletal trauma. The work is subdivided in three main sections: Overview of lesions; Imaging of traumatic injuries according to body region; typical traumatic injuries of early infancy. The third section includes also legal aspects of child abuse (battered child) and will indicate current international medical-legal guidelines. The didactical approach and the wide-ranging account of the subject makes the book particularly valuable to practitioners from various disciplines, involved in diagnosis and management of trauma of pediatric bone and joint

Insulin-like growth factor (IGF)-I is a widely expressed growth factor with diverse effects on many tissues throughout development and in adult life. The purpose of this work is to provide detailed and updated information on the role of the growth hormone (GH)-IGF axis in fetal and postnatal development, as well as its physiological functions and implications in pathology.

Recognition of the relationship between alcohol abuse and adverse prenatal outcomes is reflected in the warning labels on every alcoholic beverage sold in the United States. Because alcohol abuse has serious consequences for both individuals and society as a whole, much research has been devoted to this problem. Fetal Alcohol Syndrome provides straightforward facts regarding the impact of alcohol consumption as it affects the development of the embryo and fetus. Surveying current research of fetal alcohol syndrome and its related problems, the book addresses the immediate effects on development at various stages. Long-term action of prenatal alcohol exposure later in life is also considered. A chapter devoted to assessing the behavior of children who were prenatally exposed to alcohol emphasizes the necessity of longitudinal studies of fetal alcohol syndrome. This important reference offers a thorough overview of a problem that cannot be ignored.

An estimated 35 million people worldwide are displaced by conflict, and most of them are women and children. During their time away from their homes and communities, these women and their children are subjected to a horrifying array of misfortune, including privations of every kind, sexual assaults, disease, imprisonment, unwanted pregnancies, severe psychological trauma, and, upon return or resettlement, social disapproval and isolation. Written by the world's leading scholars and practitioners, this unique collection brings these problems - and potential solutions - into sharp focus. Based on extensive field research and a broad knowledge of other studies of the challenges facing women who are forced from their homes and homelands by conflict, this book offers in-depth understanding and problem-solving ideas. Derived from a project to advise U.N. agencies, it speaks to a broad array of students, scholars, NGOs, policymakers, government officials, and international organizations.

There are 62 million women of childbearing age in the United States, 85% of whom will give birth by age 44. One third of women enter pregnancy with a chronic medical illness and 50% are overweight or obese. Only 55% will have obtained preventive health services in any given year, and 17 million women do not have health insurance. The need for an educated provider community to care for these patients is enormous. Medical Management of the Pregnant Patient fills the need for a practical handbook that addresses the clinical care of pregnant patients. The content is protocol-based and uses algorithms to discuss preconception care, care during pregnancy, labor and delivery and how to link postpartum care with ongoing primary care. A brief overview of physiology, its impact on pregnancy and diagnostic and treatment recommendations are included. Each section covers both diseases that may exist independent of pregnancy and diseases unique to pregnancy. Additionally, symptom-based complaints are incorporated into each section and cross-referenced appropriately.

Technological developments in the life sciences confront us with new facets of a Faustian seduction. Are we "playing God" more and more, as claimed by critical authors of modernity? Achievements in genetic research produce ethical dilemmas which need to be the subject of reflection and debate in modern societies. Denial of ambivalences that ethical dilemmas arouse constitutes a threat to societies as well as to individuals. The book presents a compilation of some of the results of the interdisciplinary European study "Ethical Dilemmas Due to Prenatal and Genetic Diagnostics" (EDIG), which investigated some of these dilemmas in detail in a field which is particularly challenging: prenatal diagnosis. When results from prenatal diagnosis show fetal abnormalities, women and their partners are confronted with ethical dilemmas regarding: the right to know and the right not to know; decision-making about the remainder of the pregnancy and the desire for a healthy child; responsibility for the unborn child, for its well-being and possible suffering; life and death. This book provides answers from an ethical, psychoanalytical and medical viewpoint.

