L.L. Woodard

L.L. Woodard

Freelance writer/editor and freelance observer of life. Three decades of nursing experience in long-term care, from development of team care planning to hands-on patient care.
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School of Practical Nursing, graduated 1978; Geriatric Certification; Liberal Studies degree, BGSU


All that evil needs to succeed is for good men to do nothing.-Edmond Burke
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  • Some Progress in Diabetes Care, More Needed
    Researchers who examined data for the period 1999 through 2010 for signs of progress in diabetes care discovered both heartening information about the state of diabetes care and evidence that more progress in such care is yet needed.
  • More Older Adults Seeking Therapy for First Time
    In a trend that is occurring nationwide, more people age 80 years and older are seeking psychological counseling for the first time in their lives than have ever done so in the past, reported NYTimes.com.
  • Tulsa Dentist's Patients Test Positive for Blood-Borne Diseases
    When the unsanitary practices in the dental offices of Dr. W. Scott Harrington first came to light in March, it was as a result of one of the dentist's patients having tested positive for the blood-borne diseases HIV and hepatitis C.
  • 'Super' Germs Developing Faster Than Drugs Needed to Treat Them
    In March, Tom Frieden, M.D., M.P.H., director of the U.S. Centers for Disease Control and Prevention alerted the public to a family of 70 bacteria that have the propensity and ability to develop into "nightmare bacteria."
  • FDA Cites 30 Compounding Pharmacies for Unsanitary Practices
    The safety practices of compounding pharmacies in relation to preparation of sterile fluids came to the forefront in 2012, when products from the New England Compounding Center, NECC, were linked to the fungal meningitis outbreak that occurred.
  • Mental Health Issues Receive Nation's Attention
    Mental health issues have received much attention since the gunmen in the mass shootings that took place at Sandy Hook Elementary in Newtown, Conn. and in the Century movie theater in Aurora, Colo. are known to have, or have had, mental illness.
  • Research Reveals Another Heart-Unhealthy Component of Red Meat
    L-carnitine, a naturally-occurring substance in red meat and a chemical additive of many energy drinks, is associated with the development of atherosclerosis suggests the outcome of research published yesterday.
  • Tulsa Dentist's 'Mouthpiece' Defends 'Impeccable' Practice History
    Dr. W. Scott Harrington, the Tulsa-based dentist whose questionable safety and hygiene practices came to light March 29, has had his 'impeccable' practice record of 35 years defended in a public statement issued by his attorney.
  • Costs of Dementia Highest of Any Disease in U.S.
    Dementia care, including that of Alzheimer's disease and other conditions that result in cognitive losses, has costs so high that it tops that of the two leading causes of death in the United States, heart disease and cancer.
  • Cholesterol-Fighting Drug May Soon Prevent Blindness
    A new discovery by research scientists has identified the role cholesterol plays in contributing to age-related macular degeneration, AMD, the leading cause of blindness in older adults.
  • New Research Concludes Statin Side Effects in Question
    Research involving the examination of more than 107,000 patients at two Boston hospitals published today in the Annals of Internal Medicine concluded that at least some of the side effects associated with statins may be temporary.
  • FDA Approves First Drug of Its Kind for Type 2 Diabetes
    On March 29, the U.S. Food and Drug Administration approved the first of a new type of medication to treat type 2 diabetes. Nearly 26 million people have diabetes in the United States alone, with type 2 diabetes being the most common form.
  • Blood Testing Continues for Oklahoma Dentist's Patients
    More than 400 people who have been patients of Dr. W. Scott Harrington, the Tulsa, Okla., dentist whose practices are at the center of a health scare there lined up early Saturday for free blood testing, according to ABCNews.com.
  • 'Dirty' Dentist Office Linked to HIV, Hepatitis C Infection
    Patients of Dr. W. Scott Harrington, a dentist practicing for more than 30 years in Oklahoma will begin receiving notification letters from the Tulsa County Health Department of recommended testing for HIV, hepatitis B and hepatitis C.
  • Researchers Identify 'Haul' of New Genetic Markers for Cancer Risks
    To the layman, the science behind genetic discovery and its uses is mystifying until the scientific terms and methods are broken down into concepts readily understandable.
  • Hope on the Horizon for New Hepatitis C Treatment
    Although newer treatments have become available in recent years to treat the hepatitis C virus, HCV, but because they must be given with two other HCV treatments, substantial side effects and risk of drug interactions remain.
