This second edition updates the reader on the most common intrauterine transmitted viral infection, CMV. The history of this disease, its pathophysiological background, epidemiology and symptoms, as well as diagnostic and therapeutic strategies, will be discussed in detail. Further a section specifically dedicated to prevention measures is included to the new edition. The chapter on virus-host interaction for defense and transmission is elaborately updated.

This volume provides an overview of the research describing the effects of child maltreatment on mental health, cognitive and social-emotional development. It offers descriptions of selected empirically based treatments (EBTs) written by scholars associated with its development, training, or research on its effectiveness. Each contributor presents the theoretical foundation of the EBT and evidence of its efficacy, describes the treatment process and illustrates this process with a case study of its use with a maltreated child, and discusses possible limitations. Following the chapters describing the interventions, the editors address key issues of the dissemination and implementation of these EBTs. They describe the strategies the selected interventions have used to ensure treatment fidelity in training and dissemination from the perspective of implementation science's core components of implementation. The challenges of implementing EBTs, and the difficulty of fitting protocol to the reality of clinical practice in community mental health settings are also discussed. This volume offers a central source of information for students and practitioners who are seeking effective interventions to address problems associated with child maltreatment.

Congenital malformations are worldwide occurrences striking in every condition of society. These severe physical abnormalities which are present at birth and affecting every part of the body happen more often than usually realized, once in every 33 births. The most common, after heart defects, are those of the neural tube (the brain and spinal cord) which happen in as many as one in every 350 births. They have been noted as curiousities in man and beast throughout recorded history and received great attention in our time by various fields of study, for example, their faulty prenatal development by embryologists, familial patterns by geneticists, causation by environmentalists and variability by population scientists.

Attention turned much in recent years to the relation of these malformations to deficiency of a particular dietary ingredient, folic acid, a subject this book analyzes in depth. The greatest conundrum of all, which this latest matter like so much else hinges on, is the amazing fact of the tremendous, almost universal decrease in the frequency of these anomalies since early in the 20th century. The puzzle is 'What can this downward trend possibly mean?' and at bottom 'Whether it is part of a long-term cyclical pattern'. This fascinating biological phenomenon is explored in the book together with various other topics.

This book presents models describing HIV transmission rates at population level, discussing the main statistical methods and analytical interventions. It also assesses the practical applicability of the various modelling techniques, offering readers insights into what methods are available and, more importantly, when they should be used to address HIV transmission at global level. The book includes realistic simulation models fitted to clarify the rate of HIV mother-to-child transmission (HIV MTCT), and substantiates the conclusions that can be drawn as well as the appropriate time for making global-level clinical decisions concerning people living with HIV/AIDS (PLHIVs). Intended for students, academics and researchers, the book offers more than just an introduction to the topic - it also features in-depth, yet easy-to-understand, descriptions of a new mathematical/statistical HIV mother-to-child transmission model, making it a useful resource for clinicians, public health workers and policymakers involved in implementing HIV-prevention programmes at national /global level.

A collection of cutting-edge laboratory techniques for the study of trophoblast and placental biology. The techniques presented range from experimental animal models, to animal and human placental organ and cell culture systems, to morphological, biochemical, and molecular strategies for assessing trophoblast/placental growth, differentiation and function. Volume 1 provides readily reproducible protocols for studying embryo-uterine implantation, trophoblast cell development, and the organization and molecular characterization of the placenta. Highlights include strategies for the isolation and culture of trophoblast cells from primates, ruminants, and rodents, and precise guidance to the molecular and cellular analysis of the placental phenotype. A companion second volume concentrates on methods for investigating placental function.

Among women's health concerns, reproductive issues, both prenatal and postpartum, hold particular prominence. Yet despite the many programs dedicated to improving women's reproductive health, maternal and infant morbidity and mortality rates in minority communities remain unchanged-or have increased. Confronting this alarming statistic head-on, "Reducing Racial/Ethnic Disparities in Reproductive and Perinatal Outcomes" is the first book systematically examining public health interventions designed toward meeting this important and elusive goal. Its contributors offer the best thinking and practice on this complicated topic, clarifying the relationship between evidence-based medicine and evidence-based public health and its potential for increasing parity, considering interventions in the multiple contexts of women's lives, reviewing the evidence base for each program or initiative featured, and describing methodologies for evaluating interventions. The resulting volume advocates for an integrative lifespan approach, including topics related to: Family planning STI and HIV/AIDS screening and treatment Smoking cessation and reducing exposure to environmental smoke Preconceptional well-woman care Depression screening and treatment Labor/delivery approaches and intrapartum care Emerging prenatal care interventions, from centering pregnancy to doula support

For professionals and graduate students in psychiatry, psychology, sociology, women's health, and public health, "Reducing Racial/Ethnic Disparities in Reproductive and Perinatal Outcomes" reframes a set of ongoing issues and guides the reader toward state-of-the-art solutions.

