This first-of-its-kind text provides a multidisciplinary overview of a significant problem in hospital-based healthcare: patients who decline inpatient medical care and leave the hospital against medical advice (AMA). Compared to standard hospital discharges, AMA discharges are associated with worse health and health services outcomes. Patients discharged AMA have been found to have disproportionately higher rates of substance use, psychiatric illness, and report stigmatization and reduced access to care. By providing a far reaching examination of AMA discharges for a wide academic and clinical audience, the book serves as a reference for clinical care, research, and the development of professional guidelines and institutional policy. The book provides both a broad overview of AMA discharges with chapters on the epidemiology, ethical and legal aspects, as well as social science perspectives. For clinicians in the disciplines of hospital medicine, pediatrics, emergency medicine, nursing, and psychiatry, the book also provides a patient-centered analysis of the problem, case-based discussions, and a discussion of best practices. This comprehensive review of AMA discharges and health care quality will interest physicians and other health care professionals, social workers, hospital administrators, quality and risk managers, clinician-educators, and health services researchers.

In the recent literature, the most influential case study books in neuropsychology are in the adult realm. Pediatric neuropsychology is a rapidly developing field with increasingly greater influence in the assessment, diagnosis, early identification, and treatment of childhood illnesses. This book will provide the first centralized, comprehensive resource for case studies in pediatric neuropsychology. Not only will this supply a valuable compilation for the growing numbers of professionals in this field, but will also serve as an innovative and appealing resource for therapists, teachers, and others interested in child development.

This book will be structured in such a way that readers can easily access individual cases of interest, as well as related areas of dysfunction. Section breakdowns will be provided in order to highlight the combined focus of case presentations in acquired neuropsychological dysfunction as well as developmental disorders. Each section will begin with an introductory chapter, highlighting the salient feature of the concept and providing brief, up to date reviews of the current research and theories. Within each global section, individual case studies will serve as stand-alone chapters. Contributing authors will be provided extensive guidance and coaching with regards to the standard format and information to be included in each chapter.

The first section of this book will present cases involving neurological disorders. The intention of this section is to provide not only classic examples of neurological dysfunction in children, but also to provide interesting cases of unique or remarkable presentations. The second section will present an accumulation of cases representing both common and progressive conceptualizations of developmental disabilities. Section three has been designed to highlight cases which often present complex issues to neuropsychologists. The case examples in this section will highlight the use of alternative treatments, pathologies that are often a source of inquiry, and situations that lack the more rigorous scientific data often utilized in other diagnostic procedures. Additionally, this section may include chapters on common differential diagnosis dilemmas in clinical practice. Often multifaceted and even contradictory evidence can arise during evaluations, resulting in complex or problematic situations for the clinician. Such examples are difficult, by their nature, to forecast, but rather would be added during the book s development, as they occur."

Febrile Seizures is written by the most active researchers and clinicians in epilepsy research today. This book presents the latest developments in this field as well as the current state of knowledge in the following:
* New imaging tools and emerging data, visualizing effects of febrile seizures on the brain
* New genetic methodologies
* The use of animal models to permit scientific analysis of the electrophysiology and molecular biology of the seizure.

Key Features
* First book on febrile seizures in over 20 years
* Broad spectrum of approaches, from genetic and epidemiological to bench research using animal models and in vitro single-cell patch-clamp methods
* Comprehensive update of the topic, written by world leaders in the field
* Novel and newly discovered information based on up-to the minute methods
* Engaging style, accessible to the clinician, researcher, and educated parent

Positron emission tomography (PET) has been at the forefront of fu- tional and molecular imaging for a number of years. The future of di- nostic imaging depends upon the ability to change from imaging anatomy to examining the processes at work in the body. The fact that there are now monographs examining particular aspects of PET, such as this book on the examination of children, speaks to the newly won maturity of PET. The authors are to be congratulated for the timely appearance of this volume. In recent years, PET has transformed the contributions of nuclear medicine to the diagnosis, staging, and follow-up of patients with cancer. Children with cancer deserve the very best and most comp- sionate care that society can provide. Ultimately the greatest comp- sion we can offer as physicians is to provide the best possible care. Those charged with creating public policy in the context of diagnostic medicine must make common cause with physicians and other sci- tists to ensure that that best possible care is realized at the bedside. All of the evidence suggests that PET is central to such optimal cancer care. In addition to the distinguished cast of physicians and researchers who contributed to this book, I welcome the contributions from te- nologists who are a key part of the interaction between the diagnostic process and the sick or potentially sick child. Good care is contingent upon putting parents and child at ease, and the technologist has a lead role in this.