  • Horse Slaughter, Earthquake News in Oklahoma
    Oklahoma House Bill 1999, a measure that would allow horse slaughter in the state but maintains the ban for consuming horse meat in the state won approval from the Senate today and will be making its way to the desk of Gov. Mary Fallin for consideration.
  • Key to Long, Quality Life Tied to Social Connections
    Loneliness and social isolation may not go hand in hand as quality of life or longevity predictors, according to a study published Monday.
  • Oklahoma Graduates Women from New Prison Diversion Program
    Oklahoma County, the most populous county in the state of Oklahoma and site of the state capitol, celebrated yesterday the graduation of four women from its newly developed intensive rehabilitation program called ReMerge.
  • Oklahoma News Includes 1 Million Pound Weight Loss
    Oklahoma is often the center of controversy with its conservative legislature, governor and legislation, but it's also a state that "gets it right" on less highlypublicized issues.
  • Good News on Tuberculosis Incidence in the United States
    The United States has tuberculosis rates for 2012 and the preceding 20 consecutive years to celebrate on World TB Day, held each year on March 24, the anniversary of the announcement of the discovery of the organism responsible for the disease.
  • Feds Notify Oklahoma Insurance Commissioner They Will Enforce Law
    Even as the Oklahoma legislature works to get its Affordable Care Act nullification law through the Senate, the federal government, via the Centers for Medicare and Medicaid Services notified Oklahoma's state officials that the ACA will be enforced there.
  • 'Extra Caution' Yields New Recalls from Compounding Pharmacies
    In a nod to the contaminated injectable medicines that caused the U.S. fungal meningitis outbreak in the fall of 2012, two compounding pharmacies have exercised "extra caution" in recalling some potentially suspect medications.
  • IRS has $917 Million in Unclaimed Tax Refunds
    Baby boomers, seniors, Generation Xers and anyone who was an adult in 2009, the U.S. Internal Revenue Service has potentially good -- and surprising -- news for you.
  • Oklahoma Looks to Legalize Horse Slaughter
    Yesterday, the state House of Representatives passed HB 1021, preventing enforcement of the Affordable Care Act in the state while at the state capitol, several legislators and farmers voiced support of two measures to re-instate the slaughter of horses
  • Oklahoma House Approves Bills on Armed Teachers, Nullification of 'Obamacare'
    Both branches of the Oklahoma legislature have been busily considering proposed changes to state law, from Gov. Mary Fallin's request to a reduction in the state income tax rate to bills that were approved today by the House of Representatives.
  • Quality of Ovarian Cancer Treatment Varies Widely
    A variety of topics was presented in the field of gynecologic cancers, with one resonating not only among the conference's attendees, but also with the general public -- that of the varying degrees of the quality of treatment for ovarian cancer.
  • Deadly Skin Cancer Rate Drops in Women Who Take Aspirin
    In an analysis of data obtained in the Women's Health Initiative, WHI, Observational Study, OS, researchers established a preventive relationship between the regular use of aspirin and the incidence of melanoma, the most deadly form of skin cancer.
  • A Peek Inside Scientific Quest for the 'Fountain of Youth'
    Resveratrol, an organic compound found in quantity in red wine and dark chocolate, may well be the solution to preventing the diseases associated with aging, according to study results published March 8 in the journal Science.
  • Drug-Resistant Bacteria in Oklahoma, No Reporting to CDC
    On Tuesday, top officials of the U.S. Centers for Disease Control and Prevention sounded an alarm about what agency director, Tom Frieden, M.D., M.P.H. termed "nightmare bacteria," bacteria that have developed strong resistance to known antibiotics.
  • Move Over, Kids: Digital Games Found Good for Seniors
    If grandpa and grandma don't already own a video game system, gifting such a system to them may be in their best interest health-wise.
  • Knives and Bats on Planes: Recipe for Trouble?
    Air travel is as safe as ever, but is it? On Tuesday, the Transportation Security Administration issued a statement on changes in its prohibited items list, and it's a doozy.
  • Drug-Resistant Bacteria Pose Increasing Health Risks
    On Tuesday, the U.S. Centers for Disease Control and Prevention's director, Tom Frieden, M.D., M.P.H., sounded an alarm via a telebriefing about an antibiotic-resistant strain of bacteria that pose a triple-risk to health.