Hypertension: from basic research to clinical practice" contains a unique collection of selected chapters written by experts and enthusiasts engaged in research and treatment of hypertension, a condition that affects around a billion people in the world. The chapters describe fundamental researches at cellular and molecular levels to the science, and art of treatment of the condition in clinical practice. The topics included ranges from pathophysiology of hypertension, through monitoring of hypertension, to the treatment of hypertension in different patient categories. It contains essential background information as well as cutting edge research, and state of the art treatment alternatives in this broad field. From the beginners, and research students to the expert clinicians, and established scientists, everybody has something to learn from this book.

Alcohol and other drugs of abuse cause significant physi ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol.

The HIV pandemic continues to levy a heavy burden on the human race world-wide. The estimated number of people who became newly infected with HIV in 2009 was 2.6 million; most of these individuals live in Sub-Saharan Africa, followed by India and Southeast Asia. An estimated 370,000 new cases of pediatric infections occurred globally in 2009 (or more than 1,000 new infections every day), practically all of them through mother-to-child transmission. Up to 40% of all new infant HIV infections occur during breastfeeding. While breastfeeding by HIV-infected mothers is not recommended in the U.S. and other resource-rich settings where safe replacement feeding is easily available, the situation is different in many resource-limited settings, where replacement feeding is not safe or available and carries a high risk of infections (diarrhea, pneumonia) and infant malnutrition. Mothers in such settings are faced with a difficult dilemma: to breastfeed their infants in order to provide their infants with its many benefits (nutritional, immunologic, cognitive), but to also risk transmitting HIV. These challenges have prompted an intensive search for new prophylactic and therapeutic strategies in order to prevent infants from acquiring HIV infection through breastfeeding. In this book, expert HIV researchers critically review every aspect of this highly evolving and topical subject. The opening chapters deal with the epidemiology, global magnitude and biologic mechanisms of HIV-1 transmission from mother to child through breastfeeding and include considerations of the virus (quantity, compartments, characteristics) and the host (genetic, immunity-innate, cellular, humoral). The effects of breastfeeding on the HIV-infected mother's health and nutritional status, and the social and cultural issues associated with the practice of breastfeeding are also discussed. The next few chapters provide cutting-edge reviews of the latest approaches to prevention of HIV transmission to the infant through breastfeeding, including antiretroviral strategies, nutritional and immune-based approaches, and treatment of expressed breast milk. The remaining chapters provide a fascinating review of the many iterations this subject has received, as reflected in the several different sets of guidelines for infant feeding by HIV-infected mothers issued by the World Health Organization, and a debate by leading scientists on whether HIV-infected mothers should breastfeed their infants-in resource-limited and in resource-rich settings. A comprehensive overview of the current state of implementing the new evidence for prevention of breastfeeding transmission of HIV all over the world is also presented. Essential reading for the many disciplines of scientists and clinicians working on HIV/AIDS and other retroviruses, pediatricians, obstetricians/gynecologists, as well as all health-care professionals interested in expanding their understanding on the subject.

Pregnancy is the main determinant of some liver diseases in humans: acute fatty liver of pregnancy, cholestasis of pregnancy, and acute liver failure in toxaemia of pregnancy. Pregnancy also modifies the natural history of other more common hepatobiliary diseases, such as cholesterol gallstones. Sex hormones (mainly oestrogens, progesterone and/or some of its metabolites) and prolactin are considered responsible for these pathological consequences and they also appear to be influential in the outcome of several other hepatobiliary disorders, in both sexes and all ages. Although these disorders and their hormonal interrelations have been clinically well characterized, their pathogenesis remains obscure from the biomolecular point of view. In recent years, novel approaches using new technologies have improved our understanding of hormone actions and metabolism, hormone receptors, metabolic pathways and their interrelations with closely related molecules, such as bile acids. This book, the proceedings of the 89th Falk Symposium, held in Santiago, Chile, 10-11 November, 1995, will help research scientists and clinicians to review basic and clinical aspects of these interactions, in order to stimulate biomedical research in a relevant and exciting area.

