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Last Updated September 01, 2020 lasix generic Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and dermatology news. Based out of the New York City office, she’s worked at the company for nearly five years..

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A school district in Westchester County has browse this site announced reopening plans after lasix for cats a large number of students attended parties.Pelham Public School District Superintendent Dr. Cheryl H lasix for cats. Champ said in a letter to families and communities that she was made aware on Wednesday, Sept. 9 of the "parties in the woods for the last two evenings."She said "the number of students reported to have been at these gatherings potentially totals over 100 teens and video from these parties shows students engaging in risky behavior, failing to practice physical distancing, and not wearing masks lasix for cats or face coverings. "Needless to say, this is extremely disappointing at any time, but for students to do so just days before our schools were set to reopen potentially puts our whole school community at risk."These parties lasix for cats have the distinct potential of spreading COVID-19 among the students who attended, their siblings who may attend other schools in the district, and the community at large."As a result, the start of in-person learning is being postponed until Monday, Sept.

14. In a new statement over the weekend, Champ said, "Over the past two days we have worked to determine the scope of social gatherings this past week, to assess the level of risk to siblings, and to work lasix for cats with the Department of Health to develop appropriate next steps."Elementary Schools &. Pelham Middle School"In reviewing the information obtained by the District, we have determined that these lasix for cats gatherings were only attended by high school students," Champ said. "Additionally, the Department of Health has indicated that the risk to siblings in this situation is low. With that in mind all four elementary schools and Pelham Middle School lasix for cats will return for in-person learning under the Hybrid Plan on Monday, Sept.

14. "As per the calendar, Cohort lasix for cats A will report for in-person instruction on Monday, Tuesday and Wednesday and Cohort B will report for in-person instruction on Thursday and Friday this week. Cohorts that are not scheduled to report in person will attend classes lasix for cats remotely per the Hybrid Plan. As a reminder, Wednesday will be a noon dismissal for both Hybrid and Remote students."Pelham Memorial High School"While we recognize that not all high school students were in attendance, our investigation indicated that the scope of the situation warranted a comprehensive approach. "All PMHS students will continue to learn lasix for cats remotely through at least Wednesday, Sept.

16. During this time, students should follow the Hybrid Bell schedule, which is available on the PMHS website. Consistent with the hybrid schedule, school will end at noon on Wednesday. "PMHS will open for in-person instruction under the Hybrid Plan on Thursday, Sept. 17 for those students who can present a negative COVID-19 test that was administered on or after September 14.To facilitate this testing, the district is making arrangements for easily accessible COVID-19 testing on Monday, Sept.

14 and Tuesday, Sept. 15." Click here to sign up for Daily Voice's free daily emails and news alerts.An alert has been issued for a wanted woman who allegedly tried to pull a fast one on state police troopers in the Hudson Valley to avoid paying for tickets.New York State Police investigators in Poughkeepsie issued an alert for 31-year-old Elizabeth Roman, who was arrested on multiple charges after attempting to impersonate another person to avoid tickets.Specifically, Roman was charged with falsifying business records, criminal impersonation, and aggravated unlicensed operation of a motor vehicle.Roman is wanted by State Police and the Town of Lagrange Court following her arrest for impersonating another person in order to avoid tickets and the discovery that her license privileges were suspended during a traffic stop in Dutchess County.According to police, Roman is known to have ties to Yonkers and the New York City area.Police described Roman as being 5-foot-3 weighing approximately 113 pounds with brown hair and brown eyes. Anyone who recognizes her or has information regarding her whereabouts has been asked to contact New York State Police detectives in Poughkeepsie by calling (845) 677-7300 or emailing CrimeTip@troopers.ny.gov. Click here to sign up for Daily Voice's free daily emails and news alerts.A man wanted for trespassing in Westchester was arrested after attempting to gain entry to a residence in a neighboring village, police said.Officers from the Scarsdale Police Department responded to Taunton Road shortly before 7:15 a.m. On Saturday, Sept.

5, where there were reports of suspicious activity.Upon arrival, the Taunton Road resident said that an unknown African American man repeatedly attempted to enter his home before fleeing the property on foot.Police said the officers were able to locate the suspect wanted in Mamaroneck, 31-year-old Kofi Busia, who has no known address, who was sitting on a bench in the front yard of a nearby property.Busia told officers that he was attempting to gain entry into the home because his parents live there, police said. When told that he was at the wrong location, Busia then said that he had “been walking through Westchester” for a portion of the night, prompting further investigation.While speaking with Busia, it was determined that he was wanted by the Village of Mamaroneck Police Department for attempted criminal trespass, and he was placed under arrest without incident.Busia was transported to the Mamaroneck Police Department to be processed on the trespassing charge and was later released. No return court date has been announced. Click here to sign up for Daily Voice's free daily emails and news alerts.A new text messaging scam involving mailed packages that allow fraudsters to gain access to personal information has been making the rounds across the country, federal officials warn.The Federal Trade Commission is among the agencies that have issued an alert after consumers made numerous complaints after receiving a text message saying that a package pending, telling the user to click a link to set up delivery for the item.Once the link is clicked, users will be instructed to provide personal identifying information. Scammers have posed as drivers from FedEx, USPS, UPS, and other delivery services since the scam came to light.

The FTC said that in many cases the scammers know the cell phone user’s first name – and sometimes even their last name -- though the messages are not legitimate.“The scammers are pretty crafty in putting these things together and trying to trick people to fall for them by making them think that they’re real messages,” an FTC spokesperson noted.According to the FTC, “If you get an unexpected text message, don’t click on any links. If you think it could be legit, contact the company using a website or phone number you know is real. Don’t use the information in the text message.” Click here to sign up for Daily Voice's free daily emails and news alerts..

A school district in Westchester County has announced reopening plans https://www.cityreal.lv/buy-lasix-online-canada/ after a large number of students lasix generic attended parties.Pelham Public School District Superintendent Dr. Cheryl H lasix generic. Champ said in a letter to families and communities that she was made aware on Wednesday, Sept.

9 of the "parties in the woods for the last two evenings."She said "the lasix generic number of students reported to have been at these gatherings potentially totals over 100 teens and video from these parties shows students engaging in risky behavior, failing to practice physical distancing, and not wearing masks or face coverings. "Needless to say, this is extremely disappointing at any time, but for students to do so just days before our schools were set to reopen potentially puts our whole school community at risk."These parties have the distinct potential of lasix generic spreading COVID-19 among the students who attended, their siblings who may attend other schools in the district, and the community at large."As a result, the start of in-person learning is being postponed until Monday, Sept. 14.

In a new statement over the weekend, Champ said, "Over the past two days we have worked to determine the scope of social gatherings this past week, to assess the level of risk to siblings, and to work with lasix generic the Department of Health to develop appropriate next steps."Elementary Schools &. Pelham Middle lasix generic School"In reviewing the information obtained by the District, we have determined that these gatherings were only attended by high school students," Champ said. "Additionally, the Department of Health has indicated that the risk to siblings in this situation is low.

With that in mind all four elementary schools and Pelham Middle School will lasix generic return for in-person learning under the Hybrid Plan on Monday, Sept. 14. "As per the calendar, Cohort A will report for in-person instruction on Monday, Tuesday and Wednesday and Cohort B will report for in-person instruction on Thursday and Friday this week lasix generic.

Cohorts that are not scheduled to report in person will lasix generic attend classes remotely per the Hybrid Plan. As a reminder, Wednesday will be a noon dismissal for both Hybrid and Remote students."Pelham Memorial High School"While we recognize that not all high school students were in attendance, our investigation indicated that the scope of the situation warranted a comprehensive approach. "All PMHS students will continue to learn remotely through at least lasix generic Wednesday, Sept.

16. During this time, students should go right here follow the Hybrid Bell schedule, which is available on the PMHS website. Consistent with the hybrid schedule, school will end at noon on Wednesday.

"PMHS will open for in-person instruction under the Hybrid Plan on Thursday, Sept. 17 for those students who can present a negative COVID-19 test that was administered on or after September 14.To facilitate this testing, the district is making arrangements for easily accessible COVID-19 testing on Monday, Sept. 14 and Tuesday, Sept.

15." Click here to sign up for Daily Voice's free daily emails and news alerts.An alert has been issued for a wanted woman who allegedly tried to pull a fast one on state police troopers in the Hudson Valley to avoid paying for tickets.New York State Police investigators in Poughkeepsie issued an alert for 31-year-old Elizabeth Roman, who was arrested on multiple charges after attempting to impersonate another person to avoid tickets.Specifically, Roman was charged with falsifying business records, criminal impersonation, and aggravated unlicensed operation of a motor vehicle.Roman is wanted by State Police and the Town of Lagrange Court following her arrest for impersonating another person in order to avoid tickets and the discovery that her license privileges were suspended during a traffic stop in Dutchess County.According to police, Roman is known to have ties to Yonkers and the New York City area.Police described Roman as being 5-foot-3 weighing approximately 113 pounds with brown hair and brown eyes. Anyone who recognizes her or has information regarding her whereabouts has been asked to contact New York State Police detectives in Poughkeepsie by calling (845) 677-7300 or emailing CrimeTip@troopers.ny.gov. Click here to sign up for Daily Voice's free daily emails and news alerts.A man wanted for trespassing in Westchester was arrested after attempting to gain entry to a residence in a neighboring village, police said.Officers from the Scarsdale Police Department responded to Taunton Road shortly before 7:15 a.m.

On Saturday, Sept. 5, where there were reports of suspicious activity.Upon arrival, the Taunton Road resident said that an unknown African American man repeatedly attempted to enter his home before fleeing the property on foot.Police said the officers were able to locate the suspect wanted in Mamaroneck, 31-year-old Kofi Busia, who has no known address, who was sitting on a bench in the front yard of a nearby property.Busia told officers that he was attempting to gain entry into the home because his parents live there, police said. When told that he was at the wrong location, Busia then said that he had “been walking through Westchester” for a portion of the night, prompting further investigation.While speaking with Busia, it was determined that he was wanted by the Village of Mamaroneck Police Department for attempted criminal trespass, and he was placed under arrest without incident.Busia was transported to the Mamaroneck Police Department to be processed on the trespassing charge and was later released.

No return court date has been announced. Click here to sign up for Daily Voice's free daily emails and news alerts.A new text messaging scam involving mailed packages that allow fraudsters to gain access to personal information has been making the rounds across the country, federal officials warn.The Federal Trade Commission is among the agencies that have issued an alert after consumers made numerous complaints after receiving a text message saying that a package pending, telling the user to click a link to set up delivery for the item.Once the link is clicked, users will be instructed to provide personal identifying information. Scammers have posed as drivers from FedEx, USPS, UPS, and other delivery services since the scam came to light.

The FTC said that in many cases the scammers know the cell phone user’s first name – and sometimes even their last name -- though the messages are not legitimate.“The scammers are pretty crafty in putting these things together and trying to trick people to fall for them by making them think that they’re real messages,” an FTC spokesperson noted.According to the FTC, “If you get an unexpected text message, don’t click on any links. If you think it could be legit, contact the company using a website or phone number you know is real. Don’t use the information in the text message.” Click here to sign up for Daily Voice's free daily emails and news alerts..

What may interact with Lasix?

