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Articles 1 - 30 of 2599
Full-Text Articles in Alternative and Complementary Medicine
Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West
Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West
Adultspan Journal
This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …
Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego
Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego
Adultspan Journal
The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …
In Silico Modelling And Docking Simulation Of Egfr-Targeted Diphtheria Toxin Chimera With Various Targeting Moieties, Muhammad Afif Naufal Bmed, Benedictus Ansell Susanto Bmed, Talitha Dinda Gunawan Bmed, Azhar Ridha Lukman Bmed, Alifa Rahma Rizqina Bmed, Muhammad Misbahul Fuad Bmed
In Silico Modelling And Docking Simulation Of Egfr-Targeted Diphtheria Toxin Chimera With Various Targeting Moieties, Muhammad Afif Naufal Bmed, Benedictus Ansell Susanto Bmed, Talitha Dinda Gunawan Bmed, Azhar Ridha Lukman Bmed, Alifa Rahma Rizqina Bmed, Muhammad Misbahul Fuad Bmed
Indonesian Journal of Medical Chemistry and Bioinformatics
Introduction: Cancer is a major etiology of death worldwide due to high mortality and suboptimal medicine. However, an emerging field, targeted therapy enabled a more selective and effective therapeutic action. This article aims to analyze in-silico the hypothetical targeted therapy agent that is combinations of conjugate consisting of EGFR targeting moieties and diphtheria toxin (DT-390).
Method: Our novel peptide is a conjugate of a novel EGFR targeting peptide and DT-390, forming a chimera. The tertiary structure was predicted using AlphaFold 2.0. The best IDDT scoring and stereochemistry profiles were utilized. The HADDOCK2.4 webserver modelled the docking between our …
The Prospect Of Indonesian Herbal As An Alternative Treatment For Covid-19 Patient: A Literature-Based Study, Hadi Sunaryo, Wahyu Hidayati
The Prospect Of Indonesian Herbal As An Alternative Treatment For Covid-19 Patient: A Literature-Based Study, Hadi Sunaryo, Wahyu Hidayati
Indonesian Journal of Medical Chemistry and Bioinformatics
Coronavirus disease 2019 (COVID-19) is a new disease caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease has several symptoms from mild to severe and could lead to death for comorbidities and the elderly. Therefore, the infections and mortality cases keep growing day by day, moreover many authorities are trying to suppress it by applying several health protocols, including medicines. Several studies were conducted on drug discovery from plants to cure the disease. The article aimed to do a narrative review about the prospect of JAMU becoming an alternative medicine to cure COVID-19 by mapping …
Metabolite Biomarker Discovery For Lung Cancer Using Machine Learning, Ariski Fajarido, Linda Erlina, Aryo Tedjo, Fadilah Fadilah, Wawaimuli Arozal
Metabolite Biomarker Discovery For Lung Cancer Using Machine Learning, Ariski Fajarido, Linda Erlina, Aryo Tedjo, Fadilah Fadilah, Wawaimuli Arozal
Indonesian Journal of Medical Chemistry and Bioinformatics
Lung cancer is the leading cause of cancer death worldwide. About 2.1 million lung cancer patients were diagnosed in 2018, accounting for about 11.6% of all newly diagnosed cancer cases. For lung cancer, blood is the first choice as a source of screening biomarker candidates. Blood biomarkers provide a snapshot of the patient's entire body, including the primary tumor, metastatic disease, immune response, and peritumoral stroma. However, sputum sampling, bronchial lavage or aspiration, exhaled breath (EB), and airway epithelial sampling represent unique samples for lung cancer and other airway cancers as potential sources for alternative biomarkers. Metabolites are products of …
Increasing Occupational Engagement In Adults With Anxiety And Depression Through Martial Arts, Alfred Franklin, Keisa Boykin
Increasing Occupational Engagement In Adults With Anxiety And Depression Through Martial Arts, Alfred Franklin, Keisa Boykin
Summer 2024 OTD Capstone Symposium
This poster is for a capstone project that developed a martial arts program for adults with anxiety and depression to increase occupational engagement in these individuals.
