Medicine prescription – Clomiphene QB http://clomipheneqb.com/ Wed, 23 Nov 2022 01:58:24 +0000 en-US hourly 1 https://wordpress.org/?v=5.9 https://clomipheneqb.com/wp-content/uploads/2021/10/cropped-icon-32x32.png Medicine prescription – Clomiphene QB http://clomipheneqb.com/ 32 32 Now is not the time for the CDC to relax opioid prescribing guidelines https://clomipheneqb.com/now-is-not-the-time-for-the-cdc-to-relax-opioid-prescribing-guidelines/ Tue, 22 Nov 2022 22:44:48 +0000 https://clomipheneqb.com/now-is-not-the-time-for-the-cdc-to-relax-opioid-prescribing-guidelines/

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This month, the Centers for Disease Control and Prevention (CDC) released their 2022 Clinical practice guideline for prescribing opioids for pain. The report is an update of the previous 2016 Guidelines, but takes a step back in the national fight against the opioid crisis.

In response, Dr. Kenneth A. Scheppke, Florida Assistant Secretary of Health, wrote the response below. It was published in the Wall Street Journal on November 21, 2022.


The United States has been grappling with the opioid crisis for nearly two decades.

In 2020, more than 90,000 Americans died from drug overdoses, with 75% of those deaths involving opioids. More Americans aged 18 to 45 died from drug overdoses in 2020 than from traffic accidents and suicides combined.

Opioid use disorder is a life-threatening, chronic condition that people get from exposure to opioids, whether illicit or prescribed by a doctor. In recognition of this, in 2016 the Centers for Disease Control and Prevention highlighted the risks of overprescribing and the need to limit opioid prescriptions to three days for acute pain. He also recommended that doctors avoid increasing the dose beyond 90 milligrams of morphine per day.

Yet in early November, the CDC updated its clinical practice guideline for prescribing opioids for pain. The updated recommendations set aside the limitation of opioid therapy to three days and remove the dosage recommendation. The accompanying 2022 report even says, “Opioids can be essential medications for pain management; however, they carry considerable potential risk.

“Potential risk? In the 2016 report, opioids were described as posing “serious risks including overdose and opioid use disorder”. There’s nothing potential about that. Well While opioids may be necessary for serious conditions and end-of-life care, the general public should not be told that they are “essential” for pain management.

Many medical professionals who have entered the practice over the past few decades will identify with episodes of the Hulu series “Dopesick,” which tells the story of the dark years before the dangers of opioids were understood. Overprescription of opioids has led to addiction and dependence on illicit drugs. In one study, 80% of heroin users said they started using illicit drugs after being prescribed opioids. Therefore, the warning to prescribers should be that prescriptions are often the pathway to illicit drug addiction and have contributed to the fentanyl crisis. I suspect many doctors will wonder why the new report overturns sound advice and downplays the clear and proven danger of opioids.

In Florida, we have made great strides in understanding this disease and the need for non-opioid pain treatment options. Our state has taken aggressive action to address the deadly opioid crisis through evidence-based treatment, while ensuring that those who knowingly contribute to the spread of this disease are held accountable.

Yet there has been an explosion of deadly fentanyl in our state both as a replacement for older illicit opioids and as an additive in many other illicit drugs. Since 2015, fentanyl-related overdose deaths have increased by 790% in Florida.

In response to these alarming statistics, Governor Ron DeSantis earlier this year signed tougher penalties for criminals selling this poison in our communities and developed Florida’s Coordinated Opioid Recovery Network, or CORE, to help sufferers. substance use disorders.

The CORE Network recognizes substance use disorders as a chronic, lifelong condition. Overdose is a symptom of this disease. To disrupt the revolving door of overdose and recovery for people with substance use disorders, CORE Network connects overdose cases to long-term, sustainable recovery resources. If someone in a CORE county overdoses, Protocol 911 will begin stabilization while transporting the patient to a specialty hospital with expertise in addiction medicine. Once all emerging health threats are stabilized, the patient’s long-term health care needs are identified and addressed. Patients are then connected to organizations that support sustainable recovery, including access to drug treatments, primary care, dental care, workforce development and more.

