• Intrauterine growth restriction, or IUGR, is when a baby in the womb (a fetus) does not grow as expected. (kidshealth.org)
  • Treatment for intrauterine growth restriction depends on how far along the pregnancy is and how the baby is doing. (kidshealth.org)
  • The baby had reverse blood flow and was severe IUGR (intrauterine growth restriction). (neworleansmom.com)
  • The accompanying " Bed Rest in Pregnancy: Time to Put the Issue to Rest " makes an ethical argument that continuing to prescribe bed rest in the absence of evidence of its effectiveness violates the principles of autonomy and beneficence. (typepad.com)
  • Typically, women placed on bed rest at anytime during a pregnancy grieve the loss of a healthy, "normal" pregnancy. (baycare.org)
  • The grieving process may stir up emotions which can impact the way you cope with bed rest and the remainder of your pregnancy. (baycare.org)
  • I ended up losing twenty pounds in the first trimester of the pregnancy and was advised by the doctors to move home. (roseandherlily.com)
  • I switched doctors--loved the new one--and waited out the rest of the pregnancy. (roseandherlily.com)
  • Bed rest and pregnancy restrictions are rarely anticipated. (betterbedrest.org)
  • Living through a pandemic with a high risk pregnancy has also meant solo trips to innumerable doctors' appointments, stressful and highly anticipated ultrasound, stringent visitor restrictions on antepartum units, and emergency c-section and fast labors without a hand to hold. (betterbedrest.org)
  • Being prescribed bed rest or pregnancy restrictions can feel like being dropped in a lake with a sturdy life vest and being told to hang in there for one to twenty weeks. (betterbedrest.org)
  • I'm so sorry they're being such awful people to you, and I hope you have a speedy recovery with your bladder and a smooth rest of your pregnancy! (whattoexpect.com)
  • However, bed rest isn't prescribed often as it is not a proven remedy for preventing pregnancy complications or preterm birth. (kidborn.com)
  • Bed rest for such pregnancies are recommended just to prolong the pregnancy long enough to make that delivery is safe. (kidborn.com)
  • In some cases, bed rest during pregnancy just means to limit the activity level just for a short period. (kidborn.com)
  • Doctors will watch a baby with IUGR closely during prenatal visits . (kidshealth.org)
  • The doctors had put me on bed rest for the last month because I supposedly had IUGR (Intra-Uterine Growth Restriction) and the baby was super small. (roseandherlily.com)
  • At the follow-up ultrasound, the doctor found clubfoot, choroid plexus cysts, clenched fists, strawberry-shaped skull, and that the baby was small for his age. (trisomy18.org)
  • At 27 weeks and 6 days, after an ultrasound, my high risk doctor decided that day was the day for delivery. (neworleansmom.com)
  • The Working Group recommends weekly nonstress tests and/or biophysical profiles (repeated as indicated based on the woman's condition), twice-weekly testing if oligohydramnios or fetal growth restriction is suspected, and ultrasound examinations every three weeks. (aafp.org)
  • For the longest time j thought I was going nuts because every time id tell the dr in bleeding by the time I got in it was gone felt like they thought I was a liar after a while than the last one she seen I still was bleeding than obviously went straight into ultrasound problem found. (babycenter.com)
  • On average, Dr. Ranjan may prescribe medication, recommend bed rest, or suggest dietary restrictions to improve and manage your symptoms. (nestfamilymedicine.com)
  • After a fetal echocardiogram where they found a VSD (Ventricular Septal Defect), they started to accept that the doctors were right. (trisomy18.org)
  • In addition to fetal growth restriction, manifestations of eclampsia in the fetal-placental unit include placental abruption, oligohydramnios, and nonreassuring fetal status. (aafp.org)
  • Estonian hospitals have been taken to the limit during the coronavirus pandemic - as of Thursday morning, there were only seven open intensive care beds for coronavirus patients. (err.ee)
  • Health Board emergency medicine chief Urmas Sule said there were 423 hospital beds in Estonia that could be used for coronavirus patients. (err.ee)
  • There were 43 third-degree intensive care beds for coronavirus patients on Thursday morning, 36 of them were occupied. (err.ee)
  • The financial compensation no longer motivates doctors working with coronavirus patients. (err.ee)
  • The new restrictions come as coronavirus cases continue to surge and while the state's intensive care capacity has neared dangerously low levels. (wuky.org)
  • There may be activity restrictions until symptoms improve. (mayoclinic.org)
