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In 2003, severe acute respiratory syndrome (SARS) spread through 26 countries, infecting at least 8098 and buy cardura usa causing at least 774 deaths (a case fatality rate of 9.6%). Middle East respiratory syndrome (MERS) by January 2020 caused 2519 cases and 866 deaths (a case fatality rate of 34%). SARS and MERS are coronaviruses and both are not as easily transmitted as COVID-19 because they require close contact with those infected (or also with camels in the case of MERS), and infected humans tend not to transmit before buy cardura usa they have symptoms. Transmission of both mostly occurred within healthcare settings and could be controlled by improving infection control in hospitals.In 2015, Bill Gates in a TED lecture warned that we were more at risk of a global pandemic (he thought it would be influenza) than we were from nuclear war.COVID-19 probably first entered the human population in China in November 2019 in Wuhan and was first identified as such in December 2019.

It spreads easily with a R0 (basic reproduction number) that represents the average number of people the average infected person would infect being between 1.5 and 3.5, depending on the surrounding circumstances. While a large proportion of infections buy cardura usa are asymptomatic, there is a significant mortality rate (about 3.4% worldwide). Survival rates are worse in the elderly, in men and in those with comorbidities. There are no suitable mammal models to study.Because there is a significant proportion of asymptomatic infectious people, monitoring of epidemics necessitates screening to determine (1) the proportion of the population that is actively infected and or (2) the total number of those who have been infected.

Both require buy cardura usa screening. To gain significant data, then whole populations or representative samples have to be tested. In many circumstances, only those with high probability are tested.DNA polymerase techniques on throat swabs (notably real-time reverse transcription PCR) can identify the actively infected, but such tests will need to be repeated, especially in healthcare staff who are both at increased risk of infection and could provide an increased risk of infection to their contacts.Antibody tests in theory can reveal who has been infected. However, such tests may not provide 100% reliable results, including the fact that buy cardura usa their sensitivity will vary according to how common the infection is.

If an infection is common, then a very sensitive test will identify all those infected and also a small number of false positives, but when the infection becomes less common, then the proportion of false positives will rise and a positive test could become less useful. Moreover, for how long would the antibody-person be buy cardura usa immune?. Counting the number of hospital deaths attributed to COVID-19 may be a guide to an epidemic, but deaths may be difficult to count in the community. In any case, changes in death numbers usually lag a few weeks behind the time of infection.Would a lower infecting dose cause the following illness to be less severe?.

Does the virus need several extra doubling times to exert its effects such that in this gained time host responses will be in a better position to combat the infection in high-risk groups or in groups buy cardura usa where medical care is minimal?. Could low-dose vaccination with COVID-19 itself be useful?. Shakespeare’s Hamlet (not an epidemiologist) suggested, ‘Diseases desperate grown, By desperate appliance are relieved, Or not at all’.All the aforementioned are key questions, the answers to many of which are not known at the time of writing and, even if they were, the answers might change with the passage of time.Various countries have made various policy choicesAt the time of writing (April 2020), COVID-19 has probably been in the human population for only about 6 months. In most buy cardura usa countries, there are concerns about how the epidemic was initially handled, and it is possible to predict some damming retrospective judgements.

However, we should concentrate on where we are, not where we might have been. Recriminations should wait.Many important decisions have to be made based on incomplete information. Most COVID-19 decisions have to be made on speculations (guesswork and wishful thinking), on hypotheses (propositions made as a basis for reasoning, without an assumption of buy cardura usa its truth) or on theories (suppositions or systems of ideas explaining something based on general principles). All COVID-19 decisions have to be made at the time ‘We have to start from where we are’ guided by the experiences of other countries that are ahead of us in the epidemic.Pandemics usually reveal inequalities and the poor, or those in unstable employment or in crowded accommodation, or with underlying health issues, or where healthcare is less affordable, or are in the less well educated will suffer the most.

They will also comply less with restrictions buy cardura usa. Ideologies, power blocks, leaders, social cohesion beliefs, the relevance of centralised or regional decision making, the abilities of popularism (political doctrines chosen to appeal to a majority of the electorate), welfare states (usually capitalist nations that recognise that food, shelter, education and medicine are basic rights to be ensured by government actions) and authoritarianism are all being stress tested by COVID-19. In the future, it will be interesting to judge how these societal systems played out when confronting the conflicting requirement to reconcile conflicting priorities of health and economic factors that involve conflicts between responding and planning for deaths (‘How should we cope with these’) and actually planning deaths. €˜We will have to accept that we will cause deaths whatever policy we adopt’.There is only one initial response to COVID-19 that reduces infection rates buy cardura usa and death rates.

Dramatic quarantine ‘total lockdown’ measures. Some countries, including China, South Korea, Hong Kong, Taiwan and Singapore, hit the epidemic hard and early with lockdown quarantine to reduce the epidemic. Such countries perhaps tend towards acceptance of authoritarianism and their citizens less rebellious than in other countries buy cardura usa. New Zealand did similarly.

I could not possibly comment on the US responses. However, on what criteria and at what speed should liberalisation buy cardura usa of quarantine measure occur to avoid re-emergences?. There are in theory three final paths out of the COVID-19 crisis:First, a vaccine. Even a perfect vaccine would be difficult to evaluate with changing risks in buy cardura usa the community.

How protective would a vaccine be and for how long would it be effective?. Second, the identification of a treatment, either preventative or curative, so that the disease becomes a considerably less worrisome prospect even for those with comorbidities.Third, herd immunity, when enough of the population has acquired and survived COVID-19 and thus developed immunity with the infection persisting at a low level. Currently the buy cardura usa only, not entirely definitive, way of estimating this is by measuring antibodies such that there would not be enough opportunities for disease transmission for the virus to continue circulating through populations with an Ro of less than 1, but the risk would not disappear entirely. Moreover, how should immunity be monitored if antibody testing may not reflect herd immunity?.

Allowing herd immunity to develop initially would result in a huge spike in hospitalisations and deaths that could overwhelm most healthcare services, and that is why flattening such spikes by quarantine was indicated. With flattening, there would still be illness and deaths but at a buy cardura usa controlled slower rate and hopefully also smaller numbers, such that healthcare services could cope.There is a lot of opinion and numerous contributions by official and unofficial organisations and individuals who think their “single issue advice” should be followed. No one individual has the expertise required for management of all the complexities. Committees are required, including microbiologists, infectious diseases doctors, public health doctors, epidemiologists, hospital and general practice representatives, epidemic mathematical modellers and economic advisers.

Politicians have the responsibility to deliver buy cardura usa decisions when, especially when, information is imperfect. How many people would be infected if we did nothing?. What buy cardura usa would the epidemic curve look like in various situations?. What proportion of those infected would infect others in various situations?.

How many of which population groups would require what extra healthcare services in various situations?. What would be the effect of various measures at various buy cardura usa times?. What economic impacts might there be when these in themselves affect mortality rates?. I predict that COVID-19 will cause two significant changes in political thought.

First, it has to be buy cardura usa realised that globalisation of such epidemics, and there will be more to come, will demand an integrated globalised response. Second, in 1987, Margaret Thatcher, the UK Prime Minister, said that ‘There is no such thing as society… the quality of our lives will depend on how much each of us is prepared to take responsibility for ourselves and each of us prepared to turn round and help by our own efforts those who are unfortunate’. The current UK Prime Minister in March 2020 presented a new synthesis, ‘There really is such a thing as society’.Finally, it is important to realise that everyone, no matter where they are, for better or worse, has to rely on their existing rulers or governments..

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Publisher. Princeton, NJ. Mathematica Aug 27, 2020 Authors Alex Bohl and Michelle Roozeboom-Baker Updates to the sixth edition include information on. Added newly established codes that capture COVID-related treatments delivered in the hospital setting.

As COVID-19 disrupts people’s lives and livelihoods and threatens institutions around the world, the need for fast, data-driven solutions to combat the crisis is growing. This primer is designed to help researchers, data scientists, and others who analyze health care claims or administrative data (herein referred to as “claims”) quickly join the effort to better understand, track, and contain COVID-19. Readers can use this guidance to help them assess data on health care use and costs linked to COVID-19, create models for risk identification, and pinpoint complications that may follow a COVID-19 diagnosis. Related NewsNew findings published this month in two prominent journals provide insight into the characteristics and performance of health systems using the latest data from the Compendium of U.S.

Health Systems, created by Mathematica for the Agency for Healthcare Research and Quality (AHRQ).Mathematica and AHRQ researchers reported in Health Affairs that there was substantial consolidation of physicians and hospitals into vertically integrated health systems from 2016 to 2018. This resulted in more than half of physicians and 72 percent of hospitals being affiliated with one of the 637 health systems in the United States. Among systems operating in both 2016 and 2018 years, the median number of physicians increased by 29 percent, from 285 to 369. This has implications for cost, access, and quality of care.Although most research on health systems suggests that consolidation is associated with higher prices, a new article published in Health Services Research suggests that vertically integrated health systems might provide greater value under payment models that provide incentives to improve value.

In this study, the authors found lower costs and similar quality scores from system hospitals compared with non-system hospitals that were participating in Medicare’s Comprehensive Care for Joint Replacement, a mandatory episode payment model.These studies were conducted by researchers at Mathematica, which leads AHRQ’s Coordinating Center for Comparative Health System Performance. This initiative seeks to understand the factors that affect health systems’ use of patient-centered outcomes research in delivering care. Learn more about the Comparative Health System Performance Initiative..

Publisher. Princeton, NJ. Mathematica Aug 27, 2020 Authors Alex Bohl and Michelle Roozeboom-Baker Updates to the sixth edition include information on. Added newly established codes that capture COVID-related treatments delivered in the hospital setting.

As COVID-19 disrupts people’s lives and livelihoods and threatens institutions around the world, the need for fast, data-driven solutions to combat the crisis is growing. This primer is designed to help researchers, data scientists, and others who analyze health care claims or administrative data (herein referred to as “claims”) quickly join the effort to better understand, track, and contain COVID-19. Readers can use this guidance to help them assess data on health care use and costs linked to COVID-19, create models for risk identification, and pinpoint complications that may follow a COVID-19 diagnosis. Related NewsNew findings published this month in two prominent journals provide insight into the characteristics and performance of health systems using the latest data from the Compendium of U.S.