The CORE Network does not require overdose to access sustainable care services and provides the resources needed to achieve personalized, evidence-based care to support lifelong recovery. Florida is working tirelessly to expand this treatment model as the standard of care for recovery.

The nation has taken action to address this man-made catastrophe of opioid addiction, with a significant portion of the blame being placed squarely on pharmaceutical companies. With approximately $50 billion in global settlements for opioid recovery funds, we are well on our way to securing the resources we need to end this deadly epidemic.

The opioid crisis was caused by greed. The health care system was led to believe that these drugs were safe. Pharmaceutical companies have fraudulently convinced governments of safety. Patients have been over-prescribed these substances with devastating consequences. We begin to learn from our mistakes, reduce the stigma, recognize this disorder as the brain disease that it is, and take steps towards a better future. Now is not the time for the CDC to relax its recommendations on opioids.


Dr. Kenneth A. Scheppke is a licensed physician who is also a dual-certified specialist in emergency medicine and the EMS subspecialty. Dr. Scheppke received his medical degree from the Renaissance School of Medicine at Stony Brook University. He completed his internship and residency at the Medical Center of Delaware where he was elected chief resident.

Dr. Scheppke has over 25 years of extensive experience in EMS, and his contributions to the field have earned him national recognition and awards. A major key accomplishment is his leadership in the development of the CORE Network, initially piloted in Palm Beach County where he serves as the Fire Department Medical Director.

About the CORE Network

If you suspect an overdose, call 911 immediately. The State of Florida has deployed Resources that can be posted in public spaces to ensure Floridians remain alert to signs of overdose, how to respond, and where help is available.

CORE has been successfully piloted in Palm Beach County for nearly two years and is expanding to other counties to help patients break free from the deadly cycle of overdoses. Floridians struggling with addiction can use CORE to stabilize and receive drug treatment from a network of specialized medical experts who will help guide them on a sustained path to healthy success.

CORE Network is a partnership between the Florida Department of Health and the Department of Children and Families. Florida is proud of its efforts in battling the opioid epidemic and continues to do so with access, evidence-based care, and comprehensive treatment for life. Information about CORE and various recovery resources.

About the Florida Department of Health

The department, nationally accredited by the Public Health Accreditation Board, strives to protect, promote, and improve the health of all Florida residents through integrated state, county, and from the community.

Follow us on Twitter at @HealthyFla and on Facebook. For more information about the Florida Department of Health, please visit www.FloridaHealth.gov.

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Space tomatoes and prescription yogurt incubator rocket to the ISS today – TechCrunch https://clomipheneqb.com/space-tomatoes-and-prescription-yogurt-incubator-rocket-to-the-iss-today-techcrunch/ Mon, 21 Nov 2022 14:32:48 +0000 https://clomipheneqb.com/space-tomatoes-and-prescription-yogurt-incubator-rocket-to-the-iss-today-techcrunch/

If astronauts are to undertake multi-year missions or establish a lasting presence on the Moon and Mars, they will need fresh food and medical supplies, not exactly easy to find off-planet. The latest shipment of supplies bound for the ISS includes a few new options, including yoghurt production and potentially delicious space tomatoes.

The tomatoes (seen above) are just the latest phase of a long experiment on the space station in growing edible plants in microgravity and artificial light. But while the past few years of work have focused on leafy greens like spinach and herbs, Veg-05 will examine how a juicy payload like a dwarf tomato grows in this unusual garden environment.

The mission will examine “light and fertilizer quality on fruit production, microbial food safety, nutritional value, crew acceptability of taste, and overall behavioral health benefits of having plants and fresh food in space”. Getting the light and nutrient flow parameters, so they provide different combinations of conditions, including different combinations of LED light, is essential to see which produces the best tomatoes during the growing period of 104 days.

Like terrestrial gardening, it is quite a demanding experience for the ISS crew. “Crew members tend to plants by opening wicks to help seedlings emerge, providing water, thinning seedlings, pollinating, and monitoring health and progress,” the description reads. . In the end, of course, they’ll eat at least a few, which will likely be a bittersweet moment after raising the plants from germination.

