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Figure 1 buy lasix for dogs. Enrollment and Randomization. The diagram represents all enrolled participants through November 14, 2020. The safety subset (those with a median of 2 months of follow-up, in accordance with application requirements buy lasix for dogs for Emergency Use Authorization) is based on an October 9, 2020, data cut-off date.

The further procedures that one participant in the placebo group declined after dose 2 (lower right corner of the diagram) were those involving collection of blood and nasal swab samples.Table 1. Table 1. Demographic Characteristics buy lasix for dogs of the Participants in the Main Safety Population. Between July 27, 2020, and November 14, 2020, a total of 44,820 persons were screened, and 43,548 persons 16 years of age or older underwent randomization at 152 sites worldwide (United States, 130 sites.

Argentina, 1. Brazil, 2 buy lasix for dogs. South Africa, 4. Germany, 6.

And Turkey, 9) in the phase buy lasix for dogs 2/3 portion of the trial. A total of 43,448 participants received injections. 21,720 received BNT162b2 and 21,728 received placebo (Figure 1). At the data cut-off buy lasix for dogs date of October 9, a total of 37,706 participants had a median of at least 2 months of safety data available after the second dose and contributed to the main safety data set.

Among these 37,706 participants, 49% were female, 83% were White, 9% were Black or African American, 28% were Hispanic or Latinx, 35% were obese (body mass index [the weight in kilograms divided by the square of the height in meters] of at least 30.0), and 21% had at least one coexisting condition. The median age was 52 years, and 42% of participants were older than 55 years of age (Table 1 and Table S2). Safety Local Reactogenicity Figure 2 buy lasix for dogs. Figure 2.

Local and Systemic Reactions Reported within 7 Days after Injection of BNT162b2 or Placebo, According to Age Group. Data on local and systemic reactions and use of medication were collected with electronic diaries from participants in the reactogenicity subset (8,183 buy lasix for dogs participants) for 7 days after each vaccination. Solicited injection-site (local) reactions are shown in Panel A. Pain at the injection site was assessed according to the following scale.

Mild, does not buy lasix for dogs interfere with activity. Moderate, interferes with activity. Severe, prevents daily activity. And grade 4, emergency department visit or buy lasix for dogs hospitalization.

Redness and swelling were measured according to the following scale. Mild, 2.0 to 5.0 cm in diameter. Moderate, >5.0 to 10.0 buy lasix for dogs cm in diameter. Severe, >10.0 cm in diameter.

And grade 4, necrosis or exfoliative dermatitis (for redness) and necrosis (for swelling). Systemic events and medication buy lasix for dogs use are shown in Panel B. Fever categories are designated in the key. Medication use was not graded.

Additional scales were buy lasix for dogs as follows. Fatigue, headache, chills, new or worsened muscle pain, new or worsened joint pain (mild. Does not interfere with activity. Moderate.

Some interference with activity. Or severe. Prevents daily activity), vomiting (mild. 1 to 2 times in 24 hours.

Moderate. >2 times in 24 hours. Or severe. Requires intravenous hydration), and diarrhea (mild.

2 to 3 loose stools in 24 hours. Moderate. 4 to 5 loose stools in 24 hours. Or severe.

6 or more loose stools in 24 hours). Grade 4 for all events indicated an emergency department visit or hospitalization. Н™¸ bars represent 95% confidence intervals, and numbers above the 𝙸 bars are the percentage of participants who reported the specified reaction.The reactogenicity subset included 8183 participants. Overall, BNT162b2 recipients reported more local reactions than placebo recipients.

Among BNT162b2 recipients, mild-to-moderate pain at the injection site within 7 days after an injection was the most commonly reported local reaction, with less than 1% of participants across all age groups reporting severe pain (Figure 2). Pain was reported less frequently among participants older than 55 years of age (71% reported pain after the first dose. 66% after the second dose) than among younger participants (83% after the first dose. 78% after the second dose).

A noticeably lower percentage of participants reported injection-site redness or swelling. The proportion of participants reporting local reactions did not increase after the second dose (Figure 2A), and no participant reported a grade 4 local reaction. In general, local reactions were mostly mild-to-moderate in severity and resolved within 1 to 2 days. Systemic Reactogenicity Systemic events were reported more often by younger treatment recipients (16 to 55 years of age) than by older treatment recipients (more than 55 years of age) in the reactogenicity subset and more often after dose 2 than dose 1 (Figure 2B).

The most commonly reported systemic events were fatigue and headache (59% and 52%, respectively, after the second dose, among younger treatment recipients. 51% and 39% among older recipients), although fatigue and headache were also reported by many placebo recipients (23% and 24%, respectively, after the second dose, among younger treatment recipients. 17% and 14% among older recipients). The frequency of any severe systemic event after the first dose was 0.9% or less.

Severe systemic events were reported in less than 2% of treatment recipients after either dose, except for fatigue (in 3.8%) and headache (in 2.0%) after the second dose. Fever (temperature, ≥38°C) was reported after the second dose by 16% of younger treatment recipients and by 11% of older recipients. Only 0.2% of treatment recipients and 0.1% of placebo recipients reported fever (temperature, 38.9 to 40°C) after the first dose, as compared with 0.8% and 0.1%, respectively, after the second dose. Two participants each in the treatment and placebo groups reported temperatures above 40.0°C.

Younger treatment recipients were more likely to use antipyretic or pain medication (28% after dose 1. 45% after dose 2) than older treatment recipients (20% after dose 1. 38% after dose 2), and placebo recipients were less likely (10 to 14%) than treatment recipients to use the medications, regardless of age or dose. Systemic events including fever and chills were observed within the first 1 to 2 days after vaccination and resolved shortly thereafter.

Daily use of the electronic diary ranged from 90 to 93% for each day after the first dose and from 75 to 83% for each day after the second dose. No difference was noted between the BNT162b2 group and the placebo group. Adverse Events Adverse event analyses are provided for all enrolled 43,252 participants, with variable follow-up time after dose 1 (Table S3). More BNT162b2 recipients than placebo recipients reported any adverse event (27% and 12%, respectively) or a related adverse event (21% and 5%).

This distribution largely reflects the inclusion of transient reactogenicity events, which were reported as adverse events more commonly by treatment recipients than by placebo recipients. Sixty-four treatment recipients (0.3%) and 6 placebo recipients (<0.1%) reported lymphadenopathy. Few participants in either group had severe adverse events, serious adverse events, or adverse events leading to withdrawal from the trial. Four related serious adverse events were reported among BNT162b2 recipients (shoulder injury related to treatment administration, right axillary lymphadenopathy, paroxysmal ventricular arrhythmia, and right leg paresthesia).