Guided-Imagery Meditation As An Adjunct To Weight Management, Karen Roddy, Nancy Hamler, Niraj Bangari, Eva Lukas
Guided-Imagery Meditation As An Adjunct To Weight Management, Karen Roddy, Nancy Hamler, Niraj Bangari, Eva Lukas
Pacific Journal of Health
Objective: To assess the utility of guided imagery meditation (GIM) as a low-invasive, cost-effective modality to weight management. Researchers hypothesized that using a standardized, lifestyle-focused GIM would result in weight loss and waist circumference (WC) changes.
Design: Researchers designed a 12-week randomized, controlled pilot study in which participants were asked to use a provided GIM.
Setting: Comfort and relaxation are crucial for GIM. The study, therefore, utilized participants’ personal environments.
Participants: Convenient sampling of 82 students, faculty, and staff of the University of the Pacific.
Intervention(s): Intervention group participants were provided with a researcher-designed, lifestyle-focused …
Cruising Speed: Our Journal's 10-Year Voyage, Dennis J. Baumgardner, Joe Grundle
Cruising Speed: Our Journal's 10-Year Voyage, Dennis J. Baumgardner, Joe Grundle
Journal of Patient-Centered Research and Reviews
In this invited editorial, two long-tenured editors for the Journal of Patient-Centered Research and Reviews recount the publication’s many impactful contributions to the medical literature over its first 10 years.
Improving The Integration Of Whole Health Into A Veterans Affairs Outpatient Primary Care Clinic., Diana Lynn Blair
Improving The Integration Of Whole Health Into A Veterans Affairs Outpatient Primary Care Clinic., Diana Lynn Blair
Doctor of Nursing Practice Papers
Abstract
The annual $4.1 trillion price tag for healthcare with a simultaneous decline in patient health outcomes is the catalyst to change the current healthcare culture from disease-focused to a Whole Health wellness and prevention model. Transforming to preventative care would remedy the current costly healthcare system, thus Veterans Health Administration (VHA) set forth a mandate to implement Whole Health (WH) system wide. The purpose of this project was to provide a training program that facilitated the implementation of WH and improve the documentation of WH in the electronic health record (EHR). A needs assessment provided to the Fort Knox …
T. Boudieri Extract Potentiates The Effects Of Capecitabine Treatment In Human Colon Cancer Cells, Katia Sawaya, Mahmoud Khalil, Ghada Khawaja
T. Boudieri Extract Potentiates The Effects Of Capecitabine Treatment In Human Colon Cancer Cells, Katia Sawaya, Mahmoud Khalil, Ghada Khawaja
BAU Journal - Science and Technology
Resistance to chemotherapy remains a major challenge for colorectal cancer patients worldwide, hence the persistent need to uncover alternative treatments as well as new adjunct therapies in the fight against cancer. Natural extracts constitute an excellent source of bioactive substances that have a promising potential in that regard, with minimal negative side effects. We have previously demonstrated that both the ethanolic as well as the water extracts of Terfezia boudieri, a black desert truffle abundant in and part of the cuisine of the Mediterranean region, have significant antiproliferative effects against colon cancer cells. Our aim in this study was …
Increasing The Efficiency Of Lifestyle Medicine Counseling: A Visual Approach, Kayla A. Hinton, Ryan Smith
Increasing The Efficiency Of Lifestyle Medicine Counseling: A Visual Approach, Kayla A. Hinton, Ryan Smith
HCA Healthcare Journal of Medicine
Too much to counsel on, too little time? We would like to present a unique and innovative perspective on lifestyle medicine counseling through the lens of a homemade flyer, designed to bridge the gap between conventional health care practices and personalized, holistic well-being. In the promising field of health care humanities, the homemade lifestyle medicine flyer serves as a tangible manifestation of individual agency in promoting health and vitality. The flyer encapsulates a diverse range of self-care practices, dietary insights, and mindfulness techniques, emphasizing the inherent connection between mind, body, and spirit in one’s health journey.
