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Karen Jo Young wrote a letter to her local newspaper criticizing executives at the hospital where she worked seroquel psychotropic medications as an cheap generic seroquel activities coordinator, arguing that their actions led to staffing shortages and other patient safety problems. Hours after her letter was published in September 2017, officials at Maine Coast Memorial Hospital in Ellsworth, Maine, fired her, citing a policy that no employee may give information to the news media without the direct involvement of the media office. But a federal appellate court recently said Young’s firing violated the law and ordered that she cheap generic seroquel be reinstated.

The court’s decision could mean that hospitals and other employers will need to revise their policies barring workers from talking to the news media and posting on social media. Those media policies have been a bitter source of conflict at hospitals over the past year, as physicians, nurses and other health care workers around the country have been fired or disciplined for publicly speaking or posting about what they saw as dangerously inadequate antidepressant drugs safety precautions. These fights also cheap generic seroquel reflect growing tension between health care workers, including physicians, and the increasingly large, profit-oriented companies that employ them.

On May 26, the 1st U.S. Circuit Court of Appeals unanimously upheld a National Labor Relations Board decision issued last year that the hospital, now known as Northern Light Maine Coast Hospital, violated federal labor law by firing Young for engaging in protected “concerted activity.” The NLRB defines it as guaranteeing the right to act with co-workers to address work-related issues, such as circulating petitions for better hours or speaking up about safety issues. It also affirmed the board’s finding that the hospital’s media policy barring contact between cheap generic seroquel employees and the media was illegal.

€œIt’s great news because I know all hospitals prefer we don’t speak with the media,” said Cokie Giles, president of the Maine State Nurses Association, a union. €œWe are careful about what we say and how we say it because we don’t want to bring the hammer down on us.” The 1st Circuit opinion is noteworthy because it’s one of only a few such employee speech rulings under the National Labor Relations Act ever issued by a federal appellate court, and the first in nearly 20 years, said Frank LoMonte, a University of Florida law professor who heads the Brechner Center for Freedom of Information. The 1st Circuit and NLRB rulings should force hospitals to “pull out their handbook and make cheap generic seroquel sure it doesn’t gag employees from speaking,” he said.

€œIf you are fired for violating a ‘don’t talk to the media’ policy, you should be able to get your job back.” The American Hospital Association and the Federation of American Hospitals declined to comment for this article. While the 1st Circuit’s opinion is cheap generic seroquel binding only in four Northeastern states plus Puerto Rico, the NLRB decision carries the force of law nationwide. The case applies to both unionized and non-unionized employees, legal experts say.

In March, the NLRB similarly ordered automaker Tesla to revise its policy barring employees from speaking with the media without written permission. Hospitals and health care organizations often have policies requiring employees to clear any public comments about the cheap generic seroquel workplace with the organization’s media office. Many also have policies restricting what employees can say on Facebook and other social media.

Hospitals say requiring employees to go through their media office prevents the spread of inaccurate information that could damage the public’s confidence. In Young’s cheap generic seroquel case, the hospital argued that her letter contained false and disparaging statements. But the 1st Circuit panel agreed with the NLRB that her letter was “not abusive” and that its only false statement was not her fault.

Health care organizations have undisputed legal authority to prohibit employees from disclosing confidential patient information or proprietary business information, legal experts say. But the 1st Circuit panel made clear that an employer cannot bar an employee from engaging in “concerted actions” — such as outreach to the news media — “in furtherance of a group concern.” That’s true even cheap generic seroquel if the employee acted on her own, as Young did in writing her letter. The key in her case was that she “acted in support of what had already been established as a group concern,” the court said.

The National Labor Relations Board issued a cheap generic seroquel decision last year guaranteeing hospital workers the right to speak up about work-related issues and to contact the press. €œIt’s great news because I know all hospitals prefer we don’t speak with the media,” says Cokie Giles, president of the Maine State Nurses Association.(National Nurses United) “I think employers with a blanket ban on talking to the media need to relook at their policies,” said Eric Meyer, a partner at FisherBroyles in Philadelphia who often represents companies on employment law matters. €œIf you go to the media and say, ‘There are unsafe working conditions impacting me and my colleagues,’ that’s protected concerted activity.” Chad Hansen, Young’s attorney in a separate federal lawsuit alleging discrimination based on a disability against the hospital, said she has not yet been reinstated to her job.

Young would not comment cheap generic seroquel. The hospital’s parent company, Northern Light Health, said only that its news media policy — which was amended after Young’s firing — meets the NLRB and 1st Circuit requirements and will not be further changed. The new policy created an exception allowing employees to speak to the news media related to concerted activities protected by federal law.

Speech rights under the National cheap generic seroquel Labor Relations Act are particularly important for employees of private companies. Although the Constitution protects people who work for public hospitals and other government employers with its guarantee of unrestricted speech, employees at private companies do not have a First Amendment right to speak publicly about workplace issues. €œI hope this case keeps alive the right of health care workers to speak out about something that’s dangerous,” said Dr.

Ming Lin, an emergency physician who lost his job cheap generic seroquel last year at PeaceHealth St. Joseph Medical Center in Bellingham, Washington, after publicly criticizing the hospital’s seroquel preparedness. Lin, who was employed by TeamHealth, which provides emergency physician services at the cheap generic seroquel hospital, lost his assignment at PeaceHealth in March 2020 soon after saying on social media and in interviews with news reporters that PeaceHealth was not taking urgent enough steps to protect staff members from antidepressant drugs.

He had worked at the hospital for 17 years. In an April 2020 YouTube interview, PeaceHealth’s chief operating officer, Richard DeCarlo, said Lin was removed from the hospital’s ER schedule because he “continued to post misinformation, which was resulting in people being afraid and being scared to come to the hospital.” DeCarlo also alleged that Lin, who was out of town for part of the time he was posting, refused to communicate with his supervisors in Bellingham about the situation. PeaceHealth declined cheap generic seroquel to comment for this article.

PeaceHealth’s social media policy at that time stated that the company does not prohibit employees from engaging in federally protected concerted activity and that they “are free to communicate their opinions.” TeamHealth’s social media policy, dated July 15, 2020, states the company reserves the right to take disciplinary action in response to behavior that adversely affects the company. Lin, who’s now working for the Indian Health Service in South Dakota, has sued PeaceHealth, TeamHealth and DeCarlo in state court in Washington claiming wrongful termination in violation of public policy, breach of contract and defamation. Dr.

Jennifer Bryan, board chair of the Mississippi State Medical Association, who publicly defended two Mississippi physicians fired for posting about the inadequacy of their hospitals’ antidepressant drugs safety policies, said she faced pressure from her hospital for speaking to the news media without approval. The medical association pushed its members to talk to the media about the science of antidepressant drugs, while employers insisted doctors’ messages had to be approved by the media office. That reflected a conflict, she said, between medical professionals primarily concerned about public health and executives of for-profit systems who were seeking to shield their corporate image.

Bryan predicted the court ruling and NLRB decision will be helpful. €œPhysicians have to be able to stand up and speak out for what they believe affects the safety and well-being of patients,” she said. €œOtherwise, there are no checks and balances.” Harris Meyer.

@Meyer_HM Related Topics Contact Us Submit a Story TipA federal price transparency rule that took effect this year was supposed to give patients, employers and insurers a clearer picture of the true cost of hospital care. When the Trump administration unveiled the rule in 2019, Seema Verma, then chief of the Centers for Medicare &. Medicaid Services, promised it would “upend the status quo to empower patients and put them first.” I set out to test that statement by comparing prices in two major California hospital systems.

I am sorry to report that, at least for now, that status quo — the tangled web that long has cloaked hospital pricing — is alive and well. I have spent hours toggling among multiple spreadsheets, each containing thousands of numbers, in an effort to compare prices for 20 common outpatient procedures, such as colonoscopies, cataract surgeries, hernia repair and removal of breast lesions. After three months of glazed eyes and headaches from banging my head against walls of numbers, I am throwing in the towel.

It was a fool’s errand. My efforts ultimately yielded just one helpful piece of advice. Don’t try this at home.

I was most of the way to that realization when a conversation with Shawn Gremminger helped push me over the line. €œYou are a health care reporter, I’m a health care lobbyist, and the fact that we can’t do this ourselves is an indictment of where things stand at this point,” said Gremminger, health policy director at the Purchaser Business Group on Health, which represents large employers who pay their employees’ medical bills directly and have a big stake in price transparency. €œThe subset of people who can do this is pretty small, and most of them work for hospitals.” I heard similar comments from other veterans of the health care industry, even from the former managed-care executive who inspired the story.

He had come to me with a spreadsheet full of price info that appeared to show that a Kaiser Permanente hospital in the East Bay charged significantly higher prices for numerous procedures than a nearby hospital run by archcompetitor Sutter Health. That was a compelling assertion, since Sutter is widely viewed in California as the poster child for excessive prices. Nearly two years ago, Sutter settled a high-profile antitrust case that accused the hospital system of using its market dominance in Northern California to illegally drive up prices.

I knew from the outset it would be tricky to compare Kaiser and Sutter because, operationally, they are apples and oranges. Sutter negotiates separate deals with numerous health plans, and its prices can vary by thousands of dollars for the same service, depending on your insurance. Kaiser’s hospitals are integrated with its insurance arm, which collects premiums — so, in effect, it is playing with house money.

There is just one Kaiser health plan price for each medical service. Still, the story seemed worth looking into. Those Sutter and Kaiser prices matter, because they are used to calculate how much patients pay out of their own pockets.

And helping patients know what they’ll owe in advance is one of the goals of the transparency rule. The federal rule requires hospitals to report prices for all the medical services they provide in huge spreadsheets that can be processed by computers. It also obliges them to provide prices in a more “consumer-friendly” format for 300 so-called shoppable services, which are procedures that can be scheduled in advance.

And it requires that they report the cost of any “ancillary services,” such as anesthesia, typically rendered in concert with those procedures. Of the 300 “shoppables,” 70 are specified by the government and the rest are chosen by each hospital. Kaiser Permanente is both a provider and an insurer.

Its hospitals are integrated with the insurance arm, which collects premiums — so, in effect, they are playing with house money.(Hannah Norman / KHN) Most of the 20 common medical procedures I attempted to compare were among those 70. But a few, from lists of top outpatient procedures provided by the Health Care Cost Institute, were not. I decided to use the more comprehensive, less friendly spreadsheets for my comparisons, since they contained all 20 of the procedures I’d chosen.

