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Can you get cipro over the counter

Comfort and pain management have always been paramount in the child-centered can you get cipro over the counter approach to care at UC Davis Children’s Hospital. A new hospital initiative called Comfort Commitment launched this month, which provides a standardized approach can you get cipro over the counter to help pediatric patients better cope with distressing procedures and decrease pain and anxiety. Child life specialist Emily McDaniel and nurse Carter Todd discuss comfort planning with a patient.It involves four steps to managing a patient’s comfort:Ask the child and caregiver what they know and understand about the procedureShare more about the procedure in simple terms using honest, age-appropriate languagePlan for the procedure, considering medicine and numbing options, refocusing techniques (toys, electronics, music), comfort positions (chest-to-chest for small children with their caregiver, swaddle for infants and young toddlers) and a calming environment (with lights, noises and words)Follow the agreed-upon plan and ensure the child feels heard and modify comfort measures to meet the patient’s needs“Our ultimate goal is to establish an environment where hospital experiences can be growth-promoting for children and families,” said child life specialist Emily McDaniel. €œThrough individualizing procedural comfort plans with this collaborative four-step process, we are consistently able to provide coping support and empower the child to customize a plan that uniquely meets their specific needs.”The initiative can you get cipro over the counter was funded by a Children's Miracle Network at UC Davis grant.

For more information, visit https://ucdavis.health/comfort.A pandemic is probably not the best time to refer to someone’s personality as ‘infectious.’ Shalaine Reddic has always believed she could do more than people thought she could.But you don’t have to talk with Shalaine Reddic for long, even on the phone, to feel the positive energy and can-do spirit of this UC Davis Medical Center nurse.Reddic’s desire to help patients blends perfectly with her strong drive to succeed, academic muscle and never-say-die attitude – all wrapped up in what she calls her fashion-forward style.A single mother of three, Reddic has never stopped moving up the career ladder. She started out doing clerical work on can you get cipro over the counter the Davis campus years ago. Today, Reddic can you get cipro over the counter is on the verge of becoming a licensed nurse practitioner.“I always like to stay busy,” said Reddic.That’s an understatement. She was deftly juggling the phone conversation after a long work week while providing cooking instruction to her 16-year-old son.

€œAnd I’ve always believed that I could can you get cipro over the counter do more than people thought I could,” she said.When she first started working, the Rancho Cordova resident didn’t consider the patient side of health care. She didn’t enjoy the thought of seeing blood or being in the clinic environment. But after becoming a clinical quality improvement coordinator at UC Davis Health, she started working with nurses and quickly gained an appreciation for the profession.Reddic spent nearly 10 years slowly but steadily taking classes and moving from one nursing degree to the next – from an associate of art’s degree at a community college to a bachelor’s can you get cipro over the counter degree (cum laude, of course) from Sacramento State – all while working and almost single-handedly raising her children.“I have seen her push through personal issues on numerous occasions,” said Darrell Desmond, nurse manager of Reddic’s hospital unit. €œBut she just keeps moving forward with an always positive can you get cipro over the counter attitude despite life’s many challenges.”It was while volunteering at a community clinic for underserved women in Sacramento that Reddic had what she calls an epiphany.

It was a moment of intense clarity for someone who already had a rewarding nursing career.“I saw nurse practitioners working with patients, diagnosing health problems, prescribing medications,” Reddic said. €œThey were can you get cipro over the counter providers. They had the autonomy to make patient-care decisions. For me, can you get cipro over the counter that was it.

I was in tears because I knew then and there that was what I really wanted to do.”So, Reddic decided to add another academic achievement to her three nursing degrees and an AA degree in business administration. A graduate degree as a family nurse practitioner.Always on the can you get cipro over the counter move, Reddic never stops seeking new goals and achievements.Three years and many commute miles later, she recently completed her master’s from Sonoma State and is now studying for her boards. While working full time, of course.Reddic admits to being can you get cipro over the counter overwhelmed at times over the years. But she said strong faith and prayer helped her put things in perspective when she felt defeated and exhausted.“It’s been a journey and a learning process,” Reddic said.

€œI’ve got can you get cipro over the counter a few bruises, but I’m still here and excited about each day. When I face adversity, I always step it up a notch.”As if it wasn’t enough to become a nurse practitioner, Reddic is considering going back to school for a certificate in psychiatry and, perhaps, a doctorate at some point.She’s also dreaming about plans for starting two independent clinics. One would can you get cipro over the counter be dedicated to serving underprivileged communities. The other would be an IV hydration bar, a trending intravenous therapy program for wellness, beauty and health.“Shalaine has organized her life for success,” said Joleen Lonigan, an executive director of Patient Care Services at UC Davis Medical can you get cipro over the counter Center.

€œShe’s turned her motivation into achievements and her pathway into inspiration that can benefit others.”Her story is undoubtedly motivational for anyone who knows Reddic. Colleagues say can you get cipro over the counter her determination is impressive. Her attitude always stays positive, undoubtedly enhanced by that fashion-forward sensibility that can be seen, despite the required nursing apparel, in some colorful shoe choices and unique earrings. And those academic and clinical accomplishments? can you get cipro over the counter.

They’re likely just steppingstones leading toward further personal and professional goals.In short, Shalaine Reddic and the spirit with which she approaches life seem – even in a pandemic age – wonderfully contagious..

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Cipro
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Yes
No
Yes
Without prescription
No
Canadian pharmacy only
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In online pharmacy
100mg
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Abnormal vision
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Memory problems
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Start Preamble Centers for Medicare & cipro with or without food. Medicaid Services (CMS), HHS. Final rule cipro with or without food. Correction. In the August 4, 2020 issue of the Federal Register, we published a final rule entitled “FY 2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Special Requirements for Psychiatric Hospitals for Fiscal Year Beginning October 1, 2020 (FY 2021)”.

The August 4, 2020 final rule updates the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPF), which include psychiatric hospitals and excluded psychiatric units of an Inpatient Prospective Payment System (IPPS) hospital or critical access cipro with or without food hospital. In addition, we adopted more recent Office of Management and Budget (OMB) statistical area delineations, and applied a 2-year transition for all providers negatively impacted by wage index changes. This correction document cipro with or without food corrects the statement of economic significance in the August 4, 2020 final rule. This correction is effective October 1, 2020. Start Further Info The IPF Payment Policy mailbox at IPFPaymentPolicy@cms.hhs.gov for general information.

Nicolas Brock, (410) 786-5148, for information regarding cipro with or without food the statement of economic significance. End Further Info End Preamble Start Supplemental Information I. Background In FR cipro with or without food Doc. 2020-16990 (85 FR 47042), the final rule entitled “FY 2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Special Requirements for Psychiatric Hospitals for Fiscal Year Beginning October 1, 2020 (FY 2021)” (hereinafter referred to as the FY 2021 IPF PPS final rule) there was an error in the statement of economic significance and status as major under the Congressional Review Act (5 U.S.C. 801 et seq.).

Based on an estimated total impact of $95 million in increased transfers from the federal government to IPF providers, we previously stated that the final rule was not economically significant under Executive Order (E.O.) cipro with or without food 12866, and that the rule was not a major rule under the Congressional Review Act. However, the Office of Management and Budget designated this rule as economically significant under E.O. 12866 and major under the Congressional Review Act cipro with or without food. We are correcting our previous statement in the August 4, 2020 final rule accordingly. This correction is effective October 1, 2020.

II. Summary of Errors On page 47064, in the third column, the third full paragraph under B. Overall Impact should be replaced entirely. The entire paragraph stating. €œWe estimate that this rulemaking is not economically significant as measured by the $100 million threshold, and hence not a major rule under the Congressional Review Act.

Accordingly, we have prepared a Regulatory Impact Analysis that to the best of our ability presents the costs and benefits of the rulemaking.” should be replaced with. €œWe estimate that the total impact of this final rule is close to the $100 million threshold. The Office of Management and Budget has designated this rule as economically significant under E.O. 12866 and a major rule under the Congressional Review Act (5 U.S.C. 801 et seq.).

Accordingly, we have prepared a Regulatory Impact Analysis that to the best of our ability presents the costs and benefits of the rulemaking.” III. Waiver of Proposed Rulemaking and Delay in Effective Date We ordinarily publish a notice of proposed rulemaking in the Federal Register to provide a period for public comment before the provisions of a rule take effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive this notice and comment procedure if the Secretary of the Department of Human Services finds, for good cause, that the notice and comment process is impracticable, unnecessary, or contrary to the public interest, and incorporates a statement of the finding and the reasons therefore in the notice. This correction document does not constitute a rulemaking that would be subject to these requirements because it corrects only the statement of economic significance included in the FY 2021 IPF PPS final rule.

The corrections contained in this document are consistent with, and do not make substantive changes to, the policies and payment methodologies that were adopted and subjected to notice and comment procedures in the FY 2021 IPF PPS final rule. Rather, the corrections made through this correction document are intended to ensure that the FY 2021 IPF PPS final rule accurately reflects OMB's determination about its economic significance and major status under the Congressional Review Act (CRA). Executive Order 12866 and CRA determinations are functions of the Office of Management and Budget, not the Department of Health and Human Services, and are not rules as defined by the Administrative Procedure Act (5 U.S. Code 551(4)). We ordinarily provide a 60-day delay in the effective date of final rules after the date they are issued, in accordance with the CRA (5 U.S.C.

801(a)(3)). However, section 808(2) of the CRA provides that, if an agency finds good cause that notice and public procedure are impracticable, unnecessary, or contrary to the public interest, the rule shall take effect at such time as the agency determines. Even if this were a rulemaking to which the delayed effective date requirement applied, we found, in the FY 2021 IPF PPS Final Rule (85 FR 47043), good cause to waive the 60-day delay in the effective date of the IPF PPS final rule. In the final rule, we explained that, due to CMS prioritizing efforts in support of containing and combatting the COVID-Start Printed Page 5292419 public health emergency by devoting significant resources to that end, the work needed on the IPF PPS final rule was not completed in accordance with our usual rulemaking schedule. We noted that it is critical, however, to ensure that the IPF PPS payment policies are effective on the first day of the fiscal year to which they are intended to apply and therefore, it would be contrary to the public interest to not waive the 60-day delay in the effective date.

Undertaking further notice and comment procedures to incorporate the corrections in this document into the FY 2021 IPF PPS final rule or delaying the effective date would be contrary to the public interest because it is in the public's interest to ensure that the policies finalized in the FY 2021 IPF PPS are effective as of the first day of the fiscal year to ensure providers and suppliers receive timely and appropriate payments. Further, such procedures would be unnecessary, because we are not altering the payment methodologies or policies. Rather, the correction we are making is only to indicate that the FY 2021 IPF PPS final rule is economically significant and a major rule under the CRA. For these reasons, we find we have good cause to waive the notice and comment and effective date requirements. IV.

Correction of Errors in the Preamble In FR Doc. 2020-16990, appearing on page 47042 in the Federal Register of Tuesday, August 4, 2020, the following correction is made. 1. On page 47064, in the 3rd column, under B. Overall Impact, correct the third full paragraph to read as follows.

We estimate that the total impact of this final rule is very close to the $100 million threshold. The Office of Management and Budget has designated this rule as economically significant under E.O. 12866 and a major rule under the Congressional Review Act (5 U.S.C. 801 et seq.). Accordingly, we have prepared a Regulatory Impact Analysis that to the best of our ability presents the costs and benefits of the rulemaking.

Start Signature Dated. August 24, 2020. Wilma M. Robinson, Deputy Executive Secretary to the Department, Department of Health and Human Services. End Signature End Supplemental Information [FR Doc.

2020-18902 Filed 8-26-20. 8:45 am]BILLING CODE 4120-01-PBy Cyndie Shearing @CyndieShearing Americans from all walks of life are struggling to cope with an array of issues related to the COVID-19 pandemic. Fear and anxiety about this new disease and what could happen is sometimes overwhelming and can cause strong emotions in adults and children. But long before the pandemic hit the U.S., farmers and ranchers were struggling. Years of falling commodity prices, natural disasters, declining farm income and trade disputes with China hit rural America hard, and not just financially.

Farmers’ mental health is at risk, too. Long before the pandemic hit the U.S., farmers and ranchers were struggling. Fortunately, America’s food producers have proven to be a resilient bunch. Across the country, they continue to adopt new ways to manage stress and cope with the difficult situations they’re facing. A few examples are below.

In Oklahoma, Bryan Vincent and Gary Williams are part of an informal group that meets on a regular basis to share their burdens. “It’s way past farming,” said Vincent, a local crop consultant. €œIt’s a chance to meet with like-minded people. It’s a chance for us to let some things out. We laugh, we may cry together, we may be disgusted together.

We share our emotions, whether good, bad.” Gathering with trusted friends has given them the chance to talk about what’s happening in their lives, both good and bad. €œI would encourage anybody – any group of farmers, friends, whatever – to form a group” to meet regularly, said Williams, a farmer. €œNot just in bad times. I think you should do that regardless, even in good times. Share your victories and triumphs with one another, support one another.” James Young Credit.

Nocole Zema/Virginia Farm Bureau In Michigan, dairy farmer Ashley Messing Kennedy battled postpartum depression and anxiety while also grieving over a close friend and farm employee who died by suicide. At first she coped by staying busy, fixing farm problems on her own and rarely asking for help. But six months later, she knew something wasn’t right. Finding a meaningful activity to do away from the farm was a positive step forward. €œRunning’s been a game-changer for me,” Kennedy said.

€œIt’s so important to interact with people, face-to-face, that you don’t normally engage with. Whatever that is for you, do it — take time to get off the farm and walk away for a while. It will be there tomorrow.” Rich Baker also farms in Michigan and has found talking with others to be his stress management tactic of choice. €œYou can’t just bottle things up,” Baker said. €œIf you don’t have a built-in network of farmers, go talk to a professional.

In some cases that may be even more beneficial because their opinions may be more impartial.” James Young, a beef cattle farmer in Virginia, has found that mental health issues are less stigmatized as a whole today compared to the recent past. But there are farmers “who would throw you under the bus pretty fast” if they found out someone was seeking professional mental health, he said. €œIt’s still stigmatized here.” RFD-TV Special on Farm Stress and Farmer Mental HealthAs part of the American Farm Bureau Federation’s ongoing effort to raise awareness, reduce stigma and share resources related to mental health, the organization partnered with RFD-TV to produce a one-hour episode of “Rural America Live” on farm stress and farmer mental health. The episode features AFBF President Zippy Duvall, Farm Credit Council President Todd Van Hoose and National Farmers Union President Rob Larew, as well as two university Extension specialists, a rural pastor and the author of “Stress-Free You!. € The program aired Thursday, Aug.

27, and will be re-broadcast on Saturday, Aug. 29, at 6 a.m. Eastern/5 a.m. Central. Cyndie Shearing is director of communications at the American Farm Bureau Federation.

Quotes in this column originally appeared in state Farm Bureau publications and are reprinted with permission. Vincent, Williams (Oklahoma). Kennedy, Baker (Michigan) and Young (Virginia)..

Start Preamble can you get cipro over the counter Centers for Medicare &. Medicaid Services (CMS), HHS. Final rule can you get cipro over the counter.

Correction. In the August 4, 2020 issue of the Federal Register, we published a final rule entitled “FY 2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Special Requirements for Psychiatric Hospitals for Fiscal Year Beginning October 1, 2020 (FY 2021)”. The August 4, 2020 final rule updates the prospective payment rates, the outlier threshold, and the wage index for Medicare inpatient hospital services provided by Inpatient Psychiatric Facilities (IPF), which include psychiatric hospitals and excluded psychiatric units of an Inpatient Prospective Payment System (IPPS) hospital or critical access can you get cipro over the counter hospital.

In addition, we adopted more recent Office of Management and Budget (OMB) statistical area delineations, and applied a 2-year transition for all providers negatively impacted by wage index changes. This correction document corrects can you get cipro over the counter the statement of economic significance in the August 4, 2020 final rule. This correction is effective October 1, 2020.