In order to bridge the lack of information on child labour and to stimulate policy interventions the IREWOC Foundation (International Research on Working Children) has undertaken action-based research in the field of the worst forms of child labour in Latin America. In 2006 and 2007 a comparative study on the Worst Forms of Child Labour was carried out in 7 different economic sectors in Bolivia, Guatemala and Peru focussing on the hazardous worst forms. The central research objectives were as follows: * to map the working and living situations of children who are working in specific economic sectors and what the consequences of this work are for their physical and emotional wellbeing. * to investigate the reasons why these children are working in these worst forms sectors. The research results were expected to give important insights into the currently polarised debate between those who state child labour is above all related to cultural considerations and those who state that economic reasons are fundamental to the phenomena of child labour. * to map the existing policy initiatives for child labourers in the worst forms and to identify the best practices. In the face of challenges imposed by achieving the Millennium Development Goals (MDGs) set by the UN, specific attention was paid to educational initiatives. Is education a useful tool in combating child labour, and vice versa, is child labour a significant obstacle to achieving universal primary education? Although the evidence from the various cases discussed in the book illustrate positive trends in terms of the worst forms of child labor, thousands of children were still found to be engaged in activities that form a direct threat to their physical, mental and moral health and jeopardize their education. This book proposes several practical recommendations for possible interventions.

In 1998, the Foundation for Child Development (FCD) provided Kenneth Land a grant to explore the feasibility of producing the first national composite index of the status of American children that would chart changes in their well-being over time. Important questions needed to be answered: was it possible to trace trends in child and youth well-being over several decades? Could such an index provide a way of determining whether the United States was making progress in improving its children's lives? The Index of Child and Youth Well-Being (CWI) was born from these questions. Viewing the CWI trends from 1975 to present, there is evidence that the well-being of American children lags behind other Western nations. As conditions change, it is clear that the index is an evolving and rich enterprise. This volume attests to that evolution, and what the CWI promises for understanding the progress - or lack of progress - in enhancing the life prospects of all American children.

A dramatic and worldwide increase is occurring in the prevalence of overweight and obesity in women of childbearing age. Obese women carry a significant excess risk of a variety of serious complications during pregnancy, and in addition, maternal obesity predisposes to obesity in the offspring. This book provides a timely update on the latest knowledge on maternal obesity and pregnancy. A very wide range of issues are covered, including macrosomia and associated shoulder dystocia; the risk of miscarriage, malformations, and complications of pregnancy; the impact of hyperglycemia; clinical management; consequences for anesthesia and ultrasound; impacts on breastfeeding, fertility, and childhood obesity; and pregnancy following gastric surgery. All of the authors are recognized experts in their fields, and the book has been designed to meet the practical needs of obstetricians, gynecologists, internists, and general practitioners.

Obesity During Pregnancy in Clinical Practice highlights the medical evidence on obesity in the postpartum and interconception period, arming clinicians with the knowledge necessary to communicate with their patients on the effect of these changes on diabetes, cardio vascular disease and certain cancers. Obesity During Pregnancy in Clinical Practice provides concise and understandable summaries of the evidence-based, theory-driven lifestyle interventions that have been shown to be effective for weight loss and modifying the risk of developing diabetes and obesity.

This book explores the broad view on child well-being and the quality of life research. It starts with a discussion of the origin of the social indicator movement and a review of literature on the concepts of quality of life, (subjective) well-being and resilience. It then discusses the force of culture on child development, and shows how two prototypical environments favor either the independent or interdependent self-model. After an exploration of the shifts and changes in the child well-being indicator movement and trends of child well-being measurements, the book turns to research on Tsunami-affected children. The first part of the study gives these children and their caregivers a voice, formulating in their words what constitutes child well-being for them in the given circumstances. The concepts provided are processed in detail, contrasted, and then made into indicators. The second part of the study describes the introduction of a child well-being index based on these indicators. The book ends with four main conclusions reflected in a theoretical model of contextualized child well-being indicators.