  • certain antibiotics given by injection
  • diuretics
  • heart medicines like digoxin, dofetilide, or nitroglycerin
  • lithium
  • medicines for diabetes
  • medicines for high blood pressure
  • medicines for high cholesterol like cholestyramine, clofibrate, or colestipol
  • medicines that relax muscles for surgery
  • NSAIDs, medicines for pain and inflammation like ibuprofen, naproxen, or indomethacin
  • phenytoin
  • steroid medicines like prednisone or cortisone
  • sucralfate

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

Can dogs take lasix for humans

We live can dogs take lasix for humans in unprecedented times. But what makes them without parallel is not the current pandemic crisis nor the continued problems facing minorities in our institutions. Rather, it’s that for the first time, the problems of accessibility, can dogs take lasix for humans rights and freedoms are now invading privileged spaces.

There can be no ‘getting back to normal’, because ‘normal’ only ever benefited the white, Western, patriarchal, abled and cis ideals. For many, the world is not suddenly on fire. €¦IntroductionMinecraft is a computer can dogs take lasix for humans game with no specific goals to accomplish.

The gameworld consists of three-dimensional (3D) cubes and objects which the player (Steve) can mine and build into infinitely complex (and logically impossible) structures. Steve sometimes encounters other characters (‘mobs’), such as animals can dogs take lasix for humans and hostile creatures. He can ‘spawn’ and destroy them.

While it looks like a harmless game of logical construction, it conveys some worryingly delusive ideas about the real world. The difference between real and imagined structures is can dogs take lasix for humans at the heart of the age-old debate around categorising mental disorders.Classification in mental health has had various forms throughout history. Mack and colleagues set out a history of psychiatric classification beginning in 2600 BC with Egyptian references to melancholia and hysteria.

Through the Ancient can dogs take lasix for humans Greeks with Hippocrates’ phrenitis, mania, melancholia, epilepsy, hysteria and Scythian disease. Through the Renaissance period. Through to 19th-century psychiatry featuring Pinel (known as the first psychiatrist), Kraepelin (known for observational classification) and Freud (known for classifying neurosis and psychosis).1Although the history of psychiatric classification identifies some common trends such as the labels ‘melancholia’ and ‘hysteria’ which have survived millennia, the label ‘depression’ is relatively new.

The earliest usage noted by Snaith is from 1899 can dogs take lasix for humans. €˜in simple pathological depression…the patient exhibits a growing indifference to his former pursuits…’.2 Snaith noted that early 20th-century psychiatrists like Adolf Meyer hoped that ‘depression’ would come to encompass a broad category under which descriptions of subtypes would emerge. This did not happen until the middle can dogs take lasix for humans of the 20th century.

With the publication of the sixth International Classification of Diseases (ICD) in 1948 and the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952 and their subsequent revisions, the latter half of the 20th century has seen depression subtype labels proliferate. In their study of the social determinants of diagnostic labels in depression, McPherson and Armstrong illustrate how the codification of depression subtypes in the latter half of the 20th century has been shaped by the evolving context of psychiatry, including power struggles within the profession, a move to community care and the development of psychopharmacology.3During this period, McPherson and Armstrong describe how subsequent versions of the DSM served as battlegrounds for professional disputes and philosophical quarrels around categorisation of mental disorders. DSM I and DSM II have been described as products of an American Psychiatric Association dominated by psychoanalytic psychiatrists.4 DSM III and DSM III-R have been described as a radical rejection of psychoanalytic thinking, a ‘neo-Kraepelinian revolution’, a reference to the observational descriptive techniques of 19th-century psychiatrist can dogs take lasix for humans Emil Kraepelin who classified mental disorders into two broad categories.

€˜dementia praecox’ and ‘manic-depression’.5 DSM III was seen by some as a turning point in the use of the medical model of mental illness, through provision of specific inclusion and exclusion criteria, and use of field trials and a multiaxial system.6 These latter technocratic additions to psychiatric labelling served to engender a much closer alignment between psychiatry, science and medicine.The codification of mental disorders in manuals has been described by Thomas Schacht as intrinsic to the relationship between science and politics and the way in which psychiatrists gain significant social power by aligning themselves to science.7 His argument drew on Szasz, who saw the mental health establishment as a therapeutic state. Zimbardo, who can dogs take lasix for humans described psychiatric care as a controlling force. And Foucault, who described the categorisation of the mentally ill as a force for isolating ‘the other’.

Diagnostic critique has been further developed through a cultural relativist lens in that what Western psychiatrists classify as a depression is constructed differently in other cultures.8 Considering these limitations, some critics have gone so far as to argue that psychiatric diagnostic systems should be abolished.9Yet architects of DSM manuals have worked hard to ensure the technology of classification is regarded as genuine scientific activity with sound roots in philosophy of science. In their philosophical defence of DSM can dogs take lasix for humans IV, Allen Frances and colleagues address their critics under the headings ‘nominalism vs realism’, ‘empiricism vs rationalism’ and ‘categorical vs dimensional’.10 The implication is that there are opposing stances in which a choice must be made or a middle ground forged by those reasonable enough to recognise the need for pragmatism in the service of clinical utility. The nominalism–realism debate is illustrated using as metaphor three different stances a cricket umpire might take on calling strikes and balls.

The discussion sets out two can dogs take lasix for humans of these as extreme views. €˜at one extreme…those who take a reductionistically realistic view of the world’ versus ‘the solipsistic nominalists…might content that nothing exists’. Szasz, who is characterised as holding particularly extreme views, is named as an archetypal solipsist.

There is implied to be a degree of arrogance associated with this view in the illustrative example in which the umpire states ‘there are no balls and there are no strikes until I can dogs take lasix for humans call them’. Frances therefore sets up a means of grouping two kinds of people as philosophical extremists who can be dismissed, while avoiding addressing the philosophical problems they pose.Frances provides little if any justification for the middle ground stance, ‘There are balls and there are strikes and I call them as I see them’, other than to focus on its clinical utility and the lack of clinical utility in the alternatives ‘naïve realism’ and ‘heuristically barren solipsism’. The natural can dogs take lasix for humans conclusion the reader is invited to reach is that a middle ground of a heuristic concept is naturally right because it is not extreme and is naturally useful clinically, without specifying in what way this stance is coherent, resolves the two alternatives, and in what way a heuristic construct that is not ‘real’ can be subject to scientific testing.Similarly, in discussing the ‘categorical vs dimensional’, Frances promotes the ‘prototype approach’.

Those holding opposing views are labelled as ‘dualists’ or ‘dichotomisers’. The prototypical approach is again put forward as a clinically useful middle ground. Illustrations are drawn from can dogs take lasix for humans natural science.

€˜a triangle and a square are never the same’, inciting the reader to consider science as value-free. The prototypical approach emerges as a natural solution, yet the authors do not address how a diagnostic prototype resolves the issues posed by the two alternatives, nor how a prototype can be subjected to natural science methods.The argument presented here is not a defence can dogs take lasix for humans of solipsism or dualism. Rather it aims to illustrate that if for pragmatic purposes clinicians and policymakers choose to gloss over the philosophical flaws in classification practices, it is then risky to move beyond the heuristic and apply natural science methods to these constructs adding multiple layers of technocratic subclassification.

Doing so is more like playing Minecraft than cricket. The National Institute for Health and Care Excellence (NICE) guideline for depression is taken as an example of the philosophical errors that can follow from playing Minecraft with unsound can dogs take lasix for humans heuristic devices, specifically subcategories of persistent forms of depression. As well as serving a clinical purpose, diagnosis in medicine is a way of allocating resources for insurance companies and constructing clinical guidelines, which in turn determine rationing within the National Health Service.

The consequences for recipients of healthcare can dogs take lasix for humans are therefore significant. Clinical utility is arguably not being served at all and patients are left at risk of poor-quality care.Heterogeneity of persistent depressionAndrea Jobst and colleagues note that ‘because of their chronic clinical course, approximately 40% of CD [chronic depression] patients also fulfil criteria for TRD [treatment resistant depression]…usually defined by the number of non-successful biological treatments’.11 This position is reflected in the DSM VAmerican Psychiatric Association (2013), the European Psychiatric Association (EPA) guidance and the ICD-11(World Health Organisation, 2018), which all use a ‘persistent’ depression category, acknowledging a loosely defined mixed group of long-term, difficult-to-treat depressive conditions, often associated with dysthymia and comorbid common mental disorders, various personality traits and psychosocial disability.In contrast, the NICE 2018 draft guideline separates treatments into those for ‘new episodes’ of depression. €˜further-line’ treatment of depression (equivalent to TRD), CD and ‘depression with co-morbidities’.

The latter is can dogs take lasix for humans subdivided into treatments for ‘complex depression’ and ‘psychotic depression’. These categories and subcategories introduce an unfortunate sense of certainty as though these labels represent real things. An analysis follows of how can dogs take lasix for humans these definitions play out in terms of grouping of randomised controlled trials in the NICE evidence review.

Specifically, the analysis reveals the overlap between populations in trials which have been separated into discrete categories, revealing significant limitations to the utility of the category labels.The NICE definition of CD requires trial samples to meet the criteria for major depressive disorder (MDD) for 2 years. Dysthymia and double depression (MDD superimposed on dysthymia) were included. If 75% of can dogs take lasix for humans the trial population met these criteria, the trial was reviewed in the CD category.12 The definition of TRD (or ‘further-line treatments’) required that the trial sample had demonstrated a ‘limited response to previous treatment’ and randomised to the further-line treatment at this point.

If 80% of the trial participants met these criteria, it was reviewed in the TRD category.13 Complex depression was defined as ‘depression co-existing with personality disorder’. To be classed as complex, 51% of trial participants had to have personality disorder (PD).14It is immediately clear from these definitions that there is a potential problem with attempting to categorise trial populations into just one of these can dogs take lasix for humans categories. These populations are likely to overlap, whether or not a trial protocol sets out to explicitly record all of this information.

The analysis below will illustrate this using examples from within the NICE review.Cataloguing complexity in trial populationsWithin the category of further-line treatments (TRD), 64 trials were reviewed. Comparisons within these can dogs take lasix for humans trials were further subcategorised into ‘dose escalation strategies’, ‘augmentation strategies’ and ‘switching strategies’. In drilling down by way of illustration, this analysis considers the 51 trials in the augmentation strategy evidence review.

Of these, two were classified by the reviewers as also fulfilling the criteria for CD but were not analysed in the CD category (Study IDs. Fonagy 2015 can dogs take lasix for humans and Kocsis 200915). About half of the trials (23/51) did not report the mean duration of episode, meaning that it is not possible to know what percentage of participants also met the criteria for CD.

Of trials can dogs take lasix for humans that did report episode duration, 17 reported a mean duration longer than 24 months. While the standard deviations varied in size or were unreported, the mean indicates a good likelihood that a significant proportion of the participants across these 51 trials met the criteria for CD.Details of baseline employment, trauma history, suicidality, physical comorbidity, axis I comorbidity and PD (all clinical indicators of complexity, severity and chronicity) were not collated by NICE. For the present analysis, all 51 publications were examined and data compiled concerning clinical complexity in the trial populations.

Only 14 can dogs take lasix for humans of 51 trials report employment data. Of those that do, unemployment ranges from 12% to 56% across trial samples. None of the trials report can dogs take lasix for humans trauma history.

About half of the trials (26/51) excluded people who were considered a suicide risk. The others did not.A large proportion of trials (30/51) did not provide any data on axis 1 comorbidity. Of these, 18 did not exclude any can dogs take lasix for humans diagnoses, while 12 excluded some (but not all) disorders.