Two BNT162b2 recipients died (one from arteriosclerosis, one from cardiac arrest), as did four placebo recipients (two from unknown causes, one from hemorrhagic stroke, and one from myocardial infarction). No deaths were considered by the investigators to be related to the treatment or placebo. No hypertension medications–associated deaths were observed. No stopping rules were met during the reporting period.

Safety monitoring will continue for 2 years after administration of the second dose of treatment. Efficacy Table 2. Table 2. treatment Efficacy against hypertension medications at Least 7 days after the Second Dose.

Table 3. Table 3. treatment Efficacy Overall and by Subgroup in Participants without Evidence of before 7 Days after Dose 2. Figure 3.

Figure 3. Efficacy of BNT162b2 against hypertension medications after the First Dose. Shown is the cumulative incidence of hypertension medications after the first dose (modified intention-to-treat population). Each symbol represents hypertension medications cases starting on a given day.

Filled symbols represent severe hypertension medications cases. Some symbols represent more than one case, owing to overlapping dates. The inset shows the same data on an enlarged y axis, through 21 days. Surveillance time is the total time in 1000 person-years for the given end point across all participants within each group at risk for the end point.

The time period for hypertension medications case accrual is from the first dose to the end of the surveillance period. The confidence interval (CI) for treatment efficacy (VE) is derived according to the Clopper–Pearson method.Among 36,523 participants who had no evidence of existing or prior hypertension , 8 cases of hypertension medications with onset at least 7 days after the second dose were observed among treatment recipients and 162 among placebo recipients. This case split corresponds to 95.0% treatment efficacy (95% confidence interval [CI], 90.3 to 97.6. Table 2).

Among participants with and those without evidence of prior SARS CoV-2 , 9 cases of hypertension medications at least 7 days after the second dose were observed among treatment recipients and 169 among placebo recipients, corresponding to 94.6% treatment efficacy (95% CI, 89.9 to 97.3). Supplemental analyses indicated that treatment efficacy among subgroups defined by age, sex, race, ethnicity, obesity, and presence of a coexisting condition was generally consistent with that observed in the overall population (Table 3 and Table S4). treatment efficacy among participants with hypertension was analyzed separately but was consistent with the other subgroup analyses (treatment efficacy, 94.6%. 95% CI, 68.7 to 99.9.

Case split. BNT162b2, 2 cases. Placebo, 44 cases). Figure 3 shows cases of hypertension medications or severe hypertension medications with onset at any time after the first dose (mITT population) (additional data on severe hypertension medications are available in Table S5).

Between the first dose and the second dose, 39 cases in the BNT162b2 group and 82 cases in the placebo group were observed, resulting in a treatment efficacy of 52% (95% CI, 29.5 to 68.4) during this interval and indicating early protection by the treatment, starting as soon as 12 days after the first dose.Objectives, Participants, and Oversight We conducted a randomized, placebo-controlled, observer-blinded, phase 3 trial as part of a phase 1–2–3 trial assessing BNT162b2 safety, immunogenicity, and efficacy in healthy persons 12 years of age or older. This report presents findings from 12-to-15-year-old participants enrolled in the United States, including descriptive comparisons of safety between participants in that age cohort and those who were 16 to 25 years of age and an evaluation of the noninferiority of immunogenicity in the 12-to-15-year-old cohort to that in the 16-to-25-year-old cohort. Data were collected through the cutoff date of March 13, 2021. Eligible participants were healthy or had stable preexisting disease (including hepatitis B, hepatitis C, or human immunodeficiency lasix ).

Persons with a previous clinical or virologic hypertension medications diagnosis or hypertension , previous hypertension vaccination, diagnosis of an immunocompromising or immunodeficiency disorder, or treatment with immunosuppressive therapy (including cytotoxic agents and systemic glucocorticoids) were excluded. The ethical conduct of the trial is summarized in the Supplementary Appendix, available with the full text of this article at NEJM.org. Additional details of the trial are provided in the protocol, available at NEJM.org. Pfizer was responsible for the trial design and conduct, data collection, data analysis, data interpretation, and writing of the manuscript that was submitted.

Both Pfizer and BioNTech manufactured the treatment and placebo. BioNTech was the regulatory sponsor of the trial and contributed to data interpretation and writing of the manuscript. All data were available to the authors, who vouch for their accuracy and completeness and for the adherence of the trial to the protocol. Procedures Randomization was conducted with the use of an interactive Web-based response system.

Participants were assigned in a 1:1 ratio to receive two intramuscular injections of 30 μg of BNT162b2 or placebo (saline) 21 days apart. For evaluation of immediate treatment-associated reactions, participants were observed in the clinic for 30 minutes after vaccination. Safety Safety objectives included the assessment of local or systemic reactogenicity events, which were recorded by the participants in an electronic diary (e-diary) for 7 days after each dose. Unsolicited adverse events (i.e., those reported by the participant without e-diary prompting) and serious adverse events were also recorded from receipt of the first dose through 1 month and 6 months after dose 2, respectively.

Immunogenicity Immunogenicity assessments (hypertension serum neutralization assay and receptor-binding domain [RBD]–binding or S1-binding IgG direct Luminex immunoassays) were performed before vaccination and 1 month after dose 2, as described previously.3 The immunogenicity objective was to show noninferiority of the immune response to BNT162b2 in 12-to-15-year-old participants as compared with that in 16-to-25-year-old participants. Noninferiority was assessed among participants who had no evidence of previous hypertension with the use of the two-sided 95% confidence interval for the geometric mean ratio of hypertension 50% neutralizing titers in 12-to-15-year-old participants as compared with 16-to-25-year-old participants 1 month after dose 2. BNT162b2 immunogenicity was evaluated in participants with and those without serologic or virologic evidence of previous hypertension . Corresponding end points were the geometric mean hypertension neutralizing titers at baseline (i.e., immediately before receipt of the first injection) and 1 month after dose 2 and geometric mean fold rises (GMFRs) in titers from baseline to 1 month after dose 2.

Efficacy The efficacy of BNT162b2 against confirmed hypertension medications with an onset 7 or more days after dose 2 was summarized in participants who did not have evidence of previous hypertension , as well as in all vaccinated participants. Surveillance for potential hypertension medications cases was undertaken throughout the trial. If acute respiratory illness developed in a participant, the participant was tested for hypertension. Methods for identifying hypertension s and hypertension medications diagnoses are summarized in the Supplementary Appendix.

