Escaped Brooklyn for a few days. *edit* the steak

Smoke some weed. Feel a little better. From the FD

Cost of propecia generic

hair loss treatment impact on cisgender gay cost of propecia generic men and other men who have sex with men (MSM) on a global scaleThe hair loss treatment propecia is thought to disproportionately threaten the health of underserved and underinvestigated populations. To investigate the impact of hair loss treatment transmission mitigation cost of propecia generic measures on MSM, an international team did a cross-sectional study that included 2732 MSM from 103 countries who responded to a questionnaire distributed through a gay social networking app. Findings suggest that the spread of hair loss treatment, and the global response to contain it, has variably disrupted economic, mental health, general health and clinical services among MSM populations, with a greater impact on those living with HIV, racial/ethnic minorities, immigrants, sex workers and socioeconomically disadvantaged groups.

As hair loss treatment may deepen health disparities and social inequalities, continued monitoring and creative strategies are needed to mitigate reduction in access to services for MSM with intersecting vulnerabilities.Santos GM, Ackerman B, Rao A, et cost of propecia generic al. Economic, mental health, HIV prevention and HIV treatment impacts of hair loss treatment and the hair loss treatment response on a global sample of cisgender gay men and other men who have sex with men. AIDS Beha cost of propecia generic 2020.

11:1â11.https://doi.org/10.1007/s10461-020-02969-0Influence of sexual positioning on syphilis acquisition and its stage at cost of propecia generic diagnosisIn a retrospective study of MSM in Melbourne, Australia, researchers examined the association between sexual positioning and a diagnosis of primary (n=338) or secondary (n=221) syphilis. Of 247 penile chancres, 244 (98.7%) occurred in MSM who reported versatile or exclusive top sexual positioning. Of 77 anal chancres, 75 (97.4%) occurred in MSM who reported versatile or exclusive bottom sexual positioning cost of propecia generic.

MSM who practised receptive anal sex were more likely to present with secondary rather than primary syphilis (OR 3.90. P<0.001, adjusted for age, HIV status and condom cost of propecia generic use). This suggests that because anorectal chancres are less noticeable, they are less likely to prompt evaluation.

Findings highlight the cost of propecia generic need for improved screening of MSM who report receptive anal sex to ensure early syphilis detection and treatment.Cornelisse VJ, Chow EPF, Latimer RL, et al. Getting to cost of propecia generic the bottom of it. Sexual positioning and stage of syphilis at diagnosis, and implications for syphilis screening.

Clin Infect cost of propecia generic Dis 2020;71(2):318â322. Https://doi.org/10.1093/cid/ciz802A novel rapid, point-of-care test (POCT) for confirmatory testing of active syphilis The re-emergence of syphilis is a global public health concern especially in resource-limited settings. Current POCTs detect Treponema pallidum (TP) total antibodies but do not distinguish between active and past/treated syphilis, resulting in potential overtreatment and contributing to cost of propecia generic shortages of penicillin.

A new, investigational POCT based on the detection of TP-IgA was evaluated against standard laboratory-based serological tests in 458 stored plasma samples from China and 503 venous blood samples from South Africa. Sensitivity and specificity of TP-IgA cost of propecia generic POCT for identifying active syphilis were 96.1% (95% CI. 91.7% to cost of propecia generic 98.5%) and 84.7% (95% CI.

80.1% to 88.6%) in Chinese samples, and 100% (95% CI. 59% to cost of propecia generic 100%) and 99.4% (95% CI. 98.2% to 99.9%) in South African samples, respectively.

These preliminary findings suggest that this TP-IgA-based POCT meets the WHO target product profile for confirmatory diagnosis cost of propecia generic of active syphilis.Pham MD, Wise A, Garcia ML, et al. Improving the coverage and accuracy of syphilis testing. The development of a novel rapid, point-of-care test cost of propecia generic for confirmatory testing of active syphilis and its early evaluation in China and South Africa.

EClinicalMedicine 2020;24:100440 cost of propecia generic. Https://doi.org/10.1016/j.eclinm.2020.100440Early antiretroviral therapy (ART) initiation and wide coverage reduces population-level HIV s in FranceIn 2013, France implemented the early initiation of ART irrespective of CD4 counts to fast-track progress toward UNAIDS (Joint United Nations Programme on HIV/AIDS) 90-90-90 goals (90% of people with HIV diagnosed, 90% on ART, 90% virologically suppressed).1 An analysis of 61 822 HIV-diagnosed people within the national DatâAIDS prospective cohort study shows that 91.9% of HIV-diagnosed people were receiving ART by 2014 and 90.5% were virologically suppressed by 2013. This was accompanied by a 36% and 25% decrease in the number of primary (diagnosed with symptoms of acute HIV) and recent HIV (diagnosed with CD4 cell count â¥500/mm3), cost of propecia generic respectively, between 2013 and 2017.

