Thursday, February 21, 2013

Chiropractic Wellness- The Solution to Infant Colic

When we think of chiropractic wellness, we’re liable to connect it to purely adult concerns.  After all, back and neck pains are the most common reasons for visiting the chiropractor.  Still, more and more people are starting to turn to the chiropractor for relief of an increasing range of symptoms and chiropractic treatment has become an option not just for adults but for children as well.  One of the most exciting prospects regarding the application of chiropractic techniques to paediatrics is the connection between chiropractic wellness and infant colic.
Colic is a very mysterious condition despite the fact that many babies from birth to three months old are known to suffer from it.  A baby is considered to have colic if it cries continuously for prolonged periods of time without any apparent cause.  If you’ve fed your baby, burped him, changed his diaper and have done your utmost to rock and soothe him but he continues to cry, then you have a colicky baby on your hands.  Since no one knows exactly what causes colic, there is no clear solution to the problem.  A doctor is likely to prescribe drugs for acid reflux or to just assure parents that baby will grow out of it in time.  Babies do grow out of colic and are usually colic-free after about twelve weeks of age, but what is a harassed mom or dad to do in the meantime?
For one thing, a visit to the chiropractor or a chiropractic wellness center might be in order.  This might sound strange since many are apt to view colic as a mostly digestive problem, due to the fact that paediatricians usually ascribe it to acid reflux.  However, it’s not really so odd once you remember that chiropractic wellness is actually achieved when all the body’ s systems are in good working order as a result of the correct alignment of the spine and the smooth functioning of the nervous system.  We are apt to forget that the birthing process can be difficult on a baby’s spine and neckpain  particularly when forceps or a vacuum have been used to help the baby exit the birth canal.  When a baby is brought to the chiropractor, a series of very mild manipulations will be performed in order to remove any subluxations in the spine.  When spinal alignment has been restored, then tension disappears and energy is able to flow freely through the nervous system, making baby much more comfortable and hopefully, colic-free.

Tuesday, June 19, 2012

Easy and Legal Ways to Get Free Microsoft Points

Easy and Legal Ways to Get Free Microsoft Points

Xbox Live is the ultimate gaming service provided by Microsoft. It enables Xbox users to access multiplayer games, send and receive voice messages and get exclusive and early content for their Xbox. The two versions of this service: Xbox Live Silver and Xbox Live Gold, offer a 3-month or 12-month service. These packages also include other gaming equipment and one free Xbox Live arcade game. Prices vary from country to country and it's not cheap.

Acquiring the actual free gold Xbox Live codes used to mean that gamers would have to win a competition to acquire a code for free. The particular issue regarding this kind of account is actually that an individual will need to search for some time to find this kind of place. Even when a gamer has found a website that offers this the legitimacy will then be questioned. There A lot of times these type of sites will suddenly no longer exist on the internet. They will close the site without warning and this has not only given a bad reputation, but also affected the legitimate sites. Gamers have experienced this have expressed their frustrations with each other. Through word of mouth, this spreads to a number of individuals very fast.

In order to use the Xbox live codes you need to have an internet connection and access to broadband; ADSL and cable usually work better, because you will need to have a fast speed connection to play your games easily. The codes give access to games like Heroes, Battlefield 2, Star wars, or others, depending on the card you have got and the availability of games at any given moment. You can create your personal account connecting to the gaming console. Once you set up your first account and give the codes, you will be notified that these codes are valid for two months. Once this free period is over, you cannot use any additional trial cards; you will have to pay for your subscription or use some other valid codes.

The easiest way to get free microsoft points is to buy games that offer them. Buy games such as Star Wars Battlefront, Battlefield 2: Modern Combat and Kingdom Under Fire: Heroes. These games will give you up to 48 hours of free trial period but requires paying when your time is up.

For those yearning a longer trial period can buy games that offer a Two-Month Trial Card. You also have to ensure you have a high-speed Internet connection. To access the service and create your account, you should first take note of the Xbox Live code at the base of the card. This code then needs to be entered before you can fully enjoy the service for the next two months. When the trial period is up, you must pay to renew your membership and no, you can't extend the trial period.

If nothing works for you, you can always go online and check if there are free codes. Before actually using them, you have to check if they are legitimate and suitable for your games and your Xbox device.

Sturat enjoys writing articles on topics like How to get free Microsoft points.

Cellulean Cellulite Reviews - Does Cellulean Cream Work?

Are you sick and tired of those stubborn dimples on your legs and butt - the cellulite that refuses to shift, even though you are constantly on a diet and exercising regularly? I came across this 'rather impressive' product that is said to address this issue - and after considerable research I have decided to provide a series on Cellulean reviews to shed some light on this fat-busting product.

