Despite advances in medical technology and patient safety initiatives, maternal morbidity and mortality rates continue to increase. Maternal mortality trends in the US as reported from the CDC from 1989-2009 demonstrate increasing mortality trends from 7.2 deaths per 100,000 live births in 1987 to 17.8 deaths per 100,000 live births in 2009. To combat this problem, a thorough understanding of the critical medical and surgical issues that are often encountered in pregnancy is essential. Each article addresses a topic relevant to care of the critically ill gravida.

This title offers a fascinating 'inside-out' view of how the horse uses its body, that is presented in a graphic, easy-to-follow way to aid you in improving all aspects of riding and training. Discover the true effect of riding and training on each part of the horse by seeing the skeleton and major muscles painted on the outside. It includes practical exercises that demonstrate how to improve movement, build the right muscles and increase suppleness in the horse. It includes step-by-step guidance on the correct way to warm-up your horse and stretching routines to help guard against injury. Unlike other books on biomechanics and anatomy "How Your Horse Moves" is truly applied.

Now in a fully revised and updated third edition, Working with Voice Disorders offers practical insight and direction into all aspects of voice disorders, from assessment and diagnosis to intervention and case management. Using evidence-based material, it provides clinicians with pragmatic, accessible support, facilitating and informing decision-making along the clinical journey, from referral to discharge. Key features of this resource include: A wealth of new, up-to-date practical and theoretical information, covering topics such as the prevention, assessment, intervention and treatment of a wide spectrum of voice disorders. A multi-dimensional structure, allowing the clinician to consider both specific aspects of patient management and aspects such as clinical effectiveness, clinical efficiencies and service management. Photocopiable clinical resources, from an at-a-glance summary of voice disorders to treatment and assessment protocols, and practical exercises and advice sheets for patients. Sample programmes for voice information groups and teacher workshops. Checklists for patients on topics such as the environmental and acoustic challenges of the workplace. Self-assessed personalised voice review sheets and weekly voice diaries encourage patients to monitor their voice quality and utilise strategies to prevent vocal misuse. Combining the successful format of mixing theory and practice, this edition offers a patient-centred approach to voice disorders in a fully accessible and easy-to-read format and addresses the challenges of service provision in a changing world. This is an essential resource for speech and language therapists of varying levels of experience, from student to specialist.

Examine the anatomy of a horse from an entirely different perspective. This intriguing and original explanation of the 11 internal body systems of horses shows them painted on the outside to describe everything on the inside. The horse is a highly sophisticated living organism so to enable him to reach his full athletic performance and give him a happy, healthy quality of life it is vital to understand both his capabilities and limitations within the context of his structure and function. Gillian Higgins turns her trademark technique of painting internal diagrams directly onto live horses to show how all the systems work, and work together, to influence performance and reduce the risk of injury. Divided into 12 chapters, Horse Anatomy for Performance combines high quality photographs and intricate paintings with top tips and fascinating facts to provide a practical and useful guide to horse anatomy. Visually appealing, original and easily understandable, the book explains how anatomy influences the way we manage, ride and train our horses. This book is a sequel to How Your Horse Moves by Gillian Higgins; together the books provide a comprehensive guide to horse anatomy in action. 'Finally a book where you can learn how your horse ticks - inside out - and it is easy to understand and fun to read. A must for every serious equestrian.' Dr W. Bechtolsheimer

The "VIP" is a user-friendly, point-in-time assessment tool which provides an 'at a glance' vocal profile for the clinician, voice coach and client. It examines the potential impact of a number of specific factors on the voice: general health; vocal history; vocal health; voice care; vocal status; voice genogram; anxiety and stress; social functioning; vocal demand; and environmental factors, and offers an overview of the theory to support this choice. The questions have been carefully designed to elicit easily-recorded information from the client about a range of factors that are known to affect vocal quality. The tick-box answers then translate into the Vocal Impact Profile, a visual presentation of the areas of greatest impact on voice. In addition to offering a point-in-time profile, the "VIP" may also be used as a template for achieving change in a specific area of vulnerability and provide a robust visual reinforcement of that change over time. It is, therefore, helpful as a therapy-monitoring tool and as an evaluation of client awareness, behavioural change and clinical effectiveness. Self-administered by the client, the questionnaire should take approximately ten to fifteen minutes to complete. The clinician or voice coach enters the responses into the computer programme (supplied on downloadable resources) or transfers them manually on to the hard copy thus offering a clear visual representation of the results. Worked examples of the VIP are included, presenting six clients with very different aetiologies and with a range of vocal problems. These examples clearly demonstrate the value of the Profile and its visual impact. As a clinical tool the "VIP" provides a subjective qualitative measure, which may be used as an adjunct to other assessment procedures. In addition, it provides a concrete method of determining and ordering the factors to be targeted in terms of therapy or voice work. Using the "VIP" should shorten the time necessary for completion of case history in the case of a voice therapy client, and, when used by a voice coach, the profile will identify areas for further discussion. The Profile is not time-sensitive so it may be repeated to evaluate client awareness of vocal change and implementation of agreed strategies. The "VIP" provides the clinician or voice coach with an efficient and effective means of auditing the therapy or coaching process and promotes a holistic partnership model of intervention.