Each carried a five-digit medical code known as a CPT, a term trademarked by the American Medical Association that stands for “current procedural terminology.” The transparency rule requires hospitals to include billing codes, because they supposedly provide a basis for price comparison, or in the rule’s jargony language, “an adequate cross-walk between hospitals for their items and services.” Much to my chagrin, I soon discovered they don’t provide an adequate crosswalk even within one hospital. My first inkling of the insuperable complexity came when I noticed that Sutter’s Alta Bates Summit Medical Center in Oakland listed the same outpatient procedure with the same CPT code three times, thousands of rows apart, with entirely different prices. CPT 64483 is the designated code for injection of anesthetics or steroids into a spinal nerve root with the use of imaging, which relieves pain in the lower back, legs and feet caused by sciatica or herniated discs.

The spreadsheet showed a maximum negotiated price of $1,912 in row 12,718, $3,650.85 in row 19,014 and $5,475.80 in row 19,559 (let your eyes glaze over for just a few seconds, so you know what it feels like). The reason for the triple listing is tied to Medicare billing guidelines, Sutter later told me. I’ll spare you the details.

My head really began to hurt when I decided to double-check some of the prices I had pulled from the big spreadsheets against the same items on the shorter shoppables sheets. Kaiser’s prices were generally consistent across the two, but for Alta Bates, there were large discrepancies. The highest negotiated price for removing a breast lesion, for example, was $6,156 on the big sheet and $23,069 on the shorter one.

The difference seems largely attributable to the estimated cost of additional services, some rather nonspecific, that Sutter lists on the smaller sheet as accompaniments to the procedure. Anesthesia, EKG/ECG, imaging, laboratory, perioperative, pharmacy and supplies. But why not include them in both spreadsheets?.

And what do the two dramatically divergent prices actually encompass?. “How many bills they really represent and what they mean is difficult to interpret,” said Dr. Merrit Quarum, CEO of Portland, Oregon-based WellRithms, which helps employers negotiate fair prices with hospitals.

€œIt depends on the timing, it depends on the context, which you don’t know.” In some cases, Sutter said, its shoppables spreadsheets show charges not only for ancillary services typically rendered on the day of the procedure, but also for related procedures that may precede or follow it by days or weeks. The listings for Kaiser’s ancillary services do not always match Sutter’s, which further clouds the comparison. The problematic fact of the matter is that hospitals performing the same procedures bundle their bills differently, use different medications, estimate varying amounts of time in the operating room, and utilize more or less advanced technology.

And physician charges are not even included in the posted prices, at least in California. All of which makes it almost impossible for mere mortals to anticipate the total cost of their medical procedures, let alone compare prices among hospitals. Even if they could, it might be of limited value, since independent imaging centers and surgery centers, which are increasingly common — and generally less expensive — aren’t required to report their prices.

The bottom line, I’m afraid, is that despite my efforts I don’t have anything particularly insightful to reveal about how Kaiser’s prices compare with Sutter’s. The prices I examined were as transparent to me as hieroglyphics, and I’m pretty sure that hospital executives — who unsuccessfully sued to stop implementation of the price transparency rule — are not losing any sleep over that fact. This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Bernard J. Wolfson. bwolfson@kff.org, @bjwolfson Related Topics Contact Us Submit a Story Tip.

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1. About UsThe Eighth Affiliated Hospital, Sun Yat-Sen University is located in Futian District, the central area of Shenzhen. With the advantageous location and elegant environment, the hospital is known as the only medical landmark building on Shennan Boulevard. It's adjacent to Huanggang Port, Futian Port, and Futian Railway Station, the largest underground railway station in Asia.

With the opening of Guangzhou- Shenzhen-Hongkong high-speed railway, it takes only 14 minutes to Hong Kong.The hospital was officially incorporated into the affiliated hospital management system of Sun Yat-sen University on August 26, 2016. As an important part of Sun Yat-sen University Shenzhen Campus, it will provide the force support for the construction of the medical faculty and cultivation of the high-level talents. The Eighth Affiliated Hospital is composed of the headquarters of the hospital, 21 community healthcare service centers and three infirmaries, with more than 2,000 employees. With the strong support of Sun Yat-sen University and Futian District People's Government, the hospital's new building was put into use on July 13, 2019.

Now, the building area is approximately 210,000 square meters, with the bed capacity of 1,639 and the parking space of 1200. The laboratory of nearly 10,000 square meters, located in the Futian Free Tax Zone, will also be open in the middle of 2020.At present, the Eighth Affiliated Hospital has introduced more than 50 leading talents of Guangdong province, clinical leaders and clinical backbones of specialties, and it has become the eighth clinical college of Sun Yat-sen University. Standing at a new starting point, the Eighth Affiliated Hospital strives to build the "Regional leading, National first-class, International recognized, modern and comprehensive hospital".2. DisciplinesApplicants with the following background are welcomed:Basic Medicine, Clinical Medicine, Stomatology, Medical Technology, Life Science, Biomedical Engineering, Medical Statistics and related traditional or interdisciplinary disciplines, etc.3.

QualificationsShould have an education background as an undergraduate, postgraduate and doctorate student in a well-known domestic or international university, scientific research institute, or higher education institute with the discipline as the preponderant discipline in the field and has obtained a PhD degree. Has obtained comparatively good research results. And has great development potentials. Obtained a PhD degree within three years.4.

Remunerations and BenefitsI. Salary and Benefits. The University provides generous salary, research start-up fee, talent allowance, and settlement allowance. Talents working in Zhuhai and Shenzhen campuses can enjoy subsidies of the local campuses.II.

Housing Support. Talents can apply for the university's public rental housing. There are 1,200 new apartments in the Guangzhou campus. More than 1,000 new apartments and 1,500 new shared property houses in the Zhuhai campus.

And 3,600 new talent indemnificatory apartments in the Shenzhen campus.III. Quality Healthcare. There are 10 SYSU affiliated hospitals that provide high-level healthcare service.IV. Children Education.

SYSU has constructed affiliated primary and secondary schools and kindergartens in Guangzhou, Zhuhai and Shenzhen campuses to provide high-quality elementary education for the children of faculty members.V. Employee Wellbeing. Provides "sports time". Free use of sports facilities on campus.

And annual health checkup. The Zhuhai campus provides meal subsidies.5. ContactContact Person：Xiaoling HuangEmail. Huangxling25@mail.sysu.edu.cn Tel.

86-755-83981723, 86-13530115220Website. Http://www.sysu8h.com.cn/1.About UsZhongshan Ophthalmic Center (ZOC), Sun Yat-sen University is the only one of its kind ophthalmic hospital appointed by the National Health Commission. Its history can date back to 1835, when Peter Parker, missionary from the United States founded the oldest western hospital -the Ophthalmic Hospital in Canton. In 1965, the Zhongshan Ophthalmic Hospital was officially established located on No 54, Xianlie South Road.

In 1983, it was renamed as Zhongshan Ophthalmic Center combining clinical services, scientific research, healthcare service and preventative ophthalmology. ZOC has been entitled the State Key Laboratory of Ophthalmology, without any equivalent in China. The head quarter of Asia Pacific Association of Ophthalmology (APAO) is also located at ZOC. ZOC has consecutively been ranked the first on two well-recognized Rankings in China, one being “Hospitals with Best Reputation by Specialty in China” for 10 terms, and another one being “Hospitals with Most Influence in Technology and Science in China” for 6 terms.ZOC is the largest eye care center in China, treating complicated eye diseases.

With 185 ophthalmologists, ZOC has managed an annual workload of over 1,140,000 outpatient visits and more than 75,000 surgeries.ZOC is the China’s leading research institutes in the fields of Medical Science and Ophthalmology. ZOC have 67 full time researchers. The researches in Stem Cell, Myopia Prevention, Biology Information and Artificial Intelligence, clinical researches in prevention and treatment of eye diseases have been published in Nature, JAMA, Lancet, Nature Methods, Nature Biomedical Engineering, Nature Communications, Lancet Global Health, Ophthalmology, JAMA Ophthalmology, IOVS, and etc.ZOC is the largest training base for ophthalmic talents in China. It currently has 80 doctoral tutors, and has brought up 500 PhD in Ophthalmology, over 250 department heads of domestic tertiary hospitals and 6 full-time professors working for the universities at foreign countries.

In May 2018, the Research Building and the Clinical Building of ZOC, located on No 7, Jinsui Road, Zhujiang New Town, the Central Business District of Guangzhou, were put into full use, which ushers ZOC into the new era of functioning with the Ouzhuang Campus in Yuexiu District and the Zhujiang New Town Campus in Tianhe District. Aiming to serve the national and regional healthcare strategies, Zhongshan Ophthalmic Center gears to a world class ophthalmic center with standardized operating procedures and high-level researches.2.DisciplinesApplicants with the following background are welcomed:Ophthalmology, Medicine, Biology, Computer Science or related fields, including but not limited to, Bioinformatics, Molecular Biology, Biochemistry, Biomedical Engineering, Vascular Biology, Microbial Groups, Structural Biology, Artificial Intelligence, Virtual Reality and Augmented Reality Technology and System, Neural Science, Material Science, Genetics, Immunology, Optical Imaging Technology and Optical Design3.QualificationsShould have an education background as an undergraduate, postgraduate and doctorate student in a well-known domestic or international university, scientific research institute, or higher education institute with the discipline as the preponderant discipline in the field and has obtained a PhD degree. Has obtained comparatively good research results. And has great development potentials.

Obtained a PhD degree within three years.4.Remunerations and BenefitsI. Salary and Benefits. The University provides generous salary, research start-up fee, talent allowance, and settlement allowance. Talents working in Zhuhai and Shenzhen campuses can enjoy subsidies of the local campuses.II.

Housing Support. Talents can apply for the university's public rental housing. There are 1,200 new apartments in the Guangzhou campus. More than 1,000 new apartments and 1,500 new shared property houses in the Zhuhai campus.

And 3,600 new talent indemnificatory apartments in the Shenzhen campus.III. Quality Healthcare. There are 10 SYSU affiliated hospitals that provide high-level healthcare service.IV. Children Education.

SYSU has constructed affiliated primary and secondary schools and kindergartens in Guangzhou, Zhuhai and Shenzhen campuses to provide high-quality elementary education for the children of faculty members.V. Employee Wellbeing. Provides "sports time". Free use of sports facilities on campus.