  • Seasoned family physician Dr. Priti Ranjan can properly diagnose your condition and provide the most appropriate treatment to ease your symptoms and restore optimal health. (nestfamilymedicine.com)
  • You may have no pain or physical symptoms to support your diagnosis, and you may not fully understand why you have been put on bed rest. (baycare.org)
  • However, if feelings or symptoms of depression persist, you should contact your physician. (baycare.org)
  • As weeks passed, the isolation and physical restrictions amplified Gilman's symptoms and the inability to write or read stifled her. (theworcesterjournal.com)
  • The first, a 25-year-old female doctor, presented at a screening clinic today with COVID-like symptoms. (fiji.gov.fj)
  • For another, a recent study indicates that kids who rested only two days after a concussion actually reported fewer symptoms and experienced a faster recovery than those who underwent a strict five-day break. (summersfirm.com)
  • After your operation, bed rest and inactivity can increase the risk of chest infection and blood clots in your legs. (thewomens.org.au)
  • Prolonged inactivity or complete bed rest can drive to hip and back pain, muscle atrophy (which can make it difficult to jump back as and when you deliver), bone loss, skin irritation and even blood clots in the legs. (kidborn.com)
  • Are there activity or diet restrictions? (mayoclinic.org)
  • But what this Obstetrics & Gynecology study found that "activity restriction", such as quitting work, is still prescribed to one at three women at risk for preterm delivery. (typepad.com)
  • Since there are no activity restrictions, patients can go back to doing the things they love the very next morning. (catawbavalleyhealth.org)
  • Developed by Dr. Silas Weir Mitchell, the rest cure was a course of treatment in which the patient was instructed to completely relax and to take part in minimal physical activity. (theworcesterjournal.com)
  • Bed rest also known as activity restriction can mean anything from complete rest for a few weeks or few months to even spending some time in a hospital. (kidborn.com)
  • Mothers bearing multiples may be placed on activity restriction just because their pregnancies tend to be more challenging. (kidborn.com)
  • Moreover, research has confirmed a connection between reduced appetite (which can occur with activity restriction), maternal weight loss and less birth-weight infants. (kidborn.com)
  • The upshot to both is that restrictions on activity should be personalized to each child, balancing their need for stimulation against the need for rest. (summersfirm.com)
  • Activity restriction in the past 2 weeks. (cdc.gov)
  • Hospitals are scrambling to add new beds each day. (err.ee)
  • Top Spine Hospitals in India and the leading physicians will diagnose your spinal disc damage degree by examining your health condition, checking the history of your health condition and prescribing scans or Xrays and other physical tests if necessary to identify involvement of the spinal nerve injuries in the disc damage. (vanyahealth.com)
  • Over the last two and a half months since Nov. 1, when the "living with COVID-19" scheme kicked off, more than 8,000 beds have been added through a series of executive orders on hospitals, it said. (koreaherald.com)
  • That allows hospitals and physician groups to insist on inflated fees and generous reimbursement for whatever costs they may incur. (city-journal.org)
  • Such preferences encourage hospitals to spend millions of dollars constantly upgrading facilities to attract physicians and patients alike, a phenomenon known as the " medical arms race . (city-journal.org)
  • 123% of hospital beds currently occupied in 7 major hospitals. (who.int)
  • As need grows, more hospital beds are created. (err.ee)
  • There are a total of 19 intensive care beds at the hospital and they were all but filled - there were 18 patients in intensive care, that number has dropped down to 15. (err.ee)
  • Tartu University Hospital anesthesiology and intensive care manager Juri Karjagin said the process of creating hospital beds is complicated. (err.ee)
  • If our capacity exceeds 19, we have another place in the hospital where we can create five beds where most of the communications exist. (err.ee)
  • In May of 2006, just as everything was coming to a head - Wayne was finishing up at Cal U, Robyn was finishing up her school year, I went to another routine dr. appt. and found out that I had failed my one hour test for gestational diabetes and would have to go to the local hospital to sit for the 3 hour. (actingbalanced.com)
  • After graduating from New York Medical College in 2003, Dr. Byrnes completed an internal medicine internship and residency at St. Vincent's Hospital in Manhattan, followed by fellowships in both cardiology and interventional cardiology. (catawbavalleyhealth.org)
