How many Americans are homeless? Although taking a census may sound simple, ensuring an accurate count is the least of its problems. Census takers in all walks of life exercise great care in determining what information is to be collected, how it is to be recorded, and how the findings are ultimately to be presented. But who decides which evaluation frameworks and indicators are to be used? Do all concerned-census takers and respondents view those indicators in the same manner? Do institutional and social imperatives outweigh individual bias and perspective? And if so, is that really what we want? Informed Consent analyzes the interplay between ideology and information. Through extensive research on how information about the homeless is generated and interpreted, Lisa Schiff offers both hard evidence and a convincing argument for questioning "how service providers create forms and clients complete them, how advocates administer surveys and public agencies compile counts." At the same time, she explores the day-to-day implications of her findings by demonstrating how competing understandings affect prevailing ideologies, which in turn affect our attempts at social change.
Fetal heart rate monitoring affects the lives of millions of women and infants every year in the United States alone. Used by all members of the obstetric team - nurses, students, midwives, and physicians – it is the primary method to assess fetal oxygenation in both the antepartum and intrapartum setting. Improving outcomes and promoting patient safety depends upon correct use and interpretation of fetal heart rate monitoring, and is crucial to daily obstetric practice. This fourth edition provides the obstetrical team a framework within which to interpret and understand fetal heart rate tracings and their implications. The text covers key issues as the physiological basis for monitoring, a discussion of fetal hypoxemia and neonatal encephalopathy, instrumentation and pattern recognition. In addition to an in-depth review of the standardized NICHD nomenclature and three-tiered FHR Category approach, there are chapters on intrapartum and antepartum management as well as fetal central nervous system effects on monitor patterns. Since fetal monitoring is primarily a screening tool there are also discussions on the use of backup methods for evaluation of abnormal patterns. This 4th edition also brings the addition of Lisa A. Miller CNM, JD, who provides a nursing and midwifery perspective as well an enhanced legal and risk management review. This new fourth edition includes: Review of neonatal encephalopathy and recent studies on CP Currentinformation and discussion of most recent NICHD panel recommendations, both antepartum and intrapartum New chapter on Pitfalls in EFM Detailed chapter on risk management, liability & documentation New section on fetal maternal hemorrhage Update on new instrumentation Crucial information on maternal/fetal coincidence and FDA warnings All chapters include updated practice tips and clinical implications for the entire obstetric team Plus, with this edition clinicians have access to a companion website with full text and an image bank for fast & simplified clinical review.
Patients with cancer can suffer from a bewildering variety of neurologic signs and symptoms. The neurologic symptoms are often more disabling than the primary cancer. Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or one of several nonmetastatic complications of cancer. The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal. This monograph, an update of the first edition published in 1995, is divided into 3 sections. The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive care of common neurologic symptoms such as seizures, pain, and side effects of commonly used supportive care agents. The second section is devoted to nervous system metastases, addressing in turn, brain, spinal cord, meningeal and cranial and peripheral nerve metastases, describing clinical symptoms, approach to diagnosis and current treatment. The third section addresses several nonmetastatic complications of cancer and includes sections on vascular disease, infections, metabolic and nutritional disorders, side chemotherapy, radiation and other diagnostic and therapeutic procedures. The final chapter addresses paraneoplastic syndromes.The book is intended for practicing oncologists, neurologists, neurosurgeons and radiation oncologists as well as internists who treated patients with cancer. Our attempt was to write a book that would assist oncologists in understanding neurologic problems and neurologists in understanding oncologic problems. The book is also intended for physicians training to specialize in any of the above areas. It includes a practical approach to the diagnosis and management of patients with neurologic disease who are with known to have cancer or in whom cancer is suspected.
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