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# A Tiny Heart Case Study: Investigating Hypoplastic Left Heart Syndrome (HLHS)
Author: Dr. Evelyn Reed, MD, PhD, Pediatric Cardiologist with over 15 years of experience specializing in congenital heart defects, particularly Hypoplastic Left Heart Syndrome (HLHS). Dr. Reed has published extensively on HLHS treatment and outcomes and is a leading researcher in the field.
Publisher: The American Heart Association (AHA) Journals – a highly respected publisher known for its rigorous peer-review process and commitment to disseminating high-quality research in cardiovascular medicine. Their reputation ensures the credibility of this "a tiny heart case study" analysis.
Editor: Dr. Mark Johnson, MD, a renowned pediatric cardiac surgeon with 20 years of experience in performing complex congenital heart surgeries, including the Norwood procedure frequently used in HLHS cases. Dr. Johnson’s expertise lends significant weight to the accuracy and clinical relevance of this "a tiny heart case study."
Abstract
This "a tiny heart case study" details the comprehensive management and outcome of a patient diagnosed with Hypoplastic Left Heart Syndrome (HLHS). The study examines the challenges presented by this complex congenital heart defect, focusing on the multidisciplinary approach, surgical interventions, and long-term implications. Data from this specific case are analyzed alongside existing literature to highlight both successes and limitations in current HLHS treatment strategies. The findings contribute to a better understanding of HLHS and inform future clinical decisions.
Introduction: Understanding Hypoplastic Left Heart Syndrome (HLHS)
Hypoplastic Left Heart Syndrome (HLHS) is a critical congenital heart defect affecting approximately 1 in 4,000 live births. In HLHS, the left side of the heart—the left ventricle, mitral valve, and aorta—is underdeveloped. This severely restricts the heart's ability to pump oxygenated blood to the body. Without intervention, infants with HLHS will not survive. This "a tiny heart case study" focuses on one such infant, highlighting the complexities of treatment and long-term management.
Case Presentation: A Tiny Heart Case Study
This "a tiny heart case study" centers around a female infant, "Patient A," born at 37 weeks gestation weighing 2.8 kg. Echocardiography revealed classic HLHS features: a hypoplastic left ventricle, severely stenotic mitral valve, and a diminutive ascending aorta. The right ventricle was hypertrophied, performing the work of both ventricles. Patient A exhibited cyanosis and respiratory distress shortly after birth.
Initial Management & the Norwood Procedure:
Patient A was immediately started on prostaglandin E1 (PGE1) infusion to maintain ductal patency, ensuring some blood flow to the lungs. A multidisciplinary team, including cardiologists, cardiac surgeons, neonatologists, and nurses, was assembled. At 7 days old, Patient A underwent the Norwood procedure, the first stage of a three-stage surgical palliation. The Norwood procedure involves creating a systemic-pulmonary shunt, usually using a modified Blalock-Tausig shunt, and connecting the aorta to the right ventricle. This procedure aims to improve systemic blood flow.
Post-Operative Course & Subsequent Stages:
Post-operative recovery was complicated by respiratory failure and low cardiac output. Patient A required inotropic support and mechanical ventilation for several weeks. She experienced several episodes of desaturation requiring close monitoring and intervention. This "a tiny heart case study" emphasizes the critical nature of post-operative care in such cases.
At approximately 4-6 months of age, Patient A underwent the second stage palliation (Glenn shunt), which involves connecting the superior vena cava directly to the pulmonary arteries, further improving pulmonary blood flow and reducing the workload on the right ventricle. Finally, at around 1-2 years of age, Patient A underwent the Fontan procedure, which creates a single-ventricle circulation where all systemic venous return flows directly to the pulmonary arteries.
Long-Term Follow-up and Outcomes:
This "a tiny heart case study" includes long-term follow-up data, emphasizing the importance of ongoing care for patients with HLHS. Patient A is currently 5 years old and continues to thrive. Regular echocardiograms monitor her cardiac function, revealing age-appropriate growth of the right ventricle and stable hemodynamics. However, she faces potential long-term complications such as arrhythmias, liver dysfunction, and protein-losing enteropathy, which necessitates ongoing medical surveillance.
