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Patients First: Closing the Health Care Gap in Canada

by Terrence Montague

PATIENTS FIRST CLOSING THE HEALTH CARE GAP IN CANADA "This book is a must read for those who are interested in our health care system and who want to make it better. Dr. Montague provides an interesting overview of his journey through hospital wards, clinical trials, patient registries, patient health management and chronic disease management programs. Drawing on his diverse and unique background, he gives an important history of the past, analysis of the present and a glimpse of our future." --David Johnstone, MD President, Canadian Cardiovascular Society "Based on significant practice and research experience in the public, private and academic worlds, over many regions of Canada, Dr. Montague reveals to the reader, consumer, decision maker and patient an evolving and, until now, largely overlooked dimension in optimizing care and outcome. This optimization is important not only within the context of an individual's care, but within the scope of an entire practice, community or even nation." --Ross Tsuyuki, PharmD Director, The Epidemiology Coordinating and Research Centre, University of Alberta "Listen to Dr. Montague. He well understands both the problem and the solution, which is to pull out all the stops and to put patients first. He advocates patient health management to close the many care gaps. This will result in improved health for millions of Canadians and then, if we do it right, by emphasizing research and evidence-based health care and not merely budgets, our health care system will become more cost effective and our population healthier and more productive." --Mark Poznansky, PhD President, Robarts Research Institute

A Patient's Guide to Dental Implants

by Thomas Balshi William Becker Edmond Bedrossian Peter Wohrle

Do You Need Teeth Replacement? Are you missing a tooth? Several teeth? If so, perhaps you're like many individuals--you already wear a bridge or dentures or are considering them. But have you considered dental implants? They are "permanent teeth" that are inserted into the jawbone and function like natural teeth. They offer a more natural appearance and greater comfort than bridges or dentures. Although the trend toward dental implants is growing rapidly, you, like many consumers, may not fully understand how they work. The doctors who wrote this book recognized the need for consumer information. All specialists in dental implants, they provide answers to such questions as: * What are the benefits of dental implants? * Who is a candidate for dental implants? * How are the implants inserted? * Are the procedures painful? * How long do implants last? * Are there risks or possible complications? * How do you choose a qualified dentist or specialist? * What follow-up care is required? Your Complete Guide to Dental Implants

A Patient's Guide to Dental Implants

by William Becker Thomas Balshi Edmond Bedrossian Peter Wohrle

Do You Need Teeth Replacement? Are you missing a tooth? Several teeth? If so, perhaps you're like many individuals—you already wear a bridge or dentures or are considering them. But have you considered dental implants? They are "permanent teeth" that are inserted into the jawbone and function like natural teeth. They offer a more natural appearance and greater comfort than bridges or dentures. Although the trend toward dental implants is growing rapidly, you, like many consumers, may not fully understand how they work. The doctors who wrote this book recognized the need for consumer information. All specialists in dental implants, they provide answers to such questions as: • What are the benefits of dental implants? • Who is a candidate for dental implants? • How are the implants inserted? • Are the procedures painful? • How long do implants last? • Are there risks or possible complications? • How do you choose a qualified dentist or specialist? • What follow-up care is required? Your Complete Guide to Dental Implants

A Patient’s Guide to Obstructive Sleep Apnea Syndrome

by Arnav Shetty Peter M Baptista Jardín

This book provides a comprehensive overview of Obstructive Sleep Apnea (OSA) that is accessible to patients. OSA can have a significant and progressive impact on the lives of those who suffer from daytime sleepiness, but it is often not considered. Moreover, individuals with the condition are often unaware of it as it affects them during sleep. The book provides knowledge on appropriate pathways for investigation and treatment. The organization and clarity of the writing make it easy for readers who want quick information on diagnosis, symptoms, treatment, and more. The thorough history section covering anatomical evolution, the history of medicine, and modern-day medical and surgical advances will satisfy curious readers. Ample original hand-drawn diagrams increase the readability and approachability of the work, making pathophysiology and surgical procedures clear and accessible. The book also includes links and descriptions of up-to-date procedures, diagnostic techniques, and devices, guiding readers confidently towards other resources beyond the book for further information. Given its features, this guide will appeal also to general practitioners, ENT students, and OSA specialists.

