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1. About UsZhongshan Ophthalmic Center (ZOC), Sun Yat-sen University is the only one of its kind ophthalmic hospital appointed by the National Health Commission. Its history can date back to 1835, when Peter Parker, missionary from the United States founded the oldest western hospital -the Ophthalmic Hospital in Canton. In 1965, the Zhongshan Ophthalmic Hospital was officially established located on No 54, Xianlie South Road. In 1983, it was renamed as Zhongshan Ophthalmic Center combining clinical services, scientific research, healthcare service and preventative ophthalmology.

ZOC has been entitled the State Key Laboratory of Ophthalmology, without any equivalent in China. The head quarter of Asia Pacific Association of Ophthalmology (APAO) is also located at ZOC. ZOC has consecutively been ranked the first on two well-recognized Rankings in China, one being “Hospitals with Best Reputation by Specialty in China” for 10 terms, and another one being “Hospitals with Most Influence in Technology and Science in China” for 6 terms.ZOC is the largest eye care center in China, treating complicated eye diseases. With 185 ophthalmologists, ZOC has managed an annual workload of over 1,140,000 outpatient visits and more than 75,000 surgeries.ZOC is the China’s leading research institutes in the fields of Medical Science and Ophthalmology. ZOC have 67 full time researchers.

The researches in Stem Cell, Myopia Prevention, Biology Information and Artificial Intelligence, clinical researches in prevention and treatment of eye diseases have been published in Nature, JAMA, Lancet, Nature Methods, Nature Biomedical Engineering, Nature Communications, Lancet Global Health, Ophthalmology, JAMA Ophthalmology, IOVS, and etc.ZOC is the largest training base for ophthalmic talents in China. It currently has 80 doctoral tutors, and has brought up 500 PhD in Ophthalmology, over 250 department heads of domestic tertiary hospitals and 6 full-time professors working for the universities at foreign countries. In May 2018, the Research Building and the Clinical Building of ZOC, located on No 7, Jinsui Road, Zhujiang New Town, the Central Business District of Guangzhou, were put into full use, which ushers ZOC into the new era of functioning with the Ouzhuang Campus in Yuexiu District and the Zhujiang New Town Campus in Tianhe District. Aiming to serve the national and regional healthcare strategies, Zhongshan Ophthalmic Center gears to a world class ophthalmic center with standardized operating procedures and high-level researches.2. DisciplinesApplicants with the following background are welcomed:Ophthalmology, Medicine, Biology, Computer Science or related fields, including but not limited to, Bioinformatics, Molecular Biology, Biochemistry, Biomedical Engineering, Vascular Biology, Microbial Groups, Structural Biology, Artificial Intelligence, Virtual Reality and Augmented Reality Technology and System, Neural Science, Material Science, Genetics, Immunology, Optical Imaging Technology and Optical Design3.

QualificationsHave significant academic potentials and has achieved outstanding research results by publishing no less than three outstanding academic works in principle. For those who have made particularly significant achievements, the number of their works could be less than that stated above appropriately. Has worked as a postdoctor, lecturer or assistant professor in a well-known domestic or international higher education institute or research institute. And has worked as a Principal Investigator (PI) in at least one research project at the provincial and ministerial level or above (except for overseas applicants).4. Remunerations and BenefitsSalary and Benefits.

The University provides generous salary, research start-up fee, talent allowance, and settlement allowance. Talents working in Zhuhai and Shenzhen campuses can enjoy subsidies of the local campuses.Housing Support. Talents can apply for the university's public rental housing. There are 1,200 new apartments in the Guangzhou campus. More than 1,000 new apartments and 1,500 new shared property houses in the Zhuhai campus.

And 3,600 new talent indemnificatory apartments in the Shenzhen campus.Quality Healthcare. There are 10 SYSU affiliated hospitals that provide high-level healthcare service.Children Education. SYSU has constructed affiliated primary and secondary schools and kindergartens in Guangzhou, Zhuhai and Shenzhen campuses to provide high-quality elementary education for the children of faculty members.Employee Wellbeing. Provides "sports time". Free use of sports facilities on campus.

And annual health checkup. The Zhuhai campus provides meal subsidies.5. ContactContact Person:Mr. Wu, Ms. Liang Email.

Rencaiban@gzzoc.comTel. 0086-20-66618946Website. Http://www.gzzoc.com/1. About UsThe Eighth Affiliated Hospital, Sun Yat-Sen University is located in Futian District, the central area of Shenzhen. With the advantageous location and elegant environment, the hospital is known as the only medical landmark building on Shennan Boulevard.

It's adjacent to Huanggang Port, Futian Port, and Futian Railway Station, the largest underground railway station in Asia. With the opening of Guangzhou- Shenzhen-Hongkong high-speed railway, it takes only 14 minutes to Hong Kong.The hospital was officially incorporated into the affiliated hospital management system of Sun Yat-sen University on August 26, 2016. As an important part of Sun Yat-sen University Shenzhen Campus, it will provide the force support for the construction of the medical faculty and cultivation of the high-level talents.The Eighth Affiliated Hospital is composed of the headquarters of the hospital, 21 community healthcare service centers and three infirmaries, with more than 2,000 employees. With the strong support of Sun Yat-sen University and Futian District People's Government, the hospital's new building was put into use on July 13, 2019. Now, the building area is approximately 210,000 square meters, with the bed capacity of 1,639 and the parking space of 1200.

The laboratory of nearly 10,000 square meters, located in the Futian Free Tax Zone, will also be open in the middle of 2020.At present, the Eighth Affiliated Hospital has introduced more than 50 leading talents of Guangdong province, clinical leaders and clinical backbones of specialties, and it has become the eighth clinical college of Sun Yat-sen University. Standing at a new starting point, the Eighth Affiliated Hospital strives to build the "Regional leading, National first-class, International recognized, modern and comprehensive hospital".2. DisciplinesApplicants with the following background are welcomed:Basic Medicine, Clinical Medicine, Stomatology, Medical Technology, Life Science, Biomedical Engineering, Medical Statistics and related traditional or interdisciplinary disciplines, etc.3. QualificationsHave comparatively great academic potentials and achieved comparatively great research results by publishing no less than two outstanding academic works in principle. For those who have made particularly significant achievements, the number of their works could be reduced to one.

Be an outstanding doctoral student or postdoctor from a well-known domestic or international higher education institute or research institute4. Remunerations and BenefitsSalary and Benefits. The University provides generous salary, research start-up fee, talent allowance, and settlement allowance. Talents working in Zhuhai and Shenzhen campuses can enjoy subsidies of the local campuses.Housing Support. Talents can apply for the university's public rental housing.

There are 1,200 new apartments in the Guangzhou campus. More than 1,000 new apartments and 1,500 new shared property houses in the Zhuhai campus. And 3,600 new talent indemnificatory apartments in the Shenzhen campus.Quality Healthcare. There are 10 SYSU affiliated hospitals that provide high-level healthcare service.Children Education. SYSU has constructed affiliated primary and secondary schools and kindergartens in Guangzhou, Zhuhai and Shenzhen campuses to provide high-quality elementary education for the children of faculty members.Employee Wellbeing.

Provides "sports time". Free use of sports facilities on campus. And annual health checkup. The Zhuhai campus provides meal subsidies.5. ContactContact Person:Xiaoling HuangEmail.

Huangxling25@mail.sysu.edu.cnTel. 86-755-83981723, 86-13530115220Website. Http://www.sysu8h.com.cn/.

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Community care? ventolin hfa cost without insurance. Our Editor’s Choice this month explores a novel approach to care delivery, the Physician Response Unit (PRU), which aims to reduce ED attendances by finding a community solution to the emergency complaint. Joy and colleagues’ retrospective analysis of 12 months of data from this service, which is based in London, demonstrated that of ventolin hfa cost without insurance nearly 2000 patients attended to, 67% remained in the community. The authors conclude that this model of care is a successful demonstration of integration and collaboration that also reduced ambulance conveyances and ED attendances.

These results are promising, however, as the excellent commentary by Professor Sue Mason identifies, some unanswered questions remain. Whether these results can ventolin hfa cost without insurance be generalised across the wider NHS, beyond the unique confines of the capital, and in light of starkly heterogenous healthcare systems and workforces remains unknown.Moving closer to the front doorPhysician in Triage (PIT) remains a controversial topic in EM. In an interesting analysis of PIT from Israel, Schwarzfuchs and colleagues present an uncontrolled before-after analysis of the impacts of this triage strategy on a single time-critical condition, STEMI. At the EMJ, we usually discourage this ventolin hfa cost without insurance type of study.

However, here, the authors demonstrate how, with the inclusion of an appropriate logistic regression to consider confounders, this methodology may be an appropriate way to evaluate such interventions which may be difficult to do within a randomised controlled trial. €œMinutes mean myocardium” and as such the reduction in door-to-balloon time of 9 min when a senior physician was present, demonstrated here, may lend further support to the implementation of PIT. This is ventolin hfa cost without insurance certainly a rich area for quality improvement work evaluating such targeted interventions for our patients.All about the Bayes’We welcome an observational analysis from Hautz and colleagues that seeks to explain the patient, physician and contextual factors associated with diagnostic test ordering. Baye’s theorem describes the probability of an event based on the prior knowledge conditions that may relate to that event.

A key concept we should all adopt in test ordering. However, this manuscript goes further ventolin hfa cost without insurance in exploring that prior knowledge by evaluating physician experience, patient and situational context. Rather surprisingly, in this single centre analysis of 473 patients and 38 physicians, these factors seem to have a limited impact on test ordering. Rather, it seems that, uncertainty around the patient’s condition (high acuity) and case difficulty seem to influence test ordering more ventolin hfa cost without insurance.

So, uncertain pre-test probability equates to higher degrees of diagnostic test ordering. The Reverend Bayes would be turning in his grave.WellnessNow, unlike ever before, it is important to establish the need for physical and psychological recuperation among our staff. The first manuscript within ventolin hfa cost without insurance our Wellness section, from Graham and colleagues (this months Reader’s Choice) evaluates the Need For Recovery (NFR) Score in 168 emergency workers at a single site. The high NFR in this population provides a quantifiable insight into our high work intensity but further validation is required beyond a single site.