Health Systems, created by Mathematica for the Agency for Healthcare Research and Quality (AHRQ).Mathematica and AHRQ researchers reported in Health Affairs that there was substantial consolidation of physicians and hospitals into vertically integrated health systems from 2016 to 2018. This resulted in more than half of physicians and 72 percent of hospitals being affiliated with one of the 637 health systems in the United States. Among systems operating in both 2016 and 2018 years, the median number of physicians increased by 29 percent, from 285 to 369. This has implications for cost, access, and quality of care.Although most research on health systems suggests that consolidation is associated with higher prices, a new article published in Health Services Research suggests that vertically integrated health systems might provide greater value under payment models that provide incentives to improve value.

In this study, the authors found lower costs and similar quality scores from system hospitals compared with non-system hospitals that were participating in Medicare’s Comprehensive Care for Joint Replacement, a mandatory episode payment model.These studies were conducted by researchers at Mathematica, which leads AHRQ’s Coordinating Center for Comparative Health System Performance. This initiative seeks to understand the factors that affect health systems’ use of patient-centered outcomes research in delivering care. Learn more about the Comparative Health System Performance Initiative..

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Can’t see cardura xl 4 mg the audio player?. Click here to listen on SoundCloud. The death of Supreme Court Justice Ruth Bader Ginsburg — and the insistence of President cardura xl 4 mg Donald Trump and the GOP-led Senate to fill that vacancy this year — could have major implications for health care.

The high court will hear yet another case challenging the constitutionality of the Affordable Care Act the week after the November election, and a long list of cases involving women’s reproductive rights, including both abortion and birth control, are working their way through lower federal courts.Meanwhile, scandals at the Department of Health and Human Services continue to surface, such as the case of a media spokesperson for the National Institutes of Health who criticized his boss’s handling of the pandemic via a conservative website. And the Centers for Disease Control and Prevention continues to struggle with its credibility, after posting and then taking down another set of guidelines, this one concerning whether the COVID-19 virus is spread through aerosol particles.This week’s panelists are Julie Rovner of Kaiser Health News, Anna Edney of Bloomberg News, Kimberly Leonard of Business Insider and Mary Ellen McIntire of CQ Roll Call.Among the takeaways from this week’s podcast:The Supreme Court’s upcoming ACA case was brought by Republican state officials cardura xl 4 mg seeking to invalidate the law based Congress’ elimination of the penalty for not having insurance, a provision that the court once used to uphold the law because it was considered part of Congress’ right to impose taxes.Many legal experts believe that even if the high court were to decide that the loss of the penalty invalidates the individual mandate to get insurance, other parts of the law should be able to stand. But it’s not clear conservatives on the court will agree.With so much emphasis on the ACA’s insurance marketplace, the expansion of the Medicaid program for low-income people and protections for people with preexisting conditions, many consumers don’t realize that the law touches nearly all aspects of health care, including guarantees of preventive services, insurance practices and even requirements for calorie counts on restaurant menus.Ginsburg’s death could also influence efforts to undermine abortion rights.

Two cases are already before the court, one involving the ability of doctors to remotely prescribe drugs that can end a pregnancy and a Mississippi ban on abortions after the 15th week of pregnancy.As the nation marks more than 200,000 deaths from the coronavirus, the “What the Health?. € panel cardura xl 4 mg looks at problems in the U.S. Effort to fight COVID-19, including flip-flops on the need for masks, inconsistent messaging from different parts of government and the politicization of science.The Centers for Disease Control and Prevention’s decision to remove guidance on the coronavirus’s ability to spread through the air created more concerns about the politicization of the federal government’s scientific studies.

The controversy over the agency’s work is a stark change from the past, when the CDC was considered among the least politicized parts of the government.It may take years after cardura xl 4 mg these coronavirus controversies for the CDC to restore its credibility with the public, no matter who is elected president.Trump has touted his efforts to lower prescription drug prices, and last week The New York Times reported that the administration tried unsuccessfully to get drugmakers to send a $100 gift card to all seniors to help cover the costs of their medicines. The companies objected because, among other reasons, they were worried the move could be seen as an effort to help the Trump campaign.This week, Rovner also interviews KHN’s Sarah Jane Tribble, whose new podcast, “Where It Hurts,” drops Sept. 29.

The podcast chronicles what happens to a small rural community in Kansas after its local hospital closes.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner. KHN’s “Battle Rages Inside Hospitals Over How COVID Strikes and Kills,” by Robert Lewis and Christina JewettAnna Edney. The New Yorker’s “A Young Kennedy, in Kushnerland, Turned Whistle-Blower,” by Jane MayerKimberly Leonard.

The Wall Street Journal’s “Medicare Wouldn’t Cover Costs of Administering Coronavirus Vaccine Approved Under Emergency-Use Authorization,” by Stephanie ArmourMary Ellen McIntire. The New York Times’ “Many Hospitals Charge More Than Twice What Medicare Pays for the Same Care,” by Reed AbelsonOther stories discussed by the panelists this week:The New York Times’ “A Deal on Drug Prices Undone by White House Insistence on ‘Trump Cards,’” by Jonathan Martin and Maggie HabermanThe Daily Beast’s “A Notorious COVID Troll Actually Works for Dr. Fauci’s Agency,” by Lachlan MarkayPolitico’s “Trump Administration Shakes Up HHS Personal Office After Tumultuous Hires,” by Dan DiamondThe Washington Post’s “Pentagon Used Taxpayer Money Meant for Masks and Swabs to Make Jet Engine Parts and Body Armor,” by Aaron Gregg and Yeganeh TorbatiTo hear all our podcasts, click here.And subscribe to What the Health?.

on iTunes, Stitcher, Google Play, Spotify or Pocket Casts. Related Topics Courts Elections Health Care Costs Insurance Multimedia Pharmaceuticals The Health Law Abortion CDC COVID-19 Drug Costs HHS KHN's 'What The Health?. ' Podcasts Prescription Drugs Trump Administration.

Can’t see buy cardura usa the audio player?. Click here to listen on SoundCloud. The death of Supreme Court Justice Ruth Bader Ginsburg — and the insistence of President Donald Trump and the GOP-led Senate to fill that vacancy this year — buy cardura usa could have major implications for health care. The high court will hear yet another case challenging the constitutionality of the Affordable Care Act the week after the November election, and a long list of cases involving women’s reproductive rights, including both abortion and birth control, are working their way through lower federal courts.Meanwhile, scandals at the Department of Health and Human Services continue to surface, such as the case of a media spokesperson for the National Institutes of Health who criticized his boss’s handling of the pandemic via a conservative website. And the Centers for Disease Control and Prevention continues to struggle with its credibility, after posting and then taking down another set of guidelines, this one concerning whether the COVID-19 virus is spread through aerosol particles.This week’s panelists are Julie Rovner of Kaiser Health News, Anna Edney of Bloomberg News, Kimberly Leonard of Business Insider and Mary Ellen McIntire of CQ Roll Call.Among the takeaways from this week’s podcast:The Supreme Court’s upcoming ACA case was brought by Republican state officials seeking to invalidate the law based Congress’ elimination of the penalty for not having insurance, a provision that the court once used to uphold the law because it was considered part of Congress’ right to impose taxes.Many legal experts believe that even if the high court were to decide buy cardura usa that the loss of the penalty invalidates the individual mandate to get insurance, other parts of the law should be able to stand.

But it’s not clear conservatives on the court will agree.With so much emphasis on the ACA’s insurance marketplace, the expansion of the Medicaid program for low-income people and protections for people with preexisting conditions, many consumers don’t realize that the law touches nearly all aspects of health care, including guarantees of preventive services, insurance practices and even requirements for calorie counts on restaurant menus.Ginsburg’s death could also influence efforts to undermine abortion rights. Two cases are already before the court, one involving the ability of doctors to remotely prescribe drugs that can end a pregnancy and a Mississippi ban on abortions after the 15th week of pregnancy.As the nation marks more than 200,000 deaths from the coronavirus, the “What the Health?. € panel looks at problems in the buy cardura usa U.S. Effort to fight COVID-19, including flip-flops on the need for masks, inconsistent messaging from different parts of government and the politicization of science.The Centers for Disease Control and Prevention’s decision to remove guidance on the coronavirus’s ability to spread through the air created more concerns about the politicization of the federal government’s scientific studies. The controversy over the agency’s work is a stark change from the past, when the CDC was considered among the least politicized parts of the government.It may take years after these coronavirus controversies for the buy cardura usa CDC to restore its credibility with the public, no matter who is elected president.Trump has touted his efforts to lower prescription drug prices, and last week The New York Times reported that the administration tried unsuccessfully to get drugmakers to send a $100 gift card to all seniors to help cover the costs of their medicines.

The companies objected because, among other reasons, they were worried the move could be seen as an effort to help the Trump campaign.This week, Rovner also interviews KHN’s Sarah Jane Tribble, whose new podcast, “Where It Hurts,” drops Sept. 29. The podcast chronicles what happens to a small rural community in Kansas after its local hospital closes.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner. KHN’s “Battle Rages Inside Hospitals Over How COVID Strikes and Kills,” by Robert Lewis and Christina JewettAnna Edney. The New Yorker’s “A Young Kennedy, in Kushnerland, Turned Whistle-Blower,” by Jane MayerKimberly Leonard.

The Wall Street Journal’s “Medicare Wouldn’t Cover Costs of Administering Coronavirus Vaccine Approved Under Emergency-Use Authorization,” by Stephanie ArmourMary Ellen McIntire. The New York Times’ “Many Hospitals Charge More Than Twice What Medicare Pays for the Same Care,” by Reed AbelsonOther stories discussed by the panelists this week:The New York Times’ “A Deal on Drug Prices Undone by White House Insistence on ‘Trump Cards,’” by Jonathan Martin and Maggie HabermanThe Daily Beast’s “A Notorious COVID Troll Actually Works for Dr. Fauci’s Agency,” by Lachlan MarkayPolitico’s “Trump Administration Shakes Up HHS Personal Office After Tumultuous Hires,” by Dan DiamondThe Washington Post’s “Pentagon Used Taxpayer Money Meant for Masks and Swabs to Make Jet Engine Parts and Body Armor,” by Aaron Gregg and Yeganeh TorbatiTo hear all our podcasts, click here.And subscribe to What the Health?. on iTunes, Stitcher, Google Play, Spotify or Pocket Casts. Related Topics Courts Elections Health Care Costs Insurance Multimedia Pharmaceuticals The Health Law Abortion CDC COVID-19 Drug Costs HHS KHN's 'What The Health?.

' Podcasts Prescription Drugs Trump Administration.