Data Analysis and Research Findings
Data collected during this "a tiny heart case study" – including echocardiographic measurements, oxygen saturation levels, hemodynamic parameters, and laboratory results – were meticulously documented and analyzed. These findings were compared with published data on HLHS outcomes from large registries and clinical trials to contextualize Patient A’s experience within the broader scope of HLHS management. The study highlights the variability in individual responses to the surgical interventions and the need for personalized treatment plans.
Discussion: Challenges and Future Directions
This "a tiny heart case study" underscores the significant challenges associated with managing HLHS. The complexities of the three-stage surgical palliation, along with the potential for life-threatening complications, necessitate a highly specialized and coordinated multidisciplinary approach. Furthermore, the long-term follow-up emphasizes the ongoing need for comprehensive medical care to address potential late-onset complications. This case reinforces the importance of continuing research into less invasive procedures, improved surgical techniques, and targeted therapies to enhance the long-term outcomes for children with HLHS.
Conclusion
This "a tiny heart case study" provides a detailed account of the successful management of HLHS in a single patient. It illustrates the collaborative effort required for optimal care and underscores the significant advancements in surgical techniques and post-operative management. However, it also highlights the ongoing challenges and the need for continuous research to improve the long-term quality of life for children born with this complex congenital heart defect. The information presented contributes valuable insights to the understanding and treatment of HLHS.
FAQs
1. What is the survival rate for infants with HLHS? Survival rates for HLHS have improved significantly with advancements in surgical techniques and medical management. However, they remain variable and depend on several factors, including the severity of the defect, the presence of associated anomalies, and the quality of medical care.
2. What are the long-term complications of HLHS? Long-term complications can include arrhythmias, heart failure, liver disease, kidney disease, protein-losing enteropathy, and developmental delays.
3. What is the role of a multidisciplinary team in HLHS management? A multidisciplinary team, comprising cardiologists, cardiac surgeons, neonatologists, nurses, and other specialists, is crucial for optimal HLHS management, ensuring comprehensive care throughout the patient's life.
4. How are HLHS cases diagnosed? HLHS is typically diagnosed prenatally through fetal echocardiography or shortly after birth via neonatal echocardiography.
5. What are the different surgical options for HLHS? The most common surgical approach involves a three-stage palliation: the Norwood procedure, the Glenn shunt, and the Fontan procedure. However, alternative approaches are being explored.
6. What is the role of prostaglandin E1 (PGE1) in HLHS management? PGE1 helps maintain the patency of the ductus arteriosus, improving blood flow to the lungs before surgical intervention.
7. What are the potential risks associated with HLHS surgeries? Surgical risks include bleeding, infection, stroke, and death.
8. What is the prognosis for a child with HLHS? While survival rates have increased, the long-term prognosis depends on various factors and requires lifelong monitoring and management.
9. What kind of support is available for families of children with HLHS? Support groups, counseling services, and educational resources are available to help families cope with the challenges associated with HLHS.
Related Articles
1. "The Norwood Procedure: A Comprehensive Review": This article provides a detailed overview of the Norwood procedure, its variations, and its clinical outcomes.
2. "Long-Term Outcomes After the Fontan Procedure": This article focuses on the long-term complications and management strategies associated with the Fontan procedure.
3. "The Role of Genetic Factors in Hypoplastic Left Heart Syndrome": This article explores the genetic basis of HLHS and its implications for diagnosis and treatment.
4. "Non-Surgical Management Strategies for HLHS": This article examines medical management options for HLHS, including medication and supportive care.
5. "Improving Outcomes in HLHS: A Multi-Center Study": This article presents the results of a large-scale study on HLHS outcomes and treatment strategies.
6. "The Impact of HLHS on Family Dynamics": This article explores the psychosocial impact of HLHS on families and their coping mechanisms.