Over to you TERN….While knowing the extent of the problem is of great importance, what we do about it is perhaps a greater challenge. We would therefore encourage our readers to take home some of the top tips included in our expert practice review this month, Top Ten Evidence-Based Countermeasures for Night Shift Workers by Wallace and Haber.There’s a bug going around…We have had a record number of submissions during the COVID-19 pandemic and ventolin hfa cost without insurance the extent to which the EM community has pulled together to inform clinical practice at this time has been breath taking. We are sorry we cannot accept all your excellent work. It is a pleasure to publish a number of Reports from the Front ventolin hfa cost without insurance on this topic ranging from patient level interventions such as proning, to invaluable lessons from systems wide responses to the pandemic.

However, the importance of evidence-based medicine has never been higher and this is discussed in our excellent Concepts paper by some very eminent EM Professors.Introducing SONO case seriesLastly, this month sees the first in a series of SONO cases published in the EMJ. This will be a regular feature and is a case-based approach to demonstrate how ED Ultrasound can influence and improve patient care.As demand for healthcare in the UK rises, the challenges become those of trying to meet this demand in a patient-centred way whilst managing changes in the delivery of healthcare to enhance the effectiveness and efficiency of services. This requires an increased level ventolin hfa cost without insurance of understanding and cooperation between different healthcare professionals, provider organisations and patients. The changes mean reconsidering traditional roles and where appropriate, redefining professional roles, areas of responsibility and team structures, and renegotiating the boundaries between acute and community care.

Government policy has emphasised the need for the NHS to provide increased patient choice, ease of access and delivery of a high-quality service. This is relevant to providers of emergency care services which need to ventolin hfa cost without insurance develop new ways of meeting patient needs closer to home and work environments. In emergency care, ambulance services have had to consider new types of responses to those usually provided. Policy initiatives have meant ventolin hfa cost without insurance local NHS organisations assuming responsibility for managing and monitoring how local services respond to urgent and non-urgent 999 ambulance calls.

Alongside this, the NHS Long Term Plan emphasises the importance of integrating care through a more joined-up multidisciplinary approach that spans boundaries between primary and secondary care but aims to keep patients out of hospital.At the same time, we are facing workforce crisis across the NHS. This is especially the case in emergency medicine. Failure to seek new opportunities to develop the workforce will only ventolin hfa cost without insurance lead to further attrition. The challenge is how to do this in a sustainable, cost-effective and generalisable manner that leads to clear benefits for the workforce, services and patients.

Currently, the emphasis is on the deployment of non-medical practitioner roles in EDs and ambulance services, such as ….

Community care? ventolin expectorant price. Our Editor’s Choice this month explores a novel approach to care delivery, the Physician Response Unit (PRU), which aims to reduce ED attendances by finding a community solution to the emergency complaint. Joy and colleagues’ retrospective analysis of 12 months of data from this service, which is based in London, demonstrated ventolin expectorant price that of nearly 2000 patients attended to, 67% remained in the community. The authors conclude that this model of care is a successful demonstration of integration and collaboration that also reduced ambulance conveyances and ED attendances.

These results are promising, however, as the excellent commentary by Professor Sue Mason identifies, some unanswered questions remain. Whether these results can be generalised across the wider ventolin expectorant price NHS, beyond the unique confines of the capital, and in light of starkly heterogenous healthcare systems and workforces remains unknown.Moving closer to the front doorPhysician in Triage (PIT) remains a controversial topic in EM. In an interesting analysis of PIT from Israel, Schwarzfuchs and colleagues present an uncontrolled before-after analysis of the impacts of this triage strategy on a single time-critical condition, STEMI. At the EMJ, we usually ventolin expectorant price discourage this type of study.

However, here, the authors demonstrate how, with the inclusion of an appropriate logistic regression to consider confounders, this methodology may be an appropriate way to evaluate such interventions which may be difficult to do within a randomised controlled trial. €œMinutes mean myocardium” and as such the reduction in door-to-balloon time of 9 min when a senior physician was present, demonstrated here, may lend further support to the implementation of PIT. This is certainly a rich area for quality improvement work evaluating such targeted interventions for our patients.All about the Bayes’We welcome an observational analysis from Hautz and colleagues that seeks ventolin expectorant price to explain the patient, physician and contextual factors associated with diagnostic test ordering. Baye’s theorem describes the probability of an event based on the prior knowledge conditions that may relate to that event.

A key concept we should all adopt in test ordering. However, this manuscript goes further in exploring that prior knowledge by evaluating physician experience, patient ventolin expectorant price and situational context. Rather surprisingly, in this single centre analysis of 473 patients and 38 physicians, these factors seem to have a limited impact on test ordering. Rather, it seems that, uncertainty around the patient’s condition (high acuity) ventolin expectorant price and case difficulty seem to influence test ordering more.

So, uncertain pre-test probability equates to higher degrees of diagnostic test ordering. The Reverend Bayes would be turning in his grave.WellnessNow, unlike ever before, it is important to establish the need for physical and psychological recuperation among our staff. The first manuscript within our Wellness section, from Graham and colleagues (this months Reader’s Choice) evaluates the Need For Recovery (NFR) Score in 168 emergency workers at a single ventolin expectorant price site. The high NFR in this population provides a quantifiable insight into our high work intensity but further validation is required beyond a single site.

Over to you TERN….While knowing the extent of the problem is of great importance, what we do about it is perhaps a greater challenge. We would therefore encourage our readers to take home some of the top tips included in our expert practice review this month, Top Ten Evidence-Based Countermeasures for Night Shift Workers by Wallace and Haber.There’s a bug going around…We have had a record number of submissions during the COVID-19 pandemic and the extent to which the EM ventolin expectorant price community has pulled together to inform clinical practice at this time has been breath taking. We are sorry we cannot accept all your excellent work. It is a pleasure to publish a number of Reports from the Front on this topic ranging from patient level interventions ventolin expectorant price such as proning, to invaluable lessons from systems wide responses to the pandemic.

However, the importance of evidence-based medicine has never been higher and this is discussed in our excellent Concepts paper by some very eminent EM Professors.Introducing SONO case seriesLastly, this month sees the first in a series of SONO cases published in the EMJ. This will be a regular feature and is a case-based approach to demonstrate how ED Ultrasound can influence and improve patient care.As demand for healthcare in the UK rises, the challenges become those of trying to meet this demand in a patient-centred way whilst managing changes in the delivery of healthcare to enhance the effectiveness and efficiency of services. This requires an increased level of understanding and cooperation between different ventolin expectorant price healthcare professionals, provider organisations and patients. The changes mean reconsidering traditional roles and where appropriate, redefining professional roles, areas of responsibility and team structures, and renegotiating the boundaries between acute and community care.

Government policy has emphasised the need for the NHS to provide increased patient choice, ease of access and delivery of a high-quality service. This is relevant to ventolin expectorant price providers of emergency care services which need to develop new ways of meeting patient needs closer to home and work environments. In emergency care, ambulance services have had to consider new types of responses to those usually provided. Policy initiatives have meant local NHS organisations assuming responsibility for managing and monitoring how local services respond to urgent and non-urgent 999 ventolin expectorant price ambulance calls.

Alongside this, the NHS Long Term Plan emphasises the importance of integrating care through a more joined-up multidisciplinary approach that spans boundaries between primary and secondary care but aims to keep patients out of hospital.At the same time, we are facing workforce crisis across the NHS. This is especially the case in emergency medicine. Failure to ventolin expectorant price seek new opportunities to develop the workforce will only lead to further attrition. The challenge is how to do this in a sustainable, cost-effective and generalisable manner that leads to clear benefits for the workforce, services and patients.

Currently, the emphasis is on the deployment of non-medical practitioner roles in EDs and ambulance services, such as ….

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  • pregnant or trying to get pregnant
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Kaufman and is ventolin and proair the same colleagues have considered the relationship between minimum wage and suicide mortality in the USA.1 Overall, they found that a dollar increase in the minimum wage was related to a meaningful 3.4% decrease in suicide mortality for those of lower educational attainment. Interestingly, this is the third paper in is ventolin and proair the same recent months to address the question of how minimum wage affects suicide. Across these papers, there is a remarkable overall consistency of findings, and important subissues are highlighted in each individual paper.The first of these papers, by Gertner and colleagues, found a 1.9% reduction in suicide associated with a dollar increase in the minimum wage across the total population.2 However, this research was unable to delve into the subgroup effects that would have allowed for a difference in differences approach, or placebo tests, due to their data source. First, Dow and colleagues,3 and then Kaufman and colleagues1 built on this initial is ventolin and proair the same finding with analyses of data that facilitated examination of subgroups.

Both of these papers considered the group with a high school education or ….

Kaufman and colleagues have considered the relationship between minimum wage and suicide mortality in the USA.1 Overall, they found that a dollar increase in the minimum ventolin expectorant price wage was related to a meaningful 3.4% decrease in suicide mortality for those of lower educational attainment. Interestingly, this is the third paper in recent months to address the question of how minimum wage affects suicide ventolin expectorant price. Across these papers, there is a remarkable overall consistency of findings, and important subissues are highlighted in each individual paper.The first of these papers, by Gertner and colleagues, found a 1.9% reduction in suicide associated with a dollar increase in the minimum wage across the total population.2 However, this research was unable to delve into the subgroup effects that would have allowed for a difference in differences approach, or placebo tests, due to their data source. First, Dow and colleagues,3 and ventolin expectorant price then Kaufman and colleagues1 built on this initial finding with analyses of data that facilitated examination of subgroups.

Both of these papers considered the group with a high school education or ….

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Serum levels of lipoprotein-associated phospholipase what to do when ventolin doesn t work A2 (Lp-PLA2) activity are associated with the presence of CAVS. However, it has been unclear whether this association is due to a cause–effect relationship. In this issue of Heart, Perrot and colleagues1 used genetic association studies from eight cohorts to show that CAVS was not associated with any of four single nucleotide polymorphisms that are associated with Lp-PLA2 activity or mass.