A Patient's Guide to Surgery

by Editors of Consumer Reports Books Edward L. Bradley III

In a Patient's Guide to Surgery, Dr. Edward L. Bradley III explains all you need to know to prepare yourself for the surgical experience. This book describes how you can actively participate in the decision-making process and, as a result, improve your chances for successful surgery and recovery.A Patient's Guide to Surgery also lists specific questions you should consider when evaluating a doctor, a hospital, or a prepaid health plan.

A Patient's Guide to Unnecessary Knee Surgery: How to Avoid the Pitfalls of Hasty Medical Advice

by Ronald P. Grelsamer

Every year millions of Americas are told by an orthopedic surgeon that the only way to successfully get rid of their knee pain is to undergo some form of knee surgery. But so many of these procedures could have been avoided if the patient was fully informed regarding all the intricacies of his or her condition.In A Patient’s Guide to Unnecessary Knee Surgery, respected orthopedic surgeon Ronald P. Grelsamer intricately and accessibly conveys all the information regarding the knee and surrounding areas that any person suffering from knee pain would ever need to know in order to make an informed decision about treatment for his or her condition. Within this guide, you’ll find chapters on pertinent topics such as: Reasons behind some of the leading causes of knee pain Tips on how to understand the results of an MRI Exercises to boost your knee health Advice on how to find the best doctor for your needs And ten other areas of knee-related healthSo if you’re suffering from knee pain, make sure to you grab A Patient’s Guide to Unnecessary Knee Surgery before you decide to undergo surgery.

Patient's Healthcare Portfolio: A Practitioner’s Guide to Providing Tool for Patients

by Rebecca Mendoza Saltiel Busch

As the healthcare market moves toward an era of patient engagement, population health and patient advocates, practitioners need a practical how-to guide that helps facilitate their teaching with patients and family members on not just writing down or accumulating a personal health record, but an interactive process that converts the personal health information into a data-driven decision-making process. Through numerous forms, templates and real life examples, the author provides the tools to help patients gather critical health information while minimizing their exposure to medical and financial errors.

Patients’ Lived Experiences During the Transplant and Cellular Therapy Journey: Harvest and Hope

by Jean Coffey John M. Hill Thomas Long Elizabeth B. McGrath

The book was envisioned by bedside nurses caring for transplant and cellular therapy patients as a way to teach novice nurses and health care colleagues about the care required for this complex patient population. The nurse authors recruited an oncology nurse practitioner, transplant physician, nurse scientist and expert in medical humanities and health studies to join the project team. The dedication of the team and the willingness of the patients to contribute to the project, has led to a unique case study approach focused on the lived experience of patients and care partner(s) during the transplant/cellular therapy journey. The case studies are unique in that they encompass a qualitative narrative developed using Interpretive Phenomenological Analysis (IPA) and the inclusion of the individual's actual medical and nursing care from their health record. At every step along the trajectory of the illness, the medications and care received are described, interspersed with the voice of the patient and care partner(s) sharing their experiences. The chapters follow the individual patients and their care partner(s) through all phases of their illness. The interviews were conducted, and case studies written by the bedside clinical nurses. Visual art and prose created by patients and care partner(s)s are included in the chapters. The book also includes an introduction written by the nurse authors, a methods chapter on the inclusion of IPA in a case study, and poignant epilogue. The premise of nursing support for survivorship is woven throughout the book, highlighting how giving back aids in recovery identity.This book, full of beautiful artworks and poems, is the work of clinical nurses devoted to improving care for their patients by sharing the patient stories with others. It introduces a unique approach to the case study which could be replicated and applied to any diagnosis.

Patients Making Meaning: Theorizing Sources of Information and Forms of Support in Women’s Health (Routledge Studies in Rhetoric and Communication)

by Bryna Siegel Finer Cathryn Molloy Jamie White-Farnham

This book explores how women make meaning at various health flashpoints in their lives, overcoming fear, anxiety, and anger to draw upon self-advocacy, research, and crucial decision-making. Combining focus group research, content analysis, autoethnography, and textual inquiry, the book argues that the making and remaking of what we call “patient epistemologies” is a continual process wherein a health flashpoint—sometimes a new diagnosis, sometimes a reoccurrence or worsening of an existing condition or the progression of a natural process—can cause an individual to be thrust into a discourse community that was not of their own choosing. This study will interest students and scholars of health communication, rhetoric of health and medicine, women’s studies, public health, healthcare policy, philosophy of medicine, medical sociology, and medical humanities.