  • Study Demonstrates Heart-Healthiness of Mediterranean Diet
    All calories are not equal, nor are all fats -- that's at least part of what a seven-year study of the Mediterranean diet versus a low-fat diet revealed.
  • Flu Vaccine Barely Effective for U.S. Seniors
    The good news about the 2012-2013 influenza season in the United States is that for the fourth week in a row, health care providers reported that they are seeing fewer patients who have influenza-like illnesses, according to the CDC.
  • 17 Professional Physician Groups Support 'Choosing Wisely'
    In our current culture, patients and their health care providers are intended to be partners in developing unique treatment and preventive strategies best suited for the individual. Many people enjoy this partnership, but it can be a daunting undertaking.
  • Prescription Drugs Cause More Than Half of Deadly Drug Overdoses
    The United States has a drug problem, but it's not the illegal substances for which a drug war has been waged since the 1970s; more than half of fatal drug overdoses in 2010, were caused by prescription medications.
  • Sixth Person Dies from New SARS-like Virus
    The novel coronavirus, that public health authorities began to take note of in Sept. 2012 when nine people from Saudi Arabia, Jordan and Qatar became ill with SARS-like respiratory infections, has claimed the life of a man in Birmingham, England.
  • Course of Chronic Diseases Change with Community Interventions
    Wouldn't it be great if science finally gave us the silver bullet that would eliminate overweight and obesity -- and improve overall health at the same time? Would it be frustrating to learn that this "miracle" has been in front of our noses all the time?
  • Seasonal Flu on the Downswing in Oklahoma
    The 2012-2013 began a few weeks earlier in this current season; perhaps Oklahoma's current decrease in newly reported cases in mid-February demonstrates that continued trend of the peak of the flu season occurring within so many days/weeks after the onset
  • Health Experts Worldwide Monitor New SARS-like Virus
    Seasonal influenza isn't the only flu illness that causes concern for health experts; public health officials the world over are constantly monitoring what is and what may be developing in the area of viral illnesses.
  • Even Healthy Older Adults Hit Hard by Flu
    Cold weather and seasonal flu go hand in hand, and while we have the groundhog to provide insight into the length of winter, no one can say for certain when the 2012-2013 influenza season will taper off.
  • New Research Suggests Timing of Meals Affects Weight Loss
    While many of us still search for the magic bullet that will take and keep away extra pounds, medical science is doing what it can to improve health by unlocking the mysteries of weight control one piece at a time.
  • When the Chips Fall on Medicaid Expansion, Where Will Oklahoma Stand?
    Where will Oklahoma's uninsured be when the mandated expansion of Medicaid in 2014 by the Affordable Care Act goes into place throughout most of the nation -- but not in Oklahoma due to Gov. Mary Fallin's, R-Okla., decision for the state to opt out?
  • Study: Poor Sleep Affects Memory in Baby Boomers, Seniors
    You've heard people of various age groups laughingly refer to an occasional memory lapse as "having a senior moment." The humor of such a situation decreases proportionately with either increase in age or increase in such lapses -- or both.
  • Non-Partisan Studies Reveal Medicaid’s Changes, Shortcomings
    The Kaiser Family Foundation, a non-partisan organization that refers to itself as “a leader in health policy analysis, health journalism and communication” and one that runs its own research programs, released studies on research into changes in Medicaid
  • 30-Day Hospital Readmission Criteria May Be Faulty
    Section 3025 of the Affordable Care Act that became effective Oct. 1, 2012, requires that the Centers for Medicare & Medicaid Services, CMS, make reduced payments to participating hospitals with excessive 30 day readmission rates for discharges.
  • Overweight Americans Face Increased Risk of Death in Auto Accidents
    The costs and health concerns of being overweight or obese are far-reaching, and according to recent research, extend to the increased likelihood of death in auto accidents in the obese.
  • The Search for Successful Alzheimer's Treatments Moves in New Direction
    Alzheimer's disease is the most frequently seen form of dementia that robs those with the illness of their short term memories, and as the disease advances it leads to personality changes and loss of ability to function in activities of daily living.
  • Oklahoma Legislators Provide Glimpse into Upcoming Session
    The Oklahoma Legislature of 2013 will convene at noon on Feb. 4. If earlier years are any indication of how many proposals the state's elected officials will be considering, there could be 3,000 or so pieces of legislation up for grabs.