These findings suggest that although Lp-PLA2 activity is a biomarker for CAVS unfortunately, it is unlikely to be a therapeutic target (figure 1).Higher Lp-PLA2 activity is significantly associated with the what to do when ventolin doesn t work presence of CAVS in patients with heart disease, but variants influencing Lp-PLA2 mass or activity are not associated with CAVS in this large genetic association study. CAVS, calcific aortic valve stenosis. Lp-PLA2, lipoprotein-associated phospholipase A2." data-icon-position data-hide-link-title="0">Figure 1 Higher Lp-PLA2 activity is significantly associated with the presence of CAVS in patients with heart disease, but variants influencing Lp-PLA2 mass or activity are not associated with CAVS in this large genetic association study.

CAVS, calcific what to do when ventolin doesn t work aortic valve stenosis. Lp-PLA2, lipoprotein-associated phospholipase A2.In an editorial, Zheng and Dweck2 discuss this article, summarise current ongoing trials of medical therapy for CAVS (table 1) and comment. €˜Strong evidence points towards elevated Lp(a) levels and its associated oxidised phospholipids (OxPL) as causal risk factors for CAVS, suggesting that targeting this lipid-driven, inflammatory pathway has a real chance to translate into therapy capable of mitigating disease.

The current study suggests that this association is not mediated by Lp-PLA2 and underlines the importance of scrutinising whether biological factors within pathophysiological pathways are merely biomarkers or actually represent a feasible and causal target.’View this table:Table 1 Ongoing randomised clinical trials of medical therapies in aortic stenosisRheumatic heart disease (RHD) remains the primary cause of valve disease worldwide and contributes significantly what to do when ventolin doesn t work to maternal and fetal morbidity and mortality. In a study by Baghel and colleagues3 of 681 pregnant women with RHD, adverse cardiovascular evens occurred in about 15% of pregnancies. Multivariable predictors of adverse outcomes during pregnancy were prior adverse cardiovascular events, lack of appropriate medical therapy, severity of mitral stenosis, valve replacement and pulmonary hypertension.

Based on this analysis, the authors propose a risk score from pregnant women with RHD (table 2).View this table:Table 2 New prognostic score (DEVI’s score) to predict composite adverse what to do when ventolin doesn t work cardiac outcome in pregnant women with rheumatic valvular heart diseaseCommenting on this paper, Elkayam and Shmueli4 point out that in about one-fourth of women, the diagnosis of RHD was not known prior to pregnancy and that a late diagnosis often was associated with adverse outcomes. Their editorial provides a concise summary of optimal management of pregnant women with RHD. They conclude ‘With proper evaluation and risk stratification prior to pregnancy, a close multidisciplinary follow-up during pregnancy, and close monitoring during labour and delivery as well as the early postpartum period most complications can be prevented.’The importance of psychosocial factors in cardiovascular disease (CVD) prevalence and outcomes is increasingly recognised.

Using data from the English Longitudinal Study of Ageing, Bu and colleagues5 found that loneliness was associated with CVD, independent of possible confounders and other risk factors, with a 30% higher risk of a new CVD diagnosis in the most lonely people compared with what to do when ventolin doesn t work the least lonely people. As O’Keefe and colleagues6 point out, this data is especially important now in the context of social distancing and stay-at-home recommendations and they offer several approaches to mitigating loneliness during the COVID-19 pandemic.The Education in Heart article7 in this issue focuses on the clinical use and prognostic implications of echocardiographic speckle tracking measurements of global longitudinal strain to detect and quantify early systolic dysfunction of the left ventricle (figure 2).Left ventricular global longitudinal strain to differentiate between mutation-positive sarcomeric hypertrophic cardiomyopathy and cardiac amyloidosis. (A) Apical four-chamber view of a 66-year-old patient known with mutation-positive hypertrophic cardiomyopathy.

The thickness of the septum was 28 mm and the left ventricular what to do when ventolin doesn t work ejection fraction was 55%. (B) The polar map shows markedly impaired longitudinal strain in the septal mid and basal areas and the global longitudinal strain is impaired (−13.6%). (C) Apical four-chamber view of a 75-year-old patient diagnosed with light chain amyloidosis.

There is concentric hypertrophy of the left ventricle and the ejection fraction is what to do when ventolin doesn t work 56%. Based on speckle tracking echocardiography analysis, the left ventricular global longitudinal strain is impaired (−12.2%), with typical sparing of the longitudinal strain values in the apical segments (D). ANT, anterior.

ANT SEPT, what to do when ventolin doesn t work anteroseptal. GS, global strain. INF, inferior.

LAT, lateral. POST, posterior what to do when ventolin doesn t work. SEPT, septal." data-icon-position data-hide-link-title="0">Figure 2 Left ventricular global longitudinal strain to differentiate between mutation-positive sarcomeric hypertrophic cardiomyopathy and cardiac amyloidosis.

(A) Apical four-chamber view of a 66-year-old patient known with mutation-positive hypertrophic cardiomyopathy. The thickness of the septum was 28 mm and what to do when ventolin doesn t work the left ventricular ejection fraction was 55%. (B) The polar map shows markedly impaired longitudinal strain in the septal mid and basal areas and the global longitudinal strain is impaired (−13.6%).

(C) Apical four-chamber view of a 75-year-old patient diagnosed with light chain amyloidosis. There is concentric hypertrophy of the left what to do when ventolin doesn t work ventricle and the ejection fraction is 56%. Based on speckle tracking echocardiography analysis, the left ventricular global longitudinal strain is impaired (−12.2%), with typical sparing of the longitudinal strain values in the apical segments (D).

ANT, anterior. ANT SEPT, what to do when ventolin doesn t work anteroseptal. GS, global strain.

INF, inferior. LAT, lateral what to do when ventolin doesn t work. POST, posterior.

SEPT, septal.Our Cardiology-in-Focus article by Hudson and Pettit8 provides a clear-eyed but brief discussion and outstanding graphic of the challenges in reconciling the varying definitions of the ‘normal’ values for left ventricular ejection fraction, as stated in different guidelines (figure 3).Categories of left ventricular ejection fraction. EF, ejection what to do when ventolin doesn t work fraction. HF, heart failure.

LVEF, left ventricular ejection fraction." data-icon-position data-hide-link-title="0">Figure 3 Categories of left ventricular ejection fraction. EF, ejection what to do when ventolin doesn t work fraction. HF, heart failure.

LVEF, left ventricular ejection fraction.Loneliness is an unpleasant emotional state induced by perceived isolation. Until about 200 years ago, the English word for what to do when ventolin doesn t work being on one’s own was ‘oneliness’, a term that connoted solitude, and was generally considered an essential and positive experience in life. However, solitude and loneliness are not synonymous.

Loneliness is also described as ‘social pain’ from an unwanted lack of connection and intimacy. Artists have likened loneliness to hunger, not only because we can feel it physically, sometimes described as an ache, a hollowness or a sense of coldness, but also because these physical sensations might be the body’s way of telling us that we are missing something that is important to our survival and flourishing.In this issue of Heart, Bu and colleagues,1 in a prospective observational study that comprised approximately 5000 adults followed what to do when ventolin doesn t work for about 10 years, found that individuals reporting high levels of loneliness had 30%–48% increased risks of developing cardiovascular disease (CVD) and CVD-related hospital admission, respectively, even after adjusting for the usual cardiovascular risk factors.1 This major study has three implications. (1) loneliness should be considered among the most dangerous CVD risk factors.

(2) feeling lonely is a highly modifiable state that would seemingly respond to lifestyle adjustments as compared with the other foremost psychosocial CVD risk factors—depression and stress/anxiety—which typically require prescription medication or exercise2. And (3) social isolation without the anguish of loneliness does not appear to increase CVD risk.The current study confirms prior data showing that self-reported loneliness is significantly correlated with increased healthcare utilisation and heightened morbidity and mortality risks.3 4 Advanced age, poor health, fewer ….

Current management of calcific aortic valve stenosis (CAVS) is limited to palliation of end-stage disease with valve replacement to relieve left ventricular ventolin expectorant price outflow obstruction. Rather than treating the mechanical consequences of severe CAVS, identification of causal disease pathways at the tissue level might lead to medical therapies that could actually prevent or delay the pathological changes in the valve leaflets. Serum levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) activity are associated with the presence of CAVS.

However, it has been ventolin expectorant price unclear whether this association is due to a cause–effect relationship. In this issue of Heart, Perrot and colleagues1 used genetic association studies from eight cohorts to show that CAVS was not associated with any of four single nucleotide polymorphisms that are associated with Lp-PLA2 activity or mass. These findings suggest that although Lp-PLA2 activity is a biomarker for CAVS unfortunately, it is unlikely to be a therapeutic target (figure 1).Higher Lp-PLA2 activity is significantly associated with the presence of CAVS in patients with heart disease, but variants influencing Lp-PLA2 mass or activity are not associated with CAVS in this large genetic association study.

CAVS, calcific ventolin expectorant price aortic valve stenosis. Lp-PLA2, lipoprotein-associated phospholipase A2." data-icon-position data-hide-link-title="0">Figure 1 Higher Lp-PLA2 activity is significantly associated with the presence of CAVS in patients with heart disease, but variants influencing Lp-PLA2 mass or activity are not associated with CAVS in this large genetic association study. CAVS, calcific aortic valve stenosis.

Lp-PLA2, lipoprotein-associated phospholipase A2.In an editorial, Zheng and Dweck2 discuss this article, summarise current ongoing trials of medical therapy for ventolin expectorant price CAVS (table 1) and comment. €˜Strong evidence points towards elevated Lp(a) levels and its associated oxidised phospholipids (OxPL) as causal risk factors for CAVS, suggesting that targeting this lipid-driven, inflammatory pathway has a real chance to translate into therapy capable of mitigating disease. The current study suggests that this association is not mediated by Lp-PLA2 and underlines the importance of scrutinising whether biological factors within pathophysiological pathways are merely biomarkers or actually represent a feasible and causal target.’View this table:Table 1 Ongoing randomised clinical trials of medical therapies in aortic stenosisRheumatic heart disease (RHD) remains the primary cause of valve disease worldwide and contributes significantly to maternal and fetal morbidity and mortality.