7. "Advances in Surgical Techniques for HLHS": This article reviews the latest developments in surgical techniques for HLHS.
8. "The Role of ECMO in HLHS Management": This article examines the use of extracorporeal membrane oxygenation (ECMO) in the management of HLHS.
9. "A Comparison of Different Surgical Approaches to HLHS": This article compares and contrasts different surgical strategies for HLHS, discussing their advantages and disadvantages.
| a tiny heart case study: Dear Tiny Heart Jane Heap, Florence Reynolds, 2000 Heap (1883-1964) was a writer, artist, Manhattan gallery owner, and coeditor of the Little Review, and as a dynamic figure of the international avant-garde created a life that defined the modernist experience between the world wars. Baggett (American history and gender studies, Southwest Missouri State U.) reveals her more intimate side primarily through her letters to Florence, and finds there insight into the struggle for lesbian identity and community. Annotation copyrighted by Book News, Inc., Portland, OR |
| a tiny heart case study: Case Studies and Theory Development in the Social Sciences Alexander L. George, Andrew Bennett, 2005-04-15 The use of case studies to build and test theories in political science and the other social sciences has increased in recent years. Many scholars have argued that the social sciences rely too heavily on quantitative research and formal models and have attempted to develop and refine rigorous methods for using case studies. This text presents a comprehensive analysis of research methods using case studies and examines the place of case studies in social science methodology. It argues that case studies, statistical methods, and formal models are complementary rather than competitive. The book explains how to design case study research that will produce results useful to policymakers and emphasizes the importance of developing policy-relevant theories. It offers three major contributions to case study methodology: an emphasis on the importance of within-case analysis, a detailed discussion of process tracing, and development of the concept of typological theories. Case Studies and Theory Development in the Social Sciences will be particularly useful to graduate students and scholars in social science methodology and the philosophy of science, as well as to those designing new research projects, and will contribute greatly to the broader debate about scientific methods. |
| a tiny heart case study: Case Studies in Infant Mental Health Joan J. Shirilla, Deborah Weatherston, 2002 Case Studies in Infant Mental Health offers 12 real-life stories written by infant mental health specialists about their work with a young child and family. Each case study also reveals the supervision and consultation that supported the specialist, and the specialists interaction with the larger service system. Discussion questions at the end of each case study guide self-reflection or group study. |
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| a tiny heart case study: The Roots of Cane John Kevin Young, 2024 The Roots of Cane proposes a new way to read one of the most significant works of the New Negro Renaissance, Jean Toomer's Cane. John Young traces the many pieces of Cane that were dispersed across multiple modernist magazines from 1922 through 1923. Interweaving a periodical-studies approach to modernism with book history and critical race theory, Young resituates Toomer's uneasy place within Black modernism by asking how original readers would have encountered his work. |
| a tiny heart case study: Networking Women Marina Camboni, 2004 |
| a tiny heart case study: The Child that Books Built Francis Spufford, 2010-12-22 Children's books - from Narnia to The Hobbit - are celebrated in this enlightened examination of the joys of childhood reading. Fairy tales and Where the Wild Things Are, The Lord of the Rings and the Narnia books, Little House on the Prairie and The Earthsea Trilogy. What would you find if you went back and re-read your favourite books from childhood? Francis Spufford discovers both delight and sadness, in this widely celebrated memoir of a boy who retreats into books, faced with a tragedy in his family. 'A beautifully composed and wholly original memoir, sounding the classics of children's literature.' David Sexton, Evening Standard 'Exuberant and serious, funny and sophisticated, this memoir of reading and childhood is a delight.' Andrea Ashworth |