Start Further Info The IPF Payment Policy mailbox at IPFPaymentPolicy@cms.hhs.gov for general information. Nicolas Brock, (410) 786-5148, for information regarding the statement of can you get cipro over the counter economic significance. End Further Info End Preamble Start Supplemental Information I.

Background In can you get cipro over the counter FR Doc. 2020-16990 (85 FR 47042), the final rule entitled “FY 2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Special Requirements for Psychiatric Hospitals for Fiscal Year Beginning October 1, 2020 (FY 2021)” (hereinafter referred to as the FY 2021 IPF PPS final rule) there was an error in the statement of economic significance and status as major under the Congressional Review Act (5 U.S.C. 801 et seq.).

Based on an estimated total impact of $95 million in increased transfers from the federal government to IPF providers, we previously stated that the final rule was not economically significant under Executive Order (E.O.) 12866, and that the rule was not can you get cipro over the counter a major rule under the Congressional Review Act. However, the Office of Management and Budget designated this rule as economically significant under E.O. 12866 and major under can you get cipro over the counter the Congressional Review Act.

We are correcting our previous statement in the August 4, 2020 final rule accordingly. This correction is effective October 1, 2020. II.

Summary of Errors On page 47064, in the third column, the third full paragraph under B. Overall Impact should be replaced entirely. The entire paragraph stating.

€œWe estimate that this rulemaking is not economically significant as measured by the $100 million threshold, and hence not a major rule under the Congressional Review Act. Accordingly, we have prepared a Regulatory Impact Analysis that to the best of our ability presents the costs and benefits of the rulemaking.” should be replaced with. €œWe estimate that the total impact of this final rule is close to the $100 million threshold.

The Office of Management and Budget has designated this rule as economically significant under E.O. 12866 and a major rule under the Congressional Review Act (5 U.S.C. 801 et seq.).

Accordingly, we have prepared a Regulatory Impact Analysis that to the best of our ability presents the costs and benefits of the rulemaking.” III. Waiver of Proposed Rulemaking and Delay in Effective Date We ordinarily publish a notice of proposed rulemaking in the Federal Register to provide a period for public comment before the provisions of a rule take effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)).

However, we can waive this notice and comment procedure if the Secretary of the Department of Human Services finds, for good cause, that the notice and comment process is impracticable, unnecessary, or contrary to the public interest, and incorporates a statement of the finding and the reasons therefore in the notice. This correction document does not constitute a rulemaking that would be subject to these requirements because it corrects only the statement of economic significance included in the FY 2021 IPF PPS final rule. The corrections contained in this document are consistent with, and do not make substantive changes to, the policies and payment methodologies that were adopted and subjected to notice and comment procedures in the FY 2021 IPF PPS final rule.

Rather, the corrections made through this correction document are intended to ensure that the FY 2021 IPF PPS final rule accurately reflects OMB's determination about its economic significance and major status under the Congressional Review Act (CRA). Executive Order 12866 and CRA determinations are functions of the Office of Management and Budget, not the Department of Health and Human Services, and are not rules as defined by the Administrative Procedure Act (5 U.S. Code 551(4)).

We ordinarily provide a 60-day delay in the effective date of final rules after the date they are issued, in accordance with the CRA (5 U.S.C. 801(a)(3)). However, section 808(2) of the CRA provides that, if an agency finds good cause that notice and public procedure are impracticable, unnecessary, or contrary to the public interest, the rule shall take effect at such time as the agency determines.

Even if this were a rulemaking to which the delayed effective date requirement applied, we found, in the FY 2021 IPF PPS Final Rule (85 FR 47043), good cause to waive the 60-day delay in the effective date of the IPF PPS final rule. In the final rule, we explained that, due to CMS prioritizing efforts in support of containing and combatting the COVID-Start Printed Page 5292419 public health emergency by devoting significant resources to that end, the work needed on the IPF PPS final rule was not completed in accordance with our usual rulemaking schedule. We noted that it is critical, however, to ensure that the IPF PPS payment policies are effective on the first day of the fiscal year to which they are intended to apply and therefore, it would be contrary to the public interest to not waive the 60-day delay in the effective date.

Undertaking further notice and comment procedures to incorporate the corrections in this document into the FY 2021 IPF PPS final rule or delaying the effective date would be contrary to the public interest because it is in the public's interest to ensure that the policies finalized in the FY 2021 IPF PPS are effective as of the first day of the fiscal year to ensure providers and suppliers receive timely and appropriate payments. Further, such procedures would be unnecessary, because we are not altering the payment methodologies or policies. Rather, the correction we are making is only to indicate that the FY 2021 IPF PPS final rule is economically significant and a major rule under the CRA.

For these reasons, we find we have good cause to waive the notice and comment and effective date requirements. IV. Correction of Errors in the Preamble In FR Doc.

2020-16990, appearing on page 47042 in the Federal Register of Tuesday, August 4, 2020, the following correction is made. 1. On page 47064, in the 3rd column, under B.

Overall Impact, correct the third full paragraph to read as follows. We estimate that the total impact of this final rule is very close to the $100 million threshold. The Office of Management and Budget has designated this rule as economically significant under E.O.

12866 and a major rule under the Congressional Review Act (5 U.S.C. 801 et seq.). Accordingly, we have prepared a Regulatory Impact Analysis that to the best of our ability presents the costs and benefits of the rulemaking.

Start Signature Dated. August 24, 2020. Wilma M.

Robinson, Deputy Executive Secretary to the Department, Department of Health and Human Services. End Signature End Supplemental Information [FR Doc. 2020-18902 Filed 8-26-20.

8:45 am]BILLING CODE 4120-01-PBy Cyndie Shearing @CyndieShearing Americans from all walks of life are struggling to cope with an array of issues related to the COVID-19 pandemic. Fear and anxiety about this new disease and what could happen is sometimes overwhelming and can cause strong emotions in adults and children. But long before the pandemic hit the U.S., farmers and ranchers were struggling.

Years of falling commodity prices, natural disasters, declining farm income and trade disputes with China hit rural America hard, and not just financially. Farmers’ mental health is at risk, too. Long before the pandemic hit the U.S., farmers and ranchers were struggling.

Fortunately, America’s food producers have proven to be a resilient bunch. Across the country, they continue to adopt new ways to manage stress and cope with the difficult situations they’re facing. A few examples are below.

In Oklahoma, Bryan Vincent and Gary Williams are part of an informal group that meets on a regular basis to share their burdens. “It’s way past farming,” said Vincent, a local crop consultant. €œIt’s a chance to meet with like-minded people.

It’s a chance for us to let some things out. We laugh, we may cry together, we may be disgusted together. We share our emotions, whether good, bad.” Gathering with trusted friends has given them the chance to talk about what’s happening in their lives, both good and bad.

€œI would encourage anybody – any group of farmers, friends, whatever – to form a group” to meet regularly, said Williams, a farmer. €œNot just in bad times. I think you should do that regardless, even in good times.

Share your victories and triumphs with one another, support one another.” James Young Credit. Nocole Zema/Virginia Farm Bureau In Michigan, dairy farmer Ashley Messing Kennedy battled postpartum depression and anxiety while also grieving over a close friend and farm employee who died by suicide. At first she coped by staying busy, fixing farm problems on her own and rarely asking for help.

But six months later, she knew something wasn’t right. Finding a meaningful activity to do away from the farm was a positive step forward. €œRunning’s been a game-changer for me,” Kennedy said.

€œIt’s so important to interact with people, face-to-face, that you don’t normally engage with. Whatever that is for you, do it — take time to get off the farm and walk away for a while. It will be there tomorrow.” Rich Baker also farms in Michigan and has found talking with others to be his stress management tactic of choice.

€œYou can’t just bottle things up,” Baker said. €œIf you don’t have a built-in network of farmers, go talk to a professional. In some cases that may be even more beneficial because their opinions may be more impartial.” James Young, a beef cattle farmer in Virginia, has found that mental health issues are less stigmatized as a whole today compared to the recent past.

But there are farmers “who would throw you under the bus pretty fast” if they found out someone was seeking professional mental health, he said. €œIt’s still stigmatized here.” RFD-TV Special on Farm Stress and Farmer Mental HealthAs part of the American Farm Bureau Federation’s ongoing effort to raise awareness, reduce stigma and share resources related to mental health, the organization partnered with RFD-TV to produce a one-hour episode of “Rural America Live” on farm stress and farmer mental health. The episode features AFBF President Zippy Duvall, Farm Credit Council President Todd Van Hoose and National Farmers Union President Rob Larew, as well as two university Extension specialists, a rural pastor and the author of “Stress-Free You!.

€ The program aired Thursday, Aug. 27, and will be re-broadcast on Saturday, Aug. 29, at 6 a.m.

Eastern/5 a.m. Central. Cyndie Shearing is director of communications at the American Farm Bureau Federation.

Quotes in this column originally appeared in state Farm Bureau publications and are reprinted with permission. Vincent, Williams (Oklahoma). Kennedy, Baker (Michigan) and Young (Virginia)..

What may interact with Cipro?

Do not take Cipro with any of the following:

  • cisapride
  • droperidol
  • terfenadine
  • tizanidine

Cipro may also interact with the following:

  • antacids
  • caffeine
  • cyclosporin
  • didanosine (ddI) buffered tablets or powder
  • medicines for diabetes
  • medicines for inflammation like ibuprofen, naproxen
  • methotrexate
  • multivitamins
  • omeprazole
  • phenytoin
  • probenecid
  • sucralfate
  • theophylline
  • warfarin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Cipro 5 mg

By Robert Preidt HealthDay cipro 5 mg Reporter FRIDAY, Oct. 16, 2020 (HealthDay News) -- If you're pregnant and you think popping nonsteroidal anti-inflammatory drugs (NSAIDs) for your aches and pains is safe, think again. The U.S cipro 5 mg. Food and Drug Administration warned on Thursday that taking these widely used painkillers -- which include Advil, Motrin, Aleve and Celebrex -- at 20 weeks or later in a pregnancy could raise the risk of complications.

Specifically, taking the medications can cause rare but serious kidney problems in the unborn baby that can lead to low levels of amniotic fluid, increasing the potential for pregnancy complications. After about 20 weeks of pregnancy, the fetus's kidneys begin producing most of the amniotic fluid, so kidney problems can cause low levels of this protective fluid cipro 5 mg. Low levels of amniotic fluid usually resolve if a pregnant woman stops taking an NSAID, according to the FDA. The agency said it has ordered that NSAID labeling warns women and their health care providers about this risk.

NSAIDs are prescription and over-the-counter (OTC) drugs that include ibuprofen, naproxen, diclofenac and celecoxib, which are cipro 5 mg taken to treat pain and fever. Aspirin is also an NSAID, but the new labeling rules don't apply to the use of low-dose aspirin. "It is important that women understand the cipro 5 mg benefits and risks of the medications they may take over the course of their pregnancy," Dr. Patrizia Cavazzoni, acting director of FDA's Center for Drug Evaluation and Research, said in an agency news release.

One ob-gyn noted that over-the-counter NSAIDs may pose the greatest danger to pregnant women. "Many female patients use ibuprofen regularly for headaches and menstrual cramps," said Dr cipro 5 mg. Jennifer Wu, from Lenox Hill Hospital in New York City. "It is very important that these patients realize that ibuprofen and other NSAIDs pose a unique danger to pregnant patients.

"The majority of patients get these medications cipro 5 mg over the counter and may even be using them at the prescription-strength level," Wu added. "While many prescription drugs come with the oversight of the pharmacist and a warning label, the over-the-counter medications lack all this. Patients also often assume that over-the-counter necessarily means safe." Continued The FDA's warning comes after a review of medical literature and cases reported to the agency about low amniotic fluid levels or kidney problems in unborn babies associated with NSAID use during pregnancy. For prescription NSAIDs, cipro 5 mg the new FDA warning recommends limiting use between about 20 weeks to 30 weeks of pregnancy.

A warning to avoid taking NSAIDs after about 30 weeks of pregnancy was already included in prescribing information due to a risk of heart problems in unborn babies. If a health care cipro 5 mg provider believes NSAIDs are necessary between about 20 and 30 weeks of pregnancy, use should be limited to the lowest possible dose and shortest possible length of time, the FDA said. Makers of OTC NSAIDs intended for adults will also make similar updates to their labeling, according to the agency. WebMD News from HealthDay Copyright © 2013-2020 HealthDay.

All rights reserved.Despite that, one in eight claims included out-of-network charges cipro 5 mg. That translated to nearly 136,000 colonoscopies for which patients potentially received a surprise bill. (There was no way to determine how many patients actually did, Scheiman said.) Those out-of-network charges were typically around $1,000. Accounting for the portion the insurer would likely pay, the researchers estimated that the typical surprise bill cipro 5 mg would be about $400.

Overall, anesthesiologists and pathologists (doctors who study tissue samples) accounted for most out-of-network charges, the investigators found. And that's no surprise, said Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, in Washington, D.C. In general, Adler said, surprise bills come from a limited number of specialties -- the providers patients do cipro 5 mg not choose. Emergency room doctors, anesthesiologists, radiologists and pathologists -- as well as ambulance services -- are the primary sources.

"In my eyes, this is because of a market failure," cipro 5 mg Adler said. A primary care doctor or surgeon, for instance, has a big incentive to join health plan networks -- to attract patients covered by those plans. But with certain specialties, the hospital or other workplace determines how many patients a provider sees. Those doctors can remain out-of-network, charge what they cipro 5 mg want, collect some amount from the insurance company -- and then bill the patient for the balance.

The practice obviously has financial consequences for patients. But it's also costly to anyone with private health insurance, Adler said. Plans raise their monthly premiums to help cover the costs of out-of-network providers cipro 5 mg. That's partly because health plans do sometimes pay the full out-of-network charge.

It's also because those same specialists command higher in-network prices compared to other specialties, he noted. Many hospitals have cipro 5 mg moved to address the problem, requiring doctors to join their center's insurance networks, Adler said. A broad solution would be legislation to cap out-of-network charges, he added. Some states have cipro 5 mg passed laws to at least partially protect patients from surprise bills, but federal action has stalled.Oct.

16, 2020 -- Pfizer won't apply for emergency authorization of its coronavirus vaccine before the third week in November, the company's chief executive said in a statement posted to Pfizer's website on Friday. The reversal from the company's previous claims that it would apply for the approval in October is a blow to U.S. President Donald Trump, who repeatedly said that a vaccine would be available before Election Day on cipro 5 mg Nov. 3, The New York Times reported.

Even though Pfizer could have preliminary data about the vaccine's effectiveness by the end of October, gathering safety and manufacturing data would take until at least the third week of November, Dr. Albert Bourla said cipro 5 mg in the statement. Pfizer's announcement was welcomed by some scientists. "This is good, really good," Dr.

Eric Topol, a clinical trial expert at Scripps cipro 5 mg Research in San Diego, told The Times. He was one of 60 public health officials and other medical experts who sent a letter to Pfizer urging it not to rush its vaccine, The Times reported. Pfizer is one cipro 5 mg of four companies with a coronavirus vaccine in late-stage clinical trials in the United States. The others are Moderna, AstraZeneca and Johnson &.

Johnson. Pfizer has given the most optimistic timeline, cipro 5 mg while the other three have said later this year is more likely. WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.By Robert Preidt HealthDay Reporter FRIDAY, Oct.

16, 2020 (HealthDay News) -- An experimental COVID-19 vaccine appeared to be safe and triggered an immune response in healthy people, according to preliminary results of a small, cipro 5 mg early-stage clinical trial. The study of the vaccine based on inactivated whole SARS-CoV-2 virus (BBIBP-CorV) included more than 600 volunteers in China, ages 18 to 80. By the 42nd day after vaccination, all had antibody responses to the virus, according to researchers. The vaccine cipro 5 mg was safe and well-tolerated at all doses tested, study leaders reported.