  • Tackle Health Care, Federal Spending and High Incarceration Rates in One Fell Swoop
    Wouldn't it be awe-inspiring if a single, common sense solution were available that would reduce federal spending, reduce taxpayer health care costs and reduce the rate at which our nation incarcerates people?
  • Flu Precautions and Treatment for Baby Boomers, Seniors
    The U.S. Centers for Disease Control and Prevention issued a health advisory to clinicians on Tuesday, listing a summary of the agency's recommendations for the use of influenza antiviral medications for the 2012-2013 flu season.
  • Oklahoma Flu Hospitalizations Mid-Season Top Last Season's Totals
    In this 2012-2013 flu season that began Sept. 30, the Sooner state has seen a total of 484 hospitalizations with the illness, compared to a total of 316 hospitalizations for the entire September through May 2011-2012 flu season.
  • One-Third of Americans Turn to Online Sources for Health Information
    In a nationwide survey conducted Aug. 7 through Sept. 6, 2012 of more than 3,000 people, answers to survey questions revealed 35 percent of Americans revealed they have at least gone once to the Internet to determine what a medical condition might be.
  • CDC Unsure if Widespread Flu Trend Will Rebound or Worsen
    Forty-seven of the 50 United States reported widespread influenza illness for the week ending Jan. 5. Twenty-four states and New York City reported high influenza-like illnesses, ILI, in the same time period.
  • Oklahoma Experiencing Widespread Influenza Along with Most of Nation
    Forty-two states are reporting widespread incidence of influenza; Oklahoma is one of them as are each of the states bordering it. In Thursday's influenza update, the Oklahoma State Department of Health reported eight deaths have resulted from the flu.
  • Report Suggests How to Improve Health Care and Save Money
    After learning just yesterday about the poor health of Americans relative to other democratic wealthy nations worldwide, it is heartening to learn that the Commonwealth Fund Commission has reported on ways to improve the quality and cost of health care.
  • America Continues to Come Up Short in Health and Lifespan
    A study requested by the U.S. government, jointly conducted by the National Research Council and the Institute of Medicine, resulted in a report that reveals the state of health and lifespan in the nation continues to fall behind other wealthy nations.
  • U.S. Flu Season Activity Peaks -- for Now
    The 2012-2013 influenza season began a month early this time around. Reports of flu-like illnesses and confirmed flu cases so far indicate peak reporting in the third week of Dec. 2012.
  • Major Cancer Death Rates Are Lower; Throat and Anal Cancer Incidence on the Rise
    While the latest Annual Report to the Nation on the Status of Cancer reveals positive news in the fact that the overall death rate from cancer has decreased, the statistics mean little to anyone has lost a loved one to the disease.
  • FDA Aims to Reduce Contaminated Food Via New Rules
    With one in six people in America developing a foodborne illness each year, the U.S. Food and Drug Administration is moving forward with the proposal of two new rules as required by the Food Safety Modernization Act, signed into law Jan. 1, 2011.
  • Three of Oklahoma's Universities Rank in Top 100 Public Colleges
    Three of Oklahoma's public universities have ranked within the top 100 public colleges in the nation, according to the annual ranking of such institutions of higher learning completed by Kiplinger's Personal Finance.
  • FDA Approves 39 New Drugs in 2012
    Both pharmaceutical companies and officials at the U.S. Food and Drug Administration have been busy; the drug companies compiling stats from clinical research trials, the FDA vetting applications to ensure the safety and efficacy of proposed new drugs.
  • Oklahoma New Year's Eve Opening Night Celebration 2013
    Even though the weather forecast holds rain for today and a slight chance that the showers could turn icy if the temperatures dip, the Opening Night celebrations planned in the state's capital city.
  • Oklahoma Drought Continues; Flu Season Mild Thus Far
    Drought levels have remain relatively the same, with the majority of the state experiencing extreme to exceptional levels of dryness. On a more positive note, seasonal flu data shows regional, mild activity.
  • Reverse Mortgages: Boon or Bane for Baby Boomers, Seniors?
    There can be few people who haven't seen the commercials with aged celebrities touting the virtues of reverse mortgages. But are reverse mortgages all they're cracked up to be; could they be the financial salvation baby boomers and their seniors need?