In a study by Baghel and colleagues3 of 681 pregnant women with RHD, adverse cardiovascular evens ventolin expectorant price occurred in about 15% of pregnancies. Multivariable predictors of adverse outcomes during pregnancy were prior adverse cardiovascular events, lack of appropriate medical therapy, severity of mitral stenosis, valve replacement and pulmonary hypertension. Based on this analysis, the authors propose a risk score from pregnant women with RHD (table 2).View this table:Table 2 New prognostic score (DEVI’s score) to predict composite adverse cardiac outcome in pregnant women with rheumatic valvular heart diseaseCommenting on this paper, Elkayam and Shmueli4 point out that in about one-fourth of women, the diagnosis of RHD was not known prior to pregnancy and that a late diagnosis often was associated with adverse outcomes.

Their editorial provides a concise summary of optimal management of ventolin expectorant price pregnant women with RHD. They conclude ‘With proper evaluation and risk stratification prior to pregnancy, a close multidisciplinary follow-up during pregnancy, and close monitoring during labour and delivery as well as the early postpartum period most complications can be prevented.’The importance of psychosocial factors in cardiovascular disease (CVD) prevalence and outcomes is increasingly recognised. Using data from the English Longitudinal Study of Ageing, Bu and colleagues5 found that loneliness was associated with CVD, independent of possible confounders and other risk factors, with a 30% higher risk of a new CVD diagnosis in the most lonely people compared with the least lonely people.

As O’Keefe and colleagues6 point out, this data is especially important now in the context of social distancing ventolin expectorant price and stay-at-home recommendations and they offer several approaches to mitigating loneliness during the COVID-19 pandemic.The Education in Heart article7 in this issue focuses on the clinical use and prognostic implications of echocardiographic speckle tracking measurements of global longitudinal strain to detect and quantify early systolic dysfunction of the left ventricle (figure 2).Left ventricular global longitudinal strain to differentiate between mutation-positive sarcomeric hypertrophic cardiomyopathy and cardiac amyloidosis. (A) Apical four-chamber view of a 66-year-old patient known with mutation-positive hypertrophic cardiomyopathy. The thickness of the septum was 28 mm and the left ventricular ejection fraction was 55%.

(B) The polar map shows markedly impaired longitudinal strain in the septal mid and basal areas and the global longitudinal strain is ventolin expectorant price impaired (−13.6%). (C) Apical four-chamber view of a 75-year-old patient diagnosed with light chain amyloidosis. There is concentric hypertrophy of the left ventricle and the ejection fraction is 56%.

Based on speckle tracking echocardiography ventolin expectorant price analysis, the left ventricular global longitudinal strain is impaired (−12.2%), with typical sparing of the longitudinal strain values in the apical segments (D). ANT, anterior. ANT SEPT, anteroseptal.

GS, global strain. INF, inferior ventolin expectorant price. LAT, lateral.

POST, posterior. SEPT, septal." data-icon-position data-hide-link-title="0">Figure 2 ventolin expectorant price Left ventricular global longitudinal strain to differentiate between mutation-positive sarcomeric hypertrophic cardiomyopathy and cardiac amyloidosis. (A) Apical four-chamber view of a 66-year-old patient known with mutation-positive hypertrophic cardiomyopathy.

The thickness of the septum was 28 mm and the left ventricular ejection fraction was 55%. (B) The polar map shows markedly impaired longitudinal strain in the ventolin expectorant price septal mid and basal areas and the global longitudinal strain is impaired (−13.6%). (C) Apical four-chamber view of a 75-year-old patient diagnosed with light chain amyloidosis.

There is concentric hypertrophy of the left ventricle and the ejection fraction is 56%. Based on speckle tracking echocardiography ventolin expectorant price analysis, the left ventricular global longitudinal strain is impaired (−12.2%), with typical sparing of the longitudinal strain values in the apical segments (D). ANT, anterior.

ANT SEPT, anteroseptal. GS, global ventolin expectorant price strain. INF, inferior.

LAT, lateral. POST, posterior ventolin expectorant price. SEPT, septal.Our Cardiology-in-Focus article by Hudson and Pettit8 provides a clear-eyed but brief discussion and outstanding graphic of the challenges in reconciling the varying definitions of the ‘normal’ values for left ventricular ejection fraction, as stated in different guidelines (figure 3).Categories of left ventricular ejection fraction.

EF, ejection fraction. HF, heart ventolin expectorant price failure. LVEF, left ventricular ejection fraction." data-icon-position data-hide-link-title="0">Figure 3 Categories of left ventricular ejection fraction.

EF, ejection fraction. HF, heart ventolin expectorant price failure. LVEF, left ventricular ejection fraction.Loneliness is an unpleasant emotional state induced by perceived isolation.

Until about 200 years ago, the English word for being on one’s own was ‘oneliness’, a term that connoted solitude, and was generally considered an essential and positive experience in life. However, solitude and loneliness are ventolin expectorant price not synonymous. Loneliness is also described as ‘social pain’ from an unwanted lack of connection and intimacy.

Artists have likened loneliness to hunger, not only because we can feel it physically, sometimes described as an ache, a hollowness or a sense of coldness, but also because these physical sensations might be the body’s way of telling us that we are missing something that is important to our survival and flourishing.In this issue of Heart, Bu and colleagues,1 in a prospective observational study that comprised approximately 5000 adults followed for about 10 years, found that individuals reporting high levels of loneliness had 30%–48% increased risks of developing cardiovascular disease (CVD) and CVD-related hospital admission, respectively, even after adjusting for the usual cardiovascular risk factors.1 This major study has three implications. (1) loneliness should be considered among the most dangerous CVD risk factors.

Buy ventolin canada

SOBRE NOTICIAS EN ESPAÑOLNoticias en español es una sección de Kaiser Health News que contiene traducciones buy ventolin canada de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este buy ventolin canada contenido puede usarse de manera gratuita (detalles). Al menos la mitad de los votantes prefiere el enfoque de la atención médica del ex vicepresidente Joe Biden al del presidente Donald Trump, lo que sugiere que la preocupación por reducir los costos y manejar la pandemia podría influir en el resultado de esta elección, según revela una nueva encuesta. Los hallazgos, de la encuesta mensual de KFF, buy ventolin canada indican que los votantes no confían en las garantías del presidente de que protegerá a las personas con condiciones preexistentes de las compañías de seguros si la Corte Suprema anulara la Ley de Cuidado de Salud a Bajo Precio (ACA).Un mes antes de que el tribunal escuche los argumentos de los fiscales generales republicanos y la administración Trump a favor de revocar la ley, la encuesta muestra que el 79% del público no quiere que el Supremo cancele las protecciones de cobertura para los estadounidenses con afecciones preexistentes. La mayoría de los republicanos, el 66%, dijo que no quiere que se anulen esas garantías.Además de dejar a unos 21 millones de estadounidenses sin seguro, revocar ACA podría permitir a las compañías de seguros cobrar más o negar cobertura a las personas porque tienen condiciones preexistentes, una práctica común antes que se estableciera la ley, y que un análisis del gobierno reveló en 2017 que podría afectar hasta a 133 millones de estadounidenses.Casi 6 de cada 10 personas dijeron que tenían un familiar con una condición preexistente o crónica, como diabetes, hipertensión, o cáncer, y aproximadamente la mitad dijo que les preocupa que un ser querido no pueda pagar la cobertura, o la pierda por completo, si se anulara la ley.La encuesta revela una preferencia sorprendente por Biden sobre Trump cuando se trata de proteger a las personas con condiciones preexistentes, un tema que el 94% de los votantes dijo que ayudaría a decidir por quién votar.

Biden tiene una buy ventolin canada ventaja de 20 puntos. Un 56% prefiere su enfoque, contra buy ventolin canada un 36% para Trump.De hecho, el sondeo muestra una preferencia por Biden en todos los problemas de atención médica que se plantean, incluso entre los mayores de 65 años y en temas que Trump ha dicho que eran sus prioridades mientras estuviera en el cargo, lo que indica que los votantes no están satisfechos con el trabajo del presidente para reducir los costos de la atención médica, en particular. El apoyo a los esfuerzos de Trump para reducir el precio de los medicamentos recetados ha disminuido, y los votantes ahora prefieren el enfoque de Biden, del 50% al 43%.La mayoría de los votantes dijeron que prefieren el plan de Biden para lidiar con el brote de COVID-19, 55% a 39%, y para desarrollar y distribuir una vacuna para COVID, 51% a 42%. Trump ha delegado en gran medida la gestión de la pandemia buy ventolin canada a los funcionarios estatales y locales, al tiempo que prometió que los científicos desafiarían las expectativas y producirían una vacuna antes del día de las elecciones.Cuando se les preguntó qué tema era más importante para decidir por quién votar, la mayoría de los encuestados señaló a la atención médica. El 18% eligió el brote de COVID-19 y el 12% mencionó el cuidado de salud en general.

Casi una proporción igual, el 29%, optó por la economía.La encuesta se realizó del 7 al 12 de octubre, después del primer debate buy ventolin canada presidencial y el anuncio de Trump de que había dado positivo para COVID-19. El margen de error es más o menos 3 puntos porcentuales para la muestra completa y 4 puntos porcentuales para los votantes.(KHN es un programa editorialmente independiente de KFF). Emmarie Huetteman buy ventolin canada. ehuetteman@kff.org, @emmarieDC Related Topics Courts Elections Health Care Costs buy ventolin canada Noticias En Español The Health Law COVID-19 KFF Polls Preexisting ConditionsIn March, Sue Williams-Ward took a new job, with a $1-an-hour raise.The employer, a home health care agency called Together We Can, was paying a premium — $13 an hour — after it started losing aides when COVID-19 safety concerns mounted.Williams-Ward, a 68-year-old Indianapolis native, was a devoted caregiver who bathed, dressed and fed clients as if they were family. She was known to entertain clients with some of her own 26 grandchildren, even inviting her clients along on charitable deliveries of Thanksgiving turkeys and Christmas hams.