With a 14 day free trial on offer, I certainly had nothing to lose and everything to gain especially if it produced the results that they claimed.

My experience is documented below so that you can know what to expect from this product. My aim is to provide you with enough information to help you can make up your mind one way or the other, as to whether Cellulean is the right anti-cellulite cream for you or no

Cellulite, as you know, is the fat stored right beneath your skin's surface. Cellulean has many active ingredients to dissolve this fat, without harming your skin. This anti-cellulite treatment is really based on an original patented formula to dissolve fat. The key element of this formula is an asthma drug called Aminophylline, which triggers the natural process of removing lipid particles in our bodies.

In conclusion, I'd like to add that if you're still doubtful about the effectiveness of Cellulean, then try the free trial offer from Cellulean. It's free, and Cellulean makers promise to double your money if you don't see desired results.

For more information about the free Cellulean trial, visit my Cellulean Cellulite website. You can also read other reviews on Cellulean in this website.

Tuesday, May 29, 2012

Injury claim

If you have been involved in an accident, and through no fault of your own have suffered an injury as a result, then chances are you will be able to claim compensation. No matter how minor your injury appears to be at this stage or who the person or company at fault was, making an injury claim is your right and should be exercised to bring justice to a difficult situation.

What types of injuries can be claimed for?
One of the most frequent types of injury claim submitted relate to accidents on the road. Whether you were a driver or passenger of a car, or were travelling on public transport or a bike at the time of the accident, if you were hurt and another driver was at fault, you can claim. Common injuries include back and neck injuries, including whiplash, and injuries to the head or hands as a result of the collision.
Less common, but still a source of regular claims, relate to slips and trips when out and about. Building owners, local councils and workmen have a responsibility to ensure public rights of way and the public areas within buildings are kept safe, clean and free from hazards that could cause a trip. Slipping on wet floors, broken paving slabs or tripping over trailing cables can all result in a range of injuries, from twisted ankles to broken wrists, all of which are regularly seen by professionals handling injury claim cases.
Sometimes even the workplace is not as safe as it should be, and workers sometimes become injured as a result of faulty machinery, poor training or bad health and safety practice. In cases like this an injury claim will often result in remedial action by the employer, meaning other employees will be safer at work in the future, so it is especially important to make a claim if this has happened to you.

When should you claim?
As a general rule of thumb, the sooner the better applies to any type of injury claim. The sooner you can start the claims process, the easier it will be for your solicitor to contact any witnesses and get hold of any other evidence required. Also your injury will be fresh, so if you need to see an independent doctor they will be able to see first hand the extent of your injuries.
Personal injury law understands that making an injury claim is not necessarily the first thing on someone’s mind after they have been involved in an accident. That is why claims can still be started up to three years after the accident happened. In the case of industrial disease and other issues that take years to reveal themselves, there is still a chance to claim beyond the three year cap.

How much does it cost?
These days, the majority of solicitors who deal with injury claim cases will work on a no win no fee basis. This means you will not have to pay them anything if your claim is not successful, and there will be nothing to pay up front. 

Friday, March 16, 2012

Goldman Sachs, Corporate Culture, and Medical Ethics

When Greg Smith, an executive director at Goldman Sachs, and head of the firm's US equity derivatives business in Europe, the Middle East, and Africa, explained why he resigned from the company in a remarkable New York Times op ed piece two days ago, the story went viral. Here's the essence of what he had to say:
After almost 12 years at the firm...I believe I have worked here long enough to understand the trajectory of its culture, its people, and its identity. And I can honestly say the environment now is as toxic and destructive as I have ever seen it....I have always taken a lot of pride in advising my clients to do what I believe is right for them, even if it means less money for the firm. This view is becoming increasingly unpopular at Goldman Sachs...I attend derivatives sales meeting where not one single minute is spent asking questions about how we can help clients. It's purely about how we can make the most possible money off of them. If you were an alien from Mars and sat in on one of these meetings, you would believe that a client's success or progress was not part of the thought process at all.
Years ago, my friend Marc Bard, a brilliant consultant, taught me the aphorism - "culture beats strategy every time." This is perhaps especially true in health care, which is so strongly mission-driven. If the shared culture of a health organization is truly patient centered every action will express the organization's values.