In this unique book emphasis is placed on tests necessary to evaluate fetal well-being and to detect those fetuses at risk of hypoxia and acidosis in utero. Written by pioneers in the neonatal field, this publication contains chapters on the pathophysiology , obstetric management, and collagen diseases of intrauterine growth retardation. Ultrasound in detection of growth retarded fetuses is explored, as well as magnetic resonance imaging and magnesium substitution for the prevention of intrauterine growth retardation. Containing never-before-published information, this volume is an excellent reference source for both investigators in the field and those entering it. Topics Include: Perinatal growth chart for international reference Ultrasound guided procedures in small for gestation fetuses Utero-placental and fetal circulation

A panel of top experts in perinatal psychiatry reviews the many recent studies on the use of psychiatric medications in pregnancy and postpartum and assesses their impact on the diagnosis and treatment of pregnant/postpartum women. The authors focus on each of the major psychiatric illnesses, including depression, anxiety disorder, bipolar disorder, schizophrenia, substance abuse, eating disorders, and mental illness, as well as on the potential impact of these illnesses on infants and children. Interpreting conflicting and inconclusive clinical findings, they spell out the lesser-known risks of prenatal medication exposure and illuminate a variety of issues that must be taken into account in choosing such treatments as medications, psychotherapy, parental education, and social skills training.

Nominated for the Foundation of Sociology of Health and Illness Book Prize 2018 In the UK and beyond, Down's syndrome screening has become a universal programme in prenatal care. But why does screening persist, particularly in light of research that highlights pregnant women's ambivalent and problematic experiences with it? Drawing on an ethnography of Down's syndrome screening in two UK clinics, Thomas explores how and why we are so invested in this practice and what effects this has on those involved. Informed by theoretical approaches that privilege the mundane and micro practices, discourses, materials, and rituals of everyday life, Down's Syndrome Screening and Reproductive Politics describes the banal world of the clinic and, in particular, the professionals contained within it who are responsible for delivering this programme. In so doing, it illustrates how Down's syndrome screening is 'downgraded' and subsequently stabilised as a 'routine' part of a pregnancy. Further, the book captures how this routinisation is deepened by a systematic, but subtle, framing of Down's syndrome as a negative pregnancy outcome. By unpacking the complex relationships between professionals, parents, technology, policy, and clinical practice, Thomas identifies how and why screening is successfully routinised and how it is embroiled in both new and familiar debates surrounding pregnancy, ethics, choice, diagnosis, care, disability, and parenthood. The book will appeal to academics, students, and professionals interested in medical sociology, medical anthropology, science and technology studies (STS), bioethics, genetics, and/or disability studies.

Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection. This volume explores the usefulness and limitations of the concept of 'fetal patient' against the background of the recent seminal developments in prenatal or fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of 'fetal patient' from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine.

This casebook profiles exceptional traumatic injury prevention programs from all over the globe. Its detailed description and analysis employ a multi-stage process of identifying, evaluating, and casing effective prevention practices. The case studies reflect how legislative and regulatory information impact prevention efforts and provide insight into how national centers for injury prevention and control inform prevention practices on countrywide levels. The authors work with outcome-based research criteria to select and develop their comprehensive and contextually aware profiles of the programs. All included case studies follow the BRIO approach (Background, Resources, Implementation, and Outcome) - a model designed to provide a consistent way of describing programs that have been evaluated and found to be exceptional practices. The scope of the Casebook ranges across: The challenge of traumatic injury prevention Sports and recreation-related traumatic injury prevention Fall-related traumatic injury prevention Road traffic-related traumatic injury prevention Traumatic injury prevention within complex systems In its recognition of traumatic injury prevention across the lifespan as a critical and complex public health challenge, the Casebook of Traumatic Injury Prevention promises to be an influential and authoritative resource for professionals and students in public health, safety, injury prevention, medicine, psychology, sociology, nursing, and engineering. Government agencies and institutions such as the Centers for Disease Control and Prevention (CDC), public health departments, and safety associations also would find the Casebook relevant to their work.

