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Please do not include any personally identifiable patient information or confidential business where can i buy lasix information news in your comment. Start Further Info CAPT Meena Vythilingam, Director, Center for Health Innovation, Office of the Assistant Secretary for Health, Meena.Vythilingam@HHS.gov or 202 260 7382. End Further Info End Preamble Start Supplemental Information I. Background In response to the 2019 novel hypertension or hypertension medications lasix, the Secretary where can i buy lasix of Health and Human Services (HHS) declared a public health emergency effective January 27, 2020, under section 319 of the Public Health Start Printed Page 75022Service Act (42 U.S.C.

247d [] ) and renewed it continually since its issuance. The impact of the hypertension medications lasix on the nation's healthcare system has been complex, widespread, and potentially enduring. This unprecedented lasix has impacted the where can i buy lasix safety, quality, continuity, outcomes, value, and access to timely health care in numerous healthcare settings. Anecdotal reports as well as data from varied public sources confirmed that in addition to hypertension medications-related increases in mortality and morbidity, the mortality and morbidity for numerous non-hypertension medications-related medical conditions has also increased.[] The hypertension medications public health emergency is disproportionately affecting vulnerable populations, particularly the elderly, and racial and ethnic minorities.[] Local health systems with a significant burden of hypertension medications cases have faced multiple challenges including surge capacity, staffing, and supply chain issues, that directly impact access, quality, and experience of care for all medical conditions.[] Decreases in help-seeking behaviors in the context of the hypertension medications lasix may have also contributed to delays in accessing timely care, resulting in poor outcomes.[] In addition to the disruption in healthcare, the delivery of long-term services and supports (LTSS) to many seniors and people with disabilities has also been disrupted during the lasix.

In response to the hypertension medications lasix, medical providers, medical facilities, academic centers, and health systems rapidly reengineered healthcare policies and programs to ensure preservation of health care access, safety, quality, continuity, value, and outcomes. As a result, there has been a proliferation of innovative programs, policies, and best practices to prevent and mitigate the consequences of where can i buy lasix hypertension medications, while simultaneously preserving access to routine and emergency healthcare services for non-hypertension medications medical conditions.[] An example of the paradigmatic shift in the delivery of health care is the rapid adoption and scaling of telehealth services.[] Although the lasix disrupted the entire health care ecosystem in the U.S., it also provided an opportunity and impetus to innovate across the continuum of individual and population health, including screening, surveillance, prevention, treatment, supply chain management, and public health interventions. These changes may persist for the duration of the public health emergency, and potentially beyond it. HHS strongly supports innovation to preserve a resilient healthcare system in the face of the hypertension medications lasix and recognizes the importance of learning from effective and innovative approaches and best practices implemented by non-HHS healthcare systems, academic centers, and healthcare providers.

HHS will where can i buy lasix determine if these innovative approaches and best practices can help inform and/or improve HHS priorities and programs. II. Scope and Assumptions The main purpose of this Request for Information (RFI) is for HHS to gather information on effective innovative approaches and best practices in health care in response to the hypertension medications lasix by non-HHS health care systems and providers. The information provided will help inform and guide the HHS response to build where can i buy lasix a healthy and resilient nation.

This RFI includes innovations and best practices in health care for both hypertension medications and non-hypertension medications health conditions. The definition of “health” system or services and/or “healthcare” system or services, for the purposes of this RFI, is broad. We seek an understanding of effective best practices and innovations in the provision of services across the health and public health continuum by where can i buy lasix a variety of organizations. Responses can focus on select aspects or on the entire continuum of care, to include surveillance, screening, prevention, treatment, and/or public health interventions.

We are specifically interested in novel approaches and best practices that are associated with data confirming efficacy and/or effectiveness with demonstrated improvements in one or more of the following measures. Patient outcomes, access to health care, safety, quality, and/or where can i buy lasix value. Responses should include the following. ○ A description of the innovation/best practice.

○ The rationale for where can i buy lasix the implementation of the innovation/best practice. ○ Data and/or results confirming efficacy and/or effectiveness of the innovation/best practice, including demographic data. Control conditions. Outcomes measures where can i buy lasix (e.g., mortality, morbidity, health care access, safety, quality, cost, value, etc.).

Analytic strategy. And results. If the where can i buy lasix evaluation is currently underway, please describe the study design and expected timeline for completion of the study. ○ Costs associated with implementing the the innovation/best practice.

○ Have these innovations/best practices been incorporated as permanent organizational changes?. If not, where can i buy lasix why not?. ○ Can the innovation/best practice be scaled to larger, diverse groups and/or locations for a longer period?. If yes, please describe the potential impacts on outcomes.

○ Did where can i buy lasix or could specific HHS policies or programs facilitate the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice positively). ○ By contrast, did or could specific HHS policies or programs hinder the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the where can i buy lasix innovation/best practice negatively).

III. Information Requested/Key Questions Please respond to specific topics in which you have the most amount of evidence and expertise. Respondents are requested to share the objective results of where can i buy lasix an evaluation for each topic when possible. Response to every item is not required.

A. Health Promotion and Prevention of hypertension medications and where can i buy lasix Non-hypertension medications Medical Conditions Please provide the following information. —‹ A description of the innovation/best practice. ○ The rationale for the implementation of the innovation/best practice.

Start Printed Page 75023 ○ Data and/or results confirming efficacy and/or effectiveness where can i buy lasix of the innovation/best practice, including demographic data. Control conditions. Outcomes measures (e.g., mortality, morbidity, health care access, safety, quality, cost, value, etc.). Analytic strategy where can i buy lasix.

And results. If the evaluation is currently underway, please describe the study design and expected timeline for completion of the study. ○ Costs associated with implementing the the where can i buy lasix innovation/best practice. ○ Have these innovations/best practices been incorporated as permanent organizational changes?.