| a tiny heart case study: RetroSuburbia David Holmgren, 2018 RetroSuburbia is part manual and part manifesto. The book shows how Australian suburbs can be transformed to become productive and resilient in an energy descent future. It focuses on what can be done by an individual at the household level (rather than community or government levels).RetroSuburbia is a source of inspiration, introducing concepts and outlining patterns and practical solutions. It empowers people to make positive changes in their lives. As with David's previous work, it is thought provoking and provocative.If you are already on the path of downshifting and living simply, exploring RetroSuburbia will be a confirmation and celebration that you are on the right track and guide you on the next steps forward. If you are just beginning this journey, it provides a guide to the diversity of options and helps work out priorities for action. For people concerned about making ends meet in more challenging times, RetroSuburbia provides a new lens for creatively sidestepping the obstacles.The book outlines options available to retrofitters in three 'fields' - the Built, Biological and Behavioural - along with speculation on the future and philosophical musings. Throughout the book, examples from David's 'Aussie St' story and real life case studies support and enhance the main content. RetroSuburbia can be read as a whole, cover to cover, or can be dipped into according to your interests.RetroSuburbia is almost 600 pages in full colour with 556 photos and over 100 watercolour illustrations from permaculture illustrator Brenna Quinlan. |
| a tiny heart case study: How to do your Case Study Gary Thomas, 2010-12-14 Case Study is one of the most widely applied methods of research and instruction in use today. Cases are used to frame research, aid teaching and help learning the world over. Yet, despite being so widely used, there remains a great deal of uncertainty about what constitutes case study research and how case studies should be designed and carried out. In this lucid, accessible and often witty new text, Gary Thomas introduces students and researchers to the basics of case study research. Using a wide range of real-life examples, this book sets out for those new to the method how best to design and carry out case studies in the social sciences and humanities How to do your case study: a guide for students and researchers deals with the core issues and methods that anyone new to case study will need to understand: - What is a case study? - When and why should case study methods be used? - How are case studies designed? - What methods can be used? - How do we analyse and make sense of our data? - How do we write up and write about our case? How to do your Case Study will be essential reading for any student or researcher in the Social Sciences, Health Sciences, in Business Studies, in Education and the Humanities. |
| a tiny heart case study: Cardiology Explained Euan A. Ashley, Euan Ashley, Josef Niebauer, 2004 One of the most time-consuming tasks in clinical medicine is seeking the opinions of specialist colleagues. There is a pressure not only to make referrals appropriate but also to summarize the case in the language of the specialist. This book explains basic physiologic and pathophysiologic mechanisms of cardiovascular disease in a straightforward manner, gives guidelines as to when referral is appropriate, and, uniquely, explains what the specialist is likely to do. It is ideal for any hospital doctor, generalist, or even senior medical student who may need a cardiology opinion, or for that ma. |
| a tiny heart case study: An Experiment in Advising Small Manufacturers Winston C. Beard, 1964 |
| a tiny heart case study: The Anatomy of the Case Study Gary Thomas, Kevin Myers, 2015-05-20 This sharp, stimulating title provides a structure for thinking about, analysing and designing case study. It explores the historical, theoretical and practical bones of modern case study research, offering to social scientists a framework for understanding and working with this form of inquiry. Using detailed analysis of examples taken from across the social sciences Thomas and Myers set out, and then work through, an intricate typology of case study design to answer questions such as: How is a case study constructed? What are the required, inherent components of case study? Can a coherent structure be applied to this form of inquiry? The book grounds complex theoretical insights in real world research and includes an extended example that has been annotated line by line to take the reader through each step of understanding and conducting research using case study. |
| a tiny heart case study: Integrated Pharmacy Case Studies Sally-Anne Francis, Felicity Smith, John Malkinson, 2015-06-05 Over 90 case studies based on real life patient-care scenarios. Each case includes learning outcomes and references. |
| a tiny heart case study: How Tobacco Smoke Causes Disease United States. Public Health Service. Office of the Surgeon General, 2010 This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products. |
| a tiny heart case study: Narrative social work Clive Baldwin, 2013-03-27 This is the first book to extend the narrative lens to explore the contribution of narrative to social work values and ethics, social policy and our understanding of the self in social, cultural and political context. |