Explore Our Database KHN and The Guardian are tracking health care workers who died from COVID-19 and writing buy ventolin canada about their lives and what happened in their final days. Without her, the city’s most vulnerable would have been “lost, alone or mistreated,” said her husband, Royal Davis.Despite her husband’s fears for her health, Williams-Ward reported to work on March 16 at an apartment with three elderly women. One was blind, buy ventolin canada one was wheelchair-bound, and the third had a severe mental illness. None had been diagnosed with COVID-19 but, Williams-Ward confided in Davis, at least one had symptoms of fatigue and shortness of breath, now associated with the virus.Even after a colleague on the night shift developed pneumonia, Williams-Ward tended to her patients — without protective equipment, which she told her husband she’d repeatedly requested from the agency. Together We Can did not respond to multiple phone and email requests for comment about the PPE available to its workers.Still, Davis said, “Sue buy ventolin canada did all the little, unseen, everyday things that allowed them to maintain their liberty, dignity and freedom.”He said that within three days Williams-Ward was coughing, too.

After six buy ventolin canada weeks in a hospital and weeks on a ventilator, she died of COVID-19. Hers is one of more than 1,200 health worker COVID deaths that KHN and The Guardian are investigating, including those of dozens of home health aides.During the pandemic, home health aides have buttressed the U.S. Health care system buy ventolin canada by keeping the most vulnerable patients — seniors, the disabled, the infirm — out of hospitals. Yet even as they’ve put themselves at risk, this workforce of 2.3 million — of whom 9 in 10 are women, nearly two-thirds are minorities and almost one-third are foreign-born — has largely been overlooked.Home health providers scavenged for their own face masks and other protective equipment, blended disinfectant and fabricated sanitizing wipes amid widespread shortages. They’ve often done it all on poverty wages, buy ventolin canada without overtime pay, hazard pay, sick leave and health insurance.

And they’ve gotten sick and died — leaving little to their survivors. Email Sign-Up Subscribe to KHN’s free buy ventolin canada Morning Briefing. Speaking out about their work conditions during the pandemic has triggered retaliation by employers, according to representatives of the buy ventolin canada Service Employees International Union in Massachusetts, California and Virginia. €œIt’s been shocking, egregious and unethical,” said David Broder, president of SEIU Virginia 512.The pandemic has laid bare deeply ingrained inequities among health workers, as Broder puts it. €œThis is exactly what structural racism looks like today in our health care system.”Every worker who spoke with KHN for this article said they felt buy ventolin canada intimidated by the prospect of voicing their concerns.

All have seen colleagues fired for doing so. They agreed to talk candidly about their work environments on the condition their full names not be used.***Tina, a home health provider, said she has faced these challenges in Springfield, buy ventolin canada Massachusetts, one of the nation’s poorest cities.Like many of her colleagues — 82%, according to a survey by the National Domestic Workers Alliance — Tina has lacked protective equipment throughout the pandemic. Her employer is a family-owned company that gave her one surgical mask and two pairs of latex gloves a week to clean body fluids, change wound dressings and buy ventolin canada administer medications to incontinent or bedridden clients.When Tina received the company’s do-it-yourself blueprints — to make masks from hole-punched sheets of paper towel reinforced with tongue depressors and gloves from garbage bags looped with rubber bands — she balked. €œIt felt like I was in a Third World country,” she said.The home health agencies that Tina and others in this article work for declined to comment on work conditions during the pandemic.In other workplaces — hospitals, mines, factories — employers are responsible for the conditions in which their employees operate. Understanding the plight of home health providers begins with American labor law.The Fair Labor Standards Act, which forms the basis of protections in the American workplace, was passed in an era dually marked by President Franklin Delano Roosevelt’s buy ventolin canada New Deal changes and marred by the barriers of the Jim Crow era.

The act excluded domestic care workers — including maids, butlers and home health providers — from protections such as overtime pay, sick leave, hazard pay and insurance. Likewise, standards set by the Occupational Safety and Health Administration three decades later carved out “domestic household buy ventolin canada employment activities in private residences.”“A deliberate decision was made to discriminate against colored people — mostly women — to unburden distinguished elderly white folks from the responsibility of employment,” said Ruqaiijah Yearby, a law professor at St. Louis University.In 2015, several of these exceptions were eliminated, and protections for health providers became “very well regulated on paper,” said Nina Kohn, a professor specializing in civil rights law at Syracuse University. €œBut the reality is, noncompliance is a norm and the penalties for noncompliance are toothless.”Burkett McInturff, a civil rights lawyer working on behalf of home health workers, said, buy ventolin canada “The law itself is very clear. The problem lies in the ability to hold these companies accountable.”The Occupational Safety and Health Administration buy ventolin canada has “abdicated its responsibility for protecting workers” in the pandemic, said Debbie Berkowitz, director of the National Employment Law Project.

Berkowitz is also a former OSHA chief. In her view, political and financial decisions in recent years have buy ventolin canada hollowed out the agency. It now has the fewest inspectors and conducts the fewest inspections per year in its history.Furthermore, some home health care agencies have classified home health providers as contractors, akin to gig workers such as Uber drivers. This loophole protects them from the responsibilities of buy ventolin canada employers, said Seema Mohapatra, an Indiana University associate professor of law. Furthermore, she said, “these workers are rarely in a position to question, or advocate or lobby for themselves.”Should workers contract COVID-19, they are unlikely to receive remuneration or damages.Demonstrating causality — that a person caught the coronavirus on the job — for workers’ compensation has been extremely difficult, Berkowitz said.

As with other health care jobs, employers have been quick to point out that workers might have caught the virus at the gas station, grocery store or buy ventolin canada home.Many home health providers care for multiple patients, who also bear the consequences of their work conditions. €œIf you think about buy ventolin canada perfect vectors for transmission, unprotected individuals going from house to house have to rank at the top of list,” Kohn said. €œEven if someone didn’t care at all about these workers, we need to fix this to keep Grandma and Grandpa safe.”Nonetheless, caregivers like Samira, in Richmond, Virginia, have little choice but to work. Samira — who makes $8.25 an hour with one client and $9.44 an hour with another, and owes tens of buy ventolin canada thousands of dollars in hospital bills from previous work injuries — has no other option but to risk getting sick.“I can’t afford not to work. And my clients, they don’t have anybody but me,” she said.

€œSo I just pray every buy ventolin canada day I don’t get it.” Eli Cahan. emcahan@stanford.edu, @emcahan Related Topics Aging Health Industry Public Health COVID-19 Home Health Care Lost On The FrontlineCalifornia Healthline correspondent Angela Hart discussed how the coronavirus pandemic has derailed California’s efforts to deal with homelessness on KPBS “Midday Edition” on Oct. 8. KHN Midwest correspondent Lauren Weber discussed the difference between D.O.s and M.D.s with Newsy’s “Morning Rush” on Tuesday. KHN correspondent Anna Almendrala discussed how L.A.

County’s enforcement of workplace coronavirus protocols has cut COVID-19 deaths with KPCC’s “Take Two” on Tuesday. KHN senior correspondent Sarah Jane Tribble discussed rural hospitals and KHN’s “Where It Hurts” podcast with Illinois Public Media’s “The 21st” on Oct. 5 and “Tradeoffs” on Oct. 8. KHN chief Washington correspondent Julie Rovner joined C-SPAN’s “Washington Journal” on Tuesday to discuss the Affordable Care Act case before the Supreme Court next month and what else to expect in the realm of health care after the election.

KHN freelancer Priscilla Blossom discussed Halloween safety tips with KUNC’s “Colorado Edition” on Tuesday. Related Topics California Doctors Homeless Medical EducationTrombonist Jerrell Charleston loves the give-and-take of jazz, the creativity of riffing off other musicians. But as he looked toward his sophomore year at Indiana University, he feared that steps to avoid sharing the coronavirus would also keep students from sharing songs.“Me and a lot of other cats were seriously considering taking a year off and practicing at home,” lamented the 19-year-old jazz studies major from Gary, Indiana.His worries evaporated when he arrived on campus and discovered that music professor Tom Walsh had invented a special mask with a hole and a protective flap to allow musicians to play while masked. Don't Miss A Story Subscribe to KHN’s free Weekly Edition newsletter. Students also got masks for the ends of their wind instruments, known as bell covers, allowing them to jam in person, albeit 6 feet apart.“It’s amazing to play together,” Charleston said.

€œMusic has always been my safe space. It’s what’s in your soul, and you’re sharing that with other people.”Of course, the very act of making music powered by human breath involves blowing air — and possibly virus particles — across a room. One infamous choral practice in Washington state earlier this year led to confirmed diagnoses of COVID-19 in more than half of the 61 attendees. Two died.So musicians around the country are taking it upon themselves to reduce the risk of COVID-19 without silencing the music. With pantyhose, air filters, magnets, bolts of fabric and a fusion of creativity, those who play wind instruments or sing are improvising masks to keep the band together.

Solomon Keim rehearses in protective gear that doesn't mask the sound.(Chris Bergin for KHN) Brayden Wisley practices safe sax-playing. Other tips for musicians. Play in a big space with good ventilation, and break after 30 minutes to allow the air to clear.(Chris Bergin for KHN) Brendan Sullivan plays trombone while both he and the instrument are masked. It has been recommended that most instrumentalists face the same direction while playing and stay 6 feet apart — with a distance of 9 feet in front and back of trombonists.(Chris Bergin for KHN)A consortium of performing arts groups has commissioned research exploring ways for musicians to play safely. The group’s preliminary report from July recommends instrumentalists wear masks with small slits, use bell covers, face the same direction while playing and stay 6 feet apart for most instruments — with a distance of 9 feet in front and back of trombonists.

Other research has shown cotton bell covers on brass instruments reduced airborne particles by an average of 79% compared with playing without one.Jelena Srebric, a University of Maryland engineering researcher involved in the consortium’s study, said it’s also best to play in a big space with good ventilation, and musicians should break after 30 minutes to allow the air to clear. These rudimentary solutions, she said, promise at least some protection against the virus.“Nothing is 100%. Being alive is a dangerous business,” Srebric said. This “gives some way to engage with music, which is fantastic in this day and age of despair.”Dr. Adam Schwalje, a National Institutes of Health research fellow at the University of Iowa Hospitals and Clinics, is a bassoonist who has written about the COVID risk of wind instruments.