If not, why not?. ○ Can the innovation/best practice be scaled to larger, diverse groups and/or locations where can i buy lasix for a longer period?. If yes, please describe the potential impacts on outcomes. ○ Did or could specific HHS policies or programs facilitate the design and implementation of an innovation/best practice?.

(If yes, please provide details of how the policy or program affects or could affect the where can i buy lasix innovation/best practice positively). ○ By contrast, did or could specific HHS policies or programs hinder the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice negatively). 1 where can i buy lasix.

Describe effective innovations/best practices that prevented the transmission of hypertension s in staff, patients and/or beneficiaries. 2. Describe effective innovations/best practices to prevent hypertension outbreaks among residents and staff in long-term care facilities including assisted living where can i buy lasix facilities, nursing homes, rehabilitation facilities, intermediate care facilities for individuals with intellectual disabilities (ICF/ID), and palliative care settings. 3.

Describe innovative programs/policies and best practices to ensure timely access to health care and continuity of care for patients with chronic illnesses that increase vulnerability to hypertension medications. 4. Provide details on innovations or best practices that prevented increases in morbidity and mortality due to deferred care for acute medical conditions (e.g., cardiac arrests, strokes, etc.). 5.

Describe effective programs or practices that helped ensure timely administration of immunizations to pediatric patients and other vulnerable populations including the elderly and individuals with disabilities. 6. Elaborate on effective educational and messaging campaigns targeting prevention. 7.

Describe effective health promotion and prevention policies and programs implemented in response to hypertension medications, that will continue beyond this lasix. B. Screening/Surveillance/Case Identification of hypertension medications and Non-hypertension medications Medical Conditions Please provide the following information. ○ A description of the innovation/best practice.

○ The rationale for the implementation of the innovation/best practice. ○ Data and/or results confirming efficacy and/or effectiveness of the innovation/best practice, including demographic data. Control conditions. Outcomes measures (e.g., mortality, morbidity, health care access, safety, quality, cost, value, etc.).

Analytic strategy, and results. If the evaluation is currently underway, please describe the study design and expected timeline for completion of the study. ○ Costs associated with implementing the the innovation/best practice. ○ Have these innovations/best practices been incorporated as permanent organizational changes?.

If not, why not?. ○ Can the innovation/best practice be scaled to larger, diverse groups and/or locations for a longer period?. If yes, please describe the potential impacts on outcomes. ○ Did or could specific HHS policies or programs facilitate the design and implementation of an innovation/best practice?.

(If yes, please provide details of how the policy or program affects or could affect the innovation/best practice positively). ○ By contrast, did or could specific HHS policies or programs hinder the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice negatively). 1.

Describe effective approaches to screening, surveillance and case identification of hypertension medications. 2. Describe efforts to ensure that patients continue to receive United States Preventive Services Task Force-recommended screening procedures on time during the hypertension medications lasix. Please include data on the program's ability to prevent negative outcomes due to timely screening and early detection, if available.

3. Outline innovative programs to continue screening for HIV, hepatitis and sexually transmitted diseases during the lasix, (e.g., in syringe services programs (SSPs)). C. Treatment for hypertension medications and Non-hypertension medications Medical Conditions Please provide the following information.

○ A description of the innovation/best practice. ○ The rationale for the implementation of the innovation/best practice. ○ Data and/or results confirming efficacy and/or effectiveness of the innovation/best practice, including demographic data. Control conditions.

Outcomes measures (e.g., mortality, morbidity, health care access, safety, quality, cost, value, etc.). Analytic strategy, and results. If the evaluation is currently underway, please describe the study design and expected timeline for completion of the study. ○ Costs associated with implementing the the innovation/best practice.

○ Have these innovations/best practices been incorporated as permanent organizational changes?. If not, why not?. ○ Can the innovation/best practice be scaled to larger, diverse groups and/or locations for a longer period?. If yes, please describe the potential impacts on outcomes.

○ Did or could specific HHS policies or programs facilitate the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice positively). ○ By contrast, did or could specific HHS policies or programs hinder the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice negatively).

1. Describe innovations/best practices in hypertension medications treatment that resulted in decreased mortality and morbidity. 2. Describe if and how a health care system was effectively reengineered to ensure timely access and quality of care in the Emergency Department, Outpatient or Inpatient settings.

3. Describe how appropriate utilization of emergency medical services was facilitated during the lasix. 4. Detail effective changes in intensive care unit (ICU) care and post-hospital care/follow-up.

5. Detail best practices to ensure continuity of treatment for HIV, hepatitis and sexually transmitted diseases during the lasix.Start Printed Page 75024 6. Describe effective programs/policies to prevent/manage dental emergencies during the lasix. 7.

Outline novel and effective approaches to ensure compliance with medications, including refills, during the lasix. 8. Please list effective treatment-related policies or programs that will continue beyond the hypertension medications lasix. D.

Telehealth Please provide the following information. ○ A description of the innovation/best practice. ○ The rationale for the implementation of the innovation/best practice. ○ Data and/or results confirming efficacy and/or effectiveness of the innovation/best practice, including demographic data.

Control conditions. Outcomes measures (e.g., mortality, morbidity, health care access, safety, quality, cost, value, etc.). Analytic strategy, and results. If the evaluation is currently underway, please describe the study design and expected timeline for completion of the study.

○ Costs associated with implementing the the innovation/best practice. ○ Have these innovations/best practices been incorporated as permanent organizational changes?. If not, why not?. ○ Can the innovation/best practice be scaled to larger, diverse groups and/or locations for a longer period?.

If yes, please describe the potential impacts on outcomes. ○ Did or could specific HHS policies or programs facilitate the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice positively). ○ By contrast, did or could specific HHS policies or programs hinder the design and implementation of an innovation/best practice?.

