Patients Archives

OKC Dentist Working With On-Site Lab to Bring Patients Best in Cosmetic Dentistry

OKLAHOMA CITY, Dec. 2, 2020 /PRNewswire-PRWeb/ — Providing the highest quality, longest lasting and most honest dentistry available has been a commitment of OKC dentist Dr. Chris Saxon’s since he began practicing dentistry. He is keeping this commitment by providing his patients with an on-site dental lab. This allows Dr. Saxon and his team at Saxon Dentistry to work hand in hand with the lab specialists to ensure an outstanding level of quality and service.

The Saxon Dentistry Difference

In most practices, the standard procedure is to outsource your dental lab needs. These typically include dentures, dental crowns, porcelain veneers, implant restorations and more. While convenient and often less expensive for dentists, quality and precision are often compromised. With Saxon Dentistry, this is kept on-site, ensuring greater quality control, accuracy of fit and most importantly, higher patient satisfaction.

When patients embark on full smile makeovers, dental implants, porcelain veneers and even a single crown, they are putting a lot of trust in their dentist. This trust is not taken lightly at Saxon Dentistry. The on-site lab utilizes top tier dental materials, advanced technology and employs skilled, meticulous technicians. Combining this with Dr. Saxon’s expertise allows for predictable, high quality outcomes.

When teaming up with the on-site dental lab specialist, Dr. Saxon can bring them directly into the room with the patient and together listen to the patient’s concerns. Without an on-site lab, dentists have to relay information to their labs via phone call or email. Details get lost in translation, and details matter greatly when customizing a smile for patients. Sometimes the most minor adjustment can have the biggest impact.

Smile Makeovers OKC

Dr. Saxon has a particular passion for making dentistry beautiful and natural. His keen eye for detail can make any dental restoration, from a single cracked tooth repair to dental veneers to full mouth dental implants, blend seamlessly into a smile. This has made him a highly sought after OKC cosmetic dentist and implant dentist.

“When dentistry is done to the highest level, no one should be able to detect that you’ve had dental work completed.”

He believes in meeting patients exactly where they are in life, understanding their goals and setting forth the appropriate treatment from there. There is no one size fits all dentistry in his office. Personalized care is not only necessary; it’s what every patient deserves that walks through a dentist’s door.

Get to Know Oklahoma City Native, Dr. Chris Saxon

Dr. Saxon is a native of Oklahoma City and a graduate of Putnam City North high school. He received his doctorate from the University of Oklahoma College Of Dentistry. He takes between 100-150 hours of continuing education every year, far exceeding the Oklahoma Board of Dentistry’s requirements.

Dr. Saxon is committed to giving back to the local community. One way he does this is by being an Oklahoma Mission of Mercy participant. Dr. Saxon is an avid golfer, cyclist and kite boarder, but his greatest joy comes from spending time with

medicine

Michigan Medicine restricts visitors for adult patients as COVID-19 cases climb

ANN ARBOR – Michigan Medicine has updated its visitor policy with tightened restrictions in order to keep patients and staff safe as COVID-19 cases surge around the state.

As of Wednesday, no visitors will be permitted with adult patients in the health system’s hospitals, unless medically necessary.

Exceptions to the new restrictions include end-of-life care, labor and delivery and other scenarios which are listed here.

According to Michigan Medicine, the new policy change includes restrictions already announced:

No visitors are allowed with adult emergency department patients, except when medically necessary.
At C.S. Mott Children’s Hospital, two visitors are allowed for pediatric patients. But family and other visitors are required to wear a mask (covering their mouth and nose) at all Michigan Medicine properties. This includes in a patient room and throughout the facility. Patients who can tolerate a mask must wear one when a health care worker is present in their room.
In clinics, no visitors will be allowed for adult patients unless the patient has a cognitive or physical impairment that requires assistance. One primary caregiver is allowed to accompany each pediatric patient to an appointment, unless an additional aide or assistant is required.

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“COVID-19 transmission rates continue to climb in the community,” Laraine Washer, Michigan Medicine’s medical director of infection prevention and epidemiology said in a statement. “Our top priority is the safety of our patients and staff, and to minimize the spread of disease, we need to take this additional step.

“We know this is difficult for our patients and their families and friends. But we need to continue to keep our Michigan Medicine facilities safe for all of our patients.”