  • I've spent the last week on bed rest/home rest/hospital rest. (inkandvodka.com)
  • Yesterday I went into my checkup hoping they'd relax some of my restrictions, but then admitted me into the hospital for closer monitoring instead. (inkandvodka.com)
  • St. Joseph's Women's Hospital, we know that being placed on bed rest can be a difficult and trying time. (baycare.org)
  • A team led by Dr. Ashish Dhadas, General Surgeon and Phlebologist at Surekha Varicose Veins Clinic, Samata Hospital, Dombivli successfully treated a 24 year old chef detected with Varicose Veins with the help of Endovenous laser treatment and enabled him to move freely again. (newsdivya.com)
  • They are both doctors who work at the Lautoka hospital. (fiji.gov.fj)
  • Three-quarters of the state's hospital beds are currently full. (wuky.org)
  • The only reason I had hospital bedrest was because we lived so far from the NICU and since it was military and free the doctors didn't see any reason to send me home. (andbabiesmakesix.com)
  • Heck, even while on hospital bedrest I had weekly passes where we went out to dinner, walked around the mall, and I went downstairs to the cafeteria and outside daily! (andbabiesmakesix.com)
  • Many nations have sought to impede the upward spiral of expenditures associated with third-party payment for medical care by enacting limits on physician fees, regulating hospital capital expenditures, and capping medical expenditures. (city-journal.org)
  • At Shifa hospital, the bed occupancy rate has reached 188% . (who.int)
  • Especially the frequency of post-lumbar puncture headache will decrease, and the number of hospital readmissions or epidural blood patches for this complication will be strongly reduced," added Dr. Brouwer, who co-wrote an editorial about the study. (medscape.com)
  • As I sat in my hospital bed those next few days, my belly began to swell. (cdc.gov)
  • Bed rest during a global pandemic? (betterbedrest.org)
  • Nearly 85% of California residents are now under sweeping new restrictions as the state's struggles to bring the COVID-19 pandemic under control. (wuky.org)
  • So, medically, neither doctor was considered "vaccinated" -- not yet. (fiji.gov.fj)
  • The orthopedic physician suggested surgical intervention and in the meantime advised bed-rest with complete restriction in moving, not even turning in bed nor moving his hand and feet or any part of the body. (interhomeopathy.org)
  • Orthopedic doctors in India will be recommending effective medications to relieve you of the pain along with certain physiotherapy exercises. (vanyahealth.com)
  • As the country relaxes its grip on restrictions, its stock of vaccine and treatment will be beefed up, Kwon said. (koreaherald.com)
  • Two widely reported studies this week about bed rest for women at risk of preterm delivery and reduction of salt consumption in order to promote heart health highlight two things we don't think about enough-that a lot of standard medical practices are without any foundation in science and a lot of legal ones probably are too. (typepad.com)
  • For example, it is old news that prescribing bed rest to pregnant women at risk of preterm delivery is not effective. (typepad.com)
  • In some cases, bed rest even completely stops preterm labour happening, and the delivery happens as normally after 37 weeks. (kidborn.com)
  • In the areas of the West Bank most affected by closures and movement restrictions, immunization coverage with full primary and booster doses of programmed vaccines is below the target of above 95% achieved in other localities. (who.int)
  • ABSTRACT: Using a representative sample of public facilities surveyed in 1993 and 1997, we took advantage of exogenous changes imposed on the Indonesian health system to evaluate the contribution of physicians, nurses, and midwives to the quality of primary care. (who.int)
  • We used a sample of public facilities surveyed in 1993 and 1997, to describe the changes in numbers of physicians, nurses, and midwives by region. (who.int)
  • Nurses called the doctor when my BP hit 89/53. (cdc.gov)
  • I am lucky to be alive, and thriving, and grateful for the ICU team that saved my life, but reminded that more has to be done to educate families, nurses, and doctors to recognize the early signs of sepsis so that patients do not have to suffer what I did. (cdc.gov)
  • Doctors will also use ultrasounds to check the blood flow to the placenta and through the umbilical cord. (kidshealth.org)
  • I had many ultrasounds, and my doctor was just stumped as to why my baby was so small. (neworleansmom.com)