Nor will it be the only garden on the ISS. The October resupply mission brought up Plant Habitat-03, an experiment investigating epigenetic effects on plants in microgravity. Environmental changes can produce changes in how and which genes are expressed, and of course living in orbit is a substantial environmental change.

View of NASA’s Kennedy Space Center Advanced Plant Habitat (APH) during experiment verification testing for the Plant Habitat-03 survey.

We know that these changes occur in space, but we don’t know if the changes are heritable, or if certain strains or mutations will produce more space-friendly plant variants after these epigenetic changes. This study takes seeds produced in space and compares plants growing from them with seeds produced on the surface. With luck, we might find special adaptations to microgravity that allow plants to thrive in this unusual condition.

Some vitamins and minerals are also best fresh. And an interesting approach to making them on demand is to use beneficial microbes like those found in yogurt-like foods. BioNutrients-2 is the second phase of an attempt to create a shelf-stable pre-yogurt mix that, when hydrated, allows bacteria to naturally produce a target nutrient.

The experiment flying to the ISS today has three potential hosts: “yogurt, a different fermented dairy product called kefir, and a yeast drink. Each of these is designed to deliver specific nutritional products .

BioNutrients-2 yogurt bags on SABL tray mockup, after initial hydration. The blue color of the contents of the bag comes from the pH indicator. The SABL interface board, behind the bags, provides a reference for start and end colors.

Bacteria and yeasts are frequently modified for various purposes; one trend is bioreactors, where organisms produce a given molecule as part of their normal biological processes – a sugar like glucose, for example, but also more complex molecules like drugs. But whether and how to do it efficiently and easily in space, for human consumption, is an open question that this experiment aims to shed some light on.

That nice blue color will fade though – it’s a pH indicator and eventually the stuff takes on the color of yogurt.

In addition to food and culture, there are a variety of interesting medical experiments going on up there from these last resupply missions. Microgravity produces many interesting and sometimes deleterious effects on the human body, and not only that, but it affects possible treatments and their effectiveness. What if a given drug only works by gravity for some reason? You’d hate to find that halfway through Mars.

So we have a new biofabrication test, to see if human tissue can be efficiently (perhaps more efficiently!) grown and printed in microgravity; a “lunar microscope” intended for rapid and simple diagnosis in non-terrestrial conditions; “Falcon Goggles” which captures detailed images of the user’s eyes to see how microgravity can affect their functioning and adaptation; and a handful of other projects from various research institutes looking at how various in-orbit treatments or devices work.

You can watch the launch live here after around 1 p.m. PT.

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Free Limitation Warning: You Can Face £100 Fine For False Claim Even If Made In Mistake | Personal finance | Finance https://clomipheneqb.com/free-limitation-warning-you-can-face-100-fine-for-false-claim-even-if-made-in-mistake-personal-finance-finance/ Sat, 19 Nov 2022 06:01:00 +0000 https://clomipheneqb.com/free-limitation-warning-you-can-face-100-fine-for-false-claim-even-if-made-in-mistake-personal-finance-finance/

More than 10 million Britons rely on prescription drugs and in Wales and Scotland everyone can claim their drugs for free on the NHS. However, in England only different groups of people are eligible for free NHS prescriptions.

For example, people can apply for a free NHS prescription if, at the time the prescription is issued, they are over 60, under 16, or aged 16-18 and in full-time education .

When withdrawing their prescription, people must then tick the box on the prescription form corresponding to their situation.

Britons who ‘falsely’ or even ‘falsely’ claim they are entitled to a free prescription but are not actually entitled to it could face a £100 fine for ‘misleading’ the NHS.

If caught, they will likely be asked to pay the original NHS prescription or dental treatment fee and then the penalty fee on top of that.

READ MORE: Barclays is offering homeowners up to £2,000 to improve energy efficiency

Usually the fine is five times the original amount owed or up to £100.

The NHS can then also charge an additional £50 if a person does not pay within 28 days of receiving the penalty notice.