The most common diagnoses excluded were psychotic disorders, substance or alcohol abuse, and bipolar disorder (excluded in 26, 25 and 23 trials, respectively). Only 7 of 51 trials clearly stated that all axis 1 diagnoses can dogs take lasix for humans were excluded. This leaves only 13 studies providing any data about comorbidity.

Of these, 9 gave partial data on one or two conditions, while 4 reported either the mean number of disorders (range 1.96–2.9) or the percentage of participants (range 68.1–96.7) with any comorbid diagnosis (Nierenberg 2003a, Nierenberg 2006, Watkins 2011a, Town 201715).The majority of trials (46/51) did not report the prevalence of PD. Many stated PD as an exclusion criterion but can dogs take lasix for humans without defining a threshold for exclusion. For example, PD could be excluded if it ‘impacted’ the depression, if it was ‘significant’, ‘severe’ or ‘persistent’.

Some excluded certain PDs (such as antisocial or borderline) and can dogs take lasix for humans not others but without reporting the prevalence of those not excluded. In the five trials where prevalence was clear, prevalence ranged from 0% (Ravindran 2008a15), where all PDs were excluded, to 87.5% of the sample (Town 201715). Two studies reported the mean number of PDs.

2.0 (Nierenberg 2003a) and 0.85 (Watkins 2011a15).The majority of trials (43/51) did can dogs take lasix for humans not report the prevalence of physical illness. Many stated illness as an exclusion criterion, but the definitions and thresholds were vague and could be interpreted in different ways. For example, illness could be excluded if it was can dogs take lasix for humans ‘unstable’, ‘serious’, ‘significant’, ‘relevant’, or would ‘contraindicate’ or ‘impact’ the medication.

Of the eight trials reporting information about physical health, there was a wide variation. Four reported prevalence varying from 7.6% having a disability (Eisendrath 201615) to 90.9% having an illness or disability (Town 201715). Four used can dogs take lasix for humans scales of physical health.

Two indicating mild problems (Nierenberg 2006, Lavretsky 201115) and two indicating moderately high levels of illness (Thase 2007, Fang 201015).The NICE review also divided trial populations into a dichotomy of ‘more severe’ and ‘less severe’ on the grounds that this would be a clinically useful classification for general practitioners. NICE applied a bespoke methodology for creating this dichotomy, abandoning validated measure thresholds in order first to generate two ‘homogeneous’ groups to ‘facilitate analysis’, and second to create an algorithm to ‘read across’ different measures (such as the Beck Depression Inventory, the Hamilton Rating Scale for Depression can dogs take lasix for humans (HRSD) and the Montgomery-Asberg Depression Rating Scale).16 Examining trials which use more than one of these measures reveals problems in the algorithm. Of the 51 trials, there are 6 instances in which the study population falls into NICE’s more severe category according to one measure and into the less severe category according to another.

In four of these trials, NICE chose the less severe category (Souza 2016, Watkins 2011a, Fonagy 2015, Town 201715). The other can dogs take lasix for humans two trials were designated more severe (Barbee 2011, Dunner 200715). Only 17 of 51 trials reported two or more depression scale measures, leaving much unknown about whether other study populations could count as both more severe and less severe.Absence of knowledge or knowledge of absence?.

A key philosophical error in science is to confuse an absence of knowledge with knowledge can dogs take lasix for humans of absence. It is likely that some of the study populations deemed lacking in complexity or severity could actually have high degrees of complexity and/or severity. Data to demonstrate this may either fall foul of a guideline committee decision to prioritise certain information over other conflicting information (as in the severity algorithm).

The information may be non-existent as it was not collected can dogs take lasix for humans. It may be somewhere in the publication pipeline. Or it may be sitting in a database with a research team that can dogs take lasix for humans has run out of funds for supplementary analyses.

Wherever those data are or are not, their absence from published articles does not define the phenomenology of depression for the patients who took part. As a case in point, data from the Fonagy 2015 trial presented at conferences but not published reveal that PD prevalence data would place the trial well within the NICE complex depression category, and that the sample had high levels of past trauma and physical condition comorbidity. The trial also meets can dogs take lasix for humans the guideline criteria for CD according to the guideline’s own appendices.17 Reported axis 1 comorbidity was high (75.2% had anxiety disorder, 18.6% had substance abuse disorder, 13.2% had eating disorder).18 The mean depression scores at baseline were 36.5 on the Beck Depression Inventory and 20.1 on the HRSD (severe and very severe, respectively, according to published cut-off scores).

NICE categorised this population as less severe TRD, not CD and not complex.Notes1. Avram H can dogs take lasix for humans. Mack et al.

(1994), “A Brief History of Psychiatric Classification. From the Ancients to DSM-IV,” Psychiatric Clinics can dogs take lasix for humans 17, no. 3.

Snaith (1987), “The Concepts of Mild Depression,” British Journal of Psychiatry 150, no. 3. 387.3.

Susan McPherson and David Armstrong (2006), “Social Determinants of Diagnostic Labels in Depression,” Social Science &. Medicine 62, no. 1.

52–7.4. Gerald N. Grob (1991), “Origins of DSM-I.

A Study in Appearance and Reality,” The American Journal of Psychiatry. 421–31.5. Wilson M.

Compton and Samuel B. Guze (1995), “The Neo-Kraepelinian Revolution in Psychiatric Diagnosis,” European Archives of Psychiatry and Clinical Neuroscience 245, no. 4.

198–9.6. Gerald L. Klerman (1984), “A Debate on DSM-III.

The Advantages of DSM-III,” The American Journal of Psychiatry. 539–42.7. Thomas E.

Schacht (1985), “DSM-III and the Politics of Truth,” American Psychologist. 513–5.8. Daniel F.

Hartner and Kari L. Theurer (2018), “Psychiatry Should Not Seek Mechanisms of Disorder,” Journal of Theoretical and Philosophical Psychology 38, no. 4.

189–204.9. Sami Timimi (2014), “No More Psychiatric Labels. Why Formal Psychiatric Diagnostic Systems Should Be Abolished,” Journal of Clinical and Health Psychology 14, no.

(1994), “DSM-IV Meets Philosophy,” The Journal of Medicine and Philosophy. A Forum for Bioethics and Philosophy of Medicine 19, no. 3.

207–18.11. Andrea Jobst et al. (2016), “European Psychiatric Association Guidance on Psychotherapy in Chronic Depression Across Europe,” European Psychiatry 33.

20.12. National Institute for Health and Care Excellence (2018), Depression in Adults. Treatment and Management.

Draft for Consultation, https://www.nice.org.uk/guidance/gid-cgwave0725/documents/full-guideline-updated, 507.13. Ibid., 351–62.14. Ibid., 597.15.

Note that in order to refer to specific trials reviewed in the guideline, rather than the full citation, the Study IDs from column A in appendix J5 have been used. See www.nice.org.uk/guidance/gid-cgwave0725/documents/addendum-appendix-9 for details and full references.16. National Institute for Health and Care Excellence (2018), Depression in Adults.

Treatment and Management. Second Consultation on Draft Guideline – Stakeholder Comments Table, https://www.nice.org.uk/guidance/gid-cgwave0725/documents/consultation-comments-and-responses-2, 420–1.17. National Institute for Health and Care Excellence (2018), Depression in Adults, appendix J5.18.

Peter Fonagy et al. (2015), “Pragmatic Randomized Controlled Trial of Long-Term Psychoanalytic Psychotherapy for Treatment-Resistant Depression. The Tavistock Adult Depression Study (TADS),” World Psychiatry 14, no.

3. 312–21.19. American Psychological Association (2018), Clinical Practice Guideline for the Treatment of Depression in Children, Adolescents, and Young, Middle-aged, and Older Adults.

Draft.20. Jacqui Thornton (2018), “Depression in Adults. Campaigners and Doctors Demand Full Revision of NICE Guidance,” BMJ 361.

We live lasix generic can lasix cause pancreatitis in unprecedented times. But what makes them without parallel is not the current pandemic crisis nor the continued problems facing minorities in our institutions. Rather, it’s that for the first time, the problems of accessibility, rights and freedoms are now invading privileged spaces lasix generic.

There can be no ‘getting back to normal’, because ‘normal’ only ever benefited the white, Western, patriarchal, abled and cis ideals. For many, the world is not suddenly on fire. €¦IntroductionMinecraft is lasix generic a computer game with no specific goals to accomplish.

The gameworld consists of three-dimensional (3D) cubes and objects which the player (Steve) can mine and build into infinitely complex (and logically impossible) structures. Steve sometimes encounters lasix generic other characters (‘mobs’), such as animals and hostile creatures. He can ‘spawn’ and destroy them.

While it looks like a harmless game of logical construction, it conveys some worryingly delusive ideas about the real world. The difference lasix generic between real and imagined structures is at the heart of the age-old debate around categorising mental disorders.Classification in mental health has had various forms throughout history. Mack and colleagues set out a history of psychiatric classification beginning in 2600 BC with Egyptian references to melancholia and hysteria.

Through the Ancient Greeks with Hippocrates’ phrenitis, mania, melancholia, epilepsy, hysteria and lasix generic Scythian disease. Through the Renaissance period. Through to 19th-century psychiatry featuring Pinel (known as the first psychiatrist), Kraepelin (known for observational classification) and Freud (known for classifying neurosis and psychosis).1Although the history of psychiatric classification identifies some common trends such as the labels ‘melancholia’ and ‘hysteria’ which have survived millennia, the label ‘depression’ is relatively new.

The earliest usage noted by lasix generic Snaith is from 1899. €˜in simple pathological depression…the patient exhibits a growing indifference to his former pursuits…’.2 Snaith noted that early 20th-century psychiatrists like Adolf Meyer hoped that ‘depression’ would come to encompass a broad category under which descriptions of subtypes would emerge. This did not happen until the middle of the 20th lasix generic century.

With the publication of the sixth International Classification of Diseases (ICD) in 1948 and the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952 and their subsequent revisions, the latter half of the 20th century has seen depression subtype labels proliferate. In their study of the social determinants of diagnostic labels in depression, McPherson and Armstrong illustrate how the codification of depression subtypes in the latter half of the 20th century has been shaped by the evolving context of psychiatry, including power struggles within the profession, a move to community care and the development of psychopharmacology.3During this period, McPherson and Armstrong describe how subsequent versions of the DSM served as battlegrounds for professional disputes and philosophical quarrels around categorisation of mental disorders. DSM I and DSM II have been described as lasix generic products of an American Psychiatric Association dominated by psychoanalytic psychiatrists.4 DSM III and DSM III-R have been described as a radical rejection of psychoanalytic thinking, a ‘neo-Kraepelinian revolution’, a reference to the observational descriptive techniques of 19th-century psychiatrist Emil Kraepelin who classified mental disorders into two broad categories.

€˜dementia praecox’ and ‘manic-depression’.5 DSM III was seen by some as a turning point in the use of the medical model of mental illness, through provision of specific inclusion and exclusion criteria, and use of field trials and a multiaxial system.6 These latter technocratic additions to psychiatric labelling served to engender a much closer alignment between psychiatry, science and medicine.The codification of mental disorders in manuals has been described by Thomas Schacht as intrinsic to the relationship between science and politics and the way in which psychiatrists gain significant social power by aligning themselves to science.7 His argument drew on Szasz, who saw the mental health establishment as a therapeutic state. Zimbardo, who described lasix generic psychiatric care as a controlling force. And Foucault, who described the categorisation of the mentally ill as a force for isolating ‘the other’.