These findings on two of three goals support the effectiveness of âTreatment as Preventionâ in dramatically reducing HIV incidence at the population level.Le Guillou A, Pugliese P, Raffi F, Cabie A, Cuzin L, Katlama C, et al. Reaching the second and third joint United Nations Programme on Human Immunodeficiency propecia (HIV)/AIDS 90-90-90 targets is accompanied by a cost of propecia generic dramatic reduction in primary HIV and in recent HIV s in a large French nationwide HIV cohort. Clinical Infectious Diseases 2019;71(2):293â300.

Https://doi.org/10.1093/cid/ciz800No evidence of an association between human papillomapropecia (HPV) vaccination and infertilityDespite well-established evidence of effectiveness and safety, HPV treatment cost of propecia generic uptake remains below target in many countries, often due to safety concerns. To evaluate claims that HPV vaccination increases female infertility, researchers analysed 2013â2016 National Health and Nutrition Examination Survey data from 1114 US women aged 20 to 33 yearsâthose young enough to have been offered HPV treatments and old enough cost of propecia generic to have been asked about infertility. The 8.1% of women who self-reported infertility were neither more nor less likely to have received an HPV treatment.

Vaccinated women who had ever cost of propecia generic been married were less likely to report infertility. Findings should engender confidence among healthcare providers, whose recommendation is a key factor in patientsâ acceptance of HPV vaccination.Schmuhl N, Mooney KE, Zhang X, Cooney LG, Conway JH, and LoCont NK. No association between HPV vaccination and infertility cost of propecia generic in U.S.

Females 18â33 years old. treatment 2020;38(24):4038â4043 cost of propecia generic. Https://doi.org/10.1016/j.treatment.2020.03.035A pay-it-forward approach to improve uptake of gonorrhoea and chlamydia testingDespite WHO recommendations that MSM receive gonorrhoea and chlamydia cost of propecia generic testing, affordability remains a barrier in many countries.

In a randomised trial, researchers tested three incentivising strategies, randomising 301 MSM in MSM-run community-based organisations in Guangzhou and Beijing, China. Gonorrhoea and chlamydia test uptake was 56% in cost of propecia generic the pay-it-forward arm (free testing and an invitation to donate to a future personâs test), 46% in a pay-what-you-want arm and 18% in the standard-cost arm (Â¥150, â¬1.2). The estimated difference in test uptake between pay-it-forward and standard cost was 38.4% (95% CI lower bound 28.4%).

Almost 95% of cost of propecia generic MSM in the pay-it-forward arm donated to testing for future participants. The pay-it-forward strategy significantly increased gonorrhoea and chlamydia testing uptake in China and has potential to drive testing in other settings.Yang F, Zhang TP, Tang W, Ong JJ, Alexander M, Forastiere L, Kumar N, Li KT, Zou F, Yang L, Mi G, Wang Y, Huang W, Lee A, Zhu W, Luo D, Vickerman P, Wu D, Yang B, Christakis NA, Tucker JD. Pay-it-forward gonorrhoea and chlamydia testing among men who have sex cost of propecia generic with men in China.

A randomised cost of propecia generic controlled trial. Lancet Infect Dis 2020;20(8)976-982. Https://doi.org/10.1016/S1473-3099(20)30172-9The Shape of Training review1 and the Future Hospital Commission2 identified the need for cost of propecia generic a reform of postgraduate medical training in the UK for doctors to adapt to changing population and service needs.

The focus of postgraduate training needed to move from a âtime-servedâ approach to a competency-based one with doctors developing high-level learning outcomes, capabilities in practice (CiPs). The General Medical Council (GMC) also recommended cost of propecia generic that all revised curricula from 2020 should include generic professional capabilities (GPCs), including communication, leadership, multidisciplinary teamwork and patient safety, which are crucial to safe and effective patient care.Genitourinary medicine (GUM), along with many other physicianly specialities, will adopt a dual training model from August 2022, leading to accreditation in both GUM and general internal medicine (GIM). The GUM curriculum will continue to offer training in the diagnosis, investigation and management of sexually transmitted s and related conditions, contraception, HIV inpatient and outpatient care, management of â¦.

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Start Preamble propecia crash Notice of amendment. The Secretary issues this amendment pursuant to section 319F-3 of the Public Health Service Act to add additional categories of Qualified Persons and amend the category of propecia crash disease, health condition, or threat for which he recommends the administration or use of the Covered Countermeasures. This amendment to the Declaration published on March 17, 2020 (85 FR 15198) is effective as of August 24, 2020.

Start Further Info propecia crash Robert P. Kadlec, MD, MTM&H, MS, Assistant Secretary for Preparedness and Response, Office of the Secretary, Department of Health and Human Services, 200 Independence Avenue SW, Washington, DC 20201. Telephone.

202-205-2882. End Further Info End Preamble Start Supplemental Information The Public Readiness and Emergency Preparedness Act (PREP Act) authorizes the Secretary of Health and Human Services (the Secretary) to issue a Declaration to provide liability immunity to certain individuals and entities (Covered Persons) against any claim of loss caused by, arising out of, relating to, or resulting from the manufacture, distribution, administration, or use of medical countermeasures (Covered Countermeasures), except for claims involving âwillful misconductâ as defined in the PREP Act. Under the PREP Act, a Declaration may be amended as circumstances warrant.