Since the pandemic began in March, Michigan Medicine has been taking steps to keep staff and patients safe, including screening patients for symptoms, cleaning and disinfecting facilities, moving furniture to observe social distancing and following the latest guidelines to minimize infections.

“Limiting the risk of transmission of infection has always been a critical priority at Michigan Medicine,” Washer said in a statement. “And I want to reassure the public that if you need health care for a new problem or for continuing care of a chronic problem, you should not put it off.

“We have teams dedicated to keeping our patients and staff safe in our buildings. It is important to not delay emergency or chronic care.”

Washer urged people to avoid Thanksgiving gatherings this year with those outside your household.

“The best advice to limit risk is to continue to avoid gathering with people outside your household even if it is Thanksgiving,” she said in a statement. “If you are reporting to work, don’t have potlucks or share meals in close proximity with your co-workers: you can’t eat without taking off your mask, and that brief period of not wearing a mask could be enough to open the door to disease spread.

“We need everyone’s help with this. A large surge of

dentist

Lynnwood dentist says stress of COVID is grinding on patients, but routine care remains vital

Stress from the coronavirus pandemic has people gnashing their teeth and avoiding dental care.

LYNNWOOD, Wash. — The dentist’s office was a scary place for many people long before the coronavirus pandemic. For some, it’s even scarier now.

People are avoiding dentists because they worry it isn’t safe — and that’s creating another set of health issues.

The ongoing global pandemic is quite literally grinding people down to their breaking point.

“This patient said she started to notice herself clenching and grinding,” said Dr. Bradley Jonnes of Lynnwood’s Cedar View Dental, pointing to an X-ray. “She actually broke the tooth off at the gum line.”

Jonnes said, prior to the pandemic, he’d see a broken tooth every couple of weeks. Now he sees several a week.

“People come in and I ask them what changed, and they say, ‘Look at the world! It’s stress. I’m definitely clenching and grinding now.'”

Fear of contracting COVID-19 also has people putting off check-ups, turning small problems into big ones. Routine cavities can become root canals.

After dental offices across the country were completely shut down at the beginning of the pandemic, the American Dental Association changed its policy, designating check-ups as “essential” services.

When asked whether a check-up truly is “essential,” Jonnes responded, “That’s an interesting question. Sometimes we do a check-up and we find a lot more, so we can prevent a lot more. In some cases, it saves people time and money and pain and hassle by doing that check-up. We screen for oral cancer and other issues. We never know what we’re going to find until we get in there.”

Washington state is now allowing dentists to operate as they did prior to the pandemic with additional requirements, including screening of patients for symptoms and thorough cleaning of facilities.

Though not required, Jonnes uses a hand-held fogger to coat his office with a natural disinfectant every day.

He wears both an N95 and additional surgical mask during each procedure. A hospital grade air purification system filters the air in the office every 15 minutes.

“The good thing is, we now have a track record,” said Jonnes. “When we were first opening, we didn’t know how COVID and dentistry would be affected. Talking with my colleagues, the American Dental Association and the national association, we can see dental offices have been safe.”

The American Dental Association reports less than 1% of the nation’s 200,000 dentists have tested positive for coronavirus, compared to more than 200,000 health care workers who have been infected.

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medicine

UCLA Health collaborates with Regeneron Genetics Center to bring genomic medicine to patients

Reviewed by Emily Henderson, B.Sc.Nov 16 2020

UCLA Health has entered into a collaborative research agreement with the Regeneron Genetics Center (RGC) to provide whole exome sequencing for 150,000 UCLA Health patients. Led by the UCLA Institute for Precision Health (IPH), this initiative is set to become one of the largest and most comprehensive in the nation and is a key step in bringing genomic medicine to patients across California.

We’ve talked for some time about the promise of precision medicine – a time when preventive measures and targeted treatments can be individualized to each patient’s genetic makeup. This is a watershed moment in that timeline, a big step toward that reality and a turning point in our research dedicated to changing the way future health care will be delivered for our patients and our community.”