The NHS Business Services Authority (NHSBSA) is responsible for checking claims made for free NHS prescriptions and NHS dental care.

The group performs monthly random checks on prescription forms and dental claim forms to check for fraud and errors.

DO NOT MISS :

The calls are being made because paying for drugs could become even more unaffordable for low-income households, even with the current help some people can get.

A recent survey by the National Pharmacy Association found that nearly nine in ten pharmacists in England found they had patients who often went without prescription drugs because they could not afford to pay.

More than three-quarters of pharmacies in England said they have patients who sometimes go without prescription drugs because of the price.

The same number said it happened “one to five times a week.”

Commenting on the recent findings, Nick Kaye, Vice President of the National Pharmacy Association, said: “People should not be denied access to prescription drugs based on their ability to pay.

“For pharmacists, processing prescription fees is a task that adds workload but brings no benefit to the patient.

“We would like to see the prescription tax reformed or removed altogether, to remove this barrier to treatment.”

A DHSC spokesperson previously told Express.co.uk: “We recognize the pressures people are facing with the rising cost of living and we are taking action to support households, including freezing the cost of order for the first time in 12 years.

“Thanks to our extensive arrangements to help people pay NHS prescription costs, almost 89% of prescription items in England are already provided free of charge.”

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Americans’ use of prescription sleeping pills drops dramatically https://clomipheneqb.com/americans-use-of-prescription-sleeping-pills-drops-dramatically/ Fri, 18 Nov 2022 20:17:20 +0000 https://clomipheneqb.com/americans-use-of-prescription-sleeping-pills-drops-dramatically/

Research we monitor

After rising sharply for several decades, Americans’ use of prescription sleep aids is down sharply, a new study finds.

The study, published online July 12, 2022, by the Journal of Clinical Sleep Medicine, analyzed data from 29,400 adults collected from 2013 to 2018 as part of the National Health and Nutrition Survey. On three separate visits during this period, participants were presented with prescription bottles for all the medications they had used in the previous month. The researchers noted all medications used for sleep disorders (whether or not they were FDA-approved for this use) and looked at changes in their use over time.

Over the course of the study, the likelihood of participants using sleeping pills dropped by 31%. Notably, among participants 80 and older — who are most vulnerable to falls while using sleeping pills — researchers found an 86% reduction in use of FDA-approved sleeping pills.

Although the researchers said the COVID-19 pandemic may have since influenced the trend in sleeping pill use, they were encouraged by the study results. Medical and public health groups have strongly advised against the use of sleeping pills due to side effects such as dizziness and lightheadedness, which can lead to falls.

Image: © Prostock-Studio/Getty Images

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of the last revision or update of all articles.

Nothing on this site, regardless of date, should ever be used as a substitute for direct medical advice from your physician or other qualified clinician.

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Wheatland Union High School Hosts Prescription Drug Education Program | New https://clomipheneqb.com/wheatland-union-high-school-hosts-prescription-drug-education-program-new/ Fri, 18 Nov 2022 01:35:00 +0000 https://clomipheneqb.com/wheatland-union-high-school-hosts-prescription-drug-education-program-new/

On Wednesday, Wheatland Union High School held the “One Pill Can Kill” program to raise awareness in the community about prescription drug use, fentanyl and drug overdose treatments.

Lisa Phillips, director of health services at Wheatland Union High School District, said the district felt compelled to hold a fentanyl education event for the community given the number of reported overdoses nationwide. national.

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Ohio State experts to review FDA regulations on prescription opioids https://clomipheneqb.com/ohio-state-experts-to-review-fda-regulations-on-prescription-opioids/ Thu, 17 Nov 2022 13:59:05 +0000 https://clomipheneqb.com/ohio-state-experts-to-review-fda-regulations-on-prescription-opioids/

A team of experts from Ohio State University has been contracted through Brillient Corporation to conduct an independent review of regulatory actions and Food and Drug Administration decisions regarding currently approved opioid drugs.

The review, due for completion in January 2023, will also examine how to modify the agency’s approach to support the appropriate use of opioid painkillers in a broader public health context, said Patricia Zettler, associate professor at Moritz College. of Law at Ohio State, which is the subject leader for the team exam.