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

Rencaiban@gzzoc.com Tel. 0086-20-66618946Website. Http://www.gzzoc.com/.

1. About UsThe Eighth Affiliated Hospital, Sun Yat-Sen University is located in Futian District, the central area of Shenzhen. With the advantageous location and elegant environment, the hospital is known as the only medical landmark building on Shennan Boulevard.

It's adjacent to Huanggang Port, Futian Port, and Futian Railway Station, the largest underground railway station in Asia. With the opening of Guangzhou- Shenzhen-Hongkong high-speed railway, it takes only 14 minutes to Hong Kong.The hospital was officially incorporated into the affiliated hospital management system of Sun Yat-sen University on August 26, 2016. As an important part of Sun Yat-sen University Shenzhen Campus, it will provide the force support for the construction of the medical faculty and cultivation of the high-level talents.

The Eighth Affiliated Hospital is composed of the headquarters of the hospital, 21 community healthcare service centers and three infirmaries, with more than 2,000 employees. With the strong support of Sun Yat-sen University and Futian District People's Government, the hospital's new building was put into use on July 13, 2019. Now, the building area is approximately 210,000 square meters, with the bed capacity of 1,639 and the parking space of 1200.

The laboratory of nearly 10,000 square meters, located in the Futian Free Tax Zone, will also be open in the middle of 2020.At present, the Eighth Affiliated Hospital has introduced more than 50 leading talents of Guangdong province, clinical leaders and clinical backbones of specialties, and it has become the eighth clinical college of Sun Yat-sen University. Standing at a new starting point, the Eighth Affiliated Hospital strives to build the "Regional leading, National first-class, International recognized, modern and comprehensive hospital".2. DisciplinesApplicants with the following background are welcomed:Basic Medicine, Clinical Medicine, Stomatology, Medical Technology, Life Science, Biomedical Engineering, Medical Statistics and related traditional or interdisciplinary disciplines, etc.3.

QualificationsShould have an education background as an undergraduate, postgraduate and doctorate student in a well-known domestic or international university, scientific research institute, or higher education institute with the discipline as the preponderant discipline in the field and has obtained a PhD degree. Has obtained comparatively good research results. And has great development potentials.

Obtained a PhD degree within three years.4. Remunerations and BenefitsI. Salary and Benefits.

The University provides generous salary, research start-up fee, talent allowance, and settlement allowance. Talents working in Zhuhai and Shenzhen campuses can enjoy subsidies of the local campuses.II. Housing Support.

Talents can apply for the university's public rental housing. There are 1,200 new apartments in the Guangzhou campus. More than 1,000 new apartments and 1,500 new shared property houses in the Zhuhai campus.

And 3,600 new talent indemnificatory apartments in the Shenzhen campus.III. Quality Healthcare. There are 10 SYSU affiliated hospitals that provide high-level healthcare service.IV.

Children Education. SYSU has constructed affiliated primary and secondary schools and kindergartens in Guangzhou, Zhuhai and Shenzhen campuses to provide high-quality elementary education for the children of faculty members.V. Employee Wellbeing.

Provides "sports time". Free use of sports facilities on campus. And annual health checkup.

The Zhuhai campus provides meal subsidies.5. ContactContact Person：Xiaoling HuangEmail. Huangxling25@mail.sysu.edu.cn Tel.

86-755-83981723, 86-13530115220Website. Http://www.sysu8h.com.cn/1.About UsZhongshan Ophthalmic Center (ZOC), Sun Yat-sen University is the only one of its kind ophthalmic hospital appointed by the National Health Commission. Its history can date back to 1835, when Peter Parker, missionary from the United States founded the oldest western hospital -the Ophthalmic Hospital in Canton.

In 1965, the Zhongshan Ophthalmic Hospital was officially established located on No 54, Xianlie South Road. In 1983, it was renamed as Zhongshan Ophthalmic Center combining clinical services, scientific research, healthcare service and preventative ophthalmology. ZOC has been entitled the State Key Laboratory of Ophthalmology, without any equivalent in China.

The head quarter of Asia Pacific Association of Ophthalmology (APAO) is also located at ZOC. ZOC has consecutively been ranked the first on two well-recognized Rankings in China, one being “Hospitals with Best Reputation by Specialty in China” for 10 terms, and another one being “Hospitals with Most Influence in Technology and Science in China” for 6 terms.ZOC is the largest eye care center in China, treating complicated eye diseases. With 185 ophthalmologists, ZOC has managed an annual workload of over 1,140,000 outpatient visits and more than 75,000 surgeries.ZOC is the China’s leading research institutes in the fields of Medical Science and Ophthalmology.

ZOC have 67 full time researchers. The researches in Stem Cell, Myopia Prevention, Biology Information and Artificial Intelligence, clinical researches in prevention and treatment of eye diseases have been published in Nature, JAMA, Lancet, Nature Methods, Nature Biomedical Engineering, Nature Communications, Lancet Global Health, Ophthalmology, JAMA Ophthalmology, IOVS, and etc.ZOC is the largest training base for ophthalmic talents in China. It currently has 80 doctoral tutors, and has brought up 500 PhD in Ophthalmology, over 250 department heads of domestic tertiary hospitals and 6 full-time professors working for the universities at foreign countries.

In May 2018, the Research Building and the Clinical Building of ZOC, located on No 7, Jinsui Road, Zhujiang New Town, the Central Business District of Guangzhou, were put into full use, which ushers ZOC into the new era of functioning with the Ouzhuang Campus in Yuexiu District and the Zhujiang New Town Campus in Tianhe District. Aiming to serve the national and regional healthcare strategies, Zhongshan Ophthalmic Center gears to a world class ophthalmic center with standardized operating procedures and high-level researches.2.DisciplinesApplicants with the following background are welcomed:Ophthalmology, Medicine, Biology, Computer Science or related fields, including but not limited to, Bioinformatics, Molecular Biology, Biochemistry, Biomedical Engineering, Vascular Biology, Microbial Groups, Structural Biology, Artificial Intelligence, Virtual Reality and Augmented Reality Technology and System, Neural Science, Material Science, Genetics, Immunology, Optical Imaging Technology and Optical Design3.QualificationsShould have an education background as an undergraduate, postgraduate and doctorate student in a well-known domestic or international university, scientific research institute, or higher education institute with the discipline as the preponderant discipline in the field and has obtained a PhD degree. Has obtained comparatively good research results.

And has great development potentials. Obtained a PhD degree within three years.4.Remunerations and BenefitsI. Salary and Benefits.

The University provides generous salary, research start-up fee, talent allowance, and settlement allowance. Talents working in Zhuhai and Shenzhen campuses can enjoy subsidies of the local campuses.II. Housing Support.

Talents can apply for the university's public rental housing. There are 1,200 new apartments in the Guangzhou campus. More than 1,000 new apartments and 1,500 new shared property houses in the Zhuhai campus.

And 3,600 new talent indemnificatory apartments in the Shenzhen campus.III. Quality Healthcare. There are 10 SYSU affiliated hospitals that provide high-level healthcare service.IV.

Children Education. SYSU has constructed affiliated primary and secondary schools and kindergartens in Guangzhou, Zhuhai and Shenzhen campuses to provide high-quality elementary education for the children of faculty members.V. Employee Wellbeing.

Provides "sports time". Free use of sports facilities on campus. And annual health checkup.

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

Rencaiban@gzzoc.com Tel. 0086-20-66618946Website. Http://www.gzzoc.com/.

Where should I keep Seroquel?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

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As antidepressants continues its global buy generic seroquel online spread, it’s possible that one of the pillars of antidepressant drugs seroquel control seroquel online usa — universal facial masking — might help reduce the severity of disease and ensure that a greater proportion of new s are asymptomatic. If this hypothesis is borne out, universal masking could become a form of “variolation” that would generate immunity and thereby slow the spread of the seroquel in the United States and elsewhere, as we await a treatment.One important reason for population-wide facial masking became apparent in March, when reports started to circulate describing the high rates of antidepressants viral shedding from the noses and mouths of patients who were presymptomatic or asymptomatic — shedding rates equivalent to those among symptomatic patients.1 Universal facial masking seemed to be a possible way to prevent transmission from asymptomatic infected people. The Centers for Disease Control and Prevention (CDC) therefore recommended on April 3 that the public wear cloth face coverings in areas with high rates of community transmission — a recommendation that has been unevenly followed across the United States.Past evidence related to other respiratory seroqueles indicates that facial masking can also protect the wearer from becoming infected, by blocking viral particles from entering the nose and mouth.2 Epidemiologic investigations conducted around the world — especially in Asian countries that became accustomed to population-wide masking during the 2003 SARS seroquel — have suggested that there is a strong relationship seroquel online usa between public masking and seroquel control. Recent data from Boston demonstrate that antidepressants s decreased among health care workers after universal masking was implemented in municipal hospitals in late March.antidepressants has the protean ability to cause myriad clinical manifestations, ranging from a complete lack of symptoms to pneumonia, acute respiratory distress syndrome, and death.

Recent virologic, seroquel online usa epidemiologic, and ecologic data have led to the hypothesis that facial masking may also reduce the severity of disease among people who do become infected.3 This possibility is consistent with a long-standing theory of viral pathogenesis, which holds that the severity of disease is proportionate to the viral inoculum received. Since 1938, researchers have explored, primarily in animal models, the concept of the lethal dose of a seroquel — or the dose at which 50% of exposed hosts die (LD50). With viral s in which host immune responses play a predominant role in viral pathogenesis, such as antidepressants, high doses of viral seroquel online usa inoculum can overwhelm and dysregulate innate immune defenses, increasing the severity of disease. Indeed, down-regulating immunopathology is one mechanism by which dexamethasone improves outcomes in severe antidepressant drugs .

As proof of concept of viral inocula influencing disease manifestations, higher doses of administered seroquel led to more severe manifestations of antidepressant drugs in a Syrian hamster model of antidepressants .4If the viral inoculum matters seroquel online usa in determining the severity of antidepressants , an additional hypothesized reason for wearing facial masks would be to reduce the viral inoculum to which the wearer is exposed and the subsequent clinical impact of the disease. Since masks can filter out some seroquel-containing droplets (with filtering capacity determined by mask type),2 masking might reduce the inoculum that an exposed person inhales. If this theory bears out, population-wide masking, with any type of mask that increases acceptability and adherence,2 seroquel online usa might contribute to increasing the proportion of antidepressants s that are asymptomatic. The typical rate of asymptomatic with antidepressants was estimated to be 40% by the CDC in mid-July, but asymptomatic rates are reported to be higher than 80% in settings with universal facial masking, which provides observational evidence for this hypothesis.