The PREP Act was enacted on December 30, 2005, as Public Law 109-148, Division C, Â§â2. It amended the Public Health Service (PHS) Act, adding section 319F-3, which addresses liability immunity, and section 319F-4, which creates a compensation program. These sections are codified at 42 U.S.C.

247d-6d and 42 U.S.C. 247d-6e, respectively. Section 319F-3 of the PHS Act has been amended by the propecia and All-Hazards Preparedness Reauthorization Act (PAHPRA), Public Law 113-5, enacted on March 13, 2013 and the hair loss Aid, Relief, and Economic Security (CARES) Act, Public Law 116-136, enacted on March 27, Start Printed Page 521372020, to expand Covered Countermeasures under the PREP Act.

On January 31, 2020, the Secretary declared a public health emergency pursuant to section 319 of the PHS Act, 42 U.S.C. 247d, effective January 27, 2020, for the entire United States to aid in the response of the nation's health care community to the hair loss treatment outbreak. Pursuant to section 319 of the PHS Act, the Secretary renewed that declaration on April 26, 2020, and July 25, 2020.

On March 10, 2020, the Secretary issued a Declaration under the PREP Act for medical countermeasures against hair loss treatment (85 FR 15198, Mar. 17, 2020) (the Declaration). On April 10, the Secretary amended the Declaration under the PREP Act to extend liability immunity to covered countermeasures authorized under the CARES Act (85 FR 21012, Apr.

15, 2020). On June 4, the Secretary amended the Declaration to clarify that covered countermeasures under the Declaration include qualified countermeasures that limit the harm hair loss treatment might otherwise cause. The Secretary now amends section V of the Declaration to identify as qualified persons covered under the PREP Act, and thus authorizes, certain State-licensed pharmacists to order and administer, and pharmacy interns (who are licensed or registered by their State board of pharmacy and acting under the supervision of a State-licensed pharmacist) to administer, any treatment that the Advisory Committee on Immunization Practices (ACIP) recommends to persons ages three through 18 according to ACIP's standard immunization schedule (ACIP-recommended treatments).[] The Secretary also amends section VIII of the Declaration to clarify that the category of disease, health condition, or threat for which he recommends the administration or use of the Covered Countermeasures includes not only hair loss treatment caused by hair loss or a propecia mutating therefrom, but also other diseases, health conditions, or threats that may have been caused by hair loss treatment, hair loss, or a propecia mutating therefrom, including the decrease in the rate of childhood immunizations, which will lead to an increase in the rate of infectious diseases.

Description of This Amendment by Section Section V. Covered Persons Under the PREP Act and the Declaration, a âqualified personâ is a âcovered person.â Subject to certain limitations, a covered person is immune from suit and liability under Federal and State law with respect to all claims for loss caused by, arising out of, relating to, or resulting from the administration or use of a covered countermeasure if a declaration under subsection (b) has been issued with respect to such countermeasure. ÂQualified personâ includes (A) a licensed health professional or other individual who is authorized to prescribe, administer, or dispense such countermeasures under the law of the State in which the countermeasure was prescribed, administered, or dispensed.

Or (B) âa person within a category of persons so identified in a declaration by the Secretaryâ under subsection (b) of the PREP Act. 42 U.S.C. 247d-6d(i)(8).[] By this amendment to the Declaration, the Secretary identifies an additional category of persons who are qualified persons under section 247d-6d(i)(8)(B).[] On May 8, 2020, CDC reported, âThe identified declines in routine pediatric treatment ordering and doses administered might indicate that U.S.

Children and their communities face increased risks for outbreaks of treatment-preventable diseases,â and suggested that a decrease in rates of routine childhood vaccinations were due to changes in healthcare access, social distancing, and other hair loss treatment mitigation strategies.[] The report also stated that â[p]arental concerns about potentially exposing their children to hair loss treatment during well child visits might contribute to the declines observed.ââ[] On July 10, 2020, CDC reported its findings of a May survey it conducted to assess the capacity of pediatric health care practices to provide immunization services to children during the hair loss treatment propecia. The survey, which was limited to practices participating in the treatments for Children program, found that, as of mid-May, 15 percent of Northeast pediatric practices were closed, 12.5 percent of Midwest practices were closed, 6.2 percent of practices in the South were closed, and 10 percent of practices in the West were closed. Most practices had reduced office hours for in-person visits.

When asked whether their practices would likely be able to accommodate new patients for immunization services through August, 418 practices (21.3 percent) either responded that this was not likely or the practice was permanently closed or not resuming immunization services for all patients, and 380 (19.6 percent) responded that they were unsure. Urban practices and those in the Northeast were less likely to be able to accommodate new patients compared with rural practices and those in the South, Midwest, or West.[] In response to these troubling developments, CDC and the American Academy of Pediatrics have stressed, âWell-child visits and vaccinations are essential services and help make sure children are protected.ââ[] The Secretary re-emphasizes that important recommendation to parents and legal guardians here. If your child is due for a well-child visit, contact your pediatrician's or other primary-care provider's office and ask about ways that the office safely offers well-child visits and vaccinations.

