Surgical Treatments for Pancreatic Pseudocysts

External drainage was used in cases of misdiagnosis, high risk of anastomotic dehiscence due to infected pseudocyst, or when the wall is immature. It was considered inferior to internal drainage in that external drainage can cause hemorrhage due to mechanical abrasion by the drainage tube, frequent occurrence of secondary infection, persistent pancreatic fistura, which was 10% of all cases, disease rate at 18% and a high 10% mortality. The study revealed a 9% mortality rate for external drainage, often due in turn to the poor condition of the patient.

This last study pointed to internal drainage as the preferable surgical procedure for all uncomplicated cases of pseudocysts (Govil et al. 2004). Cystogastrostomy is the option for cysts, which densely attach to the posterior stomach walls, while cystoduodenostomy should be for pseudocysts in the head and the uncinate process of the pancreas. The authors found that cystojejunestomy would be appropriate for…… [Read More]

Knee Replacement

Article Summary: A Randomized, Controlled Trial of Total Knee Replacement
In this study, the authors conduct an assessment of two approaches for addressing moderate-to-severe knee osteoarthritis. The said approaches are; total knee replacement followed by a nonsurgical program, and the adoption of nonsurgical interventions. It is, however, important to note that as the authors point out, both approaches lead to improvements that are deemed clinically relevant. More specifically, the authors of this particular study present their findings on the efficacy rate of the fusion of both surgical treatment and nonsurgical treatment, with the nonsurgical treatment program coming after the surgical intervention. The nonsurgical treatment program was implemented for a total of 12 weeks and it included pain medications, utilization of insoles, advice on diet, education, and exercise. The patient I took care of during my clinical rotation has knee pain and is scheduled for total knee replacement. On the strength…… [Read More]

Treatment of Sex Offenders the

When one looks at the occurrence of recidivism in offenders who have partaken in treatment programs varying from organic programs to those geared to more social and emotional support programs, it becomes clear that recidivism of sexual re-offense is relatively low, compared to those who undergo no treatment program. However, there is still an issue with non-sexual re-offense. In addition, there is evidence that the contributing factors for adult and juvenile offenders are different.

As such, it is suggested that not all offenders should receive the same treatment. Correctional literature indicates that high-risk offender require the greatest use of resource, while lower risk offenders require the lowest level of resources (Andrews & Bonta, 2003).

As such, blanket policies that deem all offenders as 'high risk' are neither effective nor efficient. In addition, it may take away resources from those who truly need it, such as juvenile offenders who require longterm…… [Read More]

Surgical Site Infections Are a

The facility should strive to bring the SSI rate down below the expected level for the types of patients and surgeries that the facility has.

Plan of Action

In order to achieve better-than-average results in the SSI rates for our facility, there are a number of tactics that can be used. The first is that the culture of the organization needs to emphasize safety to a degree greater than the current degree. As of now, there is no particular focus on SSIs, and this contributes to a culture where there is little accountability with respect to the SSI rates, or to individual SSI cases. The organization must improve the accountability, so that staff members are specifically held accountable for the mistakes that they make that result in an SSI.

Beyond culture, there are specific things that the organization can do to promote an improved rate of SSI. The first is…… [Read More]

Role of Antibiotic Therapy in the Treatment

ole of Antibiotic Therapy in the Treatment of Periodontal Disease?

The objective of this work is to examine the role of antibiotic therapy in the treatment of periodontal disease. Also examined will be the delivery system, the type of antibiotics and efficacy as an adjunct to mechanical therapy in the management of periodontal disease. Toward this end, this work will examine the literature in this area of study including literature located in professional and academic journal and publications.

Sub-Antimicrobial Dose Doxycycline

The work of Preshaw, et al. (2005) entitled "Long-Term Treatment with Sub-Antimicrobial Dose Doxycycline Has No Antibacterial Effect on Intestinal Flora" reports a study that sought to determine if a nine-month regimen of subantimicrobial doxycycline (20 mg. bid) had an effect on either the intestinal or the vaginal microflora. The study involved 69 individuals with periodontal disease who were randomized to receive drug or placebo control for a nine-month…… [Read More]

Combination Use of Endovascular Laser and Microphlebectomy for Treatment of Varicose Vein

Endovascular Laser and Microphlebectomy for Treatment of Varicose Vein

Venous insufficiency is a condition that affects hundreds and thousands of individuals each year, particularly women. Venous insufficiency often results in varicose veins, phlebitis and similar physiological conditions. In general these abnormalities are thought to result from a combination of gender and heredity among other things. Historically treatment for venous insufficiencies involved very aggressive and invasive surgery which stripped veins; this process resulted in a removal of the offending veins. Often the recovery time was in excess of two weeks, with patients often only minimally mobile.

Advances in technology and procedure however have resulted in a new minimally invasive procedure that combines the use of endovascular laser surgery and microphlebectomy to remove varicosities that occur below the knee (Pearce, 2003). The use of endovascular laser is limited primarily to the greater and minor saphenous veins, which are often implicated in venous…… [Read More]

Treatment Methods for Presbyopia

Presbyopia is a disorder, where the lens of the eye loses its capacity to focus. This incapacity makes it hard to see items up close. Some scholars have suggested that presbyopia means "age of sight." Presbyopia is not similar to farsightedness because it involves the loss of accommodation and ability for the eye to correct to enhance clarity at various distances. In this context, the young eye requires to change its interval or shape to focus on close objects. The capability of the lens to change shape gives the lens elasticity, which when lost results to presbyopia. When people grow old, they tend to lose this elasticity, and this explains why the eye gradually loses its capacity to focus on close objects (ennett, 2008).

How Presbyopia Occurs

Presbyopia happens when the cornea and lens refract light so that the light appears behind the retina



People realize they have this condition…… [Read More]

Surgical Management of Cleft Lip and Palate

Speech Problems and Psychological Damage From Cleft Lips and Cleft Palates

Cleft lips and cleft palates are among the most common of birth defects and if left untreated can lead to serious speech problems as well as psychological damage that can result both from those speech and communication problems as well as from the ostracism that a child with a facial deformity must endure.

However, while the consequences of cleft lips and palates can be severe and long-lasting, these can be averted by medical intervention, especially if it is done as early as possible. This paper explores the various options for surgical and medical management of cleft lips and palates and the ways in which these interventions can help children with these particular birth defects.