This book presents pulmonary outcomes of prematurity, from their emergence in infancy through to their consequences in adulthood. With an increasing number of preterm births and more infants surviving, there is now a larger population of adults with lung disease originating in infancy requiring specialized care. Looking at the whole group of preterm infants, not just those with bronchopulmonary dysplasia, this text covers a wide spectrum of pulmonary outcomes, including: pulmonary hypertension, wheezing, and alterations in sleep. The chapter authors focus on critically appraising what is and is not known about each outcome and suggest key questions that still need to be answered. Respiratory Outcomes in Preterm Infants: Sequelae from Infancy through Adulthood is an ideal reference for the multidisciplinary group that cares for these preterm infants and the adults they become, including: neonatologists, pediatric pulmonologists, pediatricians, adult pulmonologists, primary care physicians, nurses, and fellows.

Melanoma is one of the most types of cancer. When melanoma is detected at an early stage, treatment is highly successful, but outcomes can be poor when the disease is advanced. There has been significant progress in our understanding of the molecular biology, genetics, and immunology of melanoma over the past decade. This has been accompanied by rapid advances in therapeutic strategies for patients with melanoma. This book provides the clinician and the researcher with a broad understanding of the molecular and cellular pathogenesis of melanoma, explores the clinical characteristics and criteria for clinical and pathological staging of the disease, and provides an overview of current and evolving treatment strategies in the adjuvant, metastatic, and preventive settings. The treatment of special populations and rare variants of melanoma that often present particular clinical challenges is also covered. Authored by international experts in melanoma biology and clinical management, this volume concisely explains how to diagnose, treat, and prevent melanoma while reviewing advances in basic science and providing an overview of innovative approaches still under development.

This book is the proceedings of the Falk Symposium No. 127 on Autoimmune Diseases in Paediatric Gastroenterology' (IV International Falk Symposium on Paediatric Gastroenterology), held in Basel, Switzerland, on November 8-9, 2001. The symposium focused on the role of the immune system, both the acquired and the innate systems, in inflammatory bowel disease (IBD) in children and adolescents. The innate system has an important fundamental role in host defence by initiating immune responses against potentially deleterious matter. However, a mutation within the innate system may elicit an immune response against the host: hence, an autoimmune response.

Chronic autoimmune hepatitis occurs predominantly in young people, and especially in women. Immunological changes are conspicuous. Tissue antibodies are found in a large number of patients. This is a disease of disordered immunoregulation marked by a deficit in suppressor T cells causing the production of autoantibodies against specific hepatocyte surface antigen. Liver membrane protein is found in the sera of patients with autoimmune chronic acute hepatitis and with primary biliary cirrhosis (PBC). The latter condition of progressive granulomatous destruction of intrahepatic bile ducts is, in many respects, analogous to the graft-versus-host syndrome where the immune system has become sensitized to foreign HLA-molecules.

Primary sclerosing cholangitis (PSC) is another condition of unknown origin. All parts of the biliary tree can be involved in a chronic, fibrosing, inflammatory process that results in obliteration of the biliary tree and ultimately in biliary cirrhosis. About half of the patients also suffer from ulcerative colitis and rarely from Crohn's disease. Circulating antibodies to some antigens are found in obstructed portal tracts, as well as increased concentrations of biliary immune complexes in patients with PBC.
In all three previous Falk symposia on paediatric gastroenterology, attention was focused on the role of the innate immune system in the aetiology of IBD. It has become increasingly clear in recent years that the innate system has a much more important and fundamental role in host defence. The decision to initiate an immune response is one of the major roles of the innate system. Mutations within this system could transform it into becoming constitutively active, resulting in an inflammatory reaction and thus eliciting an autoimmune response.