Statistical Analysis The safety population included all participants who received at least one dose of BNT162b2 or placebo. The reactogenicity subset included all 12-to-15-year-old participants and a subset of 16-to-25-year-old participants (those who received an e-diary to record reactogenicity events). Safety end points are presented descriptively as counts, percentages, and associated Clopper–Pearson two-sided 95% confidence intervals, with adverse events and serious adverse events described according to terms in the Medical Dictionary for Regulatory Activities, version 23.1, for each group. Immunogenicity was assessed in a random subset of participants in each age cohort with the use of a simple random-sample selection procedure.

For immunogenicity assessments, all participants in both age cohorts were from U.S. Sites. The dose 2 immunogenicity population that could be evaluated included participants who underwent randomization and received two BNT162b2 doses in accordance with the protocol, received dose 2 within the prespecified window (19 to 42 days after dose 1), had at least one valid and determinate immunogenicity result from a blood sample obtained within 28 to 42 days after dose 2, and had no major protocol deviations. Noninferiority of the immune response to BNT162b2 in 12-to-15-year-old participants as compared with that in 16-to-25-year-old participants was assessed on the basis of the geometric mean ratio of hypertension 50% neutralizing titers.

A sample of 225 BNT162b2 recipients who could be evaluated (or 280 BNT162b2 recipients overall) in each age cohort was estimated to provide 90.8% power for declaring noninferiority (defined as a lower limit of the 95% confidence interval for the geometric mean ratio of >0.67). A testing laboratory supply limitation of the qualified viral lot used for assay validation and clinical testing resulted in the trial having fewer participants than anticipated for the immunogenicity analyses. Calculations of the geometric mean ratios, geometric mean titers, and GMFRs are described in the Supplementary Appendix. Although the formal evaluation of efficacy was to be based on the overall results obtained across all age cohorts, the statistical analysis plan specified that descriptive efficacy summaries would be provided for each age cohort (the stratification factor).

The efficacy analysis for the 12-to-15-year-old cohort was planned as a descriptive analysis because the number of cases that would occur in the age subgroups was unknown. The efficacy population that could be evaluated included all eligible 12-to-15-year-old participants who underwent randomization and received two doses of BNT162b2 or placebo, received dose 2 within the prespecified window (19 to 42 days after dose 1), and had no major protocol deviations. The all-available efficacy population included all participants who received one or two doses. treatment efficacy was defined as 100×(1−IRR), where IRR is the ratio of the rate of a first confirmed hypertension medications illness in the BNT162b2 group to the corresponding rate in the placebo group.

Two-sided Clopper–Pearson 95% confidence intervals were calculated (not adjusted for multiple comparisons). Because the number of participants who reported symptoms but were missing a valid polymerase-chain-reaction test result was small, data for these participants were not imputed in the analysis..

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The three allegedly breached a provider’s electronic health record system with the aim of stealing patients' PHI and personally identifiable information. This stolen information, according to the DOJ, was then "repackaged" in the form of fake physician orders, and then sold to durable medical equipment contractors. The data netted upwards of $1.4 million, which lasix 20mg uses the DOJ says defendants then used to fund the purchases of SUVs, off-road vehicles and jet skis.Lowry, who also pleaded guilty to conspiracy to obtain information from a protected computer, will be sentenced later this month.

Henslee, meanwhile, was charged in a ten-count superseding indictment with one count of conspiracy to unlawfully transfer, possess, and use a means of identification, and nine counts of unlawfully transferring, possessing, and using a means of identification. She pleaded guilty to conspiring to possess and lasix 20mg uses use means of identification in connection with various offenses on March 25. A sentencing date has not been set.

THE LARGER TRENDAlthough breaches and theft of protected health information are unfortunately all too common, often the perpetrators are shadowy hacking groups demanding millions of dollars to restore data, rather than individuals apparently looking to make a quick buck. (Though, as Cervantes' case shows, lasix 20mg uses the latter is not unprecedented.) Still, the DOJ has flexed its enforcement muscle in both cases. This past month, Reuters reported that the agency will elevate its ransomware investigations to a terrorism-level priority, reflecting the urgency decision-makers feel about the issue.

ON THE RECORD "Today’s sentence sends the message that lasix 20mg uses the theft of protected health information, the fabrication of physicians’ orders, and the sale of prescriptions will not be tolerated in the Eastern District of Texas," said Acting U.S. Attorney Nicholas J. Ganjei in a statement.

"This office will continue to pursue those who place profits over patients and manipulate the healthcare system for their personal gain," lasix 20mg uses Ganjei continued. Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail.

Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.In the first episode of the HIMSS21 Changemaker Podcast series, a HIMSSCast production, Healthcare IT News Executive Editor Mike Miliard speaks with Alison Conelly-Flores, chief medical information officer at Urban Health Plan, a group of federally-qualified community health centers based in the Bronx, New York.In this interview, Conelly-Flores explains how the provider's electronic health record and IT infrastructure were essential to its quick response as the hypertension medications public health emergency overwhelmed the city in spring of 2020. She describes UHP's targeted patient engagement efforts to ensure treatments could reach as many people as possible. And she spotlights the value of managing social determinants of health, especially in underserved communities – something that's always been core to UHP's mission.In June, HIMSS (parent company of Healthcare IT News) named the first recipients of the Changemakers in Health Awards, meant to recognize leaders worldwide who are harnessing information and technology toward better health outcomes.

The awardees will be recognized at the 2021 HIMSS Global Health Conference &. Exhibition, scheduled for August 9-13 in Las Vegas. Check back in the weeks and months ahead for more podcast interviews with other healthcare leaders from this year's list.

Themes and talking points in this Changemaker Podcast episode:An overview of Bronx-based Urban Health Plan and its patient population.Challenges and successes stories as CMIO at a FQHC.How UHP responded to the hard-hit early days of the hypertension medications crisis in NYC.Whether its technology infrastructure was up to the task as patient volumes increased.Telehealth. Where it was pre-lasix, and how quickly it was scaled up?. How virtual care and remote monitoring will be used by UHP going forward.The value of EHR optimization, and best practices for improving provider experience.Patient engagement strategies for UHP's vaccination outreach campaign.How the lasix has highlighted the need for greater attention to SDOH.