“The focus of our review is on the future,” Zettler said. “How could the FDA use the authority it has to better serve its public health mission, and what additional legal authorities might be useful to improve opioid regulation?”

In the United States, an average of 44 people died of prescription painkiller overdoses every day in 2020, accounting for nearly 18% of all opioid overdose deaths that year, according to the Centers for Disease Control and Prevention. The more than 16,000 overdose deaths in 2020 represented a 16% single-year increase in prescription opioid-related deaths.

A 2017 National Academies of Sciences, Engineering, and Medicine (NASEM) National Strategies for Addressing the Opioid Epidemic report recommended that the FDA seek this external review. The NASEM report, which was commissioned by the FDA, generally recommended that the FDA use a comprehensive approach to integrating public health considerations into the regulatory framework for prescription opioids, including consideration of benefits and risks for patients, households and society, as well as the integration of these considerations. considerations at the clinical development stage.

“One of the really difficult things is that these are not products without benefits,” Zettler said. “Prescription opioids have significant benefits for many patients in many different circumstances. It is therefore necessary to determine how to best maximize these benefits while minimizing the truly serious risks of the products.

Ohio State is home to a collection of scholars with the right mix of expertise in law, public health, pharmacy and medicine to address the many policy considerations involved, said Micah Berman, a team member at review, associate professor at the College of Public Health and Moritz. College of Law. Zettler and Berman both worked at the FDA in the past, and Zettler was a consultant to the NASEM committee that published the 2017 report.

“We have the interdisciplinary skills to look at the entire process, from clinical trial to design to some of the post-marketing issues, but also to look at issues of legal authority and how the FDA might want to reconsider the standards it uses for approvals or any new authority it may need,” Berman said. that it has come to, and the broader lessons that can be learned from the FDA’s past experience in regulating opioids – and to address these issues from the research side, the clinical side and the legal side all at a time.

Joining Zettler and Berman for the review are Ohio State scholars Kathy Lancaster, associate professor of epidemiology at the College of Public Health; Macarius Donneyong, assistant professor of outcomes and translational sciences at the College of Pharmacy and College of Public Health; and Marty Fried, clinical assistant professor of internal medicine at the College of Medicine.

In a recent blog post, FDA Commissioner Robert Califf outlined the upcoming review.

“While previous FDA strategies focused largely on opioid use and overdose, the evolving nature of the overdose crisis calls for both a new approach and honest reflection on what the FDA can do differently to the future. … We initiated this review with the goal of understanding what revisions are needed to support the appropriate use of opioid pain relievers. Our “lessons learned” will actively inform our future approach,” he wrote.

The opioid crisis was determined in 2017 as a public health emergency, and that designation is still in effect, Califf wrote, noting that illicit opioids — particularly heroin, fentanyl, and compounds with similar chemical structures – contribute enormously to the problem of abuse and death by overdose.

For the purposes of this review, the focus will continue to be on regulatory activities related to existing prescription opioid drugs, as well as new pain management products that will be submitted for approval in the future.

“It’s commendable that the government is seeking outside feedback on its approach, especially to such a large and complicated issue,” Zettler said. “While there likely isn’t a one-size-fits-all solution, we look forward to using our expertise to help serve public health and help inform agency regulatory decisions.”

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Will the Reducing Inflation Act reduce my costs for prescription drugs? https://clomipheneqb.com/will-the-reducing-inflation-act-reduce-my-costs-for-prescription-drugs/ Thu, 17 Nov 2022 10:30:00 +0000 https://clomipheneqb.com/will-the-reducing-inflation-act-reduce-my-costs-for-prescription-drugs/

Q. My wife and I used to pay a $0 co-pay for our satin prescriptions, but when we turned 76 we had to pay a co-pay. Will this new inflation bill help?

— Hoping to save money

A. No one wants to pay a copayment for drugs if they don’t have to.

This is especially true for those on fixed incomes in these times of inflation.

There is still much to discover about the Cut Inflation Act of 2022 and whether it will help your specific situation.