Dr. Daniel Geschwind, Gordon and Virginia MacDonald distinguished professor, senior associate dean and associate vice chancellor of Precision Health

The new exome-sequencing collaboration builds on genotyping work underway with the UCLA ATLAS Community Health Initiative – a large collection of diverse patient blood, saliva and tissue samples being analyzed to help UCLA researchers and clinicians develop and deliver the best care possible. Genotyping, which is targeted to a specific place in the DNA, looks for a predefined set of variants, but whole exome sequencing – like that being performed through the new RGC collaboration – analyzes thousands of protein-coding genes and can provide information on many more potential mutations. Using a needle and haystack analogy, genotyping looks for predetermined needles in a specific location, while exome sequencing searches more of the haystack to detect unexpected needles.

“All patients who participate in this research will be given the opportunity to opt in or out of having actionable results – those that could directly impact their clinical care – returned to them. All patient information and specimens used in the research are ‘de-identified’ to protect patient privacy and confidentiality. Actionable results, which are verified by a UCLA CLIA-certified laboratory, are only returned to those patients who specifically say they want them,” Dr. Geschwind said, adding that about 2% to 3% of tested patients are expected to have a result that will have immediate clinical implications.

The RGC, a wholly owned subsidiary of the science-focused biotechnology company Regeneron, has built one of the world’s largest genetics databases, pairing the sequenced exomes and de-identified electronic health records of more than 1 million people, through collaborations with nearly 100 global health care and academic institutions. Building upon Regeneron’s strengths in genetics-driven drug discovery, the information secured from this initiative will allow for the elucidation, on a large scale, of genetic factors that cause or influence a range of human diseases.

Three factors make this research effort particularly strong: the depth of UCLA Health’s patient care and research expertise; the ethnic diversity of Los Angeles and the Southern California region; and RGC’s leading genetics research, sequencing and analysis capabilities.

“Including diverse populations is critical to

medicine

Clackamas Volunteers in Medicine helps patients prioritize their own health care: Season of Sharing 2020

In the 21 years since Miriam Patino Sanchez came to Oregon, things haven’t always been easy.

The mother of four, who emigrated from Mexico at 26, is a full-time caregiver for her daughter with special needs and has faced health problems herself. It wasn’t always possible to address her own issues.

A few years ago at the urging of a friend, she applied to Clackamas Volunteers in Medicine, a free clinic in Oregon City.

For the first time in years, she found she was getting her health needs met without worrying about getting turned away or encountering a language barrier.

“I’ve found that no matter where you’re from, there’s no discrimination — that’s not a factor in receiving treatment,” Patino Sanchez told The Oregonian/OregonLive through an interpreter.

Clackamas Volunteers in Medicine is a beneficiary of The Oregonian/OregonLive’s 2020 Season of Sharing holiday fundraising campaign.

>>To donate: Season of Sharing GoFundMe page

In the five years that Patino Sanchez, 47, attended the clinic, she got treatment for her hyperthyroidism and fibromyalgia, and a free inhaler for her asthma.

The clinic also took its own measures to help Patino Sanchez, offering her services before she even asked for them. After she had hemorrhoid surgery, Patino Sanchez was still in a lot of pain. A doctor from the clinic determined that the surgery had not been done well, and called in a specialist to fix the problem.

“If I hadn’t had anyone to go to, I would have been suffering — I’d have been in a world of hurt for who knows how long,” she said.

Clackamas Volunteers in Medicine’s development director, Rebekah Singh, said many patients, like Patino Sanchez, are in a position where it’s difficult to prioritize their own health care.

“Most of our patients are $15-per-hour wage workers, who are sometimes holding multiple jobs,” Singh said. “Their employers hold them under 32 hours (a week) to avoid having to provide benefits.”

Many also have chronic health issues like hypertension or diabetes, which could be easily managed with proper care.

The Volunteers in Medicine organization has clinics nationwide, but the Clackamas branch, the first in Oregon, opened in 2011. It was started by local doctors with the goal of providing health care to those who couldn’t get it elsewhere.

The clinic is staffed by about 200 volunteers and five paid employees. Volunteers include doctors, some of whom are retired, as well as lab technicians, nurses and nurse practitioners. There are five paid administrative staff members. The clinic serves about 700 people a year, many of whom don’t have health insurance, or earn just above the rate to qualify for the Oregon Health Plan for low-income earners.

The organization operates on a budget of $400,000 annually, with 60% of its revenue coming from grant funding. About 40% comes from community funds, including donations and a yearly fundraiser.