  • These beds cannot be used to treat mainland patients, they are meant for potential patients requiring third-degree intensive care on the islands. (err.ee)
  • Post-operative bed rest isn't necessary and unless patients requested sedatives, they can right themselves and walk to the recovery room. (catawbavalleyhealth.org)
  • Dr. Ashish Dhadas has successfully treated more than 2000 patients till date with extremely satisfactory results. (newsdivya.com)
  • The story also emphasizes the oppressive and sexist nature of a cure that gives male doctors complete authority while female patients are treated as fragile, emotional beings incapable of making their own decisions. (theworcesterjournal.com)
  • Clinics will be set up to permit home recovery patients access to in-person care without having them take up bed spaces. (koreaherald.com)
  • Over 270 patients per day need access to health care in east Jerusalem, as well as in Israeli facilities, from the rest of the West Bank. (who.int)
  • For a little while after that life continued in some semblance of normalcy: doctor appointments and looking after Kaitlyn. (trisomy18.org)
  • Follow-up appointments with their doctors have been arranged. (merckmanuals.com)
  • Doctors use it to find tumours, diagnose heart disease, brain disorders and other conditions. (healthdirect.gov.au)
  • The time required for compulsory service varied by region, and physicians willing to accept postings in the most remote areas served fewer years. (who.int)
  • They had been told they wouldn't get to 32 weeks - when they did, the restrictions lifted a bit. (trisomy18.org)
  • Then they were told they wouldn't make it to 35 weeks - when they did, most of the restrictions disappeared. (trisomy18.org)
  • I had to switch doctors recently because I got sick at work a couple weeks back and didn't have time to drive all the way to my previous Dr before they closed so I had to look online for one near my work. (nestfamilymedicine.com)
  • Staying home for three weeks is a sacrifice, but if every Californian did that for a month, we could stop this disease in its tracks," said Dr. Erica Pan, the state's acting public health officer, when the restrictions were announced. (wuky.org)
  • When there are signs of early labour such as regular contractions before 37 weeks, bed rest is recommended. (kidborn.com)
  • and away all day at work and school, so I could rest when I wanted to rest and I napped a lot. (actingbalanced.com)
  • So while our contact tracing teams are conducting their work on the ground, a digital net is being cast far and wide for Fijians who may have had contact with these two doctors. (fiji.gov.fj)
  • My high risk doctor did a panel of blood work (19 vials to be exact, OUCH! (neworleansmom.com)
  • Some women might go on bed rest to try to improve blood flow to the baby. (kidshealth.org)
  • At that time, it was discovered that the baby was measuring very behind, and I was then referred to a high risk doctor. (neworleansmom.com)
  • Now: I let my boss know I am pregnant & the Dr has found a subchorionic bleed in my uterus alongside baby. (whattoexpect.com)
  • Your baby may fail to grow properly (growth restriction). (medlineplus.gov)
  • Your doctor will advise you accordingly but you must give a full and complete medical history including your current situation to prepare for your upcoming surgery. (gorgeousgetaways.com)
  • Written in 1892, this story blurs the line between reality and perception by following the mental unraveling of a woman after she is placed on complete bed rest because of her nervous behavior. (theworcesterjournal.com)
  • Even though I was on bed rest and had repeatedly been told that "any day could be the day," I was still in complete shock. (neworleansmom.com)
  • Complete bed rest is no longer recommended. (medlineplus.gov)
  • In such cases, the women carrying multiple babies are advised complete bed rest. (kidborn.com)
  • It was only after Gilman refused to take part in the rest cure that she slowly began to show signs of improvement. (theworcesterjournal.com)
  • These pictures help doctors estimate the baby's size and weight. (kidshealth.org)
  • If the baby's mother has a condition, doctors will help her manage it. (kidshealth.org)
  • Bed rest helps to increase blood flow to the placenta, and this helps to raise the baby's birth weight slightly. (kidborn.com)
  • Blood pressure is measured after a rest period of 10 minutes or more, with the pregnant woman in an upright position. (aafp.org)
  • International Scientific Societies (European Society of Cardiology, American Heart Association, American College of Chest Physician) recommend stratification for the risk of short-term death to drive. (efim.org)