Countries that have adopted population-wide masking have fared better in terms of rates of severe antidepressant drugs-related illnesses and death, which, in environments with seroquel online usa limited testing, suggests a shift from symptomatic to asymptomatic s. Another experiment in the Syrian hamster model simulated surgical masking of the animals and showed that with simulated masking, hamsters were less likely to get infected, and if they did get infected, they either were asymptomatic or had milder symptoms than unmasked hamsters.The most obvious way to spare society the devastating effects of antidepressant drugs is to promote measures to reduce both transmission and severity of illness. But antidepressants is highly transmissible, cannot be contained by syndromic-based surveillance alone,1 and is proving difficult to eradicate, even in regions that implemented strict initial control seroquel online usa measures. Efforts to increase testing and containment in the United States have been ongoing and variably successful, owing in part to the recent increase in demand for testing.The hopes for treatments are pinned not just on prevention.

Most treatment trials include a secondary outcome of decreasing the severity of illness, since increasing the proportion of cases in which seroquel online usa disease is mild or asymptomatic would be a public health victory. Universal masking seems to reduce the rate of new s. We hypothesize that by reducing the viral inoculum, it would also increase the proportion of infected people who remain asymptomatic.3In an outbreak on a closed Argentinian cruise ship, for example, where passengers were provided with surgical masks and staff with N95 masks, the rate of asymptomatic was 81% (as compared with 20% in earlier cruise ship outbreaks without universal masking) seroquel online usa. In two recent outbreaks in U.S.

Food-processing plants, where all workers were issued masks each day and were required to wear them, the proportion of asymptomatic s among the more than 500 people who became infected was 95%, with only 5% in each outbreak experiencing mild-to-moderate symptoms.3 Case-fatality rates in countries with mandatory or enforced population-wide masking have remained low, seroquel online usa even with resurgences of cases after lockdowns were lifted.Variolation was a process whereby people who were susceptible to smallpox were inoculated with material taken from a vesicle of a person with smallpox, with the intent of causing a mild and subsequent immunity. Variolation was practiced only until the introduction of the variola treatment, which ultimately eradicated smallpox. Despite concerns regarding safety, worldwide distribution, and eventual uptake, the world has high hopes for a highly effective antidepressants treatment, and as of early September, 34 treatment candidates were seroquel online usa in clinical evaluation, with hundreds more in development.While we await the results of treatment trials, however, any public health measure that could increase the proportion of asymptomatic antidepressants s may both make the less deadly and increase population-wide immunity without severe illnesses and deaths. Re with antidepressants seems to be rare, despite more than 8 months of circulation worldwide and as suggested by a macaque model.

The scientific community has been clarifying for some seroquel online usa time the humoral and cell-mediated components of the adaptive immune response to antidepressants and the inadequacy of antibody-based seroprevalence studies to estimate the level of more durable T-cell and memory B-cell immunity to antidepressants. Promising data have been emerging in recent weeks suggesting that strong cell-mediated immunity results from even mild or asymptomatic antidepressants ,5 so any public health strategy that could reduce the severity of disease should increase population-wide immunity as well.To test our hypothesis that population-wide masking is one of those strategies, we need further studies comparing the rate of asymptomatic in areas with and areas without universal masking. To test the variolation hypothesis, we will need more studies comparing the strength and durability of antidepressants–specific T-cell immunity between people with asymptomatic and those with symptomatic , as well as a demonstration of seroquel online usa the natural slowing of antidepressants spread in areas with a high proportion of asymptomatic s.Ultimately, combating the seroquel will involve driving down both transmission rates and severity of disease. Increasing evidence suggests that population-wide facial masking might benefit both components of the response..

As antidepressants continues its global spread, it’s possible buy generic seroquel online that one of the pillars of antidepressant drugs seroquel control — universal facial masking — might help reduce the severity of disease and ensure that a greater proportion of new s are asymptomatic cheap generic seroquel. If this hypothesis is borne out, universal masking could become a form of “variolation” that would generate immunity and thereby slow the spread of the seroquel in the United States and elsewhere, as we await a treatment.One important reason for population-wide facial masking became apparent in March, when reports started to circulate describing the high rates of antidepressants viral shedding from the noses and mouths of patients who were presymptomatic or asymptomatic — shedding rates equivalent to those among symptomatic patients.1 Universal facial masking seemed to be a possible way to prevent transmission from asymptomatic infected people. The Centers for Disease Control and Prevention (CDC) therefore recommended on April 3 that the public wear cloth face coverings in areas with high rates of community transmission — a recommendation that has been unevenly followed across the United States.Past evidence related to other respiratory seroqueles indicates that facial masking can also protect the wearer from becoming infected, by blocking viral particles from entering the nose and mouth.2 Epidemiologic investigations conducted around the world — cheap generic seroquel especially in Asian countries that became accustomed to population-wide masking during the 2003 SARS seroquel — have suggested that there is a strong relationship between public masking and seroquel control. Recent data from Boston demonstrate that antidepressants s decreased among health care workers after universal masking was implemented in municipal hospitals in late March.antidepressants has the protean ability to cause myriad clinical manifestations, ranging from a complete lack of symptoms to pneumonia, acute respiratory distress syndrome, and death.

Recent virologic, epidemiologic, and ecologic data have led to the hypothesis that facial masking may also reduce the severity of disease among people who do become infected.3 This possibility is consistent with a long-standing theory of viral pathogenesis, which holds that the severity of disease cheap generic seroquel is proportionate to the viral inoculum received. Since 1938, researchers have explored, primarily in animal models, the concept of the lethal dose of a seroquel — or the dose at which 50% of exposed hosts die (LD50). With viral s in which host immune responses play a cheap generic seroquel predominant role in viral pathogenesis, such as antidepressants, high doses of viral inoculum can overwhelm and dysregulate innate immune defenses, increasing the severity of disease. Indeed, down-regulating immunopathology is one mechanism by which dexamethasone improves outcomes in severe antidepressant drugs .

As proof of concept of viral inocula influencing disease manifestations, higher doses of administered seroquel led to more severe manifestations of antidepressant drugs in a Syrian hamster model of antidepressants .4If the viral inoculum matters in determining the severity of antidepressants , an additional cheap generic seroquel hypothesized reason for wearing facial masks would be to reduce the viral inoculum to which the wearer is exposed and the subsequent clinical impact of the disease. Since masks can filter out some seroquel-containing droplets (with filtering capacity determined by mask type),2 masking might reduce the inoculum that an exposed person inhales. If this theory bears out, population-wide masking, with any type of mask that increases acceptability and adherence,2 might contribute to increasing the proportion of antidepressants s that cheap generic seroquel are asymptomatic. The typical rate of asymptomatic with antidepressants was estimated to be 40% by the CDC in mid-July, but asymptomatic rates are reported to be higher than 80% in settings with universal facial masking, which provides observational evidence for this hypothesis.

Countries that have adopted population-wide masking have fared better in terms of rates of severe antidepressant drugs-related illnesses and death, which, in environments with limited cheap generic seroquel testing, suggests a shift from symptomatic to asymptomatic s. Another experiment in the Syrian hamster model simulated surgical masking of the animals and showed that with simulated masking, hamsters were less likely to get infected, and if they did get infected, they either were asymptomatic or had milder symptoms than unmasked hamsters.The most obvious way to spare society the devastating effects of antidepressant drugs is to promote measures to reduce both transmission and severity of illness. But antidepressants is highly transmissible, cannot be contained by syndromic-based surveillance alone,1 and is proving difficult to eradicate, cheap generic seroquel even in regions that implemented strict initial control measures. Efforts to increase testing and containment in the United States have been ongoing and variably successful, owing in part to the recent increase in demand for testing.The hopes for treatments are pinned not just on prevention.

Most treatment trials cheap generic seroquel include a secondary outcome of decreasing the severity of illness, since increasing the proportion of cases in which disease is mild or asymptomatic would be a public health victory. Universal masking seems to reduce the rate of new s. We hypothesize that by reducing the cheap generic seroquel viral inoculum, it would also increase the proportion of infected people who remain asymptomatic.3In an outbreak on a closed Argentinian cruise ship, for example, where passengers were provided with surgical masks and staff with N95 masks, the rate of asymptomatic was 81% (as compared with 20% in earlier cruise ship outbreaks without universal masking). In two recent outbreaks in U.S.

Food-processing plants, where all workers were issued masks each day and were required to wear them, the proportion of asymptomatic s among the more than cheap generic seroquel 500 people who became infected was 95%, with only 5% in each outbreak experiencing mild-to-moderate symptoms.3 Case-fatality rates in countries with mandatory or enforced population-wide masking have remained low, even with resurgences of cases after lockdowns were lifted.Variolation was a process whereby people who were susceptible to smallpox were inoculated with material taken from a vesicle of a person with smallpox, with the intent of causing a mild and subsequent immunity. Variolation was practiced only until the introduction of the variola treatment, which ultimately eradicated smallpox. Despite concerns regarding safety, worldwide distribution, and eventual uptake, the world has high hopes for a highly effective antidepressants treatment, and as of early September, 34 treatment candidates were in clinical evaluation, with hundreds more in development.While we await the results of treatment trials, however, cheap generic seroquel any public health measure that could increase the proportion of asymptomatic antidepressants s may both make the less deadly and increase population-wide immunity without severe illnesses and deaths. Re with antidepressants seems to be rare, despite more than 8 months of circulation worldwide and as suggested by a macaque model.

The scientific community cheap generic seroquel has been clarifying for some time the humoral and cell-mediated components of the adaptive immune response to antidepressants and the inadequacy of antibody-based seroprevalence studies to estimate the level of more durable T-cell and memory B-cell immunity to antidepressants. Promising data have been emerging in recent weeks suggesting that strong cell-mediated immunity results from even mild or asymptomatic antidepressants ,5 so any public health strategy that could reduce the severity of disease should increase population-wide immunity as well.To test our hypothesis that population-wide masking is one of those strategies, we need further studies comparing the rate of asymptomatic in areas with and areas without universal masking. To test the variolation hypothesis, we will need more studies comparing the strength and durability of antidepressants–specific T-cell immunity between people with asymptomatic and those with symptomatic , as well as a demonstration of the natural slowing of antidepressants spread in areas with a high proportion of asymptomatic s.Ultimately, combating cheap generic seroquel the seroquel will involve driving down both transmission rates and severity of disease. Increasing evidence suggests that population-wide facial masking might benefit both components of the response..