Following an introduction to the basic phenomena of autoimmunity, the proceedings discuss clinical aspects of autoimmune diseases. In particular, current knowledge and the state of the art about the diagnosis and treatment of the autoimmune diseases of the gastrointestinal tract are described by world-renowned experts. The book also contains the short presentations on selected topics, as well as abstracts of the mini-posters read by title, which were included in the symposium.

Reoperative surgery is a problem that is confronted by every surgeon and this book offers up-to-date information and techniques for critical cases in all of the pediatric surgical specialties. The book is comprehensive, covering the full spectrum of pediatric reoperation, and it addresses the complications of common pediatric surgeries. This book is an essential resource for both surgeons and non-surgeons involved in the care of pediatric patients.

Research into child language development is being conducted more extensively, by more people, and in more countries throughout the world than at any point in the past. We now know more than we ever did before about the linguistic, cognitive, neurobio logical, and social capacities that children bring to their language learning task, as well as the ways in which these capacities interact with a whole range of factors present in the child's environment throughout the learning process, not least the particular character istics of the language or languages to which the child is exposed. Far from inducing a sense of complacency, this new knowledge seems instead to create an even stronger impetus to know more. This is partly because of the new and unforeseen questions it raises and partly because of competition between different theories to provide the best explanation of the phenomenon, and which in turn engender different methods of enquiry. This volume addresses many of the key issues which are currently exercising the minds of child language researchers, and which are likely to motivate research for some years to come. The chapters included here-all previously unpublished-present a great deal of new data and address a range of theoretical issues from a variety of perspectives."

This manual is a practical guide to the diagnosis and management of neonatal disorders, helping trainees prepare for OSCE examinations. Divided into ten sections, each chapter provides step by step direction, from history taking, clinical examination and assessment, to drugs, instruments, imaging, and interpretation. A complete chapter describes various case studies to assist understanding. The book covers both routine and more complex conditions and features more than 200 clinical photographs and diagrams to enhance learning. Key points Practical guide to diagnosis and management of neonatal disorders Provides comprehensive preparation for OSCE examinations Features case studies to assist understanding Includes more than 200 clinical photographs and diagrams

Dermatologists commonly treat acne, which affects 40 to 50 million Americans each year and about 85 percent of all patients at some point in their lives. Dermatologists, primary care doctors, and pediatricians see these patients every day in practice. It is important to treat the skin effectively not only to reduce the risk of physical scarring, but also to address the negative psychosocial impact this disease carries. Improving the skin can improve self-confidence, interpersonal relationships, and performance in school or at work. Acneiform Eruptions in Dermatology is a practical, full-color guide to the differential diagnosis of acne vulgaris and the treatment of acne-like conditions. It is organized into sections by subtype of condition (e.g., infections, genetic syndromes, medication-caused) and includes a section of variants of acne that may be misdiagnosed. Within the sections, individual chapters discuss each variant of the condition and begin with a helpful bulleted summary of its defining clinical features. Extensive color clinical images appear throughout the book.

Pain is a complex, multidimensional phenomenon, with physiological, behav ioral, emotional, cognitive, and developmental aspects (Zeltzer, Barr, McGrath, & Schechter, 1992). To effectively evaluate and manage pain in children, the clini cian must be able to assess the unique ways these complex dimensions interact for the individual child and integrate these dimensions into a treatment plan. This can be a daunting task. The purpose of this book is to provide a framework for conceptualizing pain problems in children that can guide the practitioner in developing an evaluation and treatment plan that is optimal for the individual child. This book is not in tended to be a comprehensive, exhaustive review of the literature on pain manage ment in children. There are several excellent books of this nature (e.g., Bush & Harkins, 1991: McGrath, 1990; Ross & Ross, 1988). Instead, this book is an at tempt to outline an hypothesis testing process of case conceptualizing and treat ment planning that can help structure the task of sorting through the complex interrelationships that determine children's pain."

