The electrical discharge of neurons associated with seizure activity stimulates a marked rise in cerebral metabolic activity. Estimates from animal experiments indicate that energy utilization during seizures increases by more than 200", while tissue adenosine triphosphate (ATP) levels remain at more than 95" of control, even during prolonged status epilepticus. The brain generally withstands the metabolic challenge of seizures quite well because enhanced cerebral blood flow delivers additional oxygen and glucose. Mild to moderate degrees of hypoxemia that commonly accompany seizures are usually harmless. However, severe seizures and status epilepticus can sometimes produce an imbalance between metabolic demands and cerebral perfusion, especially if severe hypotension or hypoglycemia is present. A marked increase in glutamate release, which occurs during a prolonged seizure, is likely to result in the activation of all types of glutamate receptors. Although kainic acid produces seizures in the immature brain, it produces little cytotoxicity.

This chapter demonstrates how social work ethics apply to ethical and legal decision making in forensic social work practice. It discusses the context of social work practice in legal systems. The chapter also details the basic structures of the United States (U.S.) civil and criminal legal systems. It lays the foundation for the criminal and civil court processes in the United States and introduces basic terminology and a description of associated activities and progression through these systems. The chapter focuses on providing an introductory, and overarching, picture of both civil and criminal law in the U.S. and introduces the roles social workers play in these systems. It focuses on the ETHICA model of ethical decision making as a resource and tool that can be used to help forensic social workers process difficult and complex situations across multiple systems.

This chapter explains the theoretical basis for motivational interviewing (MI). It reviews the empirical evidence for the use of MI with diverse populations in forensic settings. MI involves attention to the language of change, and is designed to strengthen personal motivation and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. It is now internationally recognized as an evidence-based practice intervention for alcohol and drug problems. MI involves an underlying spirit made up of partnership, acceptance, compassion, and evocation. The chapter discusses four key processes involved in MI: engaging, focusing, evoking, and planning. It also describes five key communication microskills used throughout MI: asking open-ended questions, providing affirmations, offering summarizing statements, providing information and advice with permission, and reflective statements.

Recent advancements in molecular genetics have expanded our understanding of the etiology of many neurological diseases and neurodevelopmental abnormalities. Having a comprehensive understanding of genetics is essential in treating patients with metabolic epilepsies. Genetic counseling has been defined as a process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. Some of the components of a genetic counseling interaction include interpretation of family and medical histories to assess the chance of disease occurrence or recurrence; education about inheritance, testing, management, prevention, resources, and research; and counseling to promote informed choices and adaptation to the risk or condition. The genetic counselor may also educate patients and their families about the underlying genetics of their epilepsy and the relevance of a genetic cause of epilepsy for family members, including recurrence risk, reproductive options and the possible teratogenic effect of antiepileptic drugs.

This chapter presents a brief review of the enzymes, transporters, and cofactor producers of the urea cycle. Seizures have long been associated with urea cycle disorders (UCDs), thought to be caused by high levels of ammonia. Furthermore, the brain damage obtained during metabolic crisis has been thought to damage critical structures, leading to epilepsy after the conclusion of the crisis. The first and most critical step of successful treatment of UCDs is recognition. Neurologic monitoring is an essential part of the emergency management of UCDs. The neurological abnormalities observed in patients with urea cycle defects are vast. Controlling ammonia levels by dialysis and complementary medication are needed. EEG monitoring should be initiated early, as this may be very useful for clinical management and indication of untreated metabolic crises. Furthermore, aggressive treatment of clinical and subclinical seizure activity may be helpful in optimizing outcomes for these patients.

This chapter explores recent insights from preclinical and clinical studies of cancer induced bone pain (CIBP). There are various neuropathic, nociceptive, and inflammatory pain mechanisms that contribute to CIBP. Neuropathic pain can be induced as tumor cell growth injures distal nerve fibers that innervate bone and pathological sprouting of both sensory and sympathetic nerve fibers. These changes in the peripheral sensory neurons result in the generation and maintenance of tumor induced pain. CIBP is usually described as dull in character, constant in presentation, and gradually increasing in intensity with time. A component of bone cancer pain appears to be neuropathic in origin as tumor cells induce injury or remodeling of the primary afferent nerve fibers that normally innervate the tumor bearing bone. The treatment of pain from bone metastases involves the use of multiple complementary approaches including radiotherapy, chemotherapy, surgery, bisphosphonates, and analgesics.

Cancer can affect the autonomic nervous system in a variety of ways: direct tumor compression or infiltration, treatment effects (irradiation, chemotherapy), indirect effects (e.g., malabsorption, malnutrition, organ failure, and metabolic abnormalities), and paraneoplastic/autoimmune effects. This chapter focuses on a diagnostic approach and treatment of cancer patients with dysautonomia, with an emphasis on immune-mediated autonomic dysfunction, a rare but potentially highly treatable cause of dysautonomia. Autonomic dysfunction can be divided into nonneurogenic (medical) and neurogenic (primary or secondary) causes. Orthostatic hypotension is a cardinal symptom of dysautonomia. The autonomic testing battery includes sudomotor, vasomotor, and cardiovagal function testing and defines the severity and extent of dysautonomia. Conditions encountered in the cancer setting that are associated with autonomic dysfunction include Lambert-Eaton Myasthenic Syndrome, anti-Hu antibody syndrome, collapsin response-mediator protein 5, subacute autonomic neuropathy, neuromyotonia (Isaacs’ syndrome), and intestinal pseudo-obstruction. The chapter describes various pharmacologic and nonpharmacologic therapies for treatment of orthostatic hypotension.

Despite treatment advances in the world of oncology, problems with sexuality, intimacy, and fertility persist for many women and men treated for cancer. Life expectancy of cancer patients, both young and old, has significantly increased due to advances in treatments of malignant diseases. Consequently, medical attention has expanded its focus to improving the quality of life of patients who have undergone cancer treatment. Sexual function and feeling healthy enough to be a parent represent two of the strongest predictors of emotional well-being in cancer survivors, and parenthood can represent a return to normalcy, contributing happiness and life-fulfillment. Often, cancer survivors fear that their disease or treatment history may adversely affect offspring conceived posttreatment, contributing risk for congenital anomalies, impaired growth and development, or even for malignancy. This chapter provides physical psychosocial spiritual dimensions of the fertility issues or symptom followed by its nonpharmacological and pharmacological treatment.

In human cancer, the role of genetic mutations, epigenetic alterations, and cellular repair mechanisms are becoming increasingly apparent. Recent studies have elucidated significant variations of the genetic codes that underpin cancer development in a variety of cancer subtypes. Genetic variations provide a backbone upon which cancer cells can adapt to overcome both intrinsic and extrinsic mechanisms designed to limit the growth of abnormal cells. This chapter provides an overview of the types of mutations, various epigenetic modifications, DNA repair mechanisms, and their relationship to the development of cancer, as well as various techniques utilized for the detection of these genetic alterations in cancer. With the development of new, advanced, and sensitive molecular techniques like next-generation sequencing and digital droplet polymerase chain reaction, our understanding of cancer biology is rapidly developing, and a critical appreciation and knowledge of these cancer-associated changes will likely lead to continued development of more effective therapies.

The vast majority of cervical cancer cases are human papillomavirus -mediated. Incidence and mortality significantly declined with introduction of screening with Pap smears. Adenocarcinoma often presents with larger tumors (“barrel cervix”) with higher risk of local failure. Cervical cancers are often asymptomatic and detected on screening, or can present with abnormal vaginal discharge, post-coital bleeding, dyspareunia, or pelvic pain. Three Food and Drug Administration approved vaccines are available that prevent the development of cervical cancer. Imaging includes positron emission tomography/computed tomography (nodal staging), pelvic magnetic resonance imaging (to delineate local disease extent and guide decisions on fertility vs. non-fertility sparing approaches). Treatment at early stages is often surgical, while Radiation therapy (RT)+/− Chemotherapy (CHT) is employed in later stages. When treating definitively, External beam radiation therapy is followed by an intracavitary or interstitial brachytherapy boost. Post-operative RT +/− CHT is occasionally indicated for adverse pathologic features.

World Health Organization grade III gliomas are referred to as anaplastic gliomas. The general treatment paradigm includes maximal safe surgical resection followed by adjuvant radiation therapy and chemotherapy (CHT). The randomized trials that established a survival benefit from chemotherapy used Procarbazine, Lomustine, and Vincristine (PCV). Concurrent and adjuvant temozolomide (TMZ) is given more often and is still subject to ongoing study. An improved understanding of genomics is rapidly informing the clinical behavior and treatment. Histologic subtypes of anaplastic gliomas include anaplastic astrocytoma and anaplastic oligodendroglioma (AO). Headache and seizures are the most common symptoms of anaplastic gliomas. Adjuvant radiation improves overall survival after surgery compared to observation or CHT alone and is indicated for all high-grade gliomas. Despite the survival advantage demonstrated with PCV in patients with AOs and AOs, many substitute TMZ as it is easier to administer and generally better tolerated.

This chapter discusses treatment planning for gastrointestinal radiotherapy. It describes patient setup, immobilization, and planning technique for esophageal cancer external beam radiation therapy (EBRT). The chapter provides patient setup and immobilization, motion management techniques, target delineation, and planning technique for pancreas fractionated EBRT. It explains patient setup and immobilization, motion management techniques, and planning technique for pancreas stereotactic body radiation therapy (SBRT). The chapter presents patient setup and immobilization, motion management techniques and planning technique for rectal cancer EBRT. It describes patient setup and immobilization, and planning technique for anal cancer EBRT. Finally the chapter explores patient setup and immobilization, motion management techniques and planning technique for liver SBRT.