Obesity, type 2 diabetes mellitus, hypertension, and coronary heart disease are serious diseases affecting asignificantnumberofadults across the globe. Insulin resistance, low-grade systemic inflammation, low-birth weight, maternalproteinmalnutrition, neonatalhighcarbohydratediet, and high fat diet are associated with these diseases. On the other hand, adequatelybreast-fedsubjects are substantially at lowerrisk. Ifso, whatis the linkbetweenthese variousfactors?Onepossibilityisthat humanbreast milk containsfactorsthatconferresistancetothese modemdiseases.Here I present arguments that long-chain polyunsaturated fatty acids (LCPUFAs) presentinthebreastmilkcouldberesponsibleforthisbeneficialaction. Though the entire class of LCPUFAs provided dunng perinatal periodislikelytohavearole inthepreventionofadultdiseases, itshouldbe understoodthateachofthese LCPUFAsexhibitauniqueand insome cases opposing bioactive properties.It is important to note that there is a close interaction between (0-6 and (0-3 fatty acids. Human breast rmlk contains almost twice (0.78 vs 0.43 %w/w)the amountof(0-6LCPUFAs (gamma linolenic acid, dihomo-gamma-linolenic acid and arachidonic acid) comparedto (0-3LCPUFAs(eicosapentaenoicacid, docosapentaenoicacid, and docosahexaenoic acid). Obviously, the best would be to mimic the composition/concentrations in which these fatty acids are present in the breastmilk. The conceptthat LCPUFAs given duringpennatalperiod(and inadultlife)isbeneficialinpreventingadultdiseasescertainlyneedsfurther exploration.Iamconfidentthat someofthe enterprisingreaderswill delve intothepossibilitiessuggestedafterreadingthisbook. UndurtiN.Das, M.D., FAMS. To MyWifeLakshmi and Mytwoeyes DaughterArundhatiandSonAditya Chapter #1 Introduction Fetal/Perinatalimprintingonlaterlife It isbelievedthat stimuliormsults during criticalorsensitiveperiods inearlylifecanhave lifetimeconsequences.Thisconceptiswellestablished in developmental biology and has been termed "programming." The evidence for programming confirmed the critical period for imprinting in animals, more so in birds'. Programming stimuli may be generated endogenously, such as hormonal signals', or they may be environm

Innovations in technology and new therapies have changed the face of medicine in the last few decades. These include advances in fetal diagnosis (preimplantation genetics, chorionic villous sampling and amniocentesis), drugs that have been developed to treat unique conditions in neonates such as respiratory distress syndrome (surfactant) and pulmonary hypertension (inhaled nitric oxide), as well as technological advances and interventions resulting in diagnostic (ultrasounds and MRI) and therapeutic interventions (intrauterine transfusion to ECMO). Research in fertility treatments has resulted in test tube babies and cloned animals, and that has also fostered technological advances in diagnostic and therapeutic interventions. The primary purpose of Innovations in Neonatal-Perinatal Medicine is to highlight these innovations in technology and therapy that have not only changed the way doctors deliver care to fetus and neonate but also reduced neonatal mortality thereby saving millions of lives in the process. These issues are addressed by the authors who are experts in their respective fields. The book will be valuable not only to healthcare providers but also to educators and policy makers.

Nominated for the Foundation of Sociology of Health and Illness Book Prize 2018 In the UK and beyond, Down's syndrome screening has become a universal programme in prenatal care. But why does screening persist, particularly in light of research that highlights pregnant women's ambivalent and problematic experiences with it? Drawing on an ethnography of Down's syndrome screening in two UK clinics, Thomas explores how and why we are so invested in this practice and what effects this has on those involved. Informed by theoretical approaches that privilege the mundane and micro practices, discourses, materials, and rituals of everyday life, Down's Syndrome Screening and Reproductive Politics describes the banal world of the clinic and, in particular, the professionals contained within it who are responsible for delivering this programme. In so doing, it illustrates how Down's syndrome screening is 'downgraded' and subsequently stabilised as a 'routine' part of a pregnancy. Further, the book captures how this routinisation is deepened by a systematic, but subtle, framing of Down's syndrome as a negative pregnancy outcome. By unpacking the complex relationships between professionals, parents, technology, policy, and clinical practice, Thomas identifies how and why screening is successfully routinised and how it is embroiled in both new and familiar debates surrounding pregnancy, ethics, choice, diagnosis, care, disability, and parenthood. The book will appeal to academics, students, and professionals interested in medical sociology, medical anthropology, science and technology studies (STS), bioethics, genetics, and/or disability studies.