I experienced how culture works especially clearly 19 years ago, when my father, near the end of his life, was a patient at the Lahey Clinic. In my distracted and distressed state, I locked my keys in my car. I went to the building services office to get help. A staff member (a) picked the car's lock with expertise, but also (b) conducted excellent common sense psychotherapy with me around how we get forgetful when we're upset, and (c) said he would pray for my father. Remembering the incident and writing about it here brought tears back to my eyes. I'm happy that I wrote to the CEO to report on the excellent care I received from his non-clinical staff and to congratulate him on the culture of the organization.

I'm lucky that the four health organizations I've been part of during my career - the Massachusetts Mental Health Center, Harvard Community Health Plan/Harvard Vanguard Medical Associates (HCHP morphed into HVMA), the Harvard Pilgrim Health Care insurance company, and the Harvard Pilgrim Health Care Institute,  have all had cultures and evinced values I've been proud to be associated with. I doubt, however, that the people at those organizations were intrinsically more ethical than the colleagues Greg Smith is writing about.

When one's colleagues and the leaders of an organization share core values they reinforce each other. Newcomers are selected for fit with the culture, and the culture (what educators call the "hidden curriculum") brings out the best in us. It's easier for a health organization than for Goldman Sachs to cultivate a positive culture because the mission of caring for people who are suffering encourages empathy. I'd like to believe that I'd leave as Greg Smith did if I found myself part of an organization with a environment that is "toxic and destructive" and was unable to influence it, but knowing the human capacity for self-delusion, I can't be smug and certain that I wouldn't follow the same playbook Greg Smith discerned at Goldman Sachs.

Aristotle conceptualized "character" as an inner state or way of being that shows itself in the patterns of our actions. "Culture" is the organizational equivalent of "character." Culture is partly formed by the characters of those who constitute it, but the influence goes both ways. In trying to understand our human natures, we need to consider "culture" and "character" along with "nature" and "nurture."

Monday, March 5, 2012

Is This Doctor-Patient Marriage Unethical?

I shouldn't have been surprised that the most read posts on this blog have been about doctor-patient sex. When I recently had occasion to review these posts a comment I received on April 23 last year caught my attention:

Let us face it squarely. There are only 4 women that a newly qualified overworked doctor intern is exposed to: a fellow doctor (usually out of reach), a nurse (may lead accusation of sexual harassment) a bar waitress (usually not of the best social character) and the patient. I chose the latter and am happily married to her for 8 years. Did I breach the ethics? Can a distinction be made between sexual attraction and real love?
In my response I made an initial sortie into the connection between professional ethics and the ethics of personal relationships. But in retrospect I wish I'd been clearer:
Congratulations on 8 happy years of marriage. I don't know what area of medicine you're in, and what its code of ethics states. In my own specialty - psychiatry - the code asserts that sex with current or former patients is unethical. So if you're a psychiatrist, the code answers your question - you did breach the ethics of the specialty....

So - you may have violated the ethics of your area of medicine, but I'm guessing that you and your wife distinguished right from the start between "real love" and "sexual attraction." You have 8 years of evidence that you got it right! For you as individuals the professional ethics precept would have been a bad guide. 
Suppose the ethics committee of the former intern's medical specialty were asked to review the ethics of the relationship he formed with his patient 8 years ago. For my specialty (psychiatry), the answer would be unambiguous. Forming a romantic or sexual relationship with a current or former patient is defined as unethical.

Given that he violated the ethics of his specialty, should he be disciplined?

If there had been no problems in his medical practice in the subsequent 8 years I think the right outcome would be (a) to reaffirm the correctness of the ethical standard but (b) to find a way of not disciplining him intern, while (c) being careful not to set a precedent that undermines the standard.

The rationale for defining romantic/sexual relationships with current and former patients as unethical is twofold: to protect patients from the harms that these relationships can cause, and to prevent the loss of trust in the profession that would accrue if the public concludes that physicians are prepared to exploit patients for personal gain, as by "hitting" on them. The former intern's happy marriage isn't evidence against the standard. The standard doesn't claim that every doctor-patient romantic/sexual relationship will result in harm, just that we know that harm is a significant possibility and is difficult to predict. And the happy marriage says nothing about the overall trustworthiness of the profession.

If this was a current question for a physician with no pattern of exploitation, an ethics committee might require an extended period of supervised practice. Assuming the former intern has practiced in exemplary fashion for 8 years, that would exceed what a probationary period would entail. As a member of the specialty society it's important for him to understand and support the ethical precepts of the society. As a response to the violation that occurred 8 years ago, the ethics committee might ask the former intern to write an essay on how he would respond to a colleague who asked him: "Look how well your doctor-patient relationship worked out - why should I follow the ethical standard on this?"