We should begin this discussion of treatment of cleft lips and palates by establishing what exactly is meant in medical terms by these two terms.…… [Read More]

Treatment of Ilds and Assessment

Interstitial lung disease is a blanket term for a big group of disorders categorized by progressive scarring of both the lung tissue supporting and between the air sacs. This tissue is called the interstitium. The interstitium consists of the region between the alveolar space and the capillaries. The scarring causes inflammation and damage in the lung tissue followed by lung stiffness, meaning the air sacs cannot expand as much as before. Lung stiffness makes it harder to breathe. People affected by the condition are not able to get enough oxygen from the lungs into their bloodstream.

Although some potential causes have been researched, there may be no underlying cause for development of interstitial lung disease. If there is no known cause, it is called idiopathic interstitial lung disease. IPF or idiopathic pulmonary fibrosis remains the most common type of this illness. Of the causes most widely recognized, cigarette smoking is…… [Read More]

Routine Shaving of the Surgical Site Select

Routine Shaving of the Surgical Site

Select a preoperative procedure (e.g., routine shaving of the surgical site) that you would commonly find on a surgical floor.

Describe the process or procedure you have chosen and why you think it needs change.

The process which I have chosen for surgical floor is routine shaving of the surgical site and I think it needs change because patients going through surgery are required to remove hair from the site of the cut. This is considered to reduce the chance of the surgical site becoming infected (National Collaborating Centre for omen's and Children's Health, 2008). Shaving, clipping the hair and using a cream which dissolves the hair are some of the different methods available to remove hair. And these are important because clinically, care plans offer a way to plan and communicate appropriate patient care.

A2. Based on your initial investigation of the situation,…… [Read More]

Technological Th Century Surgical Technological

As Pressman states, "Given what has later become known about the delicacies of brain function and the complexities of psychiatric illness, it strains credulity that such a crude procedure as the original lobotomies might truly have yielded therapeutic benefits for a great many patients." (Pressman1998, 195) This also refers to the fact that some medical theories are favored at certain times and not others. This suggests the relativity rather than the certainty of the scientific -- rational worldview.

The above brings us to the views put forward by Freeman and others concerning the technological fix. This in turn relates to other questions; such as why a method like lobotomy should have been seen to be effective in the past but not today. This leads to the view that political and social factors influence medicine and especially the success once attributed to a technology like lobotomy. For example, Pressman refers to…… [Read More]

Non Surgical Sterilization of the

Varied Perspectives on Non-Surgical Sterilization Methods:

There have been varied perspectives on the use of non-surgical sterilization of the dog since these products do not entirely solve the problem of the overpopulation of dogs and cats. Additionally, the varied perspectives and arguments on the use of these methods have also been due to the fact that some people don't care since they want to breed their animals. Given that there is no secure and effective non-surgical sterilization method of the dog that has been identified and announced, the varied perspectives have continued to increase. However, there have been various approaches to identify non-surgical products though none of the products have shown tremendous results to be widely adopted and implemented (Bowen, 2006).

One of the major perspectives has been against the non-surgical sterilization of the dog since the methods that have been explored have not only been ineffective but have also…… [Read More]

Clinical Journal Leadership Nursing Medical-Surgical

The nurse must 'read' the patient's personality, and know whether acting firm or sensitive is the best way to deal with the individual. A nurse must always comport herself in a professional manner, but needs to take a different tone with a child vs. An adult; a person in a dissociated state vs. A man experiencing chest pains. Communications decisions, much like medical decisions, must often be undertaken in a split second. The first few minutes of the encounter can set the tone of the entire client-nurse interaction, even the tone of the patient's entire experience on the unit.

Effective communication is also required with other healthcare professionals on the unit, including but not limited to doctors, other nurses, and physician's assistants. 'Triage' -- deciding what patients and procedures are of highest priority, establishing standard operating procedures to deal with being short-staffed, and using time and resources in an effective…… [Read More]

Establishing an NP-Led Day Treatment Facility in Bessemer Alabama

Establishing an NP Led Wellness and Recovery Center for Deinstitutionalized Individuals

Historically, nursing, and medicine professions have been loath to utilize tools commonly linked with mercenary aspects of business, such as market research and decision analysis. In the contemporary health care setting, however, consumers hold numerous options for care providers. The division of the market or market segmentation into different subgroups allows the determination of target markets and the buildup of marketing policies specific to the needs and interests of the selected subgroups. Market analysis allows the identification of policies for nurse practitioners to enhance their practice in a way that centers on the interests and needs of the selected market. While scores of the nurse practitioner's dream of operating their own businesses, those that have set up their own practice understand that it requires a compelling passion for owning a business, and for the profession.

A nurse practitioner is…… [Read More]

Conventional Treatment

Therapies Deprive Patients From Conventional Cancer Therapies

Future Ethical Prospective

Do public demand for, and clinicians' tendencies to prescribe novel targeted cancer therapies in a resource starved healthcare system deprive other patients of conventional treatment? If so, can it be justified?

Over the years, there have been several studies which have shown that a small but noteworthy fraction of cancer patients drop one or more conventional cancer treatments and use novel targeted cancer therapies instead. When it comes to recent public demands in healthcare, research into cancer control has addressed issues relevant to novel targeted cancer therapies in a resource starved healthcare system. Disparities have been addressed to a much greater degree than before, with studies of the conventional treatment of cancer especially in our variety of ethnic and socioeconomic settings. Conventional treatment have a greater social impact and the demand for such treatments of many (male and female) of…… [Read More]

Aromatherapy in Addiction Treatment for

S ome aromas even affect us physiologically" (p. 38). esearchers exploring human olfaction have determined that:

faint trace of lemon significantly increases people's perception of their own health.

Lavender incense contributes to a pleasant mood -- but it lowers volunteers' mathematical abilities.

A whiff of lavender and eucalyptus increases people's respiratory rate and alertness.

The scent of phenethyl alcohol (a constituent of rose oil) reduces blood pressure.

These findings have contributed to the explosive growth in the aromatherapy industry; according to Furlow (1996), "Aromatherapists point to scientific findings that smell can dramatically affect our moods as evidence that therapy with aromatic oils can help buyers manage their emotional lives" (p. 38). According to Ornstein and Sobel, one recent experiment to determine the effect, if any, of fragrances on mind/body involved subjects being wired to physiological monitoring equipment, and then being interrogated with stress-provoking questions, such as "What kind of person…… [Read More]

Carl Rogers and Abraham Maslow Treatment Approach for Out Patient Therapy

Carl ogers and Abraham Maslow Treatment Approach for Outpatient Therapy

Carl ogers and Abraham Maslow treatment approach for out-patient therapy.