Our uncertain times are hard enough for adults to navigate. For all too many young people-even many who appear to possess good coping skills-the challenges may seem overwhelming. More and more, resilience stands as an integral component in prevention programs geared to children and adolescents, whether at risk or not. Resilience Interventions for Youth in Diverse Populations details successful programs used with children and teens in a wide range of circumstances and conditions, both clinical and non-clinical. New strength-based models clarify the core aspects of resilience and translate them into positive social, health, educational, and emotional outcomes. Program descriptions and case examples cover diverse groups from homeless preschoolers to transgender youth to children with autism spectrum disorders, while interventions are carried out in settings as varied as the classroom and the clinic, the parent group and the playground. This unique collection of studies moves the field toward more consistent and developmentally appropriate application of the science of resilience building. Among the empirically supported programs featured: Promoting resilience in the foster care system. Developing social competence through a resilience model. Building resilience in young children the Sesame Street way. School-based intervention for resilience in ADHD. Girls Leading Outward: promoting resilience in at-risk middle school girls. Resiliency in youth who have been exposed to violence. Resilience Interventions for Youth in Diverse Populations is an essential resource for researchers, professionals/practitioners, and graduate students in clinical child and school psychology, social work, educational psychology, child and adolescent psychiatry, developmental psychology, and pediatrics.

Inspired by the work of Herbert C. Quay, this book builds on recent theory and research to explore the psychopathology of child and adolescent disruptive behavior disorders. The wide-ranging chapters cover oppositional defiant disorder, attention-deficit hyperactivity disorder, conduct disorder, and other subjects. The work provides a rich sample of the sort of scientific activity Dr. Quay encourged, and will encourage researchers to further pursue issues in this fascinating field.

This book explains the psychological assessment process and reviews the origins of psychological testing, referral and testing processes, and prominent psychological assessment instruments. Most important, this book details how to evaluate testing data and use them to understand an individual's needs and to inform interventions and treatments. This book addresses specific domains of psychological assessment, including: * Intelligence and academic achievement. * Speech-language and visual-motor abilities. * Memory, attention/concentration, and executive functioning. * Behavioral and social-emotional functioning. * Developmental status. Practical Guide to Child and Adolescent Psychological Testing is an essential resource for clinicians, primary care providers, and other practitioners as well as researchers, professors, and graduate students in the fields of child, school, and developmental psychology, pediatrics and social work, child and adolescent psychiatry, primary care medicine, and related disciplines.

Preeminent clinical child and adolescent psychological scientists offer an agenda for future research in this compendium of thought pieces. On a wide range of topics including ADHD, depression, self-injury, emotion regulation, conduct problems, addictions, clinical assessment and therapy, and many more, scientists review the current state of the literature and offer specific recommendations for what investigators next need to tackle to reduce mental illness among youth. Chapters include a discussion of theories and methods in clinical child and adolescent psychology, current funding priorities, and the intersection of traditional clinical psychology research with the burgeoning field of psychological neuroscience. This book is an essential resource for classes on clinical child and adolescent psychopathology and treatment. It also provides a unique guide for undergraduate and early graduate students who are determining how to start their research careers in the field. All of the chapters in this book were originally published as articles in the Journal of Clinical Child and Adolescent Psychology.

Despite wide recognition as a serious public health problem, anaphylaxis and hypersensitivity reactions remain under-recognized and under-diagnosed. This book fills the gaps in our understanding of the identification of triggers, recognition of clinical presentations, understanding of the natural history of these reactions, and selection of treatment strategies including those focused on cellular and molecular targets. The book provides a detailed examination of disease etiology, pathogenesis, and pathophysiology and their correlation to clinical practice. Forefront knowledge of the mediators and mechanisms of anaphylaxis is covered with an emphasis on how new discoveries shape our current and emerging therapies.