The most common side effect was pain at the injection site. There were no cipro 5 mg serious adverse reactions. The findings were published Oct. 15 in The Lancet Infectious Diseases journal.

Similar results cipro 5 mg were reported from a previous trial for a different vaccine also based on inactivated whole SARS-CoV-2 virus. That trial was limited to people under age 60. The new trial found that people 60 and older responded more slowly to the vaccine. It took 42 days for antibodies to be detected in all of them, compared to 28 days cipro 5 mg among 18- to 59-year-olds.

Antibody levels were also lower in 60- to 80-year-olds compared with the younger volunteers. "Protecting older people is a key aim of a successful COVID-19 vaccine as this age group is at greater risk of severe illness from the disease. However, vaccines are sometimes less effective in this group because the immune system weakens with age," said study co-author Xiaoming Yang, a professor cipro 5 mg at Beijing Institute of Biological Products Company Limited. "It is therefore encouraging to see that BBIBP-CorV induces antibody responses in people aged 60 and older, and we believe this justifies further investigation," Yang said in a journal news release.

Because the trial wasn't designed to assess the effectiveness of the BBIBP-CorV vaccine, it's not possible to know whether the antibody response cipro 5 mg it triggered is strong enough to protect people from infection with the new coronavirus. After the researchers complete a full analysis of data from the adults, they plan to test the vaccine in children and teens under age 18. Larisa Rudenko, a researcher at the Institute of Experimental Medicine in St. Petersburg, Russia, wrote an editorial that cipro 5 mg accompanied the findings.

She said more "studies are needed to establish whether the inactivated SARS-CoV-2 vaccines are capable of inducing and maintaining virus-specific T-cell responses." WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.By Robert Preidt HealthDay Reporter FRIDAY, Oct. 16, 2020 (HealthDay News) -- In what will come as reassuring news to those who were born with a heart defect, new research finds these cipro 5 mg people aren't at increased risk for moderate or severe COVID-19. The study included more than 7,000 adults and children who were born with a heart defect (congenital heart disease) and followed by researchers at Columbia University Vagelos College of Physicians and Surgeons, in New York City.

Between March and July 2020, the center reported 53 congenital heart disease patients (median age 34) with COVID-19 infection. "At the beginning of the pandemic, many feared that congenital heart disease would be as big a risk factor for COVID-19 as adult-onset cardiovascular disease," the study authors wrote in the report cipro 5 mg published online Oct. 14 in the Journal of the American Heart Association. However, the researchers were "reassured by the low number of patients treated at their center and the patients' cipro 5 mg outcomes," they said in a journal news release.

Among the 43 adults and 10 children with a congenital heart defect who were infected with COVID-19, 58% had complex congenital anatomy, 15% had a genetic syndrome, 11% had pulmonary hypertension and 17% were obese. Nine patients (17%) had a moderate/severe infection, and three patients (6%) died, according to the study. A concurrent genetic syndrome in cipro 5 mg patients of all ages and advanced physiologic stage in adult patients were each associated with an increased risk of COVID-19 symptom severity, the findings showed. Five patients had trisomy 21 (an extra chromosome at position 21), four patients had Eisenmenger's syndrome (abnormal blood circulation caused by structural defects in the heart) and two patients had DiGeorge syndrome (a condition caused by the deletion of a segment of chromosome 22).

Nearly all patients with trisomy 21 and DiGeorge syndrome had moderate/severe COVID-19 symptoms. "While our cipro 5 mg sample size is small, these results imply that specific congenital heart lesions may not be sufficient cause alone for severe COVID-19 infection," according to Dr. Matthew Lewis, of Columbia University Irving Medical Center, and his colleagues. "Despite evidence that adult-onset cardiovascular disease is a risk factor for worse outcomes among patients with COVID-19, patients with [congenital heart disease] without concomitant genetic syndrome, and adults who are not at advanced physiological stage, do not appear to be disproportionately impacted," the study authors concluded..

By Robert Preidt can you get cipro over the counter HealthDay Reporter FRIDAY, Oct. 16, 2020 (HealthDay News) -- If you're pregnant and you think popping nonsteroidal anti-inflammatory drugs (NSAIDs) for your aches and pains is safe, think again. The U.S can you get cipro over the counter. Food and Drug Administration warned on Thursday that taking these widely used painkillers -- which include Advil, Motrin, Aleve and Celebrex -- at 20 weeks or later in a pregnancy could raise the risk of complications. Specifically, taking the medications can cause rare but serious kidney problems in the unborn baby that can lead to low levels of amniotic fluid, increasing the potential for pregnancy complications.

After about 20 weeks of can you get cipro over the counter pregnancy, the fetus's kidneys begin producing most of the amniotic fluid, so kidney problems can cause low levels of this protective fluid. Low levels of amniotic fluid usually resolve if a pregnant woman stops taking an NSAID, according to the FDA. The agency said it has ordered that NSAID labeling warns women and their health care providers about this risk. NSAIDs are prescription and over-the-counter (OTC) drugs that include ibuprofen, naproxen, diclofenac can you get cipro over the counter and celecoxib, which are taken to treat pain and fever. Aspirin is also an NSAID, but the new labeling rules don't apply to the use of low-dose aspirin.

"It is important can you get cipro over the counter that women understand the benefits and risks of the medications they may take over the course of their pregnancy," Dr. Patrizia Cavazzoni, acting director of FDA's Center for Drug Evaluation and Research, said in an agency news release. One ob-gyn noted that over-the-counter NSAIDs may pose the greatest danger to pregnant women. "Many female patients use ibuprofen regularly for headaches and menstrual cramps," said Dr can you get cipro over the counter. Jennifer Wu, from Lenox Hill Hospital in New York City.

"It is very important that these patients realize that ibuprofen and other NSAIDs pose a unique danger to pregnant patients. "The majority of patients get these medications over the counter and may even be using can you get cipro over the counter them at the prescription-strength level," Wu added. "While many prescription drugs come with the oversight of the pharmacist and a warning label, the over-the-counter medications lack all this. Patients also often assume that over-the-counter necessarily means safe." Continued The FDA's warning comes after a review of medical literature and cases reported to the agency about low amniotic fluid levels or kidney problems in unborn babies associated with NSAID use during pregnancy. For prescription NSAIDs, the new FDA warning recommends limiting can you get cipro over the counter use between about 20 weeks to 30 weeks of pregnancy.

A warning to avoid taking NSAIDs after about 30 weeks of pregnancy was already included in prescribing information due to a risk of heart problems in unborn babies. If a health care provider believes NSAIDs can you get cipro over the counter are necessary between about 20 and 30 weeks of pregnancy, use should be limited to the lowest possible dose and shortest possible length of time, the FDA said. Makers of OTC NSAIDs intended for adults will also make similar updates to their labeling, according to the agency. WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.Despite can you get cipro over the counter that, one in eight claims included out-of-network charges.

That translated to nearly 136,000 colonoscopies for which patients potentially received a surprise bill. (There was no way to determine how many patients actually did, Scheiman said.) Those out-of-network charges were typically around $1,000. Accounting for the portion the insurer would likely pay, the researchers estimated that the typical surprise bill can you get cipro over the counter would be about $400. Overall, anesthesiologists and pathologists (doctors who study tissue samples) accounted for most out-of-network charges, the investigators found. And that's no surprise, said Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, in Washington, D.C.

In general, Adler said, surprise bills come from a limited number of specialties -- the can you get cipro over the counter providers patients do not choose. Emergency room doctors, anesthesiologists, radiologists and pathologists -- as well as ambulance services -- are the primary sources. "In my eyes, this is because of a market can you get cipro over the counter failure," Adler said. A primary care doctor or surgeon, for instance, has a big incentive to join health plan networks -- to attract patients covered by those plans. But with certain specialties, the hospital or other workplace determines how many patients a provider sees.

Those doctors can remain out-of-network, charge what they want, collect some amount from the insurance can you get cipro over the counter company -- and then bill the patient for the balance. The practice obviously has financial consequences for patients. But it's also costly to anyone with private health insurance, Adler said. Plans raise their monthly premiums to help cover the can you get cipro over the counter costs of out-of-network providers. That's partly because health plans do sometimes pay the full out-of-network charge.

It's also because those same specialists command higher in-network prices compared to other specialties, he noted. Many hospitals can you get cipro over the counter have moved to address the problem, requiring doctors to join their center's insurance networks, Adler said. A broad solution would be legislation to cap out-of-network charges, he added. Some states have passed laws to at least partially protect can you get cipro over the counter patients from surprise bills, but federal action has stalled.Oct. 16, 2020 -- Pfizer won't apply for emergency authorization of its coronavirus vaccine before the third week in November, the company's chief executive said in a statement posted to Pfizer's website on Friday.

The reversal from the company's previous claims that it would apply for the approval in October is a blow to U.S. President Donald Trump, who repeatedly said that a vaccine would be can you get cipro over the counter available before Election Day on Nov. 3, The New York Times reported. Even though Pfizer could have preliminary data about the vaccine's effectiveness by the end of October, gathering safety and manufacturing data would take until at least the third week of November, Dr. Albert Bourla said can you get cipro over the counter in the statement.

Pfizer's announcement was welcomed by some scientists. "This is good, really good," Dr. Eric Topol, a clinical trial expert at Scripps Research in San Diego, told can you get cipro over the counter The Times. He was one of 60 public health officials and other medical experts who sent a letter to Pfizer urging it not to rush its vaccine, The Times reported. Pfizer is can you get cipro over the counter one of four companies with a coronavirus vaccine in late-stage clinical trials in the United States.

The others are Moderna, AstraZeneca and Johnson &. Johnson. Pfizer has given the most optimistic timeline, while the other three have said later this year is more can you get cipro over the counter likely. WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.By Robert Preidt HealthDay Reporter FRIDAY, Oct.

16, 2020 (HealthDay News) -- An experimental COVID-19 vaccine appeared to be safe and triggered an immune response can you get cipro over the counter in healthy people, according to preliminary results of a small, early-stage clinical trial. The study of the vaccine based on inactivated whole SARS-CoV-2 virus (BBIBP-CorV) included more than 600 volunteers in China, ages 18 to 80. By the 42nd day after vaccination, all had antibody responses to the virus, according to researchers. The vaccine was safe and well-tolerated at can you get cipro over the counter all doses tested, study leaders reported. The most common side effect was pain at the injection site.

There were no serious can you get cipro over the counter adverse reactions. The findings were published Oct. 15 in The Lancet Infectious Diseases journal. Similar results were reported from a previous trial for a different vaccine also based can you get cipro over the counter on inactivated whole SARS-CoV-2 virus. That trial was limited to people under age 60.

The new trial found that people 60 and older responded more slowly to the vaccine. It took can you get cipro over the counter 42 days for antibodies to be detected in all of them, compared to 28 days among 18- to 59-year-olds. Antibody levels were also lower in 60- to 80-year-olds compared with the younger volunteers. "Protecting older people is a key aim of a successful COVID-19 vaccine as this age group is at greater risk of severe illness from the disease. However, vaccines are sometimes less effective in this group because the immune system weakens with age," said study co-author Xiaoming Yang, a professor at Beijing Institute of Biological can you get cipro over the counter Products Company Limited.

"It is therefore encouraging to see that BBIBP-CorV induces antibody responses in people aged 60 and older, and we believe this justifies further investigation," Yang said in a journal news release. Because the trial wasn't designed to assess the effectiveness of the BBIBP-CorV vaccine, it's not possible to know whether the antibody response it can you get cipro over the counter triggered is strong enough to protect people from infection with the new coronavirus. After the researchers complete a full analysis of data from the adults, they plan to test the vaccine in children and teens under age 18. Larisa Rudenko, a researcher at the Institute of Experimental Medicine in St. Petersburg, Russia, can you get cipro over the counter wrote an editorial that accompanied the findings.

She said more "studies are needed to establish whether the inactivated SARS-CoV-2 vaccines are capable of inducing and maintaining virus-specific T-cell responses." WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved.By Robert Preidt HealthDay Reporter FRIDAY, Oct. 16, 2020 (HealthDay News) -- In what will come as reassuring news to those who were born with a heart defect, new research finds these people aren't at increased risk for can you get cipro over the counter moderate or severe COVID-19. The study included more than 7,000 adults and children who were born with a heart defect (congenital heart disease) and followed by researchers at Columbia University Vagelos College of Physicians and Surgeons, in New York City. Between March and July 2020, the center reported 53 congenital heart disease patients (median age 34) with COVID-19 infection.

"At the beginning of the pandemic, many feared that can you get cipro over the counter congenital heart disease would be as big a risk factor for COVID-19 as adult-onset cardiovascular disease," the study authors wrote in the report published online Oct. 14 in the Journal of the American Heart Association. However, the researchers can you get cipro over the counter were "reassured by the low number of patients treated at their center and the patients' outcomes," they said in a journal news release. Among the 43 adults and 10 children with a congenital heart defect who were infected with COVID-19, 58% had complex congenital anatomy, 15% had a genetic syndrome, 11% had pulmonary hypertension and 17% were obese. Nine patients (17%) had a moderate/severe infection, and three patients (6%) died, according to the study.

A concurrent genetic syndrome in patients of all ages and advanced physiologic stage in adult patients were can you get cipro over the counter each associated with an increased risk of COVID-19 symptom severity, the findings showed. Five patients had trisomy 21 (an extra chromosome at position 21), four patients had Eisenmenger's syndrome (abnormal blood circulation caused by structural defects in the heart) and two patients had DiGeorge syndrome (a condition caused by the deletion of a segment of chromosome 22). Nearly all patients with trisomy 21 and DiGeorge syndrome had moderate/severe COVID-19 symptoms. "While our sample size is small, these results imply that specific congenital heart lesions may not be sufficient cause alone for severe COVID-19 infection," according to Dr can you get cipro over the counter. Matthew Lewis, of Columbia University Irving Medical Center, and his colleagues.

"Despite evidence that adult-onset cardiovascular disease is a risk factor for worse outcomes among patients with COVID-19, patients with [congenital heart disease] without concomitant genetic syndrome, and adults who are not at advanced physiological stage, do not appear to be disproportionately impacted," the study authors concluded..

Cipro for yeast infection

He dismisses cipro for yeast infection or suppresses it even for events that are apparent to many, including global warming, foreign intervention in U.S. Elections, the trivial head count at his inauguration, and even the projected path of a destructive hurricane. Instead, “alternative facts,” or fabrications, are substituted. This perspective from inside the brain’s neural networks also explains the cipro for yeast infection Trump administration’s unprecedented erosion of government institutions with missions intended to protect the public (ranging from the Centers for Disease Control to the FBI).

These diversions distract attention from real, uncontrollable threats, such as the coronavirus pandemic, that may undermine Trump’s political and economic objectives. Reason cannot always overcome fear, as PTSD demonstrates. But the brain’s second mechanism of neutralizing its fear circuitry—experience—can do so cipro for yeast infection. Repeated exposure to the fearful situation where the outcome is safe will rewire the brain’s subcortical circuitry.

This is the basis for “extinction therapy” used to treat PTSD and phobias. For many, cipro for yeast infection credibility has been eroded by Trump’s outlandish assertions, like suggesting injections of bleach might cure COVID-19, or enthusing over a plant toxin touted by a pillow salesman, while scientific experts in attendance grimace and bite their lips. In the last election Trump was a little-known newcomer as a political figure, but that is not the case this time with either candidate. The “gut -reaction” decision-making process excels in complex situations where there is not enough factual information or time to make a reasoned decision.

We follow gut cipro for yeast infection instinct, for example, when selecting a dish from a menu at a new restaurant, where we have never seen or tasted the offering before. We’ve had our fill of the politics this time, no matter what position one may favor. Whether voters choose to vote for Trump on the basis of emotion or reason, they will be better able to articulate the reasons, or rationalizations, for their choice. This should give pollsters better cipro for yeast infection data to make a more accurate prediction.One of the most impressive, disturbing works of science journalism I’ve encountered is Anatomy of an Epidemic.

Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, published in 2010. In the book, which I review here, award-winning journalist Robert Whitaker presents evidence that medications for mental illness, over time and in the aggregate, cause net harm. In 2012, I brought cipro for yeast infection Whitaker to my school to give a talk, in part to check him out. He struck me as a smart, sensible, meticulous reporter whose in-depth research had led him to startling conclusions.

Since then, far from encountering persuasive rebuttals of Whitaker’s thesis, I keep finding corroborations of it. If Whitaker is right, modern psychiatry, together with the pharmaceutical industry, has cipro for yeast infection inflicted iatrogenic harm on millions of people. Reports of surging mental distress during the pandemic have me thinking once again about Whitaker’s views and wondering how they have evolved. Below he answers some questions.

€”John Horgan
 Horgan cipro for yeast infection. When and why did you start reporting on mental health?. Whitaker. It came about in a very roundabout way cipro for yeast infection.

In 1994, I had co-founded a publishing company called CenterWatch that covered the business aspects of the “clinical trials industry,” and I soon became interested in writing about how financial interests were corrupting drug trials. Risperdal and Zyprexa had just come to market, and after I used a Freedom of Information request to obtain the FDA’s review of those two drugs, I could see that psychiatric drug trials were a prime example of that corruption. In addition, I had learned of NIMH-funded research that seemed abusive of schizophrenia patients, and in 1998, I co-wrote a series for cipro for yeast infection the Boston Globe on abuses of patients in psychiatric research. My interest was in that broader question of corruption and abuse in research settings, and not specific to psychiatry.

At that time, I still had a conventional understanding of psychiatric drugs. My understanding was that researchers were making great advances in understanding mental disorders, and that they had found that schizophrenia and depression were due to chemical imbalances in the brain, which psychiatric cipro for yeast infection medications then put back in balance. However, while reporting that series, I stumbled upon studies that didn’t make sense to me, for they belied what I knew to be “true,” and that was what sent me down this path of reporting on mental health. First, there were two studies by the World Health Organization that found that longer-term outcomes for schizophrenia patients in three “developing” countries were much better than in the U.S.

And five other “developed” countries cipro for yeast infection. This didn’t really make sense to me, and then I read this. In the developing countries, they used antipsychotic drugs acutely, but not chronically. Only 16 percent of patients in the cipro for yeast infection developing countries were regularly maintained on antipsychotics, whereas in the developed countries this was the standard of care.

That didn’t fit with my understanding that these drugs were an essential treatment for schizophrenia patients. Second, a study by Harvard researchers found that schizophrenia outcomes had declined in the previous 20 years, and were now no better than they had been in the first third of the 20th century. That didn’t fit with my understanding that psychiatry had made great progress cipro for yeast infection in treating people so diagnosed. Those studies led to my questioning the story that our society told about those we call “mad,” and I got a book contract to dig into that question.

That project turned into Mad in America, which told of the history of our society’s treatment of the seriously mentally ill, from colonial times until today—a history marked by bad science and societal mistreatment of those so diagnosed. Horgan. Do you still see yourself as a journalist, or are you primarily an activist?. Whitaker.

I don’t see myself as an “activist” at all. In my own writings, and in the webzine I direct, Mad in America, I think you’ll see journalistic practices at work, albeit in the service of an “activist” mission. Here is our mission statement. €œMad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad).

We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.” Thus, our starting point is that “change” is needed, and while that does have an activist element, I think journalism—serving as an informational source—is fundamental to that effort. As an organization, we are not asserting that we have the answers for what that change should be, which would be the case if we were striving to be activists. Instead, we strive to be a forum for promoting an informed societal discussion about this subject. Here’s what we do.

We publish daily summaries of scientific research with findings that are rarely covered in the mainstream media. You’ll find, in the archives of our research reports, a steady parade of findings that counter the conventional narrative. For instance, there are reports of how the effort to find genes for mental disorders has proven rather fruitless, or of how social inequalities trigger mental distress, or of poor long-term outcomes with our current paradigm of care. And so forth—we simply want these scientific findings to become known.
We regularly feature interviews with researchers and activists, and podcasts that explore these issues.

We launched MIA Reports as a showcase for our print journalism. We have published in-depth articles on promising new initiatives in Europe. Investigative pieces on such topics as compulsory outpatient treatment. Coverage of “news” related to mental health policy in the United States.

And occasional reports on how the mainstream media is covering mental health issues. €¨We also publish blogs by professionals, academics, people with lived experience, and others with a particular interest in this subject. These blogs and personal stories are meant to help inform society’s “rethinking” of psychiatric care. All of these efforts, I think, fit within the framework of “journalism.” However, I do understand that I am going beyond the boundaries of usual “science journalism” when I publish critiques of the “evidence base” related to psychiatric drugs.

I did this in my books Mad in America and Anatomy of an Epidemic, as well as a book I co-wrote, Psychiatry Under the Influence. I have continued to do this with MIA Reports. The usual practice in “science journalism” is to look to the “experts” in the field and report on what they tell about their findings and practices. However, while reporting and writing Mad in America, I came to understand that when “experts” in psychiatry spoke to journalists they regularly hewed to a story that they were expected to tell, which was a story of how their field was making great progress in understanding the biology of disorders and of drug treatments that—as I was told over and over when I co-wrote the series for the Boston Globe—fixed chemical imbalances in the brain.

But their own science, I discovered, regularly belied the story they were telling to the media. That’s why I turned to focusing on the story that could be dug out from a critical look at their own scientific literature. So what I do in these critiques—such as suicide in the Prozac era and the impact of antipsychotics on mortality—is review the relevant research and put those findings together into a coherent report. I also look at research cited in support of mainstream beliefs and see if the data, in those articles, actually supports the conclusions presented in the abstract.

None of this is really that difficult, and yet I know it is unusual for a journalist to challenge conventional “medical wisdom” in this way. Horgan. Anatomy of an Epidemic argues that medications for mental illness, although they give many people short-term reliefs, cause net harm. Is that a fair summary?.

Whitaker. Yes, although my thinking has evolved somewhat since I wrote that book. I am more convinced than ever that psychiatric medications, over the long term, cause net harm. I wish that weren’t the case, but the evidence just keeps mounting that these drugs, on the whole, worsen long-term outcomes.

However, my thinking has evolved in this way. I am not so sure any more that the medications provide a short-term benefit for patient populations as a whole. When you look at the short-term studies of antidepressants and antipsychotics, the evidence of efficacy in reducing symptoms compared to placebo is really pretty marginal, and fails to rise to the level of a “clinically meaningful” benefit. Furthermore, the problem with all of this research is that there is no real placebo group in the studies.

The placebo group is composed of patients who have been withdrawn from their psychiatric medications and then randomized to placebo. Thus, the placebo group is a drug-withdrawal group, and we know that withdrawal from psychiatric drugs can stir myriad negative effects. A medication-naïve placebo group would likely have much better outcomes, and if that were so, how would that placebo response compare to the drug response?. In short, research on the short-term effects of psychiatric drugs is a scientific mess.

In fact, a 2017 paper that was designed to defend the long-term use of antipsychotics nevertheless acknowledged, in an off-hand way, that “no placebo-controlled trials have been reported in first-episode psychosis patients.” Antipsychotics were introduced 65 years ago, and we still don’t have good evidence that they work over the short term in first episode patients. Which is rather startling, when you think of it. Horgan. Have any of your critics—E.

Fuller Torrey, for example—made you rethink your thesis?. Whitaker. When the first edition of Anatomy of an Epidemic was published (2010), I knew there would be critics, and I thought, this will be great. This is just what is needed, a societal discussion about the long-term effects of psychiatric medications.

I have to confess that I have been disappointed in the criticism. They mostly have been ad hominem attacks—I cherry-picked the data, or I misunderstood findings, or I am just biased, but the critics don’t then say what data I missed, or point to findings that tell of medications that improve long-term outcomes. I honestly think I could do a much better job of critiquing my own work. You mention E.

Fuller Torrey’s criticism, in which he states that I both misrepresented and misunderstood some of the research I cited. I took this seriously, and answered it at great length. Now if your own “thesis” is indeed flawed, then a critic should be able to point out its flaws while accurately detailing what you wrote. If that is the case, then you have good reason to rethink your beliefs.

But if a critique doesn’t meet that standard, but rather relies on misrepresenting what you wrote, then you have reason to conclude that the critic lacks the evidence to make an honest case. And that is how I see Torrey’s critique. For example, Torrey said that I misunderstood Martin Harrow’s research on long-term outcomes for schizophrenia patients. Harrow reported that the recovery rate was eight times higher for those who got off antipsychotic medication compared to those who stayed on the drugs.

However, in his 2007 paper, Harrow stated that the better outcomes for those who got off medication was because they had a better prognosis and not because of negative drug effects. If you read Anatomy of an Epidemic, you’ll see that I present his explanation. Yet, in my interview with Harrow, I noted that his own data showed that those who were diagnosed with milder psychotic disorders who stayed on antipsychotics fared worse over the long term than schizophrenia patients who stopped taking the medication. This was a comparison that showed the less ill maintained on antipsychotics doing worse than the more severely ill who got off these medications.

And I presented that comparison in Anatomy of an Epidemic. By doing that, I was going out on a limb. I was saying that maybe Harrow’s data led to a different conclusion than he had drawn, which was that the antipsychotic medication, over the long-term, had a negative effect. After Anatomy was published, Harrow and his colleague Thomas Jobe went back to their data and investigated this very possibility.

They have subsequently written several papers exploring this theme, citing me in one or two instances for raising the issue, and they found reason to conclude that it might be so. They wrote. €œHow unique among medical treatments is it that the apparent efficacy of antipsychotics could diminish over time or become harmful?. There are many examples for other medications of similar long-term effects, with this often occurring as the body readjusts, biologically, to the medications.” Thus, in this instance, I did the following.

I accurately reported the results of Harrow’s study and his interpretation of his results, and I accurately presented data from his research that told of a possible different interpretation. The authors then revisited their own data to take up this inquiry. And yet Torrey’s critique is that I misrepresented Harrow’s research. This same criticism, by the way, is still being flung at me.

Here is a recent article in Vice which, once again, quotes people saying I misrepresent and misunderstand research, with Harrow cited as an example. I do want to emphasize that critiques of “my thesis” regarding the long-term effects of psychiatric drugs are important and to be welcomed. See two papers in particular that take this on (here and here), and my response in general to such criticisms, and to the second one. Horgan.

When I criticize psychiatric drugs, people sometimes tell me that meds saved their lives. You must get this reaction a lot. How do you respond?. Whitaker.

I do hear that, and when I do, I reply, “Great!. I am so glad to know that the medications have worked for you!. € But of course I also hear from many people who say that the drugs ruined their lives. I do think that the individual’s experience of psychiatric medication, whether good or bad, should be honored as worthy and “valid.” They are witnesses to their own lives, and we should incorporate those voices into our societal thinking about the merits of psychiatric drugs.

However, for the longest time, we’ve heard mostly about the “good” outcomes in the mainstream media, while those with “bad” outcomes were resigned to telling their stories on internet forums. What Mad in America has sought to do, in its efforts to serve as a forum for rethinking psychiatry, is provide an outlet for this latter group, so their voices can be heard too. The personal accounts, of course, do not change the bottom-line “evidence” that shows up in outcome studies of larger groups of patients. Unfortunately, that tells of medications that, on the whole, do more harm than good.

As a case in point, in regard to this “saving lives” theme, this benefit does not show up in public health data. The “standard mortality rate” for those with serious mental disorders, compared to the general public, has notably increased in the last 40 years. Horgan. Do you see any promising trends in psychiatry?.

Whitaker. Yes, definitely. You have the spread of Hearing Voices networks, which are composed of people who hear voices and offer support for learning to live with voices as opposed to squashing them, which is what the drugs are supposed to do. These networks are up and running in the U.S., and in many countries worldwide.

You have Open Dialogue approaches, which were pioneered in northern Finland and proved successful there, being adopted in the United States and many European countries (and beyond.) This practice puts much less emphasis on treatment with antipsychotics, and much greater emphasis on helping people re-integrate into family and community. You have many alternative programs springing up, even at the governmental level. Norway, for instance, ordered its hospital districts to offer “medication free” treatment for those who want it, and there is now a private hospital in Norway that is devoted to helping chronic patients taper down from their psychiatric medications. In Israel, you have Soteria houses that have sprung up (sometimes they are called stabilizing houses), where use of antipsychotics is optional, and the environment—a supportive residential environment—is seen as the principal “therapy.” You have the U.N.

Special Rapporteur for Health, Dainius Pūras, calling for a “revolution” in mental health, one that would supplant today’s biological paradigm of care with a paradigm that paid more attention to social justice factors—poverty, inequality, etc.—as a source of mental distress. All of those initiatives tell of an effort to find a new way. But perhaps most important, in terms of “positive trends,” the narrative that was told to us starting in the 1980s has collapsed, which is what presents the opportunity for a new paradigm to take hold. More and more research tells of how the conventional narrative, in all its particulars, has failed to pan out.

The diagnoses in the Diagnostic and Statistical Manual (DSM) have not been validated as discrete illnesses. The genetics of mental disorders remain in doubt. MRI scans have not proven to be useful. Long-term outcomes are poor.

And the notion that psychiatric drugs fix chemical imbalances has been abandoned. Ronald Pies, the former editor in chief of Psychiatric Times, has even sought to distance psychiatry, as an institution, from ever having made such a claim. Horgan. Do brain implants or other electrostimulation devices show any therapeutic potential?.

Whitaker. I don’t have a ready answer for this. We have published two articles about the spinning of results from a trial of deep-brain stimulation, and the suffering of some patients so treated over the long-term. Those articles tell of why it may be difficult to answer that question.

There are financial influences that push for published results that tell of a therapeutic success, even if the data doesn’t support that finding, and we have a research environment that fails to study long-term outcomes. The history of somatic treatments for mental disorders also provides a reason for caution. It’s a history of one somatic treatment after another being initially hailed as curative, or extremely helpful, and then failing the test of time. The inventor of frontal lobotomy, Egas Moniz, was awarded a Nobel Prize for inventing that surgery, which today we understand as a mutilation.

It’s important to remain open to the possibility that somatic treatments may be helpful, at least for some patients. But there is plenty of reason to be wary of initial claims of success. Horgan. Should psychedelic drugs be taken seriously as treatments?.

Whitaker. I think caution applies here too. Surely there are many risks with psychedelic drugs, and if you were to do a study of first-episode psychosis today, you would find a high percentage of the patients had been using mind-altering drugs before their psychotic break—antidepressants, marijuana, LSD and so forth. At the same time, we’ve published reviews of papers that have reported positive results with use of psychedelics.

What are the benefits versus the risks?. Can possible benefits be realized while risks are minimized?. It is a question worth exploring, but carefully so. Horgan.

What about meditation?. Whitaker. I know that many people find meditation helpful. I also know other people find it difficult—and even threatening—to sit with the silence of their minds.

Mad in America has published reviews of research about meditation, we have had a few bloggers write about it, and in our resource section on “non-drug therapies,” we have summarized research findings regarding its use for depression. We concluded that the research on this is not as robust as one would like. However, I think your question leads to this broader thought. People struggling with their minds and emotions may come up with many different approaches they find helpful.

Exercise, diet, meditation, yoga and so forth all represent efforts to change one’s environment, and ultimately, I think that can be very helpful. But the individual has to find his or her way to whatever environmental change that works best for them. Horgan. Do you see any progress toward understanding the causes of mental illness?.

Whitaker. Yes, and that progress might be summed up in this way. Researchers are returning to investigations of how we are impacted by what has “happened to us.” The Adverse Childhood Experiences study provides compelling evidence of how traumas in childhood—divorce, poverty, abuse, bullying and so forth—exact a long-term toll on physical and mental health. Interview any group of women diagnosed with a serious mental disorder, and you’ll regularly find accounts of sexual abuse.