The study of human psychology is important in understanding personality of individuals. One can study personality of individuals, but there is no scientific method of studying personality of the whole humanity. Human are different from person to person and vey unique to some degree. This paper prompts a thesis, and it digs into the psychology of humans. It dwells on the person-Centered approach by Carl ogers and on the Humanistic Approach by Abraham Maslow.

Both Carl ogers and Abraham Maslow have an influence on today's outpatient therapy. Both scholars have had an influence on the humanistic psychology and personal centered approach to therapy. Although humanistic psychology gained its popularity in the mid 20th century, both scholars have further entrenched theories and practices that make it important in today's outpatient therapy.…… [Read More]

Angiography Types Categories Signs and Symptoms Treatment Imaging Modality

Angiography;, Types Categories, , Signs & Symptoms, Treatment, Imaging Modality

Angiography

An angiography involves the use of water-soluble X-ray contrast media by injecting it into blood streams in arteries or veins with the purpose of imaging blood vessels. The process is meant to observe normal or pathological conditions of the vessel organization. By seeing the lumen of blood vessels and organs, an angiography can provide information concerning conditions like luminal narrowing and aneurismal widening. Vessel access is essential and serious complications can appear if the substance is unable to pervade the veins and arteries, but this is rare and unlikely to occur. hile these are some of the conditions that are frequently detected through an angiography, it can also play an important role in analyzing sources of bleeding, tumors, and diverse malformations in veins and arteries.

The discovery of X-rays led to some of the first experiments with angiographies as…… [Read More]

Staging Diagnosis and Treatment of Cancer

Cancer and Treatment

The identification and treatment of cancer as well as the care provided the patient are essential aspects of quality care nursing. Cancer is a complicated illness that progresses in stages and takes both a physiological and psychological toll on the patient. This paper will discuss the act of diagnosing cancer, the stages of cancer, complications that can arise, available treatments, and recommendations for addressing physiological and psychological side effects of care.

Diagnosing cancer is the first step in treatment. Diagnosing consists of performing laboratory tests of blood and urine along with imaging procedures, which take pictures of target areas within the body and allow the physician to see any tumors that are growing. Imaging processes such as CT scans, ultrasounds, MIs, PET scans, nuclear scans, and x-rays are common practices and methods of diagnosing cancer. Performing a biopsy is another important step in the method of diagnosing…… [Read More]

Diagnosis and Treatment Options for Pancreatic Cancer

Etiology of Pancreatic Cancer

Pancreatic cancer has emerged as the most lethal human cancers. In fact, the World Health Organization (WHO) has termed it an unresolved health problem of the 21st century. The disease presently causes about 30,000 deaths in the U.S. per year (Yarbro et al. 2015). Despite past efforts, conventional interventions like radiation, surgery, chemotherapy and combination of these had minimal success in the course of this aggressive disease. It is imperative to develop an in-depth understanding of the molecular biology of pancreatic cancer to help us effectively diagnose, prevent and treat the disease. Nearly all pancreatic cancer patients experience metastases and die due to the frustrating metabolic effects of their unrestrained growth (Shrikhande et al. 2010). Hence, a crucial requirement for progress is the establishment of effective systemic interventions, can reverse the aggressive biology of the disease.

According to the WHO, pancreatic cancer is the fifth most…… [Read More]

The Diagnosis and Treatment of Arrhythmia

Arrhythmias cause irregular hearts beats in ways that can be life-threatening but there are a number of different types of arrhythmias that require different interventions. To determine the facts, this paper reviews the relevant literature to provide the etiology and pathogenesis, prevalence, clinical signs and symptoms, diagnostic pathways and optimal therapeutic approaches for paroxysmal atrial tachycardia, ventricular fibrillation and Brady arrhythmias, followed by a summary of the research and important findings concerning these three disease states in the conclusion.

Paroxysmal Atrial Tachycardia

Etiology & Pathogenesis. This type of arrhythmia can occur in individuals who have normal hearts as well as in people who have structurally abnormal hearts including those with congenital heart disease, especially following surgical repair of valvular or congenital heart disease (Budzikowski & ottman 2015).

Common causes of the arrhythmia, risk factors, definition of rhythm via EKG findings. Paroxysmal Atrial Tachycardia (PAT) is caused by irregular firing of…… [Read More]

Causes Symptoms Diagnosis and Treatment of Hearing Loss Among Adults

Hearing Loss Among Adults

Chou , Dana T, Bougatsos C, et al.; (2011), Screening for Hearing Loss in Adults Ages 50 Years and Older: A eview of the Evidence for the U.S. Preventive Services Task Force. Agency for Health Care esearch and Quality (U.S.); eport No.: 11-05153-EF-1

Among adults, hearing loss can be hereditary or acquired from aging related illnesses. esearch has shown that loss of hearing among adults may occur as a result of ototoxic drugs, tumors, accidental head injuries and natural occurring aging process. The hearing loss may be through absolute numbness in the years or through ringing in the years ("Tinnitus"). Loss of hearing is through damage to the inner ear, ear infection, buildup of earwax, or a ruptured eardrum.

National Institute on Deafness and Other Communicative Disorders (2011), Ten Ways to ecognize Hearing Loss. Available online: http://www.nidcd.nih.gov/health/hearing/pages/10ways.aspx. and, Yuch B, Shpiro N, Maclean CH, Shekelle PG.…… [Read More]

Abnormal Uterine Bleeding

Abnormal Uterine Bleeding and Issues

Reproductive Tract Diseases for human females are typically focused in the upper reproductive tract or the lower reproductive tract. The upper tract includes the fallopian tubes, ovary and uterus, while the lower reproductive tract focuses on the vagina, cervix and vulva. There are three major types of infections: endogenous, iatrogenic and sexually transmitted diseases. Endogenous diseases arise from internal cellular structures and may be bacterial, viral or genetic, usually the most common and arise from an overgrowth of organisms that are already present in the vagina; iatrogenic diseases are the result of medical or surgical treatment, and sexually transmitted diseases occur between humans as a result of sexual behavior. In addition to infections, there are congenital abnormalities, cancers and functional problems. Each infection has its own specific cause and symptoms; caused by bacteria, virus, fungi or other organisms. Indeed, some are easily treatable and cured,…… [Read More]

Torticollis Intervention Torticollis Is a Condition Which

Torticollis Intervention

Torticollis is a condition which can be either temporary and of a minor inconvenience or it can be chronic and physically debilitating. The implications of the condition can run the gamut of severity and susceptibility to treatment. Torticollis, or a twisting of the neck, can be extremely common but its causes and impact exist across a wide range of variations. The discussion here will offer a concise overview of the condition with consideration of its various suspected causes, its most salient symptoms, strategies for its treatment and existing technologies or adaptive strategies aimed at helping individuals live with the condition.