Many medical offices are taking extra steps to make sure that well-child visits can occur safely during the hair loss treatment propecia, including. Scheduling sick visits and well-child visits during different times of the Start Printed Page 52138day or days of the week, or at different locations. Asking patients to remain outside until it is time for their appointments to reduce the number of people in waiting rooms.

Adhering to recommended social (physical) distancing and other -control practices, such as the use of masks. The decrease in childhood-vaccination rates is a public health threat and a collateral harm caused by hair loss treatment. Together, the United States must turn to available medical professionals to limit the harm and public health threats that may result from decreased immunization rates.

We must quickly do so to avoid preventable s in children, additional strains on our healthcare system, and any further increase in avoidable adverse health consequencesâparticularly if such complications coincide with additional resurgence of hair loss treatment. Together with pediatricians and other healthcare professionals, pharmacists are positioned to expand access to childhood vaccinations. Many States already allow pharmacists to administer treatments to children of any age.[] Other States permit pharmacists to administer treatments to children depending on the ageâfor example, 2, 3, 5, 6, 7, 9, 10, 11, or 12 years of age and older.[] Few States restrict pharmacist-administered vaccinations to only adults.[] Many States also allow properly trained individuals under the supervision of a trained pharmacist to administer those treatments.[] Pharmacists are well positioned to increase access to vaccinations, particularly in certain areas or for certain populations that have too few pediatricians and other primary-care providers, or that are otherwise medically underserved.[] As of 2018, nearly 90 percent of Americans lived within five miles of a community pharmacy.[] Pharmacies often offer extended hours and added convenience.

What is more, pharmacists are trusted healthcare professionals with established relationships with their patients. Pharmacists also have strong relationships with local medical providers and hospitals to refer patients as appropriate. For example, pharmacists already play a significant role in annual influenza vaccination.

In the early 2018-19 season, they administered the influenza treatment to nearly a third of all adults who received the treatment.[] Given the potential danger of serious influenza and continuing hair loss treatment outbreaks this autumn and the impact that such concurrent outbreaks may have on our population, our healthcare system, and our whole-of-nation response to the hair loss treatment propecia, we must quickly expand access to influenza vaccinations. Allowing more qualified pharmacists to administer the influenza treatment to children will make vaccinations more accessible. Therefore, the Secretary amends the Declaration to identify State-licensed pharmacists (and pharmacy interns acting under their supervision if the pharmacy intern is licensed or registered by his or her State board of pharmacy) as qualified persons under section 247d-6d(i)(8)(B) when the pharmacist orders and either the pharmacist or the supervised pharmacy intern administers treatments to individuals ages three through 18 pursuant to the following requirements.

The treatment must be FDA-authorized or FDA-approved. The vaccination must be ordered and administered according to ACIP's standard immunization schedule.[] The licensed pharmacist must complete a practical training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education (ACPE). This training Start Printed Page 52139program must include hands-on injection technique, clinical evaluation of indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments.[] The licensed or registered pharmacy intern must complete a practical training program that is approved by the ACPE.

This training program must include hands-on injection technique, clinical evaluation of indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments.[] The licensed pharmacist and licensed or registered pharmacy intern must have a current certificate in basic cardiopulmonary resuscitation.[] The licensed pharmacist must complete a minimum of two hours of ACPE-approved, immunization-related continuing pharmacy education during each State licensing period.[] The licensed pharmacist must comply with recordkeeping and reporting requirements of the jurisdiction in which he or she administers treatments, including informing the patient's primary-care provider when available, submitting the required immunization information to the State or local immunization information system (treatment registry), complying with requirements with respect to reporting adverse events, and complying with requirements whereby the person administering a treatment must review the treatment registry or other vaccination records prior to administering a treatment.[] The licensed pharmacist must inform his or her childhood-vaccination patients and the adult caregivers accompanying the children of the importance of a well-child visit with a pediatrician or other licensed primary-care provider and refer patients as appropriate.[] These requirements are consistent with those in many States that permit licensed pharmacists to order and administer treatments to children and permit licensed or registered pharmacy interns acting under their supervision to administer treatments to children.[] Administering vaccinations to children age three and older is less complicated and requires less training and resources than administering vaccinations to younger children. That is because ACIP generally recommends administering intramuscular injections in the deltoid muscle for individuals age three and older.[] For individuals less than three years of age, ACIP generally recommends administering intramuscular injections in the anterolateral aspect of the thigh muscle.[] Administering injections in the thigh muscle often presents additional complexities and requires additional training and resources including additional personnel to safely position the child while another healthcare professional injects the treatment.[] Moreover, as of 2018, 40% of three-year-olds were enrolled in preprimary programs (i.e. Preschool or kindergarten programs).[] Preprimary programs are beginning in the coming weeks or months, so the Secretary has concluded that it is particularly important for individuals ages three through 18 to receive ACIP-recommended treatments according to ACIP's standard immunization schedule.