Here are some things to consider about the law, which includes several provisions aimed at lowering prescription drug costs for people with Medicare and reducing federal drug spending.

Prices for a small number of single-source brands can be negotiated under Medicare Part D, starting in 2026, and under Part B, starting in 2028, said Evan Drury, licensed financial consultant. at US Financial Services in Fairfield.

Subject to price negotiation, 10 Part D drugs for 2026, 15 Part D drugs for 2027, 15 Part D and Part B drugs for 2028, 20 Part D and Part B drugs for 2029 and beyond, Drury said.

“These drugs will be selected from the 50 drugs with the highest Medicare Part D total spend and the 50 drugs with the highest Medicare Part B total spend,” he said. “The number of available negotiated price drugs will accumulate over time.”

Some drugs will be excluded from negotiations, he said. These include those that are generic and those that are less than nine years (for small molecule drugs) or 13 years (for biologics) from their date of FDA approval or clearance.

Additionally, so-called “small biotech drugs” will be excluded until 2029. These are defined as those that account for 1% or less of Part D or Part B expenditures and account for 80% or more of expenses of each party on this manufacturer. drugs, he said.

In addition, drugs with Medicare expenditures of less than $200 million in 2021, which will be increased by the CPI-U for subsequent years, will be excluded, along with all plasma-derived products, he said. he declares.

Also important to note: The Inflation Reduction Act requires drug manufacturers to pay a rebate to the federal government if the prices of single-source drugs and biologics covered by Medicare Part B disease and nearly all drugs covered by Part D are rising faster than the rate of inflation (CPI-U), Drury said.

But not all drugs will have discounts and it seems unclear which drugs will have discounts at present, he said.

Overall, the legislation allocates $160 million in funding over 10 years (2022-2031) to the Centers for Medicare & Medicaid Services (CMS) to implement inflation reimbursement provisions ($80 million). dollars for Part B and $80 million for Part D), he said. .

“The Part D inflation reimbursement provision comes into effect in 2022, the starting point for measuring drug price increases, with reimbursement payments required from 2023. Part B inflation takes effect in 2023,” he said.

Consider consulting a health insurance professional with any questions about this.

Send your questions to Ask@NJMoneyHelp.com.

Karin Price Mueller writes the Bamboos column for NJ Advance Media and is the founder of NJMoneyHelp.com. Follow NJMoneyHelp on Twitter @NJMoneyHelp. To find NJMoneyHelp on Facebook. Register for NJMoneyHelp.comit is weekly e-newsletter.


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A Shared Mission and a Team Approach: A Prescription for Rewriting the History of Black Maternal Health in America | https://clomipheneqb.com/a-shared-mission-and-a-team-approach-a-prescription-for-rewriting-the-history-of-black-maternal-health-in-america/ Wed, 16 Nov 2022 22:39:00 +0000 https://clomipheneqb.com/a-shared-mission-and-a-team-approach-a-prescription-for-rewriting-the-history-of-black-maternal-health-in-america/

Ms. S, a 33-year-old black woman living in Philadelphia, had an uncomplicated pregnancy until she was 38 weeks old. It was then that, during a visit to the practice, we learned that she was suffering from high blood pressure for the first time. Given the progress of her pregnancy and the risks of this new disease, we recommended inducing her labour. Her labor and the birth of her baby went well, but immediately after delivery she started bleeding profusely – she had a postpartum hemorrhage. A hemorrhage cart, carrying all the drugs and tools needed to respond, was rushed into the room. A coordinated and rapid response from our team got her bleeding under control, and she was safely sent home with her baby, while being enrolled in a remote blood pressure monitoring program to watch for any dangers that may arise even after returning home.

Sadly, this story is all too familiar to our county’s birthing hospitals. There is a crisis in maternal health care in the United States. Not only is the maternal mortality rate in the United States higher than that of any other industrialized country, but black women continue to die from pregnancy-related causes at alarming rates. The black-white mortality gap in pregnancy-related deaths has persisted for decades, with black women dying at rates three to four times higher than white women. For every maternal death, more than 100 women experience a serious complication during or shortly after pregnancy, and these events are much more likely to occur in black women. But that doesn’t have to be the case: the majority of maternal deaths are preventable.