Condition Background:

Torticollis is not an altogether uncommon presence at the time of birth. hen the condition is present at the time of birth, it is referred to as congenital or inherited torticollis. According to the research provided by the Baby Center Medical Advisory Board (BMAB) (2012) "about…… [Read More]

Postoperative Vision Loss Elements of

More times than not, a patient will argue that he did not understand what the physician stated to him; even amidst documented proof the medical professional and the patient did engage in an informed conversation. "The fact that a meeting took place does not necessarily mean that there was a meeting of the minds" (Informed consent…, 2010, ¶ 5). This issue leads some health care providers to assert that informed consent forms possess little value, particularly when a legal battle ensues and the professional cannot prove the patient did, in fact, understand the informed consent process.

Currently, lawyers routinely challenge informed consent forms in courtrooms throughout the United States (U.S.). "The model consent forms incorporate substantial details of anesthesia techniques, risks and other elements of 'informed consent', so that a strong presumption is established on its face" (Informed consent…, 2010, ¶ 7). During the informed consent process, to help inoculate…… [Read More]

Interstitial Cystitis in Addition to the Therapeutic

Interstitial Cystitis

In addition to the therapeutic armamentarium, CAM reported to have a great role to treat interstitial cystitis (IC). It is multimodal and individualized and includes various treatment methods including: Neuromodulation, dietary modification, acupuncture, surgical methods, medications etc. The objective of this literature review is to discuss the possible causes of the IC, diagnosis, prevalence, the symptoms, and CAM treatment options.

Interstitial cystitis (IC) also called as painful bladder syndrome is an inflammatory disease of the bladder wall with typical ulceration of the urothelium. The interstitial cystitis (IC) is generally regarded as an elusive disease picture with inadequate therapeutic options. Critical to improving the prospects for therapy is the early diagnosis of the disease, which may involve only a careful history taking and clinical examination. CAM suggests multimodal treatment strategies in the early stage of disease (Abrams, Cardozo, & Fall, 2002).

Due to definition similarity, IC is often referred…… [Read More]

Temporomandibular Joint Surgery

Temporomandibular Joint Surgery: A Comparison

Between Arthrocentesis And Arthroscopic Approaches

Background and Historical Perspective:

Temporomandibular Syndrome is a somewhat general descriptive term comprising several distinct pathologies, all related to the various structures of the temporomandibular joint. TMJ symptomatology ranges from general myofascial discomfort which can often be addressed by conservative (non-invasive) approaches to profoundly pathological interarticular mechanical malfunctions requiring extensive surgical repairs.

In general, the vast majority of TMJ symptoms are temporary in duration and resolve either spontaneously, or with conservative treatment consisting of rest, anti- inflammatory agents, muscle relaxants, physical therapy, dental devices and/or bite adjustments, behavior modification and external application of thermal compresses.

A comprehensive evaluation is essential to accurate diagnosis, particularly since stress management problems and repressed aggression sometimes manifest as myofascial pain.

Surgical intervention should therefore always be considered as a last resort and limited to intracapsular pathology associated with significant pain and mechanical malfunction. Where…… [Read More]

Perioperative Nurse's Role in Caring for Pregnant Patients With Aortic Dissections

Aortic dissection is a disease of the wall of the aorta in which the aortic blood bursts into the muscular layer of the great artery, thus forming a blood filled channel along the planes of the muscularis layer. This false lumen can re-rupture back into the true lumen, through a second distal intimal tear, creating a biluminal or double barrelled aorta. Due to weakened walls, there is threat of rupture into the surrounding tissue with fatal consequences. (Boon, , Colledge, Walker, & Hunter, 2010)

The pathophysiology behind the condition is often a spontaneous or iatrogenic tear in the intima. However, in about five to ten percent of patients, these tears are absent. An intimal tear can occur anywhere along the aorta, although a vast majority of tears are found within ten centimeters of the aortic valve. The dissection may extend towards the heart, affecting the coronary arteries, or it may…… [Read More]

Polydactylism Polydactyly Is a Relatively

This would clearly be preferable to performing surgery, but may be more applicable in cases of type B than type a polydactyly. Of a total of 21 cases which were examined, this procedure resulted in a slight complication in only one case, where the digit had to be removed surgically due to failure of removal by suture ligation. The only real side effect of this simple treatment is that there was found to be a small bump remaining at the site in 43% of cases.

Conclusion

Although there has been some work into the genetic basis of polydactyly, advances in examination of the human genome may create a better understanding of the condition in the future. A large amount of the work done so far has been focused on animal models, and there is still room for further work to discover the genetic basis of the different types of polydactyly…… [Read More]

Alopecia Areata Is a Systemic Hair Loss

Alopecia areata is a systemic hair loss disorder, which affects roughly around 4.7 million people in the United States alone. [NAAF]. It is characterized as an autoimmune disease that leads to either localized or complete hair loss. The disease is independent of race, gender or age specifications, and hence affected people represent a diverse group. The effects of the disease may either be permanent or reversible depending on the nature and extent of damage to the hair follicles. It is believed that both genetic as well as environmental factors have an influence in the onset of the condition. However, the pathology of the disease is yet to be ascertained concretely. Though there is no physical distress accompanying the disease the psychological devastation suffered by the affected person is debilitating. Let us have a brief overview of the different types of alopecia before we discuss in detail the possible pathophysiology and…… [Read More]

Gender Identity Disorder the Objective

ibliography

Mouffak, Faycal; Gallarda, Thierry; aup, Nicolas; Olie, Jean-Pierre; and Krebs, Marie-Odile (2007) Gender Identity Disorders and ipolar Disorder Associated With the Ring Y Chromosome. American Journal Psychiatry 164:1122-1123 July 2007. Online available at http://ajp.psychiatryonline.org/cgi/content/full/164/7/1122#R1647CHDJECID