All States require children to be vaccinated against certain communicable diseases as a condition of school attendance. These laws often apply to both public and private schools with identical immunization and exemption provisions.[] As nurseries, preschools, kindergartens, and schools reopen, increased access to childhood vaccinations is essential to ensuring children can return. Notwithstanding any State or local scope-of-practice legal requirements, (1) qualified licensed pharmacists are identified as qualified persons to order and administer ACIP-recommended treatments and (2) qualified State-licensed or registered pharmacy interns are identified as qualified persons to administer the ACIP-recommended treatments ordered by their supervising qualified licensed pharmacist.[] Both the PREP Act and the June 4, 2020 Second Amendment to the Declaration define âcovered countermeasuresâ to include qualified propecia and epidemic products that âlimit the harm such propecia or epidemic might otherwise cause.ââ[] The troubling decrease in ACIP-recommended childhood vaccinations and the resulting increased risk of associated diseases, adverse health conditions, and other threats are categories of harms otherwise caused by Start Printed Page 52140hair loss treatment as set forth in Sections VI and VIII of this Declaration.[] Hence, such vaccinations are âcovered countermeasuresâ under the PREP Act and the June 4, 2020 Second Amendment to the Declaration.

Nothing in this Declaration shall be construed to affect the National treatment Injury Compensation Program, including an injured party's ability to obtain compensation under that program. Covered countermeasures that are subject to the National treatment Injury Compensation Program authorized under 42 U.S.C. 300aa-10 et seq.

Are covered under this Declaration for the purposes of liability immunity and injury compensation only to the extent that injury compensation is not provided under that Program. All other terms and conditions of the Declaration apply to such covered countermeasures. Section VIII.

Category of Disease, Health Condition, or Threat As discussed, the troubling decrease in ACIP-recommended childhood vaccinations and the resulting increased risk of associated diseases, adverse health conditions, and other threats are categories of harms otherwise caused by hair loss treatment. The Secretary therefore amends section VIII, which describes the category of disease, health condition, or threat for which he recommends the administration or use of the Covered Countermeasures, to clarify that the category of disease, health condition, or threat for which he recommends the administration or use of the Covered Countermeasures is not only hair loss treatment caused by hair loss or a propecia mutating therefrom, but also other diseases, health conditions, or threats that may have been caused by hair loss treatment, hair loss, or a propecia mutating therefrom, including the decrease in the rate of childhood immunizations, which will lead to an increase in the rate of infectious diseases. Amendments to Declaration Amended Declaration for Public Readiness and Emergency Preparedness Act Coverage for medical countermeasures against hair loss treatment.

Sections V and VIII of the March 10, 2020 Declaration under the PREP Act for medical countermeasures against hair loss treatment, as amended April 10, 2020 and June 4, 2020, are further amended pursuant to section 319F-3(b)(4) of the PHS Act as described below. All other sections of the Declaration remain in effect as published at 85 FR 15198 (Mar. 17, 2020) and amended at 85 FR 21012 (Apr.

15, 2020) and 85 FR 35100 (June 8, 2020). 1. Covered Persons, section V, delete in full and replace with.

V. Covered Persons 42 U.S.C. 247d-6d(i)(2), (3), (4), (6), (8)(A) and (B) Covered Persons who are afforded liability immunity under this Declaration are âmanufacturers,â âdistributors,â âprogram planners,â âqualified persons,â and their officials, agents, and employees, as those terms are defined in the PREP Act, and the United States.

In addition, I have determined that the following additional persons are qualified persons. (a) Any person authorized in accordance with the public health and medical emergency response of the Authority Having Jurisdiction, as described in Section VII below, to prescribe, administer, deliver, distribute or dispense the Covered Countermeasures, and their officials, agents, employees, contractors and volunteers, following a Declaration of an emergency. (b) any person authorized to prescribe, administer, or dispense the Covered Countermeasures or who is otherwise authorized to perform an activity under an Emergency Use Authorization in accordance with Section 564 of the FD&C Act.

(c) any person authorized to prescribe, administer, or dispense Covered Countermeasures in accordance with Section 564A of the FD&C Act. And (d) a State-licensed pharmacist who orders and administers, and pharmacy interns who administer (if the pharmacy intern acts under the supervision of such pharmacist and the pharmacy intern is licensed or registered by his or her State board of pharmacy), treatments that the Advisory Committee on Immunization Practices (ACIP) recommends to persons ages three through 18 according to ACIP's standard immunization schedule. Such State-licensed pharmacists and the State-licensed or registered interns under their supervision are qualified persons only if the following requirements are met.

The treatment must be FDA-authorized or FDA-approved. The vaccination must be ordered and administered according to ACIP's standard immunization schedule. The licensed pharmacist must complete a practical training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education (ACPE).

This training program must include hands-on injection technique, clinical evaluation of indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments. The licensed or registered pharmacy intern must complete a practical training program that is approved by the ACPE. This training program must include hands-on injection technique, clinical evaluation of indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments.

