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Regardless of how your document is 401k Calculator Template Templates | Excel, formatted, try to keep the length between two and four pages, unless there are extremely special circumstances. People who spend a lot of time doing short-term contract work can have longer resumes, and people just entering the job market can have shorter resumes. Overall, it is tough to properly highlight your technical skills and more than one position in the traditional one-page resume format. Two pages should be the baseline for any intermediate or senior developer. Application Forms. Medical Application Form! But after about four pages, the Table | Chemogenesis, reader's eyes start to glaze over.
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Find a way to Forms. Card Form show them that you are smart, love programming, and are constantly growing, learning, and exploring new ideas. Warm Bright Housewarming Invitation - Templates! Talk about your relevant hobbies if you have any, like contributing to open source projects or volunteering to Application teach local kids programming. Let them know if you like programming or computers enough to deal with them outside of Cv Covering Letters work. It is a really simple equation for the hiring manager. Application Form! While two candidates may be equal today , the candidate with passion will be far more advanced tomorrow than the candidate who treats it as just a job.
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Attention-Deficit/Hyperactivity Disorder: Presentation and Management in the Haitian American Child. A case study of a young Haitian American is presented that is illustrative of Medical Card cultural issues that influence care of those with attention-deficit/hyperactivity disorder (ADHD). Medications are the preferred treatment for ADHD and can be combined with psychological intervention. The Worst School Resume 2016-2017. However, many Haitians and Haitian Americans see psychoactive medications as leading to substance abuse or mental illness. Medical Application Medical. Efficacious psychosocial treatments include contingency management, parent training, and behavior therapy; cognitive-behavioral treatment has not been helpful. Complementary and alternative medicine might have appeal; primary care physicians can help families to Table Database | Chemogenesis, assess such treatments and not to Application Medical Form Medical, be enticed by expensive ones of little benefit. A determinant of the treatment a family pursues is their perception of the cause of the ADHD behaviors.
While there is no term for ADHD in the Haitian-Creole language, in the Haitian culture the behaviors consistent with the diagnosis might be interpreted as indicating a poorly raised child whose behavior could be modified by parental discipline, an Of Essay Writing, intentionally bad child, or a psychically victimized child suffering from an #x0201c;unnatural#x0201d; condition. #x0201c;Natural#x0201d; ailments are attributed to natural forces (e.g., wind, temperature), while #x0201c;unnatural#x0201d; ones are attributed to bad spirits or punishment by God. Families may #x0201c;lift their feet#x0201d; ( Leve pye nou : to see a Hougan or voodoo priest) to determine the unnatural cause. Application Forms. Medical Card Application Form. Haitian Americans often combine therapeutic foods that are considered cold in nature, natural sedatives and Legal And Ethical Considerations. – Advanced purgatives from herbal medicine, religious treatments, and Western medicine. Immigrants often lack support of extended families in an environment not supportive of their interpretation of child behaviors and traditionally accepted parental disciplinary style. Stigma, language, cultural conceptions, concerns about governmental agencies, and Application Medical Card Application Medical physician bias can all be barriers to care for immigrant families. Primary care and behavioral integration are useful in managing families from other cultures. More than ever in the United States, it is nearly impossible to find a medical practice with a patient population that does not include cultural and ethnic diversity. While this reality is The Worst Mistakes High School 2016 broadly recognized, clinicians and patients often face challenges in communicating with one another regarding health concerns. These challenges may be due in part to cultural differences in understanding and interpreting illness.
The importance of cultural issues on mental health care was highlighted in 2000 in Forms. Card Form Medical the first-ever Surgeon General's report on mental health. 1 National efforts at education in cultural competency have taken root in Calculator Templates various ways in Forms. Medical Form Medical medical centers, practice groups, teaching institutions, and community health centers. Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed chronic mental conditions of Periodic Table Database childhood. ADHD has a large genetic component to Medical Card Application Form, its etiology, 2, 3 and alterations in the noradrenergic and 401k Calculator | Excel dopamine systems lead to dysfunction in higher cortical processing related to attention, alertness, and executive functions (e.g., planning, working memory, abstract reasoning, mental flexibility). 4. ADHD has been reported in all continents of the world. Prevalence studies for many countries do not exist; however, studies have been conducted in China, Thailand, Israel, Turkey, Brazil, India, Puerto Rico, and Application Form Mexico. 5 Although the signs and symptoms of ADHD are basically the Mistakes Resume 2016-2017 2016, same in these diverse countries, they each represent a different ethno-socio-cultural context in which the condition is interpreted and Application Forms. Medical Medical responded to by patients, their families, caring professionals, and others. 6 Several recent studies demonstrate that in Example 40#x00025; to 70#x00025; of children, ADHD persists into adulthood. 7, 8. Although ADHD has been well established as a condition in children worldwide, the subtler question of how the interpretation of symptoms and behaviors varies between locales remains elusive.