This double-sided document highlights …
Homoeopathic Treatment Of Oral Leucoplakia: A Case Report, Suraia Parveen, Zeeshan Ahmed
Homoeopathic Treatment Of Oral Leucoplakia: A Case Report, Suraia Parveen, Zeeshan Ahmed
Indian Journal of Research in Homoeopathy
Introduction: Oral leucoplakia (OL), a premalignant lesion which is more frequently encountered in elderly people, is defined as a white lesion of the oral mucosa. Smoking is one of the most common risk factors. Conventionally, surgical excision is the most recommended treatment option for OL. Case Summary: A 55-year-old male presented with the complaint of a whitish lesion inside the left angle of the mouth (buccal mucosa) for the past 1½ years. The case was clinically diagnosed as OL. He was advised for surgical excision, but he preferred to go for homoeopathic treatment. Based on characteristic symptoms, repertorial analysis and …
Plantar Warts Treated With Homoeopathic Medicine Antimonium Crudum: A Case Report, Laijun Nahar, Ruma Debbarma
Plantar Warts Treated With Homoeopathic Medicine Antimonium Crudum: A Case Report, Laijun Nahar, Ruma Debbarma
Indian Journal of Research in Homoeopathy
Introduction: Plantar warts are cutaneous lesions brought on by human papilloma virus infection. There is a range of alternative treatment available for it, including cryotherapy, chemical cauterisation, curettage, electrodessication and laser removal. However, a majority of these treatments can leave scars or may provide only temporary relief. Case Summary: A 19-year-old female presented with multiple, right-sided plantar warts and was successfully treated by a single, individualised homoeopathic medicine, Antimonium crudum 200C for two months. The improvement was assessed through photographs taken in subsequent follow-up visits. The case was monitored further for a period of six months without any recurrence. This …
Research Highlights, Shatakshi Bhardwaj, Archna Nagar
Research Highlights, Shatakshi Bhardwaj, Archna Nagar
Indian Journal of Research in Homoeopathy
Research Highlights
Diabetic Foot Ulcer Treated With The Homoeopathic Medicine Lachesis Mutus In Millesimal Potencies: A Case Report, Lalith Singh, Raja Manoharan, Niharika Shaw, Saleem Ansari
Diabetic Foot Ulcer Treated With The Homoeopathic Medicine Lachesis Mutus In Millesimal Potencies: A Case Report, Lalith Singh, Raja Manoharan, Niharika Shaw, Saleem Ansari
Indian Journal of Research in Homoeopathy
Introduction: Diabetic foot ulcer (DFU) is the most common neuropathic complication of diabetes. Uncontrolled diabetes and improper foot care lead to serious conditions like DFU from minor injuries. Regular dressing and proper foot care are required for its improvement. Patients are left with no other option than amputation of the limb. Dressing for a longer period seems not convenient and feasible at the patient’s end. DFU also has wet gangrene as one of its major complications. Case Summary: This case report presents a case of a diabetic patient complaining of a foot ulcer for the past nine years, following the …
Management Of Post-Operative Breast Nodules With Homoeopathy: A Case Report, Nisanth K.M. Nambison, Smita N. Nambison, Abhishek D. Dwivedi, Nisha Chakravarty
Management Of Post-Operative Breast Nodules With Homoeopathy: A Case Report, Nisanth K.M. Nambison, Smita N. Nambison, Abhishek D. Dwivedi, Nisha Chakravarty
Indian Journal of Research in Homoeopathy
Introduction: Palpable masses after mastectomy are commonly detected by patients or their physicians. Imaging of palpable masses is advised following a complete history and physical examination. This is a case of breast nodules occurring after the removal of cancerous tissue in the breast. Homoeopathy, with its holistic approach, can treat the disease by addressing its multifactorial origin.
