Fertility counselors see an array of clients who may be diverse in terms of countries of origin, ethnicity, race and/or cultural background. This chapter identifies principles to guide this conversation. These principles include understanding how we consider race, ethnicity and culture, and emphasize the importance of not essentializing race, ethnicity and culture. The chapter continues with a brief overview of the meaning and consequences of infertility in various places worldwide and among migrant and racial minorities in particular, how this can affect access to, use of and experiences with fertility treatments and assisted reproductive technologies (ARTs). Finally, we offer considerations for racially and culturally sensitive clinical approaches in fertility counseling.

This chapter outlines concepts related to social exclusion that are relevant to people with mental health conditions. These concepts highlight the political and civil nature of exclusion (citizenship, equality and human rights, choice); the importance of material (poverty and deprivation), social (social capital, stigma, and discrimination) and individual factors (participation, choice, and agency); and a means of identifying and describing causal factors for social exclusion (agency and process, dynamic dimensions, multifactorial causes, life course, and longitudinal perspectives). It also covers personal recovery, which provides a bridge between the literature on social exclusion and that on mental health conditions.

Psychosis and spirituality are often accompanied by profound and disorienting difficulties with understanding, meaning and purpose. In this chapter the authors draw on their experience as rehabilitation psychiatrists, and their view of spirituality as an essential and integral aspect of being fully human, to explore key interrelationships between spirituality and psychosis in the service of promoting health and healing. Using examples of lived experience they illustrate ways in which the practical application of spiritual perspectives can be important in enabling recovery – from understanding a person’s experience in the context of their personal, religious and cultural background, to re-visioning practice as person-centred care, and from recognising the needs of individual practitioners to service development and cultivating a culture that values peer support. They argue that there is no special or specific ’spiritual’ therapy, but rather that the conscious embodiment of kind, careful and ethical practice upholds spiritual qualities.

This chapter explores the ways in which mental health patients experience spirituality, based on case studies of patients and emerging data from an ongoing study in Birmingham, UK. Psychiatric patients commonly experience spirituality/religion as an awareness of something beyond their physical senses that is of great importance to them. Many turn to spirituality when they become unwell, deriving great strength from it, and for most patients it is closely linked with recovery. However, spirituality does not always have a positive impact, and spiritual struggles can increase mental distress. Spirituality thus has a major influence on mental well-being and recovery. Spiritual care aims to overcome spiritual problems and maximise the benefits of spirituality. It involves finding the right person to help each individual and is very popular with patients. Many patients also want to talk about their spirituality with clinicians and have their spiritual needs addressed as part of clinical treatment.

Disaster governance is an emergent construct in disaster research. It refers to new sets of structural arrangements and processes involving coordinated decisionmaking and action involving multiple actors from government, private sector, and civil society. Disaster governance focuses on managing hazards by reducing exposure, vulnerabilities, and adverse consequences of disasters through improvements in local response capacities, resilience, and various types of assistance to affected communities post-event. The set of structural arrangements engages state actors, private sector actors such as businesses and multi-national corporations, social actors (non-governmental organizations, community-based organizations), and policy actors (advocacy groups, political actors) into an integrated network from local to global scales. The context within which disaster governance arrangements function is influenced by demographic changes, spatial and administrative scales (from local to national), and the phases of emergency management, that are in turn shaped by historical, economic, social, and political processes within and between places. Such contextual understanding explains why disaster governance often is reactive, fragmented, rarely risk-based, and lacks comprehensiveness. This chapter reviews the contextual changes and challenges affecting disaster governance in the United States from the perspective of disaster resilience and long-term recovery. It begins with a short discussion on the changing nature of disaster risk, followed by a section on the current realities of emergency management, the causes and consequences of the decline in federal capabilities, and ends with the challenges for disaster governance in 2021 and beyond.

This chapter traces the evolution of federal disaster law and policy in the United States from the nation’s founding to the present. While many excellent histories of related topics already exist, this chapter will focus on three key aspects of this evolution. First, the chapter illustrates how the current federal policy structure is less a comprehensive system than an ad hoc agglomeration of policies and programs built on disparate experiences including natural disasters, wartime preparation, economic crises, and others. Second, the chapter explores the outsize role that political considerations, as opposed to best practices drawn from recovery management experiences, have played in shaping current federal disaster response and recovery approaches. Finally, recent events, including Superstorm Sandy and Hurricane Maria, are explored to illustrate the tradeoffs inherent in the United States’ federated system of disaster response.

Disasters in the United States require coordinated responses by many levels of government and necessitate many areas of technical assistance and expertise. Since at least Hurricane Katrina in 2005, it has become increasingly evident that effective disaster response requires legal assistance and expertise. This need for legal expertise became particularly prominent in the Covid-19 crisis of 2020, where federal, state, tribal, and other governments took extraordinary measures to contain the pandemic, raising questions about the legal authority and limits of such measures. To help prepare lawyers for engagement in future disasters, this chapter reviews basic tenets of disaster law, including governing statutes such as the federal Stafford Act and foundational theories such as the Disaster Cycle. The chapter also introduces useful materials, such as the National Response Framework, and key operational concepts, such as the Incident Command System.

Chapter 5 focuses on survivors’ experiences in survival and the challenges for recovery that are brought by freedom. It argues that survival exposes a difficult interplay between agency and responsibility; where survival brings the potential for growth, it also brings a responsibility for the self and for others. The paradox of this potential for growth is that having previously had absolute control exercised over them, the sudden ability (and requirement) to exercise agency and responsibility over their lives confronts survivors with challenges to their growth. The assumption of that agency and responsibility is also complicated and impeded by misunderstanding, and by the fragmented and incohesive support systems that prevail. The chapter then explores survivors’ needs in liberation, looking in particular at the attitudes and practices of the authorities, the limitations of central processes, and the psychological and physical challenges of survivors’ "new lives,” and identifies the value survivors consistently place on recognition, community, family, education, and rights.

Within disaster law, fostering social or community resilience is a key goal. In principle, the aim of resilience also applies to the energy supply, which should be built (or rebuilt) to enhance communities’ ability to cope with, and regroup from, disaster. However, resilience is a contested concept within energy law, where there is a vigorous – yet narrowly technocratic – debate over what attributes contribute to a resilient energy supply. This chapter synthesizes the conversations about resilience within disaster law and energy law to clarify the notion of resilience as it relates to energy. In particular, it argues that the rich literature on disaster law offers persuasive insights into what the goals and properties of a resilient energy supply should be, as well as how institutions might be reshaped to deliver on this potential.

In the immediate post-anaesthesia phase the patient’s airway, breathing, and circulation are subject to dynamic change as the effects of anaesthesia begin to wear off. If not carefully managed, life threatening complications can occur rapidly. The experienced practitioner uses risk appraisal to inform physical assessment in order to pre-empt complications or correct them if they occur. This chapter focuses on the key priorities of assessment together with other essential factors such as pain control.