He said a combination of bell covers, social distancing and limited time playing together could be helpful, but the effectiveness of bell covers or masks for musicians to wear while playing is “completely unproven” at this point. Schwalje’s paper said it’s not possible to quantify the risk of playing wind instruments, which involves deep breathing, sometimes forceful exhalation and possible aerosolizing of the mucus in the mouth and nose.Still, early results of research at the universities of Maryland and Colorado are helping to inspire improvisational mask-making and other safety measures, said Mark Spede, national president of the College Band Directors National Association who is helping lead the commissioned research.At Middle Tennessee State University, for example, tuba teacher Chris Combest said his students tie pillowcases over the bells of their instruments, and some wear masks that can be unbuttoned to play. At the University of Iowa, wind players in small ensembles must use bell covers and masks, but they can pull them down when playing as long as they pull them up during rests. Heather Ainsworth-Dobbins said her students at Southern Virginia University use surgical masks with slits cut in them and bell covers made of pantyhose and MERV-13 air filters, similar to what is used on a furnace.Indiana University Jacobs School of Music professor Tom Walsh distributes custom masks he designed that allow students to play their instruments safely as a group.(Chris Bergin for KHN) Skyler Floe tries out his horn's bell cover to much fanfare at Indiana University Jacobs School of Music in Bloomington, Indiana.(Chris Bergin for KHN) Kyle Cantrell's sound carries while reducing the risk of virus transmission.(Chris Bergin for KHN) At Indiana, Walsh sought out whatever research he could find as he designed his tight-fitting cotton musical mask, reinforced with a layer of polypropylene and with adjustable ties in the back. A flap hangs over the hole, outfitted with two magnets that allow it to close over the instrument.

The professor’s mom, Julie Walsh — who made his clothes when he was a kid — has sewn more than 80 of the musical masks for free. The opera program’s costume shop makes bell covers with a layer of fabric over a layer of stiff woven material known as interfacing fabric.Bailey Cates, a freshman trumpet player, said the quality of the sound is about the same with these masks and they make her feel safer.Flutes present unique challenges, partly because flutists blow air across the mouthpiece. Alice Dade, an associate professor of flute at the University of Missouri, said she and her students clip on device called “wind guards” usually used outdoors, then sometimes fit surgical masks over them.Alice Dade, an associate professor at the University of Missouri, recommends using clip-on devices for flutes called “wind guards,” which shield the lip plate of the flute from wind when playing outdoors. The ventilated design helps limit condensation and interference with the player’s air stream. Amid the pandemic, some flutists now use them with surgical masks on top to curb the spread of the coronavirus.(Alice Dade)Indiana flute student Nathan Rakes uses a specially designed cloth mask with a slit and slips a silk sock on the instrument’s end.

Rakes, a sophomore, said the fabric doesn’t affect the sound unless he’s playing a low B note, which he rarely plays.Walsh is a stickler for finding big practice spaces, not playing together for more than half an hour and taking 20-minute breaks. All jazz ensemble musicians, for example, also must stay at least 10 feet apart.“I carry a tape measure everywhere I go,” he said. €œI feel responsible for our students.”Some K-12 schools are trying similar strategies, said James Weaver, director of performing arts and sports for the National Federation of State High School Associations.His son Cooper, a seventh grade sax player at Plainfield Community Middle School in Indiana, uses a surgical mask with a slit. It sometimes jerks to the side with the vibrations of playing, but Cooper said it “feels good as long as you have it in the right place.” Cooper also helped his dad make a bell cover with fabric and MERV-13 material.While many groups use homemade bell covers, McCormick’s Group in Wheeling, Illinois, has transformed its 25-year-old business of making bell covers to display school colors and insignias into one that is making musicians safer with two-ply covers made of polyester/spandex fabric. CEO Alan Yefsky said his company started reinforcing the covers with the second layer this summer.

Sales of the $20 covers have soared.“It’s keeping people employed. We’re helping keep people safe,” Yefsky said. €œAll of a sudden, we got calls from nationally known symphony organizations.”Other professional musicians take a different tack. Film and television soundtracks are often recorded in separate sessions. Woodwinds and brass players in individual plexiglass cubicles and masked, with distanced string players recording elsewhere.The U.S.

Marine Band in Washington, D.C., practices in small, socially distanced groups, but string instrumentalists are the only ones wearing masks while playing.For both professionals and students, the pandemic has virtually eliminated live audiences in favor of virtual performances. Many musicians say they miss traditional concerts but are not focusing on what they’ve lost.“Creating that sense of community — an island to come together and play — is super important,” said Cates, the Indiana trumpet player. €œPlaying music feels like a mental release for a lot of us. When I’m playing, my mind is off of the pandemic.”Indiana University Jacobs School of Music professor Tom Walsh works with students during rehearsal in Bloomington, Indiana. The professor’s mom, Julie Walsh — who made his clothes when he was a kid — has sewn more than 80 of the musical masks for free.(Chris Bergin for KHN) Laura Ungar.

lungar@kff.org, @laura_ungar Related Topics Public Health COVID-19Use Our Content This story can be republished for free (details). At least half of voters prefer former Vice President Joe Biden’s approach to health care over President Donald Trump’s, suggesting voter concern about lowering costs and managing the pandemic could sway the outcome of this election, a new poll shows.The findings, from KFF’s monthly tracking poll, signal that voters do not trust assurances from the president that he will protect people with preexisting conditions from being penalized by insurance companies if the Supreme Court overturns the Affordable Care Act. (KHN is an editorially independent program of KFF.)Coming a month before the court will hear arguments from Republican attorneys general and the Trump administration that the health law should be overturned, the poll shows 79% of the public does not want the court to cancel coverage protections for Americans with preexisting conditions. A majority of Republicans, 66%, said they do not want those safeguards overturned.In addition to leaving about 21 million Americans uninsured, overturning the ACA could allow insurance companies to charge more or deny coverage to individuals because they have preexisting conditions — a common practice before the law was established, and one that a government analysis said in 2017 could affect as many as 133 million Americans. Email Sign-Up Subscribe to KHN’s free Morning Briefing. Nearly 6 in 10 people said they have a family member with a preexisting or chronic condition, such as diabetes or cancer, and about half said they worry about a relative being unable to afford coverage, or lose it outright, if the law is overturned.The poll reveals a striking preference for Biden over Trump when it comes to protecting preexisting conditions, an issue that 94% of voters said would help decide who they vote for.

Biden has a 20-point advantage, with voters preferring his approach 56% to 36% for Trump.In fact, it shows a preference for Biden on every health care issue posed, including among those age 65 and older and on issues that Trump has said were his priorities while in office — signaling voters are not satisfied with the president’s work to lower health care costs, in particular. Support for Trump’s efforts to lower prescription drug costs has been slipping, with voters now preferring Biden’s approach, 50% to 43%.A majority of voters said they prefer Biden’s plan for dealing with the COVID-19 outbreak, 55% to 39%, and for developing and distributing a vaccine for COVID-19, 51% to 42%. Trump has largely left it up to state and local officials to manage the outbreak, while promising that scientists would defy expectations and produce a vaccine before Election Day.Asked which issue is most important to deciding whom to vote for, most pointed to health care issues, with 18% choosing the COVID-19 outbreak and 12% saying health care overall. Nearly an equal share, 29%, selected the economy.The survey was conducted Oct. 7-12, after the first presidential debate and Trump’s announcement that he had tested positive for COVID-19.

The margin of error is plus or minus 3 percentage points for the full sample and 4 percentage points for voters. Emmarie Huetteman. ehuetteman@kff.org, @emmarieDC Related Topics Courts Elections Health Care Costs The Health Law COVID-19 KFF Polls Preexisting Conditions.

SOBRE NOTICIAS EN ESPAÑOLNoticias ventolin expectorant price en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use ventolin expectorant price Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles). Al menos la mitad de los votantes prefiere el enfoque de la atención médica del ex vicepresidente Joe Biden al del presidente Donald Trump, lo que sugiere que la preocupación por reducir los costos y manejar la pandemia podría influir en el resultado de esta elección, según revela una nueva encuesta. Los hallazgos, de la encuesta mensual de KFF, indican que los votantes no confían en las garantías del presidente de que protegerá a las personas con condiciones preexistentes de las compañías de seguros ventolin expectorant price si la Corte Suprema anulara la Ley de Cuidado de Salud a Bajo Precio (ACA).Un mes antes de que el tribunal escuche los argumentos de los fiscales generales republicanos y la administración Trump a favor de revocar la ley, la encuesta muestra que el 79% del público no quiere que el Supremo cancele las protecciones de cobertura para los estadounidenses con afecciones preexistentes. La mayoría de los republicanos, el 66%, dijo que no quiere que se anulen esas garantías.Además de dejar a unos 21 millones de estadounidenses sin seguro, revocar ACA podría permitir a las compañías de seguros cobrar más o negar cobertura a las personas porque tienen condiciones preexistentes, una práctica común antes que se estableciera la ley, y que un análisis del gobierno reveló en 2017 que podría afectar hasta a 133 millones de estadounidenses.Casi 6 de cada 10 personas dijeron que tenían un familiar con una condición preexistente o crónica, como diabetes, hipertensión, o cáncer, y aproximadamente la mitad dijo que les preocupa que un ser querido no pueda pagar la cobertura, o la pierda por completo, si se anulara la ley.La encuesta revela una preferencia sorprendente por Biden sobre Trump cuando se trata de proteger a las personas con condiciones preexistentes, un tema que el 94% de los votantes dijo que ayudaría a decidir por quién votar.