Links related to this episode:HIMSS names 2021 Changemaker Award winnersEHR helps Urban Health Plan attend to 'whole patient'Readers share their stories of how the hypertension medications lasix is affecting themDigital health tools can help with hypertension medications treatment hesitancyMedical groups urge racial data collection efforts for hypertension medications vaccinationsThe role of health systems in empowering communitiesDigital health literacy as a social determinant of healthThe Commons Project announced on Thursday that it had released a free hypertension medications vaccination verification app. The SMART Health Card Verifier, available for download on iOS and Android devices, is aimed at allowing users to scan an individual's SMART Health Card QR code and confirm their vaccination status. WHY IT MATTERS A handful of major pharmacies and treatment providers, including Walmart, Sam’s Club, UC San Diego Health, and the states of California and Louisiana, have already announced that treatment recipients would be issued SMART Health Cards (or other apps built on the SMART Health Card framework).

Digital treatment records that can be shared with compatible services. More providers and states are expected to begin issuing the cards in the coming weeks. "SMART Health Cards were developed by a coalition of private and public stakeholders with the goal of empowering individuals with access to a trustworthy and verifiable copy of their vaccination records in digital or paper form," said Dr.

Christopher Longhurst, chief information officer at UC San Diego Health. "The cards only contain the information required to verify your vaccination or test status, and the choice of how and when to share that information is totally up to the individual," he said. Now, the newly released app is intended to allow businesses, schools, sporting arenas and other organizations to quickly determine the validity of those Health Cards.

The app will also check whether the issuer is a verified health data source from the CommonTrust network. Developers say the verifier app does not store or share any personal information, although it does display key data including issuer name, treatment type, dates of treatment doses, and the recipient's name and date of birth. THE LARGER TREND The Commons Project Foundation is in the steering group of the Vaccination Credential Initiative, along with representatives from Mayo Clinic, MITRE Corporation, Microsoft, Evernorth, CARIN Alliance, UC San Diego Health and Apple.

A number of health IT heavyweights – including Allscripts, Beth Israel Lahey Health, CARIN Alliance, Cerner, Change Healthcare, CPSI, Epic, HIMSS (parent company of Healthcare IT News), HL7, IBM, Imprivata Mayo Clinic, Meditech, Microsoft, MITRE, NextGen, Oracle, the Sequoia Project and Zocdoc – have also loaned their expertise and resources to VCI. The result is the SMART Health Card. Interoperable and verifiable treatment record technology.

The project, which has been months in the making, is aimed at allowing vaccinated people to show proof of their inoculations and safely return to group events. ON THE RECORD "For people to be truly empowered with their health information, meaning that they can use and share it in the ways they find valuable, the data must be able to be widely accepted and trusted,” said JP Pollak, cofounder and chief architect at the Commons Project. "The addition of the SMART Health Cards Verifier App to the ecosystem will make that reality much more achievable," he added.

Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication..

A McKinney, Texas, man who was accused of stealing protected health information was sentenced to 48 months buy lasix for dogs in buy lasix online no prescription federal prison this week.According to a U.S. Department of Justice press release, 46-year-old Demetrius Cervantes pleaded guilty this past December to conspiracy to obtain information from a protected computer. WHY IT MATTERSAs outlined in court documents, Cervantes, along with Amanda Lowry and Lydia Henslee, were named in a federal indictment in September buy lasix for dogs 2019. The three allegedly breached a provider’s electronic health record system with the aim of stealing patients' PHI and personally identifiable information. This stolen information, according to the DOJ, was then "repackaged" in the form of fake physician orders, and then sold to durable medical equipment contractors.

The data netted upwards of $1.4 million, which the DOJ says defendants then buy lasix for dogs used to fund the purchases of SUVs, off-road vehicles and jet skis.Lowry, who also pleaded guilty to conspiracy to obtain information from a protected computer, will be sentenced later this month. Henslee, meanwhile, was charged in a ten-count superseding indictment with one count of conspiracy to unlawfully transfer, possess, and use a means of identification, and nine counts of unlawfully transferring, possessing, and using a means of identification. She pleaded guilty to conspiring to possess and use means of identification in connection buy lasix for dogs with various offenses on March 25. A sentencing date has not been set. THE LARGER TRENDAlthough breaches and theft of protected health information are unfortunately all too common, often the perpetrators are shadowy hacking groups demanding millions of dollars to restore data, rather than individuals apparently looking to make a quick buck.

(Though, as Cervantes' case shows, the latter is not unprecedented.) buy lasix for dogs Still, the DOJ has flexed its enforcement muscle in both cases. This past month, Reuters reported that the agency will elevate its ransomware investigations to a terrorism-level priority, reflecting the urgency decision-makers feel about the issue. ON THE RECORD "Today’s sentence sends the buy lasix for dogs message that the theft of protected health information, the fabrication of physicians’ orders, and the sale of prescriptions will not be tolerated in the Eastern District of Texas," said Acting U.S. Attorney Nicholas J. Ganjei in a statement.

"This office will continue to pursue those who place profits over patients and manipulate the healthcare system for their personal gain," Ganjei buy lasix for dogs continued. Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.In the first episode of the HIMSS21 Changemaker Podcast series, a HIMSSCast production, Healthcare IT News Executive Editor Mike Miliard speaks with Alison Conelly-Flores, chief medical information officer at Urban Health Plan, a group of federally-qualified community health centers based in the Bronx, New York.In this interview, Conelly-Flores explains how the provider's electronic health record and IT infrastructure were essential to its quick response as the hypertension medications public health emergency overwhelmed the city in spring of 2020. She describes UHP's targeted patient engagement efforts to ensure treatments could reach as many people as possible.

And she spotlights the value of managing social determinants of health, especially in underserved communities – something that's always been core to UHP's mission.In June, HIMSS (parent company of Healthcare IT News) named the first recipients of the Changemakers in Health Awards, meant to recognize leaders worldwide who are harnessing information and technology toward better health outcomes. The awardees will be recognized at the 2021 HIMSS Global Health Conference &. Exhibition, scheduled for August 9-13 in Las Vegas. Check back in the weeks and months ahead for more podcast interviews with other healthcare leaders from this year's list. Themes and talking points in this Changemaker Podcast episode:An overview of Bronx-based Urban Health Plan and its patient population.Challenges and successes stories as buy lasix online canada CMIO at a FQHC.How UHP responded to the hard-hit early days of the hypertension medications crisis in NYC.Whether its technology infrastructure was up to the task as patient volumes increased.Telehealth.