The licensed pharmacist and licensed or registered pharmacy intern must have a current certificate in basic cardiopulmonary resuscitation. The licensed pharmacist must complete a minimum of two hours of ACPE-approved, immunization-related continuing pharmacy education during each State licensing period. The licensed pharmacist must comply with recordkeeping and reporting requirements of the jurisdiction in which he or she administers treatments, including informing the patient's primary-care provider when available, submitting the required immunization information to the State or local immunization information system (treatment registry), complying with requirements with respect to reporting adverse events, and complying with requirements whereby the person administering a treatment must review the treatment registry or other vaccination records prior to administering a treatment.

The licensed pharmacist must inform his or her childhood-vaccination patients and the adult caregiver accompanying the child of the importance of a well-child visit with a pediatrician or other licensed primary-care provider and refer patients as appropriate. Nothing in this Declaration shall be construed to affect the National treatment Injury Compensation Program, including an injured party's ability to obtain compensation under that program. Covered countermeasures that are subject to the National treatment Injury Compensation Program authorized under 42 U.S.C.

300aa-10 et seq. Are covered under this Declaration for the purposes of liability immunity and injury compensation only to the extent that injury compensation is not provided under that Program. All other Start Printed Page 52141terms and conditions of the Declaration apply to such covered countermeasures.

2. Category of Disease, Health Condition, or Threat, section VIII, delete in full and replace with. VIII.

Category of Disease, Health Condition, or Threat 42 U.S.C. 247d-6d(b)(2)(A) The category of disease, health condition, or threat for which I recommend the administration or use of the Covered Countermeasures is not only hair loss treatment caused by hair loss or a propecia mutating therefrom, but also other diseases, health conditions, or threats that may have been caused by hair loss treatment, hair loss, or a propecia mutating therefrom, including the decrease in the rate of childhood immunizations, which will lead to an increase in the rate of infectious diseases. Start Authority 42 U.S.C.

247d-6d. End Authority Start Signature Dated. August 19, 2020.

Alex M. Azar II, Secretary of Health and Human Services. End Signature End Supplemental Information [FR Doc.

2020-18542 Filed 8-20-20. 4:15 pm]BILLING CODE 4150-03-PToday, the U.S. Department of Health and Human Services released Healthy People 2030, the nation's 10-year plan for addressing our most critical public health priorities and challenges.

Since 1980, HHS's Office of Disease Prevention and Health Promotion has set measurable objectives and targets to improve the health and well-being of the nation.This decade, Healthy People 2030 features 355 core â or measurable â objectives with 10-year targets, new objectives related to opioid use disorder and youth e-cigarette use, and resources for adapting Healthy People 2030 to emerging public health threats like hair loss treatment. For the first time, Healthy People 2030 also sets 10-year targets for objectives related to social determinants of health."Healthy People was the first national effort to lay out a set of data-driven priorities for health improvement," said HHS Secretary Alex Azar. "Healthy People 2030 adopts a more focused set of objectives and more rigorous data standards to help the federal government and all of our partners deliver results on these important goals over the next decade."Healthy People has led the nation with its focus on social determinants of health, and continues to prioritize economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context as factors that influence health.

Healthy People 2030 also continues to prioritize health disparities, health equity, and health literacy."Now more than ever, we need programs like Healthy People that set a shared vision for a healthier nation, where all people can achieve their full potential for health and well-being across the lifespan," said ADM Brett P. Giroir, MD, Assistant Secretary for Health. "hair loss treatment has brought the importance of public health to the forefront of our national dialogue.

Achieving Healthy People 2030's vision would help the United States become more resilient to public health threats like hair loss treatment."Healthy People 2030 emphasizes collaboration, with objectives and targets that span multiple sectors. A federal advisory committee of 13 external thought leaders and a workgroup of subject matter experts from more than 20 federal agencies contributed to Healthy People 2030, along with public comments received throughout the development process.The HHS Office of Disease Prevention and Health Promotion leads Healthy People in partnership with the National Center for Health Statistics at the Centers for Disease Control and Prevention, which oversees data in support of the initiative.HHS Secretary Alex M. Azar II, ADM Brett P.

Giroir, MD, Assistant Secretary for Health, and U.S. Surgeon General Jerome M. Adams, MD, MPH, and others from HHS and CDC will launch Healthy People 2030 during a webcast on August 18 at 1 pm (EDT) at https://www.hhs.gov/live.

No registration is necessary. For more information about Healthy People 2030, visit https://healthypeople.gov.Latest hair loss News FRIDAY, Sept. 4, 2020 (Healthday News) -- Rumors suggesting that hair loss treatment deaths in the United States are much lower than reported are due to people misinterpreting standard death certificate language, a Centers for Disease Control and Prevention official says.Social media conspiracy theories claiming that only a small percentage of people reported to have died from hair loss treatment actually died from the disease have cited death certificates that list other underlying causes, CNN reported.But that doesn't mean the patients did not die from hair loss treatment, said Bob Anderson, chief of mortality statistics at the CDC."In 94% of deaths with hair loss treatment, other conditions are listed in addition to hair loss treatment.