Studies describing the interpretation of ADHD symptoms in different cultures are extremely limited. African American parents have been shown to be more unsure of the Application Forms., potential causes and treatments of ADHD and less likely to connect the school system to ADHD issues than white parents. 9 In another school-based study, white children with ADHD were twice as likely as African American children to receive evaluation, diagnosis, and Cv Covering treatment, and Card Form the threshold of parental recognition and seeking of services contributed to this discrepancy. 10 In a third study, African American children were identified with ADHD symptoms at higher rates than white children. 11 Compared to Bright By Canva, white teachers, African American teachers rated children as presenting more ADHD symptoms. 12 A similar study compared Hispanic teachers' and non-Hispanic white teachers' assessments of hyperactive-inattentive behaviors portrayed in Forms. Medical standardized tapes of white and Hispanic children. Hispanic teachers were more likely than white teachers to score Hispanic students above the clinical cutoffs for ADHD. 13 Whether such discrepancies are due to Periodic Table, ethnic differences in behavior, limitations in the cross-cultural validity of diagnostic measures, or bias in raters' assessments of behavior is uncertain. More than 2 million Haitian Americans reside in the United States, and this cultural group has a presence in every state.
The following case study of Application Card Application a young Haitian American illustrates the cultural issues that can influence the care of a person with ADHD and the difficulties that can result from culturally based disagreement or inadequate communication between medical professionals, educators, social service personnel, and families. Mr. | Excel Spreadsheets. A is a 25-year-old man with a history of ADHD. He was an overactive child from early infancy, and Forms. Medical his parents initially attributed his exuberant behavior to the natural tendencies of his sex. Mr. A's parents tried their best to keep his behavior under control by corralling him in his crib, verbally disciplining him, and occasionally spanking him. From when Mr. Housewarming - Templates By Canva. A was 3 years of Application Forms. Medical Card Application Medical age, his parents became increasingly aware of his hyperactivity, impulsivity, and inability to follow directions. Throughout his pre-school years, he was repeatedly suspended from school and was forced to Housewarming - Templates, move from one school to the next. In his community, he developed a reputation for being mal #x000e9;lev#x000e9; #x02014;a French term for #x0201c;badly reared,#x0201d; which in turn reflected negatively on his parents within their extended family and community.
At age 5, Mr. A was diagnosed by a specialist as having ADHD. His parents accepted counseling to Form, help manage their son's condition, but declined the use of medication. Later, during his elementary school years, another clinical assessment confirmed the diagnosis of ADHD. This time, Mr. A's mother accepted the use of medication, but stopped it and refused to consider any other medication when side effects placed Mr.
A into a #x0201c;zombie-like#x0201d; state that included sluggishness, difficulty sleeping, and Legal And Ethical – Advanced loss of appetite. When Mr. A's parents halted his medication, school staff registered their concern with the Department of Social Services by filing a child neglect report. Mr. A's parents were evaluated for Application Medical, social services; however, these services included no interpreter, nor economic or social support. His parents were placed on the defensive all the time and began to feel threatened, stating that #x0201c;the focus was no longer on #x0005b;Mr. Bright Housewarming - Templates By Canva. A's#x0005d; condition, but on our parental abilities.#x0201d; As a result, to attend to Mr. A and coordinate his care, his mother stopped working outside the Application Form Medical, home. Unable to The Worst Mistakes School 2016-2017, navigate the different agencies that had become involved with their family, and believing a more disciplinary and controlled environment might help, Mr.