Case summary: A 71-year-old female, diagnosed with post-operative breast nodules after surgical excision of mucinous carcinoma portion of the left breast, was treated with individualised homoeopathic treatment for six months with subsequent improvement. This case provides preliminary evidence for the potential usefulness of …
A Case Report Of Attention Deficit Hyperactivity Disorder In Preschool Children Treated With Individualised, Constitutional Homoeopathic Medicine, Karunakara Moorthi, Lalitha K S
A Case Report Of Attention Deficit Hyperactivity Disorder In Preschool Children Treated With Individualised, Constitutional Homoeopathic Medicine, Karunakara Moorthi, Lalitha K S
Indian Journal of Research in Homoeopathy
Introduction: Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder affecting children of all ages, including preschoolers, adolescents, and adults worldwide. ADHD patients often face challenges in academic and social settings. Notably, pre-school children are more likely to exhibit hyperactive-impulsive symptoms than school-age children. Research on treating pre-schoolers with ADHD is limited compared to older children. This case report demonstrates the treatment of ADHD in pre-schoolers using individualised homoeopathic remedies. Case Summary: A 4-year-old boy presented with a 2-year history of symptoms, such as restlessness, easy distractibility and aggressive behaviour. After assessing the case, the institute’s psychiatric consultant diagnosed it …
Laryngopharyngeal Reflux Disease With Vocal Cord Oedema Treated With Individualised Homoeopathic Medicine: A Case Report, Partha Pratim Pal, Laijun Nahar
Laryngopharyngeal Reflux Disease With Vocal Cord Oedema Treated With Individualised Homoeopathic Medicine: A Case Report, Partha Pratim Pal, Laijun Nahar
Indian Journal of Research in Homoeopathy
Introduction: The diagnosis of laryngopharyngeal reflux disease (LPRD) is still ambiguous due to limited and cumbersome diagnostic standards. To achieve regression of both symptoms and laryngeal findings due to LPRD, it typically requires more vigorous and sustained treatment. In certain patients with chronic acid or non-acid reflux, surgery may be helpful. Case Summary: This is the case of a 68-year-old man who was diagnosed with LPRD and had vocal cord oedema. Individualised homoeopathic medicine, Natrum sulphuricum, was prescribed, and the patient improved steadily in terms of signs and symptoms and had no further complaints at the end of 16 …
Management Of Psychosis With Individualised Homoeopathic Medicines: A Case Series, Karunakara Moorthi, Susu Pertin, Mohan Narvelil Devasia
Management Of Psychosis With Individualised Homoeopathic Medicines: A Case Series, Karunakara Moorthi, Susu Pertin, Mohan Narvelil Devasia
Indian Journal of Research in Homoeopathy
Background: Psychosis is a clinical syndrome. The main clinical signs of psychosis are delusion and hallucination. It is a crucial focus of diagnosis and treatment in neurologic and psychiatric practice since it functionally disturbs numerous psychiatric, neurodevelopmental, neurologic and medical diseases.
Case summary: The World Health Organization Quality of Life Scale and the Brief Psychiatric Rating Scale were used to evaluate the patients. The outcomes in all the cases suggested that homoeopathic treatment can play a significant role in easing psychotic symptoms and restoring the patient’s ability to understand. The most frequently prescribed medicines and potencies in these cases were …
Resolution Of Subdural Hygroma With Homoeopathy: A Case Report, Partha Pratim Pal, Tania Chatterjee
Resolution Of Subdural Hygroma With Homoeopathy: A Case Report, Partha Pratim Pal, Tania Chatterjee
Indian Journal of Research in Homoeopathy
Introduction: Subdural hygroma (SDH) is a collection of cerebrospinal fluid in the subdural space which may be idiopathic, traumatic or post-surgical occurring mostly in elderly patients. Case Summary: A 42-year-old female reported an acute complaint of compressing headache. The headache persisted even after initial prescriptions of Ruta graveolens 30C and 200C, which did not alleviate the condition. Further evaluation was done with a computed tomography scan, which revealed left-sided SDH. Tuberculinum 1M was prescribed, but even though the pain subsided, profuse, watery discharge began to ooze from both the ears and nose, which eventually stopped spontaneously. After six months, the …