  • Dr. Byrnes joined Catawba Valley Cardiology in April of this year and is board certified in internal medicine, nuclear cardiology, adult comprehensive echocardiography, cardiovascular disease and interventional cardiology. (catawbavalleyhealth.org)
  • So the patient was lying absolutely still in his bed, but still in agony. (interhomeopathy.org)
  • When appropriate, the radial method is extremely convenient for the patient," said Dr. Byrnes. (catawbavalleyhealth.org)
  • The course aimed to reduce the stigma related to mental illness, to analyze doctor-patient relationships, and to teach students to be more empathetic as they experienced the author's depression and psychosis. (theworcesterjournal.com)
  • Based on these records, the doctor can tell the patient how to restrict their time spent in bed until their sleep patterns improve. (discoveryvillages.com)
  • As they report in The Lancet, online December 6, Dr. Almenawer and colleagues conducted a systematic review and meta-analysis to compare patient outcomes after lumbar puncture with atraumatic needles versus conventional needles. (medscape.com)
  • Subgroup analyses of postdural-puncture headache showed no interactions between needle type and patient sex, age, position, bed rest after puncture, needle gauge, indication for lumbar puncture, use of intravenous fluid, or clinician specialty. (medscape.com)
  • Tight restrictions on purchase of such equipment mean that in 2016 each MRI machine was used an average of 5,947 times in Canada, compared with 3,287 times in the U.S. This allowed the average cost of an MRI scan to be much lower in Canada than in the U.S. (city-journal.org)
  • I was too sick to ingest the barium required for a CAT scan, so the attending physician ordered an abdominal x-ray. (cdc.gov)
  • I'm sick of doctors and needles and blood tests and transfusions. (morefamousquotes.com)
  • The researchers searched 13 databases with no language restrictions from inception to Aug 15, 2017, for randomized controlled trials comparing the use of atraumatic needles and conventional needles for any lumbar puncture indication. (medscape.com)
  • Dr. Almenawer explained that "atrauamtic needles were invented more than 70 years ago, yet most clinicians (95% according to surveys) still use the conventional needles. (medscape.com)
  • Eating just before going to bed increases risk for high blood sugar levels because resting muscles draw almost no sugar from the bloodstream. (drmirkin.com)
  • Bed rest also can raise the risk of blood clots, particularly in the veins in your legs. (kidborn.com)
  • John, who is a doctor, places his wife on the rest cure and prevents her from taking walks in the garden, writing, or having visitors. (theworcesterjournal.com)
  • Intermittent fasting prevents breast cancers more effectively than just calorie restriction (Cancer Prev Res (Phila). (drmirkin.com)
  • Before babies are born, doctors check their growth by measuring the mother's belly from the top of the pubic bone to the top of the uterus. (kidshealth.org)
  • To initiate formal rehabilitation therapy, a physician must write a referral/prescription to a physiatrist, therapist, or rehabilitation center. (msdmanuals.com)
  • HICKORY, NC -This past Friday, Dr. Luke J. Byrnes and the team at Catawba Valley Medical Center's Heart Catheterization Lab performed the region's first-ever radial heart catheterization - a revolutionary diagnostic and treatment technique for coronary artery disease. (catawbavalleyhealth.org)
  • Saurabh learnt about Dr. Ashish Dhadas from a friend who too had seeked treatment with him. (newsdivya.com)
  • The common treatment for such a state was the "rest cure. (theworcesterjournal.com)
  • Years later, Gilman wrote "The Yellow Wallpaper" in order to show the failure of Dr. Mitchell's treatment. (theworcesterjournal.com)
  • If you've had a child with a concussion, you know that the main treatment is rest - both physical and mental. (summersfirm.com)
  • Once you have selected the physician to conduct your buttock augmentation procedure, your doctor will give you specific steps to prepare for surgery. (gorgeousgetaways.com)
  • Dr. Matthijs C. Brouwer, an associate professor in the Department of Neurology at the Academic Medical Centre, University of Amsterdam, in the Netherlands, told Reuters Health by email, "The findings of the study are to some extent surprising. (medscape.com)
  • The radiologist recommend further study as something was not right, but my doctor declined. (cdc.gov)
  • The overall goal of this cognitive testing study was to test the constructs captured by questions on chronic pain, management of pain, burden of pain and participation restrictions due to pain and to select appropriate items for inclusion on the 2017 National Health Interview Survey (NHIS). (cdc.gov)