This chapter identifies how psychological frameworks can be integrated into a cohesive, multigenerational intervention to connect children with their incarcerated parents. It describes scenarios through which televisiting develops resiliency in children. The chapter delineates how geographic, financial, temporal, and intergenerational barriers can be reduced or removed via televisiting. It describes supportive televisiting services as an innovative, psychologist-directed, multidisciplinary program that connects children and teenagers with their incarcerated parents via secure, live, interactive video teleconferencing. The chapter also discusses the seven main pillars that make up the theoretical foundation of the televisiting program: child-focused; the attachment theory; trauma-informed care; resilience and strengths-based perspective; mental health challenges; the developmental, life-span, and intergenerational approach; and yellow flag not red flag policy.

This chapter introduces the theoretical basis for restorative justice (RJ). It assesses the empirical evidence for RJ programs, and explores the challenges and opportunities associated with applying core competencies. The chapter describes competencies of specific interest which include: engaging diversity and difference in practice, and engaging with individuals, families, groups, organizations, and communities. It also discusses skills essential to the success of RJ which include supporting processes that value the experiences of people associated with a crime or harm. The chapter suggests the importance of practical and context-specific knowledge and skills relevant when individuals, families, groups, organizations, and communities find themselves in conflict and require support. Programs that rely upon restorative principles have been used at a variety of points in the criminal justice process. The chapter discusses a practice, a family group conference, which was first developed in New Zealand involving social workers considerably.

This chapter discusses strategies for radiation therapy treatment planning for thoracic cancer. It provides a brief description of immobilization on 3D and modulated radiation therapy (intensity modulated radiation therapy [IMRT], volumetric modulated arc therapy [VMAT]), and stereotactic body radiation therapy (SBRT). It describes the image acquisition for 3D and modulated radiation therapy (IMRT or VMAT) and SBRT. The chapter discusses the localization for 3D and modulated radiation therapy (IMRT or VMAT) and SBRT. It presents the beam energy requirements for 3D plans, IMRT and VMAT, and SBRT. The chapter also provides treatment planning volumes for beam energy. Finally it describes treatment planning for 3D, IMRT and VMAT, and SBRT.

Intracranial imaging is vital to the initial evaluation, staging and treatment planning, and posttreatment follow-up of brain tumor patients. The modalities used to evaluate the brain are CT and MRI. A familiarity with basic radiologic concepts can enable a provider to better translate the intracranial process to clinical care. This chapter is intended to give the clinician a baseline for interpreting images independently in either the acute or chronic setting. Imaging of the brain using CT and MRI techniques is essential to the evaluation of patients with intracranial malignancy, both in the acute and chronic setting. Knowledge of basic imaging principles related to the presence of an intracranial mass and familiarity with findings unique to certain malignancies are useful tools for the clinician. These skills can be built over time by reviewing patient images independently, utilizing the kinds of fundamentals discussed in this chapter.

Interventional pain procedures are an adjunct to pharmacologic therapy for cancer pain. While pain at the location of the tumor might be the primary cause of pain, cancer patients may also have non-cancer related pain as a result of altered anatomy or biomechanics, for example, myofascial pain. Myofascial pain is pain or autonomic phenomena referred from active trigger points in the muscles, fascia, and tendons. This chapter discusses about the therapies for muscular pain which includes the trigger point, botulinum toxin, acupuncture, therapies for peripheral nerve mediated pain, local blockade, ultrasound guided procedures, sympathetic blocks, complex regional pain syndrome, spinal procedures, epidural steroid injections, neuromodulation, vertebral procedures and facet arthropathy. Kyphoplasty and vertebroplasty not only have been studied most extensively in stabilizing compression fractures from osteoporosis, but have also been used to treat fractures resulting from osteolytic metastasis, myeloma, vertebral osteonecrosis, and hemangioma.

This chapter discusses the concepts, underlying principles, benefits, and challenges of using “whole-family” approaches in social work. It articulates the theory and skills associated with family engagement as part of a human rights and social justice framework for social work practice in forensic settings. The chapter describes the ethical imperatives and evidence base supporting the use of family group decision making (FGDM) in regulatory settings. It engages whole families as partners in the use of FGDM in child protection and youth justice. The chapter also describes the theory, empirical support, and skills in use of FGDM, or family group conferencing (FGC). It concluded with an example of how alert forensic social workers must be to the potential for their best intentions to collide with the tenants of responsive practice and a quote from a child protection social worker who worked closely with the author on a pilot project using FGC.

This chapter presents ways in which forensic social workers respond flexibly, collaboratively, and effectively to situations of domestic violence. It describes ways to engage men who abuse in becoming better fathers and partners. The chapter examines how social workers can foster culturally respectful partnerships with and around families that safeguard all family members. Few services are available for men who abuse to learn how to become responsible parents, and evaluations of these programs are even more limited. Two exceptions are a Canadian program called Caring Dads and a North Carolina program called Strong Fathers. These responsible fatherhood programs seek to raise the men’s awareness of the deleterious impact of children’s exposure to domestic violence and to enhance the men’s skills in communicating and parenting.

This chapter emphasizes the importance of improving health literacy. It describes the incorporation of cultural competence standards in forensic social work practice perspectives. The chapter also explains how to promote engagement of informal support networks in promoting health and well-being among diverse groups. Disadvantaged racial and ethnic minorities in the United States have long been overrepresented in the criminal justice systems. The elimination of health care disparities and ensuring the health care delivery system is responsive to minority groups is a social justice issue. The roles and function of forensic social workers that provide services to persons with these cultural norms can be expanded using a broader ecological framework and the applied social care model to develop intervention strategies and care plans with incarceration persons. Identifying and incorporating culturally appropriate practice approaches are challenging, yet necessary undertakings for forensic social workers.

This chapter provides a brief description on principles of breast reconstruction in cancer. Breast cancer will impact one in eight women over the course of their lifetime. While breast conserving therapy is a mainstay of surgical treatment with outcomes equivalent to mastectomy in many cases, some women require or elect to have mastectomy to treat their cancer or high-risk state. Breast reconstruction is an essential aspect of the overall postmastectomy treatment, with important psychosocial impacts on patient well-being, as the reconstruction is an attempt to improve their outward appearance, their sense of femininity, and ultimately, their self-esteem. Postmastectomy reconstruction can be categorized into three modalities: implant-based reconstruction, autologous tissue-based reconstruction utilizing the patient’s own tissue, or a combination of implant and autologous-based reconstruction. Immediate postmastectomy reconstruction is currently considered the standard of care in breast reconstruction. Breast reconstruction has a positive impact on postmastectomy physical and mental quality of life.

The chapter discusses strategies for radiation therapy treatment planning for lymphoma. It explains clinical application, patient setup and immobilization. Treatment planning describes dose specification, extended field radiation therapy, involved/regional field radiation therapy, and involved site radiation therapy. Radiation therapy is used as monotherapy, or as an adjunct to chemotherapy to treat Hodgkin’s and Non-Hodgkin’s lymphoma. The chapter provides clinical application, patient setup, and treatment planning with dose specification, and treatment techniques for total skin electron irradiation. The clinical application for total skin electron irradiation is definitive treatment of cutaneous T-cell lymphoma, also called mycosis fungoides. The chapter also presents clinical application, patient setup, and treatment planning for total body irradiation. Total body irradiation is used on its own, or as an adjunct to chemotherapy as part of a myeloablative regimen, to condition the host prior to receiving a hematopoietic transplantation.

Treatment planning consists of clinical treatment planning and technical treatment planning. Clinical treatment planning refers to the treatment intent, treatment modality, and treatment dose scheme. Technical treatment planning refers to the details of patient positioning, placement of radiation beams, and the aperture shapes of radiation beams designed to achieve highly conformal radiation dose distributions to the treatment target volumes while protecting the critical organs. Treatment plan quality depends on the radiation beam orientation in combination with the treatment couch angles; the number of beams; radiation beam energies; and beam shapes or number of sub shapes. The chapter provides a brief description on: source-to-skin (patient) distance versus source-to-axis (isocenter) distance treatment planning; treatment target volumes and planning margins; treatment plan types; prescription and normalization methods; open field, wedged field, and field-in-field; forward planning versus inverse planning; boost: sequential versus integrated; intensity modulated radiation therapy and volumetric modulated arc therapy delivery methods.

Involvement of neural plexus structures in a patient with cancer may result from direct invasion by tumors originating within nerve tissue, local metastatic extension or distant spread from diseased organs, or compression by adjacent tumor masses. The function of the neural components may also be severely affected by sequelae or complications of surgical intervention or radiation therapy. Clinical history may suggest a possible etiology; however, physical examination may be of limited value in evaluation of plexopathy depending on the structure affected. Conventional radiologic methods are usually nonrevealing, although they may be helpful in advanced disease. As new techniques are introduced, improved resolution and ability to analyze chemical composition of tissues advanced MRI to the method of choice in diagnosis and assessment of treatment response in patients with plexopathy. This chapter discusses the role of conventional and new modalities in evaluation of plexus disease, including indications, current techniques, advantages, and pitfalls.