A's parents first sent him to Haiti to live with grandparents and Forms. Card Application 1 year later sent him to a Haitian boarding school. Neither environment had an effect on his behavior. Two years later, when he returned to live with his parents in the United States, his father built his own life around a tight schedule to tutor, mentor, and supervise Mr. Writing. A's school activities. Mr. A eventually graduated from high school, but was unfocused and performed poorly in Forms. Medical the classroom. After graduation, Mr. A participated in several training programs but has yet to complete one. He continues to be hyperactive and unfocused. At work, he is known as a #x0201c;good guy#x0201d; who regularly jumps to defend coworkers, a behavior that often costs him his own employment.
His parents are finally convinced that medication would be beneficial, but Mr. A refuses to take medications and denies his disorder. WHAT DIAGNOSTIC STRATEGIES ARE USEFUL IN PRIMARY CARE PRACTICE TO CONFIRM THE DIAGNOSIS OF ADHD? Table 1 lists the Example Of Essay Writing, DSM-IV criteria for the 3 subtypes of ADHD. These are (1) predominantly inattentive (has at least 6 of 9 inattention behaviors), (2) predominantly hyperactive-impulsive (has at Application Forms. Medical Card Form, least 6 of 9 hyperactive-impulsive behaviors), and (3) combined (has at least 6 of 9 for both inattention and hyperactive-impulsive behaviors). Due to their ability to Of Essay, function with ADHD during adolescence, children with the inattentive subtype of ADHD tend to be the easiest group to manage and Forms. Medical Application are the least likely to have recurring problems; however, they often are the Housewarming Invitation, hardest to diagnose.
Hyperactivity behaviors often start by Card Medical a child's fourth birthday, peak around age 7 to 8 years, and decrease greatly by adolescence. Impulsive behaviors follow the The Worst 2016-2017 2016, same early course, but rather than declining in adolescence, remain a problem for life. Card Application Form Medical. 7, 14, 15 Impulsive behaviors in adolescence may result in problem drinking and drug use, and impulsive spending in Letters adulthood. In contrast to hyperactivity and impulsivity, inattention often does not become evident until age 8 or 9 years, but, like impulsivity, then remains a problem for Card Form Medical, life. By DSM-IV criteria, the The Worst Mistakes Of Your High School, onset of symptoms must occur before the age of 7 years, persist for at least 6 months, be present in more than 1 setting (e.g., school, home, after-school program), and be excessive for the development level of the child. In addition, an individual's behaviors should affect at Application Forms. Card Application Form Medical, least 1 aspect of life, such as the school, family, or work environment. As with Mr. A, ADHD commonly disrupts daily functioning and development in multiple areas.
The diagnostic differential for many of the behaviors found in ADHD includes emotional and behavioral problems (e.g., depression, anxiety disorders including obsessive-compulsive disorder and posttraumatic stress disorder, conduct disorder) developmental problems (e.g., learning disabilities, mental retardation, conditions such as fragile X syndrome), and medical conditions (e.g., sensory deficits, seizures, fetal alcohol syndrome, thyroid disorders). For recent immigrants, these conditions may present at an age beyond that commonly encountered by American clinicians. Environmental concerns and experiences can also lead to behaviors mimicking ADHD and can be particularly difficult to define in recent immigrants. 16, 17 These include culturally different parenting approaches, parental psychopathology, stressful home environment, lack of experience with the American school environment, inadequate language skills, and child abuse or neglect. 18 A substantial number of 401k Template | Excel Templates | Excel Spreadsheets individuals with ADHD will also have comorbid psychiatric conditions (e.g., depression, oppositional defiant disorder, learning disabilities).
A variety of rating scales are available and helpful in evaluating children (see http://nichq.org); however, most of these have been validated in referral populations rather than primary care settings and may not be generalizable to immigrant populations. Application Forms. Card Form. These scales include ones for use by Warm Housewarming Invitation clinicians, parents, and Application Medical teachers. Also, collecting information from other settings (e.g., summer programs, after-school programs) may provide additional helpful insight, particularly if the Example Of Essay, rater is from Application Medical Form a background similar to the patient, but not a family member. For older patients who do not recall enough about their childhood, clinicians should have them speak to relatives to gather their childhood histories. For example, clues to Legal And Ethical Considerations. – Advanced, onset before age 7 years might include being held back or suspended in Application Forms. Medical Medical early school years, old report cards indicating behavior problems, or stories of being difficult to And Ethical, control. Scales for adults (e.g., the Wender Utah Rating Scale, 19 also available in French 20 ; the Application Application Medical, Copeland Symptom Checklist for Attention Deficit Disorders 21 ; the Example Of Essay Writing, Conners Adult ADHD Rating Scale 22 ) can be useful, but yield large numbers of false positives and cannot be relied on for diagnosis without supportive evidence from clinical assessment. Application Forms. Application Form Medical. 23.
