It is widely accepted that a multidisciplinary approach is necessary to ensure the optimal care of patients with cancer, a complex disease that frequently requires a combination of treatments (e.g., surgery, chemotherapy, radiation therapy) to offer patients a chance at long-term survival. However, little has been written on how such multidisciplinary care should best be organized and/or delivered to patients suffering from sarcoma, a rare family of bone and soft tissue cancers. The purpose of this book is to explore the rationale and specifc methods for providing multidisciplinary care for these challenging patients. As with most complex issues, there is no single solution that will ft into every community or organization dealing with this disease. Therefore, we have invited a variety of authors from sarcoma centers and practices in the United States and from around the world, emphasizing best practices that can be translated into local and regional groups seeking to improve access and care delivery for these patients. At its core, a multidisciplinary approach is simply the application and coordination of individuals and/or teams representing different specialties working together and applying their knowledge and skills in their respective felds in order to solve or overcome a challenging problem.

Chronic Obstructive Pulmonary Disease (COPD) is a common disease and prevalence is increasing worldwide. It is characterized by persistent airway obstruction that is partially reversible but it is considered preventable and treatable disease now. Airflow limitation is associated with chronic and abnormal inflammatory response in the airways and the lung to noxious stimuli . Airway obstruction is defned by a reduction of expiratory airflow. Generally, forced expiratory volume in 1 s/forced volume capacity (FEV1/FVC) ratio of less than 70% after bronchodilator has been used to identify COPD patient. The use of lower limit of normal (LLN) values has been proposed to defne airflow limitation by spirometry, but current Global initiative for chronic Obstructive Lung Disease (GOLD) and American Thoracic Society/European Respiratory Society guidelines continue to recommend the fxed ratio criteria instead of an LLN for the diagnosis of COPD . Patients with COPD have shown a great deal of heterogeneity and can be classifed according to their clinical and radiologic parameters, biomarkers, lung function impairment and prognosis . Traditionally, COPD has been classifed as chronic bronchitis (CB) and emphysema. CB is defned as the presence of a chronic productive cough for 3 months in each of two consecutive years. Emphysema is defned as the destruction of alveolar walls and permanent enlargement of the airspaces distal to the terminal bronchioles. Current GOLD guidelines do not include the use of these terms in the defnition of COPD.

This book outlines our unique conceptualization of perfectionism, as well as assessment and treatment approaches for it. It represents the culmination of over two decades of research and clinical work on this topic. Our primary purpose for writing this book is to offer insight into the complex construct of perfectionism—not only as a personality style involving traits and relational elements, but also as a clinically relevant personality vulnerability factor that predisposes individuals to myriad problems. We also provide information on appropriate assessment and treatment of those people who are paying a signifcant personal price for their perfectionism.