Diagnostic critique has been further developed through a cultural relativist lens in that what Western psychiatrists classify as a depression is constructed differently in other cultures.8 Considering these limitations, some critics have gone so far as to argue that psychiatric diagnostic systems should be abolished.9Yet architects of DSM manuals have worked hard to ensure the technology of classification is regarded as genuine scientific activity with sound roots in philosophy of science. In their philosophical defence of DSM IV, Allen Frances and colleagues address their critics under the headings ‘nominalism vs realism’, lasix generic ‘empiricism vs rationalism’ and ‘categorical vs dimensional’.10 The implication is that there are opposing stances in which a choice must be made or a middle ground forged by those reasonable enough to recognise the need for pragmatism in the service of clinical utility. The nominalism–realism debate is illustrated using as metaphor three different stances a cricket umpire might take on calling strikes and balls.

The discussion sets out two of these as extreme lasix generic views. €˜at one extreme…those who take a reductionistically realistic view of the world’ versus ‘the solipsistic nominalists…might content that nothing exists’. Szasz, who is characterised as holding particularly extreme views, is named as an archetypal solipsist.

There is implied lasix generic to be a degree of arrogance associated with this view in the illustrative example in which the umpire states ‘there are no balls and there are no strikes until I call them’. Frances therefore sets up a means of grouping two kinds of people as philosophical extremists who can be dismissed, while avoiding addressing the philosophical problems they pose.Frances provides little if any justification for the middle ground stance, ‘There are balls and there are strikes and I call them as I see them’, other than to focus on its clinical utility and the lack of clinical utility in the alternatives ‘naïve realism’ and ‘heuristically barren solipsism’. The natural conclusion the reader is invited to reach is that a lasix generic middle ground of a heuristic concept is naturally right because it is not extreme and is naturally useful clinically, without specifying in what way this stance is coherent, resolves the two alternatives, and in what way a heuristic construct that is not ‘real’ can be subject to scientific testing.Similarly, in discussing the ‘categorical vs dimensional’, Frances promotes the ‘prototype approach’.

Those holding opposing views are labelled as ‘dualists’ or ‘dichotomisers’. The prototypical approach is again put forward as a clinically useful middle ground. Illustrations are lasix generic drawn from natural science.

€˜a triangle and a square are never the same’, inciting the reader to consider science as value-free. The prototypical approach emerges as a natural lasix generic solution, yet the authors do not address how a diagnostic prototype resolves the issues posed by the two alternatives, nor how a prototype can be subjected to natural science methods.The argument presented here is not a defence of solipsism or dualism. Rather it aims to illustrate that if for pragmatic purposes clinicians and policymakers choose to gloss over the philosophical flaws in classification practices, it is then risky to move beyond the heuristic and apply natural science methods to these constructs adding multiple layers of technocratic subclassification.

Doing so is more like playing Minecraft than cricket. The National lasix generic Institute for Health and Care Excellence (NICE) guideline for depression is taken as an example of the philosophical errors that can follow from playing Minecraft with unsound heuristic devices, specifically subcategories of persistent forms of depression. As well as serving a clinical purpose, diagnosis in medicine is a way of allocating resources for insurance companies and constructing clinical guidelines, which in turn determine rationing within the National Health Service.

The consequences for lasix generic recipients of healthcare are therefore significant. Clinical utility is arguably not being served at all and patients are left at risk of poor-quality care.Heterogeneity of persistent depressionAndrea Jobst and colleagues note that ‘because of their chronic clinical course, approximately 40% of CD [chronic depression] patients also fulfil criteria for TRD [treatment resistant depression]…usually defined by the number of non-successful biological treatments’.11 This position is reflected in the DSM VAmerican Psychiatric Association (2013), the European Psychiatric Association (EPA) guidance and the ICD-11(World Health Organisation, 2018), which all use a ‘persistent’ depression category, acknowledging a loosely defined mixed group of long-term, difficult-to-treat depressive conditions, often associated with dysthymia and comorbid common mental disorders, various personality traits and psychosocial disability.In contrast, the NICE 2018 draft guideline separates treatments into those for ‘new episodes’ of depression. €˜further-line’ treatment of depression (equivalent to TRD), CD and ‘depression with co-morbidities’.

The latter is subdivided into treatments for ‘complex depression’ and ‘psychotic lasix generic depression’. These categories and subcategories introduce an unfortunate sense of certainty as though these labels represent real things. An analysis follows of how these definitions play out in terms of grouping of randomised lasix generic controlled trials in the NICE evidence review.

Specifically, the analysis reveals the overlap between populations in trials which have been separated into discrete categories, revealing significant limitations to the utility of the category labels.The NICE definition of CD requires trial samples to meet the criteria for major depressive disorder (MDD) for 2 years. Dysthymia and double depression (MDD superimposed on dysthymia) were included. If 75% of the trial population met these criteria, the trial was reviewed in the CD category.12 The definition of TRD (or ‘further-line lasix generic treatments’) required that the trial sample had demonstrated a ‘limited response to previous treatment’ and randomised to the further-line treatment at this point.

If 80% of the trial participants met these criteria, it was reviewed in the TRD category.13 Complex depression was defined as ‘depression co-existing with personality disorder’. To be classed as lasix generic complex, 51% of trial participants had to have personality disorder (PD).14It is immediately clear from these definitions that there is a potential problem with attempting to categorise trial populations into just one of these categories. These populations are likely to overlap, whether or not a trial protocol sets out to explicitly record all of this information.

The analysis below will illustrate this using examples from within the NICE review.Cataloguing complexity in trial populationsWithin the category of further-line treatments (TRD), 64 trials were reviewed. Comparisons within these trials were further subcategorised lasix generic into ‘dose escalation strategies’, ‘augmentation strategies’ and ‘switching strategies’. In drilling down by way of illustration, this analysis considers the 51 trials in the augmentation strategy evidence review.

Of these, two were classified by the reviewers as also fulfilling the criteria for CD but were not analysed in the CD category (Study IDs. Fonagy 2015 lasix generic and Kocsis 200915). About half of the trials (23/51) did not report the mean duration of episode, meaning that it is not possible to know what percentage of participants also met the criteria for CD.

Of trials that did report episode lasix generic duration, 17 reported a mean duration longer than 24 months. While the standard deviations varied in size or were unreported, the mean indicates a good likelihood that a significant proportion of the participants across these 51 trials met the criteria for CD.Details of baseline employment, trauma history, suicidality, physical comorbidity, axis I comorbidity and PD (all clinical indicators of complexity, severity and chronicity) were not collated by NICE. For the present analysis, all 51 publications were examined and data compiled concerning clinical complexity in the trial populations.

Only 14 of 51 trials report employment data lasix generic. Of those that do, unemployment ranges from 12% to 56% across trial samples. None of the trials lasix generic report trauma history.

About half of the trials (26/51) excluded people who were considered a suicide risk. The others did not.A large proportion of trials (30/51) did not provide any data on axis 1 comorbidity. Of these, 18 did not exclude any diagnoses, while 12 excluded lasix generic some (but not all) disorders.

The most common diagnoses excluded were psychotic disorders, substance or alcohol abuse, and bipolar disorder (excluded in 26, 25 and 23 trials, respectively). Only 7 of 51 trials clearly stated that all axis 1 diagnoses were excluded lasix generic. This leaves only 13 studies providing any data about comorbidity.

Of these, 9 gave partial data on one or two conditions, while 4 reported either the mean number of disorders (range 1.96–2.9) or the percentage of participants (range 68.1–96.7) with any comorbid diagnosis (Nierenberg 2003a, Nierenberg 2006, Watkins 2011a, Town 201715).The majority of trials (46/51) did not report the prevalence of PD. Many stated PD as an lasix generic exclusion criterion but without defining a threshold for exclusion. For example, PD could be excluded if it ‘impacted’ the depression, if it was ‘significant’, ‘severe’ or ‘persistent’.

Some excluded certain PDs (such as antisocial or borderline) and not lasix generic others but without reporting the prevalence of those not excluded. In the five trials where prevalence was clear, prevalence ranged from 0% (Ravindran 2008a15), where all PDs were excluded, to 87.5% of the sample (Town 201715). Two studies reported the mean number of PDs.

2.0 (Nierenberg lasix generic 2003a) and 0.85 (Watkins 2011a15).The majority of trials (43/51) did not report the prevalence of physical illness. Many stated illness as an exclusion criterion, but the definitions and thresholds were vague and could be interpreted in different ways. For example, illness could be excluded if it was ‘unstable’, ‘serious’, ‘significant’, ‘relevant’, or would ‘contraindicate’ or ‘impact’ the lasix generic medication.

Of the eight trials reporting information about physical health, there was a wide variation. Four reported prevalence varying from 7.6% having a disability (Eisendrath 201615) to 90.9% having an illness or disability (Town 201715). Four used scales of physical lasix generic health.

Two indicating mild problems (Nierenberg 2006, Lavretsky 201115) and two indicating moderately high levels of illness (Thase 2007, Fang 201015).The NICE review also divided trial populations into a dichotomy of ‘more severe’ and ‘less severe’ on the grounds that this would be a clinically useful classification for general practitioners. NICE applied a bespoke methodology for creating this dichotomy, abandoning validated measure lasix generic thresholds in order first to generate two ‘homogeneous’ groups to ‘facilitate analysis’, and second to create an algorithm to ‘read across’ different measures (such as the Beck Depression Inventory, the Hamilton Rating Scale for Depression (HRSD) and the Montgomery-Asberg Depression Rating Scale).16 Examining trials which use more than one of these measures reveals problems in the algorithm. Of the 51 trials, there are 6 instances in which the study population falls into NICE’s more severe category according to one measure and into the less severe category according to another.

In four of these trials, NICE chose the less severe category (Souza 2016, Watkins 2011a, Fonagy 2015, Town 201715). The other two trials were designated more lasix generic severe (Barbee 2011, Dunner 200715). Only 17 of 51 trials reported two or more depression scale measures, leaving much unknown about whether other study populations could count as both more severe and less severe.Absence of knowledge or knowledge of absence?.

A key philosophical error in science is to confuse an absence of knowledge with lasix generic knowledge of absence. It is likely that some of the study populations deemed lacking in complexity or severity could actually have high degrees of complexity and/or severity. Data to demonstrate this may either fall foul of a guideline committee decision to prioritise certain information over other conflicting information (as in the severity algorithm).

The information may lasix generic be non-existent as it was not collected. It may be somewhere in the publication pipeline. Or it may be sitting in a database with a research team that has run out of funds for lasix generic supplementary analyses.

Wherever those data are or are not, their absence from published articles does not define the phenomenology of depression for the patients who took part. As a case in point, data from the Fonagy 2015 trial presented at conferences but not published reveal that PD prevalence data would place the trial well within the NICE complex depression category, and that the sample had high levels of past trauma and physical condition comorbidity. The trial also meets the guideline criteria for CD according to the lasix generic guideline’s own appendices.17 Reported axis 1 comorbidity was high (75.2% had anxiety disorder, 18.6% had substance abuse disorder, 13.2% had eating disorder).18 The mean depression scores at baseline were 36.5 on the Beck Depression Inventory and 20.1 on the HRSD (severe and very severe, respectively, according to published cut-off scores).