Although Patino Sanchez received health insurance this year through Project Access NOW, which helps insure Oregonians, she has urged friends to seek out Clackamas Volunteers

medicine

The Lancet Respiratory Medicine: Clinical trial finds inhaled immune response protein increases odds of recovery for hospitalised COVID-19 patients

Peer-reviewed / Randomised Controlled Trial / People

Inhaled delivery of a formulation of a key protein involved in the immune response – interferon beta-1a – to hospitalised COVID-19 patients in the UK reduced the odds that they would develop severe disease or die from SARS CoV-2 infection.
Those patients who received inhaled interferon beta-1a were more than twice as likely to recover from COVID-19 infection to a point where everyday activities were not limited compared with those who received a placebo.
The trial included 101 patients, with the data providing strong rationale for larger studies to further investigate the impact of this treatment on clinical outcomes.

Hospitalised COVID-19 patients in the UK who received an inhaled form of interferon beta-1a (SNG001) were more likely to recover and less likely to develop severe symptoms than patients who received a placebo, according to a new clinical trial published in The Lancet Respiratory Medicine journal. This is the first evidence published in a peer-reviewed medical journal that inhaled interferon beta-1a could lessen the clinical consequences of COVID-19 and serves as proof-of-concept that this treatment could help hospitalised patients recover, but further research is required.

As the number of COVID-19 infections continues to rise around the world, there is a pressing need to develop new treatments for the more severe and life-threatening symptoms such as pneumonia and respiratory failure.

Interferon beta is a naturally occurring protein that coordinates the body’s immune response to viral infections. Laboratory studies have found that the SARS CoV-2 virus directly suppresses the release of interferon beta, while clinical trials demonstrate decreased activity of this important protein in COVID-19 patients. The formulation of interferon beta used in this new study – SNG001 – is directly delivered to the lungs via inhalation and has been trialled in the treatment of asthma and chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the safety and efficacy of SNG001 to treat hospitalised COVID-19 patients.

The trial was conducted at nine UK hospitals with patients who had a confirmed SARS-CoV-2 infection. It compared the effects of SNG001 and placebo given to patients once daily for up to 14 days, and followed up patients for a maximum of 28 days after starting the treatment. Patients were recruited from March 30 to May 30, 2020, and were randomly assigned to receive the treatment or a placebo. All members of the research team were blinded to which group the patients were allocated. During the study, changes in the clinical condition of patients were monitored.

Of the 101 patients enrolled in the study, 98 patients were given the treatment in the trial (three patients withdrew from the trial) – 48 received SNG001 and 50 received a placebo. At the outset of the trial 66 (67%) patients required oxygen supplementation at baseline (29 people in the placebo group and 37 in the SNG001 group). Patients who received SNG001 were twice as likely to show an improvement in their clinical condition at day 15 or 16, compared with

medicine

Treating Opioid Addiction in Primary Care Benefits Both Patients and Cash-Strapped Medical Practices

Press release content from PR Newswire. The AP news staff was not involved in its creation.

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ANN ARBOR, Mich., Nov. 11, 2020 /PRNewswire/ — Buprenorphine-based treatment for opioid addiction is in short supply in many areas of the United States. And while many physicians want to offer it, clinics are unsure how to offer buprenorphine therapy in a financially sustainable way. Cost and revenue analysis from a team of Harvard Medical School researchers finds that even cash-strapped primary practices in high-poverty rural and urban communities can offer financially sustainable buprenorphine-based opioid addiction treatment.

The team, led by Sanjay Basu, MD, PhD, a Harvard primary care physician and epidemiologist and Jonathan E. Fried, MD, MPH, an internal medicine resident at Brigham and Women’s Hospital, interviewed practice managers and identified four common approaches to delivering buprenorphine-based treatment in primary care practices. The approaches differed based on who in the clinic delivered the majority of face-to-face care, the presence of nurse care managers, and whether care was delivered in traditional one-on-one or group settings.

The research team then used microsimulation modeling to identify the cost and financial benefit of delivering buprenorphine-based treatment in a variety of primary care settings, including Federally Qualified Health Centers (FQHC), non-FQHCs in both rural and urban high poverty areas,, and practices outside of high poverty areas. They found that all four approaches to care produced positive net revenue after the first year in a variety of practice settings, and net revenues were consistently highest for rural practices.

Physician-led treatment and shared medical visits, both of which relied on nurse care managers, consistently produced the greatest net revenue gains, generating from $29,000 to $70,000 per full-time physician per year across the practice types.