The Patient's Playbook

by Leslie D. Michelson

The Patient's Playbook will change the way you manage your health and your family's health, from finding the right doctor to coordinating the best medical care. An expertly informed guide to the steps that everyone should take--even before illness strikes. The Patient's Playbook is a compelling narrative of personal stories that impart lessons and illuminate strategies for better, and even life-saving, medical decision-making. With clarity and as a call to action, Michelson presents the most effective approach to getting the best from a broken system: sourcing excellent doctors, choosing the right treatment protocols in the "no mistake zone," researching with precision, and structuring the ideal support team. Leslie D. Michelson has devoted his life's work to helping people access the best quality medical care--serving as an expert navigator for hundreds of clients. As the former head of the Prostate Cancer Foundation and the CEO of Private Health Management he has dedicated his life's work to helping individuals find the courage and confidence to get what they need in a challenging health system.

The Patient's Playbook

by Leslie D. Michelson

Too many Americans die each year as a result of preventable medical error--mistakes, complications, and misdiagnoses. And many more of us are not receiving the best care possible, even though it's readily available and we're entitled to it. The key is knowing how to access it. The Patient's Playbook is a call to action. It will change the way you manage your health and the health of your family, and it will show you how to choose the right doctor, coordinate the best care, and get to the No-Mistake Zone in medical decision making. Leslie D. Michelson has devoted his life's work to helping people achieve superior medical outcomes at every stage of their lives. Michelson presents real-life stories that impart lessons and illuminate his easy-to-follow strategies for navigating complex situations and cases. The Patient's Playbook is an essential guide to the most effective techniques for getting the best from a broken system: sourcing excellent physicians, selecting the right treatment protocols, researching with precision, and structuring the ideal support team. Along the way you will learn: Why having the right primary care physician will change your lifeThree things you can do right now to be better prepared when illness strikesThe ten must-ask questions at the end of a hospital stayHow to protect yourself from unnecessary and dangerous treatmentsWays to avoid the four most common mistakes in the first twenty-four hours of a medical emergency This book will enable you to become a smarter health care consumer--and to replace anxiety with confidence.From the Hardcover edition.

The Patient's Playbook: How to Save Your Life and the Lives of Those You Love

by Leslie D. Michelson

Too many Americans die each year as a result of preventable medical error--mistakes, complications, and misdiagnoses. And many more of us are not receiving the best care possible, even though it's readily available and we're entitled to it. The key is knowing how to access it. The Patient's Playbook is a call to action. It will change the way you manage your health and the health of your family, and it will show you how to choose the right doctor, coordinate the best care, and get to the No-Mistake Zone in medical decision making. Leslie D. Michelson has devoted his life's work to helping people achieve superior medical outcomes at every stage of their lives. Michelson presents real-life stories that impart lessons and illuminate his easy-to-follow strategies for navigating complex situations and cases. The Patient's Playbook is an essential guide to the most effective techniques for getting the best from a broken system: sourcing excellent physicians, selecting the right treatment protocols, researching with precision, and structuring the ideal support team. Along the way you will learn: Why having the right primary care physician will change your lifeThree things you can do right now to be better prepared when illness strikesThe ten must-ask questions at the end of a hospital stayHow to protect yourself from unnecessary and dangerous treatmentsWays to avoid the four most common mistakes in the first twenty-four hours of a medical emergency This book will enable you to become a smarter health care consumer--and to replace anxiety with confidence.From the Hardcover edition.

Patients, Power and Responsibility: The First Principles of Consumer-Driven Reform

by John Spiers

Care pathways are being developed throughout the health service to improve the quality and effectiveness of care. Are they being developed efficiently and making the most of the latest clinical computing systems? This is the first practical guide on how Information Technology and systems methods can support the development implementation and maintenance of "e-Pathways". Case studies throughout highlight team approaches to facilitation clinical knowledge management process analysis and redesign and computerisation - providing insights into how e-Pathways can be used to support high quality patient care. The information is presented in an easy-to-read style and requires no prior knowledge of IT systems. Doctors nurses and managers throughout primary and secondary care as well as healthcare information technology specialists and suppliers will find this to be essential reading. An accompanying CD-ROM includes supplementary information providing useful website links and additional material on specific topic areas.