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Before that date, people enrolled in a Medicaid http://www.ec-cath-altorf.ac-strasbourg.fr/?page_id=254 managed care plan obtained all of their health care through the plan, but used their regular Medicaid card to access any drug available on the state formulary on a "fee for service" basis without needing to utilize a restricted pharmacy network or seroquel kidney side effects comply with managed care plan rules. COMING IN April 2021 - In the NYS Budget enacted in April 2020, the pharmacy benefit was "carved out" of "mainstream" Medicaid managed care plans. That means that members of managed care plans will access their drugs outside their plan, unlike the rest of their medical care, which is accessed from in-network providers. How Prescription Drugs are seroquel kidney side effects Obtained through Managed Care plans No - Until April 2020 HOW DO MANAGED CARE PLANS DEFINE THE PHARMACY BENEFIT FOR CONSUMERS?.

The Medicaid pharmacy benefit includes all FDA approved prescription drugs, as well as some over-the-counter drugs and medical supplies. Under Medicaid managed care. Plan formularies will seroquel kidney side effects be comparable to but not the same as the Medicaid formulary. Managed care plans are required to have drug formularies that are “comparable” to the Medicaid fee for service formulary.

Plan formularies do not have to include all drugs covered listed on the fee for service formulary, but they must include generic or therapeutic equivalents of all Medicaid covered drugs. The Pharmacy seroquel kidney side effects Benefit will vary by plan. Each plan will have its own formulary and drug coverage policies like prior authorization and step therapy. Pharmacy networks can also differ from plan to plan.

Prescriber Prevails applies in seroquel kidney side effects certain drug classes. Prescriber prevails applys to medically necessary precription drugs in the following classes. atypical antipsychotics, anti-depressants, anti-retrovirals, anti-rejection, seizure, epilepsy, endocrine, hemotologic and immunologic therapeutics. Prescribers will seroquel kidney side effects need to demonstrate reasonable profession judgment and supply plans witht requested information and/or clinical documentation.

Pharmacy Benefit Information Website -- http://mmcdruginformation.nysdoh.suny.edu/-- This website provides very helpful information on a plan by plan basis regarding pharmacy networks and drug formularies. The Department of Health plans to build capacity for interactive searches allowing for comparison of coverage across plans in the near future. Standardized Prior Autorization (PA) Form -- The Department of Health worked with managed care plans, provider organizations and other state agencies to develop seroquel kidney side effects a standard prior authorization form for the pharmacy benefit in Medicaid managed care. The form will be posted on the Pharmacy Information Website in July of 2013.

Mail Order Drugs -- Medicaid managed care members can obtain mail order/specialty drugs at any retail network pharmacy, as long as that retail network pharmacy agrees to a price that is comparable to the mail order/specialty pharmacy price. CAN CONSUMERS seroquel kidney side effects SWITCH PLANS IN ORDER TO GAIN ACCESS TO DRUGS?. Changing plans is often an effective strategy for consumers eligible for both Medicaid and Medicare (dual eligibles) who receive their pharmacy service through Medicare Part D, because dual eligibles are allowed to switch plans at any time. Medicaid consumers will have this option only in the limited circumstances during the first year of enrollment in managed care.

Medicaid managed care enrollees can only leave and join another plan within the first 90 days of seroquel kidney side effects joining a health plan. After the 90 days has expired, enrollees are “locked in” to the plan for the rest of the year. Consumers can switch plans during the “lock in” period only for good cause. The pharmacy benefit seroquel kidney side effects changes are not considered good cause.

After the first 12 months of enrollment, Medicaid managed care enrollees can switch plans at any time. STEPS CONSUMERS CAN TAKE WHEN A MANAGED CARE PLAM DENIES ACCESS TO A NECESSARY DRUG As a first step, consumers should try to work with their providers to satisfy plan requirements for prior authorization or step therapy or any other utilization control requirements. If the plan still denies access, consumers can pursue review seroquel kidney side effects processes specific to managed care while at the same time pursuing a fair hearing. All plans are required to maintain an internal and external review process for complaints and appeals of service denials.

Some plans may develop special procedures for drug denials. Information on these procedures should be provided in seroquel kidney side effects member handbooks. Beginning April 1, 2018, Medicaid managed care enrollees whose plan denies prior approval of a prescription drug, or discontinues a drug that had been approved, will receive an Initial Adverse Determination notice from the plan - See Model Denial IAD Notice and IAD Notice to Reduce, Suspend or Stop Services The enrollee must first request an internal Plan Appeal and wait for the Plan's decision. An adverse decision is called a 'FInal Adverse Determination" or FAD.

See model Denial FAD Notice and FAD Notice to Reduce, Suspend or Stop Services seroquel kidney side effects. The enroll has the right to request a fair hearing to appeal an FAD. The enrollee may only request a fair hearing BEFORE receiving the FAD if the plan fails to send the FAD in the required time limit, which is 30 calendar days in standard appeals, and 72 hours in expedited appeals. The plan may extend the time to decide both standard and expedited appeals by up to 14 days if more information is needed and it is in the seroquel kidney side effects enrollee's interest.

AID CONTINUING -- If an enrollee requests a Plan Appeal and then a fair hearing because access to a drug has been reduced or terminated, the enrollee has the right to aid continuing (continued access to the drug in question) while waiting for the Plan Appeal and then the fair hearing. The enrollee must request the Plan Appeal and then the Fair Hearing before the effective date of the IAD and FAD notices, which is a very short time - only 10 days including mailing time. See more about the changes in Managed Care appeals seroquel kidney side effects here. Even though that article is focused on Managed Long Term Care, the new appeals requirements also apply to Mainstream Medicaid managed care.

Enrollees who are in the first 90 days of enrollment, or past the first 12 months of enrollment also have the option of switching plans to improve access to their medications. Consumers who experience problems with access to prescription drugs should seroquel kidney side effects always file a complaint with the State Department of Health’s Managed Care Hotline, number listed below. ACCESSING MEDICAID'S PHARMACY BENEFIT IN FEE FOR SERVICE MEDICAID For those Medicaid recipients who are not yet in a Medicaid Managed Care program, and who do not have Medicare Part D, the Medicaid Pharmacy program covers most of their prescription drugs and select non-prescription drugs and medical supplies for Family Health Plus enrollees. Certain drugs/drug categories require the prescribers to obtain prior authorization.

These include brand name drugs that have a generic alternative under New York's mandatory generic drug program or prescribed drugs that are not on seroquel kidney side effects New York's preferred drug list. The full Medicaid formulary can be searched on the eMedNY website. Even in fee for service Medicaid, prescribers must obtain prior authorization before prescribing non-preferred drugs unless otherwise indicated. Prior authorization seroquel kidney side effects is required for original prescriptions, not refills.

A prior authorization is effective for the original dispensing and up to five refills of that prescription within the next six months. Click here for more information on NY's prior authorization process. The New York State Board of Pharmacy publishes an annual list of the http://jamessmithc21.com/?p=1 150 seroquel kidney side effects most frequently prescribed drugs, in the most common quantities. The State Department of Health collects retail price information on these drugs from pharmacies that participate in the Medicaid program.

Click here to search for a specific drug from the most frequently prescribed drug list and this site can also provide you with the locations of pharmacies that provide this drug as well as their costs. Click here to view New York State Medicaid’s Pharmacy Provider Manual seroquel kidney side effects. WHO YOU CAN CALL FOR HELP Community Health Advocates Hotline. 1-888-614-5400 NY State Department of Health's Managed Care Hotline.

1-800-206-8125 (Mon seroquel kidney side effects. - Fri. 8:30 am - 4:30 pm) NY State Department of Insurance. 1-800-400-8882 NY State Attorney seroquel kidney side effects General's Health Care Bureau.

1-800-771-7755Haitian individuals and immigrants from some other countries who have applied for Temporary Protected Status (TPS) may be eligible for public health insurance in New York State. 2019 updates - The Trump administration has taken steps to end TPS status. Two courts have temporarily enjoined the seroquel kidney side effects termination of TPS, one in New York State in April 2019 and one in California in October 2018. The California case was argued in an appeals court on August 14, 2019, which the LA Times reported looked likely to uphold the federal action ending TPS.

See US Immigration Website on TPS - General TPS website with links to status in all countries, including HAITI. See seroquel kidney side effects also Pew Research March 2019 article. Courts Block Changes in Public charge rule- See updates on the Public Charge rule here, blocked by federal court injunctions in October 2019. Read more about this change in public charge rules here.

What is Temporary Protected seroquel kidney side effects Status?. TPS is a temporary immigration status granted to eligible individuals of a certain country designated by the Department of Homeland Security because serious temporary conditions in that country, such as armed conflict or environmental disaster, prevents people from that country to return safely. On January 21, 2010 the United States determined that individuals from Haiti warranted TPS because of the devastating earthquake that occurred there on January 12. TPS gives undocumented Haitian seroquel kidney side effects residents, who were living in the U.S.

On January 12, 2010, protection from forcible deportation and allows them to work legally. It is important to note that the U.S. Grants TPS to individuals from other countries, as well, including individuals from El Salvador, Honduras, Nicaragua, Somalia and seroquel kidney side effects Sudan. TPS and Public Health Insurance TPS applicants residing in New York are eligible for Medicaid and Family Health Plus as long as they also meet the income requirements for these programs.

In New York, applicants for TPS are considered PRUCOL immigrants (Permanently Residing Under Color of Law) for purposes of medical assistance eligibility and thus meet the immigration status requirements for Medicaid, Family Health Plus, and the Family Planning Benefit Program. Nearly all children in New York remain eligible for Child Health Plus including seroquel kidney side effects TPS applicants and children who lack immigration status. For more information on immigrant eligibility for public health insurance in New York see 08 GIS MA/009 and the attached chart. Where to Apply What to BringIndividuals who have applied for TPS will need to bring several documents to prove their eligibility for public health insurance.

Individuals will need to bring. 1) Proof of identity. 2) Proof of residence in New York. 3) Proof of income.