Childhood Gender-Identity Disorder Diagnosis Under Attack (2007) National Association for Research and Therapy of Homosexuality. NARTH. Leadership U. Online available at http://www.leaderu.com/orgs/narth/childhood.html

Osborne, Duncan (2003) Voices - Identity Crisis. OUT magazine. Los Angeles, April 2003. Liberation Publications, Inc. Online available at http://www.antijen.org/Out.html

Hepp U, Kraemer , Schnyder U, Miller N, Delsignore a: Psychiatric comorbidity in gender identity disorder. J Psychosom Res 2005; 58:259-261

Habermeyer E, Kamps I, Kawohl W: A case of bipolar psychosis and transsexualism. Psychopathology 2003; 36:168-170

Diagnosing and Treating Gender Identity in Women (1997) Medscape Psychiatry & Mental Health eJournal. 1997 Online available at http://www.medscape.com/viewarticle/430853_4

Zucker, K.J. (1985) Cross-gender-identified children. Chapter 4 in .W. Steiner (ED.) Gender Dysphoria: Development, Research, Management, New…… [Read More]

Carpal Instability Is Any Mal-Alignment

When using open reduction of dorsal displaced fractures of the radius to restore congruency and extra-articular anatomy, the authors recommended the use of their double-plating method. This method is reliable in providing stable internal fixation and in allowing early function. It is, however, and as earlier mentioned, a demanding technique, as ot requires careful; attention to detail.

Carter, P.. And PR Stuart. The Sauva-Kapankji Procedure for Post-Traumatic Disorders of the Distal Radio-Ulnar Joint. Journal of one and Joint Surgery: ritish Editorial Society of one and Joint Surgery, September 2000

Only one surgeon performed all the operations on a total of 37 patients for pain on the ulnar side of the wrist and decreased rotation of the forearm. The authors reported that most of the tested patients were better after the operation, although a significant number had some pain. Relief from pain could not be guaranteed and that residual pain associated…… [Read More]

Headache One in Eight Americans Suffers From

Headache

One in eight Americans suffers from headaches (Pain, Academy of General Dentistry). As much as eighty percent of all headaches are caused by muscle tension, which may be related to bite problems. Headaches also can be caused by clenching jaw muscles for long periods of time. Signs that may indicate a headache from a dental origin include:

Pain behind the eyes

Sore jaw muscles or "tired" muscles upon awaking

Teeth grinding

Clicking or popping jaw joints

Head and/or scalp is painful to the touch

Earaches or ringing

Neck, shoulder or back pain

Dizziness

There are a variety of treatments that will help alleviate orofacial symptoms. One device is called an orthotic, or splint, that is worn over the teeth until the bite can be stabilized. Often permanent correction is practiced such as reshaping teeth (coronoplasty), building crowns or bonding, orthodontics, or surgery that installs a permanent appliance for the…… [Read More]

Vater or Vacterl Is Referred

All surgeries were successful and the prognosis based on follow up testing was good. (Yamashiro et al., 2007)

racheoplasty was also carried out for fourteen patients, seven of whom showed other symptoms of VAER association and the rest presented tracheal problems without other VAER symptoms. (Fiore, Brown, Weber, & urrentine, 2005)the same treatment modality was used for all patients with the loss of only two patients. Follow up indicated that this was a sound modality for treatment of tracheal defects in VAER associations. Similarly, urinary tract reconstruction was deemed successful and safe for end-stage renal disease in infants. he overall patient survival rate was 95%. (DeFoor et al., 2003) and, in another study, it was shown that neurosurgical treatment was successful 60% of the time for hydrocephalus from VAER, which prompts the researchers to indicate that the prognosis of certain death is not necessarily true and that the patients who…… [Read More]

Pancreatitis the Pancreas Is an Important Source

Pancreatitis

The pancreas is an important source of digestive enzymes and fluids, and plays a critical role in regulating blood sugar levels through the production of insulin and glucagon (NDDIC, 2012). Should the pancreas become inflamed there is the risk that the digestive enzymes will become activated within the pancreas, resulting in self-digestion. This disease is known as pancreatitis and even mild cases require hospitalization. This essay will review what is known about pancreatitis in the United States and the clinical guidelines for diagnosis and treatment.

Pancreatitis Pathophysiology, Epidemiology, and Etiology

The digestive enzymes produced by a healthy pancreas are secreted into the small intestine as zymogens, which are enzymes that have their catalytic domain blocked by a peptide group (Berg, Tymoczko, and Stryer, 2002). The intestinal brush border cells secrete enteropeptidase, which removes the peptide blocking the catalytic domain of trypsin. Trypsin then activates the digestive enzymes secreted by…… [Read More]

Aging in Our Society

bio-psychosocial model to assess a 70-year-old adult (referred as Mr. X) suffering from mental retardation and makes appropriate recommendations regarding a treatment plan. However, before we make a medical diagnosis of Mr. X, it is important that we briefly review the "mental retardation" ailment. "Mental retardation is not something you have, like blue eyes, or a bad heart. Nor is it something you are, like short, or thin. It is not a medical disorder, nor a mental disorder. Mental retardation is a particular state of functioning that begins in childhood and is characterized by limitation in both intelligence and adaptive skills. Mental retardation reflects the "fit" between the capabilities of individuals and the structure and expectations of their environment." Taken from (http://www.aamr.org/Policies/faq_mental_retardation.shtml).

Medical diagnosis

Mental retardation ailment of Mr. X has had two fundamental and noteworthy impacts. The first is the intellectual performance that is considerably below normal standard and…… [Read More]

Peri-Implantitis Infections of the Implantation Area the

Peri-Implantitis

Infections of the implantation area the mainly widespread of the dental implant complications. Implant infection is a state which is known as peri-implantitis which has a sign of swelling or inflammation of the tissues adjacent to the implantation area. Peri-implantitis is a type of periodontal disease that is able to result to inflammation, bone loss and failure in dental implant in any case it is not treated appropriately. A flame is part of a fire. Inflammation is a situation where a tissue gets swollen, red, and frequently hurts. About dental implants, it is an inflammation that can be caused by trauma or infection. Inflammation causes several special defensive cells to move to the inflamed area. Inflammation is capable of resulting to bone loss together with dental implants, where bone loss is a dangerous situation. The supporting bone holds the dental implant in the jaw.