The first of its kind, this book describes pediatric palliative care in more than 23 countries. Each region in the world is covered and countries included are both resource poor and rich. Authors are multidisciplinary and regarded nationally and internationally in their field. Clinicians, advocates, policymakers, funders, and researchers will learn how programs were developed and implemented in each country. Authors describe children for whom pediatric palliative care is needed and provided for in their country. When applicable, a brief history of pediatric palliative care is included noting especially policy changes and legislative acts. For example, the chapter on Poland describes how pediatric palliative care grew from the Catholic church into a national movement spearheaded by several health care workers. The Pole national spirit that brought them through a change in political regime has also been a driving force in the pediatric palliative care movement. The chapter on South Africa, for example, illustrates how a resource poor country has been able to leverage philanthropic and government funding tomake its dream of having an infrastructure of pediatric palliative care a reality. These are just a few examples of the inspiring stories that are included in this book. Readers from countries who wish to start a pediatric palliative care program, or advance an existing program, will learn valuable lessons from others who have faced similar barriers. Introduction and concluding chapters highlight the strengths and weaknesses of the modern pediatric palliative care movement."

The state of health care isreflected by perinatal and neonatal morbidity and mortality as weIl as by the frequencies of long-term neurological and developmental disorders. Many factors, some without immediately recognizable significance to childbearing and many still unknown, undoubtedly contribute beneficially or adversely to the outcome of pregnancy. Knowledge concerning the impact of such factors on the fetus and survivinginfant iscritical. Confounding analysesofpregnancy outcome, especially these past 2 or 3 decades, are the effects of newly undertaken invasive or inactive therapeutic approaches coupled with the advent of high technology. Many innovations have been introduced without serious efforts to evaluate their impact prospectively and objectively. The consequences of therapeutic misadventures character ized the past; it seems they have been replaced to a degree by some of the complications of applied technology. Examples abound: after overuse of oxygen was recognized to cause retrolental fibroplasia, its restriction led to an increase in both neonatal death rates and neurologic damage in surviving infants. Administration of vitamin K to prevent neonatal hemorrhagic disease, particularly when given in what we now know as excessive dosage, occasionally resulted in kernicterus. Prophy lactic sulfonamide use had a similar end result. More recent is the observation of bronchopulmonary dysplasia as a complication of re spirator therapy for hyaline membrane disease. The decade of the eighties opened with the all-time highest rate of cesarean section in the United States.

This book describes key knowledge concepts, skills and up-to-date algorithms pertaining to common emergencies that can take place in a pediatric office, including: seizures, anaphylaxis and shock, and diabetic ketoacidosis. The authors supported by peer review from top specialists in Pediatric Emergency Medicine at the Baylor College of Medicine offer the first comprehensive educational resource on pediatric office emergency preparedness devoted exclusively to the practicing primary care health care provider and his/her team. During emergencies, providers and their staff are called on to work efficiently as a "code-team" which is a source of considerable apprehension for many primary care pediatricians. This unique reference guide contains a wealth of information and resources in a compact and practical form. It presents the most important knowledge, skills, office resources and team interactions required by practitioners to successfully treat pediatric emergencies in the office.

Promoting Reproductive Security in Developing Countries provides a comprehensive approach to developing and implementing reproductive health programs in the developing world. It fills a major gap in the literature by responding to the global need for a detailed guide to comprehensive reproductive health services. Promoting Reproductive Security in Developing Countries furnishes an innovative conceptual model - reproductive security - and offers an in-depth analysis of major reproductive health issues. The need for skilled, dedicated professionals is great. Those who choose to pursue the discipline are promised an endlessly rewarding and absorbing profession that will touch upon the most intimate aspects of life while reverberating globally. This book will be of great interest to public health professionals on both a local and global level, international policy makers, and relief workers.