NICE categorised this population as less severe TRD, not CD and not complex.Notes1. Avram H lasix generic. Mack et al.

(1994), “A Brief History of Psychiatric Classification. From the Ancients to DSM-IV,” Psychiatric Clinics 17, no lasix generic. 3.

Snaith (1987), “The Concepts of Mild Depression,” British Journal of Psychiatry 150, no. 3. 387.3.

Susan McPherson and David Armstrong (2006), “Social Determinants of Diagnostic Labels in Depression,” Social Science &. Medicine 62, no. 1.

52–7.4. Gerald N. Grob (1991), “Origins of DSM-I.

A Study in Appearance and Reality,” The American Journal of Psychiatry. 421–31.5. Wilson M.

Compton and Samuel B. Guze (1995), “The Neo-Kraepelinian Revolution in Psychiatric Diagnosis,” European Archives of Psychiatry and Clinical Neuroscience 245, no. 4.

198–9.6. Gerald L. Klerman (1984), “A Debate on DSM-III.

The Advantages of DSM-III,” The American Journal of Psychiatry. 539–42.7. Thomas E.

Schacht (1985), “DSM-III and the Politics of Truth,” American Psychologist. 513–5.8. Daniel F.

Hartner and Kari L. Theurer (2018), “Psychiatry Should Not Seek Mechanisms of Disorder,” Journal of Theoretical and Philosophical Psychology 38, no. 4.

189–204.9. Sami Timimi (2014), “No More Psychiatric Labels. Why Formal Psychiatric Diagnostic Systems Should Be Abolished,” Journal of Clinical and Health Psychology 14, no.

(1994), “DSM-IV Meets Philosophy,” The Journal of Medicine and Philosophy. A Forum for Bioethics and Philosophy of Medicine 19, no. 3.

207–18.11. Andrea Jobst et al. (2016), “European Psychiatric Association Guidance on Psychotherapy in Chronic Depression Across Europe,” European Psychiatry 33.

20.12. National Institute for Health and Care Excellence (2018), Depression in Adults. Treatment and Management.

Draft for Consultation, https://www.nice.org.uk/guidance/gid-cgwave0725/documents/full-guideline-updated, 507.13. Ibid., 351–62.14. Ibid., 597.15.

Note that in order to refer to specific trials reviewed in the guideline, rather than the full citation, the Study IDs from column A in appendix J5 have been used. See www.nice.org.uk/guidance/gid-cgwave0725/documents/addendum-appendix-9 for details and full references.16. National Institute for Health and Care Excellence (2018), Depression in Adults.

Treatment and Management. Second Consultation on Draft Guideline – Stakeholder Comments Table, https://www.nice.org.uk/guidance/gid-cgwave0725/documents/consultation-comments-and-responses-2, 420–1.17. National Institute for Health and Care Excellence (2018), Depression in Adults, appendix J5.18.

Peter Fonagy et al. (2015), “Pragmatic Randomized Controlled Trial of Long-Term Psychoanalytic Psychotherapy for Treatment-Resistant Depression. The Tavistock Adult Depression Study (TADS),” World Psychiatry 14, no.

3. 312–21.19. American Psychological Association (2018), Clinical Practice Guideline for the Treatment of Depression in Children, Adolescents, and Young, Middle-aged, and Older Adults.

Draft.20. Jacqui Thornton (2018), “Depression in Adults. Campaigners and Doctors Demand Full Revision of NICE Guidance,” BMJ 361.

Diuretic lasix dosage

Can you remember the last time diuretic lasix dosage you heard the sound your vehicle's turn signal makes?. Do you keep thinking everyone around you is mumbling?. In other words, you may think your hearing is just fine until a friend or family member calls it to your attention that's it not them, it's you. Even then, it's normal diuretic lasix dosage to want to deny the obvious. You may tell yourself "My hearing isn't that bad" or "I've had a cold lately.

My ears must be stuffy." You may tell yourself "My hearing isn't that bad" or "I've had a cold lately. My ears must be stuffy." Even those who relent and see an audiologist for diuretic lasix dosage a hearing test wait an average of seven years after their hearing loss is diagnosed before purchasing their first set of hearing aids. Stage 2. Anger Once you can no longer deny you're not hearing well, you may move into the second stage of grief—anger. You might be upset about having to add another doctor to your growing diuretic lasix dosage list or the money you have to spend on tests and medical devices.

You may become angry with family members who continually ask you to down the volume on the television or insist you have your hearing checked by a health professional. Realize that your family members may be angry, too. They may think you're ignoring them on purpose—or have a hard diuretic lasix dosage time understanding why you won't make an appointment to see the doctor. In the case of hearing loss, it's important to realize the stages of grief can apply to all family members as well as the one who's lost their hearing. This is especially true in this particular stage.

Realize that your family members may be diuretic lasix dosage angry, too. They may think you're ignoring them on purpose—or have a hard time understanding why you won't make an appointment to see the doctor. Regardless, it's important for all affected parties to work through the anger. If you're the one with hearing loss, consider talking to diuretic lasix dosage a trusted friend or counselor about what you're feeling, writing in a journal or exercising to release stress and tension. Stage 3.

Bargaining After the anger has passed, it's common to enter the bargaining stage and search for ways to restore normal hearing. Maybe it's a promise you make to yourself to wear hearing protection when you're pushing the lawn mower or turn down the volume on diuretic lasix dosage your car stereo. After the anger has passed, it's common to enter the bargaining stage and search for ways to restore normal hearing. Depending on the type of hearing loss you're experiencing, the reality is you may never hear normally again. The good news diuretic lasix dosage.

If your hearing loss is associated with presbycusis (old age hearing loss) or another sensorineural condition, you are most likely a perfect candidate for hearing aids. Your audiologist can make that determination following an extensive hearing test. Stage 4 diuretic lasix dosage. Depression If you're feeling a bit depressed about your hearing loss, you're not alone—especially if you're an older adult. When it becomes difficult and exhausting to participate in daily conversations with friends and loved ones, it's natural to want to avoid those situations.

Knowing we've lost something valuable, like our hearing, diuretic lasix dosage can make us sad—no matter what our age. Not only does hearing loss mean one of your five senses isn't as sharp as it used to be, it may also contribute to a loss identity. Knowing we've lost something extremely valuable, like our hearing, can make us sad—no matter what our age. Hearing health professionals know untreated diuretic lasix dosage hearing loss can lead to anxiety, depression, paranoia and social isolation. It's one of the reasons they stress the importance of maintaining contact with friends and family as we age.

Stage 5. Acceptance The diuretic lasix dosage final stage of grief is acceptance. In the case of those with a hearing impairment, that means you've accepted your physical limitations. Hopefully, you've elected to consult with a hearing health professional and are a candidate for one of the numerous ways of improving your ability to hear. If your audiologist has recommended hearing aids and you've decided not to diuretic lasix dosage purchase them, you may want to reconsider.

If your hearing loss is severe or profound, you may also be a candidate for cochlear implants (even if you're older). Once you've accepted your hearing loss, hopefully you've elected to consult with a hearing health professional to receive help. Many treatment options diuretic lasix dosage exist. Recent research confirms a direct link between hearing aid usage and improved quality of life. Most hearing aid users report higher levels of happiness and say hearing aids have significantly improved their relationships with family and friends and given them a greater sense of independence.

Research also shows that hearing aids also have health benefits, such as reduced rates of depression, social isolation and the risk of falls.When you live with bothersome tinnitus, having the right coping tools close at hand can make a big difference in the quality of your day. But if you have a smartphone, you already own one of the most powerful tinnitus coping toolkits ever created. There are many apps that can help you to better manage tinnitus in a variety of different ways. The only problem is that there are quite a lot of apps to choose from, and not all of them are created equal. So I’m here to help.

I’ve put together a list of my favorite tinnitus-related apps across many different categories, all to help you find relief from the ringing in your ears. From sound masking, guided meditation and breathing techniques, to educational content, habituation assistance, and sensorineural hearing loss improvement, there is an app for every need. Despite what your doctor might have told you or what you might have read online, if you suffer from tinnitus, you do not “just have to live with it.” There are many ways to find tinnitus relief, and these apps are just one more toolset available to every tinnitus patient. I hope you find them helpful!. Best apps for sound masking myNoise (Android and iOS) NatureSpace (Android and iOS) At its best, sound masking is one the most powerful coping tools available to tinnitus sufferers.

The strategy is remarkably simple. You just use various types of background noise to partially cover the sound of your tinnitus. For most sufferers, the right background noise can often provide immediate (though temporary) relief. Smartphone apps for tinnitus can help calm theringing in your ears. It’s an effective way to cope, but in practice it can get tricky, because not all sound masking sounds are created equal, and there are a seemingly endless number of sound masking/sound therapy apps available in the app store.

Here are my top two app recommendations, available for both Android and iOS devices. MyNoise (Android and iOS). MyNoise features a massive library of soundscapes and ambiances, including various experimental sounds specifically created for tinnitus patients. Best of all, every soundscape is completely customizable via sliders that let you control the individual volume of various elements of the soundscape. Want more birds, but less rain, stronger wind, and no chimes?.

Simple. Or maybe you want the sound of more chatter in the café ambiance, but less clinking of cups and silverware?. Two clicks and it’s done. MyNoise makes it easy to dial in the perfect soundscape to mask the sound of your tinnitus. NatureSpace (Android and iOS).

Naturespace has been one of my favorite masking apps for a long time for one very specific reason. No other app can hold a candle to the quality of their nature soundscapes. And that’s because all of the soundscapes are actual high-fidelity audio recordings of real nature. According to NatureSpace, “Our specialized team of audio engineers record outdoor environments in 3D using proprietary holographic microphone techniques drawn from binaural, classical, and field recording practices. The results are astonishing.

Naturespace recordings preserve the entire hemispheric sound field, including the sounds that occur in front, behind, beside, and above the listener over headphones.” The app itself is free, along with 6 included soundscapes, with the remaining 120+ recordings available via in-app purchases a la carte. Runner up. Relax Melodies (Android and iOS) Best apps for comprehensive tinnitus relief and habituation Rewiring Tinnitus Relief Project Quieten (Android and iOS) There may not currently be a cure for tinnitus, but lasting relief is entirely possible through a mental process called habituation. And only a select few apps are specifically designed to help you habituate to the sound of your tinnitus. The human brain is fully capable of tuning out the sound of tinnitus (even when it’s loud) just like it does all other meaningless background noise.

The problem is that when tinnitus becomes severe, it triggers a powerful and progressively worsening fight-or-flight stress response that never fully ends because the tinnitus doesn’t just magically go away. And it’s this reaction that prevents the brain from being able to ignore the sound. We are evolutionarily hardwired to focus on sounds that our brain and nervous system interpret as the sound of something dangerous. But you can completely change your underlying emotional, psychological and physiological reaction to the sound of your tinnitus. And when you do, your brain can start to automatically tune out and ignore the sound of your tinnitus more and more of the time.

Here are two apps whose sole purpose is to help you habituate and find lasting relief. Rewiring Tinnitus Relief Project. First I have to disclose that this is my app that I created to help tinnitus sufferers habituate and find relief as quickly as possible. It was originally designed to accompany my book (Rewiring Tinnitus. How I finally Found Relief from the Ringing in my Ears), but ultimately evolved into a standalone program for tinnitus habituation.