(If yes, please provide details of how the policy or program affects or could affect the innovation/best practice negatively). 1. Describe effective best practices to deliver clinical and nonclinical services using telehealth (e.g., surveillance, prevention and treatment services, etc). 2.

Describe best practices and innovations to improve access to care for rural/remote populations using telehealth, during the lasix. 3. Detail effective use of remote monitoring/telemonitoring of chronic medical conditions including diabetes and hypertension and for delivering home health services. 4.

List criticial barriers to implement telehealth in healthcare systems. 5. What are some of the key facilitators of telehealth?. 6.

Outline innovative approaches to integrate telehealth into the clinical work flow. 7. List effective telehealth programs that will continue beyond this lasix. 8.

Describe technological systems that facilitate telehealth, including use of audio or video telehealth, telehealth programs or apps, or other approaches. 9. Describe technological systems that might or might not facilitate telehealth, including uses of audio or video telehealth, telehealth programs or apps, or other approaches. E.

Mental Health/Behavioral Health and Substance Use Disorder Innovations/Best Practices Please provide the following information. ○ A description of the innovation/best practice. ○ The rationale for the implementation of the innovation/best practice. ○ Data and/or results confirming efficacy and/or effectiveness of the innovation/best practice, including demographic data.

Control conditions. Outcomes measures (e.g., mortality, morbidity, health care access, safety, quality, cost, value, etc.). Analytic strategy, and results. If the evaluation is currently underway, please describe the study design and expected timeline for completion of the study.

○ Costs associated with implementing the the innovation/best practice. ○ Have these innovations/best practices been incorporated as permanent organizational changes?. If not, why not?. ○ Can the innovation/best practice be scaled to larger, diverse groups and/or locations for a longer period?.

If yes, please describe the potential impacts on outcomes. ○ Did or could specific HHS policies or programs facilitate the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice positively). ○ By contrast, did or could specific HHS policies or programs hinder the design and implementation of an innovation/best practice?.

(If yes, please provide details of how the policy or program affects or could affect the innovation/best practice negatively). 1. Describe effective, novel mental health prevention and/or treatment programs in response to the hypertension medications lasix. 2.

Describe effective and innovative substance use disorder programs during the hypertension medications lasix. 3. Describe innovative efforts to provide medication-assisted treatment, including access to counseling and support groups, during the lasix. 4.

Provide information on effective suicide prevention programs implemented during the lasix. 5. Provide information on effective programs designed to identify childhood abuse, elder abuse and/or domestic violence during the lasix. 6.

Detail effective approaches to prevent hypertension medications transmission in psychiatric and substance use disorder residential and group treatment facilities. F. Population-Level Interventions Please provide the following information. ○ A description of the innovation/best practice.

○ The rationale for the implementation of the innovation/best practice. ○ Data and/or results confirming efficacy and/or effectiveness of the innovation/best practice, including demographic data. Control conditions. Outcomes measures (e.g., mortality, morbidity, health care access, safety, quality, cost, value, etc.).

Analytic strategy, and results. If the evaluation is currently underway, please describe the study design and expected timeline for completion of the study. ○ Costs associated with implementing the the innovation/best practice. ○ Have these innovations/best practices been incorporated as permanent organizational changes?.

If not, why not?. ○ Can the innovation/best practice be scaled to larger, diverse groups and/or locations for a longer period?. If yes, please describe the potential impacts on outcomes. ○ Did or could specific HHS policies or programs facilitate the design and implementation of an innovation/best practice?.

(If yes, please provide details of how the policy or program affects or could affect the innovation/best practice positively). ○ By contrast, did or could specific HHS policies or programs hinder the design and implementation of an innovation/best practice?. (If yes, please provide details of how the policy or program affects or could affect the innovation/best practice negatively). 1.

Describe innovations/best practices in preventing and/or treating hypertension medications in high risk and vulnerable populations including but not limited to, African-Americans, Asian Americans, Start Printed Page 75025Hispanics/Latinos, American Indians/Alaska Natives, persons with disabilities, persons with limited English proficiency and others who might have been disproportionately impacted by hypertension medications, directly or because treatment for other medical conditions has been disrupted. 2. Provide details on effective, community-based, innovative programs to improve population health during the hypertension medications lasix (e.g., programs to address social determinants of health). 3.

Outline effective and innovative approaches to address health disparities across the continuum of care during the hypertension medications lasix. 4. Detail effective approaches to address social isolation in vulnerable populations including older-adults and people with disabilities in both institutional and community settings. G.

Other Topics 1. Please describe effective strategies to address other critical barriers, including work force concerns, provider well-being, supply chain, etc., to ensure continuity of operations in a healthcare system. 2. Outline best practices to ensure seamless delivery of long-term services and supports (LTSS) to residents of group homes for individuals with disabilities, and other recipients of home-and-community-based services during the lasix.

3. Detail new programs/policies and efforts that were implemented during the lasix, but found to be ineffective in improving healthcare access, safety, quality, continuity, value and outcomes. 4. Please describe other input not already covered by the previous topics.

HHS encourages all potentially interested parties including individuals, healthcare providers, networks and/or associations, academic researchers and institutions, non-HHS federal healthcare systems, non-governmental organizations, and private sector entities to respond. IV. How To Submit Your Response Please upload your responses to each question in this Innovation RFI response tool which has clearly marked sections for individual questions. Please respond concisely, in plain language, and in narrative format.

You may respond to some or all of the questions listed in the RFI. Please ensure it is clear which question you are responding to. You may also include links to online material or interactive presentations. Please note that this is a request for information (RFI) only.

