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.