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€‹15 full-time equivalent specialist counsellors will be cardura pill deployed across rural NSW to help prevent suicide, with the first two counsellors starting in the Eurobodalla and Snowy Mountains regions.NSW Mental Health Minister Bronnie Taylor said the relatively high rates of suicide in rural areas are devastating families and communities, and the $6.75 million investment will add another layer of help.“Many factors can contribute to suicide, from domestic violence, to relationship issues or unemployment, to stress and hardship,” Mrs Taylor said. €œThese specialist mental health counsellors are there on the ground to support people thinking of suicide or impacted by suicide, and I encourage communities across the state to lean on them for support.”Director Mental Health Drug and Alcohol for Southern NSW Local Health District Damien Eggleton said he wants more people to ask for help when they need it. €œOur rural communities have proven beyond a doubt they’re resilient and fearless when faced with adversity, whether that be geographic isolation, searing drought or the impact of the cardura pill current pandemic – but they don’t need to go it alone,” Mr Eggleton said.

€œThe support provided by these counsellors will complement the peer work and drought support provided by our Farm Gate Counsellors and Drought Counsellors.”Rural counsellor Samara Byrne said she wants young people to know there are people you can turn to when feeling overwhelmed with life or feeling like a burden on others. €œWe are cardura pill here for you and here to listen if you are feeling distressed, anxious or a burden to loved ones. The service is easily accessible through the Mental Health Line.

Just ask for the Rural Counsellor.”“Having moved from Sydney in 2016 to our beautiful farm in SNSW, I am so pleased to be able to do cardura pill what I am most passionate about, supporting people’s wellbeing in Rural Australia and building on the natural local community resilience”.Minister Taylor urges people in the bush to get help by contacting these rural counsellors. €œSupport is available, all you need to do is pick up the phone and make an appointment by calling the NSW Mental Health Line on 1800 011 511.”The 15 rural counselling positions are part of the Towards Zero Suicides. A $87 million investment over three years in new suicide prevention cardura pill initiatives.

A NSW Premier’s Priority, this is a whole-of-government commitment to transforming the way we identify and support anyone impacted by suicide.If you, or someone you know, is thinking about suicide or experiencing a personal crisis or distress, please seek help immediately in a life-threatening situation by calling 000 or seek support though one of these services:Lifeline 13 11 14Suicide Call Back Service 1300 659 467NSW Mental Health Line 1800 011 511Minister for Mental Health Bronnie Taylor and Minister for Police and Emergency Services David Elliott today announced the expansion of the Police Ambulance and Clinical Early Response (PACER) pilot program.“This ground breaking collaboration embeds mental health experts with first responders to support them to appropriately recognise, assess, and respond to mental health emergencies live at the scene,” Mrs Taylor said. €œThe pilot program has had incredible results with significant reductions in emergency department presentations, police and cardura pill ambulance time on scene. €œThis approach has enormous potential to change lives, with the community getting more appropriate care at the time when they need it most.” Mr Elliott welcomed the support for the police officers who are deeply committed to serving and protecting the people of NSW “During the pilot program, police time-on-scene was reduced by an average of 45 minutes, not only supporting first responders to appropriately recognise and respond to psychiatric incidents in the community, but also freeing up officers to serve thecommunity in other areas,” Mr Elliott said.

€œThe presence and availability of a PACER clinician in a police station increases the knowledge and understanding of mental health issues amongst officers This initiative is crucial, now more than ever, following the devastating ‘Black Summer’ bushfires and the COVID-19 pandemic, which have affected us all.” NSW Police Force Deputy Commissioner, Malcolm Lanyon APM, said cardura pill the PACER model has been a success at the trial site in St George Police Area Command. €œDuring the trial we saw a significant reduction in time taken for police to respond to these matters. It translated to a better outcome for both our officers and cardura pill the individuals in need of assistance,” Mr Lanyon said.

The PACER program will expand to Campbelltown, Nepean, Northern Beaches, Sutherland Shire, Blacktown, Eastern Beaches, Kuring-gai, Metro Combined consisting of Kings Cross/Surry Hills/City of Sydney, South Sydney and Bankstown Police Area Commands with recruitment underway for the specialist mental health clinicians from July 2020. This investment is part of the $73 million suite of mental health measures recently announced by cardura pill the NSW Government. This includes 216 new mental health staff, additional funding for the NSW Mental Health Line, extra support for Telehealth, funding for extra therapeutic programs to aid recovery in mental health units and a $6 million investment in Lifeline to expand their invaluable service..

€‹15 full-time equivalent specialist counsellors will be deployed across rural NSW to help prevent suicide, with the first two counsellors starting in the Eurobodalla and Snowy Mountains regions.NSW Mental Health Minister Bronnie Taylor said the relatively high rates buy cardura usa of suicide in rural areas are devastating families and communities, and the $6.75 million investment will add another layer of help.“Many factors can contribute to suicide, from domestic violence, to relationship issues or unemployment, to stress and hardship,” Mrs Taylor said. €œThese specialist mental health counsellors are there on the ground to support people thinking of suicide or impacted by suicide, and I encourage communities across the state to lean on them for support.”Director Mental Health Drug and Alcohol for Southern NSW Local Health District Damien Eggleton said he wants more people to ask for help when they need it. €œOur rural communities have proven beyond a doubt they’re resilient and fearless when faced with adversity, whether buy cardura usa that be geographic isolation, searing drought or the impact of the current pandemic – but they don’t need to go it alone,” Mr Eggleton said. €œThe support provided by these counsellors will complement the peer work and drought support provided by our Farm Gate Counsellors and Drought Counsellors.”Rural counsellor Samara Byrne said she wants young people to know there are people you can turn to when feeling overwhelmed with life or feeling like a burden on others. €œWe are here for you and here to listen if you are feeling distressed, anxious or a burden to buy cardura usa loved ones.

The service is easily accessible through the Mental Health Line. Just ask for the Rural Counsellor.”“Having moved from Sydney in 2016 to our beautiful farm in SNSW, I am so pleased to be able to do what I am most passionate about, buy cardura usa supporting people’s wellbeing in Rural Australia and building on the natural local community resilience”.Minister Taylor urges people in the bush to get help by contacting these rural counsellors. €œSupport is available, all you need to do is pick up the phone and make an appointment by calling the NSW Mental Health Line on 1800 011 511.”The 15 rural counselling positions are part of the Towards Zero Suicides. A $87 million buy cardura usa investment over three years in new suicide prevention initiatives. A NSW Premier’s Priority, this is a whole-of-government commitment to transforming the way we identify and support anyone impacted by suicide.If you, or someone you know, is thinking about suicide or experiencing a personal crisis or distress, please seek help immediately in a life-threatening situation by calling 000 or seek support though one of these services:Lifeline 13 11 14Suicide Call Back Service 1300 659 467NSW Mental Health Line 1800 011 511Minister for Mental Health Bronnie Taylor and Minister for Police and Emergency Services David Elliott today announced the expansion of the Police Ambulance and Clinical Early Response (PACER) pilot program.“This ground breaking collaboration embeds mental health experts with first responders to support them to appropriately recognise, assess, and respond to mental health emergencies live at the scene,” Mrs Taylor said.

€œThe pilot program buy cardura usa has had incredible results with significant reductions in emergency department presentations, police and ambulance time on scene. €œThis approach has enormous potential to change lives, with the community getting more appropriate care at the time when they need it most.” Mr Elliott welcomed the support for the police officers who are deeply committed to serving and protecting the people of NSW “During the pilot program, police time-on-scene was reduced by an average of 45 minutes, not only supporting first responders to appropriately recognise and respond to psychiatric incidents in the community, but also freeing up officers to serve thecommunity in other areas,” Mr Elliott said. €œThe presence and availability of a PACER clinician in a police station increases the knowledge and understanding of mental health issues amongst officers This initiative is crucial, now more than ever, following the devastating ‘Black Summer’ bushfires and the COVID-19 pandemic, which have affected us all.” NSW Police Force Deputy Commissioner, Malcolm Lanyon APM, said the PACER model buy cardura usa has been a success at the trial site in St George Police Area Command. €œDuring the trial we saw a significant reduction in time taken for police to respond to these matters. It translated to a better outcome for both our officers and the individuals in need of assistance,” Mr buy cardura usa Lanyon said.

The PACER program will expand to Campbelltown, Nepean, Northern Beaches, Sutherland Shire, Blacktown, Eastern Beaches, Kuring-gai, Metro Combined consisting of Kings Cross/Surry Hills/City of Sydney, South Sydney and Bankstown Police Area Commands with recruitment underway for the specialist mental health clinicians from July 2020. This investment is part buy cardura usa of the $73 million suite of mental health measures recently announced by the NSW Government. This includes 216 new mental health staff, additional funding for the NSW Mental Health Line, extra support for Telehealth, funding for extra therapeutic programs to aid recovery in mental health units and a $6 million investment in Lifeline to expand their invaluable service..

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Can’t see the how to buy cheap cardura online audio player?. Click here to how to buy cheap cardura online listen on SoundCloud. Republicans appear to be on track to confirm Judge Amy Coney Barrett to the Supreme Court before Election Day, cementing a 6-3 conservative majority on the high court regardless of what happens Nov. 3. Democrats, meanwhile, lacking the votes to block the nomination, used the high-profile hearings to batter Republicans for trying to overturn the Affordable Care Act.Meanwhile, a number of scientific journals that typically eschew politics, including the prestigious New England Journal of Medicine, threw their support to Democratic presidential candidate Joe Biden, citing what they call the Trump administration’s bungling of the coronavirus pandemic.This week’s panelists are Julie Rovner of Kaiser Health News, Mary Ellen McIntire of CQ Roll Call, Shefali Luthra of The 19th and Sarah Karlin-Smith of Pink Sheet.Among the takeaways from this week’s podcast:The lack of progress on a bipartisan coronavirus relief package is making both Democrats and Republicans nervous as they approach Election Day without something to help voters.During hearings on the nomination of Judge Amy Coney Barrett for the Supreme Court, Democrats were consistently on message, seeking to focus public attention before the election on the threat that Republicans pose to the Affordable Care Act as the law goes before the court next month.

Four members of the Senate Judiciary Committee, which will vote on the nomination, are up for reelection. Also on the committee is Sen. Kamala Harris, the Democrats’ vice presidential candidate.The public health optics of the hearing were jarring for some viewers. Although the committee chairman said the room was set up to meet federal health guidelines, Republican senators often did not wear masks, including Sens. Thom Tillis (N.C.) and Mike Lee (Utah), who both were diagnosed with COVID-19 after attending a White House celebration for Barrett.The lack of masks could add to confusion about public health messages.