In accordance with the implementing regulations of the Paperwork Reduction Act of 1995 (PRA), specifically 5 CFR 1320.3(h) (4), this general solicitation is exempt from the PRA. Facts or opinions submitted in response to general solicitations of comments from the public, published in the Federal Register or other publications, regardless of the form or format thereof, provided that no person is required to supply specific information pertaining to the commenter, other than that necessary for self-identification, as a condition of the agency's full consideration, are not generally considered information collections and therefore not subject to the PRA. This RFI is issued solely for information and planning purposes. It does not constitute a Request for Proposal (RFP), applications, proposal abstracts, or quotations.

This RFI does not commit the U.S. Government to contract for any supplies or services or make a grant award. Further, we are not seeking proposals through this RFI and will not accept unsolicited proposals. We note that not responding to this RFI does not preclude participation in any future procurement, if conducted.

It is the responsibility of the potential responders to monitor this RFI announcement for additional information pertaining to this request. HHS may or may not choose to contact individual responders. Such communications would be for the sole purpose of clarifying statements in written responses. Contractor support personnel may be used to review responses to this RFI.

Responses to this notice are not offers and cannot be accepted by the Government to form a binding contract or issue a grant. Information obtained as a result of this RFI may be used by the Government for program planning on a non-attribution basis. This RFI should not be construed as a commitment or authorization to incur cost for which reimbursement would be required or sought. All submissions become U.S.

Government property. And will not be returned. Start Signature Dated. November 5, 2020.

Eric D. Hargan, Deputy Secretary, Department of Health and Human Services (HHS). End Signature End Supplemental Information [FR Doc. 2020-25795 Filed 11-23-20.

8:45 am]BILLING CODE 4150-28-PThis document is unpublished. It is scheduled to be published on 12/02/2020. Once it is published it will be available on this page in an official form. Until then, you can download the unpublished PDF version.

Although we make a concerted effort to reproduce the original document in full on our Public Inspection pages, in some cases graphics may not be displayed, and non-substantive markup language may appear alongside substantive text. If you are using public inspection listings for legal research, you should verify the contents of documents against a final, official edition of the Federal Register. Only official editions of the Federal Register provide legal notice to the public and judicial notice to the courts under 44 U.S.C. 1503 &.

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Personally, I think sitting has gotten a bad where can i buy lasix rap, and what we really need to do is look at our lack of physical activity overall. When we sit every day for our job, it can have a negative impact on the body, but an overall lack of physical activity is much more concerning than sitting itself. When we sit, our bodies adapt to that position. There are several things that occur, such as a where can i buy lasix tightening of the hamstrings and a forward head and rounded shoulder posture.

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Their legs will then form a “W.” Often, babies also transition back to a single hip, toward a side sitting position. When a where can i buy lasix baby varies his or her sitting position, W-sitting is rarely a problem. However, when a baby sits back straight to a W-sit consistently, they don’t get the opportunity to elongate and activate lateral trunk muscles to develop their core muscles. W-sitting is a very stable position that children find useful, however, it allows them to play without developing muscle that provide the ability for kids to reach out to where can i buy lasix their sides or rotate across their midline, leading to underdevelopment of lower trunk muscles, which stabilize the pelvis.

When a child uses this position as their preference without the normal variety in movements, it can affect development. They may demonstrate an in-toeing gait, core where can i buy lasix weakness or balance difficulties. The hips are positioned in extreme internal rotation, placing stress on the hips and the knee joints. This can lead to hip and knee orthopedic issues as the child develops.

So, what can you do to prevent any development issues? where can i buy lasix. Encourage your child to alternate sitting positions, such as side sitting (alternating sides), ring sitting, or, with older children, sitting in a chair or on a ball. This might be challenging initially, but once your child gets used to where can i buy lasix it, they may just need reminders. If it’s difficult for your child to sit in alternate positions or they begin to show other developmental concerns, a referral to a physical therapist may be helpful to facilitate trunk muscle development.

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Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USAPublication date:01 September 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as hypertension medications, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USAPublication date:01 September 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as hypertension medications, asthma, COPD, child lung health and where can i buy lasix the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details. The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health.

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If you visit a MidMichiganHealth facility during the month of October, you may notice staff wearing pinkand blue ribbons to show their support. We will also participate in theInternational Wave of Light, a worldwide remembrance event on is lasix for dogs the same as for humans October 15, 7 to 8p.m. During this time, candles will be lit at the entrances of MidMichigan’sMedical Centers in Alma, Alpena, Midland and West Branch (the sites of our fourMaternity Centers) to honor babies gone too soon and their families.

Patients,staff and is lasix for dogs the same as for humans community members are welcome to attend. Resources for Grieving Parents Your primarycare doctor or OB/Gyn can be a good first contact to help you understand thephysical and emotional impact of a loss and to identify other resources. MidMichiganHome Care offers grief support for individuals and families who have lost aloved one, including education, support groups, short-term is lasix for dogs the same as for humans counseling and referralsto community professionals for longer-term follow-up.

For more information,visit www.midmichigan.org/grief-supportor call (800) 862-5002. There are is lasix for dogs the same as for humans manylocal and national nonprofits that specialize in helping families throughinfant and pregnancy loss. Their services range from resources and materialsthat discuss what families can expect during the grieving process, to in-personand online support groups to financial assistance with funeral and otherexpenses.

Some organizations focus on certain bereaved family is lasix for dogs the same as for humans members, such asparents or siblings, or on specific causes of perinatal death. Consider callingUnited Way’s 2-1-1 hotline to identify local agencies in your area that mayprovide targeted grief services. What to Say When Someone Loses a Child People tend is lasix for dogs the same as for humans totreat pregnancy or infant loss as a taboo subject, so loved ones are oftenuncomfortable or unfamiliar with what to say or do.

