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By I. Kan. LeMoyne-Owen College.

Failing to stay alert to things that can go wrong in our efforts to stay healthy and trim can result in mystery maladies order cialis black 800 mg line. Case Study: Maria Maria was a forty-eight-year-old Miami homemaker whose last child had just entered college cialis black 800mg with amex. With time on her hands 800 mg cialis black free shipping, too many birthdays behind her buy cialis black 800mg without prescription, and an ob-gyn husband who was on call and often not at home cheap 800mg cialis black free shipping, Maria decided it was time to take care of herself and get in shape. She joined a local fitness center, hired a personal trainer, and worked out at least five times a week. Some would say Maria became almost obsessive about her exercise program and the shape of her body. Over the next ten months, however, all her hard work seemed to be paying off as she transformed herself into a svelte, muscular woman. They all loved to party and frequent the hottest South Beach night spots. When they invited Maria to join them, she began to drag her husband, Burt, along as they went clubbing on the weekends. While Burt was happy his wife looked so good and was filling her new- found time without the kids in a seemingly healthy manner, he was not so thrilled to be spending his weekends off with her new friends. The clubs didn’t start hopping until midnight, and unlike most of Maria’s new friends—many of whom were considerably younger and certainly not obste- tricians who were expected to deliver babies at all hours of the night—he needed his rest when he wasn’t working. Maria was not happy when he refused to join her in her new social life, so she began to party without him. As time went on, Burt became concerned that his wife might be cling- ing to her youth in an inappropriate way. She laughed it off, retorting, “With the amount of sex you get—with a body like mine—I shouldn’t hear you complaining. Two years into her exercise routine, when she was about fifty and her friends thought she looked fabulous, Maria started to gain weight. Being married to a gynecologist, she knew the symptoms of menopause and also knew her husband would probably suggest hormone replacement therapy, which she thought would only make her gain more weight. She decided not to mention it to Burt but instead worked harder at the gym and added nat- ural supplements (including soy, evening primrose oil, and other vitamins and herbals) to her diet to help with the symptoms of menopause. She was successful in curbing her weight gain, but she was becoming chronically tired and weak. There were no more personal checks being written to her personal trainer. While he was secretly delighted in this change, he was also concerned about her fatigue and depression. He questioned Maria carefully, and she responded somewhat evasively that she had simply become bored with it all. Not only had his wife put on a few pounds (which he reasoned could have been a nor- mal result of having given up the exercise), but she had become less inter- Are Your Ways of Staying Healthy Making You Sick? Burt assumed menopause might be setting in and sug- gested that Maria might want to check her estrogen levels. Because Burt was not altogether unhappy with this turn of events—Maria was at home more, seemed less hyper, and actually looked better with a couple of extra pounds—he tried to deny the muscle weakness he was also observing in his wife. Finally, when he could ignore it no longer, Burt told Maria to make an appointment to be examined by their friend and family physician and at the very least to have her thyroid checked. Just to prove there was nothing wrong with her, she had her personal trainer start coming to their home to help her return to a physical fitness routine. He also attributed the change to menopause and tried to work her harder. Maria would keep her act together until he left and then break down in tears. Eventually Maria had to tell him that she could no longer train, but she made him promise not to tell her husband something was wrong. Rather than tell Burt, however, she tried alternative healing methods, including Reiki, acupuncture, and massage. When all of them failed to work, she tried Rolf- ing, which was extremely painful.

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Drafting your report Once you have gathered your information and organised it into a basic framework cheap cialis black 800mg online, you can start to prepare a draft order cialis black 800mg overnight delivery. Writing a report is not just about what you say but also how you say it discount cialis black 800 mg without prescription. Remember that the majority of reports will now be read by the client and the client’s family or carers (NHS Plan 2001) order cialis black 800mg without a prescription. Try to phrase your re­ port in a way that is more accessible for a lay person with limited clinical or technical knowledge purchase cialis black 800mg with visa. One idea to get around this problem is to provide a summary writ­ ten specifically for the client (NHS Training Division 1994). Remember that the way in which the message is expressed often inad­ vertently conveys underlying attitudes. Look at this example: ‘Mother ini­ tially denied any concerns about his hearing, but then confessed that she thought he did have problems…’ These words imply some sort of negative judgement on the part of the report writer about the client. Check that your report is objective and your interpretations have a clear evidence base. When preparing your final draft, consider how you will present the re­ port. Here are some general guidelines: ° Place the name or logo of the employing organisation at the top of the report. Indicate if there has been a delay between a report being dictated or drafted, and the date when it was actually typed. Type or print your full name, title and profession underneath your signature. Do not repeat any headings or addresses used on the first page, but you might want to include some client identification information. Editing your report Once you have written your draft, you can check the content, spelling, grammar and presentation. Check you have used: q A clear framework q A logical sequence q Headings. Check the content is: q Balanced (no one area is given too much emphasis) q Accurate q Current q Objective. Check that you have: q Reduced unnecessary repetition q Included all the key points q Summarised the main points in a conclusion q Clearly stated recommendations and actions. Check you have: q Reduced jargon q Reduced complexity 90 WRITING SKILLS IN PRACTICE q Made it easy for the reader to find information q Used non-judgemental language. Once you have finished your edit you are ready to complete your final draft. Remember to ensure that copies of your report go to other relevant professionals or agencies. Initial assessment report – key content ° Name, address and identification details (date of birth, hospital number and so on) of the subject of the report. Discharge report – key content ° Name, address and identification details (date of birth, hospital number and so on) of the subject of the report. Summary Points ° Letters and reports about the care and management of clients are an essential form of communication within the health service. Careful consideration needs to be given to the choice of vocabulary and the way the message is phrased. Providing written material is one way of help­ ing to meet this need and involving clients in decision making. However, both professionals and clients have expressed concern about the quality of some of this information. The following chapter looks at how the writing and presentation of written leaflets may be improved. Getting started Most written material benefits from a team approach to its development, writing and production. Useful members might include: ° clinicians with relevant experience ° researchers or academics with knowledge of current research relevant to the subject matter ° persons with writing experience ° representative(s) from the users (clients, clinicians, administrative staff) ° persons with design experience.

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