  • Medicare Quality Bonuses to Hospitals a Game-Changer
    As the Affordable Care Act moves toward its third anniversary, more of its incremental changes are being implemented. One of those changes, that of linking hospital quality of care with at least some of its Medicare reimbursement, is now in full swing.
  • CDC Provides New Update on Fungal Meningitis Outbreak of 2012
    The health risks of the fungal meningitis outbreak of 2012 that began in mid-September are still not behind those people unfortunate enough to have received contaminated injections of methylprednisolone acetate in 19 states.
  • Oklahoma Ranks Solidly in the Middle in Public Health Preparedness
    Public health readiness is a measure of a state's ability to provide basic health protections and safety for its residents. With many states' budgets being economically challenged, many states have had to reduce or eliminate essential services.
  • Obama: Pot Arrests Not a Priority but Not Off the Table Either
    The election of Nov. 7, 2012 will be remembered for many changes, but none any more potentially game-changing than voters in the states of Colorado and Washington legalizing the recreational use of marijuana.
  • Study: Talk Therapy May Help Depression when Medications Inadequate
    A first of it's kind of a large scale research study concluded that the addition of talk therapy to a medication regimen helps to relieve the symptoms of depression, the leading cause of disability in the United States in those ages 15 years to 44 years.
  • Medicare Open Enrollment Period Comes to a Close on Dec. 7
    Oklahoma residents age 65 or older and disabled residents have until midnight Friday to make their choices for supplement health insurance and/or prescription drug coverage -- as do the residents in the rest of the nation.
  • Flu Season Begins Earliest in a Decade
    Flu season has begun in the United States, according to Dr. Thomas Friedan, director of the Centers for Disease Control and Prevention. The good news: The vaccine available for the season matches up well with the flu already being reported.
  • New Cases, Death Rate Slows in Fungal Meningitis Outbreak
    If there's any positive news to be known about the fungal meningitis outbreak 2012, linked to tainted injectable medications, is that at long last the reports of new infections and deaths having occurred are coming in more slowly.
  • Oklahoma Employment Present is Good; Future Looks Even Brighter
    Wednesday's Bureau of Labor Statistics' report on employment/unemployment statistics reported by metropolitan areas throughout the nation revealed that Oklahoma City had the lowest unemployment rate among 49 major cities for the seventh month straight.
  • Second Panel of Experts Weigh in on Hep C Testing for Baby Boomers
    In August 2012, the U.S. Centers for Disease Control and Prevention issued the recommendation that all baby boomers get tested for hepatitis C. On Monday, the U.S. Preventive Services Task Force provided a draft opinion on the need for such testing.
  • Oklahoma and West Virginia Left Out of Education Grants 'Lottery'
    The U.S. Department of Education has $400 million in grant funds available to what will be 20 or so finalists around the nation to improve education in innovative and ambitious ways. Neither Oklahoma nor West Virginia will be seeing those grant dollars.
  • Rolling Stones Tour to Celebrate 50th Anniversary
    Consider this: Mick Jagger, 69, Keith Richards, 68, and Charlie Watts, 71, founding members of the Rolling Stones just completed the first step of their worldwide tour to celebrate the band's 50th anniversary.
  • Injection Site Infections Join Meningitis, Joint Infections from Tainted Drugs
    The more than 14,000 people who were potentially exposed to tainted injectable drugs through back or joint injections already have health concerns; yesterday public health officials announced that there is an increase in serious injection site infections.
  • Twinkies Union Deserves Some Empathy
    COMMENTARY | Before Twinkies lovers feel compelled to stone the Bakery, Confectionery, Tobacco Workers and Grain Millers International Union, BCTGM, for refusing to return to work by a Hostess-imposed deadline, let's consider the worker's side of the it.
  • Oklahoma Compounding Pharmacy Laws Some of Strictest in Nation
    Jerrod Roberts, owner of Flourish Integrative Pharmacy, wants people to know that it is not the science of compounding that is behind the current meningitis outbreak, but people working in the industry who are not following protocol, such as at NECC.
  • Massive Open Online Courses Revolutionizing Higher Education
    Perhaps you've heard of Massive Online Open Courses, MOOCs. The first such course so named was available in 2008, but it wasn't until 2011 that both institutions and the public entered the arena that may well change higher learning.