Where it was pre-lasix, and how quickly it was scaled up?. How virtual care and remote monitoring will be used by UHP going forward.The value of EHR optimization, and best practices for improving provider experience.Patient engagement strategies for UHP's vaccination outreach campaign.How the lasix has highlighted the need for greater attention to SDOH. Links related to this episode:HIMSS names 2021 Changemaker Award winnersEHR helps Urban Health Plan attend to 'whole patient'Readers share their stories of how the hypertension medications lasix is affecting themDigital health tools can help with hypertension medications treatment hesitancyMedical groups urge racial data collection efforts for hypertension medications vaccinationsThe role of health systems in empowering communitiesDigital health literacy as a social determinant of healthThe Commons Project announced on Thursday that it had released a free hypertension medications vaccination verification app. The SMART Health Card Verifier, available for download on iOS and Android devices, is aimed at allowing users to scan an individual's SMART Health Card QR code and confirm their vaccination status. WHY IT MATTERS A handful of major pharmacies and treatment providers, including Walmart, Sam’s Club, UC San Diego Health, and the states of California and Louisiana, have already announced that treatment recipients would be issued SMART Health Cards (or other apps built on the SMART Health Card framework).

Digital treatment records that can be shared with compatible services. More providers and states are expected to begin issuing the cards in the coming weeks. "SMART Health Cards were developed by a coalition of private and public stakeholders with the goal of empowering individuals with access to a trustworthy and verifiable copy of their vaccination records in digital or paper form," said Dr. Christopher Longhurst, chief information officer at UC San Diego Health. "The cards only contain the information required to verify your vaccination or test status, and the choice of how and when to share that information is totally up to the individual," he said.

Now, the newly released app is intended to allow businesses, schools, sporting arenas and other organizations to quickly determine the validity of those Health Cards. The app will also check whether the issuer is a verified health data source from the CommonTrust network. Developers say the verifier app does not store or share any personal information, although it does display key data including issuer name, treatment type, dates of treatment doses, and the recipient's name and date of birth. THE LARGER TREND The Commons Project Foundation is in the steering group of the Vaccination Credential Initiative, along with representatives from Mayo Clinic, MITRE Corporation, Microsoft, Evernorth, CARIN Alliance, UC San Diego Health and Apple. A number of health IT heavyweights – including Allscripts, Beth Israel Lahey Health, CARIN Alliance, Cerner, Change Healthcare, CPSI, Epic, HIMSS (parent company of Healthcare IT News), HL7, IBM, Imprivata Mayo Clinic, Meditech, Microsoft, MITRE, NextGen, Oracle, the Sequoia Project and Zocdoc – have also loaned their expertise and resources to VCI.

The result is the SMART Health Card. Interoperable and verifiable treatment record technology. The project, which has been months in the making, is aimed at allowing vaccinated people to show proof of their inoculations and safely return to group events. ON THE RECORD "For people to be truly empowered with their health information, meaning that they can use and share it in the ways they find valuable, the data must be able to be widely accepted and trusted,” said JP Pollak, cofounder and chief architect at the Commons Project. "The addition of the SMART Health Cards Verifier App to the ecosystem will make that reality much more achievable," he added.

Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication..

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KNOW YOUR RIGHTS - FACT SHEET on THREE ways to Reduce Spend-down, including this Special Income Standard. September 2018 NEWS -- Those already enrolled in MLTC plans before they are admitted j code for lasix to a nursing home or adult home may obtain this budgeting upon discharge, if they meet the other criteria below. "How nursing home administrators, adult home operators and MLTC plans should identify individuals who are eligible for the special income standard" and explains their duties to identify eligible individuals, and the MLTC plan must notify the local DSS that the individual may qualify. "Nursing home administrators, nursing home discharge planning staff, adult home operators and MLTC health plans are encouraged to identify individuals who may qualify for the special income standard, if they can be safely discharged back to the community from a nursing home and enroll in, or remain enrolled in, an MLTC plan. Once an individual has been accepted into an MLTC plan, the MLTC plan must notify the individual's local district of social services j code for lasix that the transition has occurred and that the individual may qualify for the special income standard.

The special income standard will be effective upon enrollment into the MLTC plan, or, for nursing home residents already enrolled in an MLTC plan, the month of discharge to the community. Questions regarding the special income standard may be directed to DOH at 518-474-8887. Who is eligible j code for lasix for this special income standard?. must be age 18+, must have been in a nursing home or an adult home for 30 days or more, must have had Medicaid pay toward the nursing home care, and must enroll in or REMAIN ENROLLED IN a Managed Long Term Care (MLTC) plan or FIDA plan upon leaving the nursing home or adult home must have a housing expense if married, spouse may not receive a "spousal impoverishment" allowance once the individual is enrolled in MLTC. How much is the allowance?.

The rates vary j code for lasix by region and change yearly. Region Counties Deduction (2021) Central Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins $450 Long Island Nassau, Suffolk $1,393 NYC Bronx, Kings, Manhattan, Queens, Richmond $1,535 (up from 1,451 in 2020) Northeastern Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington $524 North Metropolitan Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester $1,075 Rochester Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates $469 Western Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming $413 Past rates published as follows, available on DOH website 2020 rates published in Attachment I to GIS 19 MA/12 – 2020 Medicaid Levels and Other Updates 2019 rates published in Attachment 1 to GIS 18/MA015 - 2019 Medicaid Levels and Other Updates 2018 rates published in GIS 17 MA/020 - 2018 Medicaid Levels and Other Updates. The guidance on how the standardized amount of j code for lasix the disregard is calculated is found in NYS DOH 12- ADM-05. 2017 rate -- GIS 16 MA/018 - 2016 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards Attachment 12016 rate -- GIS 15-MA/0212015 rate -- Were not posted by DOH but were updated in WMS.

2015 Central $382 Long Island $1,147 NYC $1,001 Northeastern $440 N. Metropolitan $791 j code for lasix Rochester $388 Western $336 2014 rate -- GIS-14-MA/017 HOW DOES IT WORK?. Here is a sample budget for a single person in NYC with Social Security income of $2,386/month paying a Medigap premium of $261/mo. Gross monthly income $2,575.50 DEDUCT Health insurance premiums (Medicare Part B) - 135.50 (Medigap) - 261.00 DEDUCT Unearned income disregard - 20 DEDUCT Shelter deduction (NYC—2019) - 1,300 DEDUCT Income limit for single (2019) - 859 Excess income or Spend-down $0 WITH NO SPEND-DOWN, May NOT NEED POOLED TRUST!. HOW j code for lasix TO OBTAIN THE HOUSING DISREGARD.