  • Heather was placed on bed rest and had another episode of premature labor, during which time she was given shots to mature Jeremiah's lungs. (trisomy18.org)
  • After being on bed rest for a short time you may begin to feel sad, lonely or depressed. (baycare.org)
  • In other cases, bed rest means you might need to remain in a sitting or reclining position on the bed most of the time, only getting up to use the toilet or shower. (kidborn.com)
  • After two or three rest days, the child might return to school half-time. (summersfirm.com)
  • Sleep efficiency is known as the ratio between the time spent asleep and the time spent awake in bed every night. (discoveryvillages.com)
  • When an individual is able to sleep for about 90% of the time in bed, they can start going to sleep earlier. (discoveryvillages.com)
  • My doctor dismissed my complaints and told me it would take more time for my intestines to heal. (cdc.gov)
  • However, medicine has more and more taken the public health approach of examining the practices of individual doctors to see how effective they actually are in the general population. (typepad.com)
  • I know I'm really lucky to have health insurance and a team of doctors who are on top of things. (inkandvodka.com)
  • I will now be going to Dr Ranjan for all of my health care needs, including pap smears and physicals as well as sick visits. (nestfamilymedicine.com)
  • For the same reason doctor and dentist check-ups are necessary: for better health! (welloflifecenter.com)
  • There is no place to transfer people if we run out of beds," San Francisco Health Officer Dr. Tomás Aragón said. (wuky.org)
  • Also, they're as easy to use as the conventional ones," senior author Dr. Saleh A. Almenawer of Hamilton Health Sciences and McMaster University in Hamilton, Canada, told Reuters Health by email. (medscape.com)
  • Present in the room are WHO Director-General, Dr Tedros, Dr Mike Ryan, Executive Director, Health Emergencies, Dr Maria Van Kerkhove, Technical Lead for COVID-19, Dr Bruce Aylward, Special Advisor to DG and Lead on the ACT Accelerator and Derek Walton, WHO Legal Counsel. (bvsalud.org)
  • While these two doctors responsibly had the app running, we know the effectiveness of the app's contact tracing function depends on how many other people also had it running on their phones. (fiji.gov.fj)
  • The stimulus control technique comes from the idea that people should only go to bed when they are tired. (discoveryvillages.com)
  • Because Europeans earn less for high-skilled labor, they may pay doctors less. (city-journal.org)
  • Food is generally available in the Gaza Strip and the West Bank, but access to food is limited due to physical restrictions (curfews and closures) and economic reasons (high unemployment, depletion of resources, exhaustion of coping strategies and strained social support networks). (who.int)
  • When you eat late and then go to bed, your muscles are inactive and blood sugar levels rise much higher than when you move after eating. (drmirkin.com)
  • The story reads like a supernatural thriller, but much of it was actually taken from the "rest cure" that was imposed upon Gilman to treat her postpartum depression. (theworcesterjournal.com)
  • Shortly after, Gilman began to experience extreme depression and was placed on Dr. Michel's rest cure. (theworcesterjournal.com)
  • The trend is expected to continue throughout the rest of the state within the next week or two. (wuky.org)
  • It is literally exhausting staying in bed all day. (inkandvodka.com)
  • When I was really sick , literally NONE of my doctors talked to me about the foods I was eating. (beautybeyondbones.com)
  • This also includes intensive care beds. (err.ee)
  • Each operating room is basically one intensive care bed. (err.ee)
  • I was left on that gurney in the corridor of a psychiatric ER for two days before an inpatient-psychiatric bed became available. (nami.org)
  • In these mild cases, only a couple of days' rest is required. (summersfirm.com)
  • I thank Dr. Dhadas and his team for helping me walk properly again. (newsdivya.com)
  • In cases where the doctors feel that the woman's uterus is very weak or in few other scenarios, bed rest is recommended. (kidborn.com)
  • We run 200 meters, we run fast, we make it to the finish and can rest," Karjagin said. (err.ee)
  • These new guidelines should make the post-concussion rest period much easier to bear. (summersfirm.com)
  • Unless arranged before discharge, upon arriving home, they should call their regular doctor to make a follow-up appointment. (merckmanuals.com)
  • The doctor on call raised the concern that I was malnourished and needed to have supplemental nutrition immediately. (cdc.gov)
  • Prolonged bedrest can leave children feeling anxious and isolated. (summersfirm.com)