And voters sometimes find it insulting that politicians play down risks that the public is called upon to assume.Barrett’s testimony did not change many perceptions of her. Although she was extremely careful not to reveal her personal views on issues that could come before the court, including the ACA and abortion, both Democrats and Republicans highlighted her strong conservative credentials.Scientific American and the New England Journal of Medicine have published stinging critiques of the current administration’s policies on science and medicine. Although it’s not clear what impact the editorials will have, they are a sign of the further politicization of public health.This week, Rovner also interviews Dr. Ashish Jha, dean of the Brown University School of Public Health. Jha talked about the challenges public health professionals have faced in trying to deal with the COVID-19 pandemic.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner.

The Atlantic’s “How to Tell If Socializing Indoors Is Safe,” by Olga KhazanShefali Luthra. The New York Times’ “A $52,112 Air Ambulance Ride. Coronavirus Patients Battle Surprise Bills,” by Sarah KliffMary Ellen McIntire. KHN’s “Making Money Off Masks, COVID-Spawned Chain Store Aims to Become Obsolete,” by Markian HawrylukSarah Karlin-Smith. Politico’s “Health Officials Scrambling to Produce Trump’s ‘Last-Minute’ Drug Cards by Election Day,” by Dan DiamondAlso mentioned in this week’s podcast:Bill of the Month update.

KHN’s “Moved by Plight of Young Heart Patient, Stranger Pays His Hospital Bill,” by Laura UngarScientific journal endorsements. The New England Journal of Medicine’s “Dying in a Leadership Vacuum”“Scientific American Endorses Joe Biden,” by The EditorsTo hear all our podcasts, click here.And subscribe to What the Health?. on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts. Related Topics Courts Multimedia Public Health The Health Law COVID-19 KHN's 'What The Health?. ' PodcastsThis story also ran on NPR. This story can be republished for free (details). In late March, shortly after New York state closed nonessential businesses and asked people to stay home, Ashley Laderer began waking each morning with a throbbing headache.“The pressure was so intense it felt like my head was going to explode,” recalled the 27-year-old freelance writer from Long Island.She tried spending less time on the computer and taking over-the-counter pain medication, but the pounding kept breaking through — a constant drumbeat to accompany her equally incessant worries about COVID-19.After a month and a half with a pounding headache, Ashley Laderer decided to visit a neurologist, who ordered an MRI.

But the doctor found no physical cause. The scan was clear.(Alissa Castleton)“Every day I lived in fear that I was going to get it and I was going to infect my whole family,” she said.After a month and a half, Laderer decided to visit a neurologist, who ordered an MRI. But the doctor found no physical cause. The scan was clear.Then he asked. Are you under a lot of stress?.

Throughout the pandemic, people who never had the coronavirus have been reporting a host of seemingly unrelated symptoms. Excruciating headaches, episodes of hair loss, upset stomach for weeks on end, sudden outbreaks of shingles and flare-ups of autoimmune disorders. The disparate symptoms, often in otherwise healthy individuals, have puzzled doctors and patients alike, sometimes resulting in a series of visits to specialists with few answers. But it turns out there’s a common thread among many of these conditions, one that has been months in the making. Chronic stress.Although people often underestimate the influence of the mind on the body, a growing catalog of research shows that high levels of stress over an extended time can drastically alter physical function and affect nearly every organ system.Now, at least eight months into the pandemic, alongside a divisive election cycle and racial unrest, those effects are showing up in a variety of symptoms.“The mental health component of COVID is starting to come like a tsunami,” said Dr.

Jennifer Love, a California-based psychiatrist and co-author of an upcoming book on how to heal from chronic stress. Email Sign-Up Subscribe to KHN’s free Morning Briefing. Nationwide, surveys have found increasing rates of depression, anxiety and suicidal thoughts during the pandemic. But many medical experts said it’s too soon to measure the related physical symptoms, since they generally appear months after the stress begins.Still, some early research, such as a small Chinese study and an online survey of more than 500 people in Turkey, points to an uptick.In the U.S., data from FAIR Health, a nonprofit database that provides cost information to the health industry and consumers, showed slight to moderate increases in the percentage of medical claims related to conditions triggered or exacerbated by stress, like multiple sclerosis and shingles. The portion of claims for the autoimmune disease lupus, for example, showed one of the biggest increases — 12% this year — compared with the same period last year (January to August).Express Scripts, a major pharmacy benefit manager, reported that prescriptions for anti-insomnia medications increased 15% early in the pandemic.Perhaps the strongest indicator comes from doctors reporting a growing number of patients with physical symptoms for which they can’t determine a cause.Dr.

Shilpi Khetarpal, a dermatologist at the Cleveland Clinic, used to see about five patients a week with stress-related hair loss. Since mid-June, that number has jumped to 20 or 25. Mostly women, ages 20 to 80, are reporting hair coming out in fistfuls, Khetarpal said.In Houston, at least a dozen patients have told fertility specialist Dr. Rashmi Kudesia they’re having irregular menstrual cycles, changes in cervical discharge and breast tenderness, despite normal hormone levels.Stress is also the culprit dentists are pointing to for the rapid increase in patients with teeth grinding, teeth fractures and TMJ.“We, as humans, like to have the idea that we are in control of our minds and that stress isn’t a big deal,” Love said. €œBut it’s simply not true.”How Mental Stress Becomes PhysicalStress causes physical changes in the body that can affect nearly every organ system.Although symptoms of chronic stress are often dismissed as being in one’s head, the pain is very real, said Kate Harkness, a professor of psychology and psychiatry at Queen’s University in Ontario.When the body feels unsafe — whether it’s a physical threat of attack or a psychological fear of losing a job or catching a disease — the brain signals adrenal glands to pump stress hormones.

Adrenaline and cortisol flood the body, activating the fight-or-flight response. They also disrupt bodily functions that aren’t necessary for immediate survival, like digestion and reproduction.When the danger is over, the hormones return to normal levels. But during times of chronic stress, like a pandemic, the body keeps pumping out stress hormones until it tires itself out. This leads to increased inflammation throughout the body and brain, and a poorly functioning immune system.Studies link chronic stress to heart disease, muscle tension, gastrointestinal issues and even physical shrinking of the hippocampus, an area of the brain associated with memory and learning. As the immune system acts up, some people can even develop new allergic reactions, Harkness said.The good news is that many of these symptoms are reversible.

But it’s important to recognize them early, especially when it comes to the brain, said Barbara Sahakian, a professor of clinical neuropsychology at the University of Cambridge.“The brain is plastic, so we can to some extent modify it,” Sahakian said. €œBut we don’t know if there’s a cliff beyond which you can’t reverse a change. So the sooner you catch something, the better.”The Day-to-Day ImpactIn some ways, mental health awareness has increased during the pandemic. TV shows are flush with ads for therapy and meditation apps, like Talkspace and Calm, and companies are announcing mental health days off for staff.For Alex Kostka, pandemic-related stress has brought on mood swings, nightmares and jaw pain.(Jordan Battiste)But those spurts of attention fail to reveal the full impact of poor mental health on people’s daily lives.For Alex Kostka, pandemic-related stress has brought on mood swings, nightmares and jaw pain.He’d been working at a Whole Foods coffee bar in New York City for only about a month before the pandemic hit, suddenly anointing him an essential worker. As deaths in the city soared, Kostka continued riding the subway to work, interacting with co-workers in the store and working longer hours for just a $2-per-hour wage increase.

(Months later, he’d get a $500 bonus.) It left the 28-year-old feeling constantly unsafe and helpless.“It was hard not to break down on the subway the minute I got on it,” Kostka said.Soon he began waking in the middle of the night with pain from clenching his jaw so tightly. Often his teeth grinding and chomping were loud enough to wake his girlfriend.Kostka tried Talkspace, but found texting about his troubles felt impersonal. By the end of the summer, he decided to start using the seven free counseling sessions offered by his employer. That’s helped, he said. But as the sessions run out, he worries the symptoms might return if he’s unable to find a new therapist covered by his insurance.“Eventually, I will be able to leave this behind me, but it will take time,” Kostka said.

€œI’m still very much a work in progress.”How to Mitigate Chronic StressWhen it comes to chronic stress, seeing a doctor for stomach pain, headaches or skin rashes may address those physical symptoms. But the root cause is mental, medical experts say.That means the solution will often involve stress-management techniques. And there’s plenty we can do to feel better:Exercise. Even low- to moderate-intensity physical activity can help counteract stress-induced inflammation in the body. It can also increase neuronal connections in the brain.Meditation and mindfulness.

Research shows this can lead to positive, structural and functional changes in the brain.Fostering social connections. Talking to family and friends, even virtually, or staring into a pet’s eyes can release a hormone that may counteract inflammation.Learning something new. Whether it’s a formal class or taking up a casual hobby, learning supports brain plasticity, the ability to change and adapt as a result of experience, which can be protective against depression and other mental illness.“We shouldn’t think of this stressful situation as a negative sentence for the brain,” said Harkness, the psychology professor in Ontario. €œBecause stress changes the brain, that means positive stuff can change the brain, too. And there is plenty we can do to help ourselves feel better in the face of adversity.” Aneri Pattani.

apattani@kff.org, @aneripattani Related Topics Mental Health Public Health COVID-19About HealthBent KHN's chief Washington correspondent, Julie Rovner, who has covered health care for more than 30 years, offers insight and analysis of policies and politics in her regular HealthBent columns.Send questions to jrovner@kff.org. Use Our Content This story can be republished for free (details). Democrats on the Senate Judiciary Committee know that, barring something unexpected, they lack the votes to block President Donald Trump from installing his third justice in four years on the Supreme Court and creating a 6-3 conservative majority.They also know that, in a normal year, by mid-October Congress would be out of session and members home campaigning. But 2020 is obviously no normal year. So, while the rest of Congress is home, Democratic Judiciary members are trying something very different in the hearings for nominee Amy Coney Barrett. Rather than prosecuting their case against Barrett, currently a federal appeals court judge, they are refighting the war that helped them pick up seats in 2018 — banging on Republicans for trying to eliminate the Affordable Care Act.Conveniently, the ACA is relevant to the Supreme Court debate because the justices are scheduled to hear a case that could invalidate the law on Nov.

10 — exactly a week after Election Day.As California Sen. Kamala Harris, a member of the Judiciary Committee and the Democratic vice presidential candidate, put it to Barrett on Tuesday, “Republicans are scrambling to confirm this nominee as fast as possible because they need one more Trump judge on the bench before Nov. 10th to win and strike down the entire Affordable Care Act. This is not hyperbole. This is not hypothetical.