Racism exacts a toll. So too poverty, oppressive working conditions, and so forth. You can go on and on, but all of this is a reminder that we humans are designed to respond to our environment, and it is quite clear that mental distress, in large part, arises from difficult environments and threatening experiences, past and present. And with a focus on life experiences as a source of “mental illness,” a related question is now being asked.

What do we all need to be mentally well?. Shelter, good food, meaning in life, someone to love and so forth—if you look at it from this perspective, you can see why, when those supporting elements begin to disappear, psychiatric difficulties appear. I am not discounting that there may be biological factors that cause “mental illness.” While biological markers that tell of a particular disorder have not been discovered, we are biological creatures, and we do know, for instance, that there are physical illnesses and toxins that can produce psychotic episodes. However, the progress that is being made at the moment is a moving away from the robotic “it’s all about brain chemistry” toward a rediscovery of the importance of our social lives and our experiences.

Horgan. Do we still have anything to learn from Sigmund Freud?. Whitaker. I certainly think so.

Freud is a reminder that so much of our mind is hidden from us and that what spills into our consciousness comes from a blend of the many parts of our mind, our emotional centers and our more primal instincts. You can still see merit in Freud’s descriptions of the id, ego and superego as a conceptualization of different parts of the brain. I read Freud when I was in college, and it was a formative experience for me. Horgan.

I fear that American-style capitalism doesn’t produce good health care, including mental-health care. What do you think?. Whitaker. It’s clear that it doesn’t.

First, we have for-profit health-care that is set up to treat “disease.” With mental-health care, that means there is a profit to be made from seeing people as “diseased” and treating them for that “illness.” Take a pill!. In other words, American-style capitalism, which works to create markets for products, provides an incentive to create mental patients, and it has done this to great success over the past 35 years. Second, without a profit to be made, you don’t have as much investment in psychosocial care that can help a person remake his or her life. There is a societal expense, but little corporate profit, in psychosocial care, and American-style capitalism doesn’t lend itself to that equation.

Third, with our American-style capitalism (think neoliberalism), it is the individual that is seen as “ill” and needs to be fixed. Society gets a free pass. This too is a barrier to good “mental health” care, for it prevents us from thinking about what changes we might make to our society that would be more nurturing for us all. With our American-style capitalism, we now have a grossly unequal society, with more and more wealth going to the select few, and more and more people struggling to pay their bills.

That is a prescription for psychiatric distress. Good “mental health care” starts with creating a society that is more equal and just. Horgan. How might the COVID-19 pandemic affect care of the mentally ill?.

Whitaker. That is something Mad in America has reported on. The pandemic, of course, can be particularly threatening to people in mental hospitals, or in group homes. The threat is more than just the exposure to the virus that may come in such settings.

People who are struggling in this way often feel terribly isolated, alone, and fearful of being with others. COVID-19 measures, with calls for social distancing, can exacerbate that. I think this puts hospital staff and those who run residential homes into an extraordinarily difficult position—how can they help ease the isolation of patients even as they are being expected to enforce a type of social distancing?. Horgan.

If the next president named you mental health czar, what would be at the top of your To Do list?. Whitaker. Well, I am pretty sure that’s not going to happen, and if it did, I would quickly confess to my being utterly unqualified for the job. But from my perch at Mad in America, here is what I would like to see happen in our society.

As you can see from my answers above, I think the fundamental problem is that our society has organized itself around a false narrative, which was sold to us as a narrative of science. In the early 1980s, we began to hear that psychiatric disorders were discrete brain illnesses, which were caused by chemical imbalances in the brain, and that a new generation of psychiatric drugs fixed those imbalances, like insulin for diabetes. That is a story of an amazing medical breakthrough. Researchers had discovered the very chemicals in our brain that cause madness, depression, anxiety or ADHD, and they had developed drugs that could put brain chemistry back into a normal state.

Given the complexity of the human brain, if this were true, it would arguably be the greatest achievement in medical history. And we understood it to be true. We came to believe that there was a sharp line between the “normal” brain and the “abnormal” brain, and that it was medically helpful to screen for these illnesses, and that psychiatric drugs were very safe and effective, and often needed to be taken for life. But what can be seen clearly today is that this narrative was a marketing story, not a scientific one.

It was a story that psychiatry, as an institution, promoted for guild purposes, and it was a story that pharmaceutical companies promoted for commercial reasons. Science actually tells a very different story. The biology of psychiatric disorders remains unknown. The disorders in the DSM have not been validated as discrete illnesses.

The drugs do not fix chemical imbalances but rather perturb normal neurotransmitter functions. And even their short term efficacy is marginal at best. As could be expected, organizing our thinking around a false narrative has been a societal disaster. A sharp rise in the burden of mental illness in our society.

Poor long-term functional outcomes for those who are continuously medicated. The pathologizing of childhood. And so on. What we need now is a new narrative to organize ourselves around, one steeped in history, literature, philosophy, and good science.

I think step one is ditching the DSM. That book presents the most impoverished “philosophy of being” imaginable. Anyone who is too emotional, or struggles with his or her mind, or just doesn’t like being in a boring environment (think ADHD) is a candidate for a diagnosis. We need a narrative that, if truth be told, can be found in literature.

Novels, Shakespeare, the Bible—they all tell of how we humans struggle with our minds, our emotions and our behaviors. That is the norm. It is the human condition. And yet the characters we see in literature, if they were viewed through the DSM lens, would regularly qualify for a diagnosis.

At the same time, literature tells of how humans can be so resilient, and that we change as we age and move through different environments. We need that to be part of a new narrative too. Our current disease-model narrative tells of how people are likely going to be chronically ill. Their brains are defective, and so the therapeutic goal is to manage the symptoms of the “disease.” We need a narrative that replaces that pessimism with hope.

If we embraced that literary understanding of what it is to be human, then a “mental health” policy could be forged that would begin with this question. How do we create environments that are more nurturing for us all?. How do we create schools that build on a child’s curiosity?. How do we bring nature back into our lives?.

How do we create a society that helps provide people with meaning, a sense of community, and a sense of civic duty?. How do we create a society that promotes good physical health, and provides access to shelter and medical care?. Furthermore, with this conception in mind, individual therapy would help people change their environments. You could encourage walks in nature.

Recommend volunteer work. Provide settings where people could go and recuperate, and so forth. Most important, in contrast to a “disease-based” paradigm of care, a “wellness-based” paradigm would help people feel hopeful, and help them find a way to create a different future for themselves. This is an approach, by the way, that can be helpful to people who have suffered a psychotic episode.

Soteria homes and Open Dialogue are “therapies” that strive to help psychotic patients in this manner. Within this “wellness” paradigm of care, there would still be a place for use of medications that help people feel differently, at least for a time. Sedatives, tranquilizers, and so forth. And you would still want to fund science that seeks to better understand the many pathways to debilitating mood states and to “psychosis”—trauma, poor physical health, physical disease, lack of sleep, setbacks in life, isolation, loneliness, and yes, whatever biological vulnerabilities that may be present.

At the same time, you would want to fund science that seeks to better understand the pillars of “wellness.” Horgan. What’s your utopia?. Whitaker. My “utopia” would be a world like the one I just described, based on a new narrative about mental illness, rooted in an understanding of how emotional we humans are, of how we struggle with our minds, and of how we are built to be responsive to our environments.

And that really is the mission of Mad in America. We want it to be a forum for creating a new societal narrative for “mental health.” Further Reading. Can Psychiatry Heal Itself?. Are Psychiatric Medications Making Us Sicker?.

Meta-Post. Posts on Mental Illness Meta-Post. Posts on Brain Implants Meta-Post. Posts on Psychedelics Meta-Post.

Posts on Buddhism and Meditation See also “The Meaning of Madness,” a chapter in my free online book Mind-Body Problems.1970 Sweet Suburbia “Massive movement from central cities to their suburbs, a population boom in the West and Southwest, and a lower rate of population growth in the 1960's than in the 1950's are the findings that stand out in the preliminary results of the 1970 Census as issued by the U.S. Bureau of the Census. The movement to the suburbs was pervasive. Its extent is indicated by the fact that 13 of the 25 largest cities lost population, whereas 24 of the 25 largest metropolitan areas gained.

Washington, D.C., was characteristic. The population of the city changed little between 1960 and 1970, but the metropolitan area grew by 800,000, or more than 38 percent.” 1920 Air Cargo “The proposed machine, known as the ‘Pelican Four-Ton Lorry,' is a colossal cantilever monoplane designed for two 460-horse-power Napier engines. Its cruising speed is 72 miles per hour. Its total weight is to be 24,100 pounds.

The useful load is four tons, with sufficient fuel for the London-Paris journey. Most interesting of all, however, is the novel system of quick loading and unloading which has been planned. This permits handling of shipments with the utmost speed, and is based on a similar practice in the motor truck field. Idle airplanes mean a large idle capital, hence the designers plan to keep the airplane in the air for the greater part of the time.” Don't Try This Anywhere “Dr.

Charles Baskerville points out that while the data thus far obtained on chlorine and influenza do not warrant drawing conclusions, such facts as have been established would indicate to the medical man the advisability of trying experimentally dilute chlorinated air as a prophylactic in such epidemics as so-called influenza. Dr. Baskerville determined to what extent workers in plants where small amounts of chlorine were to be found in the atmosphere were affected seriously by influenza. Many of those from whom information was requested expressed the opinion that chlorine workers are noticeably free from colds and other pneumatic diseases.” 1870 The Rise of Telegraphy “The rapid progress of the telegraph during the last twenty-five years has changed the whole social and commercial systems of the world.

Its advantages and capabilities were so evident that immediately on its introduction, and demonstration of its true character, the most active efforts were made to secure them for every community which desired to keep pace with the advances of modern times. The Morse or signal system seemed for a time to be the perfection of achievement, until Professor Royal E. House astonished the world with his letter printing telegraph. Now, almost every considerable expanse of water is traversed, or soon will be, by the slender cords which bind continents and islands together and practically bring the human race into one great family.” The Transport of Goods 1887.

Cargo ship launched as Golconda had room for 6,000 tons of cargo, loaded and unloaded by crane and cargo nets, and 108 passengers. Credit. Scientific American Supplement, Vol. XXIII, No.

574. January 1, 1887 Oxcarts, railroad cars and freight ships can be loaded and unloaded one item at a time, but it is more efficient to handle cargo packed into “intermodal shipping containers” that are a standardized size and shape. Our October 1968 issue noted that a “break-bulk” freighter took three days to unload, a container ship less than one (including loading new cargo). Air transport became a link in this complex system, but the concept in the 1920 illustration shown is a little ahead of its time.

These days air cargo (and luggage) makes abundant use of “unit load devices,” cargo bins shaped to fit the fuselage of specific aircraft models.The items below are highlights from the free newsletter, “Smart, useful, science stuff about COVID-19.” To receive newsletter issues daily in your inbox, sign-up here. Are you in need of a “dose of optimism” about the pandemic, at least in the U.S.?. Check out this 10/12/20 story at The New York Times by by Donald McNeil Jr., who has covered infectious diseases and epidemics for many years. McNeil notes the 215,000 people in the U.S.

Dead so far from the novel coronavirus, as well as the estimates that the figure could go as high as 400,000 before this era draws to a close. But here is some of the good news that he tallies. 1) mask-wearing by the public is “widely accepted”. 2) the development of vaccines to protect against SARS-CoV-2 and of treatments for COVID-19 are proceeding at record speed.

3) “experts are saying, with genuine confidence, that the pandemic in the United States will be over far sooner than they expected, possibly by the middle of next year”. And 4) fewer infected people die today than did earlier this year, even at nursing homes. About 10 percent of people in the U.S. Have been infected with the virus so far, according to the U.S.

Centers for Disease Control, the story states. €œPandemics don’t end abruptly. They decelerate gradually,” McNeil writes. A 10/14/20 story by Carl Zimmer for The New York Times puts into context three late-stage (Phase 3 safety and effectiveness) COVID-19 experiments that have been paused in recent weeks due to illness among some study participants.

Pauses in vaccine studies — in this case Johnson &. Johnson’s vaccine candidate and AstraZeneca’s vaccine candidate — are “not unusual,” the story states, partly because the safety threshold is extremely high for a product that, if approved, could be given to millions or billions of people. But pauses are rare in treatment studies — in this case Eli Lilly’s monoclonal antibody cocktail drug. Once a drug or treatment experiment (trial) is paused, a safety board determines whether the ill participant was given the new product or a placebo.

If it was the placebo, the study can resume. If not, the board looks deeper into the case to determine whether or not the illness is related to the drug or treatment.

In 2020, Trump continues to use the same strategy of appealing to the brain’s can you get cipro over the counter threat-detection circuitry and emotion-based decision process to attract votes and vilify opponents. €œBiden wants to surrender our country to the violent left-wing mob…. If Biden wins, very simple, China wins. If Biden can you get cipro over the counter wins, the mob wins. If Biden wins, the rioters, anarchists, arsonists and flag-burners, they win,” Trump declared at his Wisconsin campaign rally on September 17, 2020, offering new alleged threats to our nation as his 2016 bogeymen of rapist immigrants and foreign terrorists have lost potency.

As Trump invokes threats of anarchy and street violence, any tangible rise in violence at political assemblies will benefit the Trump strategy of generating fear. Trump supporters have reacted by brandishing can you get cipro over the counter and sometimes using firearms at public demonstrations. In the 2016 campaign, Trump egged his supporters on to commit violence, suggesting that an assassination of Hillary Clinton by gun rights advocates could be used to prevent her from picking Supreme Court justices. The president has inflamed the atmosphere surrounding large protests by calling to the scene military and unidentified federal security agents, even as local officials object. He can you get cipro over the counter continues to make bombastic statements.

€œI am your wall between the American dream and chaos,” he told an audience in Minnesota. When asked by debate moderator Chris Wallace whether he was willing to condemn white supremacists and paramilitary groups, he would not do so. Instead, he barked out what sounded like strategic instructions to the right-wing Proud Boys, widely regarded as an extremist hate group, can you get cipro over the counter “Proud Boys—stand back, and stand by.” But fear-driven appeals will likely persuade fewer voters this time, because we overcome fear in two ways. By reason and experience. Inhibitory neural pathways from the prefrontal cortex to the limbic system will enable reason to quash fear if the dangers are not grounded in fact.

The type of street violence Trump rails against now was not the norm during the Obama can you get cipro over the counter and Biden years. Nor was fear that Biden would turn the U.S. Into a socialist state an issue even a year ago. On the contrary, Biden defeated the self-described “democratic socialist” can you get cipro over the counter candidate Bernie Sanders in the presidential primaries. A psychology- and neuroscience-based perspective also illuminates Trump’s constant interruptions and insults during the first presidential debate, steamrolling over the moderator’s futile efforts to have a reasoned airing of facts and positions.

The structure of a debate is designed to engage the deliberative reasoning in the brain’s cerebral cortex, so Trump annihilated the format to inflame emotion in the limbic system. Trump’s dismissal of experts, be they military generals, career public servants, scientists or even his own political appointees, is necessary can you get cipro over the counter for him to sustain the subcortical decision-making in voters’ minds that won him election and sustains his support. The fact-based decision-making that scientists rely upon is the polar opposite of emotion-based decision-making. In his rhetoric, Trump does not address factual evidence. He dismisses or suppresses it even for events that are apparent to many, including can you get cipro over the counter global warming, foreign intervention in U.S.

Elections, the trivial head count at his inauguration, and even the projected path of a destructive hurricane. Instead, “alternative facts,” or fabrications, are substituted. This perspective can you get cipro over the counter from inside the brain’s neural networks also explains the Trump administration’s unprecedented erosion of government institutions with missions intended to protect the public (ranging from the Centers for Disease Control to the FBI). These diversions distract attention from real, uncontrollable threats, such as the coronavirus pandemic, that may undermine Trump’s political and economic objectives. Reason cannot always overcome fear, as PTSD demonstrates.