Some well-meaning peoplemay even say things that are more hurtful than helpful. Experts recommend keepingyour condolences simple, following the family’s cues, and is lasix for dogs the same as for humans asking about theirpreferences if you straight from the source are unsure. Tips.

Acknowledgetheir loss in short, simple phrases, such as, “I’m sorry for your loss.” Or “Iimagine this must be painful for you.” Offer to listen if they want to talk.It’s also okay to simply admit that you don’t know what to say.Askwhether it is okay to talk about the baby and to use the baby’s name.Peopleoften treat miscarriage as “no big deal,” but the value of is lasix for dogs the same as for humans a life is notproportional to the time spent on earth. When a family loses a child, they losethe entire future they had dreamed for themselves and that child. A lifetime ofmilestones and memories is lasix for dogs the same as for humans.

In some cases, they may not have another opportunityto become parents, which can compound their grief. Avoidstatements that downplay their emotions, tell them how to feel, attempt to finda “silver lining” in their grief, or are based on religion, is lasix for dogs the same as for humans such as:Perhapsit was for the best.Godmust have wanted your special angel to be with him.You’reyoung. You can still have another child.Atleast now you know you can get pregnant.Atleast you didn’t really know him/her.Atleast you weren’t that far along.Rememberthe father, siblings and other family members.

The focus tends to be on mothers,but the whole family may need is lasix for dogs the same as for humans your support. Be aware that men may feel the needto “be strong” which can impede their grieving process.Offerto help with specific tasks. People who are grieving may is lasix for dogs the same as for humans not be able toidentify their needs or ask for help.

You can offer to help with caring forother children, preparing meals, doing housework, funeral preparations, notifyingextended family or friends, or creating a special memento or ritual to rememberthe baby. Remember that is lasix for dogs the same as for humans help and support may be especially needed after otherhelpers have moved on.Acknowledgethem as parents. This isoften overlooked if they don’t have living children, yet they are parents andshould be supported and addressed as parents.Rememberthem in years to come.

Call, send a card, or offer to is lasix for dogs the same as for humans spend time with them onmilestone days. Grief does not end with the delivery or memorial service. You can findmore helpful tips at these and other websites:.

Each year, more than a million families in the United States experience a where can i buy lasix miscarriage, stillbirth or death of an infant. Yet because these events can be emotionally difficult to discuss, there is little public awareness, so families may not always get the support they need. October is Pregnancy and Infant Loss Awareness Month, a time to show support for where can i buy lasix these families, highlight available resources and build understanding of how family, friends and the community can help. If you visit a MidMichiganHealth facility during the month of October, you may notice staff wearing pinkand blue ribbons to show their support. We will also participate in theInternational Wave of Light, a worldwide remembrance where can i buy lasix event on October 15, 7 to 8p.m.

During this time, candles will be lit at the entrances of MidMichigan’sMedical Centers in Alma, Alpena, Midland and West Branch (the sites of our fourMaternity Centers) to honor babies gone too soon and their families. Patients,staff and where can i buy lasix community members are welcome to attend. Resources for Grieving Parents Your primarycare doctor or OB/Gyn can be a good first contact to help you understand thephysical and emotional impact of a loss and to identify other resources. MidMichiganHome Care offers grief support for individuals and families who have lost aloved one, including where can i buy lasix education, support groups, short-term counseling and referralsto community professionals for longer-term follow-up. For more information,visit www.midmichigan.org/grief-supportor call (800) 862-5002.

There are manylocal where can i buy lasix and national nonprofits that specialize in helping families throughinfant and pregnancy loss. Their services range from resources and materialsthat discuss what families can expect during the grieving process, to in-personand online support groups to financial assistance with funeral and otherexpenses. Some organizations focus on certain where can i buy lasix bereaved family members, such asparents or siblings, or on specific causes of perinatal death. Consider callingUnited Way’s 2-1-1 hotline to identify local agencies in your area that mayprovide targeted grief services. What to Say When where can i buy lasix Someone Loses a Child People tend totreat pregnancy or infant loss as a taboo subject, so loved ones are oftenuncomfortable or unfamiliar with what to say or do.

Some well-meaning peoplemay even say things that are more hurtful than helpful. Experts recommend where can i buy lasix keepingyour condolences simple, following the family’s cues, and asking about theirpreferences if you are unsure. Tips. Acknowledgetheir loss in short, simple phrases, such as, “I’m sorry for your loss.” Or “Iimagine this must be painful for you.” Offer to listen if they want to talk.It’s also okay to simply admit that you don’t know what to say.Askwhether it is okay to talk about the where can i buy lasix baby and to use the baby’s name.Peopleoften treat miscarriage as “no big deal,” but the value of a life is notproportional to the time spent on earth. When a family loses a child, they losethe entire future they had dreamed for themselves and that child.

A lifetime where can i buy lasix ofmilestones and memories. In some cases, they may not have another opportunityto become parents, which can compound their grief. Avoidstatements that downplay their emotions, tell them how to feel, attempt to finda “silver lining” where can i buy lasix in their grief, or are based on religion, such as:Perhapsit was for the best.Godmust have wanted your special angel to be with him.You’reyoung. You can still have another child.Atleast now you know you can get pregnant.Atleast you didn’t really know him/her.Atleast you weren’t that far along.Rememberthe father, siblings and other family members. The focus tends to be on mothers,but the whole family where can i buy lasix may need your support.

Be aware that men may feel the needto “be strong” which can impede their grieving process.Offerto help with specific tasks. People who are grieving may not be able toidentify their needs or ask for where can i buy lasix help. You can offer to help with caring forother children, preparing meals, doing housework, funeral preparations, notifyingextended family or friends, or creating a special memento or ritual to rememberthe baby. Remember that help and support may be especially needed after otherhelpers have moved on.Acknowledgethem where can i buy lasix as parents. This isoften overlooked if they don’t have living children, yet they are parents andshould be supported and addressed as parents.Rememberthem in years to come.