The Patient's Survival Guide: Seven Key Questions for Navigating the Medical Maze

by Edward H Morgan Jr.

In the US medical environment where medical mistakes, over-diagnosis, and over-treatment have become the third leading cause of death, leadership consultant and long-time charity CEO Edward Morgan argues that protecting yourself with medical wisdom can add 10-15 years to your life.We're a nation on meds, where 60% of adults are now diagnosed with some chronic condition. We're listening to unwise advice and becoming permanent patients.Longevity is declining in America, even though medical costs in the US are twice that of other developed nations. Don't get caught in medical misadventures that escalate into permanent conditions, screenings that cascade into fear-driven decisions, prescriptions that simply suppress symptoms, or worst of all, end up dying in an ICU in the vain hope for a few more days.Smart is not the same as wise. Medical wisdom and discernment will extend your life. Taking today's aggressive, profit-driven advice will quite possibly shorten it. Living to see your grandchildren grow up is your responsibility, not your doctor's. This is a must read for anyone already feeling like a patient for life. With courage and wisdom you can become a well person again and live out your full lifespan.

Patients, the Public and Priorities in Healthcare (Radcliffe Ser.)

by Peter Littlejohns Michael Rawlins

Sharing the costs of ill health is the mark of a civilised society. However, every society has limited healthcare resources, and must therefore make finely balanced decisions on how best to allocate them. The National Institute for Health and Clinical Excellence (NICE) has been responsible for the UK's health resource allocation for a decade. To inform its decisions, a Citizens Council of 30 members of the general public was established by NICE to gauge the underlying values of the society it serves. A number of national and international organisations and governments have asked NICE to share its experiences in establishing and running the Citizens Council, and encouraging and supporting patient involvement. As part of NICE's response, this book provides an up to date 'position statement' on the Citizens Council, an exploration of how patients interact with NICE and how their views are taken into account, and a national and international perspective on new issues facing the interaction between patients, the public and healthcare provision. 'Reading this volume will enable you, the reader, to assess how well NICE is acting as a means of fostering responsible public choice. I hope you profit from its chapters as much as I have.' - Albert Weale in his Foreword

The Patient's Voice: Experiences of Illness

by Jeanine Young-Mason

Do you need to add caring to your course? Do your students need to become more aware of the process patients and families go through as they adapt to an illness or death? Sixteen contemporary autobiographical case studies written by children and adults who have experienced psychiatric and physical illnesses are contained in this unique text. Each case study begins with a brief description of the patient's clinical situation. Chapters are followed by points for discussion and study questions to further direct the exploration of the accounts and enhance students' critical thinking skills.

Patiëntveiligheid

by I. P. Leistikow K. Ridder Den B. Vries De

De auteurs hebben in Patiëntveiligheid, Systematische Incident Reconstructie en Evaluatie (SIRE) de ervaringen verwerkt die zij hebben opgedaan bij het uitvoeren van, en onderwijs geven in, SIRE. Daarnaast is de scoop verbreed met voorbeelden uit de huisartsenpraktijk, GGZ en care sector.