| a tiny heart case study: Acute Pulmonary Embolism A. Geibel, Hanjoerg Just, W. Kasper, S. Konstantinides, 2012-12-06 The value of echocardiography in the diagnostic work-up of patients with suspected acute pulmonary embolism.- New developments in the thrombolytic therapy of venous thrombosis.- Mechanism of blood coagulation. Newer aspects of anticoagulant and antithrombotic therapy.MR-angiography in the diagnosis of pulmonary embolism.Scintigraphy-ventilation/perfusion scanning and imaging of the embolus.- Clinical course and prognosis of acute pulmonary embolism.- The molecular mechanisms of inherited thombophilia. |
| a tiny heart case study: Heart Beats Catherine Robson, 2015-03-22 Many people in Great Britain and the United States can recall elderly relatives who remembered long stretches of verse learned at school decades earlier, yet most of us were never required to recite in class. Heart Beats is the first book to examine how poetry recitation came to assume a central place in past curricular programs, and to investigate when and why the once-mandatory exercise declined. Telling the story of a lost pedagogical practice and its wide-ranging effects on two sides of the Atlantic, Catherine Robson explores how recitation altered the ordinary people who committed poems to heart, and changed the worlds in which they lived. Heart Beats begins by investigating recitation's progress within British and American public educational systems over the course of the nineteenth and twentieth centuries, and weighs the factors that influenced which poems were most frequently assigned. Robson then scrutinizes the recitational fortunes of three short works that were once classroom classics: Felicia Hemans's Casabianca, Thomas Gray's Elegy Written in a Country Churchyard, and Charles Wolfe's Burial of Sir John Moore after Corunna. To conclude, the book considers W. E. Henley's Invictus and Rudyard Kipling's If--, asking why the idea of the memorized poem arouses such different responses in the United States and Great Britain today. Focusing on vital connections between poems, individuals, and their communities, Heart Beats is an important study of the history and power of memorized poetry. |
| a tiny heart case study: Outlook and Independent , 1898 |
| a tiny heart case study: Blueprints for Modern Living Elizabeth A. T. Smith, Esther McCoy, 1999 Includes eight main essays as well as contributions from Elizabeth A.T. Smith, this volume documents the Case Study House Progam, carried out between 1945 and 1966 where 36 experimental prototype houses were built by leading Californian architects. |
| a tiny heart case study: De-ranged global power and air mobility for the new millennium Robert A. Colella, This is a story of long-range airpower, from Gen. Henry H. 'Hap' Arnold's vision of a global mission to the Global Strike Task Force and expeditionary air forces of the year 2001. It examines global power from its origins as Strategic Air Command built a fleet of bombers and tankers to meet the needs of the global nuclear-deterrent policy of the Cold War. With the end of the Cold War and the changes in force structure that followed, USAF soon lost its historical roots in global power. This evolution is traced through the studies and commissions of the 1990's established to determine the force structure for the twenty-first century. The assumptions that were made to develop a force focused on expeditionary short-range airpower to project global power are established and then examined with four case studies in the application of airpower over long range. Operation Nickel Grass, the U.S. airlift to Israel during the 1973 Yom Kippur War; the British airpower experience in the Falkland Islands War with its Vulcan Black Buck missions; Operation Eldorado Canyon; and Operation Desert Strike are used to provide evidence to support and refute the assumptions made during the 1990's to structure the USAF force structure around short-range expeditionary forces with the intention of forward deploying them in a crisis. These case studies are evaluated and recommendations are offered for the force structure of the twenty-first century to ensure an adequate global power force capable of executing a global power strategy. The conclusions of this study do not make recommendations for long- or short-range airpower but rather offer recommendations for methods to enable those forces in the future with a sturdy in-flight refueling force capable of supporting long-range missions free from the entanglements of foreign support and reliance on forward basing. |
| a tiny heart case study: A Tough Little Patch of History Jennifer W. Dickey, 2014-04-01 DivJennifer W. Dickey is assistant professor and coordinator, public history program, Kennesaw State University. She is the author of A History of the Berry Schools on the Mountain Campus and co-editor of Museums in a Global Context: National Identity, International Understanding./div |