Infantile Haemangioma Treated With Homoeopathy: A Case Report, Harpreet Kaur, Ravinder Singh
Infantile Haemangioma Treated With Homoeopathy: A Case Report, Harpreet Kaur, Ravinder Singh
Indian Journal of Research in Homoeopathy
Introduction: Infantile haemangiomas (IH) are common benign tumours of infancy. Approximately, one in ten infants gets affected. The male-tofemale ratio is variable, with some reports suggesting that females are more prone than males. In India, the prevalence of IH in various studies has been reported as varying from 0.1% to 0.28%. The head and neck are the regions where most of the haemangiomas are located. The lesions are apparent soon after birth and are followed by rapid proliferation during the first year of life and a gradual involution occurs over the next five to ten years. Case summary: …
Management Of Tinea Corporis With The Minimum Doses Of Homoeopathic Nosode Psorinum: A Case Report, Punam Kumari, Shivam Kumar, Renu Verma
Management Of Tinea Corporis With The Minimum Doses Of Homoeopathic Nosode Psorinum: A Case Report, Punam Kumari, Shivam Kumar, Renu Verma
Indian Journal of Research in Homoeopathy
Introduction: Tinea corporis (TC) is the most common superficial fungal infection of the skin that invades and grows in dead keratin. The topical treatment causes suppression of TC and with the effect of it, a repeated episode of relapse occurs, which hampers the quality of life of the patient. Case Summary: This case of TC, with extensive spread on the body, demonstrates the curative effect of homoeopathic medicine with minimum dosage. A 64-year-old male diagnosed with TC was treated successfully with individualised homoeopathic medicine for seven months. The outcome was assessed through before-and-after-treatment photographs. Dermatology Life Quality Index (DLQI) score …
Reporting Clinical Cases: Advancing Homoeopathy, One Case At A Time, Subhash Kaushik
Reporting Clinical Cases: Advancing Homoeopathy, One Case At A Time, Subhash Kaushik
Indian Journal of Research in Homoeopathy
Case reports have been invariably contributing to the research world in their own way. They remain a popular genre among the readers, especially the clinicians who lay their hands upon a clinical journal with an interest to pick new knowledge about a certain disease or a drug than to learn about new evidence generated through statistical calculations. Its presence in medical literature is reported to be quite ancient, with some evidence dated back to the Egyptian antiquity. In fact, a well-documented case report is a representative version of many similar clinical success stories.
Homoeopathic Medicine Arsenic Album 200c In Treatment Of Plaque Psoriasis: A Case Report, Neha Nagar, Ravi K. Poswal, Ajay Kumar, Kanak Singhal
Homoeopathic Medicine Arsenic Album 200c In Treatment Of Plaque Psoriasis: A Case Report, Neha Nagar, Ravi K. Poswal, Ajay Kumar, Kanak Singhal
Indian Journal of Research in Homoeopathy
Introduction: Psoriasis is a non-communicable, chronic, mostly painful, disfiguring disease. It can have a negative impact on patients’ quality of life, which may occur at any age. The conventional treatment includes local and systemic therapies, as well as phototherapy. The need for treatment is usually lifelong as remission occurs quite frequently. Case Summary: We present here a case report of a 32-year-old woman with psoriatic lesions all over the body for 15 years with intolerable itching. The present case was completely cured after 1 year 6 months of regular treatment with individualised homoeopathic medicine without any adverse effects. After detailed …
Individualised Homoeopathic Treatment For Pilonidal Sinus: A Case Report, Sumit Paliwal, Laijun Nahar, Rachna Paliwal
Individualised Homoeopathic Treatment For Pilonidal Sinus: A Case Report, Sumit Paliwal, Laijun Nahar, Rachna Paliwal
Indian Journal of Research in Homoeopathy
Introduction: Pilonidal sinus is a very common inflammatory disease of the gluteal region. The most common site of occurrence is the natal cleft. It can cause discomfort, absence from work and social embarrassment. There is no single, widely accepted therapy available for this condition. In most cases, the treatment option for this disease is surgical intervention, but recurrences following surgery are common. Case Summary: A 15-year-old male patient reported discharge from the sinus cavity in the natal cleft along with pain and discomfort. Nitric acid, a homoeopathic medicine, was prescribed during the initial consultation and the patient was followed …