Generally, the purpose of the…… [Read More]

Controversial Business Practice

Plastic Surgery

Teen Plastic Surgery: A Controversial Medical Practice

According to the American Society of Plastic Surgeons, in 2007, more than 87,000 teenagers had cosmetic surgery; and that number has grown exponentially since. Although aesthetic cosmetic surgery is popular amongst United States teens, physicians and plastic surgeons worry that such invasive surgery on teens' still growing bodies can be dangerous. Other developed countries, including Germany and Australia, are considering banning all but medically necessary plastic surgery for anyone under the age of 18. However, the question remains, if such a measure were taken like that in the United States for minors stem the tide of teenagers going under the knife? This paper will address the controversy associated with teenagers and aesthetic cosmetic surgery in the United States, and the business of plastic surgery for teens, from a legal, ethical, and social responsibility standpoint.

Introduction

In a country, and dare say…… [Read More]

Analyzing the Endometriosis Phenomenon

Endometriosis' is taken from the Greek work endon which means "within," metra, meaning "uterus" and osis, meaning "uncommon or sick state." Endometriosis is said to be very complicated and tiring gynecological sickness. This disease causes the functional endometrial stroma and glands grow outside of uterus that is usually present inside (the endometrium). These areas mostly consist of fallopian tubes, ovaries, gastrointestinal tract, rectovaginalseptum, bladder, pelvic peritoneum and unusually Pleura and pericardium. Endometriosis is a widespread disease most common in women who are in age of reproduction. This disease depends on estrogen and involves a chronic inflammatory component. Sampson was the first person to classify hemorrhagic ovarian lumps. He further explained these cysts as follicular, stromal, endometrial and corpus luteal. He also presented the endometrial hematomas based on thehistologic form. A number of categories have been formed after that, which is based on the histologic appearance, anatomic size, location and the…… [Read More]

Management of Osteomyelitis in the Diabetic Patient

Osteomyelitis in the Diabetic Patient

Management OF OSTEOMYELITIS IN THE DIABETIC PATIENT

Osteomyelitis is an infection of the bone or bone marrow which is typically categorized as acute, subacute or chronic.1 It is characteristically defined according to the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and physical location of the infection site.2 Infection modes usually take one of three forms: direct bone contamination from an open fracture, puncture wound, bone surgery, total joint replacement, or traumatic injury; extension of a soft tissue infection such as a vascular ulcer; or hematogenous (blood borne) spread from other infected areas of the body such as the tonsils, teeth or the upper respiratory system.2(p807) Bacteria such as Staphylococcus aureus, Pseudomonas, Klebsiella, Salmonella, and Escherichia coli are the most common causative agents of the disease, although viruses, parasites and fungi may also lead to the development of osteomyelitis.3

Patients…… [Read More]

Nursing Definitions Autonomy in the Nursing Profession

Nursing Definitions

Autonomy

Autonomy in the nursing profession states the importance of the client's role in making decisions that reflect advocacy for the client (Wade, 1999, p.310). Ultimately, this includes taking care of the patient physically as well as mentally and emotionally, developing a relationship with the patient that is beneficial to his care and actively advocating for the patient's rights and care. This type of autonomy, it is important to note, is not the same as individual or work autonomy, yet it must be considered that empowerment in nursing autonomy will inevitably lead to better professional and personal autonomy and should also lead to increased job satisfaction (Wade, 1999, p.310).

Typical definitions of autonomy would include the idea of complete independence for the person making the decisions. However, in the case of the nursing profession, the client's needs and desires must be heavily weighed and, in fact, become central…… [Read More]

Mrs Mansfield Is Being Handed Over to

Mrs. Mansfield is being handed over to care from the operating theatre nurse. We would require an update chart information. She has had an ovary removal (bilateral salpingo-oophrectomy) and is currently on an IV infusion of .8% Normal Saline. In order to continue her care, we would need previous vitals, lab work, and any details on her condition. We know she has a bellovac drain insitu and a PCA along with O2 via nasal prongs. We would need the orders on the PCA and the physician's assessment of pain medications. There would likely be instructions on wound draining, as well as potential additional fluids and/or blood transfusion information (part of vitals in chart). Post-operative care instructions would be mandatory -- including diet, hourly rounding instructions and additional materials to assist with her post-operative care condition (Fogel & Woods, 2008 p. 428).

Q2 -- esearch shows that unrelieved pain has a…… [Read More]

Technical Instructions for Coronary Artery

Indeed, "time heals all wounds," even those resulting from open heart surgery, and the payoff was shown to be clearly worth the risks involved for most of the people who electively seek out the CABG procedure for their coronary heart disease.

eferences

CABG and PCI Each Have Strengths, Weaknesses Ann Intern Med. 2007 [Published online Oct.

16, 2007] cited in Latest research. (2007, November 2). Medical Economics, 84(21), 75.

Ben-Zur, H., appaport, B., Ammar, . & Uretzky, G. (2001). Coping strategies, life style changes and pessimism after open-heart surgery. Health and Social Work, 25(3), 201-

Kos-Munson, B. A, Alexander, L.D., Culbert, P.A., Hinthorn, E.L. & Goetze, C.M. (1988).

Psychosocial predictors of optimal rehabilitation post-coronary artery bypass surgery.

Scholarly Inquiry for Nursing Practice, 2(3), 171-172.

Peterson, J.C., Charleson, M.E., Williams-usso, P. & Krieger, K.H. (2002). New

postoperative depressive symptoms and long-term cardiac outcomes after coronary artery bypass surgery. The American Journal…… [Read More]

Shin Splints From Ecs Conditions

Practical esearch Finding Implementation and Experimentation Stage -- Phase I

The experimenter did not set out to determine specifically which of the various contributing factors (or combinations of factors) identified by the empirical research of medial tibial stress syndrome was most responsible for the experimenter's symptoms. However, since the initial attempts to resolve the symptoms incorporated changes to all of the external variables except a change in running surface, the experimenter immediately sought a softer running surface and temporarily abandoned running on any hard surface that magnified instead of minimized the physiological trauma associated with running on harder surfaces.