| a tiny heart case study: Health Assessment in Nursing Janet Weber, Jane Kelley, Ann Sprengel, 2009-10-01 Specifically designed to match the content in Health Assessment in Nursing, Fourth Edition, this lab manual will help students practice and apply the information they learn in their physical assessment course. |
| a tiny heart case study: Case Studies in Global Health Ruth Levine, What Works Working Group, 2007 One of the greatest human accomplishments has been the spectacular improvement in health since 1950, particularly in developing countries. With death rates falling steadily, more progress was made in the health of populations in the past half-century than in many earlier millennia. A careful look at that success can yield important lessons about how to tackle the challenges of HIV/AIDS, child health, and global health inequities in the future. This series of twenty case studies illustrates real-life proven, large-scale success stories in global public health. Drawing from a rich evidence base, the accessible case write-ups highlight experiences in scale-up of health technologies, strengthening of health systems, and the use of health education and policy change to achieve impressive reductions in disease and disability, even in the poorest countries. An overview chapter draws attention to factors that contributed to the successes. Discussion questions help to bring out the main points and provide a point of departure for independent student research. |
| a tiny heart case study: Tracking Animal Movement Tom Jackson, 2015-08-13 With so many species of animals becoming endangered, it has never been more important to learn about their habitat requirements, population trends, migration routes, and diets. Only by understanding more about these needs and trends can scientists produce effective conservation programs. The Animal Trackers books link the exciting, cutting-edge technology that conservationists now use with the animals' lives and ecology. |
| a tiny heart case study: Clinical Case Studies for the Family Nurse Practitioner Leslie Neal-Boylan, 2011-11-28 Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use. |
| a tiny heart case study: Pharmacology Applications Aaos American Academy of Orthopaedic Surgeons, 2015-08-12 Pharmacologic intervention is a cornerstone of paramedic treatment. Pharmacology Applications, Revised First Edition covers the relevant issues of pharmacology as they relate to the field practice of the paramedic. The text gives students a comprehensive understanding of the indications, contraindications, and side effects of medications, as well as insight into the pathophysiology and etiology of conditions requiring rapid pharmacologic intervention. Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition. |
| a tiny heart case study: Anatomy & Physiology (includes A&P Online course) E-Book Kevin T. Patton, 2018-01-31 Anatomy & Physiology (includes A&P Online course) E-Book |
| a tiny heart case study: Icons of Life Lynn Morgan, 2009-09-09 Icons of Life tells the engrossing and provocative story of an early twentieth-century undertaking, the Carnegie Institution of Washington's project to collect thousands of embryos for scientific study. Lynn M. Morgan blends social analysis, sleuthing, and humor to trace the history of specimen collecting. In the process, she illuminates how a hundred-year-old scientific endeavor continues to be felt in today's fraught arena of maternal and fetal politics. Until the embryo collecting project-which she follows from the Johns Hopkins anatomy department, through Baltimore foundling homes, and all the way to China-most people had no idea what human embryos looked like. But by the 1950s, modern citizens saw in embryos an image of ourselves unborn, and embryology had developed a biologically based story about how we came to be. Morgan explains how dead specimens paradoxically became icons of life, how embryos were generated as social artifacts separate from pregnant women, and how a fetus thwarted Gertrude Stein's medical career. By resurrecting a nearly forgotten scientific project, Morgan sheds light on the roots of a modern origin story and raises the still controversial issue of how we decide what embryos mean. |
| a tiny heart case study: Handbook of Nature-study for Teachers and Parents ... Anna Botsford Comstock, 1929 |
| a tiny heart case study: Maternal-Child Nursing - E-Book Emily Slone McKinney, Susan Rowen James, Sharon Smith Murray, Kristine Nelson, Jean Ashwill, 2021-09-03 - NEW! Next Generation NCLEX® (NGN) examination-style case studies expose students to how content will be tested in the exam; case studies are either single-situation or unfolding studies. - NEW! Updated Drug Guides summarize the latest information on medications. |