Endocrine late effects are among the common late effects seen in cancer survivors, and can be quite complex for the patients, their caregivers, and the medical providers to delineate. This chapter educates the importance of basic concepts and facts that can help in caring for survivors at risk for endocrinopathies. It discusses risk factors, evaluation and management of growth hormone deficiency, thyroid disorders, gonadal dysfunction, adrenal gland disorders, disorders of glucose homeostasis, fluid and sodium homeostasis disorders, calcium homeostasis and bone health disorders, bone density in cancer patients, and endocrine complications resulting from abnormal body mass index (BMI). It is important to evaluate and optimize bone mineral density (BMD) in cancer survivors. Long-standing underweight or overweight/obesity may negatively impact morbidity and quality of life in cancer survivors; monitoring/intervention according to guidelines is thus advised.

Substance abuse is a significant problem among persons who are homeless. This chapter explores the application of addiction recovery management (ARM) principles for developing practice skills in the recovery process among vulnerable populations. It examines demographic and social action factors that may impede or foster successful completion of this long-term recovery for persons who are experiencing home insecurity. The chapter offers insight for forensic social workers about how to engage diversity and differences in practice, as well as advance human rights and social, economic, and environmental justice. Analytic concepts in forensic social work can enhance the capacity of educators to prepare practitioners to be effective in closing the gap that exists for racial disparities in treatment approaches and programs. Critical race theory can be used to develop guiding principles for competency-based education and outcomes that address the gaps in existing systems of care.

This chapter promotes a better understanding of women’s experience of abuse. It articulates strategies used in victim advocacy, and addresses the experiences and needs of female victims of intimate partner violence. The chapter examines common practices used and issues faced by victim advocates–who are often trained social workers–who work with women who have been victimized by a male intimate partner. It also highlights firsthand experiences of a victim advocate for female victims of intimate partner violence. Many women continue to be victims of intimate partner violence, and the work of victim advocates who serve these women is challenging. Advocates must be able to assess the needs of victims, refer them to appropriate services, protect their rights, empower them, and help them navigate the criminal and civil justice systems. These responsibilities require advocates to possess various personal and professional skills and to collaborate with many different professionals.

Gastrointestinal (GI) complications of cancer are significant and can be challenging to manage. Dysphagia, nausea, vomiting, diarrhea, constipation, fecal impaction, bowel obstruction, and infections are just a few of the adverse effects experienced by the cancer patient. This chapter discusses the current strategies for diagnosis and treatment. The treatment of cancer with chemotherapy agents, immunotherapy, and radiotherapy has dramatically improved the prognosis and survival of many patients diagnosed with cancer. However, these interventions may cause significant GI side effects that can limit tolerability of treatment. The prevention and treatment strategies often utilize a combined pharmacological approach and target the receptors located in the chemoreceptor trigger zone and periphery. Cancer rehabilitation includes vigilant monitoring for GI complications of cancer. GI complications resulting from cancer treatment are variable in presentation and often multifactorial. Proper diagnosis of treatment related symptoms and more serious sequelae are imperative.

This chapter describes how forensic social workers can develop their expert witness testimony skills. It explains how to advocate on behalf of vulnerable racial and ethnic populations generally underrepresented in American legal system, to increase advocacy from a human rights perspective. The chapter explores how to use expert testimony to highlight a range of social justice issues including human trafficking, death, and persecution. It introduces forensic social workers to integrating narrative methods with evidence-based trends that can best support any legal claim for hardship. Expert witness testimony comprises core mitigation components: client interviews; collateral interviewing; obtaining institutional records; identifying core themes of hardship that have directly impacted the individual or family; identifying intergenerational patterns of illness and/or systemic traumas that impact family; identifying environmental and country conditions; writing a report; and preparing for direct testimony and cross-examination.

Neurologic paraneoplastic disorders are nonmetastatic syndromes that are not attributable to toxicity of cancer therapy, cerebrovascular disease, coagulopathy, infection, or toxic/metabolic causes. Paraneoplastic disorders can affect any part of the central or peripheral nervous systems. Several syndromes should always raise the possibility of a paraneoplastic etiology, including limbic encephalopathy, subacute cerebellar degeneration, opsoclonus–myoclonus, severe sensory neuronopathy, Lambert–Eaton myasthenic syndrome, and dermatomyositis. Most types of tumor can be associated with paraneoplastic disorders, but the most common and best known are thymoma with myasthenia gravis and small cell lung carcinoma with Lambert–Eaton myasthenic syndrome. Paraneoplastic encephalomyelitis is characterized clinically and pathologically by patchy, multifocal involvement of any or all areas of the cerebral hemispheres, limbic system, cerebellum, brainstem, spinal cord, dorsal root ganglia, and autonomic ganglia. The most common clinical manifestation of paraneoplastic encephalomyelitis is subacute sensory neuronopathy reflecting involvement of the dorsal root ganglia.

This chapter aims to disseminate theoretical and practical knowledge of practice using an empowerment and feminist perspective specifically when working with marginalized and oppressed forensic populations and in forensic settings. Forensic social work focuses on both victims and offenders, and strives to integrate the skills and knowledge of empowerment and feminist theory and practice with principles of social justice and human rights. The chapter discusses empowerment and feminist theories and their relevance to practice with forensic populations. It highlights a case example of group work with women, who were sexually abused, that was first presented in the 1990s and told from a strengths-based approach, but could very much be considered both a feminist and empowerment process of working. The chapter also highlights applying an empowerment approach to working with female and male prisoners in London.

This chapter describes the life course pathways of cumulative health and justice disparities experienced by historical and emerging diverse groups, which is often found among forensic populations. It helps readers articulate a life course systems power analysis strategy for use with forensic populations and in forensic settings. The chapter demonstrates how a data-driven and evidence-based assessment and intervention plan can be used to address clinical and legal issues using case examples of an aging prison population. It uses older people in prison to illustrate the complex life course of health and social structural barriers and needs of incarcerated people who have histories of victimization and criminal convictions. Information about trauma and justice, especially related to the trauma of incarceration, which in itself is often a form of abuse, especially when frail elders are involved and they are at increased risk for victimization, medical neglect, and “resource” exploitation is presented.

This chapter discusses dermatological toxicities of anticancer therapies and mainly focuses on two adverse events: hand–foot syndrome (HFS) and paronychia. HFS is a well-documented reversible adverse effect of many chemotherapeutic therapies, causing a wide variety of cutaneous symptoms ranging from erythema, dysesthesia, pain, and desquamation of the palms and soles to impairing daily activities of living. The standard approach used in the management of HFS is treatment interruption or dose modification, with symptom improvement reported within 1 to 2 weeks. Paronychia is the inflammation of the nail folds, jeopardizing the nail fold barrier and potentially exposing the nail matrix to damage. Paronychia is also an adverse effect of chemotherapeutic agents. The known causes of acute paronychia prior to the introduction of epidermal growth factor receptor (EGFR) inhibitors included staphylococci, streptococci, and pseudomonas, whereas, Candida albicans was frequently associated with chronic paronychia, with diabetes mellitus being a predisposing factor.

This chapter provides a brief description on evaluation and treatment of lung and bronchus cancer. An estimated 234,030 cases of lung cancer will occur in 2018, accompanied by an estimated 155,870 deaths from the disease. Lung cancer is the second most common cancer in men and women but is the leading cause of cancer mortality in both. This chapter discusses epidemiology, pathology, screening, diagnosis, and prevention of lung cancer. Paraneoplastic syndromes are a combination of symptoms produced by substances formed by the tumor or produced by the body in response to the tumor. Lung carcinoma is a pathologically heterogeneous tumor. The most important distinction is between small cell carcinoma and non-small cell carcinoma. Treatment for early-stage disease usually involves one or more modalities of treatment, which include surgery, chemotherapy, and radiation therapy. Patients with advanced disease are treated with chemotherapy, immunotherapy, or targeted therapy.

This chapter defines restorative justice and discusses the various forms that this approach to wrongdoing and offending may take. It reveals the relevance of restorative interventions to social work practice. The chapter recognizes pioneers in the field of restorative justice with special emphasis on social work theorists. It describes the various forms of restorative justice from micro level victim-offender conferencing to community-level healing circles to macro level reparative justice. The chapter argues for greater social work involvement in shaping policies that include restorative justice options in situations of wrongdoing and social work involvement in facilitating victim–offender and anti bullying conferencing. The chapter also describes aspects of restorative justice that address competencies related to advocacy for human rights and issues of spirituality.

This chapter illustrates how factors outside of families affect lives of people within families. It examines the potential impact that two major issues—work-family conflict and mass incarceration—can have on the lives of family members. The chapter describes ways in which laws governing systems external to families, particularly work and criminal justice, can disrupt families in ways that may lead them to use social workers. It aims at providing necessary understanding of how social workers can help support such families, keeping in mind that family needs often develop from the social and economic context in which each family is situated. The chapter discusses the relevant ethical, legal, and policy issues facing work-family conflict and mass incarceration. It encourages social workers to look beyond the individual—to the systems in which individuals are situated, to better understand the behaviors, decisions, and mental health of individual clients.

This chapter addresses nonpharmacologic pain approaches in cancer survivors. It is important to note that effective pain management usually involves a multipronged approach that may include over-the-counter or prescription medications, injections, and potentially more invasive procedures such as radiation therapy and surgery. It describes those therapies that are commonly prescribed and have some evidence to suggest that they may be useful in reducing pain symptoms in cancer survivors. Most physical modalities have not been studied extensively in cancer patients due to the concern of exacerbating an underlying malignancy. Those that are generally believed to be safe include cryotherapy (e.g., the use of cold packs), biofeedback, iontophoresis, and transcutaneous electrical nerve stimulation, and massage. Pharmacologic management certainly has an important role, as do nonpharmacologic measures. While there is certainly some evidence to suggest that the nonpharmacologic interventions, especially therapeutic exercise can be quite helpful to cancer survivors.