Because the empirical research also implicated poor running stride mechanics and excessive vertical elevation, the experimenter devoted considerable attention to making the following specific changes to the running stride: (1) shorter strides to minimize travel of the body while neither foot is in contact with the running surface; (2) conscious attempts…… [Read More]

Ectopic Heterotopic Brain Tissue Extracranial Brain Tissue Without

ectopic/heterotopic brain tissue. Extracranial brain tissue without direct connection to the brain itself may be an isolated cutaneous embryonic defect that is usually located on the occipital or parietal area of the scalp. Most of the time these are harmless and can be removed. These often are called heterotopic brain tissue or cutaneous ectopic brain tissue or (CEB).

ECTOPIC OR HETEROTOPIC BRAIN TISSUE

Extracranial brain tissue that is directly connected to the brain itself may be an isolated cutaneious embryonic defect. These are usually located on the occipital or parietal areas of the scalp. They are often called heteropic brain tissue or cutaneous ectopic brain (CEB) (Janniger 1). Most of the time these are simple defective tissue that can easily be removed from the scalp. However, there are several different types of ectopic brain tissues and some of these can be signs of underlying central nervous system problems. Each of…… [Read More]

Mold Spore Analysis and Toxicity

Mold Spore Trapping

Current Scientific Knowledge

People are exposed to aeroallergens in a variety of settings, both at home and at work. Fungi are ubiquitous airborne allergens and are important causes of human diseases, especially in the upper and lower respiratory tracts. These diseases occur in persons of various ages.

Airborne spores and other fungi particles are ubiquitous in nonpolar landscapes, especially amongst field crops, and often form the bulk of suspended biogenic debris. The term mold often is used synonymously with the term fungi. A more precise definition would specify that molds lack macroscopic reproductive structures but may produce visible colonies. Respiratory illness in subjects exposed to rust and dark-spored imperfecti fungi was described more than 60 years ago, and physicians worldwide now recognize a sensitization to diverse fungi.

Since fungus particles commonly are derived from wholly microscopic sources, exposure hazards are assessed largely through direct sampling of a…… [Read More]

Women Disability Sexuality and the

Stocker, deaf since birth, admittedly attempted to compensate for her disability, her imperfection, through the relentless pursuit of achieving perfection physically and athletically, and even when she excelled, Stocker confesses, for a long time she remained emotionally tortured by disability for which no amount of body shaping or athletic skill in sports could change that disability (2001, p. 154). Stocker's struggle with her self-image, her identity and hers sexuality were in large part shaped by her disability.

While it is not an attempt here to disparage Stocker, or to belittle the significance of her disability; Stocker is a woman who suffered her hearing impairment from birth. Stocker suffered emotionally as a result of her disability, struggled with it for most of her life in the ways in which it impacted her self-esteem, self-image, and sexuality. So, might not a woman who acquired a disability at that point her life when…… [Read More]

Policy Changes in Healthcare Finance Healthcare Finance

Policy Changes in Healthcare Finance

Healthcare Finance

CPT Codes

The American Medical Association (2013) developed the Current Procedure Terminology (CPT) codes decades ago in the 1960s. The first edition was published in 1966 and over the subsequent years several updated versions were created. The reasons for developing the CPT code system was to make communications about medical procedures easier between health care providers, help patients and their doctors submit claims for services to insurance providers, create a structure that would facilitate the development of an electronics records system, and create categories that would help researchers collect data on the health care field.

The CPT code system expanded with each subsequent edition and with publication of the second edition the codes were transitioned from a 4 to a 5 digit system (American Medical Association, 2013). This transition was necessary as the services covered by the code expanded beyond medicine, radiology, and…… [Read More]

Ulnar Collateral Ligament

Ulnar Collateral Ligament. Discussed is how one can injure it and what can one do for it.

Ulnar collateral Ligament structure that holds bones together and aides in controlling movement of joints in a ligament. It is like a tether between the bones, "which gets too tight when the bones move...hen a ligament is torn, the tether is too long and the bones move too much" (Eisner pg).

This causes pain and an instability and/or looseness. It can also lead to the inability to work at one's profession or activities, especially sports. "The ulnar collateral ligament complex (UCL) is lovated on the inside (or medial side) of the elbow (small finger of the arm)" (Eisner pg). The three bands or divisions that compose it are the anterior, posterior, and transverse bands. The ulnar collateral ligament "attaches on one side of the humerus (the bone of the upper arm) and on…… [Read More]

Listerine Today vs Listerine From Yesterday

LISTEINE TODAY VS. LISTEINE FOM YESTEDAY

Listerine

Listerine is one of those few renowned products which have ruled globally for more than a century. Since, its inception since 1890s, it has managed to provide sustainable and effective solutions for oral hygiene.

One noticeable thing about Listerine is that its original formula hasn't changed much. In fact, now it is known as Listerine original. One can still find the same formula of Listerine which was used six decades back, in the market. However, science has made great advancement in 1900s and we have also made great progress in dental sciences. Therefore, for curing other problems related to oral protection, various other types of Listerine have been introduced in the market.

These new types are quite different from the original formula. Their color and uses that they are meant for, are also different. By providing this vast range of products, Listerine has…… [Read More]

Article Analysis and Evaluation

performed by a group of professionals that included: Dr. Xiao-Mei Li (Doctor of Philosophy in Nursing, egistered Nurse), dean and associate professor of the nursing department of Chinese university, Jiao tong University's College of Medicine; Kai-Na Zhou (Master of Science in Nursing, N), assistant researcher in the same department; Professor Dr. Hong Yan (PhD), public health department of same university's College of Medicine; Yin-Ping Zhang (PhD N), Associate Professor at the same department; and Professor Dr. Duo-Lao Wang (PhD) from Medical Statistics department, Faculty of Population Health and Epidemiology, London School of Hygiene and Tropical Medicine, UK. The randomized clinical study was titled "Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy." The Care, Cure and Core model of Hall was used. A clinical trial of 120 women suffering from breast cancer was conducted between March and November 2009, using randomized controlled research design. Half…… [Read More]

Female Gender Disparities in Cardiovascular

Gender variation in clinical decision-making was measured, including (1) the number, types, and certainty levels of diagnoses considered and (2) how diagnoses vary according to patient characteristics, when patients have identical symptoms of CHD (Maserejian et al., 2009).