While continuing nationwide efforts to improve maternal morbidity and mortality and working to eliminate disparities are essential, a specific focus on health care delivery is essential. We need to make changes that deliver care to patients when and where they need it – in hospital rooms, outpatient clinics, and even in their homes.

Mrs. S’s story is not unique, and it highlights the need for a coordinated team to recognize and respond to the most common postpartum complications. A hemorrhage like hers is one of the leading causes of maternal death. Additionally, pregnancy-related high blood pressure is one of the leading causes of illness among new moms, even after they return home.

Changes in healthcare have led to increased consolidation, with the formation of multi-hospital systems – 67% of US hospitals are now affiliated with a healthcare system in some way. The same model applied throughout our region. These organizational changes provide a unique opportunity to use a “systems” approach to address maternal morbidity and mortality and to embed equity into quality improvement efforts across multiple hospitals. This allows for a “learning lab” where we can quickly measure whether our efforts are working, and successes can be accelerated to help more women. In order to capitalize on this opportunity, health systems – large and small, urban, suburban or rural – must set expectations for a collaborative approach with a clear and common goal.

In 2020, our healthcare system – which spans a wide geographic footprint, including five hospitals that provide obstetric care and assist 20,000 births annually in Philadelphia and surrounding Pennsylvania and New Jersey – has set itself a bold goal that places women’s health as a central pillar of system success. This included a measurable, system-wide goal to reduce maternal morbidity and mortality among Black women, who account for 28% of the nearly 20,000 deliveries in our hospitals each year. The purpose of the framework was to create a “system,” a system-wide shared goal, to enable faster dissemination of best practices to reduce severe maternal mortality among black women much faster than any individual hospital could not do it alone.

This system-wide setup created a team culture that allowed each hospital to share best practices and learn from other proven approaches that they may not have yet implemented. Previously, for example, patients pregnant with twins who had large uterine fibroids might not have been identified as high risk for postpartum hemorrhage in a hospital in our system, but would have been identified as such in a another hospital. Together, we’ve standardized our approach with a bleeding risk assessment tool that ensures patients like this are identified as high risk across all of our hospitals and receive the right care in every location.

In addition to standardizing our methods for being prepared, recognizing and responding to patients with postpartum hemorrhage, we also shared research on strategies to reduce rates of cesarean delivery and birth complications in order to stimulate discussions on other interventions that may have an impact on maternal morbidity and mortality. For example, we made changes to the care of patients with anemia during pregnancy and standardized the processes used to induce labor to reduce cesarean delivery and other complications. And we’ve extended our care through text messaging and remote monitoring to monitor dangerous conditions that can arise even after patients return from the hospital. This text-based follow-up after pregnancy-related high blood pressure is the standard of care across our system.

The focus on equity is at the heart of all this work. We launched implicit bias training to eradicate discrimination that can impact patient care, conducted staff and provider surveys, conducted an education and awareness campaign, and invited guest speakers to expand our prospects. Above all, we have developed a dashboard to regularly monitor and communicate our progress to all members of the care teams.

In our first year, these efforts resulted in a 30% reduction in maternal morbidity and mortality among Black women system-wide, compared to the previous year. We have now expanded our efforts to focus on improving outcomes for all pregnant patients of color. We know that this work is a journey, that each year we will encounter new challenges, and even setbacks, which will remind us of the urgency and necessity of our work to overcome the sustained perils of giving birth as a black woman in America. . .

A patchwork of advocacy, good intentions, pilot programs and even new laws are not enough to reverse what has become a shameful part of American health care. We can make a difference through a deliberate, system-wide approach and quality improvement efforts that put equity first. Behind all of this, we must deploy a fundamental and unwavering commitment to breaking the cycle that too often costs the lives of black women while those of their children are just beginning.

Sindhu K. Srinivas, MD, MSCE, is the Physician Lead, Women’s Health Service Line and Maternal Fetal Medicine Clinician at Penn Medicine. Elizabeth A. Howell, MD, MPP, is chair of the Department of Obstetrics and Gynecology at Penn Medicine. Kevin B. Mahoney is the CEO of the University of Pennsylvania Health System.