The 54-track album feature a powerful audio technology called Brainwave Entrainment that can change your mental state in minutes, and all you have to do is press play. It features guided tinnitus meditation tracks, sleep induction tracks, guided tinnitus spike relief techniques, relaxation tracks, and more, all embedded with various masking sounds and brainwave entrainment to put you in a sedated state of relaxation automatically. I may be biased, but as an experienced tinnitus coach, I know what works. Quieten (Android and iOS). Quieten is an excellent new app from author, therapist, and tinnitus expert Julian Cowan Hill.

It features a wide variety of free audio and video educational content to help you habituate and better understand tinnitus, as well as meditations, coping tools, relaxation techniques and more!. Runner up. Beltone Tinnitus Calmer (Android and iOS) Best paid app for meditation Waking Up (Android and iOS) When it comes to tinnitus coping, it’s important to reduce your stress and anxiety levels as much as possible, and mindfulness meditation is one of the most powerful tools at your disposal. Mindfulness has been shown to be helpful for tinnitus coping, but it’s also a remarkably effective way to better manage your mind. There are a ton of excellent mindfulness meditation apps on the market, but for me, the Waking Up meditation app from author Sam Harris stands above the rest.

The app itself is not marketed or built for tinnitus patients specifically, but mindfulness is an important tool that should be every tinnitus sufferer's toolkit. I’ve personally used Waking Up on a daily basis for more than a year now and it has had a profoundly positive impact on my quality of life with tinnitus on almost every level. I cannot recommend this app enough!. Runners up. 10% App, Headspace, Calm Best free app for meditation Insight Timer (Android and iOS) Insight Timer is the most popular free meditation app by far, and for good reason.

It features more than 60,000 free guided meditations, breathing exercises, and music tracks. It’s not just traditional meditation either, Insight Timer features guided meditations for better sleep, relaxation, anxiety relief, focus, and more, making it an excellent option for tinnitus sufferers who want to experiment with different types of meditation to help them cope. Insight Timer also includes a great meditation timer feature built into the app that allows you to set up custom meditation sessions. This is a focus training tool that plays a soft chime (or whatever sound you select) at preset intervals to help keep you focused while you meditate. This way, if your mind is wandering, and the chime goes off, it instantly brings you back to the meditation.

You can also incorporate various background sounds into your meditation sessions, such as ambient music, nature sounds, and white noise. Best apps for breathing techniques Breathwrk (iOS only) Prana Breath. Calm &. Meditate (Android only) Breathing techniques are a powerful way to cope with tinnitus, especially during spikes and on difficult days. Fortunately, there are a handful of excellent apps featuring guided breathing exercises to help you learn and practice the most effective techniques, of which there are many.

Some breathing techniques can trigger a relaxation response in the nervous system very quickly, while other techniques can help with everything from falling asleep faster, lowering stress levels, improving emotional regulation, increasing energy and focus, and so much more!. Here my top two app recommendations for learning the most powerful breathing techniques. Breathwrk (iOS only). Breathwrk is one of the top breathing exercise apps for iOS, featuring thousands of positive reviews in the app store, with a combined 4.9/5 star rating. As far features, Breathwrk includes 10+ guided breathing techniques, visual, audio, and vibration cues, breathing lessons, progress tracking, and so much more.

Prana Breath. Calm &. Meditate (Android only). Prana Breath is one of the most popular and powerful free guided breathing apps for Android, featuring 8 preset breathing protocols, visual, audio, and vibration cues to make it easy to follow along, as well as the ability to set up custom breathing sessions with timing intervals of your choosing. Prana Breath also allows you to increase the difficulty and complexity level of each technique as you practice, while recording of all of your breathing sessions so you can see your results and track progress over time.

The app itself is free and ad-free, though there is a premium “Guru” version of the app (that I highly recommend) that can be unlocked via in-app purchase that adds an additional 50 breathing techniques. Best app for improving hearing loss AudioCardio (Android and iOS) Many patients with tinnitus also have hearing loss. It's a difficult combination, but it opens the door to additional treatment strategies, because improving a person's hearing can often improve their tinnitus as well. AudioCardio delivers a new type of sound therapy that functions kind of like physical therapy for hearing, and one that could actually improve and strengthen hearing in patients with sensorineural hearing loss, based on preliminary data. In a clinical trial at Stanford University, more than 70% of 42 study participants experienced at least a 10-decibel improvement in their hearing at the targeted frequency after two weeks of using AudioCardio’s algorithmically generated sound therapy for one hour per day.

Self-reported user data over the longer term shows that some people experienced as much as 15-25 decibel improvements across the whole frequency range. So how does it work?. First, the app performs a hearing test to identify the lowest decibel level sound that you are able to hear at a range of different frequencies. The app then targets the user’s worst frequency and delivers a unique sound therapy called Threshold Sound Conditioning. In most cases of sensorineural hearing loss, the hair cells are damaged, but not destroyed.

A person can still hear sounds at the affected frequency if they are loud enough. The app plays algorithmically generated tones right at the threshold of what a person can hear.

Not many of us get lasix generic through life without experiencing it at some point. However, everyone moves through the process differently.It's normal to feel a range of emotions afterbeing diagnosed with hearing loss. Elisabeth Kubler-Ross, a Swedish-American psychologist, wrote about five psychological stages terminally ill patients commonly experience in her book On Death and Dying in 1969. At its lasix generic core, the book is about how we process loss. Therefore, these stages can be applied to other painful life-changing experiences such as divorce, the death of a loved one—even coming to terms with hearing loss.

It's important to keep in mind that not everyone will experience all these stages, and the order of how you experience them can be unpredictable, too. However, the five stages are quite useful for improving self-awareness of how lasix generic you or a loved one may be coping with a diagnosis of hearing loss. That anger you may feel?. Quite normal. So is lasix generic sadness.

Stage 1. Denial In many situations, especially with older adults, hearing loss occurs gradually. You may not realize you haven't heard the lasix generic birds sing outside your bedroom window lately. Can you remember the last time you heard the sound your vehicle's turn signal makes?. Do you keep thinking everyone around you is mumbling?.

In other lasix generic words, you may think your hearing is just fine until a friend or family member calls it to your attention that's it not them, it's you. Even then, it's normal to want to deny the obvious. You may tell yourself "My hearing isn't that bad" or "I've had a cold lately. My ears lasix generic must be stuffy." You may tell yourself "My hearing isn't that bad" or "I've had a cold lately. My ears must be stuffy." Even those who relent and see an audiologist for a hearing test wait an average of seven years after their hearing loss is diagnosed before purchasing their first set of hearing aids.

Stage 2. Anger Once you can no longer lasix generic deny you're not hearing well, you may move into the second stage of grief—anger. You might be upset about having to add another doctor to your growing list or the money you have to spend on tests and medical devices. You may become angry with family members who continually ask you to down the volume on the television or insist you have your hearing checked by a health professional. Realize that your family members may be angry, too lasix generic.

They may think you're ignoring them on purpose—or have a hard time understanding why you won't make an appointment to see the doctor. In the case of hearing loss, it's important to realize the stages of grief can apply to all family members as well as the one who's lost their hearing. This is especially true in this lasix generic particular stage. Realize that your family members may be angry, too. They may think you're ignoring them on purpose—or have a hard time understanding why you won't make an appointment to see the doctor.

Regardless, it's important for all affected parties to work lasix generic through the anger. If you're the one with hearing loss, consider talking to a trusted friend or counselor about what you're feeling, writing in a journal or exercising to release stress and tension. Stage 3. Bargaining After the anger has passed, it's lasix generic common to enter the bargaining stage and search for ways to restore normal hearing. Maybe it's a promise you make to yourself to wear hearing protection when you're pushing the lawn mower or turn down the volume on your car stereo.

After the anger has passed, it's common to enter the bargaining stage and search for ways to restore normal hearing. Depending on the type of hearing loss you're experiencing, the reality is you lasix generic may never hear normally again. The good news. If your hearing loss is associated with presbycusis (old age hearing loss) or another sensorineural condition, you are most likely a perfect candidate for hearing aids. Your audiologist can lasix generic make that determination following an extensive hearing test.

Stage 4. Depression If you're feeling a bit depressed about your hearing loss, you're not alone—especially if you're an older adult. When it becomes difficult and exhausting to participate lasix generic in daily conversations with friends and loved ones, it's natural to want to avoid those situations. Knowing we've lost something valuable, like our hearing, can make us sad—no matter what our age. Not only does hearing loss mean one of your five senses isn't as sharp as it used to be, it may also contribute to a loss identity.

Knowing we've lost something extremely valuable, like our hearing, can make us sad—no lasix generic matter what our age. Hearing health professionals know untreated hearing loss can lead to anxiety, depression, paranoia and social isolation. It's one of the reasons they stress the importance of maintaining contact with friends and family as we age. Stage 5 lasix generic. Acceptance The final stage of grief is acceptance.

In the case of those with a hearing impairment, that means you've accepted your physical limitations. Hopefully, you've elected to consult with a hearing health professional and are a candidate for one lasix generic of the numerous ways of improving your ability to hear. If your audiologist has recommended hearing aids and you've decided not to purchase them, you may want to reconsider. If your hearing loss is severe or profound, you may also be a candidate for cochlear implants (even if you're older). Once you've accepted your hearing loss, hopefully you've elected to consult with a hearing health professional to receive lasix generic help.

Many treatment options exist. Recent research confirms a direct link between hearing aid usage and improved quality of life. Most hearing aid users report higher levels of happiness and say hearing aids have significantly improved their relationships with family and friends and given them lasix generic a greater sense of independence. Research also shows that hearing aids also have health benefits, such as reduced rates of depression, social isolation and the risk of falls.When you live with bothersome tinnitus, having the right coping tools close at hand can make a big difference in the quality of your day. But if you have a smartphone, you already own one of the most powerful tinnitus coping toolkits ever created.

There are many lasix generic apps that can help you to better manage tinnitus in a variety of different ways. The only problem is that there are quite a lot of apps to choose from, and not all of them are created equal. So I’m here to help. I’ve put together a list of my favorite tinnitus-related apps across many different categories, all to help you lasix generic find relief from the ringing in your ears. From sound masking, guided meditation and breathing techniques, to educational content, habituation assistance, and sensorineural hearing loss improvement, there is an app for every need.

Despite what your doctor might have told you or what you might have read online, if you suffer from tinnitus, you do not “just have to live with it.” There are many ways to find tinnitus relief, and these apps are just one more toolset available to every tinnitus patient. I hope you find lasix generic them helpful!. Best apps for sound masking myNoise (Android and iOS) NatureSpace (Android and iOS) At its best, sound masking is one the most powerful coping tools available to tinnitus sufferers. The strategy is remarkably simple. You just use various types of background noise to partially cover the sound of your tinnitus.

For most sufferers, the right background noise can lasix generic often provide immediate (though temporary) relief. Smartphone apps for tinnitus can help calm theringing in your ears. It’s an effective way to cope, but in practice it can get tricky, because not all sound masking sounds are created equal, and there are a seemingly endless number of sound masking/sound therapy apps available in the app store. Here are my top two app lasix generic recommendations, available for both Android and iOS devices. MyNoise (Android and iOS).

MyNoise features a massive library of soundscapes and ambiances, including various experimental sounds specifically created for tinnitus patients. Best of all, every soundscape is completely customizable via lasix generic sliders that let you control the individual volume of various elements of the soundscape. Want more birds, but less rain, stronger wind, and no chimes?. Simple. Or maybe you want the sound of more chatter in the café ambiance, but lasix generic less clinking of cups and silverware?.