Cutaneous Warts Treated With A Single Dose Of The Homoeopathic Medicine Carcinosin 200c: An Evidence-Based Case Report, Sivakumar K, Mamatha Mohan
Cutaneous Warts Treated With A Single Dose Of The Homoeopathic Medicine Carcinosin 200c: An Evidence-Based Case Report, Sivakumar K, Mamatha Mohan
Indian Journal of Research in Homoeopathy
Introduction: Cutaneous warts are hyperkeratotic protrusions over the skin caused by human papilloma virus (HPV). These are common throughout the world. Cutaneous warts can occur at any age but are unusual in early childhood and infancy. Warts are often diagnosed clinically on physical examination, but some dysplastic lesions may require laboratory confirmation of HPV. Spontaneous clearance is not always possible, and offering a reliable prognosis to the individual case is impossible. Even though warts are frequently encountered in the day-to-day practice of homoeopathy, and the results are promising, there are limited research studies available in the online database. Case Summary: …
Benefits Of Acceptance And Commitment Therapy (Act) For Chronic Pain, Maria Kleinstaeuber, Ashley Yaugher, Emily Roundy, Michael Levin
Benefits Of Acceptance And Commitment Therapy (Act) For Chronic Pain, Maria Kleinstaeuber, Ashley Yaugher, Emily Roundy, Michael Levin
All Current Publications
Chronic pain is a common experience for people and can be difficult to manage. However, there are many evidence-based and effective psychological treatments for chronic pain to help people improve their lives. One of these is acceptance and commitment therapy, or ACT. ACT teaches how to accept pain and live a life full of meaning and quality, with pain. It helps individuals increase their quality of life through mindfulness-based methods, experiential processing, and a focus on values, goals, and actions. ACT has been shown to be effective in reducing pain and improving pain management and personal well-being. Consult the resources …
What Are The Lessons Learned From A Survivorship Trial During The Pandemic?, Alanna Horowitz, Sharneet Sandhu, Sherry Guo, Gabriel Barreto-D'Silva, Leonardo Barreto-D'Silva, Krishna Gunturu
What Are The Lessons Learned From A Survivorship Trial During The Pandemic?, Alanna Horowitz, Sharneet Sandhu, Sherry Guo, Gabriel Barreto-D'Silva, Leonardo Barreto-D'Silva, Krishna Gunturu
The Lahey Journal
Purpose: The American Cancer Society (ACS) has acknowledged the importance of maintaining a healthy diet and engaging in regular physical activity for cancer survivors. While studies have found that adherence to these guidelines improves long-term quality of life, several studies showed that up to 70% of cancer survivors do not meet the standards. The purpose of this pilot study is to determine the effectiveness of a multi-disciplinary survivorship clinic (MDSC) in helping patients adhere to the ACS survivorship guidelines and its impacts on quality of life (QOL).
Methods: Primary objective of the study is to encourage cancer patients to adhere …
Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel
Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel
University Honors Theses
Substance Use Disorder (SUD) and stress are often predictive of one another, bidirectionally causal, and mutually intensifying. This thesis describes the bi-directional connection between physiological stress-modulating systems and Substance Use Disorder, and explores some emerging biofeedback stress-reduction gaming technology as a potential adjunct to recovery treatments. Improving autonomic balance, often described by Heart Rate Variability, has been shown to be beneficial for physical and psychological recovery, as well as improving self-control. For this reason, regular biofeedback for stress relief could be helpful in augmenting SUD treatment and preventing relapse. This exploration found that presenting it through a gaming lens may …
Balancing And Intention In Zero Balancing?, John J. Hamwee Mr
Balancing And Intention In Zero Balancing?, John J. Hamwee Mr
Journal of Transformative Touch
The word 'balancing' is used in many complementary therapies - what does it mean, exactly, and how is it used in Zero Balancing?