Treatment approaches to ADHD include an array of psychotropic medications, behavioral and psychological treatments, and complementary and alternative medicine approaches. Medications are generally the preferred treatment modality and can be combined with behavioral or psychological interventions, especially in children with behavioral problems or comorbid psychiatric conditions. Stimulant medications and psychosocial treatment have been the major foci of clinical research; however, the duration of most randomized trials has been 3 months or less, and thus the Of Essay Writing, literature on long-term treatment is sparse. In general, studies suggest that stimulants and psychosocial treatments are efficacious. 24, 25 They also indicate that treatment with stimulants is superior to psychosocial treatment. 26. Short-term trials of stimulants support their efficacy, with response rates in the 70#x00025;-to-90#x00025; range. 27 Methyl-phenidate and Medical Card Medical dextroamphetamine are the Legal Considerations. – Advanced, most studied stimulants.
While there are longer-acting stimulants, these do not appear to provide any improvement in efficacy. Application Card Application Form. Studies have found that stimulants improve the defining symptoms of ADHD and associated aggression. However, there are not consistent findings that improvement in symptoms leads to improvement in academic achievement or social skills. 28, 29. Aside from studies suggesting the efficacy of using stimulants, there are also studies of antidepressants showing that tricyclic antidepressants (e.g., imipramine, desipramine, nortriptyline) produce improvements over placebo. 30 The primary concern regarding their use is the risk of Writing cardiac side effects, especially in overdose. Atomoxetine also has proven efficacy for ADHD 31, 32 ; it is the only medication approved by Application Card Form Medical the U.S. Food and Warm Housewarming Invitation - Templates Drug Administration for use in adult ADHD, is not a controlled medication, and might be particularly useful when possible comorbid substance abuse is a concern. Forms. Medical Card Form. 33 However, it does have a new black-box warning regarding the potential for severe liver injury, based on 2 reports (1 of a teenager and 1 of an Letters, adult). Psychosocial treatments of ADHD with demonstrated efficacy include behavioral strategies such as contingency management (e.g., point/token reward systems, timeout, response cost) that is conducted in the classroom, parent training (parent is taught child management skills), and Forms. Card Form Medical clinical behavior therapy (parent, teacher, or both are taught to 401k Calculator | Excel Spreadsheets, use contingency management procedures).
34 In contrast, cognitive-behavioral treatment (e.g., self-monitoring, self-instruction, problem-solving strategies, self-reinforcement) has not been found to be helpful in Application Application Form children with ADHD. 35, 36. Complementary and alternative medicine strategies are very commonly used and might have particular appeal to families from Of Your Resume 2016-2017 2016 other cultures. 37 Such therapies include special diets and supplements, megavitamins, applied kinesiology, and biofeedback; however, their benefits have not been demonstrated in clinical trials. 38 Diet, including reducing sugar, affects behavior in less than 1#x00025; of children. 39 One role in which the primary care physician can be helpful is to help families assess alternative treatments and not be enticed by expensive treatments of little benefit.
The treatment of ADHD should be viewed as involving 3 stages of Forms. Medical Form Medical therapy: initiation and titration, maintenance, and termination. 40 During the initial phase of treatment, patients and families should be educated regarding ADHD ( Table 2 for examples of parental activities that may be helpful), therapeutic goals should be established with the patient and family, and treatment should be initiated. Template | Excel Spreadsheets. If medications available in short- and long-acting forms are selected, initial titration can best be accomplished using short-acting forms, observing for response and side effects. This can be followed by switching to longer-acting forms if desired. Application. Starting and adjusting medications on a weekend provides opportunity for parents to observe effects and side effects directly. During the Of Essay, maintenance phase, ongoing family education, dosage adjustment, and monitoring of growth, efficacy, and side effects are appropriate. The duration and Application Card Medical approach to termination should be individualized, with regular discussions with patients and Calculator Template | Excel Templates | Excel families to support adherence to treatment rather than unsupervised treatment termination. Stimulant medications and atomoxetine may be stopped at once, while other medications (e.g., tricyclic antidepressants) may need to Medical Card Form, be tapered. Trials off therapy, for instance during school holidays, may help determine if medications are still beneficial. In summary, although there are a range of treatment modalities that have been tried in the treatment of ADHD in children, the management approach that has proved most effective includes stimulants and psychosocial treatments focused on Cv Covering Letters, behavioral strategies. Of note, in one large study funded by the National Institute of Mental Health, there was no difference in response to treatment between ethnic groups (Latino, African American, and white).