4) Proof of application for TPS. 5) Proof that U.S. Citizenship and Immigration Services (USCIS) has received the application for TPS. Free Communication Assistance All applicants for public health insurance, including Haitian Creole speakers, have a right to get help in a language they can understand.

All Medicaid offices and enrollers are required to offer free translation and interpretation services to anyone who cannot communicate effectively in English. A bilingual worker or an interpreter, whether in-person or over the telephone, must be provided in all interactions with the office. Important documents, such as Medicaid applications, should be translated either orally or in writing. Interpreter services must be offered free of charge, and applicants requiring interpreter services must not be made to wait unreasonably longer than English speaking applicants.

An applicant must never be asked to bring their own interpreter. Related Resources on TPS and Public Health Insurance o The New York Immigration Coalition (NYIC) has compiled a list of agencies, law firms, and law schools responding to the tragedy in Haiti and the designation of Haiti for Temporary Protected Status. A copy of the list is posted at the NYIC’s website at http://www.thenyic.org. o USCIS TPS website with links to status in all countries, including HAITI.

O For information on eligibility for public health insurance programs call The Legal Aid Society’s Benefits Hotline 1-888-663-6880 Tuesdays, Wednesdays and Thursdays. 9:30 am - 12:30 pm FOR IMMIGRATION HELP. CONTACT THE New York State New Americans Hotline for a referral to an organization to advise you. 212-419-3737 Monday-Friday, from 9:00 a.m.

To 8:00 p.m.Saturday-Sunday, from 9:00 a.m. To 5:00 p.m. Or call toll-free in New York State at 1-800-566-7636 Please see these fact sheets and web sites of national organizations for more information about the new PUBLIC CHARGE rules. Printable Fact Sheets for Distribution This article was co-authored by the New York Immigration Coalition, Empire Justice Center and the Health Law Unit of the Legal Aid Society.

COMING IN April 2021 - In the NYS Budget enacted https://sarahpace.de/blog/review/training-in-der-schwangerschaft/ in April 2020, the pharmacy benefit was "carved out" of "mainstream" Medicaid managed care plans cheap generic seroquel. That means that members of managed care plans will access their drugs outside their plan, unlike the rest of their medical care, which is accessed from in-network providers. How Prescription Drugs are Obtained through Managed Care plans No - Until April 2020 HOW DO MANAGED CARE PLANS DEFINE THE PHARMACY BENEFIT FOR CONSUMERS?.

The Medicaid pharmacy benefit includes cheap generic seroquel all FDA approved prescription drugs, as well as some over-the-counter drugs and medical supplies. Under Medicaid managed care. Plan formularies will be comparable to but not the same as the Medicaid formulary.

Managed care plans are required to have drug formularies that are “comparable” to the Medicaid fee for service formulary cheap generic seroquel. Plan formularies do not have to include all drugs covered listed on the fee for service formulary, but they must include generic or therapeutic equivalents of all Medicaid covered drugs. The Pharmacy Benefit will vary by plan.

Each plan will have its own formulary and drug coverage policies like prior cheap generic seroquel authorization and step therapy. Pharmacy networks can also differ from plan to plan. Prescriber Prevails applies in certain drug classes.

Prescriber cheap generic seroquel prevails applys to medically necessary precription drugs in the following classes. atypical antipsychotics, anti-depressants, anti-retrovirals, anti-rejection, seizure, epilepsy, endocrine, hemotologic and immunologic therapeutics. Prescribers will need to demonstrate reasonable profession judgment and supply plans witht requested information and/or clinical documentation.

Pharmacy Benefit cheap generic seroquel Information Website -- http://mmcdruginformation.nysdoh.suny.edu/-- This website provides very helpful information on a plan by plan basis regarding pharmacy networks and drug formularies. The Department of Health plans to build capacity for interactive searches allowing for comparison of coverage across plans in the near future. Standardized Prior Autorization (PA) Form -- The Department of Health worked with managed care plans, provider organizations and other state agencies to develop a standard prior authorization form for the pharmacy benefit in Medicaid managed care.

The cheap generic seroquel form will be posted on the Pharmacy Information Website in July of 2013. Mail Order Drugs -- Medicaid managed care members can obtain mail order/specialty drugs at any retail network pharmacy, as long as that retail network pharmacy agrees to a price that is comparable to the mail order/specialty pharmacy price. CAN CONSUMERS SWITCH PLANS IN ORDER TO GAIN ACCESS TO DRUGS?.

Changing cheap generic seroquel plans is often an effective strategy for consumers eligible for both Medicaid and Medicare (dual eligibles) who receive their pharmacy service through Medicare Part D, because dual eligibles are allowed to switch plans at any time. Medicaid consumers will have this option only in the limited circumstances during the first year of enrollment in managed care. Medicaid managed care enrollees can only leave and join another plan within the first 90 days of joining a health plan.

After the cheap generic seroquel 90 days has expired, enrollees are “locked in” to the plan for the rest of the year. Consumers can switch plans during the “lock in” period only for good cause. The pharmacy benefit changes are not considered good cause.

After the first 12 months of enrollment, Medicaid managed care cheap generic seroquel enrollees can switch plans at any time. STEPS CONSUMERS CAN TAKE WHEN A MANAGED CARE PLAM DENIES ACCESS TO A NECESSARY DRUG As a first step, consumers should try to work with their providers to satisfy plan requirements for prior authorization or step therapy or any other utilization control requirements. If the plan still denies access, consumers can pursue review processes specific to managed care while at the same time pursuing a fair hearing.

All plans are required to maintain an internal and external review process for cheap generic seroquel complaints and appeals of service denials. Some plans may develop special procedures for drug denials. Information on these procedures should be provided in member handbooks.

Beginning April 1, 2018, Medicaid managed care enrollees whose plan denies prior approval of a prescription drug, or discontinues a drug that had been approved, will receive an Initial Adverse Determination notice cheap generic seroquel from the plan - See Model Denial IAD Notice and IAD Notice to Reduce, Suspend or Stop Services The enrollee must first request an internal Plan Appeal and wait for the Plan's decision. An adverse decision is called a 'FInal Adverse Determination" or FAD. See model Denial FAD Notice and FAD Notice to Reduce, Suspend or Stop Services.

The enroll has the right to request a fair hearing to appeal an cheap generic seroquel FAD. The enrollee may only request a fair hearing BEFORE receiving the FAD if the plan fails to send the FAD in the required time limit, which is 30 calendar days in standard appeals, and 72 hours in expedited appeals. The plan may extend the time to decide both standard and expedited appeals by up to 14 days if more information is needed and it is in the enrollee's interest.

AID CONTINUING -- If an enrollee requests a Plan Appeal and then a fair hearing because access cheap generic seroquel to a drug has been reduced or terminated, the enrollee has the right to aid continuing (continued access to the drug in question) while waiting for the Plan Appeal and then the fair hearing. The enrollee must request the Plan Appeal and then the Fair Hearing before the effective date of the IAD and FAD notices, which is a very short time - only 10 days including mailing time. See more about the changes in Managed Care appeals here.

Even though that article is focused cheap generic seroquel on Managed Long Term Care, the new appeals requirements also apply to Mainstream Medicaid managed care. Enrollees who are in the first 90 days of enrollment, or past the first 12 months of enrollment also have the option of switching plans to improve access to their medications. Consumers who experience problems with access to prescription drugs should always file a complaint with the State Department of Health’s Managed Care Hotline, number listed below.

ACCESSING MEDICAID'S PHARMACY BENEFIT IN FEE FOR SERVICE MEDICAID For those Medicaid recipients who are not yet in a Medicaid Managed Care program, and who do not have cheap generic seroquel Medicare Part D, the Medicaid Pharmacy program covers most of their prescription drugs and select non-prescription drugs and medical supplies for Family Health Plus enrollees. Certain drugs/drug categories require the prescribers to obtain prior authorization. These include brand name drugs that have a generic alternative under New York's mandatory generic drug program or prescribed drugs that are not on New York's preferred drug list.

The full Medicaid formulary can be cheap generic seroquel searched on the eMedNY website. Even in fee for service Medicaid, prescribers must obtain prior authorization before prescribing non-preferred drugs unless otherwise indicated. Prior authorization is required for original prescriptions, not refills.

A prior authorization is effective for the original dispensing and up cheap generic seroquel to five refills of that prescription within the next six months. Click here for more information on NY's prior authorization process. The New York State Board of Pharmacy publishes an annual list of the 150 most frequently prescribed drugs, in the most common quantities.

The State Department of Health collects retail price information can you buy seroquel over the counter on these drugs from pharmacies that cheap generic seroquel participate in the Medicaid program. Click here to search for a specific drug from the most frequently prescribed drug list and this site can also provide you with the locations of pharmacies that provide this drug as well as their costs. Click here to view New York State Medicaid’s Pharmacy Provider Manual.

WHO YOU CAN CALL FOR HELP Community Health Advocates Hotline cheap generic seroquel. 1-888-614-5400 NY State Department of Health's Managed Care Hotline. 1-800-206-8125 (Mon.

- Fri cheap generic seroquel. 8:30 am - 4:30 pm) NY State Department of Insurance. 1-800-400-8882 NY State Attorney General's Health Care Bureau.

1-800-771-7755Haitian individuals and immigrants from some other countries who have applied for Temporary Protected Status (TPS) may be eligible for cheap generic seroquel public health insurance in New York State. 2019 updates - The Trump administration has taken steps to end TPS status. Two courts have temporarily enjoined the termination of TPS, one in New York State in April 2019 and one in California in October 2018.

The California case was argued in an appeals court on August 14, 2019, which the LA cheap generic seroquel Times reported looked likely to uphold the federal action ending TPS. See US Immigration Website on TPS - General TPS website with links to status in all countries, including HAITI. See also Pew Research March 2019 article.

Courts Block Changes in Public charge rule- See updates on the Public Charge rule here, blocked by federal cheap generic seroquel court injunctions in October 2019. Read more about this change in public charge rules here. What is Temporary Protected Status?.

TPS is a temporary immigration status granted to eligible individuals of a certain country designated by the Department of Homeland Security because serious temporary conditions in that country, such as armed cheap generic seroquel conflict or environmental disaster, prevents people from that country to return safely. On January 21, 2010 the United States determined that individuals from Haiti warranted TPS because of the devastating earthquake that occurred there on January 12. TPS gives undocumented Haitian residents, who were living in the U.S.