Call, send a card, or offer to where can i buy lasix spend time with them onmilestone days. Grief does not end with the delivery or memorial service. You can findmore helpful tips at these and other websites:.

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Amid mounting lasix prescription concerns over the U.S. Pharmaceutical supply chain, a Department of Defense watchdog found an overreliance on foreign suppliers that could harm national security and that the Pentagon failed to assess the risks of shortages or develop strategies to mitigate disruptions.Among the shortcomings, the Defense Department did not aggregate and analyze the origins of finished medicines or active ingredients to determine the reliance on foreign suppliers or identify gaps in information about where the products are made, according to the Office of Inspector General at DOD. The OIG report also noted the military is not required to run lasix prescription such analyses. Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!. GET STARTED Log In | Learn lasix prescription More What is it?.

STAT+ is STAT's premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care lasix prescription disruption in Silicon Valley and beyond. What's included?. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.An expert task force on Thursday released a new and much-anticipated approach for diagnosing kidney function, saying there is no need for controversial algorithms that consider race in the assessment of kidney disease.The new recommendations come lasix prescription as a victory for a growing number of physicians and activists who argue the use of race-based tools in medicine is outdated and wrong because race is not a good proxy for genetic difference — and sends the message that some races are biologically inferior. Many also argue that the separate racial thresholds for classifying kidney disease underestimate the extent of disease in Black patients, leaving them less likely to receive the speciality kidney care they need or be placed on transplant waitlists.Black Americans are four times more likely than white Americans to have kidney failure and, despite having higher rates of end-stage kidney disease, are less likely to receive kidney transplants.advertisement Using equations, or algorithms, to refine lab results is a long-standing practice in medicine.

The first commonly used equations for assessing kidney function came into place in the mid-1970s, and may have been lasix prescription faulty from the start because they were based on a patient sample that included only white men. Those equations were first adjusted for sex. Then, in the late 1990s, when studies showed Black patients had higher average levels of creatinine — a byproduct of muscle metabolism that is a marker for kidney function — than white patients, the equations were adjusted for race, in an effort to provide more accurate estimates. But using race as a proxy for genetics is problematic since studies show race is not always reported accurately or inclusive lasix prescription of people who are multiracial. Some of those early studies on creatinine levels were likely imprecise, with one determining race “probably by examination of skin color.” Ancestry can be far more important than race in determining genetic susceptibility to disease, but is rarely tested for in most clinic settings.

Many also argue there is no biologically plausible reason to explain why some Black patients may have higher serum creatinine levels and that levels of the marker can vary more between people from the same race than in people from different races.advertisement The task force report recommends the use of a revised equation with no racial correction to estimate kidney function (or GFR, glomerular fiation rate) using lasix prescription serum creatinine. The equation is called “the eGFR 2021 CKD EPI creatinine equation” and is considered a “refit” equation because it doesn’t simply drop the racial correction from the previously used equation, but was recalculated using data from a large and diverse pool of patients. The new equation lasix prescription is one of 26 approaches considered by the task force.Because creatinine tests are useful for screening but may need further confirmation, the report makes a second recommendation. It encourages clinicians who need more information about kidney function to order tests for a different blood marker — cystatin C — which, when used with creatinine, provides a better indicator of kidney function than either test alone. (Cystatin C has not been used routinely as a marker because tests for it are not available in most labs or on high volume analyzers lasix prescription and it is also more expensive.

Task force members hope these things will change in the near future as demand for the better test grows.)“If I had my way, I’d want everyone to go out and have the option to use these [combination] tests tomorrow, but this isn’t yet in every lab,” said Lesley A. Inker, a task force member and director of the Kidney Function and Evaluation Center at Tufts Medical Center who led the CKD-EPI research lasix prescription team that developed the new equations. For now, she said, the new equations that do not include race provide highly accurate results and can be used immediately. The task force report was issued on the same day as two new reports in the New England Journal of Medicine, one that showed that cystatin C works better lasix prescription as a diagnostic tool, and one that described the new recommended equations and showed, while not perfect, they were far more accurate in Black patients and off by only minor amounts in non-Black patients. An editorial in the journal said shedding the race correction was an important step that could lead to earlier identification and care of patients most at risk.Complaints over the use of racial algorithms have been bubbling for years but grew increasingly loud last year as a widespread racial reckoning spread across the country.

Due to concerns raised by medical students and trainees, some large hospital systems, including at Vanderbilt University and the University of Washington, have already dropped the racial correction, while others were awaiting the task force report for guidance.Some nephrologists had argued that dropping the race correction could lead to other inequities for Black patients, such as improper dosing for some medicines and chemotherapy, not being eligible for life insurance due to being diagnosed with kidney disease, or not being able to become kidney donors.Saying they did not want to cause additional harm with new recommendations, the 14-member task force of the National Kidney Foundation and American Society of Nephrology waded through these issues deliberatively, considering hundreds of papers, hours of expert testimony, and input from patients. The panel unanimously agreed that the use of race in assessments was lasix prescription not appropriate. €œI’m glad we could uphold medical quality with utmost scientific rigor while embracing social change,” said Cynthia Delgado, an associate professor at the University of California, San Francisco, and associate chief of nephrology at the San Francisco VA Medical Center who was a co-chair of the task force. €œPatients can be reassured there is equity in how they are being assessed.”While task force leaders said they could not discuss their internal deliberations, some said the debate was contentious at times and that it took the lasix prescription group longer than expected — an entire year — to reach consensus. Some had worried the task force might take years to arrive at a decision, or postpone a decision by issuing a call for more data.