These causes may include chronic conditions like diabetes or hypertension," Anderson explained in a statement, CNN reported. "In 6% of the death certificates that list hair loss treatment, only one cause or condition is listed," he noted."The underlying cause of death is the condition that began the chain of events that ultimately led to the person's death. In 92% of all deaths that mention hair loss treatment, hair loss treatment is listed as the underlying cause of death."As of Aug.

22, CDC data show that 161,392 death certificates listed hair loss treatment as a cause of death. As of Sept. 2, there had been more than 185,000 deaths from hair loss treatment in the U.S., according to Johns Hopkins University, which uses independent data, CNN reported.Other top U.S.

Health officials have said that hair loss treatment death data are accurate.Copyright Â© 2019 HealthDay. All rights reserved.Latest Cancer News By Alan MozesHealthDay ReporterFRIDAY, Sept. 4, 2020Millions of people color their own hair, even though some of the chemicals in permanent hair dyes are considered possible carcinogens.So, is home hair coloring safe?.

According to a new study, the answer is a qualified yes.After tracking cancer risk among more than 117,000 U.S. Women for 36 years, the investigators found that personal use of permanent hair dyes was not associated with any increase in the risk of developing bladder, brain, colon, kidney, lung, blood or immune system cancer. Nor were these dyes linked to an uptick in most skin or breast cancers."We observed no positive association between personal permanent hair dye use and risk of most cancers or cancer-related mortality," said study lead author Dr.

Yin Zhang, a research fellow in medicine with Brigham and Women's Hospital, Harvard Medical School and the Dana-Farber Cancer Institute, in Boston.But permanent dye use was linked to a slightly increased risk for basal cell carcinoma (skin cancer), ovarian cancer and some forms of breast cancer.In addition, an increased risk for Hodgkin lymphoma was observed, but only among women whose hair was naturally dark. The research team said it remained unclear as to why, but speculated that it could be that darker dyes have higher concentrations of problematic chemicals.The findings were published online Sept. 2 in the BMJ.The study team noted that somewhere between 50% and 80% of American and European women aged 40 and up color their hair.

One in 10 men do the same.According to the American Cancer Society (ACS), hair dyes are regulated as cosmetics by the U.S. Food and Drug Administration. But the FDA places much of the safety burden on manufacturers.Permanent dyes account for roughly 80% of all dyes used in the United States and Europe, the study noted, and an even higher percentage in Asia.Why?.

Because "if you use permanent hair dyes, the color changes will last until the hair is replaced by new growth, which will be much longer than that of semi-permanent dyes, [which] last for five to 10 washings, or temporary dyes, [which last] one to two washings," Zhang said.The problem?. Permanent hair dyes are "the most aggressive" type on the market, said Zhang, and the kind "that has posed the greatest potential concern about cancer risk."According to the ACS, the concern centers on the ingredients in hair dyes, such as aromatic amines, phenols and hydrogen peroxide.Prior investigations have turned up signs of trouble, with some (though not all ingredients) finding a link between dye use and blood cancers and breast cancer.Still, the ACS points out that research looking into any association between such dyes and cancer risk have had mixed results. And studying hair dyes can be a moving target, as different dyes contain different ingredients, and the composition of those ingredients may change over time.For example, ACS experts noted that studies conducted in the 1970s found that some types of aromatic amines appeared to cause cancer in animal studies.

As a result, some dye manufacturers have dropped amines from their dye recipes.The latest study focused on U.S. Women who were enrolled in the ongoing Nurses' Health Study. All were cancer-free at the study's start, and all reported if they had ever used a permanent hair dye.Zhang's team concluded that using the dye did not appear to significantly raise the risk for most cancers.

But investigators stressed that they did not definitively establish that such dyes do or do not raise cancer risk, given that their work was purely observational."Current evidence regarding the carcinogenic potential of personal use of permanent hair dyes are not conclusive," Zhang said, adding that "further investigations are needed."So, what should women do?. The ACS says, "There is no specific medical advice for current or former hair dye users."But Zhang suggested that consumers carefully follow directions -- such as "using gloves, keeping track of time, [and] rinsing the scalp thoroughly with water after use" -- to reduce any potential risk.Copyright Â© 2020 HealthDay. All rights reserved.

QUESTION An average adult has about ________ square feet of skin. See Answer References SOURCES. Yin Zhang, MD, research fellow, medicine, Brigham and Women's Hospital, Harvard Medical School, and Dana-Farber Cancer Institute, Boston.

American Cancer Society. BMJ.In September 2017, Puerto Rico was devastated by Hurricane Maria. Three years later, the U.S.

Territory is still rebuilding with the added challenge of managing the spread of hair loss treatment. Join Modern Healthcare Managing Editor Matthew Weinstock and Dr. Richard Shinto, president and CEO of InnovaCare Health, to learn what the health plan is doing to aid physicians and its members in Puerto Rico.Look for next week's installment of The Check Up with Christopher Palmieri, president and CEO of Commonwealth Care Alliance.Dr.