This is happening.”Said Sen. Richard Durbin (D-Ill.), also on Tuesday. €œWe really believe the Supreme Court’s consideration of that case is going — could literally change America for millions of people.” Email Sign-Up Subscribe to KHN’s free Morning Briefing. To be sure, Republicans too were playing to their electorate during the questioning of Barrett, as they expounded on her conservative credentials on issues such as gun rights.Nonetheless, Democrats were uniformly disciplined in their assault on her potential vote in the ACA case. They chided both Barrett and the Republicans who are rushing her nomination to the floor literally days before a presidential election.

In addition, Democrats criticized Republicans for spending time on a nonemergency nomination while continuing to ignore the need for financial and other relief for the COVID-19 pandemic.And they raised what in more normal times would be the featured talking point for Democrats. The threat to abortion and other reproductive rights from Barrett, who before her elevation to the federal bench publicly opposed abortion and taught law at Notre Dame, one of the nation’s preeminent Catholic universities.“For many people, and particularly for women, this is a fundamental question,” said Sen. Dianne Feinstein (D-Calif.), the committee’s top Democrat.Barrett, like every other Supreme Court nominee for the past three decades, declined to offer positions that could suggest which way she might rule on hot-button issues, including abortion and the ACA.She repeatedly cited what has come to be called the “Ginsburg rule” — after the justice she would replace, Ruth Bader Ginsburg — saying “no hints, no previews, no forecasts.”Still, Democrats suggested that she may have tipped her hand on the Affordable Care Act case. In pointing out that the issues in the case, now known as California v. Texas, are different from the previous cases upholding the health law in 2012 and 2015, she said the current case will turn on “severability.”She was referring to the question of whether, if one portion of a law is found to be unconstitutional, the rest of the law can stand without it.

In the current ACA case, a group of Republican attorneys general — and the Trump administration — are arguing that when Congress reduced the ACA’s penalty for not having insurance to zero, the requirement to be covered no longer had a tax attached, and therefore the law is now unconstitutional. They based their argument on Chief Justice John Roberts’ 2012 conclusion that the ACA was valid because that penalty was a constitutionally appropriate tax.The law’s opponents say the rest of the law cannot be “severed” and must therefore fall, too. A federal district judge in Texas agreed with them.But merely saying the case turns on severability suggests that Barrett has already prejudged major parts of the case, Democrats said. Sen. Chris Coons (D-Del.) noted, “You don’t get to the question of severability if you haven’t already determined the question of constitutionality.”Barrett insisted repeatedly that despite an article she wrote in 2017 suggesting that the 2012 case upholding the law was wrongly decided, “I have no animus to nor agenda for the ACA,” as she told Sen.

Amy Klobuchar (D-Minn.) on Wednesday.In their rare show of unity of message, Democrats made clear that their primary audience in these hearings was not their Senate colleagues, but the voting public. While this battle looks lost, they hope to win the War of Nov. 3.HealthBent, a regular feature of KHN, offers insight and analysis of policies and politics from KHN’s chief Washington correspondent, Julie Rovner, who has covered health care for more than 30 years. Julie Rovner. jrovner@kff.org, @jrovner Related Topics Courts Elections HealthBent The Health Law Abortion U.S.

CongressThis story also ran on LAist. This story can be republished for free (details). Los Angeles County officials attribute a dramatic decline in COVID-19 death and case rates among Blacks and Latinos over the past two months to aggressive workplace health enforcement and the opening of tip lines to report violations.Now, officials intend to cement those gains by creating workplace councils among employees trained to look for COVID-19 prevention violations and correct or report them — without fear of being fired or punished.Cal/OSHA, the state’s workplace safety and health authority, is overwhelmed with complaints and tips about COVID-19 violations, and the county’s health investigators — there were officially 346 of them as of last Friday — can’t possibly keep tabs on all of Los Angeles’ more than 240,000 businesses, labor advocates say.The councils could help keep Los Angeles from backsliding on its progress in mitigating cases and racial disparities in the fall as more businesses are likely to reopen, said Tia Koonse, a researcher with the UCLA Labor Center and co-author of an assessment of the workplace council proposal. The L.A. County Board of Supervisors is expected to approve an ordinance this month requiring businesses to permit employees to form the councils, which would troubleshoot compliance issues and report to the health department when necessary. Email Sign-Up Subscribe to KHN’s free Morning Briefing. Critics, including many business leaders, say the measure will create more red tape at the worst possible time for the economy.

But labor groups and some businesses say it is crucial to fighting the pandemic. Workers around the country have been sacked or reprimanded for complaining about COVID-related safety violations, and laws protecting them are spotty.“Workers have a right to be in a safe space and shouldn’t face any retaliation” for noting poor practices, said Barbara Ferrer, director of the L.A. County Public Health Department. Low-wage workers have been “tremendously disadvantaged” by having to work outside the home in contact with other people, often without sufficient protection, she said.During the upsurge of COVID cases that followed Memorial Day weekend family gatherings and business openings, Latinos in Los Angeles were dying at a rate more than four times higher than that of whites, while Blacks were twice as likely as whites to die of the disease. Two months later, death rates among Blacks and Latinos had fallen by more than half and were approaching the rate for whites, according to age-adjusted data from the county health department.

While four times as many Latinos as whites were reported COVID-positive in late July, the Latino case rates were only 64% higher by mid-September. The positivity rate among Blacks was 60% higher than that of whites in late July, but the disparity had waned by mid-September.Experts can’t be certain that any one policy is responsible for the decline in deaths among Blacks and Latinos in Los Angeles — and state and county rates have declined for the entire population in recent weeks. But Ferrer attributed the progress to her department’s focus on workplace enforcement of health orders, which include rules about physical distancing, providing face coverings for workers and requiring face coverings for customers.“If you’re in violation, at this point we can either issue citations, or there are cases where we just close the place down because the violations are egregious,” she said.The sharp racial disparities that characterized the pandemic from the beginning are under even more scrutiny now that California has become the first state to make “health equity” a factor in its decisions to allow expanded reopening.Large counties may not advance toward full reopening until their most disadvantaged neighborhoods, and not just the county as a whole, meet or are lower than the targeted levels of disease. The criteria prod local governments to invest more in testing, contact tracing and education in poor neighborhoods with high levels of the disease.Ferrer’s focus on workplaces crystallized during a crackdown on Los Angeles Apparel, a clothing factory that had pivoted to face mask manufacturing during the pandemic. Despite the ready inventory of masks, an outbreak at the factory resulted in at least 300 cases — and four deaths.The health department, acting on a tip from community health centers flooded with sick Los Angeles Apparel workers, shut down the factory on June 27.

That action highlighted the need to bring the government and labor unions together to fight the pandemic, said Jim Mangia, CEO of St. John’s Well Child &. Family Center, a chain of community health centers in South L.A.“At St. John’s, almost all of our patients are the working poor,” Mangia said. €œThey were getting infected at work and bringing it home to their families, and I think intervening at the workplace is what really made all the difference.”Early in the pandemic, Ferrer had also set up an anonymous complaint line for employees who want to report workplace violations.

It gets about 2,000 calls a week, she said. As of Oct. 10, the department’s website lists 132 workplaces that have had three or more confirmed COVID-19 cases, with a total of 2,191 positives. Another table dated Oct. 7 lists 124 citations — mostly to gyms and places of worship — for failing to comply with a health officer order.“Fortunately, we’re not like Cal/OSHA, in the sense that it doesn’t take us months to complete an investigation,” Ferrer said.

€œWe’re able to move more swiftly under the health officer orders to actually make sure that we’re protecting workers.”Public health councils are the next phase in Ferrer’s plan to keep workers safe. The plan stemmed from the response of Overhill Farms, a frozen-food factory in Vernon, California, after an outbreak of more than 20 cases and one death. The factory and its temporary job agency were hit with more than $200,000 in proposed penalties from Cal/OSHA in September, but before the fines landed, the factory leadership was already responding by beginning to hold meetings with workers to improve safety there.“They found that the workers helped them bring down infection rates and helped solve problems,” said Roxana Tynan, executive director of the Los Angeles Alliance for a New Economy, a worker advocacy organization.While it’s not exactly a feel-good story about corporate beneficence, the turnaround at Overhill Farms added credence to the benefits of workplace councils, said Koonse of UCLA.No company would have to spend more than 0.44% of its payroll cost on the health councils, she estimated.Still, the idea has gotten a mixed reception from businesses. In an Aug. 24 statement, CEO Tracy Hernandez of the L.A.

County Business Federation wrote that the proposal would add “burdensome and convoluted programs that will further hinder an employer’s ability to meet demands, get back on their feet, and adequately serve their employees and customers.”But Jim Amen, president of the eight-store Super A Foods grocery chain, said businesses should welcome the councils as a way to keep lines of communication open. Such practices have kept infection rates low at his stores, even without a mandate, Amen said.“All I know is, for Super A, our employees are heavily involved in everything we do,” Amen said.Labor groups see the councils as a crucial way for workers to raise concerns without fear of retaliation.“In low-wage industries like the garment industry, workers coming together gets them fired,” said Marissa Nuncio, director of the Garment Worker Center, a nonprofit that mainly serves immigrants from Mexico and Central America.While disparities are narrowing in L.A. County, some shops are still unsafe and potential whistleblowers aren’t confident their reports to the county’s tip line are being acted on, she said.“We continue to get calls from our members who are sick, have COVID and are hospitalized,” Nuncio said. €œAnd the most obvious location for them to have been infected is in their workplace, because so many precautions are not being taken.”KHN data reporter Hannah Recht contributed to this article. Anna Almendrala.

aalmendrala@kff.org, @annaalmendrala Related Topics California Multimedia Public Health Race and Health States COVID-19.

Can’t see the audio buy cardura usa player?. Click here to listen on buy cardura usa SoundCloud. Republicans appear to be on track to confirm Judge Amy Coney Barrett to the Supreme Court before Election Day, cementing a 6-3 conservative majority on the high court regardless of what happens Nov. 3. Democrats, meanwhile, lacking the votes to block the nomination, used the high-profile hearings to batter Republicans for trying to overturn the Affordable Care Act.Meanwhile, a number of scientific journals that typically eschew politics, including the prestigious New England Journal of Medicine, threw their support to Democratic presidential candidate Joe Biden, citing what they call the Trump administration’s bungling of the coronavirus pandemic.This week’s panelists are Julie Rovner of Kaiser Health News, Mary Ellen McIntire of CQ Roll Call, Shefali Luthra of The 19th and Sarah Karlin-Smith of Pink Sheet.Among the takeaways from this week’s podcast:The lack of progress on a bipartisan coronavirus relief package is making both Democrats and Republicans nervous as they approach Election Day without something to help voters.During hearings on the nomination of Judge Amy Coney Barrett for the Supreme Court, Democrats were consistently on message, seeking to focus public attention before the election on the threat that Republicans pose to the Affordable Care Act as the law goes before the court next month.