Two clicks and it’s done. MyNoise makes it easy to dial in the perfect soundscape to mask the sound of your tinnitus. NatureSpace (Android and lasix generic iOS). Naturespace has been one of my favorite masking apps for a long time for one very specific reason. No other app can hold a candle to the quality of their nature soundscapes.

And that’s because all of the soundscapes are actual high-fidelity audio lasix generic recordings of real nature. According to NatureSpace, “Our specialized team of audio engineers record outdoor environments in 3D using proprietary holographic microphone techniques drawn from binaural, classical, and field recording practices. The results are astonishing. Naturespace recordings preserve the entire hemispheric sound lasix generic field, including the sounds that occur in front, behind, beside, and above the listener over headphones.” The app itself is free, along with 6 included soundscapes, with the remaining 120+ recordings available via in-app purchases a la carte. Runner up.

Relax Melodies (Android and iOS) Best apps for comprehensive tinnitus relief and habituation Rewiring Tinnitus Relief Project Quieten (Android and iOS) There may not currently be a cure for tinnitus, but lasting relief is entirely possible through a mental process called habituation. And only a select few lasix generic apps are specifically designed to help you habituate to the sound of your tinnitus. The human brain is fully capable of tuning out the sound of tinnitus (even when it’s loud) just like it does all other meaningless background noise. The problem is that when tinnitus becomes severe, it triggers a powerful and progressively worsening fight-or-flight stress response that never fully ends because the tinnitus doesn’t just magically go away. And it’s this reaction that prevents the brain from being able to ignore the sound lasix generic.

We are evolutionarily hardwired to focus on sounds that our brain and nervous system interpret as the sound of something dangerous. But you can completely change your underlying emotional, psychological and physiological reaction to the sound of your tinnitus. And when you do, your brain can start to automatically tune out and ignore the sound of your tinnitus more and more lasix generic of the time. Here are two apps whose sole purpose is to help you habituate and find lasting relief. Rewiring Tinnitus Relief Project.

First I have to disclose that this is my app that I created to help tinnitus sufferers habituate and lasix generic find relief as quickly as possible. It was originally designed to accompany my book (Rewiring Tinnitus. How I finally Found Relief from the Ringing in my Ears), but ultimately evolved into a standalone program for tinnitus habituation. The 54-track lasix generic album feature a powerful audio technology called Brainwave Entrainment that can change your mental state in minutes, and all you have to do is press play. It features guided tinnitus meditation tracks, sleep induction tracks, guided tinnitus spike relief techniques, relaxation tracks, and more, all embedded with various masking sounds and brainwave entrainment to put you in a sedated state of relaxation automatically.

I may be biased, but as an experienced tinnitus coach, I know what works. Quieten (Android lasix generic and iOS). Quieten is an excellent new app from author, therapist, and tinnitus expert Julian Cowan Hill. It features a wide variety of free audio and video educational content to help you habituate and better understand tinnitus, as well as meditations, coping tools, relaxation techniques and more!. Runner up lasix generic.

Beltone Tinnitus Calmer (Android and iOS) Best paid app for meditation Waking Up (Android and iOS) When it comes to tinnitus coping, it’s important to reduce your stress and anxiety levels as much as possible, and mindfulness meditation is one of the most powerful tools at your disposal. Mindfulness has been shown to be helpful for tinnitus coping, but it’s also a remarkably effective way to better manage your mind. There are lasix generic a ton of excellent mindfulness meditation apps on the market, but for me, the Waking Up meditation app from author Sam Harris stands above the rest. The app itself is not marketed or built for tinnitus patients specifically, but mindfulness is an important tool that should be every tinnitus sufferer's toolkit. I’ve personally used Waking Up on a daily basis for more than a year now and it has had a profoundly positive impact on my quality of life with tinnitus on almost every level.

I cannot recommend this app lasix generic enough!. Runners up. 10% App, Headspace, Calm Best free app for meditation Insight Timer (Android and iOS) Insight Timer is the most popular free meditation app by far, and for good reason. It features more than 60,000 free guided meditations, breathing exercises, lasix generic and music tracks. It’s not just traditional meditation either, Insight Timer features guided meditations for better sleep, relaxation, anxiety relief, focus, and more, making it an excellent option for tinnitus sufferers who want to experiment with different types of meditation to help them cope.

Insight Timer also includes a great meditation timer feature built into the app that allows you to set up custom meditation sessions. This is a focus training tool that plays a soft chime (or whatever sound you select) at preset intervals lasix generic to help keep you focused while you meditate. This way, if your mind is wandering, and the chime goes off, it instantly brings you back to the meditation. You can also incorporate various background sounds into your meditation sessions, such as ambient music, nature sounds, and white noise. Best apps for breathing techniques lasix generic Breathwrk (iOS only) Prana Breath.

Calm &. Meditate (Android only) Breathing techniques are a powerful way to cope with tinnitus, especially during spikes and on difficult days. Fortunately, there lasix generic are a handful of excellent apps featuring guided breathing exercises to help you learn and practice the most effective techniques, of which there are many. Some breathing techniques can trigger a relaxation response in the nervous system very quickly, while other techniques can help with everything from falling asleep faster, lowering stress levels, improving emotional regulation, increasing energy and focus, and so much more!. Here my top two app recommendations for learning the most powerful breathing techniques.

Breathwrk (iOS lasix generic only). Breathwrk is one of the top breathing exercise apps for iOS, featuring thousands of positive reviews in the app store, with a combined 4.9/5 star rating. As far features, Breathwrk includes 10+ guided breathing techniques, visual, audio, and vibration cues, breathing lessons, progress tracking, and so much more. Prana Breath lasix generic. Calm &.

Meditate (Android only). Prana Breath is one of the most popular and powerful free guided breathing apps for Android, featuring 8 preset breathing protocols, visual, audio, and vibration cues to make it easy to follow along, as well as the ability to set up custom breathing sessions with timing intervals of your choosing.

Hold lasix for low bp

€œDespite a new wave which began on 25 July which Viet Nam is now also in the process of bringing under effective control, it is benefits of lasix globally recognized hold lasix for low bp that Viet Nam demonstrated one of the world’s most successful responses to the COVID-19 pandemic between January and April 16. After that date, no cases of local transmission were recorded for 99 consecutive days.There were less than 400 cases of infection across the country during that period, most of them imported, and zero deaths, a remarkable accomplishment considering the country’s population of 96 million people and the fact that it shares a 1,450 km land border with China.Long-term planning pays offKamal Malhotra is the UN Resident Coordinator in Viet Nam. , by UN Viet Nam/Nguyen Duc HieuViet Nam’s success hold lasix for low bp has drawn international attention because of its early, proactive, response, led by the government, and involving the whole political system, and all aspects of the society. With the support of theWorld Health Organization (WHO) and other partners, Viet Nam had already put a long-term plan in place, to enable it to cope with public health emergencies, building on its experience dealing with previous disease outbreaks, such as SARS, which it also handled remarkably well.Viet Nam’s successful management of the COVID-19 outbreak so far can, therefore, be at least partly put down to the its investment during “peacetime”.

The country has now demonstrated that preparedness to deal with infectious disease is a key ingredient for protecting people and securing public health in times of pandemics such as COVID-19.As early as January 2020, Viet Nam conducted its first risk assessment, immediately after hold lasix for low bp the identification of a cluster of cases of “severe pneumonia with unknown etiology” in Wuhan, China. From the time that the first two COVID-19 cases were confirmed in Viet Nam in the second half of January 2020, the government started to put precautionary measures into effect by strengthening entry-screening measures and extending the Tết (Lunar New Year) holiday for schools. © UNICEFTeachers and students were able to return to school in Lao Cai, Viet Nam, in May.By 13 February 2020, the number of cases had climbed to 16 with limited local transmission detected in a village near the capital city, Hanoi. As this had the potential to cause a further spread of the virus in Viet Nam, the country implemented a targeted three-week village-wide quarantine, hold lasix for low bp affecting 11,000 people.

There were then no further local cases for three weeks.But Viet Nam had simultaneously developed its broader quarantine and isolation policy to control COVID-19. As the next wave began in early March, through hold lasix for low bp an imported case from the UK, the government knew that it was crucial to contain virus transmission as fast as possible, in order also to safeguard its economy.Viet Nam therefore closed its borders and suspended international flights from mainland China in February, extending this to UK, Europe, the US and then the rest of the world progressively in March, whilst requiring all travelers entering the country, including its nationals, to undergo 14-day mandatory quarantine on arrival.This helped the authorities keep track of imported cases of COVID-19 and prevent further local transmission which could have then led to wider community transmission. Both the military and local governments were mobilized to provide testing, meals and amenity services to all quarantine facilities which remained free during this period.No lockdown requiredWhile there was never a nationwide lockdown, some restrictive physical distancing measures were implemented throughout the country. On 1 April 2020, the Prime Minister issued a nationwide two week physical distancing directive, hold lasix for low bp which was extended by a week in major cities and hotspots.

People were advised to stay at home, non-essential businesses were requested to close, and public transportation was limited.Such measures were so successful that, by early May, following two weeks without a locally confirmed case, schools and businesses resumed their operations and people could return to regular routines. Green One UN House, the home of most UN agencies in Viet Nam, remained open throughout this period, with the Resident Coordinator, WHO Representative and approximately 200 UN staff and consultants physically in the office throughout this period, to provide vital support to the Government and people of Viet Nam.Notably, the Vietnamese public had been exceptionally compliant with government directives and advice, partly as a result of trust built up thanks to real time, transparent communication from the Ministry of Health, supported by the WHO and other UN agencies. Innovative methods were used to keep hold lasix for low bp the public informed and safe. For instance, regular text updates were sent by the Ministry of Health, on preventive measures and COVID-19’s symptoms.

A COVID-19 song was released, with lyrics raising public awareness of the disease, which later went viral on social media with a dance challenge on Tik Tok initiated by Quang Dang, a local hold lasix for low bp celebrity.. UN Viet Nam/Nguyen Duc HieuYoung people in Viet Nam take part in International Youth Day 2020 festivities in June. Protecting the vulnerableStill, challenges remain to ensure that the people across the country, especially the hardest hit people, from small and medium-sized enterprises hold lasix for low bp (SMEs) and poor and vulnerable groups, are well served by an adequately resourced and effectively implemented social protection package. The UN in Viet Nam is keen to help the government support clean technology-based SMEs, with the cooperation of international financial institutions, which will need to do things differently from the past and embrace a new, more inclusive and sustainable, perspective on growth.Challenges remainAs I write, Viet Nam stands at a critical point with respect to COVID-19.

On 25 July, 99 days after being COVID-free in terms of local transmission, a new case was confirmed in Da Nang, a well-known tourist destination. Hundreds of thousands of people flocked to the city and surrounding region over the summer.The government hold lasix for low bp is once again demonstrating its serious commitment to containing local virus transmission. While there have been a few hundred new local transmission cases and 24 deaths, all centered in a major hospital in Danang (sadly, all the deaths were of people with multiple pre-conditions) aggressive contact tracing, proactive case management, extensive quarantining measures and comprehensive public communication activities are taking place.I am confident that the country will be successful in its efforts to once again successfully contain the virus, once more over the next few weeks.”The Review Committee will advise whether any amendments to the International Health Regulations (IHR) are necessary to ensure it is as effective as possible, WHO Director General Tedros Adhanom Ghebreyesus told journalists. He said the COVID-19 pandemic has been “an acid test” for many hold lasix for low bp countries, organizations and the treaty.

