A managerial perspective on controlling the quality of patient care.
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Biomedical subjects
Publications and source records attributed to N O'Brien.
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Testicular feminisation syndrome in a neonate was confirmed by cytogenetic studies. Karyotype analysis in 2 phenotypically female siblings showed the presence of the disorder in the 2 year old sibling. Subsequently a fourth phenotypically female sibling showed the disorder.
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The parents of a child who dies feel the emotions of shock, mourning, and confusion as they slowly come to accept the finality of the child's death. In contemporary America they frequently feel isolated and abandoned. The individuals and institutions that were sources of emotional support in the period immediately after the child's death are no longer available after a few weeks or months. This is due to several factors: (1) American society is very mobile and the nuclear family often does not have the emotional support of the stable, extended family. (2) Children die less frequently today than they did in the past. In fact, it is almost a unique event. As a consequence, the parents of the dead child have less opportunity to share their feelings with other adults and the community at large. (3) There appears to be a misconception held by the general population that the mourning process and emotional confusion terminate after an interval of a few weeks or months. These factors were influential in motivating a number of parents who had lost children to organize a group which meets bi-monthly. The group is open-ended and nothing said is out of place. The parents have been very helpful to each other in diminishing feelings of isolation, concerns about "strange" thoughts, and feelings of hopeless depression. Requests for information on how to form such a group have come from a number of communities in various parts of the country.
A case is described of chilblain-like lesions in the fingers with punched-out erosions in the phalanges on x-ray which appears to be an example of Maroteaux's phalangeal microgeodic syndrome of infancy.
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