This chapter aims to provide social workers with a historical and contemporary understanding of mass incarceration in the United States. The goal is to facilitate informed forensic social work practice and advocacy with individuals, families, and communities impacted by this destructive phenomenon. The chapter examines the prevalence of jails and prisons, as well as an overview of the people who inhabit them. It discusses the core roles and functions of forensic social work. Restorative justice is often hailed as a prevention, and/or intervention, in justice settings. High levels of suspensions have seen schools become feeders not for college, but for the juvenile, and adult criminal justice systems. This phenomenon has been titled the school to prison pipeline; its impact can be felt predominantly among poor students of color. Research has demonstrated the effectiveness of restorative justice in both juvenile justice and school settings.

This chapter discusses in detail the scope of the problem of child maltreatment, and current evidence-based assessment and interventions in the child welfare system. It covers the history of child protection legislation, and describes the foster care crisis in the United States, including the foster care to prison pipeline, the impact of parental incarceration, and current policies such as reforms in the juvenile jurisdiction system. Additionally, trauma-informed care and the juvenile jurisdiction system is examined in light of recent trends to more closely align systems of care with neuroscience research and best practices for serving children and adolescents. The chapter reviews the relevant theoretical and practical approaches, including the application of neuroscience research, trauma-informed care, father engagement, and addressing secondary trauma among child welfare professionals. It also presents a case study and challenges of working with incarcerated fathers who may have children in the child welfare system.

Breast cancer is the most common cause of cancer among women in the United States, with approximately 260,000 new cases of breast cancer and more than 40,000 breast cancer related deaths anticipated in 2018. Fortunately, an improved understanding of the importance of tumor biology has led to significant advances in the management of breast cancer in both the adjuvant and metastatic settings, as well as an improvement in patient morbidity and breast cancer specific survival. When an abnormality is detected on screening, breast cancer diagnosis and management typically require a multidisciplinary approach that incorporates some combination of radiology, surgery, pathology, medical oncology, radiation oncology, and/or specialists in rehabilitation. This chapter provides an overview of the principles of using systemic therapy (i.e., medications that are absorbed and carried throughout the bloodstream, such as chemotherapy and endocrine therapy) for the management of breast cancer.

Melanoma has traditionally been a challenging disease to manage due to a lack of effective therapies for advanced disease. Fortunately, recent advances in our understanding of the molecular pathways underlying melanoma pathogenesis and of tumor immunology have led to unprecedented advances in targeted and immunological therapies that have dramatically improved patient outcomes. This chapter serves as a practical guide for the nononcologist and provides updated information on the epidemiology, prevention, staging, biology, and management of melanoma. The introduction of immune checkpoint inhibitors and targeted agents has dramatically improved survival for patients with advanced melanoma. Novel immune checkpoint molecules such as CD40, CD137, OX40, and LAG-3, are already under investigation in early phase I studies. With a growing number of treatment options, continued efforts to find the optimal combination and sequence of therapies will be important.

Head and neck cancer is a group of cancers that are linked by a shared anatomical space. The anatomical space includes structures that are critical for speech, swallowing, breathing, vision, and hearing. It has long been recognized that head and neck cancer and its therapy adversely impact function. Rehabilitation in the head and neck cancer population is often challenging: it requires the coordinated care of experienced clinicians spanning a wide array of specialties. This chapter begins with a discussion of the socioeconomic considerations that are paramount in treating head and neck cancer patients. This is followed by a broad overview of the epidemiology, etiology, pathology, and staging of head and neck cancers. The chapter then discusses the specific modalities of therapy used in the treatment of head and neck cancer with an emphasis on the associated toxicities. Finally, it discusses site-specific considerations that impact functional outcomes.

Renal function impairment can affect a cancer patient’s functional capacity and mobility and thus limit participation in a rehabilitation program. This chapter discusses how acute or chronic declines in renal function can affect cancer patients’ ability to participate in rehabilitation programs and to provide information on how to optimize this very important aspect of their care. Acute and chronic kidney disease (CKD) can hinder a patient’s mental status and functional status due to electrolyte derangements. Additionally, CKD can result in anemia and mineral bone disease, which can affect a patient’s capacity to exercise and increase the risk of fractures. Patients on dialysis benefit from rehabilitation, and additional research should be fueled into structuring home exercise programs. Careful selection of pain medications that are renally dosed can provide temporary relief for patients with kidney disease and allow them to participate in rehabilitation.

This chapter provides an orientation to the critical issues, history, trends, policies, programs, and intervention strategies of the juvenile justice system. It reviews the types, functions, and legal responsibilities of the various juvenile justice agencies and institutions. The chapter describes the case flow within the juvenile justice system. It also discusses systems of care in juvenile justice, and specialized assessment and treatment issues with adolescents, including sexually abusive youth. It explores the foundation and groundwork for the study of juvenile delinquency and juvenile justice system while delineating the legal definitions of juvenile status offenses and juvenile delinquency, examining the nine steps in the juvenile justice case-flow process. The chapter also gives attention to systems of care, the link between trauma and delinquency, as well as the assessment and treatment considerations for forensic social workers when addressing the specialized needs of juveniles in the justice system.

This chapter describes strategies for radiation therapy treatment planning for soft tissue sarcoma. It explains simulation and immobilization for abdomen/thorax/pelvis, and extremities. Bolus is added over any postoperative surgical scars during simulation or during treatment planning, typically 5 to 10 mm. Surgical scars and drain sites should be wired for bolus to aid visualization during treatment planning. The chapter discusses image registration and localization, preoperative versus postoperative radiotherapy, planning goals and critical structure objectives, and external beam radiation therapy treatment techniques. It presents treatment planning for preoperative radiotherapy with examples of abdomen and thigh. The chapter also describes treatment planning for postoperative radiotherapy with examples of chest wall/abdomen wall, thorax, calf (left), lower limb, dual-isocenter intensity modulated radiation therapy/volumetric modulated arc therapy, and extended source-to-skin distance. Finally, it discusses treatment planning with brachytherapy examples.

Rehabilitation of individuals with spinal cord dysfunction (SCDys) in the cancer setting is defined as a process that relieves distressing symptoms related to the cancer or SCDys. It assists the person to achieve the maximal physical, functional, social, and psychological abilities within the limits of the SCDys, the cancer, its treatments, and prognosis. Cancer-related SCD can result from spinal cord compression due to epidural, intramedullary, or leptomeningeal tumor; as a consequence of radiation therapy; or from iatrogenic causes such as infection or hematoma. MRI is the investigation of choice when suspecting a tumor causing spinal cord compression. Radiotherapy is now well established as routine treatment for many primary and secondary spinal cord tumors, and often used in conjunction with surgery. This chapter discusses rehabilitation therapies such as compensatory mobility techniques and therapeutic exercise to improve quality of life, performance of activities of daily living, and prevent complications related to immobility.

The hematologic and thromboembolic complications of cancer and its treatments are common. This chapter discusses the etiology and management of each of the hematologic and thromboembolic complications of cancer. Anemia, erythrocytosis, thrombocytopenia, leukocytosis, leukopenia, thrombocytosis, and thrombocytopenia are frequently seen in cancer patients. Chemotherapy remains the major treatment modality, and because of its myelosuppressive properties, anemia, leukopenia, thrombocytopenia, and pancytopenia are common and should be expected. All chemotherapy treated patients are at risk for neutropenic complications. The degree and the duration of neutropenia also increase the infection risk. In cancer populations, anemia can be due to bone marrow underproduction such as chronic disease, myelophthisis, renal failure, endocrine dysfunction, nutritional deficiencies, myelosuppressive therapy; blood loss anemia such as acute blood loss, chronic blood loss, and chronic occult blood loss; and hemolysis such as immune and nonimmune hemolytic anemia.

This chapter provides a brief description on: simulation and immobilization; 3D conformal planning; intensity modulated radiation therapy/volumetric modulated arc therapy planning principles; planning objectives and evaluation for external beam treatment involving central nervous system. It discusses simultaneous integrated boost (SIB), and gamma knife (GK) and linear accelerator-based stereotactic radiosurgery. SIB is delivered with intensity modulated radiation therapy or volumetric modulated arc therapy and is an efficient technique to incorporate the boost into a single treatment plan. GK requires 3D imaging, a high degree of dose conformity, sleep dose gradient, and accuracy of beam delivery less than 1 mm. GK is for cranial irradiation, and has typically used a frame attached to the patient’s head for immobilization. Treatment time depends on source strength, number of targets, shape, size, and prescription, and can vary between 10 minutes to several hours.

This chapter describes a forensic practice framework using a human rights and social justice systems approach. It articulates the definition and theme-based strategies that distinguish forensic social work from social work practice as usual. The chapter then proposes an integrated theoretical perspective that the authors refer to as a human rights and social justice systems (HR-SJS) approach. This approach helps to visualize forensic social work practice in any practice setting. The chapter also reviews the history of forensic social work using the United States as the case example to illustrate how a two-pronged approached to practice was integrated throughout this specialized arena of practice. A review of forensic social work history shows that well over 100 years ago, social workers understood that government, as author and institutor of policy, can and should be an arena for reform.