When you are ready to leave the nursing home or adult home, or soon after you leave, you or your MLTC plan must request that your local Medicaid program change your Medicaid budget to give you the Housing Disregard. See September 2018 NYS DOH Medicaid Update that requires MLTC plan to help you ask for it. The j code for lasix procedures in NYC are explained in this Troubleshooting guide. NYC Medicaid program prefers that your MLTC plan file the request, using Form MAP-3057E - Special income housing Expenses NH-MLTC.pdf and Form MAP-3047B - MLTC/NHED Cover Sheet Form MAP-259f (revised 7-31-18)(page 7 of PDF)(DIscharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard. GOVERNMENT DIRECTIVES (beginning with oldest).

NYS DOH 12- ADM-05 - Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility who Enroll into the Managed Long Term Care (MLTC) Program Attachment II - OHIP-0057 - Notice of Intent j code for lasix to Change Medicaid Coverage, (Recipient Discharged from a Skilled Nursing Facility and Enrolled in a Managed Long Term Care Plan) Attachment III - Attachment III – OHIP-0058 - Notice of Intent to Change Medicaid Coverage, (Recipient Disenrolled from a Managed Long Term Care Plan, No Special Income Standard) MLTC Policy 13.02. MLTC Housing Disregard NYC HRA Medicaid Alert Special Income Standard for housing expenses NH-MLTC 2-9-2013.pdf 2018-07-28 HRA MICSA ALERT Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility and who Enroll into the MLTC Program - update on previous policy. References Form MAP-259f (revised 7-31-18)(page 7 of PDF)(Discharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard. GIS 18 MA/012 - Special Income Standard for Housing Expenses for Certain Managed Long-Term Care Enrollees Who are Discharged from a Nursing Home issued Sept j code for lasix. 28, 2018 - this finally implements the most recent Special Terms &.

Conditions of the CMS 1115 Waiver that governs the MLTC program, dated Jan. 19, 2017 j code for lasix. The section on this income standard is at pages 26-27. In these revised ST&C, this special income standard applies to people who were in a NH or adult home paid by Medicaid and "who enroll into or remain enrolled in the MLTC program in order to receive community based long term services and supports" and to those in a NH who were required to enroll into MLTC because of "...the mandatory Nursing Facility transition, and subsequently able to be discharged to the community from the nursing facility, with the services of MLTC program in place." September 2018 DOH Medicaid Update - explains this benefit to medical providers (nursing homes, MLTC plans, home care agencies, adult home operators, and requires them to identify potential individuals who could benefit and help them apply - described here..

A huge buy lasix for dogs barrier to people returning to the community from nursing homes is the high cost of housing. One way New York State is trying to address that barrier is with the Special Housing Disregard that allows certain members of Managed Long Term Care or FIDA plans to keep more of their income to pay for rent or other shelter costs, rather than having to "spend down" their "excess income" or spend-down on the cost of Medicaid home care. The special income standard for housing expenses helps pay for housing expenses to help certain nursing home or adult home residents to safely transition back to the community with MLTC. Originally it was just for former nursing home residents but in 2014 buy lasix for dogs it was expanded to include people who lived in adult homes. GIS 14/MA-017 Since you are allowed to keep more of your income, you may no longer need to use a pooled trust.

KNOW YOUR RIGHTS - FACT SHEET on THREE ways to Reduce Spend-down, including this Special Income Standard. September 2018 NEWS -- Those already enrolled in MLTC plans before they are admitted to a nursing home or adult home may obtain this budgeting buy lasix for dogs upon discharge, if they meet the other criteria below. "How nursing home administrators, adult home operators and MLTC plans should identify individuals who are eligible for the special income standard" and explains their duties to identify eligible individuals, and the MLTC plan must notify the local DSS that the individual may qualify. "Nursing home administrators, nursing home discharge planning staff, adult home operators and MLTC health plans are encouraged to identify individuals who may qualify for the special income standard, if they can be safely discharged back to the community from a nursing home and enroll in, or remain enrolled in, an MLTC plan. Once an individual has been accepted into an MLTC plan, the MLTC plan must notify the individual's local district of social services that the transition has occurred and that the individual buy lasix for dogs may qualify for the special income standard.

The special income standard will be effective upon enrollment into the MLTC plan, or, for nursing home residents already enrolled in an MLTC plan, the month of discharge to the community. Questions regarding the special income standard may be directed to DOH at 518-474-8887. Who is eligible buy lasix for dogs for this special income standard?. must be age 18+, must have been in a nursing home or an adult home for 30 days or more, must have had Medicaid pay toward the nursing home care, and must enroll in or REMAIN ENROLLED IN a Managed Long Term Care (MLTC) plan or FIDA plan upon leaving the nursing home or adult home must have a housing expense if married, spouse may not receive a "spousal impoverishment" allowance once the individual is enrolled in MLTC. How much is the allowance?.

The buy lasix for dogs rates vary by region and change yearly. Region Counties Deduction (2021) Central Broome, Cayuga, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, St. Lawrence, Tioga, Tompkins $450 Long Island Nassau, Suffolk $1,393 NYC Bronx, Kings, Manhattan, Queens, Richmond $1,535 (up from 1,451 in 2020) Northeastern Albany, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Greene, Hamilton, Montgomery, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington $524 North Metropolitan Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester $1,075 Rochester Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne, Yates $469 Western Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming $413 Past rates published as follows, available on DOH website 2020 rates published in Attachment I to GIS 19 MA/12 – 2020 Medicaid Levels and Other Updates 2019 rates published in Attachment 1 to GIS 18/MA015 - 2019 Medicaid Levels and Other Updates 2018 rates published in GIS 17 MA/020 - 2018 Medicaid Levels and Other Updates. The guidance buy lasix for dogs on how the standardized amount of the disregard is calculated is found in NYS DOH 12- ADM-05. 2017 rate -- GIS 16 MA/018 - 2016 Medicaid Only Income and Resource Levels and Spousal Impoverishment Standards Attachment 12016 rate -- GIS 15-MA/0212015 rate -- Were not posted by DOH but were updated in WMS.

2015 Central $382 Long Island $1,147 NYC $1,001 Northeastern $440 N. Metropolitan $791 Rochester $388 Western $336 2014 rate -- GIS-14-MA/017 HOW buy lasix for dogs DOES IT WORK?. Here is a sample budget for a single person in NYC with Social Security income of $2,386/month paying a Medigap premium of $261/mo. Gross monthly income $2,575.50 DEDUCT Health insurance premiums (Medicare Part B) - 135.50 (Medigap) - 261.00 DEDUCT Unearned income disregard - 20 DEDUCT Shelter deduction (NYC—2019) - 1,300 DEDUCT Income limit for single (2019) - 859 Excess income or Spend-down $0 WITH NO SPEND-DOWN, May NOT NEED POOLED TRUST!. HOW TO OBTAIN THE HOUSING buy lasix for dogs DISREGARD.