Additionally, net revenues were positive for all primary care practices that had at least nine patients in buprenorphine treatment per provider at any given time and no-show rates less than 34 percent. The findings suggest that in the current fee-for-service–dominated environment, offering office-based therapy for opioid addiction with buprenorphine can be a financially sustainable choice for cash-strapped primary care practices, despite hurdles.

Financing Buprenorphine Treatment in Primary Care: A Microsimulation Model

Jonathan E. Fried, et al

Center for Primary Care, Harvard Medical School, Boston, Massachusetts

View original content to download multimedia: http://www.prnewswire.com/news-releases/annals-of-family-medicine-treating-opioid-addiction-in-primary-care-benefits-both-patients-and-cash-strapped-medical-practices-301170615.html

SOURCE Annals of Family Medicine

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medicine

Integrative Medicine Shows Benefits for Patients With MPNs

A recent survey of patients with myeloproliferative neoplasms found integrative medicine interventions improved symptom burden, fatigue, depression, and improved quality of life.

For patients with myeloproliferative neoplasms, integrative medicine (IM) offers a range of benefits, according to a new study of survey results, which found that the interventions improved symptom burden, fatigue, and depression, and improved quality of life (QoL).

IM approaches, which work to optimize health, QoL, and clinical outcomes, are increasingly being leveraged by both patients with cancer and cancer care providers and organizations, although there is need for more evidence-based data to guide clinical practice, particularly for hematologic malignancies.

“The treatment of MPNs has revolutionized in recent decades with the approval JAK inhibitor therapy and other targeted therapies, leading to improvements in splenomegaly, symptom burden, and even overall survival,” wrote the researchers. “Despite these advancements, the need for IM interventions to address high symptom burden and poor quality of life remain a large unmet need in the MPN patient population.”

The researchers of the current study disseminated a survey of IM among patients with MPN, with more than 800 respondents. Among the respondents, 338 had essential thrombocythemia, 188 had myelofibrosis, 315 had polycythemia vera, and 17 had other/unspecified MPN. IM interventions ranged widely, with the most common interventions including aerobic activity (51.5%), massage (28.4%), yoga (25.6%), nutrition (25.2%), and strength training (23.8%).

Both aerobic activity and strength training lowered MPN-Symptom Assessment Form (SAF) scores (33.3 vs 39.7 and 34.0 vs 37.7, respectively), indicating lower symptom burden, although they were surprisingly associated with a lower QoL. However, the researchers added the caveat that the latter association may be due to those with lower QoL are more likely to try exercise-based wellness strategies like these.

In a similar pattern, massage and support groups led to higher symptoms burden (MPN SAF-TSS mean score 40.5 vs. 35.3 and 42.3 vs. 36.0, respectively) but were associated with a higher QoL, with the researchers noting that highly symptomatic patients may be more likely to try non-pharmacologic symptom management and social support.

Decreased levels of depression were noted among patients participating in aerobic activity and strength training, as well as yoga. Aerobic activity and strength training also reaped benefits for fatigue, with patients participating in the interventions reporting lower levels of fatigue, while patients participating in massage and breathing techniques noted higher levels of fatigue.

According to the researchers, while most patients participated in some form of IM intervention, “80.2% of patients felt their integrative health needs were not heard by their healthcare provider. This underscores the importance of enhancing integrative therapy communication in our health system.”

The finding, they say, indicates “the need for more integrative medicine practitioners and more robust integration of these practitioners and modalities within standard medical care.”

Reference

Gowin K, Langlais B, Kosiorek H, et al. The SIMM study: survey of integrative medicine in myeloproliferative neoplasms. Cancer Med. Published online November 3, 2020. doi: 10.1002/cam4.3566.

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medicine

Virtual Patients Could Revolutionize Medicine

Every day, it seems, some new algorithm enables computers to diagnose a disease with unprecedented accuracy, renewing predictions that computers will soon replace doctors. What if computers could replace patients as well? If virtual humans could have replaced real people in some stages of a coronavirus vaccine trial, for instance, it could have sped development of a preventive tool and slowed down the pandemic. Similarly, potential vaccines that weren’t likely to work could have been identified early, slashing trial costs and avoiding testing poor vaccine candidates on living volunteers. These are some of the benefits of “in silico medicine,” or the testing of drugs and treatments on virtual organs or body systems to predict how a real person will respond to the therapies. For the foreseeable future, real patients will be needed in late-stage studies, but in silico trials will make it possible to conduct quick and inexpensive first assessments of safety and efficacy, drastically reducing the number of live human subjects required for experimentation.