This chapter delves into some of the frequently encountered cancers in childhood, their incidence, and common presenting features from a rehabilitation practitioner’s point of view. It highlights the multimodality approach in treatment for various types of pediatric cancer. Pediatric cancer is fairly rare compared to cancer in adults. There has been a remarkable progress in the outcomes for cancer in childhood overall, over the past half-century. One of the key determinants for this success has been a collaborative effort by pediatric oncologists all over the world in enrolling majority of the patients in cooperative group studies. With improved survival, there have been efforts to decrease the intensity of treatment to curtail some of the long-term effects in low-risk cancers. Recently, there has been explosive growth in genomic information that led to a better understanding of various subtypes, revised classifications, and therapeutic strategies for various cancers.

This chapter discusses about immobilization using reusable devices such as prone belly board; supine thoracic immobilization; prone breast system; and conformal bag systems. It also describes immobilization with single use devices including thermoplastic masks; custom head pads; and alpha cradle device. The chapter also presents immobilization using special devices such as bite block or mouthpiece and bolus material. It describes patient setup, motion management, scan acquisition and virtual simulation, patient marking, and quality assurance and charting. The patient should be placed in a reproducible and comfortable position so he or she is able to hold the position for the entire treatment using immobilization devices as an aid. Sites including lung, liver, breast, and pancreas are affected by respiratory motion. This motion may be accounted for via margins that represent the extent of motion as determined by fluoroscopy or 4D-CT imaging, reducing the motion, and adapting the treatment.

Gynecologic cancers have the potential to originate from anywhere in the reproductive tract, which includes the uterus, ovaries, cervix, vulva, vagina, fallopian tubes, or peritoneum. This chapter focuses on three gynecologic cancers, namely endometrial, ovarian, and cervical carcinomas. The interested reader is referred elsewhere for a more detailed description of these cancers and for information on the other less common gynecologic malignancies. The initial treatment of endometrial cancer involves surgical staging if the patient is medically fit. Adjuvant therapy is based on several key factors, namely stage, grade, and age, with the goal of adjuvant therapy to decrease the risk of cancer recurrence. Surgery followed by postoperative chemotherapy is the standard treatment for all patients with advanced-stage epithelial ovarian cancer and for many patients with early-stage disease. Postoperative chemotherapy is known to significantly prolong survival, and the current data support the use of platinum- and taxane-based regimens.

Patients with head and neck malignancy may present with a palpable mass or nonspecific symptoms to their physician. This chapter provides a brief description on principles of head and neck imaging in cancer. The high metabolic uptake of head and neck tumors makes positron emission tomography essential in the staging and surveillance of disease. Cross-sectional imaging with computerized tomography (CT) or magnetic resonance imaging (MRI) should be performed with contrast. When performing CT, attention to detail in the oral cavity to minimize metal artifact and delineate mucosal surfaces with puff cheek maneuver should routinely be done. Para-axial thin sections of the larynx with thin sections should be routine for laryngeal imaging to assess the anterior commissure and paraglottic spaces. As MRI exams are lengthy and less well tolerated by patients, protocols should be designed to tailor sequences to address the clinical query.

This chapter provides a brief description on the principles of neurosurgery in cancer. Metastatic spinal tumors are a major source of morbidity in cancer patients. The overriding goals for treatment are palliative in order to improve or maintain neurological status, provide spinal stability, and achieve local, durable tumor control. The principle treatments for spinal tumors are radiation and/or surgery. Recent advances in surgical and radiation techniques, such as image-guided intensity modulated radiation therapy, have made treatment of spine metastases safer and more effective. Additionally, the development of newer chemotherapy, hormonal, and immunotherapy treatments has led to improved systemic control of many types of cancers. Rehabilitative medicine plays a large role in achieving meaningful palliation and improved quality of life for patients with spinal tumors. A fundamental understanding of treatment decisions and outcomes will help in the assessment of cancer patients.

Body imaging utilizes multiple modalities such as ultrasound, conventional radiographs, CT, and MRI, in the care of the cancer patient. Advances in CT technology to allow faster scanning at lower dose and postprocessing imaging ensure that imaging is constantly developing to meet the needs of patients with cancer. Newly developed hybrid imaging techniques such as PET–CT and PET–magnetic resonance (MR) provide metabolic and functional information that helps improve staging and treatment planning. This chapter broadly discusses the modalities used in body imaging and imaging recommendations for diagnosis, staging, follow-up, and detection of complications. Imaging is an essential element of the management of patients with cancer. Imaging aids with many facets of the cancer treatment, including conditions requiring immediate attention, diagnosis, staging, therapy decisions, and response assessment. A basic overview of imaging is provided for evaluation of some of the more common malignancies and conditions seen in adults.

Sarcomas constitute less than 1% of all cancers diagnosed annually, with ~15,000 people estimated to develop a sarcoma in 2018 in the United States. Approximately half of the patients with newly diagnosed sarcoma will die of this disease. This chapter provides a brief description on evaluation and management of sarcomas. The principles of sarcoma management are consistent between patients, and are highlighted in this chapter. New and advancing modalities of care are improving survival for patients with sarcomas of all forms. Surgical approaches have benefitted from improvements in tumor imaging, which now make limb-sparing surgeries routine. Improved techniques in tissue transfer make reconstruction of very large tissue defects feasible. Intensity modulated radiation therapy and proton irradiation are improving local control of tumors. With advances in local and systemic therapy the burden of disease becomes smaller over time, making the rehabilitation for such patients easier as well.

This chapter promotes understanding of the intersection of social work case level practice skills and social welfare programs and policy. It describes the social work advocacy process, and explores how social and political values impact accessibility to social welfare programs. It assists social workers in developing competence in policy practice and in case and policy advocacy. The chapter also helps social workers recognize when social welfare and economic policies are not fairly distributed, and to become skilled in taking action at the micro-, mezzo, and/or macro level. It discusses the interaction of direct practice with case advocacy to underscore the critical need to understand and interpret policy to achieve social justice. The chapter further highlights the importance of social workers engaging in case and policy advocacy to achieve a socially just outcome for any individual or group, especially those impacted by involvement in the criminal justice system.

This chapter enhances the understanding of the multifaceted challenges that individuals, especially older adults, seeking housing with a criminal background face. It reviews the ways in which individuals, especially older adults, can be vulnerable in terms of safety and security in their housing settings. Older adults may be particularly concerned about security and safety at home because their homes have been shown to be places where they can be victimized, either by telephone scams, door-to-door solicitation, bullying in age-congregate settings, and witnessing other crimes occurring in their residences. The chapter discusses ways in which forensic practitioners can support vulnerable populations, including older adults. It also discusses the complexities of affordable and safe housing using case examples and descriptions focusing on the older adult population. The chapter provides further recommendations on other areas of assessment and intervention that forensic social workers can conduct.

Thyroid cancer accounts for 3.4% of all new cancer cases diagnosed in the United States, but it constitutes more than 90% of all endocrine malignancies. While the 30-year disease-specific survival in thyroid cancer in most patients exceeds 90%, the risk of recurrent disease is as high as 30% over the same period of time. Over the past 20 years, the combination of highly sensitive thyroglobulin with high-resolution neck ultrasonography has resulted in earlier detection of locally recurrent disease allowing for more effective treatment of these recurrences. Recent discoveries in molecular medicine have led to enormous progress in the diagnosis and treatment of patients with thyroid cancer. The development of new compounds with greater specificity for oncogenic targets and combinatorial regimens that overcome resistance to single agents promises a bright future for the treatment of radioactive iodine-resistant and advanced forms of thyroid cancer.

This chapter briefly discusses the principles of orthopedic surgery in cancer. The musculoskeletal manifestations of cancer are far reaching, and have broad implications for the patient’s prognosis and function. Primary tumors are typically managed with curative surgical intent, in the form of limb salvage surgery or amputation. Secondary tumors of bone are treated with palliative intent, which most often requires stabilization of the bone without removing the entirety of the tumor. The role of the orthopedic oncologist is primarily twofold: surgically eradicate cancer from soft tissue and/or bone, and to stabilize or reconstruct the resulting defects, optimizing function and quality of life. The orthopedic oncologist is often called upon to biopsy to establish a diagnosis and oversee the patient’s musculoskeletal care such as directing the timing of radiation plans or providing activity guidelines. The chapter reviews the surgical principles of treating both primary and secondary musculoskeletal malignancies in the extremities.

This chapter explains the paths and obstacles that immigrants face when they navigate the justice system in an attempt to stay in the United States. It provides an overview of what happens to an immigrant who seeks to enter the country “legally”, as well as the challenges for an immigrant who enters the country without authorization. The chapter also discusses paths to authorized immigration, including application for resident visas using the family- or merit-based immigration systems. It provides an insight into why 11.9 million immigrants have entered the United States without authorization rather than attempt legal means to immigrate. The chapter primarily focuses on those who either crossed the border without authorization or who remained here despite the expiration of their visas. It further explores how social workers can support immigrants who are involved in the immigration justice system.

Pharmacologic cancer pain management requires the following skills: (a) making a pain diagnosis; (b) choosing and titrating an analgesic agent; (c) recognizing and addressing side effects of the analgesics; (d) learning about alternative analgesics including opioid rotation; (e) accessing the institutional resources and algorithm for escalation of care and recruiting additional resources. The effective use of analgesic medications should be a major part of every physician’s armamentarium in managing cancer pain. The World Health Organization (WHO) cancer pain and palliative care program advocates the three step approach incorporating the use of nonopioid, opioid, and adjuvant analgesics alone, and in combination, titrated to the needs of the individual patient. Nausea, vomiting, sedation, and constipation are the most common opioid-induced side effects, while sedation, respiratory depression, and addiction being the most dangerous. Patients should be screened for opioid-misuse risk factors and educated about safe drug use and disposal.