But the brain’s second can you get cipro over the counter mechanism of neutralizing its fear circuitry—experience—can do so. Repeated exposure to the fearful situation where the outcome is safe will rewire the brain’s subcortical circuitry. This is the basis for “extinction therapy” used to treat PTSD and phobias. For many, credibility has been eroded by Trump’s outlandish assertions, like suggesting can you get cipro over the counter injections of bleach might cure COVID-19, or enthusing over a plant toxin touted by a pillow salesman, while scientific experts in attendance grimace and bite their lips. In the last election Trump was a little-known newcomer as a political figure, but that is not the case this time with either candidate.

The “gut -reaction” decision-making process excels in complex situations where there is not enough factual information or time to make a reasoned decision. We follow gut instinct, for example, when selecting a dish from a menu at a new restaurant, can you get cipro over the counter where we have never seen or tasted the offering before. We’ve had our fill of the politics this time, no matter what position one may favor. Whether voters choose to vote for Trump on the basis of emotion or reason, they will be better able to articulate the reasons, or rationalizations, for their choice. This should give pollsters better data to make a more accurate prediction.One of the most impressive, disturbing works of science journalism can you get cipro over the counter I’ve encountered is Anatomy of an Epidemic.

Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, published in 2010. In the book, which I review here, award-winning journalist Robert Whitaker presents evidence that medications for mental illness, over time and in the aggregate, cause net harm. In 2012, I can you get cipro over the counter brought Whitaker to my school to give a talk, in part to check him out. He struck me as a smart, sensible, meticulous reporter whose in-depth research had led him to startling conclusions. Since then, far from encountering persuasive rebuttals of Whitaker’s thesis, I keep finding corroborations of it.

If Whitaker is right, modern psychiatry, together can you get cipro over the counter with the pharmaceutical industry, has inflicted iatrogenic harm on millions of people. Reports of surging mental distress during the pandemic have me thinking once again about Whitaker’s views and wondering how they have evolved. Below he answers some questions. €”John Horgan
 can you get cipro over the counter Horgan. When and why did you start reporting on mental health?.

Whitaker. It came about in can you get cipro over the counter a very roundabout way. In 1994, I had co-founded a publishing company called CenterWatch that covered the business aspects of the “clinical trials industry,” and I soon became interested in writing about how financial interests were corrupting drug trials. Risperdal and Zyprexa had just come to market, and after I used a Freedom of Information request to obtain the FDA’s review of those two drugs, I could see that psychiatric drug trials were a prime example of that corruption. In addition, I had learned of NIMH-funded research that seemed abusive of schizophrenia patients, and in 1998, I can you get cipro over the counter co-wrote a series for the Boston Globe on abuses of patients in psychiatric research.

My interest was in that broader question of corruption and abuse in research settings, and not specific to psychiatry. At that time, I still had a conventional understanding of psychiatric drugs. My understanding was that researchers were making great advances can you get cipro over the counter in understanding mental disorders, and that they had found that schizophrenia and depression were due to chemical imbalances in the brain, which psychiatric medications then put back in balance. However, while reporting that series, I stumbled upon studies that didn’t make sense to me, for they belied what I knew to be “true,” and that was what sent me down this path of reporting on mental health. First, there were two studies by the World Health Organization that found that longer-term outcomes for schizophrenia patients in three “developing” countries were much better than in the U.S.

And five other can you get cipro over the counter “developed” countries. This didn’t really make sense to me, and then I read this. In the developing countries, they used antipsychotic drugs acutely, but not chronically. Only 16 percent of patients in the developing countries were regularly maintained on antipsychotics, whereas in the developed can you get cipro over the counter countries this was the standard of care. That didn’t fit with my understanding that these drugs were an essential treatment for schizophrenia patients.

Second, a study by Harvard researchers found that schizophrenia outcomes had declined in the previous 20 years, and were now no better than they had been in the first third of the 20th century. That didn’t fit with my understanding that psychiatry had made great progress in treating can you get cipro over the counter people so diagnosed. Those studies led to my questioning the story that our society told about those we call “mad,” and I got a book contract to dig into that question. That project turned into Mad in America, which told of the history of our society’s treatment of the seriously mentally ill, from colonial times until today—a history marked by bad science and societal mistreatment of those so diagnosed. Horgan.

Do you still see yourself as a journalist, or are you primarily an activist?. Whitaker. I don’t see myself as an “activist” at all. In my own writings, and in the webzine I direct, Mad in America, I think you’ll see journalistic practices at work, albeit in the service of an “activist” mission. Here is our mission statement.

€œMad in America’s mission is to serve as a catalyst for rethinking psychiatric care in the United States (and abroad). We believe that the current drug-based paradigm of care has failed our society, and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change.” Thus, our starting point is that “change” is needed, and while that does have an activist element, I think journalism—serving as an informational source—is fundamental to that effort. As an organization, we are not asserting that we have the answers for what that change should be, which would be the case if we were striving to be activists. Instead, we strive to be a forum for promoting an informed societal discussion about this subject. Here’s what we do.

We publish daily summaries of scientific research with findings that are rarely covered in the mainstream media. You’ll find, in the archives of our research reports, a steady parade of findings that counter the conventional narrative. For instance, there are reports of how the effort to find genes for mental disorders has proven rather fruitless, or of how social inequalities trigger mental distress, or of poor long-term outcomes with our current paradigm of care. And so forth—we simply want these scientific findings to become known.
We regularly feature interviews with researchers and activists, and podcasts that explore these issues. We launched MIA Reports as a showcase for our print journalism.

We have published in-depth articles on promising new initiatives in Europe. Investigative pieces on such topics as compulsory outpatient treatment. Coverage of “news” related to mental health policy in the United States. And occasional reports on how the mainstream media is covering mental health issues. €¨We also publish blogs by professionals, academics, people with lived experience, and others with a particular interest in this subject.

These blogs and personal stories are meant to help inform society’s “rethinking” of psychiatric care. All of these efforts, I think, fit within the framework of “journalism.” However, I do understand that I am going beyond the boundaries of usual “science journalism” when I publish critiques of the “evidence base” related to psychiatric drugs. I did this in my books Mad in America and Anatomy of an Epidemic, as well as a book I co-wrote, Psychiatry Under the Influence. I have continued to do this with MIA Reports. The usual practice in “science journalism” is to look to the “experts” in the field and report on what they tell about their findings and practices.

However, while reporting and writing Mad in America, I came to understand that when “experts” in psychiatry spoke to journalists they regularly hewed to a story that they were expected to tell, which was a story of how their field was making great progress in understanding the biology of disorders and of drug treatments that—as I was told over and over when I co-wrote the series for the Boston Globe—fixed chemical imbalances in the brain. But their own science, I discovered, regularly belied the story they were telling to the media. That’s why I turned to focusing on the story that could be dug out from a critical look at their own scientific literature. So what I do in these critiques—such as suicide in the Prozac era and the impact of antipsychotics on mortality—is review the relevant research and put those findings together into a coherent report. I also look at research cited in support of mainstream beliefs and see if the data, in those articles, actually supports the conclusions presented in the abstract.

None of this is really that difficult, and yet I know it is unusual for a journalist to challenge conventional “medical wisdom” in this way. Horgan. Anatomy of an Epidemic argues that medications for mental illness, although they give many people short-term reliefs, cause net harm. Is that a fair summary?. Whitaker.

Yes, although my thinking has evolved somewhat since I wrote that book. I am more convinced than ever that psychiatric medications, over the long term, cause net harm. I wish that weren’t the case, but the evidence just keeps mounting that these drugs, on the whole, worsen long-term outcomes. However, my thinking has evolved in this way. I am not so sure any more that the medications provide a short-term benefit for patient populations as a whole.

When you look at the short-term studies of antidepressants and antipsychotics, the evidence of efficacy in reducing symptoms compared to placebo is really pretty marginal, and fails to rise to the level of a “clinically meaningful” benefit. Furthermore, the problem with all of this research is that there is no real placebo group in the studies. The placebo group is composed of patients who have been withdrawn from their psychiatric medications and then randomized to placebo. Thus, the placebo group is a drug-withdrawal group, and we know that withdrawal from psychiatric drugs can stir myriad negative effects. A medication-naïve placebo group would likely have much better outcomes, and if that were so, how would that placebo response compare to the drug response?.

In short, research on the short-term effects of psychiatric drugs is a scientific mess. In fact, a 2017 paper that was designed to defend the long-term use of antipsychotics nevertheless acknowledged, in an off-hand way, that “no placebo-controlled trials have been reported in first-episode psychosis patients.” Antipsychotics were introduced 65 years ago, and we still don’t have good evidence that they work over the short term in first episode patients. Which is rather startling, when you think of it. Horgan. Have any of your critics—E.

Fuller Torrey, for example—made you rethink your thesis?. Whitaker. When the first edition of Anatomy of an Epidemic was published (2010), I knew there would be critics, and I thought, this will be great. This is just what is needed, a societal discussion about the long-term effects of psychiatric medications. I have to confess that I have been disappointed in the criticism.

They mostly have been ad hominem attacks—I cherry-picked the data, or I misunderstood findings, or I am just biased, but the critics don’t then say what data I missed, or point to findings that tell of medications that improve long-term outcomes. I honestly think I could do a much better job of critiquing my own work. You mention E. Fuller Torrey’s criticism, in which he states that I both misrepresented and misunderstood some of the research I cited. I took this seriously, and answered it at great length.

Now if your own “thesis” is indeed flawed, then a critic should be able to point out its flaws while accurately detailing what you wrote. If that is the case, then you have good reason to rethink your beliefs. But if a critique doesn’t meet that standard, but rather relies on misrepresenting what you wrote, then you have reason to conclude that the critic lacks the evidence to make an honest case. And that is how I see Torrey’s critique. For example, Torrey said that I misunderstood Martin Harrow’s research on long-term outcomes for schizophrenia patients.

Harrow reported that the recovery rate was eight times higher for those who got off antipsychotic medication compared to those who stayed on the drugs. However, in his 2007 paper, Harrow stated that the better outcomes for those who got off medication was because they had a better prognosis and not because of negative drug effects. If you read Anatomy of an Epidemic, you’ll see that I present his explanation. Yet, in my interview with Harrow, I noted that his own data showed that those who were diagnosed with milder psychotic disorders who stayed on antipsychotics fared worse over the long term than schizophrenia patients who stopped taking the medication. This was a comparison that showed the less ill maintained on antipsychotics doing worse than the more severely ill who got off these medications.

And I presented that comparison in Anatomy of an Epidemic. By doing that, I was going out on a limb. I was saying that maybe Harrow’s data led to a different conclusion than he had drawn, which was that the antipsychotic medication, over the long-term, had a negative effect. After Anatomy was published, Harrow and his colleague Thomas Jobe went back to their data and investigated this very possibility. They have subsequently written several papers exploring this theme, citing me in one or two instances for raising the issue, and they found reason to conclude that it might be so.

They wrote. €œHow unique among medical treatments is it that the apparent efficacy of antipsychotics could diminish over time or become harmful?. There are many examples for other medications of similar long-term effects, with this often occurring as the body readjusts, biologically, to the medications.” Thus, in this instance, I did the following. I accurately reported the results of Harrow’s study and his interpretation of his results, and I accurately presented data from his research that told of a possible different interpretation. The authors then revisited their own data to take up this inquiry.

And yet Torrey’s critique is that I misrepresented Harrow’s research. This same criticism, by the way, is still being flung at me. Here is a recent article in Vice which, once again, quotes people saying I misrepresent and misunderstand research, with Harrow cited as an example. I do want to emphasize that critiques of “my thesis” regarding the long-term effects of psychiatric drugs are important and to be welcomed. See two papers in particular that take this on (here and here), and my response in general to such criticisms, and to the second one.

Horgan. When I criticize psychiatric drugs, people sometimes tell me that meds saved their lives. You must get this reaction a lot. How do you respond?. Whitaker.

I do hear that, and when I do, I reply, “Great!. I am so glad to know that the medications have worked for you!. € But of course I also hear from many people who say that the drugs ruined their lives. I do think that the individual’s experience of psychiatric medication, whether good or bad, should be honored as worthy and “valid.” They are witnesses to their own lives, and we should incorporate those voices into our societal thinking about the merits of psychiatric drugs. However, for the longest time, we’ve heard mostly about the “good” outcomes in the mainstream media, while those with “bad” outcomes were resigned to telling their stories on internet forums.

What Mad in America has sought to do, in its efforts to serve as a forum for rethinking psychiatry, is provide an outlet for this latter group, so their voices can be heard too. The personal accounts, of course, do not change the bottom-line “evidence” that shows up in outcome studies of larger groups of patients. Unfortunately, that tells of medications that, on the whole, do more harm than good. As a case in point, in regard to this “saving lives” theme, this benefit does not show up in public health data. The “standard mortality rate” for those with serious mental disorders, compared to the general public, has notably increased in the last 40 years.

Horgan. Do you see any promising trends in psychiatry?. Whitaker. Yes, definitely. You have the spread of Hearing Voices networks, which are composed of people who hear voices and offer support for learning to live with voices as opposed to squashing them, which is what the drugs are supposed to do.

These networks are up and running in the U.S., and in many countries worldwide. You have Open Dialogue approaches, which were pioneered in northern Finland and proved successful there, being adopted in the United States and many European countries (and beyond.) This practice puts much less emphasis on treatment with antipsychotics, and much greater emphasis on helping people re-integrate into family and community. You have many alternative programs springing up, even at the governmental level. Norway, for instance, ordered its hospital districts to offer “medication free” treatment for those who want it, and there is now a private hospital in Norway that is devoted to helping chronic patients taper down from their psychiatric medications. In Israel, you have Soteria houses that have sprung up (sometimes they are called stabilizing houses), where use of antipsychotics is optional, and the environment—a supportive residential environment—is seen as the principal “therapy.” You have the U.N.

Special Rapporteur for Health, Dainius Pūras, calling for a “revolution” in mental health, one that would supplant today’s biological paradigm of care with a paradigm that paid more attention to social justice factors—poverty, inequality, etc.—as a source of mental distress. All of those initiatives tell of an effort to find a new way. But perhaps most important, in terms of “positive trends,” the narrative that was told to us starting in the 1980s has collapsed, which is what presents the opportunity for a new paradigm to take hold. More and more research tells of how the conventional narrative, in all its particulars, has failed to pan out. The diagnoses in the Diagnostic and Statistical Manual (DSM) have not been validated as discrete illnesses.

The genetics of mental disorders remain in doubt. MRI scans have not proven to be useful. Long-term outcomes are poor. And the notion that psychiatric drugs fix chemical imbalances has been abandoned. Ronald Pies, the former editor in chief of Psychiatric Times, has even sought to distance psychiatry, as an institution, from ever having made such a claim.

Horgan. Do brain implants or other electrostimulation devices show any therapeutic potential?. Whitaker. I don’t have a ready answer for this. We have published two articles about the spinning of results from a trial of deep-brain stimulation, and the suffering of some patients so treated over the long-term.

Those articles tell of why it may be difficult to answer that question. There are financial influences that push for published results that tell of a therapeutic success, even if the data doesn’t support that finding, and we have a research environment that fails to study long-term outcomes. The history of somatic treatments for mental disorders also provides a reason for caution. It’s a history of one somatic treatment after another being initially hailed as curative, or extremely helpful, and then failing the test of time. The inventor of frontal lobotomy, Egas Moniz, was awarded a Nobel Prize for inventing that surgery, which today we understand as a mutilation.

It’s important to remain open to the possibility that somatic treatments may be helpful, at least for some patients. But there is plenty of reason to be wary of initial claims of success. Horgan. Should psychedelic drugs be taken seriously as treatments?. Whitaker.