Biden tiene ventolin expectorant price una ventaja de 20 puntos. Un 56% prefiere su enfoque, contra un 36% para Trump.De hecho, el sondeo muestra una preferencia por Biden en todos los problemas de atención médica que se plantean, incluso entre los mayores de 65 años y en temas que Trump ha dicho que eran sus prioridades mientras estuviera en el ventolin expectorant price cargo, lo que indica que los votantes no están satisfechos con el trabajo del presidente para reducir los costos de la atención médica, en particular. El apoyo a los esfuerzos de Trump para reducir el precio de los medicamentos recetados ha disminuido, y los votantes ahora prefieren el enfoque de Biden, del 50% al 43%.La mayoría de los votantes dijeron que prefieren el plan de Biden para lidiar con el brote de COVID-19, 55% a 39%, y para desarrollar y distribuir una vacuna para COVID, 51% a 42%. Trump ha delegado en gran medida la gestión de la pandemia ventolin expectorant price a los funcionarios estatales y locales, al tiempo que prometió que los científicos desafiarían las expectativas y producirían una vacuna antes del día de las elecciones.Cuando se les preguntó qué tema era más importante para decidir por quién votar, la mayoría de los encuestados señaló a la atención médica. El 18% eligió el brote de COVID-19 y el 12% mencionó el cuidado de salud en general.

Casi una proporción igual, el 29%, optó por la economía.La encuesta se realizó del 7 al ventolin expectorant price 12 de octubre, después del primer debate presidencial y el anuncio de Trump de que había dado positivo para COVID-19. El margen de error es más o menos 3 puntos porcentuales para la muestra completa y 4 puntos porcentuales para los votantes.(KHN es un programa editorialmente independiente de KFF). Emmarie Huetteman ventolin expectorant price. ehuetteman@kff.org, @emmarieDC Related Topics Courts Elections Health Care Costs Noticias En Español The Health Law COVID-19 KFF Polls Preexisting ConditionsIn March, Sue Williams-Ward took a new job, with a $1-an-hour raise.The employer, a home health care agency called Together We Can, was paying a premium — $13 an hour — after it started losing aides when COVID-19 safety concerns mounted.Williams-Ward, a 68-year-old Indianapolis native, was a ventolin expectorant price devoted caregiver who bathed, dressed and fed clients as if they were family. She was known to entertain clients with some of her own 26 grandchildren, even inviting her clients along on charitable deliveries of Thanksgiving turkeys and Christmas hams.

Explore Our Database KHN and The ventolin expectorant price Guardian are tracking health care workers who died from COVID-19 and writing about their lives and what happened in their final days. Without her, the city’s most vulnerable would have been “lost, alone or mistreated,” said her husband, Royal Davis.Despite her husband’s fears for her health, Williams-Ward reported to work on March 16 at an apartment with three elderly women. One was blind, ventolin expectorant price one was wheelchair-bound, and the third had a severe mental illness. None had been diagnosed with COVID-19 but, Williams-Ward confided in Davis, at least one had symptoms of fatigue and shortness of breath, now associated with the virus.Even after a colleague on the night shift developed pneumonia, Williams-Ward tended to her patients — without protective equipment, which she told her husband she’d repeatedly requested from the agency. Together We Can did not respond to multiple phone and email requests for comment about the PPE available to its workers.Still, Davis said, “Sue did all the little, unseen, everyday things that allowed them to ventolin expectorant price maintain their liberty, dignity and freedom.”He said that within three days Williams-Ward was coughing, too.

After six weeks in a hospital and ventolin expectorant price weeks on a ventilator, she died of COVID-19. Hers is one of more than 1,200 health worker COVID deaths that KHN and The Guardian are investigating, including those of dozens of home health aides.During the pandemic, home health aides have buttressed the U.S. Health care system by keeping the most vulnerable patients — seniors, the disabled, the infirm — out ventolin expectorant price of hospitals. Yet even as they’ve put themselves at risk, this workforce of 2.3 million — of whom 9 in 10 are women, nearly two-thirds are minorities and almost one-third are foreign-born — has largely been overlooked.Home health providers scavenged for their own face masks and other protective equipment, blended disinfectant and fabricated sanitizing wipes amid widespread shortages. They’ve often done it all on ventolin expectorant price poverty wages, without overtime pay, hazard pay, sick leave and health insurance.

And they’ve gotten sick and died — leaving little to their survivors. Email Sign-Up Subscribe to KHN’s ventolin expectorant price free Morning Briefing. Speaking out about their work conditions during the pandemic ventolin expectorant price has triggered retaliation by employers, according to representatives of the Service Employees International Union in Massachusetts, California and Virginia. €œIt’s been shocking, egregious and unethical,” said David Broder, president of SEIU Virginia 512.The pandemic has laid bare deeply ingrained inequities among health workers, as Broder puts it. €œThis is exactly what structural racism looks like today in our health care system.”Every worker who spoke with KHN ventolin expectorant price for this article said they felt intimidated by the prospect of voicing their concerns.

All have seen colleagues fired for doing so. They agreed to talk candidly about their work environments on the condition their full names not be used.***Tina, a home health provider, said she has faced these challenges in Springfield, Massachusetts, one of the nation’s poorest ventolin expectorant price cities.Like many of her colleagues — 82%, according to a survey by the National Domestic Workers Alliance — Tina has lacked protective equipment throughout the pandemic. Her employer is a family-owned company that gave her one surgical mask and two pairs of latex gloves a week to clean body ventolin expectorant price fluids, change wound dressings and administer medications to incontinent or bedridden clients.When Tina received the company’s do-it-yourself blueprints — to make masks from hole-punched sheets of paper towel reinforced with tongue depressors and gloves from garbage bags looped with rubber bands — she balked. €œIt felt like I was in a Third World country,” she said.The home health agencies that Tina and others in this article work for declined to comment on work conditions during the pandemic.In other workplaces — hospitals, mines, factories — employers are responsible for the conditions in which their employees operate. Understanding the plight of home ventolin expectorant price health providers begins with American labor law.The Fair Labor Standards Act, which forms the basis of protections in the American workplace, was passed in an era dually marked by President Franklin Delano Roosevelt’s New Deal changes and marred by the barriers of the Jim Crow era.

The act excluded domestic care workers — including maids, butlers and home health providers — from protections such as overtime pay, sick leave, hazard pay and insurance. Likewise, standards set by the Occupational Safety and Health Administration three decades later carved out “domestic household employment activities in private residences.”“A ventolin expectorant price deliberate decision was made to discriminate against colored people — mostly women — to unburden distinguished elderly white folks from the responsibility of employment,” said Ruqaiijah Yearby, a law professor at St. Louis University.In 2015, several of these exceptions were eliminated, and protections for health providers became “very well regulated on paper,” said Nina Kohn, a professor specializing in civil rights law at Syracuse University. €œBut the reality is, noncompliance is a ventolin expectorant price norm and the penalties for noncompliance are toothless.”Burkett McInturff, a civil rights lawyer working on behalf of home health workers, said, “The law itself is very clear. The problem lies in the ability to hold these companies accountable.”The Occupational Safety and Health Administration has “abdicated its responsibility for protecting workers” in the pandemic, said Debbie Berkowitz, director of the National Employment Law Project ventolin expectorant price.

Berkowitz is also a former OSHA chief. In her view, political and financial decisions in recent years have hollowed out ventolin expectorant price the agency. It now has the fewest inspectors and conducts the fewest inspections per year in its history.Furthermore, some home health care agencies have classified home health providers as contractors, akin to gig workers such as Uber drivers. This loophole protects them from ventolin expectorant price the responsibilities of employers, said Seema Mohapatra, an Indiana University associate professor of law. Furthermore, she said, “these workers are rarely in a position to question, or advocate or lobby for themselves.”Should workers contract COVID-19, they are unlikely to receive remuneration or damages.Demonstrating causality — that a person caught the coronavirus on the job — for workers’ compensation has been extremely difficult, Berkowitz said.

As with other health care jobs, employers have been quick to point out that workers might have caught the virus at the gas station, grocery store or home.Many home health providers care for multiple patients, who also bear the consequences of their work ventolin expectorant price conditions. €œIf you think about perfect vectors for transmission, unprotected individuals going from house to house have to rank at the top of ventolin expectorant price list,” Kohn said. €œEven if someone didn’t care at all about these workers, we need to fix this to keep Grandma and Grandpa safe.”Nonetheless, caregivers like Samira, in Richmond, Virginia, have little choice but to work. Samira — who makes $8.25 an hour with one client and $9.44 an hour with another, and owes tens of thousands of dollars in hospital bills ventolin expectorant price from previous work injuries — has no other option but to risk getting sick.“I can’t afford not to work. And my clients, they don’t have anybody but me,” she said.

€œSo I just pray every ventolin expectorant price day I don’t get it.” Eli Cahan. emcahan@stanford.edu, @emcahan Related Topics Aging Health Industry Public Health COVID-19 Home Health Care Lost On The FrontlineCalifornia Healthline correspondent Angela Hart discussed how the coronavirus pandemic has derailed California’s efforts to deal with homelessness on KPBS “Midday Edition” on Oct. 8. KHN Midwest correspondent Lauren Weber discussed the difference between D.O.s and M.D.s with Newsy’s “Morning Rush” on Tuesday. KHN correspondent Anna Almendrala discussed how L.A.

County’s enforcement of workplace coronavirus protocols has cut COVID-19 deaths with KPCC’s “Take Two” on Tuesday. KHN senior correspondent Sarah Jane Tribble discussed rural hospitals and KHN’s “Where It Hurts” podcast with Illinois Public Media’s “The 21st” on Oct. 5 and “Tradeoffs” on Oct. 8. KHN chief Washington correspondent Julie Rovner joined C-SPAN’s “Washington Journal” on Tuesday to discuss the Affordable Care Act case before the Supreme Court next month and what else to expect in the realm of health care after the election.

KHN freelancer Priscilla Blossom discussed Halloween safety tips with KUNC’s “Colorado Edition” on Tuesday. Related Topics California Doctors Homeless Medical EducationTrombonist Jerrell Charleston loves the give-and-take of jazz, the creativity of riffing off other musicians. But as he looked toward his sophomore year at Indiana University, he feared that steps to avoid sharing the coronavirus would also keep students from sharing songs.“Me and a lot of other cats were seriously considering taking a year off and practicing at home,” lamented the 19-year-old jazz studies major from Gary, Indiana.His worries evaporated when he arrived on campus and discovered that music professor Tom Walsh had invented a special mask with a hole and a protective flap to allow musicians to play while masked. Don't Miss A Story Subscribe to KHN’s free Weekly Edition newsletter. Students also got masks for the ends of their wind instruments, known as bell covers, allowing them to jam in person, albeit 6 feet apart.“It’s amazing to play together,” Charleston said.