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Prescription Gin removed an “irresponsible” design https://clomipheneqb.com/prescription-gin-removed-an-irresponsible-design/ Wed, 16 Nov 2022 11:48:08 +0000 https://clomipheneqb.com/prescription-gin-removed-an-irresponsible-design/

Personalized gift company Mixpixie has agreed to discontinue its Prescription Gin after a complaint was upheld over its medicine-inspired bottle design.

Prescription Gin’s label featured a green pharmacy cross

Industry watchdog the Portman Group has received a complaint from a member of the public against Mixpixie’s Prescription Gin. It was upheld on two counts, the gin having been found to encourage irresponsible and immoderate consumption, and implying that it had therapeutic qualities.

The Independent Complaints Committee (ICP) noted that the bottle was designed to look like a prescription drug due to the shape of the bottle, its name and the use of a green cross on the label, which was an exact copy of the UK Pharmacy Cross.

The bottle also included the text “Take a sip before each exam”. Good luck ! , which the jury considered as an encouragement to drink before an exam.

The front of the bottle also had the words “Possible side effects: may include extreme relaxation, dizziness and happiness.” This implies a link between consumption and recovery from physical and mental ailments, the ICP found.

The gin broke the irresponsible drinking rule because it suggested the drink would make a consumer feel “better”, the panel noted. Also, listing “dizziness” as a “possible side effect” implied that some level of alcohol would have been consumed, the ICP added.

ICP President Nicola Williams said: ‘It is totally irresponsible to present an alcoholic drink as a prescription drug and to suggest that its consumption can cure mental and physical ailments.

“In this case, the product also created a link with irresponsible and immoderate consumption, which was of particular concern when the product encouraged consumption based on health reasons. Caution should be exercised with tongue-in-cheek marketing so that it does not violate the Code.

Following the complaint, Mixpixie said they added the text: “Please note that these are not real prescriptions, these are fake labels intended for use as humorous gin.” Please drink in moderation’ as a mandatory checkbox for the customer before placing the order and on the bottle labels.

Mixpixie has agreed to quit gin and will work with the Portman Group on designing a new label.

In July 2022 complaints against a trio of gins, including two Marks & Spencer liqueurs, were upheld for appealing to under-18s and failing to clearly communicate their alcohol content.

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Drug wholesaler backs pharmacists’ warning over supply of prescription drugs in Northern Ireland https://clomipheneqb.com/drug-wholesaler-backs-pharmacists-warning-over-supply-of-prescription-drugs-in-northern-ireland/ Tue, 15 Nov 2022 22:49:26 +0000 https://clomipheneqb.com/drug-wholesaler-backs-pharmacists-warning-over-supply-of-prescription-drugs-in-northern-ireland/
Pharmacy

An organization representing hundreds of local pharmacies, Community Pharmacy NI, issued a stern warning last month that drugs used to treat health conditions including osteoporosis, high blood pressure, insomnia, mental health and coronary heart disease, could soon be unavailable with a “very real” threat. to the supply.

The Department of Health, however, highlighted “immediate interventions worth over £5.3million” which it said would help pharmacists cope with rising costs.

Now, however, the managing director of Northern Ireland’s biggest pharmacy wholesaler, Numark, has said the £5.3million offered by Stormont’s government is not enough.

In a statement, Jeremy Meader from Numark said: “It simply cannot be acceptable that if the situation deteriorates further there is a real risk that community pharmacists will no longer be able to afford commonly prescribed medicines.”

He continued: “Clients tell us they have never seen such astronomical prices and fluctuations which, combined with drug shortages and underfunding, pose a significant risk to patient access. to essential care. These are not created by wholesalers, but a reimbursement mechanism that is no longer suitable for today’s medicine supply chain in Northern Ireland.”

Mr Meader added: “The Department’s recent offer of £5.3million is well below Community Pharmacy Northern Ireland’s (CPNI) estimate of what is needed to meet a cut in funding. £20m to £30m.”

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