Four members of the Senate Judiciary Committee, which will vote on the nomination, are up for reelection. Also on the committee is Sen. Kamala Harris, the Democrats’ vice presidential candidate.The public health optics of the hearing were jarring for some viewers. Although the committee chairman said the room was set up to meet federal health guidelines, Republican senators often did not wear masks, including Sens. Thom Tillis (N.C.) and Mike Lee (Utah), who both were diagnosed with COVID-19 after attending a White House celebration for Barrett.The lack of masks could add to confusion about public health messages.

And voters sometimes find it insulting that politicians play down risks that the public is called upon to assume.Barrett’s testimony did not change many perceptions of her. Although she was extremely careful not to reveal her personal views on issues that could come before the court, including the ACA and abortion, both Democrats and Republicans highlighted her strong conservative credentials.Scientific American and the New England Journal of Medicine have published stinging critiques of the current administration’s policies on science and medicine. Although it’s not clear what impact the editorials will have, they are a sign of the further politicization of public health.This week, Rovner also interviews Dr. Ashish Jha, dean of the Brown University School of Public Health. Jha talked about the challenges public health professionals have faced in trying to deal with the COVID-19 pandemic.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner.

The Atlantic’s “How to Tell If Socializing Indoors Is Safe,” by Olga KhazanShefali Luthra. The New York Times’ “A $52,112 Air Ambulance Ride. Coronavirus Patients Battle Surprise Bills,” by Sarah KliffMary Ellen McIntire. KHN’s “Making Money Off Masks, COVID-Spawned Chain Store Aims to Become Obsolete,” by Markian HawrylukSarah Karlin-Smith. Politico’s “Health Officials Scrambling to Produce Trump’s ‘Last-Minute’ Drug Cards by Election Day,” by Dan DiamondAlso mentioned in this week’s podcast:Bill of the Month update.

KHN’s “Moved by Plight of Young Heart Patient, Stranger Pays His Hospital Bill,” by Laura UngarScientific journal endorsements. The New England Journal of Medicine’s “Dying in a Leadership Vacuum”“Scientific American Endorses Joe Biden,” by The EditorsTo hear all our podcasts, click here.And subscribe to What the Health?. on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts. Related Topics Courts Multimedia Public Health The Health Law COVID-19 KHN's 'What The Health?. ' PodcastsThis story also ran on NPR. This story can be republished for free (details). In late March, shortly after New York state closed nonessential businesses and asked people to stay home, Ashley Laderer began waking each morning with a throbbing headache.“The pressure was so intense it felt like my head was going to explode,” recalled the 27-year-old freelance writer from Long Island.She tried spending less time on the computer and taking over-the-counter pain medication, but the pounding kept breaking through — a constant drumbeat to accompany her equally incessant worries about COVID-19.After a month and a half with a pounding headache, Ashley Laderer decided to visit a neurologist, who ordered an MRI.

But the doctor found no physical cause. The scan was clear.(Alissa Castleton)“Every day I lived in fear that I was going to get it and I was going to infect my whole family,” she said.After a month and a half, Laderer decided to visit a neurologist, who ordered an MRI. But the doctor found no physical cause. The scan was clear.Then he asked. Are you under a lot of stress?.

Throughout the pandemic, people who never had the coronavirus have been reporting a host of seemingly unrelated symptoms. Excruciating headaches, episodes of hair loss, upset stomach for weeks on end, sudden outbreaks of shingles and flare-ups of autoimmune disorders. The disparate symptoms, often in otherwise healthy individuals, have puzzled doctors and patients alike, sometimes resulting in a series of visits to specialists with few answers. But it turns out there’s a common thread among many of these conditions, one that has been months in the making. Chronic stress.Although people often underestimate the influence of the mind on the body, a growing catalog of research shows that high levels of stress over an extended time can drastically alter physical function and affect nearly every organ system.Now, at least eight months into the pandemic, alongside a divisive election cycle and racial unrest, those effects are showing up in a variety of symptoms.“The mental health component of COVID is starting to come like a tsunami,” said Dr.

Jennifer Love, a California-based psychiatrist and co-author of an upcoming book on how to heal from chronic stress. Email Sign-Up Subscribe to KHN’s free Morning Briefing. Nationwide, surveys have found increasing rates of depression, anxiety and suicidal thoughts during the pandemic. But many medical experts said it’s too soon to measure the related physical symptoms, since they generally appear months after the stress begins.Still, some early research, such as a small Chinese study and an online survey of more than 500 people in Turkey, points to an uptick.In the U.S., data from FAIR Health, a nonprofit database that provides cost information to the health industry and consumers, showed slight to moderate increases in the percentage of medical claims related to conditions triggered or exacerbated by stress, like multiple sclerosis and shingles. The portion of claims for the autoimmune disease lupus, for example, showed one of the biggest increases — 12% this year — compared with the same period last year (January to August).Express Scripts, a major pharmacy benefit manager, reported that prescriptions for anti-insomnia medications increased 15% early in the pandemic.Perhaps the strongest indicator comes from doctors reporting a growing number of patients with physical symptoms for which they can’t determine a cause.Dr.

Shilpi Khetarpal, a dermatologist at the Cleveland Clinic, used to see about five patients a week with stress-related hair loss. Since mid-June, that number has jumped to 20 or 25. Mostly women, ages 20 to 80, are reporting hair coming out in fistfuls, Khetarpal said.In Houston, at least a dozen patients have told fertility specialist Dr. Rashmi Kudesia they’re having irregular menstrual cycles, changes in cervical discharge and breast tenderness, despite normal hormone levels.Stress is also the culprit dentists are pointing to for the rapid increase in patients with teeth grinding, teeth fractures and TMJ.“We, as humans, like to have the idea that we are in control of our minds and that stress isn’t a big deal,” Love said. €œBut it’s simply not true.”How Mental Stress Becomes PhysicalStress causes physical changes in the body that can affect nearly every organ system.Although symptoms of chronic stress are often dismissed as being in one’s head, the pain is very real, said Kate Harkness, a professor of psychology and psychiatry at Queen’s University in Ontario.When the body feels unsafe — whether it’s a physical threat of attack or a psychological fear of losing a job or catching a disease — the brain signals adrenal glands to pump stress hormones.

Adrenaline and cortisol flood the body, activating the fight-or-flight response. They also disrupt bodily functions that aren’t necessary for immediate survival, like digestion and reproduction.When the danger is over, the hormones return to normal levels. But during times of chronic stress, like a pandemic, the body keeps pumping out stress hormones until it tires itself out. This leads to increased inflammation throughout the body and brain, and a poorly functioning immune system.Studies link chronic stress to heart disease, muscle tension, gastrointestinal issues and even physical shrinking of the hippocampus, an area of the brain associated with memory and learning. As the immune system acts up, some people can even develop new allergic reactions, Harkness said.The good news is that many of these symptoms are reversible.

But it’s important to recognize them early, especially when it comes to the brain, said Barbara Sahakian, a professor of clinical neuropsychology at the University of Cambridge.“The brain is plastic, so we can to some extent modify it,” Sahakian said. €œBut we don’t know if there’s a cliff beyond which you can’t reverse a change. So the sooner you catch something, the better.”The Day-to-Day ImpactIn some ways, mental health awareness has increased during the pandemic. TV shows are flush with ads for therapy and meditation apps, like Talkspace and Calm, and companies are announcing mental health days off for staff.For Alex Kostka, pandemic-related stress has brought on mood swings, nightmares and jaw pain.(Jordan Battiste)But those spurts of attention fail to reveal the full impact of poor mental health on people’s daily lives.For Alex Kostka, pandemic-related stress has brought on mood swings, nightmares and jaw pain.He’d been working at a Whole Foods coffee bar in New York City for only about a month before the pandemic hit, suddenly anointing him an essential worker. As deaths in the city soared, Kostka continued riding the subway to work, interacting with co-workers in the store and working longer hours for just a $2-per-hour wage increase.

(Months later, he’d get a $500 bonus.) It left the 28-year-old feeling constantly unsafe and helpless.“It was hard not to break down on the subway the minute I got on it,” Kostka said.Soon he began waking in the middle of the night with pain from clenching his jaw so tightly. Often his teeth grinding and chomping were loud enough to wake his girlfriend.Kostka tried Talkspace, but found texting about his troubles felt impersonal. By the end of the summer, he decided to start using the seven free counseling sessions offered by his employer. That’s helped, he said. But as the sessions run out, he worries the symptoms might return if he’s unable to find a new therapist covered by his insurance.“Eventually, I will be able to leave this behind me, but it will take time,” Kostka said.

€œI’m still very much a work in progress.”How to Mitigate Chronic StressWhen it comes to chronic stress, seeing a doctor for stomach pain, headaches or skin rashes may address those physical symptoms. But the root cause is mental, medical experts say.That means the solution will often involve stress-management techniques. And there’s plenty we can do to feel better:Exercise. Even low- to moderate-intensity physical activity can help counteract stress-induced inflammation in the body. It can also increase neuronal connections in the brain.Meditation and mindfulness.

Research shows this can lead to positive, structural and functional changes in the brain.Fostering social connections. Talking to family and friends, even virtually, or staring into a pet’s eyes can release a hormone that may counteract inflammation.Learning something new. Whether it’s a formal class or taking up a casual hobby, learning supports brain plasticity, the ability to change and adapt as a result of experience, which can be protective against depression and other mental illness.“We shouldn’t think of this stressful situation as a negative sentence for the brain,” said Harkness, the psychology professor in Ontario. €œBecause stress changes the brain, that means positive stuff can change the brain, too. And there is plenty we can do to help ourselves feel better in the face of adversity.” Aneri Pattani.

apattani@kff.org, @aneripattani Related Topics Mental Health Public Health COVID-19About HealthBent KHN's chief Washington correspondent, Julie Rovner, who has covered health care for more than 30 years, offers insight and analysis of policies and politics in her regular HealthBent columns.Send questions to jrovner@kff.org. Use Our Content This story can be republished for free (details). Democrats on the Senate Judiciary Committee know that, barring something unexpected, they lack the votes to block President Donald Trump from installing his third justice in four years on the Supreme Court and creating a 6-3 conservative majority.They also know that, in a normal year, by mid-October Congress would be out of session and members home campaigning. But 2020 is obviously no normal year. So, while the rest of Congress is home, Democratic Judiciary members are trying something very different in the hearings for nominee Amy Coney Barrett. Rather than prosecuting their case against Barrett, currently a federal appeals court judge, they are refighting the war that helped them pick up seats in 2018 — banging on Republicans for trying to eliminate the Affordable Care Act.Conveniently, the ACA is relevant to the Supreme Court debate because the justices are scheduled to hear a case that could invalidate the law on Nov.