On January 12, 2010, cheap generic seroquel protection from forcible deportation and allows them to work legally. It is important to note that the U.S. Grants TPS to individuals from other countries, as well, including individuals from El Salvador, Honduras, Nicaragua, Somalia and Sudan.

TPS and Public Health Insurance TPS applicants residing in New York are eligible for Medicaid and Family Health Plus as long as they also meet the income requirements for these cheap generic seroquel programs. In New York, applicants for TPS are considered PRUCOL immigrants (Permanently Residing Under Color of Law) for purposes of medical assistance eligibility and thus meet the immigration status requirements for Medicaid, Family Health Plus, and the Family Planning Benefit Program. Nearly all children in New York remain eligible for Child Health Plus including TPS applicants and children who lack immigration status.

For more information on immigrant eligibility for public health cheap generic seroquel insurance in New York see 08 GIS MA/009 and the attached chart. Where to Apply What to BringIndividuals who have applied for TPS will need to bring several documents to prove their eligibility for public health insurance. Individuals will need to bring.

1) cheap generic seroquel Proof of identity. 2) Proof of residence in New York. 3) Proof of income.

4) Proof of application cheap generic seroquel for TPS. 5) Proof that U.S. Citizenship and Immigration Services (USCIS) has received the application for TPS.

Free Communication Assistance All applicants for public health insurance, including Haitian Creole speakers, have a right to get help in a language they can understand. All Medicaid offices and enrollers are required to offer free translation and interpretation services to anyone who cannot communicate effectively in English. A bilingual worker or an interpreter, whether in-person or over the telephone, must be provided in all interactions with the office.

Important documents, such as Medicaid applications, should be translated either orally or in writing. Interpreter services must be offered free of charge, and applicants requiring interpreter services must not be made to wait unreasonably longer than English speaking applicants. An applicant must never be asked to bring their own interpreter.

Related Resources on TPS and Public Health Insurance o The New York Immigration Coalition (NYIC) has compiled a list of agencies, law firms, and law schools responding to the tragedy in Haiti and the designation of Haiti for Temporary Protected Status. A copy of the list is posted at the NYIC’s website at http://www.thenyic.org. o USCIS TPS website with links to status in all countries, including HAITI.

O For information on eligibility for public health insurance programs call The Legal Aid Society’s Benefits Hotline 1-888-663-6880 Tuesdays, Wednesdays and Thursdays. 9:30 am - 12:30 pm FOR IMMIGRATION HELP. CONTACT THE New York State New Americans Hotline for a referral to an organization to advise you.

212-419-3737 Monday-Friday, from 9:00 a.m. To 8:00 p.m.Saturday-Sunday, from 9:00 a.m. To 5:00 p.m.

Or call toll-free in New York State at 1-800-566-7636 Please see these fact sheets and web sites of national organizations for more information about the new PUBLIC CHARGE rules. Printable Fact Sheets for Distribution This article was co-authored by the New York Immigration Coalition, Empire Justice Center and the Health Law Unit of the Legal Aid Society. 1/29/10, updated 3/1/10, updated 8/15/19 by NY Legal Assistance Group.

Chewing seroquel xr

€˜Significant reduction of the impact of AF on healthcare utilisation and chewing seroquel xr improvement of QOL metrics should be regarded as important and patient-relevant healthcare values gained by catheter ablation of paroxysmal AF. Moreover, Gupta and colleagues1 report an inverse association between the extent of QOL improvement and residual AF burden post-ablation. These results emphasise the importance of incorporating AF-specific QOL metrics in AF ablation studies.’ Ongoing innovations in approaches to AF ablation are discussed as well.Identification of predictors of sudden cardiac death (SCD) at the population level are needed for prevention because up to ½ of events occur in people with no prior history of heart disease. Ågesen and colleagues3 report the temporal trends in SCD in 14 562 participants followed in the Copenhagen chewing seroquel xr City Heart Study from 1993 to 2016. Of the 8394 deaths with full information, 1335 (16%) were classified as SCD with a 41% decrease in SCD incident over the study period in persons aged 40–90 years (figure 2).

There was a higher incidence of SCD in men, compared with women in those age 75 years or less with an incidence ratio of 1.99 (95% CI 1.62 to 2.46) with SCD being the first known manifestation of cardiac disease in 50% of cases.The incidence rate of sudden cardiac death from 1993 to 2016 per age group stratified by sex. Data are chewing seroquel xr expressed as incidence rates and 95% CIs. PY, person-years." data-icon-position data-hide-link-title="0">Figure 2 The incidence rate of sudden cardiac death from 1993 to 2016 per age group stratified by sex. Data are expressed as incidence rates and 95% CIs. PY, person-years.Tzeis urges in an chewing seroquel xr editorial4 that.

€˜Further actions should aim to reduce the rate of SCD by focusing on two priority areas. The first one is prevention of cardiovascular disease by promoting the adoption of healthy lifestyle and behavioural habits and by implementing comprehensive intervention programmes to tackle cardiovascular risk factors. The second priority area is primary chewing seroquel xr and secondary prevention of SCD’ (figure 3).Priority areas and relevant actions needed to reduce the burden of SCD. BLS, basic life support. CPR, cardiopulmonary resuscitation.

CVD, cardiovascular disease chewing seroquel xr. EMS, emergency medical service. ICD, implantable cardioverter defibrillator. OHCA, out-of-hospital cardiac chewing seroquel xr arrest. PAD, public access defibrillator.

SCD, sudden cardiac death." data-icon-position data-hide-link-title="0">Figure 3 Priority areas and relevant actions needed to reduce the burden of SCD. BLS, basic chewing seroquel xr life support. CPR, cardiopulmonary resuscitation. CVD, cardiovascular disease. EMS, emergency chewing seroquel xr medical service.

ICD, implantable cardioverter defibrillator. OHCA, out-of-hospital cardiac arrest. PAD, public chewing seroquel xr access defibrillator. SCD, sudden cardiac death.The increasing recognition that some types of mild valve disease are associated with adverse clinical outcomes is highlighted in a study by Taylor and colleagues5 in this issue of Heart. In a population-based cohort from the OxVALVE (Oxford Valvular Heart Disease) study that included 3511 participants over age 65 years, advanced aortic valve sclerosis (present in 2.25%) and advanced mitral annular calcification (present in 1.31%) were associated with a higher risk of death (HR 2.05, 95% CI 1.28 to 3.30 and HR 2.51, 95% CI 1.41 to 4.49, respectively) (figure 4).Kaplan-Meier curve demonstrating the unadjusted survival rates for people with advanced aortic sclerosis (Ao.Scl) or mitral annular calcification (MAC) compared with people with early or no disease.

Participants are categorised as chewing seroquel xr having advanced aortic sclerosis or mitral annular calcification (types of calcific valve disease without functional effect), irrespective of the presence of valvular heart disease. Advanced disease describes moderate or significant sclerosis or calcification, although without functional impact" data-icon-position data-hide-link-title="0">Figure 4 Kaplan-Meier curve demonstrating the unadjusted survival rates for people with advanced aortic sclerosis (Ao.Scl) or mitral annular calcification (MAC) compared with people with early or no disease. Participants are categorised as having advanced aortic sclerosis or mitral annular calcification (types of calcific valve disease without functional effect), irrespective of the presence of valvular heart disease. Advanced disease describes moderate or significant sclerosis or calcification, although without functional impactIung and Bouleti comment6 that ‘This chewing seroquel xr analysis of the OxValve cohort suggests that more attention should be paid to the extent of the calcific valve lesion as assessed by echocardiography even at the early stages of valvular disease. Although this cannot translate in effective prevention measures at the present time, these findings further highlight the need for continuous research on the pathophysiology of calcific valve diseases, and the identification of metabolic pathways which may reduce the consequences of calcium deposits.’A systematic review on patient preferences and values related to the choice of prosthetic valve for treatment of severe aortic stenosis provides useful insights and also underlines the need to more fully integrate the patient point of view into future clinical trial designs.7 Identifying the factors important to patients in shared decision making and involving patients in defining relevant outcomes is essential for ensuring that medical care meets patient needs.The Education in Heart article in this issue reviews the causes, diagnosis and management of left ventricular non-compaction (figure 5).8Management algorithm of individuals with excessive LV trabeculation.

ACE-I, ACE inhibitor. AF, atrial fibrillation chewing seroquel xr. ARB, angiotensin II receptor blocker. ARNI, angiotensin receptor-neprilysin inhibitor. AVC, arrhythmogenic ventricular cardiomyopathy chewing seroquel xr.

CHADS2, congestive heart failure, hypertension, age, diabetes, stroke or transient ischaemic attack. CMR, cardiac magnetic resonance. CRT, cardiac chewing seroquel xr resynchronisation therapy. DCM, dilated cardiomyopathy. HCM, hypertrophic cardiomyopathy.

HFrEF, heart failure with reduced ejection fraction chewing seroquel xr. ICD, implantable cardioverter-defibrillator. LBBB, left bundle branch block. LGE, late gadolinium chewing seroquel xr enhancement. LV, left ventricular.

LVEF, left ventricular ejection fraction. LVSD, left ventricular chewing seroquel xr systolic dysfunction. MRA, mineralocorticoid receptor antagonist. NI-DCM, non-ischaemic dilated cardiomyopathy. RCM, restrictive chewing seroquel xr cardiomyopathy.

RV, right ventricular. SGLT2i, sodium-glucose cotransporter 2 inhibitor. TIA, transient ischaemic attack." data-icon-position data-hide-link-title="0">Figure 5 Management algorithm of individuals with excessive chewing seroquel xr LV trabeculation. ACE-I, ACE inhibitor. AF, atrial fibrillation.

ARB, angiotensin chewing seroquel xr II receptor blocker. ARNI, angiotensin receptor-neprilysin inhibitor. AVC, arrhythmogenic ventricular cardiomyopathy. CHADS2, congestive heart failure, hypertension, chewing seroquel xr age, diabetes, stroke or transient ischaemic attack. CMR, cardiac magnetic resonance.

CRT, cardiac resynchronisation therapy. DCM, dilated chewing seroquel xr cardiomyopathy. HCM, hypertrophic cardiomyopathy. HFrEF, heart failure with reduced ejection fraction.