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The handbook synthesizes the comprehensive interdisciplinary research on the psychological and behavioral dimensions of life before, during, and immediately after birth. It examines how experiences during the prenatal period are associated with basic physiological and psychological imprints that last a lifetime and explores the ways in which brain networks reflect these experiences. Chapters offer findings on prenatal development, fetal programming, fetal stress, and epigenetics. In addition, chapters discuss psychotherapy for infants - before, during, and after birth - as well as prevention to promote positive health and well-being outcomes. Topics featured in this handbook include: Contemporary environmental stressors and adverse pregnancy outcomes The psychology of newborn intensive care. Art therapy and its use in treating prenatal trauma. The failures and successes of Cathartic Regression Therapy. Prenatal bonding and its positive effects on postnatal health and well-being. The role of family midwives and early prevention. The cultural meaning of prenatal psychology. The Handbook of Prenatal and Perinatal Psychology is an essential resource for researchers, clinicians and related professionals, as well as graduate students in a wide range of interrelated disciplines, including developmental psychology, pediatric and obstetrical medicine, neuroscience, infancy and early child development, obstetrics and gynecology, nursing, social work, and early childhood education.

This book outlines a scientific approach to understanding and treating children and adolescents who display a severe pattern of aggressive antisocial behaviour. Unlike other works which tend to focus exclusively on research data or practical guidelines for treatment approaches, this reference integrates both of these aspects, providing clear guidelines for intervention based on the most current research. Outstanding features include 23 tables and figures, and two chapters detailing a comprehensive approach to treatment tailored to the needs of the individual child or adolescent.

John Money's career constitutes the foundation of pediatric psychoendocrinology. In this book he takes a second look at his publications on many different psychoendocrine syndromes, intersexual or hermaphroditic, with respect to sex, gender, amative orientation, and the "lovemap," (his own designation from an individual's experience of sexuality). His ultimate conclusion is that, from prenatal life onward, demasculization of development is not synonymous with feminization, nor is defeminization synonymous with masculinization. This volume will serve to illuminate the evolution of Dr. Money's work and point the way to future investigations in this field.

This volume provides a comprehensive overview of critical care of the pediatric immunocompromised hematology-oncology patient. The text focuses on unique aspects of the pediatric immunocompromised patient that predisposes the child to significant illness, and presents critical care management strategies specific to the patient population. In addition to chapters on oncology, primary immune deficiency, immunocompromised hematology, and hematopoietic cell transplant patients, the book covers the changing landscape of ICU care, pharmacologic considerations, and psychological and social aspects of the critical care of hematology-oncology patients. Written by experts from a range of disciplines, Critical Care of the Pediatric Immunocompromised Hematology/Oncology Patient: An Evidence-Based Guide is a valuable resource for clinicians and practitioners who treat this patient population.

Perinatal Programming addresses the environment-dependent setting of fundamental life functions and dispositions for diseases in developmental periods during pregnancy and in early infancy. It provides a new view of the origins of health and diseases. To realize these associations may enable us to prevent diseases for the long term.This book reviews actual state-of-the-art knowledge in the perinatal programming field. The authors are internationally known scientists of this research area.

Over the last decade, the number of children diagnosed with bipolar disorder has increased up to fortyfold. This is a trend exclusive to the United States, and one that, alarmingly, leads to most of the diagnosed children--some still in their infancy--being prescribed antipsychotic drugs, often in combination with anticonvulsants. These classes of drugs have dangerous side effects, including a doubling of mortality rates, shortened life span, extreme weight gain, and Type II diabetes. In this book, psychologist Sharna Olfman leads a team of widely known experts who examine the astonishing rise in the diagnosis of pediatric bipolar disorder, particularly in the absence of any compelling evidence for either the validity of the criteria being used to diagnose it or the safety and effectiveness of the drugs being used to treat it. "When a child is unnecessarily prescribed antipsychotic and anticonvulsant drugs, his or her mental and physical health may be irrecoverably compromised," says Olfman. "With as many as two-and-a-half million children from across the socioeconomic spectrum now taking antipsychotics, we have set the stage for widescale child abuse." The contributors to this revealing and disturbing volume include psychiatrist David Healy, one of the world's leading authorities on psychotropic drugs; pediatrician Philip Landrigan, an internationally renowned health researcher; and Robert Whitaker, an award winning medical journalist. The contributors identify and explain complex and interrelated factors that have set the stage for the pediatric bipolar "epidemic," and they recommend practice and policy changes to stem the tide of misdiagnosis and dangerous drug prescriptions.