41. ADHD AND ITS CARE FROM A HAITIAN PERSPECTIVE. While there is no corresponding term for ADHD in the Haitian-Creole language, in the Haitian culture the behaviors consistent with the diagnosis of ADHD might be interpreted as indicating the following: Among Haitians, the interpretation of ADHD-related behaviors varies widely from family to family depending on religious affiliations, level of Application Form education, and experience with school and primary care systems. Stigma, language, cultural conceptions, concerns about governmental agencies, and physician and teacher bias can all serve as barriers to care for immigrant families ( Table 3 ). An important determinant of the treatment or other intervention strategy a family pursues is their perception of the cause of the ADHD behaviors.
Whether the Writing, cause is Medical Medical natural or unnatural is extremely important in the Haitian belief system. #x0201c;Natural#x0201d; ailments are often attributed to natural forces (heat/cold, gas, wind, temperature), while #x0201c;unnatural#x0201d; ailments are attributed to bad spirits or punishment inflicted by God. Periodic Table Database. These are treated using either natural remedies or religious intervention. Medical Medical. 42 Such belief systems can influence a family's acceptance of a physician's diagnosis of ADHD and The Worst Mistakes High | Resume their adherence to Western medical treatments. In the United States, as in many other countries, the Forms. Form, diagnosis of ADHD is mainly a medical one and involves pediatric and family medicine providers, social workers, and psychologists. – Advanced. However, for most of the Application Form Medical, population in Haiti, a child would not be brought to a primary care physician for care of a behavioral problem. Doctors are generally seen only for Warm Housewarming Invitation - Templates By Canva, physical illness and emergency care; access to primary care is limited and generally available only to the most affluent. ADHD manifesting as a negative behavior usually is handled by parents, extended family, and school teachers through verbal or corporal discipline.
Verbal discipline includes preaching to Application Medical Application Form, the child, comparing the child to others, begging the child to Of Essay, behave, and humiliating the child. Corporal discipline and punishment can be inflicted by Application Forms. Card Application Medical any member of the family, neighbors, and schoolteachers, all of whom are given full authority to educate and #x0201c;correct#x0201d; the child. Immigration adds a complex dimension to raising children. New families find themselves devoid of the support of the Letters, extended family, in an environment that is not supportive of their interpretation of child behaviors and traditionally accepted parental disciplinary style. Like many Haitian American parents living in the United States faced with similar circumstances, Mr.
A's parents chose to send him back to Haiti with the Application Form Medical, hope that a more authoritative parenting style, the enforcement of discipline in school (schoolteachers are very respected), and removal of the Cv Covering Letters, interference of the American social worker would offer a better environment for rearing their child. Mr. A went to live with his grandmother first and then off to a boarding school, a setting seen by many Haitian parents as the ultimate answer to Application Application, a child with behavioral problems. There are many beliefs among Haitian Americans surrounding the use of medication. Many in the Haitian American community see the Legal And Ethical, use of Application Card Application Form psychoactive medications as a gateway to substance abuse or mental illness. Periodic Database. Therefore, even parents who agree to Medical Card Form, allow their children to try them will most likely have low thresholds for terminating medication and be unsupported by Legal Considerations. – Advanced Production family members, friends, neighbors, and Application Forms. Medical Application even religious leaders. Mr.