Now in a fully revised and updated third edition, Working with Voice Disorders offers practical insight and direction into all aspects of voice disorders, from assessment and diagnosis to intervention and case management. Using evidence-based material, it provides clinicians with pragmatic, accessible support, facilitating and informing decision-making along the clinical journey, from referral to discharge. Key features of this resource include: A wealth of new, up-to-date practical and theoretical information, covering topics such as the prevention, assessment, intervention and treatment of a wide spectrum of voice disorders. A multi-dimensional structure, allowing the clinician to consider both specific aspects of patient management and aspects such as clinical effectiveness, clinical efficiencies and service management. Photocopiable clinical resources, from an at-a-glance summary of voice disorders to treatment and assessment protocols, and practical exercises and advice sheets for patients. Sample programmes for voice information groups and teacher workshops. Checklists for patients on topics such as the environmental and acoustic challenges of the workplace. Self-assessed personalised voice review sheets and weekly voice diaries encourage patients to monitor their voice quality and utilise strategies to prevent vocal misuse. Combining the successful format of mixing theory and practice, this edition offers a patient-centred approach to voice disorders in a fully accessible and easy-to-read format and addresses the challenges of service provision in a changing world. This is an essential resource for speech and language therapists of varying levels of experience, from student to specialist.

From the author of the hugely successful titles How Your Horse Moves and Horse Anatomy for Performance, comes a completely different training manual, also based on the Horses Inside Out philosophy: 'Understanding Anatomy Improves Performance and Reduces the Risk of Injury'. Divided into three main parts: Principles of Anatomical Riding and Training; Exercises for Horse and Rider; Troubleshooting, the book contains a wealth of practical tips and exercises broken down into easy to follow, well-illustrated steps showing how riders can improve their riding skills and potential. The author suggests ways to improve horses' physique, posture, flexibility, stability, core strength, performance and movement and how to reduce muscular and movement problems, and reduce the risk of injury. This beautifully illustrated book looks at how to deliver a safe, varied, fun, effective and achievable training programme. It provides all the ingredients for riders to make informed decisions to maximise their own and their horse's potential, gain more enjoyment, satisfaction and improve their skills.

Triple bill of exercise programmes presented by personal trainer Stephanie Martin. Each workout guides the user through various exercises so they can then personalise their routine to meet their individual requirements. Titles comprise: 'Step - Level 1', 'Stretching' and 'Abs and Buttocks'.

Exercise programme presented by personal trainer Stephanie Martin. The workout focuses on relaxtion and flexibility using stretching exercises.

Narrating Midlife: Crisis, Transition, and Transformation is rooted in a discussion about why it is important to address the midlife years in ways that challenge and interrogate the myths that surround this phase of life. Although readers are free to construct their own meaning after reading each narrative, they are encouraged to attend to the ways in which each narrative reveals how the author grapples with their particular issues communicatively. More important, readers are invited to see the power of narrative re-framing as authors seek to understand, interpret and "live" midlife change(s) in ways that are empowering and life affirming. In this book, contributors spin compelling and meaningful narratives about change at midlife. The empty nest, the surprise discovery of cancer, re-defining one's life at midlife and re-imagining long term commitment after divorce are just some of the topics explored in this book. Auto-ethnographically crafted, the narratives presented throughout the book aim to show how managing and living through change at midlife is very much a communicative endeavor.

Exercise programme presented by personal trainer Stephanie Martin. The workout focuses on endurance and cardio-training using step-based exercises.