This chapter discusses patient setup and immobilization, target volumes and organs at risk (OARs), planning objectives, treatment planning for conventional fractionated prostate intensity modulated radiation therapy and volumetric modulated arc therapy. It describes patient setup and immobilization, target volumes and OARs, planning objectives, and treatment planning for prostate stereotactic body radiation therapy (SBRT). The chapter provides patient setup and immobilization, planning objectives, and treatment planning for low dose rate brachytherapy. It explains patient setup and immobilization, target volumes and OARs, planning objectives, and treatment planning for bladder radiotherapy. Finally the chapter explores patient setup and immobilization, target volumes and OARs, and 3D planning for testicular seminoma treatment.

This chapter examines the significance for vulnerable groups of social welfare policies and advocacy to meet basic human needs. It identifies key policies and programs established to meet needs of income, food, and shelter. The chapter encourages students to begin using research and statistical data to assess needs and adequacy of programs. It also identifies social work’s role and skills in addressing needs of vulnerable groups. The chapter focuses on the key role of social work professionals in establishing, maintaining, and improving programs needed to ensure a basic level of income for families with children (i.e., income security), access to adequate nutrition (i.e., food security), and access to adequate shelter (i.e., housing security). It also discusses the challenges faced by social workers who serve populations with the basic human needs, including offenders and victims of crime.

This chapter deals with interviewing techniques that have been empirically found to elicit the most detailed and accurate information when conducting a forensic interview. It describes three evidence-based best practices for forensic interviewing. The chapter also delineates the ways in which interviewer beliefs and expectations can bias the interview. It describes forensic interview as the first step in the investigation, when an allegation of child sexual abuse is referred to Child Protective Services. Although there are a number of forensic interviewing models, all consist of sequential phases or stages and include the following: rapport building, substantive phase, and closure. Forensic interviews should be video- or audio-recorded, so that a clear record of the interview is preserved. The chapter also discusses some of the main points in the NICHD protocol and the Michigan protocol for best practices.

This chapter describes how mental health and substance use interact with criminal justice involvement. It examines the common assessment and intervention strategies for co morbid mental health and substance abuse in forensic population and settings. The chapter gives a brief review of how substance use disorders co-occur with psychiatric disorders. The chapter describes prevalence of co-occurring disorders such as anxiety/depression, bipolar disorders, psychotic disorders, personality disorders, and posttraumatic stress disorder in general. It then discusses prevalence of psychiatric disorders in the prison/jail systems. The chapter also describes medication-assisted therapies for opioid use disorders and, treatment and aftercare services. It explores two of the most common types of treatments for those in the CJS, cognitive behavioral therapy (CBT) and 12-Step groups. The chapter further reviews two CBT programs, aggression replacement training and strategies for self-improvement and change.

Cancer pain can be classified into two broad categories: nociceptive pain or pain caused by damage or injury to body tissues and neuropathic pain or pain caused by damage or injury to nerves. Nociceptive pain can be further subdivided into somatic, which is usually well localized to the area of tissue damage, and visceral, which arises from the stretching or irritation of the hollow organs and is poorly localized. This chapter elucidates the pathophysiology and clinical presentation of visceral pain as it relates to the cancer patient. For those patients suffering from cancer related visceral pain, treatment options include pharmacologic, manual, interventional, and complementary/alternative medicine techniques. Psychosocial support should also be an integral part of any treatment program. The ultimate outcome of pain management in individuals with cancer is to relieve suffering and enable such individuals the best possible quality of life.

This chapter provides a brief description on the history of cancer rehabilitation. The early history of cancer rehabilitation certainly would not be complete without a review of some of the pioneer rehabilitation programs. Although the political legislation of the 1960s and 1970s was lofty and admirable, seemingly very little tangible benefit accrued to cancer patients and indeed most cancer rehabilitation programs. At present, the efficacy and worth of rehabilitation efforts are proven and undoubted. Recent works have documented the very positive effects of exercise and other rehabilitation therapies on functional improvement, independence, a feeling of well-being, and fatigue problems in the cancer patient. Clearly, the cancer population needs, and should demand, the services of rehabilitation professionals. Supported by the convincing pioneer works of their predecessors, the modern-day cancer rehabilitation specialist is empowered by evidence, inspiration, and experience to march forward and provide the expertise and support for this deserving population.

This chapter discusses the history of forensic research atrocities. It promotes the use of National Association of Social Workers (NASW) Code of Ethics as a foundation for forensic research. The NASW Code of Ethics purports that social workers should promote and facilitate evaluation and research to contribute to the development of knowledge. This underscores both an ethical and a human rights obligation for the need for more prevention and intervention studies with incarcerated individuals. The chapter describes national and international responses to historic forensic research, and aims to build awareness of the need for new research to serve forensic populations and to increase familiarity with forensic research methodologies. The National Commission for the Protection of Human Subjects identifies three categories of research in prison settings: convenience research, prison-oriented research, and treatment-oriented research.

Cancer patients may experience brain injury due to primary brain tumors, metastatic brain tumors, radiation related effects, and leptomeningeal disease. This chapter focuses on the factors unique to the rehabilitation of patients with brain tumors. Metastatic brain tumors are the most common intracranial tumors in adults. The most common primary cancers to metastasize to the brain include lung cancer, breast cancer, melanoma, and renal cell carcinoma. As the management of these cancers has evolved (including the use of immunotherapy), their systemic manifestations have shown more response to treatment. Brain cancer patients benefit from rehabilitation and improve at similar rates to noncancer brain injury patients. Cancer treatments including radiation and chemotherapy can contribute to functional impairments. The Stupp Regimen is the most commonly used initial treatment, which includes radiation and temozolomide chemotherapy. Many glioma patients are receiving the Stupp Regimen while receiving rehabilitation.

Pulmonary disease and its complications are prevalent in the general population and are the third leading cause of death in the United States. Primary lung cancer is the leading cause of cancer death in men and women in the United States. Since the lungs are one of the primary sites of metastatic disease, morbidity caused by the secondary metastases to the lungs is also common. Further injury to the lungs may stem from the effects of treatment, including surgery, radiation therapy, chemotherapy, and from complications such as pneumonia and pulmonary embolism. Maintaining good pulmonary toilet practices, preserving overall conditioning, and focusing on strengthening and compensatory exercises will allow patients to maintain their capacity despite their condition and its complications. This chapter provides a brief description on metastatic disease, restrictive lung conditions, radiation pneumonitis, chemotherapy-induced lung injury, obstructive lung disease in cancer patients, pulmonary vascular disease, and rehabilitation treatment options.

Neuromuscular complications in patients with cancer are common and they meaningfully affect function and quality of life. Recognition of specific processes is necessary for appropriate diagnosis and intervention. Complications can occur as a direct result of the underlying malignancy, complications of therapy, paraneoplastic effects, indirect effects of chronic illness, infection, or unrelated underlying medical conditions. Careful clinical examination and electrodiagnostic studies are central to accurate diagnosis and characterization of neuropathy. Mononeuropathy affects a single named nerve, most commonly by nerve compression or entrapment. Polyneuropathy, typically refers to a more generalized or systemic process. Mononeuropathy (mononeuritis) multiplex is a distinct pattern of multiple evolving mononeuropathies and is produced by several processes. The chapter discusses chemotherapy-induced peripheral neuropathy, neuropathy associated with monoclonal gammopathies and lymphoproliferative disorders, neuropathies associated with monoclonal gammopathies or lymphoproliferative syndromes, neuropathies associated with myeloma and nonmalignant immunoglobulin G or immunoglobulin A monoclonal gammopathies, and amyloid neuropathy.

This chapter provides a brief description on the principles of breast surgery. Modern breast surgery practice began in the late 1890s with the work of Dr. William S. Halsted. In the years since, the art of breast surgery has been a process in evolution, searching for a balance between the safest oncologic procedures with the least morbid results. And while multimodality therapy is increasingly being utilized, breast cancer remains largely a surgical disease. The chapter covers the basic principles of breast surgery, focusing on the current concepts of screening, preoperative diagnosis, staging, and modern surgical management of the breast and axilla. The goal of breast cancer screening is to facilitate early diagnosis and decrease breast cancer mortality. Individual screening recommendations are tailored according to a woman’s risk and breast density. The backbone of routine breast cancer screening includes clinical breast exam and mammography.

Heart disease is the most common cause of death in the United States. Although the primary focus of this chapter is the rehabilitation of patients with cancer, it is important to remember that cardiac disease is as prevalent in cancer patients as it is in the general population and accounts for a significant share of morbidity and mortality. This chapter focuses primarily on the additional cardiac sequelae from cancer and its treatment. However, the impact of the underlying cardiac disease must always be considered. Long-term cancer survivors are likely to have treatment-related heart disease, necessitating cardiac revascularization or other procedures. Dilated cardiomyopathy in the setting of oncologic disease is usually associated with chemotherapy, specifically doxorubicin, other anthracycline agents, or trastuzumab. The approaches to rehabilitative treatment of cancer patients with heart disease follow basic cardiac rehabilitation guidelines.

