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dyspnoea is a subjective experience that includes interactions of various physical, psychological, social, and environmental factors that influence the person's perception of the symptom. This chapter focuses on the multidimensional assessment of dyspnoea. Assessment of this symptom involves clinical assessment and measurement of the different factors that influence the perception of breathlessness and which impact on the breathing mechanisms of a person. Clinical assessments are designed to determine the underlying pathophysiology to pinpoint appropriate treatment and to evaluate response to therapy. Measurement tools meanwhile are used to bring objectivity and accuracy to the evaluation of the clinical assessments, interventions, and clinical researches. Among the clinical assessment methods discussed herein are: clinical history of the symptom; physical examination; laboratory examinations; and determining the qualitative dimensions of dyspnoea. Measurement of dyspnoea includes: unidimensional scales (Borg scale, numeric rating scale, Breathlessness, Cough and Sputum Scale (BCSS)); multidimensional indirect scales (Baseline/Transitional dyspnoea Index (BDI/TDI), Pulmonary Functional Status Scale (PFSS)); and disease specific scales (chronic respiratory questionnaire (CRQ), Saint George Respiratory Questionnaire (SGRQ)).

This chapter provides an overview of conducting forensic mental health assessments in death penalty cases. It begins by briefly tracing the history and development of the specialty field of forensic psychology. After discussing various conceptualizations of “forensic mental health assessment,” this chapter discusses how such assessments differ in important respects from traditional clinical assessments. It then discusses the quality of forensic mental health assessments both generally and in the specific context of death penalty cases. This chapter also describes the many roles that may be played by forensic mental health professionals in all phases of death penalty proceedings. Finally, this chapter provides an overview for the remainder of the book.

Dyspnoea is a common and distressing symptom in people with advanced disease of diverse aetiologies. The American Thoracic Society defines dyspnoea as: ‘a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity’. This chapter discusses the multidimensional assessment of dyspnoea. The process involves both a clinical appraisal and measurement of the different factors that impact on the perception of breathlessness and the effects of shortness of breath on the individual. Prior to embarking on an assessment of a person's dyspnoea it is important to determine what questions you are trying to answer and in the setting of advanced disease for which clinical assessments and measurements are reasonable to consider given the patient's diagnosis, prognosis, functional abilities, setting, and goals of care. Clinical assessments are usually to determine the underlying pathophysiology, the most effective treatments, and subsequently the response to the interventions. Measurement instruments or tools are used to bring some objectivity and precision to the evaluation of clinical assessments or interventions and to answer research questions.

The results of fundamental research on human hand function offer valuable information about the capacities and limitations of the human user. Such information may be directed toward the solution of a number of real-world problems that depend on the sense of touch and manual dexterity. This chapter addresses five application domains that have been selected because of the critical mass of scientific results that are relevant to these topics. These include the evaluation of hand function and rehabilitation, language communication with the hand, sensory communication systems for the blind, haptic interfaces, and exploring art by touch. In each case, a description of the application domain is offered, followed by consideration of design issues and possible implications of selected research findings.

This chapter examines pain management problems in terminally ill patients. Terminal pain is frequently treated ineptly and the public myth that death from cancer involves unremitting distress is perpetuated. There are many reasons why terminal pain has been so poorly controlled. These include misconceptions concerning the use of analgesics, medical reluctance, and inadequate finance. The chapter discusses the nature of terminal pain, the prevalence of different types of pain, and the clinical assessment of pain.

All pulmonary and many non-pulmonary conditions can present with a cough. Most will be evident after a simple clinical assessment that includes a history, physical examination, a chest radiograph, and a spirogram. A cough that remains unexplained after such an assessment is a common reason for referral to secondary care. Potential causes include asthma, eosinophilic bronchitis, rhinitis and gastro-oesophageal reflux. This chapter discusses the cough reflex, clinical aspects of chronic cough, treatment of chronic cough, cough in malignancy and palliative care, and cough in children.

This chapter defines “clinical consultation” that includes three primary approaches: 1) completion of psychosocial case histories to facilitate the development of IEPs; 2) identification of family priorities, needs, and resources for the IFSP; and 3) response to crisis and traumatic events. Each of these approaches is discussed in terms of professional social work that prepares practitioners to assess a situation, collect pertinent data, engage their colleagues in problem-solving efforts, recommend scientifically supported interventions, monitor progress, and evaluate processes and outcomes. The chapter includes examples to illustrate the main concepts of the three clinical consultation approaches and discusses how they are consistent with different RtI levels. Suggested readings and resources are offered for the school social worker who wishes to learn more about clinical consultation theory and practice.

This chapter examines the significant overlap between the risk factors for offending, poor mental health and substance use, and assessed risk factors. Research on the prevalence of mental disorders in youth justice has increased steadily over the years but it remains limited compared to the researches on adult mental disorders. In addition, mental health treatment within the youth justice system is lacking for those in need. In research conducted in 2003, only 20% of youths with mental disorders were receiving treatment. In terms of assessment and clinical assessment tools, it is necessary that the purpose and the feasibility of assessments such as needs and risk assessment should be considered. In addition to discussing the prevalence of mental disorders and the principles of assessing such disorders in youths, the chapter also discusses the different types of mental disorders that may be associated with offending. Such disorders are marked by anomalous perceptual experiences, abnormal reasoning, and motivational factors. Some of the disorders prevalent in children and that may result to violence and offending is: oppositional disorder, conduct disorder and ADHD; depression anxiety and PTSD; autism-spectrum disorders; and early on-set psychosis. In working with young people who offend, regardless of whether they are addressing offending behaviour or mental health problems, the developmental and cognitive factors significant to their age groups should be considered as interventions designed for adults prove to be alienating for youths.

Although the future, as regards patients with spinal injury, must lie in the fields of regrowth and connection of nerve fibres and in the development of genetic engineering techniques to encourage growth connection, there is real evidence for improved function using new approaches to intervention and treatment. All rehabilitation measures must rely upon accurate assessment. This is essential in order to plan rehabilitation programmes and to delineate goals, and also as a means of monitoring progress and validating therapy. There are many clinical assessment schedules, but, unfortunately, no general accepted disability assessment, and most rehabilitation units use a locally adapted schedule. Although this is useful for the individual unit, it becomes impossible to compare the outcome of therapy from unit to unit.

This chapter clinically assesses patients with pruritus. Although pruritus is not a disease, it is a symptom that can accompany many conditions. The chapter looks at the possible symptoms that can accompany pruritus, the possible age when it can occur, and if it is associated with skin disease or not. Localized and generalized pruritus, its relation to treatment, and the symptoms of systemic disease are also discussed. The origins, the testing procedures, and the factors that relieve and precipitate pruritus are examined in the latter portion of the chapter.