  • Oklahoma's Tom Coburn Exposes Non-Defense Military Spending
    Sen. Tom Coburn, R-Okla., is perhaps best known for his fiscal conservatism and annual publication of the Wastebook, yesterday provided a 73-page booklet about wasteful spending by the U.S. Department of Defense.
  • Oklahoma's Rate of Diabetes Triples in 16-Year Time Span
    There's plenty of bad news to go around much of the nation when it comes to the current rates of type 2 diabetes, but Oklahoma especially so, with a triple rate increase from 1995 through 2010.
  • Meningitis Outbreak 2012 May Be a Game-Changer
    Congress and the U.S. Food and Drug Administration are seeking remedies to prevent future situations from developing due to shoddy practices by compounding pharmacies who presently escape the strict oversight traditional pharmaceutical manufacturers face.
  • Long-term Multivitamin Use Benefits Questioned
    In the elusive search for the Fountain of Youth or the magic potion that will keep serious disease at bay, there is new research that demonstrates the search must continue.
  • Meningitis Outbreak Numbers Continue to Mount
    While it's a relief to learn that the rate of new cases of fungal meningitis is slowing down, some of the people who are slowly recovering from the meningitis are developing a second infection, this one located at the epidural injection site.
  • Study Demonstrates Damage of a Single Unhealthy Meal
    The rate of overweight and/or obese baby boomer Americans hovers in the 70+ percent range, indicating that people of this generation need to know and heed good nutrition. Dr. Anil Nigam presented a recent study that demonstrated just how important it is.
  • Compounding Pharmacies Feeling the Effects of NECC's Errors
    Closing the barn door after the horse has escaped doesn't help those it might encounter, but it does protect people from the many other horses that remain in the barn. This is analogous to what's going on with compounding pharmacies in some states now.
  • Meningitis Outbreak Updates and Insights
    Physicians, health experts, and public health officials continue to grapple with the ongoing outbreak of fungal meningitis related to contaminated vials of an injectable steroid medication.
  • Sununu and Cain: What Were They Thinking?
    COMMENTARY | Yesterday, retired Army General Colin Powell announced his endorsement of Barack Obama for re-election, citing concerns with Republican presidential candidate Mitt Romney's wavering views on foreign policy.
  • Could Donald Trump Be More Irrelevant?
    COMMENTARY | On Tuesday, the man who is a legend in his own mind, Donald Trump, made an announcement that he had an announcement to make that might effect the outcome of the upcoming presidential election.
  • Roe vs. Wade Decision Not Enough to Silence Politicians
    COMMENTARY | When some politicians open their mouths, few people listen. Other elected officials can't avoid controversy; each time they speak, people are listening and, very often, shaking their heads in disbelief.
  • Hormone Replacement Therapy for Women Reviewed
    Since 2005, the U.S. Preventive Services Task Force has recommended against such long-term use; guidelines published on Monday in the Annals of Internal Medicine reaffirmed the panel's 2005 statement.
  • Where is the Line for Personal/Parental Responsibility?
    COMMENTARY | I am not unsympathetic to the Maryland parents whose 14-year-daughter died in December 2011 from heart failure caused by caffeine toxicity that negatively impacted a pre-existing condition.
  • A Kinder, Gentler America Since Obama Took Office?
    It was once thought by some that the election of the first black president in the United States might result in an increase of racial hate crimes as a backlash. The latest FBI's Hate Crimes Statistics report shows that just the opposite happened.
  • Health Experts Sort Out Relevant Meningitis Outbreak Info
    As much as health experts and clinicians alike would like to have the answers to many questions related to the fungal meningitis outbreak in the United States, they also know that undue haste may provide false information with which to proceed.
  • What Needs to Be Done to Increase Overall Cancer Awareness?
    October is National Breast Cancer Awareness month, as it has been for more than 25 years. Since the invasive form of this potentially life-threatening illness will strike about one in eight American women, it is an important health topic.
  • Fungal Meningitis Outbreak Now in 16 States
    In what has turned out to be a real-life horror story for people who inadvertently received contaminated spinal injections and for the health care field in general, the news isn't getting any better.
  • Native American Tribes Boost Oklahoma's Economy
    Oklahoma has the largest population of Native Americans among all 50 states, a population that adds nearly $11 billion to the state's economy each and every year.
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