Cancer is a complex group of hundreds of distinct diseases, with occurrence that varies by cancer type, age, sex, race/ethnicity, socioeconomic status, geographic location, and time. This chapter describes cancer occurrence patterns in the United States for all cancers combined and for seven select cancer sites (prostate, lung and bronchus, and colorectum in men and breast, lung and bronchus, and colorectum in women). These cancers account for 42% and 50% of new diagnoses in men and women, respectively. Lung and bronchus cancer is the leading cause of cancer death in both men and women, followed by prostate and colorectal cancers in men and breast and colorectal cancers in women. The chapter focuses on these four cancer types, as well as three additional cancers (liver and intrahepatic bile duct, esophagus, and pancreas) that are unique with respect to risk factors, distribution and trends by histologic subtype, and low survival.

According to the National Institutes of Health Surveillance, Epidemiology, and End Results (SEER) program database, there are estimated to be 3,200 patients diagnosed with primary bone cancer in 2017. The staging system helps guide surgical management. The primary aim of surgical intervention is to resect the tumor in a manner that will prevent local recurrence. Conventional bone radiography is the mainstay for imaging techniques for the primary evaluation of bone. Biopsy is often the most important procedure performed in patient management. With the exception of the Ewing family of tumors, radiation therapy has a limited role in the management of primary bone sarcomas. When surgery is not possible, radiotherapy has been used to help provide local control, although with results that are not comparable to the combination of chemotherapy and surgery. The primary surgical objective for the management of primary malignant bone tumors is resection with wide surgical margins.

This chapter articulates a basic understanding of human rights and how they relate to social work. It describes some of the changes that are needed in social work practice in the United States in order to adhere to human rights principles. The chapter then addresses the implication of human rights for social workers. It offers some background on the concept of human rights, with emphasis on the relationship between human rights and social work and human rights and the law. The chapter further discussed the implication of human rights for social work education and social work practice, with a focus on building community. It discusses obstacles to social work practice from a human rights perspective, and concludes with a discussion on how social work needs to change to have consistency between discourse and action.

This chapter provides a brief description on simulation and general planning principles for head and neck cases. It describes specific case planning for T2 N0 M0 squamous cell carcinoma of the glottis; T2, N2b, M0 squamous cell carcinoma of the base of tongue; T4b N0 M0 esthesioneuroblastoma of the nasal cavity; T2 N0 M0 squamous cell carcinoma of the scalp; and T2b N1 M0 malignant neoplasm of connective tissue of head, face, and neck. The chapter describes planning for T3 N0 M0 squamous cell carcinoma of the tonsil, re-irradiation and T4b N2b M0 P16+ malignant neoplasm of the right tonsil re-irradiation. It describes planning for special cases such as two isocenter treatment plan for a T4b N0 M0 teratocarcinoma of the ethmoidal sinus and cases involved with pacemaker.

The chapter discusses strategies for radiation therapy treatment planning for gynecologic cancer. It presents patient simulation and localization, planning targets and goals, critical structure objectives, 3D conformal planning, and intensity modulated planning for whole pelvis radiation therapy. Intensity modulated therapy is used for extended field treatment including para-aortic lymph nodes. The chapter gives examples of intensity modulated planning for endometrial cancer, cervical cancer, vulvar cancer, vaginal cancer. It describes patient simulation and localization, planning targets and goals, critical structure objectives and high dose rate (HDR) planning for HDR brachytherapy. The chapter also presents five examples of HDR planning for vaginal cuff brachytherapy, tandem and ring applicator for cervical cancer, tandem and ring applicator for uterine cancer, and interstitial implant for large gynecological tumors.

This chapter focuses on the role that Adult Protective Services (APS) and related service systems play in protecting vulnerable older adults and adults with disabilities from abuse, neglect, and exploitation. It articulates policy issues connected to elder justice. The chapter also explores human rights issues related to elder abuse, aging, and disabilities, particularly how to balance rights to self-determination and safety when working with abused, neglected, and exploited older adults. APS operate within a continuum of services that challenge social workers in their efforts to respond effectively to elder abuse. In addition to knowledge of aging, disabilities, the dynamics of family violence and care giving, and community resources and skills in capacity assessment, working in multidisciplinary teams, advocacy, and systems navigation, social workers need commitment to values of self-determination and empowerment to guide their work in this system.

Tumors arising from the musculoskeletal system include benign and malignant neoplasms. Benign etiologies include posttraumatic, infectious, and inflammatory conditions. Malignant neoplasms include primary tumors of soft tissue and bone. Metastatic disease to the musculoskeletal system may present as soft tissue masses, bone destruction, or marrow replacement. The choice of a radiologic diagnostic imaging test takes into account the sensitivity of each modality as it pertains to the patient’s cancer history, presentation, and clinical query. The entire skeletal system is evaluated with a whole body nuclear medicine bone scan. Musculoskeletal imaging in evaluating cancer patients requires complementary exams to diagnose patients and evaluate treatment response. Most important are the availability of prior scans for comparison and a detailed history of treatment and current medication to allow the interpreting radiologist the ability to provide a thorough comprehensive detailed consultation.

While the entire discipline was founded on the management of serious toxicity associated with chemotherapy, medical oncology now encompasses newer treatment paradigms, including molecularly targeted agents and immunotherapy, which are widely used in clinical practice. The longer survival of patients with cancer has led to an increase in the chronic long-term toxicities associated with treatment. The entire field is increasingly focused on the problems of “cancer survivors” and we are likely to see an expanding role for rehabilitation medicine. This chapter describes common antineoplastic agents and their major toxicities, focusing primarily on the subacute and chronic toxicities associated with treatment. Acute common toxicities of chemotherapy often include acute infusion reactions, myelosuppression, which increases the risk of neutropenia, infection, and need for transfusion due to anemia or thrombocytopenia, alopecia, fatigue, and nausea to varying degrees. The chapter focuses only on currently Food and Drug Administration (FDA) approved therapies.

This chapter describes the importance and need for interdisciplinary collaboration in forensic settings. It discusses how the evidence-based principles of risk, need, and responsivity (RNR) model can guide interdisciplinary collaboration with justice-involved individuals. The chapter highlights a treatment program for high-risk justice-involved males demonstrating interdisciplinary collaboration and specifically the role of the forensic social worker. Interdisciplinary collaboration is an essential core skill in evidence-based forensic social work practice. Interdisciplinary collaboration can be multidimensional, interactional, and developmental, and the following strategies have been identified as most important in achieving a best practice: preplanning, commitment, communication, strong leadership, understanding the cultures of collaborating agencies, and structural supports and adequate resources for collaboration.

This chapter helps forensic social workers (FSWs) understand how to incorporate research into their practices. It clarifies the terms associated with evidence-based practice (EBP), and demonstrates three different approaches that FSWs can use in their practice settings. The chapter focuses on clinical interventions within forensic settings. It provides a brief summary and overview of some of the intervention models used in forensic settings with established empirical support, along with a discussion of their strengths and limitations. The chapter highlights commonly used forensic intervention models such as risk-needs-responsivity models, motivational interviewing, trauma-informed care, trauma-focused cognitive behavioral therapy, schema-focused therapy, and dialectical behavioral therapy. It concludes with a case example to illustrate how to use EBP in order to ensure that FSWs are providing interventions that are the best combination of art and science.

Much consideration and discussion should take place between physicians, dosimetry, physics, and therapists before a patient is brought into the simulator and scheduled on a treatment machine. One should try to anticipate factors such as how the patient will be immobilized, target and organ at risk dose goals, and beam angles. Whenever possible, patient’s care should be referred to a high-volume pediatric oncology center, and clinical trial enrolment should be considered. Patients should be in a tolerable, reproducible position. Patients under anesthesia are often very limp, so immobilization should be maximized to limit movement. The treatment time for a pediatric patient is an important factor. Treatment can affect the growth of developing organs, particularly growth plates in the bone. The chapter provides a brief description on patient setup, immobilization, and treatment planning for Wilms’ tumor, Ewing’s sarcoma, rhabdomyosarcoma, craniopharyngioma, craniospinal irradiation of embryonal tumors, and total body irradiation.

Cancer patients with symptoms referable to the spine present a unique imaging challenge. Metastatic disease can involve any portion of the spine, with the osseous spine most commonly involved, often with concomitant epidural disease. The purpose of this chapter is to impart an understanding of fundamental spine imaging anatomy to clinicians as well as to advance their knowledge of the most common lesions involving the spine in cancer patients. It discusses the choice of optimal imaging modalities for evaluation of such lesions. The chapter then reviews lesions that occur directly or indirectly from cancer treatment and that may mimic recurrent or metastatic disease. The diagnosis and treatment of spine metastasis and related processes in the cancer patient require a multidisciplinary approach and with the proper use of imaging will lead to earlier diagnosis, better management options, and ultimately improved neurological, functional, and potentially oncologic outcomes.

This chapter briefly discusses the evaluation and management of lymphoma. It provides a brief description on introduction, epidemiology and etiology, signs and symptoms, diagnosis and staging, prognostic factors of non-Hodgkin lymphoma and Hodgkin lymphoma. Non-Hodgkin lymphoma refers to all malignancies of the lymphoid system, with the exception of Hodgkin disease. The treatment of non-Hodgkin lymphoma’s can vary greatly depending on several factors including tumor stage, lymphoma-related symptoms, patient’s age and comorbidities but it is mostly driven by the histology of the disease and its biologic characteristics (e.g., indolent vs. aggressive lymphoma). Hodgkin disease is typically considered a chemotherapy and radiation sensitive disease. Clearly, advances in the treatment of lymphoma have been significant, and may be among the most successful of any malignancy. As new drugs and new treatment paradigms emerge, the probability of curing or managing these patients will improve still further.