Patiëntveiligheid in de verpleegkunde

by Annelies Bon Yvonne Tuijn Yvonne Asten Karien Ridder

Dit boek biedt de nodige basiskennis over patiëntveiligheid voor verpleegkundigen en andere zorgprofessionals die betrokken zijn bij de directe patiëntenzorg. Het is opgebouwd uit drie delen. Deel 1 bespreekt de systeembenadering. Waar liggen de risico’s en wat kun je doen om het zelf als verpleegkundige veiliger te maken voor je patiënten? In dit deel is een nieuw hoofdstuk over Patiëntveiligheid in België opgenomen. Deel 2 geeft inzicht in het MOTTO-model (voorheen het SEIPS-model). MOTTO staat voor de structuur Mens, Organisatie, Taak, Techniek en Omgeving. Deel 3 behandelt de specifieke zorg vanuit verschillende perspectieven, bijvoorbeeld de zorg op de ok, de polikliniek, de thuiszorg en de psychiatrie. In Nederland is de afgelopen jaren veel geïnvesteerd om de zorg veiliger te maken. De WHO heeft Patiëntveiligheid hoog op haar lijst staan omdat onveiligheid in de zorg veel schade berokkent. Het kan zelfs leiden tot overlijden en beschadiging van patiënten. Veilige zorg begint bij de directe zorg rond het bed. Voor het onderwijs aan alle zorgprofessionals zijn patiëntveiligheidscompetenties ontwikkeld die in dit boek zijn vertaald naar praktisch verpleegkundig handelen. Diverse casussen helpen dit te visualiseren. Patiëntveiligheid in de verpleegkunde is bestemd voor verpleegkundigen in de zorg, zowel intramuraal (ziekenhuizen, zorginstellingen, psychiatrie) als extramuraal (huisarts, thuiszorg) of in opleiding op hbo- en mbo-niveau. Het volledige boek is ook digitaal beschikbaar met samenvattingen en toetsvragen per hoofdstuk en interessante en verdiepende links. De redactie bestaat uit: Karien den Ridder, Yvonne Tuitert, Yvonne van der Tuijn en Annelies van Bon. Aan deze druk hebben bijna vijftig professionals meegewerkt, die allen werkzaam zijn in de zorg en daar veel te maken krijgen met patiëntveiligheid in hun specifieke werkgebied. De auteurs kennen de dagelijkse werkelijkheid en zien het als een grote uitdaging hun bijdrage te leveren aan een veiligere patiëntenzorg.

Pattern Analysis for Histopathologic Diagnosis of Melanocytic Lesions: A Guide to Practical Dermatopathology

by Almut Böer-Auer Harald Kittler Philipp Tschandl

Pattern analysis is a powerful method that changed dermatopathology, nowadays an indispensable tool in the diagnostic workup of inflammatory and neoplastic lesions. The diagnosis of melanocytic lesions can also be mastered by pattern analysis, which is the link between pathology, dermatoscopy, and clinical dermatology and supports the integration of all views. The histopathologic diagnosis of melanocytic lesions can be challenging for novices and experts alike. While classifications of melanocytic lesions come and go, pattern analysis is timeless; it can be assigned to any classification, current or future, and provides a framework that allows to address complex and uncertain cases in a repeatable manner. While uncertainty cannot be totally eliminated, pattern analysis helps to express this uncertainty in a meaningful way. Written by expert dermatopathologists with experience in dermatoscopy, this book is dedicated to young colleagues and to those who have not yet settled on one of the competing schools of thought; it is intended as a practical guide to help making correct observations, to describe them with a well-defined terminology, and to yield critical decisions in the face of incomplete or conflicting information. The illustrations contained in the volume are all original pictures in high-quality and full-color: reproductions of histopatological cuts in low and high magnification will assist pathologists, dermatologists, and dermatopathologists in interpreting histological slides of melanocytic skin lesions.

Pattern Analysis of the Human Connectome

by Dewen Hu Ling-Li Zeng

This book presents recent advances in pattern analysis of the human connectome. The human connectome, measured by magnetic resonance imaging at the macroscale, provides a comprehensive description of how brain regions are connected. Based on machine learning methods, multiviarate pattern analysis can directly decode psychological or cognitive states from brain connectivity patterns. Although there are a number of works with chapters on conventional human connectome encoding (brain-mapping), there are few resources on human connectome decoding (brain-reading). Focusing mainly on advances made over the past decade in the field of manifold learning, sparse coding, multi-task learning, and deep learning of the human connectome and applications, this book helps students and researchers gain an overall picture of pattern analysis of the human connectome. It also offers valuable insights for clinicians involved in the clinical diagnosis and treatment evaluation of neuropsychiatric disorders.