NKF President Paul Palevsky, a nephrologist, lasix prescription hailed the decision as a major improvement that will be a step toward health equity in his field, but said much more needed to be done. €œIncluding race in equations for GFR, or any other algorithms in medicine, delivers the wrong message. It reinforces this concept that skin color drives biology, which lasix prescription is not the case,” he said. €œBut anyone who thinks this is the whole solution, that we’re done addressing race and racism in the treatment of kidney disease is deluding themselves.”Vanessa Grubbs, a San Francisco Bay Area nephrologist who has been fighting against the algorithms for more than a decade, said “the fact that it took a national task force to do this shows how entrenched systemic racism is in medicine.”“It’s great they did this, but the fact that it took years, and I don’t know how many meetings deliberating what we already knew, shows how obsessed this country is with trying to prove the races are inherently different,” Grubbs said.Palevsky said the recommendation to use a “refit” creatinine equation without a racial correction would require no changes or upgrades to laboratory equipment, just changes to software and possibly the codes used to facilitate the exchange or pooling of lab results. His foundation has been lasix prescription prepping and educating leaders of labs that process medical tests.

€œThey have been very engaged,” he said. €œThey are primed for lasix prescription this.”He said patients could check kidney function under the revised equation using a calculator on the NKF website. Many Black patients whose kidney function may have been underestimated using the racial correction may find themselves moved into an advanced stage of disease, or even to the point where they would be recommended for a transplant. He advised patients to discuss any concerns with their physician or a nephrologist. Mallika L.

Mendu is a nephrologist who served on the task force and executive medical director of clinical operations for Brigham Health, which abandoned the race correction for kidney diagnostics in June 2020 after protests by medical students and residents. Wondering how removal of the racial correction would affect patients, she helped conduct a study to see how some 2,000 Black kidney patients in the Mass General Brigham health care system would be reclassified.Mendu found that removing the race multiplier led to 1 in 3 patients being reclassified with more severe kidney disease, with many moving into stage 4, the final stage before kidney failure. She also found 64 patients who had not previously been eligible meeting criteria for kidney transplants. Her findings, she said, supported removing the race-based algorithms that she had not previously questioned.“Honestly, I took this as gospel, I didn’t even think about it. It shows you our generation didn’t always question what we were taught,” said Mendu, who graduated from medical school in 2009.

€œIt makes me really proud of this generation of medical students who are questioning everything.”Mendu said the medical student protests, which started in her hospital around 2016, made her reexamine the algorithms she’d long taken for granted as correct. €œA lot of people said, ‘This is based on good science. Don’t open this can of worms.’ But when I looked at it, it didn’t make sense to me,” she said.While she’s happy with the new recommendations, Mendu said she, like other task force members, thinks the work needed to end health disparities in her field is only beginning. Her study showed that even when Black patients qualified for transplant under the racially corrected algorithm, they were still rarely referred for transplant. €œMy hope,” she said, “is that this is the start of conversation to end these truly profound disparities.”.

Amid mounting concerns over the U.S where can i buy lasix. Pharmaceutical supply chain, a Department of Defense watchdog found an overreliance on foreign suppliers that could harm national security and that the Pentagon failed to assess the risks of shortages or develop strategies to mitigate disruptions.Among the shortcomings, the Defense Department did not aggregate and analyze the origins of finished medicines or active ingredients to determine the reliance on foreign suppliers or identify gaps in information about where the products are made, according to the Office of Inspector General at DOD. The OIG report where can i buy lasix also noted the military is not required to run such analyses. Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!.

GET STARTED Log In | Learn More What is it? where can i buy lasix. STAT+ is STAT's premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical where can i buy lasix trial results, and health care disruption in Silicon Valley and beyond. What's included?.

Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day where can i buy lasix STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.An expert task force on Thursday released a new and much-anticipated approach for diagnosing kidney function, saying there is no need for controversial algorithms that consider race in the assessment of kidney disease.The new recommendations come as a victory for a growing number of physicians and activists who argue the use of race-based tools in medicine is outdated and wrong because race is not a good proxy for genetic difference — and sends the message that some races are biologically inferior. Many also argue that the separate racial thresholds for classifying kidney disease underestimate the extent of disease in Black patients, leaving them less likely to receive the speciality kidney care they need or be placed on transplant waitlists.Black Americans are four times more likely than white Americans to have kidney failure and, despite having higher rates of end-stage kidney disease, are less likely to receive kidney transplants.advertisement Using equations, or algorithms, to refine lab results is a long-standing practice in medicine. The first commonly used equations for assessing kidney function came into place in the mid-1970s, and may have been faulty from the where can i buy lasix start because they were based on a patient sample that included only white men. Those equations were first adjusted for sex.

Then, in the late 1990s, when studies showed Black patients had higher average levels of creatinine — a byproduct of muscle metabolism that is a marker for kidney function — than white patients, the equations were adjusted for race, in an effort to provide more accurate estimates. But using race as a proxy for genetics is problematic since studies show race is not always reported accurately or where can i buy lasix inclusive of people who are multiracial. Some of those early studies on creatinine levels were likely imprecise, with one determining race “probably by examination of skin color.” Ancestry can be far more important than race in determining genetic susceptibility to disease, but is rarely tested for in most clinic settings. Many also argue there is no biologically plausible reason to explain why some Black patients may have higher serum creatinine levels and that levels of the marker can vary more between people from the same race than in people from different races.advertisement The task force report recommends the use of a revised equation with no racial correction to estimate kidney function (or GFR, where can i buy lasix glomerular fiation rate) using serum creatinine.