Genitourinary cancers include cancers of the urinary tract (prostate, bladder, urethra, and kidney) and the male genital tract (testis and penis). This chapter briefly discusses the epidemiology, diagnosis, treatment, and the rehab perspective of prostate cancer, carcinoma of the bladder and the upper urogenital tract, testis cancer, renal cell carcinoma, and penile cancer. Patients with prostate cancer now live longer with their metastatic disease and pose greater challenges for rehabilitation physicians. Bladder cancer most commonly presents with total (present throughout the length of micturition) gross painless hematuria. Radical orchiectomy through the inguinal approach is required for diagnosis and staging of testis cancer. Carcinoma of the penis comprises less than 1% of all malignancies in men. Predisposing factors include the presence of foreskin, and human papillomavirus exposure. The treatment recommendation for this rare disease is by stage. Penile conservation surgical techniques can include laser, Mohs surgery, and partial penectomy when feasible.

Gastrointestinal cancers, defined as those occurring in the esophagus, stomach, colon, or rectum, are among the most common forms of cancers occurring worldwide. The incidence of these cancers amounts to millions of individuals each year. When considered as a whole, these cancers have a higher prevalence than breast and lung cancers combined. Although these cancers are often group together, their risk factors, incidence, prevalence, and prognosis vary considerably. This chapter provides an overview of the more common types of gastrointestinal malignancies, focusing on their risk factors, diagnostic workup, and treatment options. Gastrointestinal cancers are treated by utilizing a multidisciplinary approach often including surgery, chemotherapy, and radiation depending upon stage and location. Screening programs in colorectal cancer have resulted in earlier detection of disease while advances in surgical techniques and medical and radiation therapies have resulted in improved outcomes in all gastrointestinal cancers.

Primary central nervous system (CNS) tumors encompass a heterogeneous mix of histologies and sites of origin. The 2016 World Health Organization (WHO) classification introduces molecular parameters in addition to histology to define many tumor types with the goal to facilitate clinical, experimental, and epidemiological studies in the molecular era. This chapter reviews epidemiology, symptoms, and signs, as well as diagnosis and treatment of CNS tumors. It also provides an overview of specific brain and spine tumor types followed by a brief discussion of long-term sequelae of CNS tumors and their treatments. Long-term CNS sequelae of treatment include neurocognitive dysfunction, stroke, radiation therapy necrosis, and secondary cancers, among others. Radiation is also a risk factor for secondary tumors including meningiomas, malignant gliomas, and nerve sheath tumors. The incidence of CNS neoplasm is 8.1 to 52.3 times higher in survivors of childhood cancer who received cranial irradiation compared with the general population.

This chapter aims to enhance understanding of the justice-involved veteran population including the extent of involvement, risk, and protective factors associated with offending, and the impact of criminal justice involvement on the veteran and the veteran’s family system. It discusses the targeted programs and services for justice-involved veterans, how social workers assist this population, and the specific skill set required for effective intervention. The chapter also deals with health and mental health of incarcerated veterans, causes and consequences of arrest among veterans, and the use of trauma-informed care models and other interventions designed to address trauma that are critical for addressing the complex needs of justice-involved veterans. It further discusses jail-diversion programs, and jail and prison-based programs and services.

This chapter describes how forensic social workers can use the knowledge and skills of intervention development to design or evaluate existing interventions with forensic populations or settings, and about funding for their cause. It articulates the language of program and proposal development to prepare forensic social workers to be the creators of programs needed for forensic populations. The chapter enables preparing forensic social workers to possess basic competencies for understanding the language and practice of program development and evaluation of forensic social work interventions. The chapter provides an overview of the different parts of the logic model and how it can be linked to program development and evaluation. It provides questions related to the common types of evaluation, which include a needs assessment and process, outcome, or efficiency evaluations. The chapter also reviews forensic intervention development using a human rights and social justice systems approach.

Neuropathic pain is defined by the International Association for the Study of Pain as “pain initiated or caused by a primary lesion or dysfunction of the nervous system”. Neuropathic pain is initiated or caused by a primary lesion or dysfunction of the nervous system. Its pathophysiology is explained through various immune, cell receptor, and cell signaling modalities. The medications commonly used in the treatment of neuropathic pain include tricyclic antidepressants, anticonvulsants, antiarrhythmics, opioid analgesics, N-methyl-D-aspartate antagonists, topical medications, and certain drugs that mimic the γ-aminobutyric acid receptor. Many patients with neuropathic pain do not achieve satisfactory pain relief with medications alone. Neuromodulation therapy is an expanding field; it is used to treat these various neuropathic conditions refractory to pharmacologic interventions, such as Parkinson’s disease, dystonia, obsessive compulsive disorder, refractory pain, and complex regional pain syndrome.

Cancer and its treatment can result in various lower extremity musculoskeletal complications that may negatively influence a patient’s function. This chapter discusses the causes, evaluation, and treatment of common lower extremity musculoskeletal complications and conditions likely to occur in patients with cancer. The causes of lower extremity pain in patients with cancer are numerous. The pain may be from muscle, joint, or bone disorders. In addition, there are neurologic, vascular, and systemic causes that should be considered. The chapter describes some of the musculoskeletal causes such as bone metastases, insufficiency fracture, soft tissue tumors, bursitis, myofascial pain, arthritis, plantar fasciitis, and sprains. Goals should be determined based on an aggregate of factors, including a patient’s age, type and stage of cancer, and comorbidities, and should be established with the patient and family, as their “buy in” is vital.

Electrodiagnostic tools, such as nerve conduction studies (NCS) and needle electromyography (EMG) are invaluable in assessing the function of the peripheral nervous system and evaluation of neuromuscular disorders in cancer patients. Nerve conduction studies are typically divided into sensory NCS and motor NCS. Needle EMG can be used to distinguish between lower motor neuron, peripheral nerve, neuromuscular junction, and muscle disease. The indications for performing electrodiagnostic studies include confirming a suspected neuropathic lesion, ruling out other likely possibilities, localizing lesions, determining chronicity and severity, and detecting subclinical neuropathic/myopathic processes. Information regarding pathophysiology and assessing prognosis for neurologic recovery can be achieved with electrodiagnosis. Information obtained with NCS and needle EMG in the cancer patient can often assist in chemotherapy or radiation therapy decision making. This chapter describes electrodiagnostic findings in cancer, indirect neuromuscular effects of cancer, and electrodiagnosis of neuromuscular complications of cancer treatments.

Patients with cancer are susceptible to a variety of infections. Common infections include sepsis, cellulitis, pneumonia, urinary tract infections, and colitis. Infections can result in a decline in functional status, with subsequent debility, fatigue, and reduced oral intake. The cancer patient will also have a broader differential diagnosis for the cause of an infection, which can include bacterial, fungal, viral, and parasitic etiologies. This chapter tabulates common infections seen in the rehabilitation setting like bladder infections, cellulitis, sepsis and pneumonia. Pneumonia is common in patients with primary lung cancer or metastasis, due to partial obstruction of the air ways with subsequent atelectasis and postobstructive pneumonia. This may cause lung abscess formation with polymicrobial organisms. If this occurs, treatment in addition to antibiotics is needed to ensure eradication of the infection, such as chemotherapy, radiation, stent placement, or endobronchial brachytherapy.

This chapter provides a brief description on the principles of neoplasia. The ability to study cancer genomics has been enhanced exponentially as a result of innovative technologies used to sequence DNA and ribonucleic acid (RNA). The chapter reviews current models and mechanisms of oncogenesis and the basic principles of next-generation sequencing technology, highlights the classic mutations and syndromes, and reviews newer therapeutic tools, namely in the field of adoptive T-cell immunotherapy. Due to limitations in space and the complexity of the subject matter and the many excellent textbooks and review articles that are available for each topic, the chapter highlights the most important principles and their impact on clinical medicine while referring the interested reader to comprehensive reviews of the pioneering work. The chapter highlights the basic principles of the next-generation sequencing and illustrates their application as it relates to our understanding of current models of oncogenesis.

Working with justice-involved youth and employment-related services requires a wide range of social work and systems knowledge, skills, and expertise. This chapter enhances understanding of the role employment services play in forensic social work with youth. It presents relevant findings from recent research on employment services for justice-involved youth and their effects on recidivism. The chapter discusses the targeted programs and services for justice-involved youth, providing case examples and discussion of how social workers assist this population, and the skills required for effective intervention. It also provides a basic understanding for how employment services fit within the system. The chapter aims to connect research with real-life examples. It outlines two of the ways inequality and oppression impact juvenile justice and employment. The chapter also discusses two evidence-based employment intervention strategies that are available to justice-involved youth in New York.

This chapter discusses the complexity of the role of the school social worker. It describes how to respond collaboratively and effectively to the variety of issues presented within public schools. The chapter provides a brief history of social work services in schools. It addresses recent demographics and trends and the scope of the problems in this specialty area. Specific legal and ethical issues of concern in the practice of school social work, and issues of assessment, prevention, and intervention are also discussed. The chapter describes the types of services provided through social work in schools, ranging from traditional child study team work to reentry services for students returning from correctional and/or treatment facilities. The chapter further examines the origin and development of school social work services in the United States.