This was a factorial experiment presenting videotaped CHD symptoms, systematically altering patient gender, age, socioeconomic status (SES) and race, and physician gender and level of experience. The primary end point was physicians' most certain diagnosis. The results: Physicians (n=128) mentioned five diagnoses on average, most commonly heart, gastrointestinal, and mental health conditions. Physicians were significantly less certain of the underlying cause of symptoms among female patients regardless of age, but only among middle-aged women were they significantly less certain of the CHD diagnosis. Among middle-aged women, 31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts. An interaction effect showed that females with high…… [Read More]

Pour the Role of the

However, from my point-of-view, the doctor should have a free hand and should be able to take the decision he sees fit in that particular case. It is very important, however, for this to occur in the same context of rules and regulations that I have discussed above. If the doctor abides by the set of rules established, then he should be only partially constrained in what the decision is concerned.

General Recommendations

It is very important in this case for the hospital to accept its business-like, economic component. As an organization, it has costs and revenues and it needs to minimize costs, while attempting at the same time to best manage revenue and incoming cash flows. The doctors themselves need to understand that it is best to save 10 people rather than one person and, in order for this to be achieved, certain cost cuts need to be performed…… [Read More]

Nursing and Religion Practice Religion and Nursing

Nursing and eligion Practice

ELIGION AND NUSING PACTICE

Nursing success depends on the ability to put the patient in a state of rest and comfort as much as it is about administering the prescriptions of the doctor. To secure the rest of the patient, nurses need to understand their needs and show respect to their beliefs and values. This requires courteous and open communication with the patient and adopting a patient-centric orientation. Along with other factors, the religious background of the patient makes a lot of difference to their values and expectations. eligious doctrines and practices may differ across religions and denominations such as Jehovah's Witnesses, Muslims, Seventh Day Adventists and Scientologists and may impose restrictions on certain kinds of interaction between nurse and patient or on certain forms of treatment. Moreover, people with a different religious background are not usually aware of such differences. Therefore, it is necessary for…… [Read More]

Night Eating Explore the Individuals

"…people with NES tend to be more depressed than obese people without NES, and the mood of those with NES tends to worsen during the evening, something not seen in other obese people"(Logue, 2004, p. 185).

Among the many studies that provide insight into the background and origins of this syndrome, one of the most enlightening was Obesity by Stunkard, in Fairburn and Brownell (2002). This provides an in-depth analysis of night eating syndrome as well as a concise overview of the background of this condition. Stunkard also refers to a detailed overview of this condition.

Studies using the above criteria estimate that the prevalence of the night eating syndrome in the general population is approximately 1.5% and that prevalence increases with increasing weight, from about 10% of persons enrolling in obesity clinics to as high as 25% of patients undergoing surgical treatment for obesity…it occurs among about 5% of…… [Read More]

Mayo Clinic Is a Useful

org.

For a nurse seeking information about a patient, the website may be a good starting point, although it should be added that the material is not technical and is not specifically designed for nurses. Its best use for medical professionals might be a way to describe difficult information in fairly simple terms that are not 'dumbed down' and is medically accurate without being arcane.

Summary:

Authorship: The Mayo Clinic

The publishing body: Mayo Foundation for Education and Research

Point-of-view or bias: General, medically-established knowledge as disseminated through peer-reviewed literature

Referral to and/or knowledge of the literature: Layperson orientation, little direct information about scientific studies or recent innovations in treatment

Accuracy or verifiability of details: Recipient of numerous watchdog group awards for accuracy.

orks Cited

The May Clinic. (2008). Retrieved 10 Nov 2008 at http://www.mayoclinic.com… [Read More]

Genetic Counseling Dealing With Its

"Accurate descriptions of sex chromosome differences are critical, the decisions potentially regrettable, and the long-term outcomes devastating if a termination is based on the misinformation," that the patient later discovers to be misinformation for instance, "that any of these conditions is comparable to Down's Syndrome" (Biesecker r 2001:2) Conversely, it is also important not to minimize the odds of a potentially fatal genetic condition like Tay Sachs disease.

Providers are obliged to obtain useful up-to-date information and to ensure parents have adequate opportunity to consider their decision with the help of an experienced healthcare provider, preferably in medical genetics, and if necessary, a counselor who is attuned to the cultural assumptions and needs of the couple's population group, and religious beliefs. Certain populations might have a different view and understanding of the real difficulty of raising a child suffering from a heritable disorder, or even the concept of heritability of…… [Read More]

Quality Improvement in Health Care

Furthermore, the VA hospitals are devoted to new research on Parkinson's disease in the development of surgical treatment for late-stage patients for whom medical therapy is no longer effective and development of new medications, which are more effective and have fewer side effects (Department of Veterans Affairs, 2001). In this way the VA's rehabilitation services structure assists in the transition of patients from one level to another level of care.

alanced Scorecard of the VA's Rehabilitation Services

The creation of a balanced scorecard for the rehabilitation services offered by the VA consists of developing metrics, collecting data and analyzing the data in relation to: 1) the learning and growth perspective, 2) the business process perspective, 3) the customer perspective, and 4) the financial perspective. The learning and growth perspective includes employee training and corporate cultural attitudes related to both individual and corporate self-improvement. In the current climate of rapid technological…… [Read More]

Massages Have Been Shown to

In some instances this will mean lying prone on a massage table, or using an ergonomically design massage chair.

Relax your mind and let yourself drift close to a state of sleep and deep relaxation. Try not to talk or move unnecessarily in order to adjust your mind to a new mindset.

Communicate with your masseuse so that they will adjust pressure according to your needs. Become accustomed to their touch and relax under their guidance.

Listen to soothing music or light therapeutic candles to further establish the mood of the session.

These above guidelines will ensure that you have optimize your experience while getting a massage. The most important rule of thumb to remember is to follow the guidance of your massage therapist!

There are some easy steps to follow after a massage that will help you release your muscle strains and extend the lasting benefits of your massage.…… [Read More]

Personality Theorist Isabel Briggs Myers

Her wellness did not allow participation in the second that took place in 1977; however Isabel Myers took pleasure in the other 2 extensively, though sometimes she would be dismayed at the different ways that the analysts treated her information. She understood that the intuitive 'kind' or personality indexes will need to alter the MBTI [instrument] as that is in their nature but she hoped that prior to the time when they altered it, they will initially attempt to comprehend exactly what had been done as the foundation of the theory because her reasons for choosing a certain structure were logical and justified. In 1975, publication of the Indicator was presumed by CPP, Inc. For the first time, the MBTI [instrument] was readily available as an instrument prepared for use in assisting individuals (Kirby and Myers, 2000).

In the last months of her life, when she invested much time sleeping…… [Read More]