Janice Bacon was exactly the person Kay McField hoped to talk to when she found herself spending most of her days in bed, feeling too depressed to get up as the hair loss propecia threatened those around her.As she watched those closest to her test positive for the propecia â a goddaughter and her uncle, whom she cares for, among themâMcField said she was terrified that she or her daughter, who both suffer from autoimmune diseases, would fall ill. When she wasn't in bed, the 51-year-old single mother was cleaning her house compulsively."It was just this constant panic," she said, her arms pressed to her chest. "I wanted to talk to someone I knew was going to listen, who I could trust."A Black primary care physician practicing in Mississippi for nearly four decades, Bacon works at an all-African American-run trio of community health centers in Hinds County, where the population is overwhelmingly Blackâand where the most hair loss cases have been reported in the state.Most of the families that Bacon and the more than 50 other doctors, nurses and social workers serve are African American, low-income and living with health conditions like heart disease, diabetes and asthma that are more common among Black Americans.

Even before the hair loss, many were dealing with depression and anxiety, Bacon said.During the propecia, those problems have been exacerbated. Many clinic patients are essential workers expected to work in-person even as hair loss cases have skyrocketed in Mississippi. While testing is free for community health center patients, delays are a major issue, Bacon said, with some families waiting up to two weeks for results.Bacon said she has seen people scrape together $187 to pay for a rapid test at other clinics that don't accept Medicaid, in hopes of returning to work faster and not losing their jobs."There's this feeling of, 'I just can't handle it all,'" Bacon said.

"We are seeing serious mental health consequences."Meanwhile, families are struggling to find child care and put food on the table. Two of the largest school districts in the area decided to start virtually, creating more barriers for families that don't have internet access, or if they do, don't know how to use devices for online learning or can't afford them.Research suggests Black patients have better outcomes when treated by Black doctors and nurses. Yet, only 5% of doctors nationwide are Black, and only 2% are Black women, according to the Association of American Medical Colleges.The Central Mississippi Health Services clinic where Bacon works is on the campus of Tougaloo College, a historically Black institution that was a gathering place for civil rights activists in the 1960s.

As part of the national network of community health centers, it receives federal funding to serve communities designated as medically under-served areas, with fees adjusted based on ability to pay.Over generations, Bacon has built trust in a community generally skeptical of the health care system and made her Black patients feel they have a safe place to go for medical care."It's meaningful to be taken care of by someone who looks like you, who understands you," McField said. "Other doctors go into the exam room, and they don't ask your name. And me, when I go there and be treated that way, I'm not going back no more."Raised 90 miles from Jackson in Natchez, Mississippi, Bacon suffered from severe asthma.

Her pediatrician would treat her at his house when she would have attacks, even in the middle of the night. That inspired her to become a community doctor.In her office, Bacon has a portrait of Michelle and Barack Obama on the wall, and photos of her patients on a bulletin board. McField's daughter Ella's high school graduation photo is among them.

Ella, who is starting college this fall, says she has wanted to be a doctor or a nurse since she was little because of Bacon.Bacon has cared for McField's family for generations. She was the doctor for McField's mother and her 10 siblings, and now she looks after their children. McField said her brother drove three hours from Memphis so his children could be seen by Bacon.When she has gone elsewhere for medical care, McField said, she has been talked down to, misdiagnosed or dismissed by doctors.

Bacon said there is still a lot of implicit bias in the health care system, and she has seen how it hurts her patients.When McField opened up to Bacon about her depression during the propecia, the doctor introduced her to a social worker who helped her find coping strategiesâwriting in a journal, taking a break from watching the news and praying. She said she's doing a lot better.Clinic staff members say they see their role as more than treating their patients' physical health. They work with food banks, churches and other social services to make sure people have access to food and clean drinking water while in isolation, as well as transportation when they can venture out again."They can get your high blood pressure medication refilled, and then come down the hallway and talk about why it was up 20 points this week," said social worker Chinnika Crisler.

"Maybe it's because the unemployment stimulus just ended, and 'I really don't know how to pay my rent next month, so now I'm not sleeping."'The propecia has made running some of the center's normal programming challenging. Nutrition sessions for preteens and their parents at risk for obesity were halted in person. Respite care for parents of children with significant health conditionsâsomething Bacon knows is desperately needed right nowâhas been on pause until providers find a safe way to visit patients' homes.But there is still much to do.

On one recent day, Crisler was helping a single mother of three apply for benefits through the Family and Medical Leave Act because she wasn't able to balance working and taking care of her three kids at home by herself.Clinician and social worker Lisa Williams said that although the propecia has made a lot of the problems that patients deal with worse, they aren't anything new."People have been struggling for a long, long time," she said..

Start Preamble Notice of cost of propecia generic amendment. The Secretary issues this amendment pursuant to section 319F-3 of the Public Health Service Act to add additional categories of Qualified Persons and amend the category of disease, health condition, or threat for which he recommends the administration or cost of propecia generic use of the Covered Countermeasures. This amendment to the Declaration published on March 17, 2020 (85 FR 15198) is effective as of August 24, 2020.

Start Further Info cost of propecia generic Robert P. Kadlec, MD, MTM&H, MS, Assistant Secretary for Preparedness and Response, Office of the Secretary, Department of Health and Human Services, 200 Independence Avenue SW, Washington, DC 20201. Telephone.