A's parents received much unsolicited advice, and some friends wanted them to #x0201c;lift their feet#x0201d; ( Leve pye nou : to see a Hougan or voodoo priest) who might be able to determine the Considerations. – Advanced Production, unnatural but real cause of their son's problem. Being transnational and Application Medical Card Application Medical having access to both native Haitian medicine and Western medicine, Haitian Americans routinely combine therapeutic foods that are considered cold in nature, natural sedatives and purgatives from traditional herbal medicine, religious treatments, and Western medicine to treat illness. Examples of folk treatments for ADHD include mint tea, sweetsop (apple custard), or leaf teas (usually hot drinks); tizanne (usually cold drinks) of lettuce or other refreshing vegetables; and Example baths with boiled leaves ( bain de feuille ), which are often used as natural sedatives. While it may be difficult to establish trust with Haitian families initially, such trust in the doctor-patient relationship is essential in obtaining their participation in the development of Card Application Medical a treatment plan to which they will adhere. Clinicians should work to disarm or to gain acceptance with parents and family members. It may be helpful to The Worst Mistakes Of Your High School | Resume, learn a few words of Creole or tidbits of Haitian history, to be respectful of Application Medical Form combining benign natural remedies with conventional Western medicine, and to find ways to show respect for the family's heritage. Engaging families in supportive behavioral management approaches (see Table 2 ) can give them a sense of control and involvement that will help build adherence to other treatments recommended. Cultural sensitivity is essential in Legal And Ethical Considerations. – Advanced dealing with not only Haitian patients but also patients from Application Medical Card Medical various cultural and ethnic backgrounds. One definition of cultural competency is #x0201c;a set of congruent attitudes, behaviors, and The Worst High School policies that come together in a system, agency, or amongst professionals and enables them to work effectively in cross-cultural situations.#x0201d; 43 Haitians, like most immigrant patients, need sympathetic advice and Medical help from their physicians, as they often feel governmental agencies such as the local department of social services place a great deal of pressure on them to either medicate their children or move their children to other school systems.
In direct contrast, it is also important not to #x0201c;overemphasize#x0201d; a patient's culture when considering a diagnosis and treatment. While many of the Considerations. – Advanced Production, barriers listed above may be relevant for some patients, culture is only one factor in Application Card their understanding of their illness. Educational, social, economic, and individual factors may also hold relevance. Because the interface of psychiatric disorders#x02014;in this case ADHD#x02014;and culture is Legal And Ethical Considerations. complex, it is a useful context for Forms. Medical Card Application Form, examining the Letters, integration of psychiatric and Application Application primary care. While there are a number of models of such primary care and behavioral integration, one, called #x0201c;primary mental health care,#x0201d; 44#x02013;47 is particularly useful in Legal And Ethical Production managing families from other cultures. The goal of this approach is to resolve problems within the primary care service context: #x0201c;primary mental health#x0201d; is designed to support the ongoing behavioral health interventions of the Application Medical Form Medical, primary care provider. This model of And Ethical – Advanced behavioral health care is consistent with the Application Forms. Medical Card, philosophy, service goals, and health care strategies of Warm Housewarming primary care. This approach involves making psychiatric consultative services available to primary care providers and allows for behavioral health and Forms. Medical Form Medical primary care comanagement of patients who require more concentrated services, but nevertheless can be managed in primary care. Both consultative and condensed specialty treatment services are delivered as first-line interventions for primary care patients who have behavioral health needs.
In summary, there are several options for assisting Mr. The Worst Mistakes 2016. A and his family and other Haitian children and adults with ADHD: Drug names: atomoxetine (Strattera), desipramine (Norpramin and others), dextroamphetamine (Dexedrine, Dextrostat, and others), imipramine (Tofranil and others), methylphenidate (Metadate, Ritalin, and Application Forms. Medical Card Application Medical others), nortriptyline (Pamelor, Aventyl, and Cv Covering Letters others). The authors acknowledge Jean-Robert Boisrond, Coordinator of the Haitian Health Institute at Boston Medical Center, Boston, Mass., for assistance in preparation of the case and for Application Medical Card Application Form, commitment to the special needs of the Haitian people. Cultural Currents presents clinical experience derived from the Writing, practices of clinicians caring for patients and families whose cultural backgrounds are outside of the mainstream of society. At times, those very clinicians will be in the position to provide rich insights afforded by their own unique cultural backgrounds. These case reports and commentaries provide knowledge and strategies helpful in Forms. Application the clinical encounter with patients from other cultures.
This article is based on Mistakes High School 2016-2017 | Resume 2016, a Grand Rounds presented at Application Forms. Medical Application Form Medical, the Department of Family Medicine, Boston Medical Center, Boston, Mass., on Sept. Warm Housewarming. 16, 2003. The authors received no direct support related to this article. Dr. Culpepper has been a consultant for Card Application Form Medical, Eli Lilly. Drs.
Prudent, Johnson, and Carroll report no financial or other relationship relevant to the subject of this article.