The equation is called “the eGFR 2021 CKD EPI creatinine equation” and is considered a “refit” equation because it doesn’t simply drop the racial correction from the previously used equation, but was recalculated using data from a large and diverse pool of patients. The new equation is one of 26 approaches considered by the task force.Because creatinine tests are useful for screening but may need further confirmation, the report makes a second recommendation where can i buy lasix. It encourages clinicians who need more information about kidney function to order tests for a different blood marker — cystatin C — which, when used with creatinine, provides a better indicator of kidney function than either test alone. (Cystatin C has not been used routinely as a marker because tests for it are not available in most labs or on where can i buy lasix high volume analyzers and it is also more expensive.

Task force members hope these things will change in the near future as demand for the better test grows.)“If I had my way, I’d want everyone to go out and have the option to use these [combination] tests tomorrow, but this isn’t yet in every lab,” said Lesley A. Inker, a task force member and director of the Kidney Function and where can i buy lasix Evaluation Center at Tufts Medical Center who led the CKD-EPI research team that developed the new equations. For now, she said, the new equations that do not include race provide highly accurate results and can be used immediately. The task force report was issued on the same day as two new reports in the New where can i buy lasix England Journal of Medicine, one that showed that cystatin C works better as a diagnostic tool, and one that described the new recommended equations and showed, while not perfect, they were far more accurate in Black patients and off by only minor amounts in non-Black patients.

An editorial in the journal said shedding the race correction was an important step that could lead to earlier identification and care of patients most at risk.Complaints over the use of racial algorithms have been bubbling for years but grew increasingly loud last year as a widespread racial reckoning spread across the country. Due to concerns raised by medical students and trainees, some large hospital systems, including at Vanderbilt University and the University of Washington, have already dropped the racial correction, while others were awaiting the task force report for guidance.Some nephrologists had argued that dropping the race correction could lead to other inequities for Black patients, such as improper dosing for some medicines and chemotherapy, not being eligible for life insurance due to being diagnosed with kidney disease, or not being able to become kidney donors.Saying they did not want to cause additional harm with new recommendations, the 14-member task force of the National Kidney Foundation and American Society of Nephrology waded through these issues deliberatively, considering hundreds of papers, hours of expert testimony, and input from patients. The panel unanimously agreed that the use where can i buy lasix of race in assessments was not appropriate. €œI’m glad we could uphold medical quality with utmost scientific rigor while embracing social change,” said Cynthia Delgado, an associate professor at the University of California, San Francisco, and associate chief of nephrology at the San Francisco VA Medical Center who was a co-chair of the task force.

€œPatients can be reassured there is equity in how they are being assessed.”While task force leaders said they could not discuss their internal deliberations, some said the debate was contentious at times where can i buy lasix and that it took the group longer than expected — an entire year — to reach consensus. Some had worried the task force might take years to arrive at a decision, or postpone a decision by issuing a call for more data. NKF where can i buy lasix President Paul Palevsky, a nephrologist, hailed the decision as a major improvement that will be a step toward health equity in his field, but said much more needed to be done. €œIncluding race in equations for GFR, or any other algorithms in medicine, delivers the wrong message.

It reinforces this concept that skin color drives biology, which is where can i buy lasix not the case,” he said. €œBut anyone who thinks this is the whole solution, that we’re done addressing race and racism in the treatment of kidney disease is deluding themselves.”Vanessa Grubbs, a San Francisco Bay Area nephrologist who has been fighting against the algorithms for more than a decade, said “the fact that it took a national task force to do this shows how entrenched systemic racism is in medicine.”“It’s great they did this, but the fact that it took years, and I don’t know how many meetings deliberating what we already knew, shows how obsessed this country is with trying to prove the races are inherently different,” Grubbs said.Palevsky said the recommendation to use a “refit” creatinine equation without a racial correction would require no changes or upgrades to laboratory equipment, just changes to software and possibly the codes used to facilitate the exchange or pooling of lab results. His foundation has been prepping and educating leaders of labs that where can i buy lasix process medical tests. €œThey have been very engaged,” he said.

€œThey are primed for this.”He said patients could check kidney function under the revised equation using a calculator on where can i buy lasix the NKF website. Many Black patients whose kidney function may have been underestimated using the racial correction may find themselves moved into an advanced stage of disease, or even to the point where they would be recommended for a transplant. He advised patients to discuss any concerns with their physician or a nephrologist. Mallika L where can i buy lasix.

Mendu is a nephrologist who served on the task force and executive medical director of clinical operations for Brigham Health, which abandoned the race correction for kidney diagnostics in June 2020 after protests by medical students and residents. Wondering how removal of the racial correction would affect patients, she helped conduct a study to see how some 2,000 Black kidney patients in the Mass General Brigham health care system would be reclassified.Mendu found that removing the race multiplier led to 1 in 3 patients being reclassified with more severe kidney where can i buy lasix disease, with many moving into stage 4, the final stage before kidney failure. She also found 64 patients who had not previously been eligible meeting criteria for kidney transplants. Her findings, she said, supported removing the race-based algorithms that she had not previously questioned.“Honestly, I took this as gospel, I didn’t where can i buy lasix even think about it.

It shows you our generation didn’t always question what we were taught,” said Mendu, who graduated from medical school in 2009. €œIt makes me really proud of this generation of medical students who are questioning everything.”Mendu said the medical student protests, which started in her hospital around 2016, made her reexamine the algorithms she’d long taken for granted as correct. €œA lot of people said, ‘This is based on good science. Don’t open this can of worms.’ But when I looked at it, it didn’t make sense to me,” she said.While she’s happy with the new recommendations, Mendu said she, like other task force members, thinks the work needed to end health disparities in her field is only beginning.

Her study showed that even when Black patients qualified for transplant under the racially corrected algorithm, they were still rarely referred for transplant. €œMy hope,” she said, “is that this is the start of conversation to end these truly profound disparities.”.