10 — exactly a week after Election Day.As California Sen. Kamala Harris, a member of the Judiciary Committee and the Democratic vice presidential candidate, put it to Barrett on Tuesday, “Republicans are scrambling to confirm this nominee as fast as possible because they need one more Trump judge on the bench before Nov. 10th to win and strike down the entire Affordable Care Act. This is not hyperbole. This is not hypothetical.

This is happening.”Said Sen. Richard Durbin (D-Ill.), also on Tuesday. €œWe really believe the Supreme Court’s consideration of that case is going — could literally change America for millions of people.” Email Sign-Up Subscribe to KHN’s free Morning Briefing. To be sure, Republicans too were playing to their electorate during the questioning of Barrett, as they expounded on her conservative credentials on issues such as gun rights.Nonetheless, Democrats were uniformly disciplined in their assault on her potential vote in the ACA case. They chided both Barrett and the Republicans who are rushing her nomination to the floor literally days before a presidential election.

In addition, Democrats criticized Republicans for spending time on a nonemergency nomination while continuing to ignore the need for financial and other relief for the COVID-19 pandemic.And they raised what in more normal times would be the featured talking point for Democrats. The threat to abortion and other reproductive rights from Barrett, who before her elevation to the federal bench publicly opposed abortion and taught law at Notre Dame, one of the nation’s preeminent Catholic universities.“For many people, and particularly for women, this is a fundamental question,” said Sen. Dianne Feinstein (D-Calif.), the committee’s top Democrat.Barrett, like every other Supreme Court nominee for the past three decades, declined to offer positions that could suggest which way she might rule on hot-button issues, including abortion and the ACA.She repeatedly cited what has come to be called the “Ginsburg rule” — after the justice she would replace, Ruth Bader Ginsburg — saying “no hints, no previews, no forecasts.”Still, Democrats suggested that she may have tipped her hand on the Affordable Care Act case. In pointing out that the issues in the case, now known as California v. Texas, are different from the previous cases upholding the health law in 2012 and 2015, she said the current case will turn on “severability.”She was referring to the question of whether, if one portion of a law is found to be unconstitutional, the rest of the law can stand without it.

In the current ACA case, a group of Republican attorneys general — and the Trump administration — are arguing that when Congress reduced the ACA’s penalty for not having insurance to zero, the requirement to be covered no longer had a tax attached, and therefore the law is now unconstitutional. They based their argument on Chief Justice John Roberts’ 2012 conclusion that the ACA was valid because that penalty was a constitutionally appropriate tax.The law’s opponents say the rest of the law cannot be “severed” and must therefore fall, too. A federal district judge in Texas agreed with them.But merely saying the case turns on severability suggests that Barrett has already prejudged major parts of the case, Democrats said. Sen. Chris Coons (D-Del.) noted, “You don’t get to the question of severability if you haven’t already determined the question of constitutionality.”Barrett insisted repeatedly that despite an article she wrote in 2017 suggesting that the 2012 case upholding the law was wrongly decided, “I have no animus to nor agenda for the ACA,” as she told Sen.

Amy Klobuchar (D-Minn.) on Wednesday.In their rare show of unity of message, Democrats made clear that their primary audience in these hearings was not their Senate colleagues, but the voting public. While this battle looks lost, they hope to win the War of Nov. 3.HealthBent, a regular feature of KHN, offers insight and analysis of policies and politics from KHN’s chief Washington correspondent, Julie Rovner, who has covered health care for more than 30 years. Julie Rovner. jrovner@kff.org, @jrovner Related Topics Courts Elections HealthBent The Health Law Abortion U.S.

CongressThis story also ran on LAist. This story can be republished for free (details). Los Angeles County officials attribute a dramatic decline in COVID-19 death and case rates among Blacks and Latinos over the past two months to aggressive workplace health enforcement and the opening of tip lines to report violations.Now, officials intend to cement those gains by creating workplace councils among employees trained to look for COVID-19 prevention violations and correct or report them — without fear of being fired or punished.Cal/OSHA, the state’s workplace safety and health authority, is overwhelmed with complaints and tips about COVID-19 violations, and the county’s health investigators — there were officially 346 of them as of last Friday — can’t possibly keep tabs on all of Los Angeles’ more than 240,000 businesses, labor advocates say.The councils could help keep Los Angeles from backsliding on its progress in mitigating cases and racial disparities in the fall as more businesses are likely to reopen, said Tia Koonse, a researcher with the UCLA Labor Center and co-author of an assessment of the workplace council proposal. The L.A. County Board of Supervisors is expected to approve an ordinance this month requiring businesses to permit employees to form the councils, which would troubleshoot compliance issues and report to the health department when necessary. Email Sign-Up Subscribe to KHN’s free Morning Briefing. Critics, including many business leaders, say the measure will create more red tape at the worst possible time for the economy.

But labor groups and some businesses say it is crucial to fighting the pandemic. Workers around the country have been sacked or reprimanded for complaining about COVID-related safety violations, and laws protecting them are spotty.“Workers have a right to be in a safe space and shouldn’t face any retaliation” for noting poor practices, said Barbara Ferrer, director of the L.A. County Public Health Department. Low-wage workers have been “tremendously disadvantaged” by having to work outside the home in contact with other people, often without sufficient protection, she said.During the upsurge of COVID cases that followed Memorial Day weekend family gatherings and business openings, Latinos in Los Angeles were dying at a rate more than four times higher than that of whites, while Blacks were twice as likely as whites to die of the disease. Two months later, death rates among Blacks and Latinos had fallen by more than half and were approaching the rate for whites, according to age-adjusted data from the county health department.

While four times as many Latinos as whites were reported COVID-positive in late July, the Latino case rates were only 64% higher by mid-September. The positivity rate among Blacks was 60% higher than that of whites in late July, but the disparity had waned by mid-September.Experts can’t be certain that any one policy is responsible for the decline in deaths among Blacks and Latinos in Los Angeles — and state and county rates have declined for the entire population in recent weeks. But Ferrer attributed the progress to her department’s focus on workplace enforcement of health orders, which include rules about physical distancing, providing face coverings for workers and requiring face coverings for customers.“If you’re in violation, at this point we can either issue citations, or there are cases where we just close the place down because the violations are egregious,” she said.The sharp racial disparities that characterized the pandemic from the beginning are under even more scrutiny now that California has become the first state to make “health equity” a factor in its decisions to allow expanded reopening.Large counties may not advance toward full reopening until their most disadvantaged neighborhoods, and not just the county as a whole, meet or are lower than the targeted levels of disease. The criteria prod local governments to invest more in testing, contact tracing and education in poor neighborhoods with high levels of the disease.Ferrer’s focus on workplaces crystallized during a crackdown on Los Angeles Apparel, a clothing factory that had pivoted to face mask manufacturing during the pandemic. Despite the ready inventory of masks, an outbreak at the factory resulted in at least 300 cases — and four deaths.The health department, acting on a tip from community health centers flooded with sick Los Angeles Apparel workers, shut down the factory on June 27.

That action highlighted the need to bring the government and labor unions together to fight the pandemic, said Jim Mangia, CEO of St. John’s Well Child &. Family Center, a chain of community health centers in South L.A.“At St. John’s, almost all of our patients are the working poor,” Mangia said. €œThey were getting infected at work and bringing it home to their families, and I think intervening at the workplace is what really made all the difference.”Early in the pandemic, Ferrer had also set up an anonymous complaint line for employees who want to report workplace violations.

It gets about 2,000 calls a week, she said. As of Oct. 10, the department’s website lists 132 workplaces that have had three or more confirmed COVID-19 cases, with a total of 2,191 positives. Another table dated Oct. 7 lists 124 citations — mostly to gyms and places of worship — for failing to comply with a health officer order.“Fortunately, we’re not like Cal/OSHA, in the sense that it doesn’t take us months to complete an investigation,” Ferrer said.

€œWe’re able to move more swiftly under the health officer orders to actually make sure that we’re protecting workers.”Public health councils are the next phase in Ferrer’s plan to keep workers safe. The plan stemmed from the response of Overhill Farms, a frozen-food factory in Vernon, California, after an outbreak of more than 20 cases and one death. The factory and its temporary job agency were hit with more than $200,000 in proposed penalties from Cal/OSHA in September, but before the fines landed, the factory leadership was already responding by beginning to hold meetings with workers to improve safety there.“They found that the workers helped them bring down infection rates and helped solve problems,” said Roxana Tynan, executive director of the Los Angeles Alliance for a New Economy, a worker advocacy organization.While it’s not exactly a feel-good story about corporate beneficence, the turnaround at Overhill Farms added credence to the benefits of workplace councils, said Koonse of UCLA.No company would have to spend more than 0.44% of its payroll cost on the health councils, she estimated.Still, the idea has gotten a mixed reception from businesses. In an Aug. 24 statement, CEO Tracy Hernandez of the L.A.

County Business Federation wrote that the proposal would add “burdensome and convoluted programs that will further hinder an employer’s ability to meet demands, get back on their feet, and adequately serve their employees and customers.”But Jim Amen, president of the eight-store Super A Foods grocery chain, said businesses should welcome the councils as a way to keep lines of communication open. Such practices have kept infection rates low at his stores, even without a mandate, Amen said.“All I know is, for Super A, our employees are heavily involved in everything we do,” Amen said.Labor groups see the councils as a crucial way for workers to raise concerns without fear of retaliation.“In low-wage industries like the garment industry, workers coming together gets them fired,” said Marissa Nuncio, director of the Garment Worker Center, a nonprofit that mainly serves immigrants from Mexico and Central America.While disparities are narrowing in L.A. County, some shops are still unsafe and potential whistleblowers aren’t confident their reports to the county’s tip line are being acted on, she said.“We continue to get calls from our members who are sick, have COVID and are hospitalized,” Nuncio said. €œAnd the most obvious location for them to have been infected is in their workplace, because so many precautions are not being taken.”KHN data reporter Hannah Recht contributed to this article. Anna Almendrala.

aalmendrala@kff.org, @annaalmendrala Related Topics California Multimedia Public Health Race and Health States COVID-19.