€œMusic has always been my safe space. It’s what’s in your soul, and you’re sharing that with other people.”Of course, the very act of making music powered by human breath involves blowing air — and possibly virus particles — across a room. One infamous choral practice in Washington state earlier this year led to confirmed diagnoses of COVID-19 in more than half of the 61 attendees. Two died.So musicians around the country are taking it upon themselves to reduce the risk of COVID-19 without silencing the music. With pantyhose, air filters, magnets, bolts of fabric and a fusion of creativity, those who play wind instruments or sing are improvising masks to keep the band together.

Solomon Keim rehearses in protective gear that doesn't mask the sound.(Chris Bergin for KHN) Brayden Wisley practices safe sax-playing. Other tips for musicians. Play in a big space with good ventilation, and break after 30 minutes to allow the air to clear.(Chris Bergin for KHN) Brendan Sullivan plays trombone while both he and the instrument are masked. It has been recommended that most instrumentalists face the same direction while playing and stay 6 feet apart — with a distance of 9 feet in front and back of trombonists.(Chris Bergin for KHN)A consortium of performing arts groups has commissioned research exploring ways for musicians to play safely. The group’s preliminary report from July recommends instrumentalists wear masks with small slits, use bell covers, face the same direction while playing and stay 6 feet apart for most instruments — with a distance of 9 feet in front and back of trombonists.

Other research has shown cotton bell covers on brass instruments reduced airborne particles by an average of 79% compared with playing without one.Jelena Srebric, a University of Maryland engineering researcher involved in the consortium’s study, said it’s also best to play in a big space with good ventilation, and musicians should break after 30 minutes to allow the air to clear. These rudimentary solutions, she said, promise at least some protection against the virus.“Nothing is 100%. Being alive is a dangerous business,” Srebric said. This “gives some way to engage with music, which is fantastic in this day and age of despair.”Dr. Adam Schwalje, a National Institutes of Health research fellow at the University of Iowa Hospitals and Clinics, is a bassoonist who has written about the COVID risk of wind instruments.

He said a combination of bell covers, social distancing and limited time playing together could be helpful, but the effectiveness of bell covers or masks for musicians to wear while playing is “completely unproven” at this point. Schwalje’s paper said it’s not possible to quantify the risk of playing wind instruments, which involves deep breathing, sometimes forceful exhalation and possible aerosolizing of the mucus in the mouth and nose.Still, early results of research at the universities of Maryland and Colorado are helping to inspire improvisational mask-making and other safety measures, said Mark Spede, national president of the College Band Directors National Association who is helping lead the commissioned research.At Middle Tennessee State University, for example, tuba teacher Chris Combest said his students tie pillowcases over the bells of their instruments, and some wear masks that can be unbuttoned to play. At the University of Iowa, wind players in small ensembles must use bell covers and masks, but they can pull them down when playing as long as they pull them up during rests. Heather Ainsworth-Dobbins said her students at Southern Virginia University use surgical masks with slits cut in them and bell covers made of pantyhose and MERV-13 air filters, similar to what is used on a furnace.Indiana University Jacobs School of Music professor Tom Walsh distributes custom masks he designed that allow students to play their instruments safely as a group.(Chris Bergin for KHN) Skyler Floe tries out his horn's bell cover to much fanfare at Indiana University Jacobs School of Music in Bloomington, Indiana.(Chris Bergin for KHN) Kyle Cantrell's sound carries while reducing the risk of virus transmission.(Chris Bergin for KHN) At Indiana, Walsh sought out whatever research he could find as he designed his tight-fitting cotton musical mask, reinforced with a layer of polypropylene and with adjustable ties in the back. A flap hangs over the hole, outfitted with two magnets that allow it to close over the instrument.

The professor’s mom, Julie Walsh — who made his clothes when he was a kid — has sewn more than 80 of the musical masks for free. The opera program’s costume shop makes bell covers with a layer of fabric over a layer of stiff woven material known as interfacing fabric.Bailey Cates, a freshman trumpet player, said the quality of the sound is about the same with these masks and they make her feel safer.Flutes present unique challenges, partly because flutists blow air across the mouthpiece. Alice Dade, an associate professor of flute at the University of Missouri, said she and her students clip on device called “wind guards” usually used outdoors, then sometimes fit surgical masks over them.Alice Dade, an associate professor at the University of Missouri, recommends using clip-on devices for flutes called “wind guards,” which shield the lip plate of the flute from wind when playing outdoors. The ventilated design helps limit condensation and interference with the player’s air stream. Amid the pandemic, some flutists now use them with surgical masks on top to curb the spread of the coronavirus.(Alice Dade)Indiana flute student Nathan Rakes uses a specially designed cloth mask with a slit and slips a silk sock on the instrument’s end.

Rakes, a sophomore, said the fabric doesn’t affect the sound unless he’s playing a low B note, which he rarely plays.Walsh is a stickler for finding big practice spaces, not playing together for more than half an hour and taking 20-minute breaks. All jazz ensemble musicians, for example, also must stay at least 10 feet apart.“I carry a tape measure everywhere I go,” he said. €œI feel responsible for our students.”Some K-12 schools are trying similar strategies, said James Weaver, director of performing arts and sports for the National Federation of State High School Associations.His son Cooper, a seventh grade sax player at Plainfield Community Middle School in Indiana, uses a surgical mask with a slit. It sometimes jerks to the side with the vibrations of playing, but Cooper said it “feels good as long as you have it in the right place.” Cooper also helped his dad make a bell cover with fabric and MERV-13 material.While many groups use homemade bell covers, McCormick’s Group in Wheeling, Illinois, has transformed its 25-year-old business of making bell covers to display school colors and insignias into one that is making musicians safer with two-ply covers made of polyester/spandex fabric. CEO Alan Yefsky said his company started reinforcing the covers with the second layer this summer.

Sales of the $20 covers have soared.“It’s keeping people employed. We’re helping keep people safe,” Yefsky said. €œAll of a sudden, we got calls from nationally known symphony organizations.”Other professional musicians take a different tack. Film and television soundtracks are often recorded in separate sessions. Woodwinds and brass players in individual plexiglass cubicles and masked, with distanced string players recording elsewhere.The U.S.

Marine Band in Washington, D.C., practices in small, socially distanced groups, but string instrumentalists are the only ones wearing masks while playing.For both professionals and students, the pandemic has virtually eliminated live audiences in favor of virtual performances. Many musicians say they miss traditional concerts but are not focusing on what they’ve lost.“Creating that sense of community — an island to come together and play — is super important,” said Cates, the Indiana trumpet player. €œPlaying music feels like a mental release for a lot of us. When I’m playing, my mind is off of the pandemic.”Indiana University Jacobs School of Music professor Tom Walsh works with students during rehearsal in Bloomington, Indiana. The professor’s mom, Julie Walsh — who made his clothes when he was a kid — has sewn more than 80 of the musical masks for free.(Chris Bergin for KHN) Laura Ungar.

lungar@kff.org, @laura_ungar Related Topics Public Health COVID-19Use Our Content This story can be republished for free (details). At least half of voters prefer former Vice President Joe Biden’s approach to health care over President Donald Trump’s, suggesting voter concern about lowering costs and managing the pandemic could sway the outcome of this election, a new poll shows.The findings, from KFF’s monthly tracking poll, signal that voters do not trust assurances from the president that he will protect people with preexisting conditions from being penalized by insurance companies if the Supreme Court overturns the Affordable Care Act. (KHN is an editorially independent program of KFF.)Coming a month before the court will hear arguments from Republican attorneys general and the Trump administration that the health law should be overturned, the poll shows 79% of the public does not want the court to cancel coverage protections for Americans with preexisting conditions. A majority of Republicans, 66%, said they do not want those safeguards overturned.In addition to leaving about 21 million Americans uninsured, overturning the ACA could allow insurance companies to charge more or deny coverage to individuals because they have preexisting conditions — a common practice before the law was established, and one that a government analysis said in 2017 could affect as many as 133 million Americans. Email Sign-Up Subscribe to KHN’s free Morning Briefing. Nearly 6 in 10 people said they have a family member with a preexisting or chronic condition, such as diabetes or cancer, and about half said they worry about a relative being unable to afford coverage, or lose it outright, if the law is overturned.The poll reveals a striking preference for Biden over Trump when it comes to protecting preexisting conditions, an issue that 94% of voters said would help decide who they vote for.

Biden has a 20-point advantage, with voters preferring his approach 56% to 36% for Trump.In fact, it shows a preference for Biden on every health care issue posed, including among those age 65 and older and on issues that Trump has said were his priorities while in office — signaling voters are not satisfied with the president’s work to lower health care costs, in particular. Support for Trump’s efforts to lower prescription drug costs has been slipping, with voters now preferring Biden’s approach, 50% to 43%.A majority of voters said they prefer Biden’s plan for dealing with the COVID-19 outbreak, 55% to 39%, and for developing and distributing a vaccine for COVID-19, 51% to 42%. Trump has largely left it up to state and local officials to manage the outbreak, while promising that scientists would defy expectations and produce a vaccine before Election Day.Asked which issue is most important to deciding whom to vote for, most pointed to health care issues, with 18% choosing the COVID-19 outbreak and 12% saying health care overall. Nearly an equal share, 29%, selected the economy.The survey was conducted Oct. 7-12, after the first presidential debate and Trump’s announcement that he had tested positive for COVID-19.

The margin of error is plus or minus 3 percentage points for the full sample and 4 percentage points for voters. Emmarie Huetteman. ehuetteman@kff.org, @emmarieDC Related Topics Courts Elections Health Care Costs The Health Law COVID-19 KFF Polls Preexisting Conditions.

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