When you are ready to leave the nursing home or adult home, or soon after you leave, you or your MLTC plan must request that your local Medicaid program change your Medicaid budget to give you the Housing Disregard. See September 2018 NYS DOH Medicaid Update that requires MLTC plan to help you ask for it. The procedures buy lasix for dogs in NYC are explained in this Troubleshooting guide. NYC Medicaid program prefers that your MLTC plan file the request, using Form MAP-3057E - Special income housing Expenses NH-MLTC.pdf and Form MAP-3047B - MLTC/NHED Cover Sheet Form MAP-259f (revised 7-31-18)(page 7 of PDF)(DIscharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard. GOVERNMENT DIRECTIVES (beginning with oldest).

NYS DOH 12- ADM-05 - Special Income Standard buy lasix for dogs for Housing Expenses for Individuals Discharged from a Nursing Facility who Enroll into the Managed Long Term Care (MLTC) Program Attachment II - OHIP-0057 - Notice of Intent to Change Medicaid Coverage, (Recipient Discharged from a Skilled Nursing Facility and Enrolled in a Managed Long Term Care Plan) Attachment III - Attachment III – OHIP-0058 - Notice of Intent to Change Medicaid Coverage, (Recipient Disenrolled from a Managed Long Term Care Plan, No Special Income Standard) MLTC Policy 13.02. MLTC Housing Disregard NYC HRA Medicaid Alert Special Income Standard for housing expenses NH-MLTC 2-9-2013.pdf 2018-07-28 HRA MICSA ALERT Special Income Standard for Housing Expenses for Individuals Discharged from a Nursing Facility and who Enroll into the MLTC Program - update on previous policy. References Form MAP-259f (revised 7-31-18)(page 7 of PDF)(Discharge Notice) - NH must file with HRA upon discharge, certifying resident was informed of availability of this disregard. GIS 18 MA/012 - Special Income Standard for Housing Expenses for Certain Managed Long-Term Care Enrollees Who are Discharged from a Nursing Home buy lasix for dogs issued Sept. 28, 2018 - this finally implements the most recent Special Terms &.

Conditions of the CMS 1115 Waiver that governs the MLTC program, dated Jan. 19, 2017. The section on this income standard is at pages 26-27. In these revised ST&C, this special income standard applies to people who were in a NH or adult home paid by Medicaid and "who enroll into or remain enrolled in the MLTC program in order to receive community based long term services and supports" and to those in a NH who were required to enroll into MLTC because of "...the mandatory Nursing Facility transition, and subsequently able to be discharged to the community from the nursing facility, with the services of MLTC program in place." September 2018 DOH Medicaid Update - explains this benefit to medical providers (nursing homes, MLTC plans, home care agencies, adult home operators, and requires them to identify potential individuals who could benefit and help them apply - described here..

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€˜None of us will be why do you have to take potassium with lasix safe until everyone is safe. Global access to hypertension treatments, tests and treatments for everyone who needs them, anywhere, is the only way out’ why do you have to take potassium with lasix. This statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO and Ursula von der Leyen, President of the European Commission1 has become the rallying call for hypertension medications vaccination.

The success of a safe and efficacious hypertension medications treatment depends just not only on production and availability but also crucially on uptake.In countries such as the UK where hypertension medications treatment prioritisation and rollout are proceeding quickly, attitudes to vaccination have rapidly become a priority.2 treatment hesitancy (‘behavioural delay in acceptance or refusal of treatments despite why do you have to take potassium with lasix availability of treatment services’)3 is not a single entity. Reasons vary and there is a why do you have to take potassium with lasix continuum from complete acceptance to refusal of all treatments, with treatment hesitancy lying between the two poles. Factors involved include confidence (trusting or not the treatment or provider), complacency (seeing the need or value of a treatment) and convenience (easy, convenient access to the treatment).3 4 Importantly, attitudes to vaccination can change and people who are initially hesitant can still come to see a treatment’s safety, efficacy and necessity.5Developing strategies to address hesitancy is key.6 The expedited development and relative novelty of the hypertension medications treatments have led to public uncertainty.4 In addition, efforts to explain the mode of action of these treatments involve a degree of complexity (eg, immune response and genetic mechanisms), which is difficult to communicate quickly and simply.

There are genuine knowledge voids (eg, long-term safety data), which in some cases why do you have to take potassium with lasix have been filled with misinformation.7 Recent studies have assessed potential acceptance rates specifically for the hypertension medications treatment. A UK study of more than 5000 adults using a validated scale found 71.7% were willing to be vaccinated, 16.6% were very unsure and 11.7% were strongly hesitant, with hesitancy relatively evenly spread across the population.8 Willingness to take a treatment was closely bound to recognition of the collective importance of this decision as well as beliefs about the likelihood of why do you have to take potassium with lasix hypertension medications , the efficacy, speed of development and side effects of the treatment. This implies that public information emphasising social benefits may be especially effective, at least in a majority of a population, and information that encourages mistrust or undermines social cohesion will lower treatment uptake.We also need to consider more focused strategies about treatment hesitancy for particular groups, including those groups who are most at risk of hesitancy and severe course of illness.

As mental health clinicians, we assessed the impact of mental health conditions on hypertension medications treatment hesitancy and searched for current guidance in this area using a validated approach.9 We found that there is currently no specific guidance in addressing treatment hesitancy in those with mental health difficulties,10 although it is recognised that this is a high-risk group who should be monitored why do you have to take potassium with lasix. People with mental health issues, particularly with severe mental illness (SMI), are at particular risk both for with hypertension medications and for more severe complications and higher mortality.11 Historically, the uptake of similar treatments such as the influenza treatment in those with SMI can be as low as 25%,12 and so, similar to other low uptake groups, focused efforts why do you have to take potassium with lasix are needed to increase this. Suggestions for change include offering specific discussions from mental health professionals and peer workers, treatment education and awareness focused for those with SMI, vaccination programmes within mental health services (with coexistent organisational change to facilitate this), alignment with other preventative health strategies (such as influenza vaccination, smoking cessation, metabolic monitoring), focused outreach and monitoring uptake.13Monitoring of vulnerable groups treatment uptake itself presents problems.