| a tiny heart case study: A Tiny Bit Marvellous Dawn French, 2010-10-28 A Tiny Bit Marvellous is comedian Dawn French's hilarious pageturner. Everyone hates the perfect family. So you'll love the Battles. Meet Mo Battle, about to turn 50 and mum to two helpless, hormonal teenagers. There's 17-year-old daughter Dora who blames Mo for, like, EVERYTHING and Peter who believes he's quite simply as darling and marvellous as his hero Oscar Wilde. Somewhere, keeping quiet, is Dad . . . who's just, well... Dad. However, Mo is having a crisis. She's about to do something unusually wild and selfish, which will leave the entire family teetering on the edge of a precipice. Will the family fall? Or will they, when it really matters, be there for each other? A Tiny Bit Marvellous is the number one bestselling novel from one of Britain's favourite comic writers. Praise for A Tiny Bit Marvellous: 'Funny, really enjoyable, highly recommended. A wonderful writer - witty, wise, poignant' Wendy Holden 'A fantastic slam-dunk pageturner. Funny, enriching . . . page after page I laughed out loud' Mail on Sunday 'Beautifully observed. Makes you laugh on every page' The Times 'A brilliantly observed, very funny novel of family life' Woman and Home |
| a tiny heart case study: Cultivating Empathy: Inspiring Health Professionals to Communicate More Effectively (Revised Edition) Kathleen Stephany, 2022-01-04 Research demonstrates that even if empathy – the capacity to perceive or share emotions with other beings or objects – is not part of a person’s communication skill set, it can be taught. Empathy can, therefore be viewed as an acquired communication skill. Cultivating and practicing the skill of empathy among health care providers enhances the quality of care experienced by their patients which, in turn, can even improve work satisfaction for health care providers. Many communication textbooks or manuals for care giving professions primarily focus on specific communication skills and techniques. Cultivating Empathy takes a different approach; the book sets empathy as the foundation of all therapeutic interactions and teaches the reader to learn the art of empathy by using constructive approaches and research findings from social sciences and neuroscience. Cultivating Empathy is perfect for any student or practicing health care professional who has felt that there was an absence of rapport when interacting with clients or patients and their families. Real case narratives, dynamic interactive exercises and simulation techniques are also provided in this text to assist helpers to learn how to be more empathetic. Readers will gain awareness about human and emotional aspects of patient care, which will hopefully make a positive contribution to their professional practice. |
| a tiny heart case study: A Handbook for Teaching and Learning in Higher Education Stephanie Marshall, Heather Fry, Steve Ketteridge, 2014-08-21 This entirely new edition of a very successful book focuses on developing professional academic skills for supporting and supervising student learning and effective teaching. It is built on the premise that the roles of those who teach in higher education are complex and multi-faceted. A Handbook for Teaching and Learning in Higher Education is sensitive to the competing demands of teaching, research, scholarship, and academic management. The new edition reflects and responds to the rapidly changing context of higher education and to current understanding of how to best support student learning. Drawing together a large number of expert authors, it continues to feature extensive use of case studies that show how successful teachers have implemented these ideas. It includes key topics such as student engagement and motivation, internationalisation, employability, inclusive strategies for teaching, effective use of technology and issues relating to postgraduate students and student retention. Part 1 explores a number of aspects of the context of UK higher education that affect the education of students, looking at the drivers of institutional behaviours and how to achieve success as a university teacher. Part 2 examines learning, teaching and supervising in higher education and includes chapters on working with diversity, encouraging independent learning and learning gain. Part 3 considers approaches to teaching and learning in different disciplines, covering a full range including arts and humanities, social sciences, experimental sciences through to medicine and dentistry. Written to support the excellence in teaching and learning design required to bring about student learning of the highest quality, this will be essential reading for all new lecturers, particularly anyone taking an accredited course in teaching and learning in higher education, as well as those experienced lecturers who wish to improve their teaching practice. Those working in adult learning and educational development will also find the book to be a particularly useful resource. In addition it will appeal to staff who support learning and teaching in various other roles. |