I think caution applies here too. Surely there are many risks with psychedelic drugs, and if you were to do a study of first-episode psychosis today, you would find a high percentage of the patients had been using mind-altering drugs before their psychotic break—antidepressants, marijuana, LSD and so forth. At the same time, we’ve published reviews of papers that have reported positive results with use of psychedelics. What are the benefits versus the risks?. Can possible benefits be realized while risks are minimized?.

It is a question worth exploring, but carefully so. Horgan. What about meditation?. Whitaker. I know that many people find meditation helpful.

I also know other people find it difficult—and even threatening—to sit with the silence of their minds. Mad in America has published reviews of research about meditation, we have had a few bloggers write about it, and in our resource section on “non-drug therapies,” we have summarized research findings regarding its use for depression. We concluded that the research on this is not as robust as one would like. However, I think your question leads to this broader thought. People struggling with their minds and emotions may come up with many different approaches they find helpful.

Exercise, diet, meditation, yoga and so forth all represent efforts to change one’s environment, and ultimately, I think that can be very helpful. But the individual has to find his or her way to whatever environmental change that works best for them. Horgan. Do you see any progress toward understanding the causes of mental illness?. Whitaker.

Yes, and that progress might be summed up in this way. Researchers are returning to investigations of how we are impacted by what has “happened to us.” The Adverse Childhood Experiences study provides compelling evidence of how traumas in childhood—divorce, poverty, abuse, bullying and so forth—exact a long-term toll on physical and mental health. Interview any group of women diagnosed with a serious mental disorder, and you’ll regularly find accounts of sexual abuse. Racism exacts a toll. So too poverty, oppressive working conditions, and so forth.

You can go on and on, but all of this is a reminder that we humans are designed to respond to our environment, and it is quite clear that mental distress, in large part, arises from difficult environments and threatening experiences, past and present. And with a focus on life experiences as a source of “mental illness,” a related question is now being asked. What do we all need to be mentally well?. Shelter, good food, meaning in life, someone to love and so forth—if you look at it from this perspective, you can see why, when those supporting elements begin to disappear, psychiatric difficulties appear. I am not discounting that there may be biological factors that cause “mental illness.” While biological markers that tell of a particular disorder have not been discovered, we are biological creatures, and we do know, for instance, that there are physical illnesses and toxins that can produce psychotic episodes.

However, the progress that is being made at the moment is a moving away from the robotic “it’s all about brain chemistry” toward a rediscovery of the importance of our social lives and our experiences. Horgan. Do we still have anything to learn from Sigmund Freud?. Whitaker. I certainly think so.

Freud is a reminder that so much of our mind is hidden from us and that what spills into our consciousness comes from a blend of the many parts of our mind, our emotional centers and our more primal instincts. You can still see merit in Freud’s descriptions of the id, ego and superego as a conceptualization of different parts of the brain. I read Freud when I was in college, and it was a formative experience for me. Horgan. I fear that American-style capitalism doesn’t produce good health care, including mental-health care.

What do you think?. Whitaker. It’s clear that it doesn’t. First, we have for-profit health-care that is set up to treat “disease.” With mental-health care, that means there is a profit to be made from seeing people as “diseased” and treating them for that “illness.” Take a pill!. In other words, American-style capitalism, which works to create markets for products, provides an incentive to create mental patients, and it has done this to great success over the past 35 years.

Second, without a profit to be made, you don’t have as much investment in psychosocial care that can help a person remake his or her life. There is a societal expense, but little corporate profit, in psychosocial care, and American-style capitalism doesn’t lend itself to that equation. Third, with our American-style capitalism (think neoliberalism), it is the individual that is seen as “ill” and needs to be fixed. Society gets a free pass. This too is a barrier to good “mental health” care, for it prevents us from thinking about what changes we might make to our society that would be more nurturing for us all.

With our American-style capitalism, we now have a grossly unequal society, with more and more wealth going to the select few, and more and more people struggling to pay their bills. That is a prescription for psychiatric distress. Good “mental health care” starts with creating a society that is more equal and just. Horgan. How might the COVID-19 pandemic affect care of the mentally ill?.

Whitaker. That is something Mad in America has reported on. The pandemic, of course, can be particularly threatening to people in mental hospitals, or in group homes. The threat is more than just the exposure to the virus that may come in such settings. People who are struggling in this way often feel terribly isolated, alone, and fearful of being with others.

COVID-19 measures, with calls for social distancing, can exacerbate that. I think this puts hospital staff and those who run residential homes into an extraordinarily difficult position—how can they help ease the isolation of patients even as they are being expected to enforce a type of social distancing?. Horgan. If the next president named you mental health czar, what would be at the top of your To Do list?. Whitaker.

Well, I am pretty sure that’s not going to happen, and if it did, I would quickly confess to my being utterly unqualified for the job. But from my perch at Mad in America, here is what I would like to see happen in our society. As you can see from my answers above, I think the fundamental problem is that our society has organized itself around a false narrative, which was sold to us as a narrative of science. In the early 1980s, we began to hear that psychiatric disorders were discrete brain illnesses, which were caused by chemical imbalances in the brain, and that a new generation of psychiatric drugs fixed those imbalances, like insulin for diabetes. That is a story of an amazing medical breakthrough.

Researchers had discovered the very chemicals in our brain that cause madness, depression, anxiety or ADHD, and they had developed drugs that could put brain chemistry back into a normal state. Given the complexity of the human brain, if this were true, it would arguably be the greatest achievement in medical history. And we understood it to be true. We came to believe that there was a sharp line between the “normal” brain and the “abnormal” brain, and that it was medically helpful to screen for these illnesses, and that psychiatric drugs were very safe and effective, and often needed to be taken for life. But what can be seen clearly today is that this narrative was a marketing story, not a scientific one.

It was a story that psychiatry, as an institution, promoted for guild purposes, and it was a story that pharmaceutical companies promoted for commercial reasons. Science actually tells a very different story. The biology of psychiatric disorders remains unknown. The disorders in the DSM have not been validated as discrete illnesses. The drugs do not fix chemical imbalances but rather perturb normal neurotransmitter functions.

And even their short term efficacy is marginal at best. As could be expected, organizing our thinking around a false narrative has been a societal disaster. A sharp rise in the burden of mental illness in our society. Poor long-term functional outcomes for those who are continuously medicated. The pathologizing of childhood.

And so on. What we need now is a new narrative to organize ourselves around, one steeped in history, literature, philosophy, and good science. I think step one is ditching the DSM. That book presents the most impoverished “philosophy of being” imaginable. Anyone who is too emotional, or struggles with his or her mind, or just doesn’t like being in a boring environment (think ADHD) is a candidate for a diagnosis.

We need a narrative that, if truth be told, can be found in literature. Novels, Shakespeare, the Bible—they all tell of how we humans struggle with our minds, our emotions and our behaviors. That is the norm. It is the human condition. And yet the characters we see in literature, if they were viewed through the DSM lens, would regularly qualify for a diagnosis.

At the same time, literature tells of how humans can be so resilient, and that we change as we age and move through different environments. We need that to be part of a new narrative too. Our current disease-model narrative tells of how people are likely going to be chronically ill. Their brains are defective, and so the therapeutic goal is to manage the symptoms of the “disease.” We need a narrative that replaces that pessimism with hope. If we embraced that literary understanding of what it is to be human, then a “mental health” policy could be forged that would begin with this question.

How do we create environments that are more nurturing for us all?. How do we create schools that build on a child’s curiosity?. How do we bring nature back into our lives?. How do we create a society that helps provide people with meaning, a sense of community, and a sense of civic duty?. How do we create a society that promotes good physical health, and provides access to shelter and medical care?.

Furthermore, with this conception in mind, individual therapy would help people change their environments. You could encourage walks in nature. Recommend volunteer work. Provide settings where people could go and recuperate, and so forth. Most important, in contrast to a “disease-based” paradigm of care, a “wellness-based” paradigm would help people feel hopeful, and help them find a way to create a different future for themselves.

This is an approach, by the way, that can be helpful to people who have suffered a psychotic episode. Soteria homes and Open Dialogue are “therapies” that strive to help psychotic patients in this manner. Within this “wellness” paradigm of care, there would still be a place for use of medications that help people feel differently, at least for a time. Sedatives, tranquilizers, and so forth. And you would still want to fund science that seeks to better understand the many pathways to debilitating mood states and to “psychosis”—trauma, poor physical health, physical disease, lack of sleep, setbacks in life, isolation, loneliness, and yes, whatever biological vulnerabilities that may be present.

At the same time, you would want to fund science that seeks to better understand the pillars of “wellness.” Horgan. What’s your utopia?. Whitaker. My “utopia” would be a world like the one I just described, based on a new narrative about mental illness, rooted in an understanding of how emotional we humans are, of how we struggle with our minds, and of how we are built to be responsive to our environments. And that really is the mission of Mad in America.

We want it to be a forum for creating a new societal narrative for “mental health.” Further Reading. Can Psychiatry Heal Itself?. Are Psychiatric Medications Making Us Sicker?. Meta-Post. Posts on Mental Illness Meta-Post.

Posts on Brain Implants Meta-Post. Posts on Psychedelics Meta-Post. Posts on Buddhism and Meditation See also “The Meaning of Madness,” a chapter in my free online book Mind-Body Problems.1970 Sweet Suburbia “Massive movement from central cities to their suburbs, a population boom in the West and Southwest, and a lower rate of population growth in the 1960's than in the 1950's are the findings that stand out in the preliminary results of the 1970 Census as issued by the U.S. Bureau of the Census. The movement to the suburbs was pervasive.

Its extent is indicated by the fact that 13 of the 25 largest cities lost population, whereas 24 of the 25 largest metropolitan areas gained. Washington, D.C., was characteristic. The population of the city changed little between 1960 and 1970, but the metropolitan area grew by 800,000, or more than 38 percent.” 1920 Air Cargo “The proposed machine, known as the ‘Pelican Four-Ton Lorry,' is a colossal cantilever monoplane designed for two 460-horse-power Napier engines. Its cruising speed is 72 miles per hour. Its total weight is to be 24,100 pounds.

The useful load is four tons, with sufficient fuel for the London-Paris journey. Most interesting of all, however, is the novel system of quick loading and unloading which has been planned. This permits handling of shipments with the utmost speed, and is based on a similar practice in the motor truck field. Idle airplanes mean a large idle capital, hence the designers plan to keep the airplane in the air for the greater part of the time.” Don't Try This Anywhere “Dr. Charles Baskerville points out that while the data thus far obtained on chlorine and influenza do not warrant drawing conclusions, such facts as have been established would indicate to the medical man the advisability of trying experimentally dilute chlorinated air as a prophylactic in such epidemics as so-called influenza.

Dr. Baskerville determined to what extent workers in plants where small amounts of chlorine were to be found in the atmosphere were affected seriously by influenza. Many of those from whom information was requested expressed the opinion that chlorine workers are noticeably free from colds and other pneumatic diseases.” 1870 The Rise of Telegraphy “The rapid progress of the telegraph during the last twenty-five years has changed the whole social and commercial systems of the world. Its advantages and capabilities were so evident that immediately on its introduction, and demonstration of its true character, the most active efforts were made to secure them for every community which desired to keep pace with the advances of modern times. The Morse or signal system seemed for a time to be the perfection of achievement, until Professor Royal E.

House astonished the world with his letter printing telegraph. Now, almost every considerable expanse of water is traversed, or soon will be, by the slender cords which bind continents and islands together and practically bring the human race into one great family.” The Transport of Goods 1887. Cargo ship launched as Golconda had room for 6,000 tons of cargo, loaded and unloaded by crane and cargo nets, and 108 passengers. Credit. Scientific American Supplement, Vol.

XXIII, No. 574. January 1, 1887 Oxcarts, railroad cars and freight ships can be loaded and unloaded one item at a time, but it is more efficient to handle cargo packed into “intermodal shipping containers” that are a standardized size and shape.

What is a cipro certificate

Latest Prevention what is a cipro certificate &. Wellness News what is a cipro certificate THURSDAY, Sept. 10, 2020 (American Heart Association News)Like ordering a ride or food delivery on your smartphone, keeping track of your heart rate, blood pressure or weight is just a few taps away thanks to thousands of free or inexpensive health apps.But with each click, you may be unwittingly handing over your health data to a third party.As health apps skyrocket in popularity, experts and medical organizations have begun warning consumers of the hidden dangers. In May, the American Medical Association called on lawmakers and the health care industry to install "regulatory guardrails" to protect all types of patient privacy in the digital age.Until that happens, health app users are largely unprotected from having their data passed along to tech giants and marketing companies that might target them with ads, said Mohammed Abdullah, senior author what is a cipro certificate of a new study about privacy issues and apps.The study, being presented at the American Heart Association's virtual Hypertension Scientific Sessions that begins Thursday, examined 35 diabetes mobile apps and found that all of them gave data to a third party, even in cases where the app's privacy policy said it wouldn't. The research is considered preliminary until published in a peer-reviewed journal."Right now, there are no limitations on what companies can do with this data," said Abdullah, a medical student at the University of Texas Medical Branch in Galveston.

"As technology and health care become further intertwined and companies spend billions of dollars on health care-related apps, it's becoming more and more important what is a cipro certificate to make sure we have checks and balances in place."That's because the data on health apps, he said, is not safeguarded by HIPAA, the 1996 law that protects health information gathered by doctors and health systems."Right now, it's like the Wild West, with zero protection," said Dr. David Grande, author of a study about health privacy in the digital age published in July in JAMA Network Open. "Health privacy concerns are growing at an astronomical pace, but we still have a very antiquated view of them."For example, Grande what is a cipro certificate said many Americans are unaware that once their health data is collected, it's available online forever. In Europe, what is a cipro certificate "right to be forgotten" online privacy laws offer consumers some protection. But in the U.S., digital health info is "immortal," he said."People don't understand all the digital footprints they're leaving behind each time they interact with heath apps, and frankly, it's very hard to understand.

Who on earth what is a cipro certificate would want to read a long, complicated privacy agreement?. " said Grande, policy director at the University of Pennsylvania's Leonard Davis Institute of Health Economics in Philadelphia.As arduous as that task might seem, Abdullah urges people to take five minutes to read the agreements and find out what might happen to their data once they click "agree.""You have to weigh the risks and benefits," he said. "The app might help patients track their what is a cipro certificate blood sugar, but is it worth using if you know your data might possibly be shared?. "For consumers concerned with privacy, one red flag is the presence of ads on the health app."If you open the app and find ad services, you can be sure your data is being sent off to a third party in some way, shape or form," Abdullah said.Another tip is to check the app's automatic settings and make changes that will protect privacy, like turning off your location. But that, too, has what is a cipro certificate a drawback, Grande said.

"In some cases, turning off privacy what is a cipro certificate settings makes an app harder to use."Like many internet-based services, health apps are usually free to download, with app-makers earning money through advertising or selling data to third parties, he said.However, that business model could change if lawmakers start enacting stricter guidelines and consumers become more willing to pay for health apps."Consumers put health very high on their list in terms of where they want privacy protection," Grande said. "As they grow more uncomfortable with every aspect of their life being tracked, I think the thirst for regulation and privacy control will grow, too."American Heart Association News covers heart and brain health. Not all views expressed in this story reflect what is a cipro certificate the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or what is a cipro certificate comments about this story, please email [email protected]Copyright © 2020 HealthDay.

All rights reserved. SLIDESHOW Heart Disease what is a cipro certificate. Causes of a Heart Attack See Slideshow.