Cardura vs flomax

NCHS Data Brief No cardura vs flomax. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic conditions such cardura vs flomax as cardiovascular disease (1) and diabetes (2).

Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is “the permanent cessation of menstruation that occurs after the loss of cardura vs flomax ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status.

The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women cardura vs flomax are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal. Keywords.

Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three cardura vs flomax nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 cardura vs flomax. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend by menopausal status cardura vs flomax (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cardura vs flomax cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data cardura vs flomax table for Figure 1pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one cardura vs flomax in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 cardura vs flomax. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by cardura vs flomax menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no cardura vs flomax longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data cardura vs flomax table for Figure 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the past week cardura vs flomax (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 cardura vs flomax. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by cardura vs flomax menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and cardura vs flomax their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data cardura vs flomax table for Figure 3pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up feeling well rested cardura vs flomax 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 cardura vs flomax. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories.

Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status.

A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. €.

2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?.

€Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?. €Trouble falling asleep.

Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone.

Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option.

Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454.

2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50.

2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N.

Perimenopause. From research to practice. J Women’s Health (Larchmt) 25(4):332–9.

2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society.

J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International.

SUDAAN (Release 11.0.0) [computer software]. 2012. Suggested citationVahratian A.

Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286. Hyattsville, MD.

National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J.

Blumberg, Ph.D., Associate Director for Science.

NCHS Data buy cardura usa Brief No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2) buy cardura usa.

Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is “the permanent cessation of menstruation that occurs after the loss of ovarian buy cardura usa activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status.

The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal buy cardura usa. Keywords.

Insufficient sleep, menopause, National Health Interview Survey buy cardura usa Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 buy cardura usa. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend by menopausal status buy cardura usa (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago buy cardura usa or less.

Women were premenopausal if they still had a menstrual cycle. Access data buy cardura usa table for Figure 1pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling buy cardura usa asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 buy cardura usa. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal buy cardura usa status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago buy cardura usa or less.

Women were premenopausal if they still had a menstrual cycle. Access data buy cardura usa table for Figure 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged buy cardura usa 40–59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 buy cardura usa. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal buy cardura usa status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle buy cardura usa and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for buy cardura usa Figure 3pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal buy cardura usa women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 buy cardura usa. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories.

Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status.

A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. €.

2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?.

€Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?. €Trouble falling asleep.

Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone.

Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option.

Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454.

2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50.

2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N.

Perimenopause. From research to practice. J Women’s Health (Larchmt) 25(4):332–9.

2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society.

J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International.

SUDAAN (Release 11.0.0) [computer software]. 2012. Suggested citationVahratian A.

Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286. Hyattsville, MD.

National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J.

Blumberg, Ph.D., Associate Director for Science.

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At the cardura 10mg start of field work season, ecologist Jory Brinkerhoff usually advises his crew to watch out for summertime fevers. If you develop a fever at that time of year, he tells them, it’s probably not the flu, but a tick-borne illness.But this year, Brinkerhoff, who studies human risk for flea- and tick-transmitted diseases at the University of Richmond, didn’t know exactly what to tell his field crew. A fever in the middle cardura 10mg of summer 2020 could mean a tick-borne illness.

Or, it could mean COVID-19.With the novel SARS-CoV-2 virus still spreading across the country, some experts worry about the overlap between COVID-19 and Lyme disease, which is caused by a bacterium carried by black-legged ticks. While it’s too soon to know exactly how the pandemic will affect Lyme disease rates this year, experts like Brinkerhoff wonder if more people spending time outside beating the quarantine cardura 10mg blues could lead to more people being exposed to disease-carrying ticks. Some overlapping symptoms might also lead to delayed diagnosis and treatment of Lyme, he notes.

At the same time, weather patterns in some parts of the country may actually lead to fewer Lyme disease cases this year. No matter the broader trends, there are things anyone cardura 10mg getting outside can do to protect themselves from ticks. Lyme Disease on the MoveOver the last few decades, Lyme disease has been on the rise in the United States.

There are cardura 10mg many overlapping reasons for this, says Brinkerhoff. Awareness has gone up since the 1970s, when Lyme was first described in the U.S. Landscape changes like cutting forests and building suburbs near wooded areas has put humans in closer contact with ticks and tick-carrying animals.

Deer populations cardura 10mg have exploded in the last 100 years, he notes. And climate change is likely allowing ticks to spread to and thrive in new parts of the continent. This year, people cardura 10mg have flocked to the great outdoors to escape their home quarantines and engage in socially-distant fun.

It’s possible that more people trying to get outside could mean more people exposed to ticks and, therefore, Lyme disease, says Brinkerhoff, who wrote an article in The Conversation on the issue earlier this year. Animals have been behaving differently during the pandemic as well, especially during the early days of lockdown, and it’s unclear if that could also have an effect on Lyme disease rates, he says.In some parts of the country, however, Lyme may be less of a concern this summer than it normally is. Maine is usually a Lyme hotspot in early summer, but unusually hot cardura 10mg and dry weather this year may be keeping ticks close to the ground and away from human contact, says Robert P.

Smith Jr., an infectious disease physician and director of the division of infectious diseases at Maine Medical Center. While it’s too early to tell, Lyme disease rates in Maine could actually go down this summer as a result, he says.Overlapping SymptomsWith everyone rightfully concerned about COVID-19, Lyme disease likely cardura 10mg isn’t at the forefront of someone’s mind if they develop a fever. Plus, about two-thirds of people with Lyme disease don’t remember being bitten by a tick, says Smith.

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At the start of field work season, ecologist Jory Brinkerhoff usually advises his crew buy cardura usa to watch out for summertime fevers. If you develop a fever at that time of year, he tells them, it’s probably not the flu, but a tick-borne illness.But this year, Brinkerhoff, who studies human risk for flea- and tick-transmitted diseases at the University of Richmond, didn’t know exactly what to tell his field crew. A fever in the middle of summer 2020 could buy cardura usa mean a tick-borne illness. Or, it could mean COVID-19.With the novel SARS-CoV-2 virus still spreading across the country, some experts worry about the overlap between COVID-19 and Lyme disease, which is caused by a bacterium carried by black-legged ticks.

While it’s too soon to know exactly how the pandemic will affect Lyme disease rates this year, experts like Brinkerhoff wonder if more people spending time outside beating buy cardura usa the quarantine blues could lead to more people being exposed to disease-carrying ticks. Some overlapping symptoms might also lead to delayed diagnosis and treatment of Lyme, he notes. At the same time, weather patterns in some parts of the country may actually lead to fewer Lyme disease cases this year. No matter the broader trends, there are things anyone getting outside can do buy cardura usa to protect themselves from ticks.

Lyme Disease on the MoveOver the last few decades, Lyme disease has been on the rise in the United States. There are many overlapping buy cardura usa reasons for this, says Brinkerhoff. Awareness has gone up since the 1970s, when Lyme was first described in the U.S. Landscape changes like cutting forests and building suburbs near wooded areas has put humans in closer contact with ticks and tick-carrying animals.

Deer populations have exploded in the last 100 years, buy cardura usa he notes. And climate change is likely allowing ticks to spread to and thrive in new parts of the continent. This buy cardura usa year, people have flocked to the great outdoors to escape their home quarantines and engage in socially-distant fun. It’s possible that more people trying to get outside could mean more people exposed to ticks and, therefore, Lyme disease, says Brinkerhoff, who wrote an article in The Conversation on the issue earlier this year.

Animals have been behaving differently during the pandemic as well, especially during the early days of lockdown, and it’s unclear if that could also have an effect on Lyme disease rates, he says.In some parts of the country, however, Lyme may be less of a concern this summer than it normally is. Maine is usually a Lyme hotspot in early summer, but unusually hot and dry weather this year may be keeping ticks close to the ground and away from human contact, says buy cardura usa Robert P. Smith Jr., an infectious disease physician and director of the division of infectious diseases at Maine Medical Center. While it’s too early to tell, Lyme disease rates in Maine could actually go down this summer as a result, he says.Overlapping SymptomsWith everyone rightfully buy cardura usa concerned about COVID-19, Lyme disease likely isn’t at the forefront of someone’s mind if they develop a fever.

Plus, about two-thirds of people with Lyme disease don’t remember being bitten by a tick, says Smith. Many who develop Lyme disease are bitten by poppy seed-sized immature ticks that can stay on the body unnoticed for two or three days before dropping off, he says.There is some overlap between COVID-19 and Lyme disease symptoms that could cause confusion. In both cases, people usually develop a fever and muscle aches, says buy cardura usa Smith. He has heard secondhand about a few cases in Maine in which patients with these symptoms were first tested for COVID-19 and were later found to have Lyme disease.However, there are some crucial differences between the two illnesses, Smith says.

The majority of buy cardura usa people with symptomatic COVID-19 will have a cough or shortness of breath, whereas Lyme disease generally has no respiratory component, says Smith. COVID-19 patients also have a higher risk for gastrointestinal issues, and Lyme patients do not. While not all people with Lyme disease develop a rash, 70 to 80 percent do, Smith notes. Rashes are not common symptoms buy cardura usa for COVID-19 infections.

Receiving an accurate diagnosis and relatively quick treatment can greatly reduce the severity of a Lyme disease infection. €œIt doesn’t have to be buy cardura usa immediate. If you think you might have Lyme disease, you need to get diagnosed with a week or so,” says Smith. €œThat’s usually very early in the disease and you can expect an excellent response to antibiotic treatment.” Delaying treatment by a couple of weeks can lead to more serious complications, including nerve-related symptoms, Lyme meningitis, facial muscle weakness (Bell’s palsy), Lyme arthritis and other conditions, he says.

While antibiotics are still effective at this stage, it tends to take longer to fully buy cardura usa recover.Fortunately, for anyone concerned about safe outdoor excursions here and now, there are several practical steps you can take to avoid ticks. Use insect repellant and wear protective layers. Stick to the path instead of straying into dense underbrush, says Smith. When you return from an adventure, put your clothes in the washer and check yourself for ticks.

And if you do start to feel feverish a few days later, call your doctor and be sure to mention you’ve been spending time outside..

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