A Pattern Approach to Lymph Node Diagnosis

by Anthony S-Y Leong

While a pattern approach to diagnosis is taught and practiced with almost every other tissue or organ in the body, the lymph node remains a mystery to most residents starting out in pathology and those pathologists with limited experience in the area. A Pattern Approach to Lymph Node Diagnosis demonstrates that a systematic approach to lymph node examination can be achieved through recognition of morphological patterns produced by different disease processes. It presents a combination of knowledge-based assessment and pattern recognition for diagnosis covering the major primary neoplastic and non neoplastic diseases and metastatic tumors in lymph nodes. This volume demonstrates that lymph node compartments can be recognized histologically especially with the aid of immunohistological markers and how this knowledge can be employed effectively to localize and identify pathological changes in the different compartments in order to facilitate histological diagnosis. It also defines histological features that, because of their pathological occurrence in lymph nodes, are useful pointers to specific diagnoses or disease processes. The volume is organized in accordance with the primary pattern of presentation of each diagnostic entity. Differential diagnosis is discussed and each diagnostic entity is accompanied by color illustrations that highlight the diagnostic features. Immunohistochemistry, clinical aspects, relevant cytogenetics and molecular information of each entity is provided by authors who are experts in lymphoproliferative diseases. An algorithmic approach to diagnosis is adopted at the end of each section by listing a set of questions that help to consider diagnostic entities that can present with the morphological features observed. A Pattern Approach to Lymph Node Diagnosis will be of great utility to residents and fellows in pathology and general pathologists making first hand lymph node diagnoses as well as to hematologists and physicians who treat patients with lymphoprolifeative diseases.

Pattern Classification of Medical Images: Computer Aided Diagnosis

by Xiao-Xia Yin Sillas Hadjiloucas Yanchun Zhang

This book presents advances in biomedical imaging analysis and processing techniques using time dependent medical image datasets for computer aided diagnosis. The analysis of time-series images is one of the most widely appearing problems in science, engineering, and business. In recent years this problem has gained importance due to the increasing availability of more sensitive sensors in science and engineering and due to the wide-spread use of computers in corporations which have increased the amount of time-series data collected by many magnitudes. An important feature of this book is the exploration of different approaches to handle and identify time dependent biomedical images. Biomedical imaging analysis and processing techniques deal with the interaction between all forms of radiation and biological molecules, cells or tissues, to visualize small particles and opaque objects, and to achieve the recognition of biomedical patterns. These are topics of great importance to biomedical science, biology, and medicine. Biomedical imaging analysis techniques can be applied in many different areas to solve existing problems. The various requirements arising from the process of resolving practical problems motivate and expedite the development of biomedical imaging analysis. This is a major reason for the fast growth of the discipline.

Pattern Formation in Morphogenesis

by Annick Harel-Bellan Misha Gromov Linda Louise Pritchard Nadya Morozova Vincenzo Capasso

Pattern Formation in Morphogenesis is a rich source of interesting and challenging mathematical problems. The volume aims at showing how a combination of new discoveries in developmental biology and associated modelling and computational techniques has stimulated or may stimulate relevant advances in the field. Finally it aims at facilitating the process of unfolding a mutual recognition between Biologists and Mathematicians of their complementary skills, to the point where the resulting synergy generates new and novel discoveries. It offers an interdisciplinary interaction space between biologists from embryology, genetics and molecular biology who present their own work in the perspective of the advancement of their specific fields, and mathematicians who propose solutions based on the knowledge grasped from biologists.

Pattern Recognition Neuroradiology

by Scott E. Forseen Neil M. Borden

Faced with a single neuroradiological image of an unknown patient, how confident would you be to make a differential diagnosis? Despite advanced imaging techniques, a confident diagnosis also requires knowledge of the patient's age, clinical data and the lesion location. Pattern Recognition Neuroradiology provides the tools you will need to arrive at the correct diagnosis or a reasonable differential diagnosis. This user-friendly book includes basic information often omitted from other texts: a practical method of image analysis, sample dictation templates and didactic information regarding lesions/diseases in a concise outline form. Image galleries show more than 700 high quality representative examples of the diseases discussed. Whether you are a trainee encountering some of these conditions for the first time or a resident trying to develop a reliable system of image analysis, Pattern Recognition Neuroradiology is an invaluable diagnostic resource.

Patterns of Parental Behavior: From Animal Science to Comparative Ethology and Neuroscience (Advances in Neurobiology #27)

by Gabriela González-Mariscal

Modern neuroscience has presented new opportunities for exploring the molecular and neural mechanisms controlling specific social responses. This book reviews insights into the neural circuits underlying a particularly fascinating form of social interaction, parental behavior. This book presents a detailed review of maternal and paternal behavior of particular mammalian species. It offer neuroscientists a spectrum of specific mammals that can be used as experimental models to explore particular topics on the functions of the nervous system. It shows that results coming from the laboratory can be translated into useful information for raising mammals on the farm, and it stimulates biologists to gain insights into the underpinnings of the complex mechanisms governing mammalian behavior in the wild. It also discusses the implications of this research for human parental behavior.

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