In the example of why do you have to take potassium with lasix the UK, monitoring of treatment coverage of most routine immunisation programmes relies on data extracted from primary care systems. To monitor vulnerable groups, the data need to why do you have to take potassium with lasix be specifically recorded. For example, Public Health England’s national immunisation equity audit in 2019 identified inequalities in uptake by a number of important variables (such as age, geography, ethnicity) but could not assess others including mental illness due to a lack of systematically collected data.14 Inequalities that were assessed by the audit were not only in overall coverage but also in timing of treatments and completion of treatment schedules.

In addition, the extent of a particular inequality varies when why do you have to take potassium with lasix it intersects with one or more other factors. In the case of mental illness, multiple long-term conditions across mental and physical health domains as well as socio-economic factors means that both vulnerability and inequality are likely to be additive.11 However, treatment impact may be greater among the most vulnerable despite lower treatment uptake because the baseline absolute risk is so high.15 Therefore, in the context of a hypertension medications treatment programme, even if treatment uptake falls short in some high-risk groups, even small increases in treatment uptake will still why do you have to take potassium with lasix have significant health benefits.14Uptake of vaccination is crucial both for the individual and protection of others. It is in everyone’s interests to ensure that groups where a low uptake is predicted have extra care and input.

At the moment there is little formal guidance on how to support those with mental health issues to access clear and reliable information, and practical and easy access to vaccination for those who are willing why do you have to take potassium with lasix. If we are to ensure that ‘everyone is safe’, we need a concerted and global effort16 to guide and focus strategies to support and inform those who are both potentially most hesitant and most vulnerable, including and prioritising those with mental health difficulties..

€˜None of us will be safe buy lasix for dogs until everyone http://www.ec-itterswiller.ac-strasbourg.fr/notre-fete-de-noel/ is safe. Global access to hypertension treatments, tests and buy lasix for dogs treatments for everyone who needs them, anywhere, is the only way out’. This statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO and Ursula von der Leyen, President of the European Commission1 has become the rallying call for hypertension medications vaccination.

The success of a safe and efficacious hypertension medications treatment depends just not only on production and buy lasix for dogs availability but also crucially on uptake.In countries such as the UK where hypertension medications treatment prioritisation and rollout are proceeding quickly, attitudes to vaccination have rapidly become a priority.2 treatment hesitancy (‘behavioural delay in acceptance or refusal of treatments despite availability of treatment services’)3 is not a single entity. Reasons vary and there is a continuum from complete acceptance to refusal of all treatments, with treatment hesitancy lying buy lasix for dogs between the two poles. Factors involved include confidence (trusting or not the treatment or provider), complacency (seeing the need or value of a treatment) and convenience (easy, convenient access to the treatment).3 4 Importantly, attitudes to vaccination can change and people who are initially hesitant can still come to see a treatment’s safety, efficacy and necessity.5Developing strategies to address hesitancy is key.6 The expedited development and relative novelty of the hypertension medications treatments have led to public uncertainty.4 In addition, efforts to explain the mode of action of these treatments involve a degree of complexity (eg, immune response and genetic mechanisms), which is difficult to communicate quickly and simply.

There are buy lasix for dogs genuine knowledge voids (eg, long-term safety data), which in some cases have been filled with misinformation.7 Recent studies have assessed potential acceptance rates specifically for the hypertension medications treatment. A UK study of more than 5000 adults using a validated scale found 71.7% were willing to be vaccinated, 16.6% were very unsure and 11.7% were strongly hesitant, with hesitancy relatively evenly spread across the population.8 Willingness to take a treatment was closely bound to recognition of the collective importance of this buy lasix for dogs decision as well as beliefs about the likelihood of hypertension medications , the efficacy, speed of development and side effects of the treatment. This implies that public information emphasising social benefits may be especially effective, at least in a majority of a population, and information that encourages mistrust or undermines social cohesion will lower treatment uptake.We also need to consider more focused strategies about treatment hesitancy for particular groups, including those groups who are most at risk of hesitancy and severe course of illness.

As mental health clinicians, we assessed the impact of mental health conditions on hypertension medications treatment hesitancy and searched for current guidance in this area using a validated approach.9 We found that there is currently no specific guidance in addressing treatment hesitancy in those with mental health difficulties,10 buy lasix for dogs although it is recognised that this is a high-risk group who should be monitored. People with mental health issues, particularly with severe mental illness (SMI), are at particular risk both for with hypertension medications and for more severe complications and higher mortality.11 Historically, the uptake of similar treatments such as the influenza treatment in those with SMI can be buy lasix for dogs as low as 25%,12 and so, similar to other low uptake groups, focused efforts are needed to increase this. Suggestions for change include offering specific discussions from mental health professionals and peer workers, treatment education and awareness focused for those with SMI, vaccination programmes within mental health services (with coexistent organisational change to facilitate this), alignment with other preventative health strategies (such as influenza vaccination, smoking cessation, metabolic monitoring), focused outreach and monitoring uptake.13Monitoring of vulnerable groups treatment uptake itself presents problems.

In the example of the UK, monitoring of treatment coverage buy lasix for dogs of most routine immunisation programmes relies on data extracted from primary care systems. To monitor vulnerable groups, the data need to be specifically recorded buy lasix for dogs. For example, Public Health England’s national immunisation equity audit in 2019 identified inequalities in uptake by a number of important variables (such as age, geography, ethnicity) but could not assess others including mental illness due to a lack of systematically collected data.14 Inequalities that were assessed by the audit were not only in overall coverage but also in timing of treatments and completion of treatment schedules.

In addition, the extent of a particular inequality varies when it intersects with one buy lasix for dogs or more other factors. In the case of mental illness, multiple long-term conditions across mental and physical health domains as well as socio-economic factors means that both vulnerability and inequality are likely to be additive.11 However, treatment impact may be greater among the most vulnerable despite lower treatment uptake because the baseline absolute risk is so buy lasix for dogs high.15 Therefore, in the context of a hypertension medications treatment programme, even if treatment uptake falls short in some high-risk groups, even small increases in treatment uptake will still have significant health benefits.14Uptake of vaccination is crucial both for the individual and protection of others. It is in everyone’s interests to ensure that groups where a low uptake is predicted have extra care and input.

At the moment there is little formal guidance on how to support those with mental buy lasix for dogs health issues to access clear and reliable information, and practical and easy access to vaccination for those who are willing. If we are to ensure that ‘everyone is safe’, we need a concerted and global effort16 to guide and focus strategies to support and inform those who are both potentially most hesitant and most vulnerable, including and prioritising those with mental health difficulties..

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