Latest Prevention can you get cipro over the counter &. Wellness News can you get cipro over the counter THURSDAY, Sept. 10, 2020 (American Heart Association News)Like ordering a ride or food delivery on your smartphone, keeping track of your heart rate, blood pressure or weight is just a few taps away thanks to thousands of free or inexpensive health apps.But with each click, you may be unwittingly handing over your health data to a third party.As health apps skyrocket in popularity, experts and medical organizations have begun warning consumers of the hidden dangers. In May, the American Medical Association called on lawmakers and the health care industry to install "regulatory guardrails" to protect all types of patient privacy in the digital age.Until that happens, health app users are largely unprotected from having their data passed along to tech giants and marketing companies that might target them with ads, said can you get cipro over the counter Mohammed Abdullah, senior author of a new study about privacy issues and apps.The study, being presented at the American Heart Association's virtual Hypertension Scientific Sessions that begins Thursday, examined 35 diabetes mobile apps and found that all of them gave data to a third party, even in cases where the app's privacy policy said it wouldn't. The research is considered preliminary until published in a peer-reviewed journal."Right now, there are no limitations on what companies can do with this data," said Abdullah, a medical student at the University of Texas Medical Branch in Galveston.

"As technology and health care become further intertwined and companies spend billions of dollars on health care-related apps, it's becoming more and more important can you get cipro over the counter to make sure we have checks and balances in place."That's because the data on health apps, he said, is not safeguarded by HIPAA, the 1996 law that protects health information gathered by doctors and health systems."Right now, it's like the Wild West, with zero protection," said Dr. David Grande, author of a study about health privacy in the digital age published in July in JAMA Network Open. "Health privacy can you get cipro over the counter concerns are growing at an astronomical pace, but we still have a very antiquated view of them."For example, Grande said many Americans are unaware that once their health data is collected, it's available online forever. In Europe, "right to be forgotten" online privacy laws offer consumers some can you get cipro over the counter protection. But in the U.S., digital health info is "immortal," he said."People don't understand all the digital footprints they're leaving behind each time they interact with heath apps, and frankly, it's very hard to understand.

Who on earth would want to read can you get cipro over the counter a long, complicated privacy agreement?. " said Grande, policy director at the University of Pennsylvania's Leonard Davis Institute of Health Economics in Philadelphia.As arduous as that task might seem, Abdullah urges people to take five minutes to read the agreements and find out what might happen to their data once they click "agree.""You have to weigh the risks and benefits," he said. "The app might help patients track their blood can you get cipro over the counter sugar, but is it worth using if you know your data might possibly be shared?. "For consumers concerned with privacy, one red flag is the presence of ads on the health app."If you open the app and find ad services, you can be sure your data is being sent off to a third party in some way, shape or form," Abdullah said.Another tip is to check the app's automatic settings and make changes that will protect privacy, like turning off your location. But that, too, can you get cipro over the counter has a drawback, Grande said.

"In some cases, turning off privacy settings makes an app harder to use."Like many internet-based services, health apps are usually free to download, with app-makers earning money through advertising or selling data to third parties, he said.However, that business model could change if lawmakers can you get cipro over the counter start enacting stricter guidelines and consumers become more willing to pay for health apps."Consumers put health very high on their list in terms of where they want privacy protection," Grande said. "As they grow more uncomfortable with every aspect of their life being tracked, I think the thirst for regulation and privacy control will grow, too."American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the can you get cipro over the counter American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, can you get cipro over the counter please email [email protected]Copyright © 2020 HealthDay.

All rights reserved. SLIDESHOW Heart Disease. Causes of a Heart Attack See Slideshow.

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Source Search can you drink on cipro for uti for this keyword SearchFunding support. Shockwave Medical, Inc. (Santa Clara, CA)Disclosures. Dr. Hill reports fees and grant support from Abbott Vascular, Boston Scientific, Abiomed, Shockwave Medical and is a stockholder in Shockwave Medical.

Dr. Kereiakes is a consultant for SINO Medical Sciences Technologies, Inc., Boston Scientific, Elixir Medical, Svelte Medical Systems, Inc., Caliber Therapeutics/Orchestra Biomed, Shockwave Medical and is a stockholder in Ablative Solutions, Inc. Dr. Shlofmitz is a speaker for Shockwave Medical, Inc. Dr.

Klein reports no relationships with industry. Dr. Riley reports honoraria from Boston Scientific, Asahi Intecc, and Medtronic. Dr. Price reports personal fees from ACIST Medical, AstraZeneca, Abbott Vascular, Boston Scientific, Chiesi USA, Medtronic, and W.L.

Gore. Dr. Herrmann reports research funding from Abbott, Boston Scientific, Medtronic, Shockwave Medical and is a consultant for Abbott, Medtronic, and Shockwave. Dr. Bachinsky reports consultant, speakers bureau and research grant support from Abbott Vascular, Boston Scientific, BD Bard Vascular, Medtronic, Shockwave Medical.

Dr. Waksman is on the Advisory Board of Amgen, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd. Is a consultant for Amgen, Biotronik, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.. Has received grant support from AstraZeneca, Biotronik, Boston Scientific, Chiesi. Is a speaker for AstraZeneca, Chiesi.

And is a stockholder in MedAlliance. Dr. Stone is a speaker for Cook Medical.

Shockwave Medical, can you get cipro over the counter Inc. (Santa Clara, CA)Disclosures. Dr. Hill reports fees and grant support from Abbott Vascular, Boston can you get cipro over the counter Scientific, Abiomed, Shockwave Medical and is a stockholder in Shockwave Medical. Dr.

Kereiakes is a consultant for SINO Medical Sciences Technologies, Inc., Boston Scientific, Elixir Medical, Svelte Medical Systems, Inc., Caliber Therapeutics/Orchestra Biomed, Shockwave Medical and is a stockholder in Ablative Solutions, Inc. Dr. Shlofmitz is a speaker for Shockwave Medical, Inc. Dr. Klein reports no relationships with industry.

Dr. Riley reports honoraria from Boston Scientific, Asahi Intecc, and Medtronic. Dr. Price reports personal fees from ACIST Medical, AstraZeneca, Abbott Vascular, Boston Scientific, Chiesi USA, Medtronic, and W.L. Gore.

Dr. Herrmann reports research funding from Abbott, Boston Scientific, Medtronic, Shockwave Medical and is a consultant for Abbott, Medtronic, and Shockwave. Dr. Bachinsky reports consultant, speakers bureau and research grant support from Abbott Vascular, Boston Scientific, BD Bard Vascular, Medtronic, Shockwave Medical. Dr.

Waksman is on the Advisory Board of Amgen, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd. Is a consultant for Amgen, Biotronik, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.. Has received grant support from AstraZeneca, Biotronik, Boston Scientific, Chiesi. Is a speaker for AstraZeneca, Chiesi. And is a stockholder in MedAlliance.

Dr. Stone is a speaker for Cook Medical. Is a consultant for Valfix Medical, TherOx, Vascular Dynamics, Robocath, HeartFlow, Gore, Ablative Solutions, Miracor, Neovasc, V-Wave, Abiomed, Ancora, MAIA Pharmaceuticals, Vectorious, Reva, Cardiomech.

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Protecting the safety and cipro antibiotic side effects health of essential workers who support America’s food security—including the meat, poultry, and pork processing industries—is a top priority for the Occupational Safety and Health Administration (OSHA). OSHA and the Centers for Disease Control and Prevention issued additional guidance to reduce the risk of exposure to the coronavirus and keep workers safe and healthy in the meatpacking and meat processing industries —including those involved in beef, pork, and poultry operations. This new guidance provides specific recommendations for employers to meet their obligations to protect workers in these facilities, where people normally work closely together and share workspaces and equipment. Here are eight ways to help minimize meat cipro antibiotic side effects processing workers’ exposure to the coronavirus. Screen workers before they enter the workplace.

If a worker becomes sick, send them home and disinfect their workstation and any tools they used. Move workstations cipro antibiotic side effects farther apart. Install partitions between workstations using strip curtains, plexiglass, or similar materials. To limit spread between groups, assign the same workers to the same shifts with the same coworkers. Prevent workers from using cipro antibiotic side effects other workers’ equipment.

Allow workers to wear face coverings when entering, inside, and exiting the facility. Encourage workers to report any safety and health concerns to their supervisors. OSHA is committed to ensuring that workers and employers in essential industries have clear guidance to keep workers safe and healthy from the coronavirus—including guidance for cipro antibiotic side effects essential workers in construction, manufacturing, package delivery, and retail. Workers and employers who have questions or concerns about workplace safety can contact OSHA online or by phone at 1-800-321-6742 (OSHA). You can find additional resources and learn more about OSHA’s response to the coronavirus at www.osha.gov/coronavirus.

Loren Sweatt is the Principal Deputy Assistant Secretary for the cipro antibiotic side effects U.S. Department of Labor’s Occupation Safety and Health Administration Editor’s Note. It is important to note that information and guidance about COVID-19 continually evolve as conditions change. Workers and employers are encouraged to cipro antibiotic side effects regularly refer to the resources below for updates:One in 10 people in the United States will get the flu in a given season, according to estimates from the Centers for Disease Control and Prevention. And while viruses can live all year round, flu activity tends to rise in October and then peak between December and February.

With COVID-19 a factor this year, it's even more important to take precautions to prevent the flu from spreading. Here are 10 ways cipro antibiotic side effects to keep workers safe. Recommend all workers get vaccinated. Vaccination is the most important way to prevent the spread of the flu. It takes about two weeks for flu antibodies to develop, so the time to get a shot is before peak cipro antibiotic side effects flu season.

Encourage workers to stay home if they are sick. The Centers for Disease Control and Prevention recommend that workers who have a fever and respiratory symptoms stay at home until 24 hours after their fever ends (100 degrees Fahrenheit or lower) without the use of medication. Not everyone who cipro antibiotic side effects has the flu will have a fever. Other symptoms can include a runny nose, body aches, headache, fatigue, diarrhea or vomiting. Wash hands frequently with soap and water for 20 seconds.

Use an alcohol-based cipro antibiotic side effects hand rub if soap and water are not available. When using soap and water, rub soapy hands together for at least 20 seconds, rinse with water, and dry completely. If soap and water are not available, use an alcohol-based hand rub until you can wash your hands. Continue practicing social distancing cipro antibiotic side effects. Staying at least 6 feet apart from co-workers, whenever possible, can help prevent the spread of the flu.

Cover coughs and sneezes with a tissue or upper sleeve. Tissues should go into a "no-touch" wastebasket and wash your hands after cipro antibiotic side effects coughing, sneezing or blowing your nose. Avoid touching your face. Keep frequently touched surfaces clean. Commonly used surfaces such cipro antibiotic side effects as counters, door handles, phones, computer keyboards and touchpads should be cleaned after each use.

Limit shared equipment or clean equipment before others use it. Avoid using a co-worker's phone, desk, office, computer or other equipment unless they are cleaned with an EPA-approved disinfectant. Training is cipro antibiotic side effects knowledge. Make sure all workers understand how to stay healthy at work during flu season, including new and temporary workers. Wear a face covering.

These can help limit the flu's cipro antibiotic side effects spread. Consider alternate work arrangements. If feasible, offer options such as telework or staggered shifts for workers considered high risk for seasonal flu (such as older workers, pregnant women, and those with asthma). Learn more cipro antibiotic side effects about workplace safety and the flu on OSHA's website. You can find additional resources and learn more about OSHA's response to the coronavirus at osha.gov/coronavirus.

Workers and employers who have questions or concerns about workplace safety can contact OSHA online or by phone at 1-800-321-6742 (OSHA). Loren Sweatt is the Principal Deputy Assistant Secretary for cipro antibiotic side effects the U.S. Department of Labor's Occupational Safety and Health Administration. Follow OSHA on Twitter at @OSHA_DOL..

Protecting the safety and health of essential workers who can you get cipro over the counter support America’s food security—including the meat, poultry, and pork processing industries—is a top priority for the Occupational Safety and Health Administration (OSHA). OSHA and the Centers for Disease Control and Prevention issued additional guidance to reduce the risk of exposure to the coronavirus and keep workers safe and healthy in the meatpacking and meat processing industries —including those involved in beef, pork, and poultry operations. This new guidance provides specific recommendations for employers to meet their obligations to protect workers in these facilities, where people normally work closely together and share workspaces and equipment. Here are can you get cipro over the counter eight ways to help minimize meat processing workers’ exposure to the coronavirus. Screen workers before they enter the workplace.

If a worker becomes sick, send them home and disinfect their workstation and any tools they used. Move workstations can you get cipro over the counter farther apart. Install partitions between workstations using strip curtains, plexiglass, or similar materials. To limit spread between groups, assign the same workers to the same shifts with the same coworkers. Prevent workers can you get cipro over the counter from using other workers’ equipment.

Allow workers to wear face coverings when entering, inside, and exiting the facility. Encourage workers to report any safety and health concerns to their supervisors. OSHA is committed to ensuring that workers and employers in essential industries have clear guidance to keep workers safe and healthy from the coronavirus—including guidance for essential workers in construction, can you get cipro over the counter manufacturing, package delivery, and retail. Workers and employers who have questions or concerns about workplace safety can contact OSHA online or by phone at 1-800-321-6742 (OSHA). You can find additional resources and learn more about OSHA’s response to the coronavirus at www.osha.gov/coronavirus.

Loren Sweatt is the Principal Deputy Assistant Secretary for can you get cipro over the counter the U.S. Department of Labor’s Occupation Safety and Health Administration Editor’s Note. It is important to note that information and guidance about COVID-19 continually evolve as conditions change. Workers and employers are encouraged to regularly refer to the resources below for updates:One in 10 people in the United States will get the flu can you get cipro over the counter in a given season, according to estimates from the Centers for Disease Control and Prevention. And while viruses can live all year round, flu activity tends to rise in October and then peak between December and February.

With COVID-19 a factor this year, it's even more important to take precautions to prevent the flu from spreading. Here are 10 ways to keep workers can you get cipro over the counter safe. Recommend all workers get vaccinated. Vaccination is the most important way to prevent the spread of the flu. It takes about two weeks for flu antibodies to develop, so the time can you get cipro over the counter to get a shot is before peak flu season.

Encourage workers to stay home if they are sick. The Centers for Disease Control and Prevention recommend that workers who have a fever and respiratory symptoms stay at home until 24 hours after their fever ends (100 degrees Fahrenheit or lower) without the use of medication. Not everyone who has the flu will can you get cipro over the counter have a fever. Other symptoms can include a runny nose, body aches, headache, fatigue, diarrhea or vomiting. Wash hands frequently with soap and water for 20 seconds.

Use an alcohol-based hand rub if soap and water can you get cipro over the counter are not available. When using soap and water, rub soapy hands together for at least 20 seconds, rinse with water, and dry completely. If soap and water are not available, use an alcohol-based hand rub until you can wash your hands. Continue practicing can you get cipro over the counter social distancing. Staying at least 6 feet apart from co-workers, whenever possible, can help prevent the spread of the flu.

Cover coughs and sneezes with a tissue or upper sleeve. Tissues should go into a "no-touch" wastebasket and wash your hands after can you get cipro over the counter coughing, sneezing or blowing your nose. Avoid touching your face. Keep frequently touched surfaces clean. Commonly used surfaces such as counters, door handles, phones, computer keyboards and touchpads should be cleaned after each can you get cipro over the counter use.

Limit shared equipment or clean equipment before others use it. Avoid using a co-worker's phone, desk, office, computer or other equipment unless they are cleaned with an EPA-approved disinfectant. Training is knowledge can you get cipro over the counter. Make sure all workers understand how to stay healthy at work during flu season, including new and temporary workers. Wear a face covering.

These can help limit can you get cipro over the counter the flu's spread. Consider alternate work arrangements. If feasible, offer options such as telework or staggered shifts for workers considered high risk for seasonal flu (such as older workers, pregnant women, and those with asthma). Learn more about workplace safety and the flu can you get cipro over the counter on OSHA's website. You can find additional resources and learn more about OSHA's response to the coronavirus at osha.gov/coronavirus.

Workers and employers who have questions or concerns about workplace safety can contact OSHA online or by phone at 1-800-321-6742 (OSHA). Loren Sweatt can you get cipro over the counter is the Principal Deputy Assistant Secretary for the U.S. Department of Labor's Occupational Safety and Health Administration. Follow OSHA on Twitter at @OSHA_DOL..

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