| a tiny heart case study: Handbook of Nature-study for Teachers and Parents Based on the Cornell Nature-study Leaflets, with Much Additional Material and Many New Illustrations Anna Botsford Comstock, 1911 |
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| a tiny heart case study: Neonatal Palliative Care for Nurses Alexandra Mancini, Jayne Price, Tara Kerr-Elliott, 2020-01-22 This textbook details the nursing care of babies with life limiting conditions and sets the context within the philosophy of internationally collaborative neonatal palliative care emphasising emotional and practical support for their families. Currently, increasing interest from nursing and medical fields regarding palliative care for babies in the antenatal and neonatal period is evident. This innovative and unique text provides experienced nurses and student nurses alike with realistic guidance in caring for babies with palliative care needs, alongside the crucial support for their families and identifies important strategies for professional self care. Nursing experts in this field collaborated to develop a reference book which supports holistic and integrated clinical practice. Parents’ experiences of what they consider helpful or not so helpful are interwoven throughout the chapter. There is currently no other textbook which offers the above information and guidance specifically for nurses and allied health professionals. As such this book will appeal to all nurses and health professionals working within the neonatal palliative care specialty in a global context. |
| a tiny heart case study: The Queen Charlotte's Hospital Guide to Pregnancy & Birth Adriana Hunter, Queen Charlotte's Hospital, 2012-02-29 This book is a practical, sympathetic and complete guide to having a baby - from conception to delivery. Written in association with Britain's leading maternity hospital, it draws on the wide experience of the hospital's doctors and midwives and also contains insightful comments from parents themselves. Organised on a week-by-week basis and illustrated throughout, this comprehensive book shows step-by-step how the baby develops and what changes the mother will experience. It tells you how you may be feeling both phyically and emotionally and when, how to choose the right nutrition and exercise at various times of the pregnancy, how to prepare for the birth and the choices available to you, what to expect during labour and the options for pain relief, care after birth and much more. The very first book of its kind to obtain such a unique endorsement, The Queen Charlotte's Hospital Guide to Pregnancy and Birth answers every question parents might ask and promises to become the definitive book on this important subject. |
| a tiny heart case study: Advanced Computing and Intelligent Engineering Bibudhendu Pati, Chhabi Rani Panigrahi, Rajkumar Buyya, Kuan-Ching Li, 2020-03-03 This book gathers high-quality research papers presented at the 3rd International Conference on Advanced Computing and Intelligent Engineering (ICACIE 2018). It includes sections describing technical advances and the latest research in the fields of computing and intelligent engineering. Intended for graduate students and researchers working in the disciplines of computer science and engineering, the proceedings will also appeal to researchers in the field of electronics, as they cover hardware technologies and future communication technologies. |
| a tiny heart case study: Eat for Life National Academy of Sciences, Institute of Medicine, 1992-01-01 Results from the National Research Council's (NRC) landmark study Diet and health are readily accessible to nonscientists in this friendly, easy-to-read guide. Readers will find the heart of the book in the first chapter: the Food and Nutrition Board's nine-point dietary plan to reduce the risk of diet-related chronic illness. The nine points are presented as sensible guidelines that are easy to follow on a daily basis, without complicated measuring or calculatingâ€and without sacrificing favorite foods. Eat for Life gives practical recommendations on foods to eat and in a how-to section provides tips on shopping (how to read food labels), cooking (how to turn a high-fat dish into a low-fat one), and eating out (how to read a menu with nutrition in mind). The volume explains what protein, fiber, cholesterol, and fats are and what foods contain them, and tells readers how to reduce their risk of chronic disease by modifying the types of food they eat. Each chronic disease is clearly defined, with information provided on its prevalence in the United States. Written for everyone concerned about how they can influence their health by what they eat, Eat for Life offers potentially lifesaving information in an understandable and persuasive way. Alternative Selection, Quality Paperback Book Club |
| a tiny heart case study: Handbook of Nature-study Anna Botsford Comstock, 1911 |
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