A strikingly effective, one-of-a-kind learning resource This one-of-a-kind learning resource for Neonatal Nurse Practitioner/CNS students in both academic and clinical settings is distinguished by its use of complex case studies to reinforce best practices in treating vulnerable neonatal patients. Based on applications and outcomes, the case study approach is a particularly effective method of enhancing critical thinking and clinical decision-making and fostering effective role transition in practice-based disciplines. Authored by leading NNP educators nationwide, these multi-faceted, unfolding case studies address and synthesize the most important content covered throughout the NNP curriculum. Topics addressed include maternal/neonatal complexities, risk factors, neonatal disorders and emergencies by body system, health promotion/maintenance, communicating effectively with parents, and guidance on handling unexpected outcomes. Case studies progress from basic to complex, and each includes objectives, clinical pearls, and critical thinking questions. A robust instructor toolkit contains pedagogical strategies for facilitating online discussion, chapter conclusion quizzes, a variety of simulation experiences, and more. Key Features: Uses a complex case-based learning approach for neonatal advanced practice nursing - the first book to do so Authored by leading NNP educators nationwide Provides 40-50 case studies synthesizing key content areas Helps prepare students for effective role transition Includes a robust instructor toolkit and can be used in online courses

Technology has come to dominate the modern experience of pregnancy and childbirth, but instead of empowering pregnant women, technology has been used to identify the foetus as a second patient characterised as a distinct entity with its own needs and interests. Often, foetal and the woman's interests will be aligned, though in legal and medical discourses the two 'patients' are frequently framed as antagonists with conflicting interests. This book focuses upon the permissibility of encroachment on the pregnant woman's autonomy in the interests of the foetus. Drawing on the law in England & Wales, the United States of America and Germany, Samantha Halliday focuses on the tension between a pregnant woman's autonomy and medical actions taken to protect the foetus, addressing circumstances in which courts have declared medical treatment lawful in the face of the pregnant woman's refusal of consent. As a work which calls into question the understanding of autonomy in prenatal medical care, this book will be of great use and interest to students, researchers and practitioners in medical law, comparative law, bioethics, and human rights.

The contributors to this collection look into the experiences of women in the Western world going through pregnancy and birth over the last hundred years.

If you are an obstetrician whose patient has been admitted to ICU, you need to know how she is managed there. If you are an intensivist, you need to adapt to changes in physiology, alter techniques for the pregnant patient and keep the fetus from harm. This book addresses the challenges of managing critically ill obstetric patients by providing a truly multidisciplinary perspective. Almost every chapter is co-authored by both an intensivist/anesthesiologist and an obstetrician/maternal-fetal medicine expert to ensure that the clinical guidance reflects best practice in both specialties. Topics range from the purely medical to the organizational and the sociocultural, and each chapter is enhanced with color images, tables and algorithms. Written and edited by leading experts in anesthesiology, critical care medicine, maternal-fetal medicine, and obstetrics and gynecology, this is an important resource for anyone who deals with critically ill pregnant or postpartum patients.

Embryology at a Glance is a highly illustrated and innovative introduction to key embryological concepts, with concise, memorable descriptions of major embryological developments. This new edition covers the basic principles of human development, from mitosis and meiosis, before exploring the primary formation of each body system, including the development of the musculoskeletal, circulatory, digestive, reproductive, and nervous systems during the foetal and neonatal periods. Key features include: New chapters on cell signalling genes, stem cells, and antenatal screening for common congenital and genetic defects Full colour photographs and illustrations Links to clinical practice highlighted throughout Timelines of each developmental stage MCQs and EMQs for revision and review A companion website at www.ataglanceseries.com/embryology featuring 15 brand new animations, and podcasts to help clearly explain the processes that occur during development. An additional instructor resource contains an image bank of all the figures from the book to aid teaching this fascinating area Embryology at a Glance provides the perfect alternative to the overwhelming detail seen in conventional embryology texts. It provides just the right level of detail on embryology and congenital abnormalities for all medical students and health professionals to develop a thorough understanding of human development and its implications for clinical practice.