Systemic Method Mark B. Mengel, M. D. , M. P. H. Learning Objectives 3 The Biomedical Model 6 A New Framework: The Systemic Patient-Centered Method 9 Physician Roles Patient Roles 22 Patient-Centered Clinical Decision-Making Data Base Responding to Patient Cues Constructing a Mutually Agreeable Plan The Systemic Patient-Centered Method: Other Concerns Changing Larger Systems Ethics of the Systemic Patient-Centered Method Efficacy of the Systemic Patient-Centered Method 32 Safety of the Systemic Patient-Centered Method Conclusion Cases for Discussion Recommended Readings XV 36 34 32 32 31 30 30 27 25 23 16 10 Patient-Centered The 1: Chapter !iiiii!i !ili !iil !i!i !iii !iii iiii !iiiii!i !iii !iil !iii!ii! !i!i!iiiiiii !i!i !i!i!iil ii!i !i!i !iii iiii!iiiiiii !ill !i!i!iii !iii !i!i !i!ilili!iii iiii !iil i!ii iili iii! i!ii ii!i i!ii iiii iiil iiiiiii! iiii iiiiii!iiiiiiiiiii!iiii!iiii iiii iiii ii!i iiiiii!i!i!iiiiiiiii !iii iiii iiiiiiiiii!i iiiiiiiiiiii iiiiiiii iiiiiiiiiiiiii!i iiii iiii iiiiiiii iiiiiiil iii!iiii iii! iiii iiii i!i! ilil iiii iiii iiii iiii iiii iiii iiii iiiiiiii iiii!iiiiiii iiii !iiiiiii iiii iiiiii!i iiii !iii !iiii!iii!i ii!i ii!i iiil iiii !i!i!iiiii!i!ill iiiiiiii! i!i iiii iili ii!i iiiiii!i iliiii!i iili iiiiiiiiiiililil iiii iiil ilil iliiiiiiiiiiiiii ilii ilii iiii iiii iiii iiii iiii iiiiiiii ilil i!il iiil iiii ii ii iiiiiiii iiiiiiii iiii !i !i!i !i!i !i!i !i!i !i!i !i!i !i!i !i!i !ill !i!i !i!iii!iii!i !i!i !i!i !!ii !iil !iii !iii !iii !i!i iiiiiiiiiiiiiiiiiiiiii!iii!i ililili! iii iiii iiii iiiil iii iiiil iiii iiii iiii xvi Part II.

The state of health care is reflected by perinatal and neonatal morbidity and mortality as well as by the frequencies of long-term neurological and developmental disorders. Many factors, some without immediately recognizable significance to childbearing and many still unknown, undoubtedly contribute beneficially or adversely to the outcome of pregnancy. Knowledge concerning the impact of such factors on the fetus and surviving infant is critical. Confounding analyses of pregnancy outcome, especially these past 2 or 3 decades, are the effects of newly undertaken invasive or inactive therapeutic approaches coupled with the advent of high technology. Many innovations have been introduced without serious efforts to evaluate their impact prospectively and objectively. The consequences of therapeutic misadventures character ized the past; it seems they have been replaced to a degree by some of the complications of applied technology. Examples abound: after overuse of oxygen was recognized to cause retrolental fibroplasia, its restriction led to an increase in both neonatal death rates and neurologic damage in surviving infants. Administration of vitamin K to prevent neonatal hemorrhagic disease, particularly when given in what we now know as excessive dosage, occasionally resulted in kernicterus. Prophy lactic sulfonamide use had a similar end result. More recent is the observation of bronchopulmonary dysplasia as a complication of re spirator therapy for hyaline membrane disease. The decade of the eighties opened with the all-time highest rate of cesarean section in the United States.

Growth, as we conceive it, is the study of change in an organism not yet mature. Differential growth creates form: external form through growth rates which vary from one part of the body to another and one tissue to another; and internal form through the series of time-entrained events which build up in each cell the special ized complexity of its particular function. We make no distinction, then, between growth and development, and if we have not included accounts of differentiation it is simply because we had to draw a quite arbitrary line somewhere. It is only rather recently that those involved in pediatrics and child health have come to realize that growth is the basic science peculiar to their art. It is a science which uses and incorporates the traditional disciplines of anatomy, physiology, biophysics, biochemistry, and biology. It is indeed apart ofbiology, and the study of human growth is a part of the curriculum of the rejuvenated science of Human Biology. What growth is not is aseries of charts of height and weight. Growth standards are useful and necessary, and their construction is by no means void of intellectualchallenge. Theyare a basic instrument in pediatric epidemiology. But they do not appear in this book, any more than clinical accounts of growth disorders. This appears to be the first large handbook-in three volumes-devoted to Human Growth. Smaller textbooks on the subject began to appear in the late nineteenth century, some written by pediatricians and some by anthropologists."