If the intern's medical specialty and medical society held the same standard as the American Psychiatric Association, the relationship he formed with his patient violated the ethics of the profession. But his report of 8 years of happy marriage suggests that the ethics of his personal relationship is excellent. The professional and personal domains overlap, but not totally. Four years ago I argued that the Karolinska Institute in Stockholm did the right thing in expelling a medical student who had been convicted of murder 8 years earlier, even though he performed competently in his student role.

In the U.K. the medical profession does not have a blanket ethical rule against romantic/sexual relationships with former patients. The General Medical Council (GMC), whose role is to "ensure proper standards in the practice of medicine," has formulated guidance about professional boundaries in terms of personal ethics. Recast to eliminate reference to the doctor-patient relationship, the values in the GMC espouses could form the basis of a high school or college class on relationship ethics:
  • You must not pursue a sexual relationship with a former patient, where at the time of the professional relationship the patient was vulnerable, for example, because of mental health problems or because of their lack of maturity.
  • Pursuing a sexual relationship with a former patient may be inappropriate, regardless of the length of time elapsed since the therapeutic relationship ended. This is because it may be difficult to be certain that the professional relationship is not being abused.
  • If circumstances arise in which social contact with a former patient leads to the possibility of a sexual relationship beginning, you must use your professional judgment and give careful consideration to the nature and circumstances of the relationship, taking account of the following:
       (a) when the professional relationship ended and how long it lasted
       (b) the nature of the previous professional relationship
       (c) whether the patient was particularly vulnerable at the time of the relationship, and whether they are still vulnerable
       (d) whether you will be caring for other members of the patient's family

Saturday, March 3, 2012

Wartime Heroism and Personal Ideals

I'm sorry I never met Dr. Tina Strobos, whose obituary I read in this morning's Boston Globe. But I have a new hero.

Dr. Strobos was a 19 year old medical student in Amsterdam when Nazi Germany invaded in May, 1940. When she and her fellow students refused to sign a loyalty oath to Adolf Hitler, the school was closed.

Dr. Strobos joined the Dutch underground, initially ferrying arms and supplies to resistance fighters. Then she turned to helping her Jewish friends and ultimately others to escape. She and her mother had a secret room constructed on the third floor of their Amsterdam home, just a short walk from the home that sheltered Ann Frank and her family. It became part of an underground railroad for escapees. During the war they helped save 100 Jews, for which, in 1989, the Yad Vashem Holocaust Museum in Jerusalem honored her and her late mother as "righteous among the nations."

 After the war Dr. Strobos came to the U.S. and studied child psychiatry. Despite extensive Google searching I haven't been able to learn much about her career. She appears to have run a treatment facility in Rye, N.Y. One listing said it was for people with chronic psychiatric ailments. Another site said she'd helped Katrina victims. I like to think that her work as a psychiatrist carried forward the same values she lived by during her years of wartime heroism.

I've thought a lot about the concept of health care as a "calling." For religious persons the call may come from their God. But what about agnostics and atheists? Dr. Strobos answered this way: "I never believed in God, but I believed in the sacredness of life." This outlook ran in her family. Her mother and maternal grandmother were also athiests, socialists, and activists. During World War I her grandmother had also hidden refugees! And all three of her children work in helping professions.

Dr. Strobos seems to have been a practical idealist. During the war, along with her work in the resistance, she also sought opportunities to continue her medical studies. "You have to be a little bit selfish and look after yourself; otherwise you just die inside, you burn out. There's just so much you can do for other people."

I'm proud to be part of the same psychiatric profession as Tina Strobos!

(For a moving video of Dr. Strobos receiving an award from the Holocaust and Human Rights Education Center in 2009, see here. For additional details on her life, see here, here, and here.)

Tuesday, February 28, 2012

Tatooing Medical Directives on our Bodies

Unfortunately I don't know Dr. Ed Friedlander, a pathologist in Kansas City, so I haven't had a chance to ask him about his decision to have "No CPR" tatooed on the center of his chest. If you want to see what his distinctive form of advance directive looks like, the Associated Press article about using tatoos to convey medical information shows him holding his shirt open.

Many people are afraid that their wishes for how medical care should and should not be administered will not be followed. Since the default option in emergencies is to "do everything," folks like Dr. Friedlander who want to let nature take its course when their heart stops have good reason to fear chest pounding and electrical shocking if an ambulance was called for them.

It's just a matter of time until we see a Saturday Night Live routine in which the emergency medical technician gets preoccupied reading an essay on the chest of the person whose side they are called to. Whatever Dr. Friedlander's motive for the tatoo is, he's dramatizing the degree to which many people fear that health care on automatic pilot will (literally) run roughshod over them.