“Even before the pandemic, I have spoken about how emergencies such as the Ebola outbreak in eastern DRC (the Democratic Republic of the Congo) have demonstrated that some elements of the IHR may need review, including the binary nature of the mechanism for declaring a public health emergency of international concern,” said Mr. Tedros. Interaction with pandemic panel The IHR Review Committee will hold its first meeting on 8 hold lasix for low bp and 9 September. The committee will also interact with two other entities, exchanging information and sharing findings.

They are the hold lasix for low bp Independent Panel for Pandemic Preparedness and Response, established last month to evaluate global response to the COVID-19 pandemic, and the Independent Oversight Advisory Committee for the WHO Health Emergencies Programme. It is expected that the committee will present a progress report to the World Health Assembly, WHO’s decision-making body, at its resumed session in November. The Assembly comprises delegations from WHO’s 194 member States who hold lasix for low bp meet annually in May. A truncated virtual session was held this year due to the pandemic.

The committee will present its full report to the Assembly in 2021. Committed to ending COVID-19 The IHR was first adopted in 1969 and is legally-binding hold lasix for low bp on 196 countries, including all WHO Member States. It was last revised in 2005. The treaty outlines rights and obligations for countries, hold lasix for low bp including the requirement to report public health events, as well as the criteria to determine whether or not a particular event constitutes a “public health emergency of international concern”.

Mr. Tedros underscored WHO’s commitment to ending the pandemic, “and to working with all countries to learn from it, and hold lasix for low bp to ensure that together we build the healthier, safer, fairer world that we want.” Invest in mental health WHO is also shining light on the pandemic’s impact on mental health at a time when services have suffered disruptions. For example, Mr. Tedros said lack of social interaction has affected many people, while others have experienced anxiety and fear.

Meanwhile, some mental hold lasix for low bp health facilities have been closed and converted to COVID-19 treatment facilities. Globally, close to one billion people are living with a mental disorder. In low- and middle-income countries, more hold lasix for low bp than three-quarters of people with mental, neurological and substance use disorders do not receive treatment. World Mental Health Day is observed annually on 10 October, and WHO and partners are calling for a massive scale-up in investments.

The UN agency also will host its first-ever global online advocacy event on mental health where experts, musicians and sports figures will discuss action to improve mental health, in addition to hold lasix for low bp sharing their stories. Global fight against polio continues The milestone eradication of wild poliovirus in Africa does not mean the disease has been defeated globally, Mr. Tedros reminded journalists. WHO announced on Tuesday that the continent has been declared free of the virus, which can cause paralysis, after no cases were reported for four years “We still have a lot of work to do to eradicate polio from the last hold lasix for low bp two countries where it exists.

Afghanistan and Pakistan,” he said. Mr. Tedros also congratulated Togo, which on Wednesday celebrated the end of sleeping sickness as a public health problem. The disease, officially known as human African Trypanosomiasis, is spread by tsetse flies and is fatal without treatment..

€œDespite a new wave which began on 25 July which Viet Nam is now also in the process of bringing under effective control, it is globally recognized that Viet Nam demonstrated one of the world’s lasix generic most successful responses to the COVID-19 pandemic between January and April 16. After that date, no cases of local transmission were recorded for 99 consecutive days.There were less than 400 cases of infection across the country during that period, most of them imported, and zero deaths, a remarkable accomplishment considering the country’s population of 96 million people and the fact that it shares a 1,450 km land border with China.Long-term planning pays offKamal Malhotra is the UN Resident Coordinator in Viet Nam. , by UN Viet Nam/Nguyen Duc HieuViet Nam’s success has drawn international attention because of its early, proactive, response, led by the government, and involving the whole political system, and all aspects of the society lasix generic.

With the support of theWorld Health Organization (WHO) and other partners, Viet Nam had already put a long-term plan in place, to enable it to cope with public health emergencies, building on its experience dealing with previous disease outbreaks, such as SARS, which it also handled remarkably well.Viet Nam’s successful management of the COVID-19 outbreak so far can, therefore, be at least partly put down to the its investment during “peacetime”. The country has now demonstrated that preparedness to deal with infectious disease is a key ingredient for protecting lasix generic people and securing public health in times of pandemics such as COVID-19.As early as January 2020, Viet Nam conducted its first risk assessment, immediately after the identification of a cluster of cases of “severe pneumonia with unknown etiology” in Wuhan, China. From the time that the first two COVID-19 cases were confirmed in Viet Nam in the second half of January 2020, the government started to put precautionary measures into effect by strengthening entry-screening measures and extending the Tết (Lunar New Year) holiday for schools.

© UNICEFTeachers and students were able to return to school in Lao Cai, Viet Nam, in May.By 13 February 2020, the number of cases had climbed to 16 with limited local transmission detected in a village near the capital city, Hanoi. As this had the lasix generic potential to cause a further spread of the virus in Viet Nam, the country implemented a targeted three-week village-wide quarantine, affecting 11,000 people. There were then no further local cases for three weeks.But Viet Nam had simultaneously developed its broader quarantine and isolation policy to control COVID-19.

As the next wave began in early March, through an imported case from the UK, the government knew that it was crucial to contain virus transmission as fast as possible, in order also to safeguard its economy.Viet Nam therefore closed its borders and suspended international flights from mainland China in February, extending this to lasix generic UK, Europe, the US and then the rest of the world progressively in March, whilst requiring all travelers entering the country, including its nationals, to undergo 14-day mandatory quarantine on arrival.This helped the authorities keep track of imported cases of COVID-19 and prevent further local transmission which could have then led to wider community transmission. Both the military and local governments were mobilized to provide testing, meals and amenity services to all quarantine facilities which remained free during this period.No lockdown requiredWhile there was never a nationwide lockdown, some restrictive physical distancing measures were implemented throughout the country. On 1 April 2020, the Prime lasix generic Minister issued a nationwide two week physical distancing directive, which was extended by a week in major cities and hotspots.

People were advised to stay at home, non-essential businesses were requested to close, and public transportation was limited.Such measures were so successful that, by early May, following two weeks without a locally confirmed case, schools and businesses resumed their operations and people could return to regular routines. Green One UN House, the home of most UN agencies in Viet Nam, remained open throughout this period, with the Resident Coordinator, WHO Representative and approximately 200 UN staff and consultants physically in the office throughout this period, to provide vital support to the Government and people of Viet Nam.Notably, the Vietnamese public had been exceptionally compliant with government directives and advice, partly as a result of trust built up thanks to real time, transparent communication from the Ministry of Health, supported by the WHO and other UN agencies. Innovative methods were lasix generic used to keep the public informed and safe.

For instance, regular text updates were sent by the Ministry of Health, on preventive measures and COVID-19’s symptoms. A COVID-19 song was released, with lyrics raising public awareness of the disease, which later went viral on social media with a dance challenge on Tik Tok lasix generic initiated by Quang Dang, a local celebrity.. UN Viet Nam/Nguyen Duc HieuYoung people in Viet Nam take part in International Youth Day 2020 festivities in June.

Protecting the vulnerableStill, challenges remain to ensure that the people across the lasix generic country, especially the hardest hit people, from small and medium-sized enterprises (SMEs) and poor and vulnerable groups, are well served by an adequately resourced and effectively implemented social protection package. The UN in Viet Nam is keen to help the government support clean technology-based SMEs, with the cooperation of international financial institutions, which will need to do things differently from the past and embrace a new, more inclusive and sustainable, perspective on growth.Challenges remainAs I write, Viet Nam stands at a critical point with respect to COVID-19. On 25 July, 99 days after being COVID-free in terms of local transmission, a new case was confirmed in Da Nang, a well-known tourist destination.

Hundreds of thousands lasix generic of people flocked to the city and surrounding region over the summer.The government is once again demonstrating its serious commitment to containing local virus transmission. While there have been a few hundred new local transmission cases and 24 deaths, all centered in a major hospital in Danang (sadly, all the deaths were of people with multiple pre-conditions) aggressive contact tracing, proactive case management, extensive quarantining measures and comprehensive public communication activities are taking place.I am confident that the country will be successful in its efforts to once again successfully contain the virus, once more over the next few weeks.”The Review Committee will advise whether any amendments to the International Health Regulations (IHR) are necessary to ensure it is as effective as possible, WHO Director General Tedros Adhanom Ghebreyesus told journalists. He said the lasix generic COVID-19 pandemic has been “an acid test” for many countries, organizations and the treaty.

“Even before the pandemic, I have spoken about how emergencies such as the Ebola outbreak in eastern DRC (the Democratic Republic of the Congo) have demonstrated that some elements of the IHR may need review, including the binary nature of the mechanism for declaring a public health emergency of international concern,” said Mr. Tedros. Interaction with pandemic panel The IHR Review lasix generic Committee will hold its first meeting on 8 and 9 September.

The committee will also interact with two other entities, exchanging information and sharing findings. They are the Independent Panel for Pandemic Preparedness lasix generic and Response, established last month to evaluate global response to the COVID-19 pandemic, and the Independent Oversight Advisory Committee for the WHO Health Emergencies Programme. It is expected that the committee will present a progress report to the World Health Assembly, WHO’s decision-making body, at its resumed session in November.

The Assembly comprises delegations from WHO’s 194 member States who lasix generic meet annually in May. A truncated virtual session was held this year due to the pandemic. The committee will present its full report to the Assembly in 2021.

Committed to ending lasix generic COVID-19 The IHR was first adopted in 1969 and is legally-binding on 196 countries, including all WHO Member States. It was last revised in 2005. The treaty outlines rights and obligations for countries, including the requirement to report public health events, as well as the criteria to determine whether or not lasix generic a particular event constitutes a “public health emergency of international concern”.

Mr. Tedros underscored WHO’s commitment to ending the pandemic, “and to working with all countries to learn from it, and to ensure that together we build the healthier, safer, fairer world that we want.” Invest in mental health WHO is also shining light on lasix generic the pandemic’s impact on mental health at a time when services have suffered disruptions. For example, Mr.

Tedros said lack of social interaction has affected many people, while others have experienced anxiety and fear. Meanwhile, some mental health lasix generic facilities have been closed and converted to COVID-19 treatment facilities. Globally, close to one billion people are living with a mental disorder.

In low- lasix generic and middle-income countries, more than three-quarters of people with mental, neurological and substance use disorders do not receive treatment. World Mental Health Day is observed annually on 10 October, and WHO and partners are calling for a massive scale-up in investments. The UN agency also will host its first-ever global online advocacy event on mental health where lasix generic experts, musicians and sports figures will discuss action to improve mental health, in addition to sharing their stories.

Global fight against polio continues The milestone eradication of wild poliovirus in Africa does not mean the disease has been defeated globally, Mr. Tedros reminded journalists. WHO announced on Tuesday that the continent has been declared free of the virus, lasix generic which can cause paralysis, after no cases were reported for four years “We still have a lot of work to do to eradicate polio from the last two countries where it exists.

Afghanistan and Pakistan,” he said. Mr. Tedros also congratulated Togo, which on Wednesday celebrated the end of sleeping sickness as a public health problem.

The disease, officially known as human African Trypanosomiasis, is spread by tsetse flies and is fatal without treatment..


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