With virtual organs, the modeling begins by feeding anatomical data drawn from noninvasive high-resolution imaging of an individual’s actual organ into a complex mathematical model of the mechanisms that govern that organ’s function. Algorithms running on powerful computers resolve the resulting equations and unknowns, generating a virtual organ that looks and behaves like the real thing.

In silico clinical trials are already underway to an extent. The U.S. Food and Drug Administration, for instance, is using computer simulations in place of human trials for evaluating new mammography systems. The agency has also published guidance for designing trials of drugs and devices that include virtual patients.

Beyond speeding results and mitigating the risks of clinical trials, in silico medicine can be used in place of risky interventions that are required for diagnosing or planning treatment of certain medical conditions. For example, HeartFlow Analysis, a cloud-based service approved by the FDA, enables clinicians to identify coronary artery disease based on CT images of a patient’s heart. The HeartFlow system uses these images to construct a fluid dynamic model of the blood running through the coronary blood vessels, thereby identifying abnormal conditions and their severity. Without this technology, doctors would need to perform an invasive angiogram to decide whether and how to intervene. Experimenting on digital models of individual patients can also help personalize therapy for any number of conditions and is already used in diabetes care.

The philosophy behind in silico medicine is not new. The ability to create and simulate the performance of an object under hundreds of operating conditions has been a cornerstone of engineering for decades, such as for designing electronic circuits, airplanes and buildings. Various hurdles remain to its widespread implementation in medical research and treatment.

First, the predictive power and reliability of this technology must be confirmed, and that will require several advances. Those include the generation of high-quality medical databases from a large, ethnically diverse patient base that has women as well as men; refinement of mathematical models to account for

dentist

Dentist Jailed For Treating 41 Patients During Mandatory Self-Quarantine In Perth

KEY POINTS

Natalia Nairn, a dentist from Perth, breached quarantine rules
She has been sentenced for a period of seven months
Instead of self-quarantining at home, she went to her clinic to treat patients

A dentist has been sentenced to two months of imprisonment in Perth, West Australia, for treating more than 40 patients during her supposed mandatory self-quarantine, ABC News reported.

Natalia Nairn, 31, flew back to Perth from Canberra on June 16 and was supposed to self-isolate at home for two weeks. Instead, she was found breaching quarantine rules.

Nairn treated a total of 41 patients at her clinic for eight days within the quarantine period. She reportedly went to her dental clinic even after the police had contacted her over the breach.

Matthew Walton, magistrate at Joondalup Magistrates Court, observed that Nairn’s blatant violation indicated her “complete disregard for the rules.” He also noted that she could have been responsible for spreading the virus through the community. “The offender did pose a significant risk to the health and safety of West Australians,” he added.

Nairn claimed that she had taken necessary safety precautions, such as wearing protective equipment when she traveled. However, the magistrate dismissed her claims, saying she had taken those measures “to fundamentally protect herself.” Walton also slammed Nairn for claiming that she was “feeling fine.” He labeled her excuse as “patently ridiculous” and “naive.”

The court observed that although Nairn’s COVID -19 test results came out negative, the up-close nature of her work meant that she had potentially put other people at risk, reported 7NEWS.

The court found that she went to her dental clinic even after the police contacted her over the breach. Photo: pixabay

Nairn, who had no previous history of convictions, pleaded guilty on Oct 21. She was charged with eight offenses of failing to comply with a direction under the Emergency Management Act, which aims to “provide for the prompt and coordinated organization of emergency management in Western Australia.”

Nairn has been sentenced for a period of seven months, of which she has to spend two months in prison.

In a similar incident of quarantine breach in Perth, a woman was sentenced to six months of imprisonment in August, BBC reported. Asher Faye Vander Sanden, 28, was permitted to fly home to Perth from Victoria, Southeast Australia. She was supposed to be on quarantine in a hotel for 14 days at her own expense. Instead of following protocols, she arrived secretly in a truck and stayed at her partner’s home, where she was later arrested.

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