Moreover, Gupta Buy propecia online and colleagues1 report an inverse association between the extent of QOL improvement and residual AF cheap generic seroquel burden post-ablation. These results emphasise the importance of incorporating AF-specific QOL metrics in AF ablation studies.’ Ongoing innovations in approaches to AF ablation are discussed as well.Identification of predictors of sudden cardiac death (SCD) at the population level are needed for prevention because up to ½ of events occur in people with no prior history of heart disease. Ågesen and colleagues3 report the temporal trends in SCD in 14 562 participants followed in the Copenhagen City Heart Study from 1993 to 2016.

Of the 8394 deaths with full information, 1335 (16%) were classified as SCD with a 41% decrease in SCD cheap generic seroquel incident over the study period in persons aged 40–90 years (figure 2). There was a higher incidence of SCD in men, compared with women in those age 75 years or less with an incidence ratio of 1.99 (95% CI 1.62 to 2.46) with SCD being the first known manifestation of cardiac disease in 50% of cases.The incidence rate of sudden cardiac death from 1993 to 2016 per age group stratified by sex. Data are expressed as incidence rates and 95% CIs.

PY, person-years." data-icon-position data-hide-link-title="0">Figure 2 The incidence rate of sudden cardiac death from 1993 cheap generic seroquel to 2016 per age group stratified by sex. Data are expressed as incidence rates and 95% CIs. PY, person-years.Tzeis urges in an editorial4 that.

€˜Further actions should aim to cheap generic seroquel reduce the rate of SCD by focusing on two priority areas. The first one is prevention of cardiovascular disease by promoting the adoption of healthy lifestyle and behavioural habits and by implementing comprehensive intervention programmes to tackle cardiovascular risk factors. The second priority area is primary and secondary prevention of SCD’ (figure 3).Priority areas and relevant actions needed to reduce the burden of SCD.

BLS, basic life support cheap generic seroquel. CPR, cardiopulmonary resuscitation. CVD, cardiovascular disease.

EMS, emergency medical cheap generic seroquel service. ICD, implantable cardioverter defibrillator. OHCA, out-of-hospital cardiac arrest.

PAD, public access defibrillator cheap generic seroquel. SCD, sudden cardiac death." data-icon-position data-hide-link-title="0">Figure 3 Priority areas and relevant actions needed to reduce the burden of SCD. BLS, basic life support.

CPR, cardiopulmonary resuscitation cheap generic seroquel. CVD, cardiovascular disease. EMS, emergency medical service.

ICD, implantable cardioverter defibrillator cheap generic seroquel. OHCA, out-of-hospital cardiac arrest. PAD, public access defibrillator.

SCD, sudden cheap generic seroquel cardiac death.The increasing recognition that some types of mild valve disease are associated with adverse clinical outcomes is highlighted in a study by Taylor and colleagues5 in this issue of Heart. In a population-based cohort from the OxVALVE (Oxford Valvular Heart Disease) study that included 3511 participants over age 65 years, advanced aortic valve sclerosis (present in 2.25%) and advanced mitral annular calcification (present in 1.31%) were associated with a higher risk of death (HR 2.05, 95% CI 1.28 to 3.30 and HR 2.51, 95% CI 1.41 to 4.49, respectively) (figure 4).Kaplan-Meier curve demonstrating the unadjusted survival rates for people with advanced aortic sclerosis (Ao.Scl) or mitral annular calcification (MAC) compared with people with early or no disease. Participants are categorised as having advanced aortic sclerosis or mitral annular calcification (types of calcific valve disease without functional effect), irrespective of the presence of valvular heart disease.

Advanced disease describes moderate or cheap generic seroquel significant sclerosis or calcification, although without functional impact" data-icon-position data-hide-link-title="0">Figure 4 Kaplan-Meier curve demonstrating the unadjusted survival rates for people with advanced aortic sclerosis (Ao.Scl) or mitral annular calcification (MAC) compared with people with early or no disease. Participants are categorised as having advanced aortic sclerosis or mitral annular calcification (types of calcific valve disease without functional effect), irrespective of the presence of valvular heart disease. Advanced disease describes moderate or significant sclerosis or calcification, although without functional impactIung and Bouleti comment6 that ‘This analysis of the OxValve cohort suggests that more attention should be paid to the extent of the calcific valve lesion as assessed by echocardiography even at the early stages of valvular disease.

Although this cannot translate in effective prevention measures at the present time, these findings further highlight the need for continuous research on the pathophysiology of calcific valve diseases, and the identification of metabolic pathways which may reduce the consequences of calcium cheap generic seroquel deposits.’A systematic review on patient preferences and values related to the choice of prosthetic valve for treatment of severe aortic stenosis provides useful insights and also underlines the need to more fully integrate the patient point of view into future clinical trial designs.7 Identifying the factors important to patients in shared decision making and involving patients in defining relevant outcomes is essential for ensuring that medical care meets patient needs.The Education in Heart article in this issue reviews the causes, diagnosis and management of left ventricular non-compaction (figure 5).8Management algorithm of individuals with excessive LV trabeculation. ACE-I, ACE inhibitor. AF, atrial fibrillation.

ARB, angiotensin cheap generic seroquel II receptor blocker. ARNI, angiotensin receptor-neprilysin inhibitor. AVC, arrhythmogenic ventricular cardiomyopathy.

CHADS2, congestive heart failure, hypertension, age, diabetes, cheap generic seroquel stroke or transient ischaemic attack. CMR, cardiac magnetic resonance. CRT, cardiac resynchronisation therapy.

DCM, dilated cheap generic seroquel cardiomyopathy. HCM, hypertrophic cardiomyopathy. HFrEF, heart failure with reduced ejection fraction.

ICD, implantable cardioverter-defibrillator cheap generic seroquel. LBBB, left bundle branch block. LGE, late gadolinium enhancement.

LV, left ventricular cheap generic seroquel. LVEF, left ventricular ejection fraction. LVSD, left ventricular systolic dysfunction.

MRA, mineralocorticoid cheap generic seroquel receptor antagonist. NI-DCM, non-ischaemic dilated cardiomyopathy. RCM, restrictive cardiomyopathy.

RV, right cheap generic seroquel ventricular. SGLT2i, sodium-glucose cotransporter 2 inhibitor. TIA, transient ischaemic attack." data-icon-position data-hide-link-title="0">Figure 5 Management algorithm of individuals with excessive LV trabeculation.

ACE-I, ACE cheap generic seroquel inhibitor. AF, atrial fibrillation. ARB, angiotensin II receptor blocker.

ARNI, angiotensin cheap generic seroquel receptor-neprilysin inhibitor. AVC, arrhythmogenic ventricular cardiomyopathy. CHADS2, congestive heart failure, hypertension, age, diabetes, stroke or transient ischaemic attack.

CMR, cardiac cheap generic seroquel magnetic resonance. CRT, cardiac resynchronisation therapy. DCM, dilated cardiomyopathy.

HCM, hypertrophic cardiomyopathy cheap generic seroquel. HFrEF, heart failure with reduced ejection fraction. ICD, implantable cardioverter-defibrillator.

Seroquel 200mg side effects

About This TrackerThis tracker provides the number seroquel online in canada of confirmed cases and deaths from novel antidepressants by country, the trend in confirmed case and death counts by seroquel 200mg side effects country, and a global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) antidepressants Resource Center’s antidepressant drugs Map and the World Health Organization’s (WHO) antidepressants Disease (antidepressant drugs-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About antidepressant drugs antidepressantsIn late 2019, a new antidepressants emerged in central China to cause disease in seroquel 200mg side effects humans. Cases of this disease, known as antidepressant drugs, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the seroquel represents a public health emergency of international concern, and on seroquel 200mg side effects January 31, 2020, the U.S.

Department of Health and Human Services declared it to be a health emergency for the United States.Key PointsOn January 23, 2017, President Donald Trump reinstated and expanded the Mexico City Policy via presidential memorandum, renaming it “Protecting Life in Global Health Assistance.” This explainer provides an overview of the policy, including its history, changes over time, and current application.First announced in 1984 by the Reagan administration, the policy has been rescinded and reinstated by subsequent administrations along party lines and has now been in effect for 19 of the past 34 years.The policy requires foreign non-governmental organizations (NGOs) to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. Funds) as seroquel 200mg side effects a condition of receiving U.S. Government global family planning assistance and, as of Jan. 23, 2017, most other seroquel 200mg side effects U.S. Global health assistance.The Trump administration’s application of the policy extends to the vast majority of U.S.

Bilateral global health assistance, including funding for HIV under PEPFAR, seroquel 200mg side effects maternal and child health, malaria, nutrition, and other programs. This marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounts for approximately $600 million of that total).Additionally, as a result of a March 2019 policy announcement and subsequent information released in June 2019, the policy, for the first time, prohibits foreign NGOs who accept the policy from providing any financial support using any source of funds and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning. This greatly extends seroquel 200mg side effects its reach to other areas of U.S. Development assistance beyond global health and to other non-U.S. Funding streams.More recently, in September 2020, a proposed seroquel 200mg side effects rule to extend the policy to contracts was published.

If finalized, it would greatly extend the reach of the policy beyond grants and cooperative agreements to also include contracts.KFF analyses have found that:more than half of the countries in which the U.S. Provides bilateral global health assistance allow for legal abortion in at least one case not permitted by the policy (analysis) seroquel 200mg side effects. Andhad the expanded policy been in effect during the FY 2013 – FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy (analysis).What is the Mexico City Policy?. The Mexico seroquel 200mg side effects City Policy is a U.S. Government policy that – when in effect – has required foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S.

Funds) as a condition of seroquel 200mg side effects receiving U.S. Global family planning assistance and, as of Jan. 23, 2017, seroquel 200mg side effects most other U.S. Global health assistance.The policy was first announced by the Reagan administration at the 2nd International Conference on Population, which was held in Mexico City, Mexico, on August 6-14, 1984 (hence its name. See Box seroquel 200mg side effects 1).

Under the Trump administration, the policy has been renamed “Protecting Life in Global Health Assistance” (PLGHA). Among opponents, it is also known as the “Global Gag Rule,” because among other activities, it prohibits foreign NGOs from using seroquel 200mg side effects any funds (including non-U.S. Funds) to provide information about abortion as a method of family planning and to lobby a foreign government to legalize abortion. €œ[T]he United States does not consider abortion an acceptable element seroquel 200mg side effects of family planning programs and will no longer contribute to those of which it is a part. €¦[T]he United States will no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations.”When first instituted in 1984, the Mexico City Policy marked an expansion of existing legislative restrictions that already prohibited U.S.

Funding for seroquel 200mg side effects abortion internationally, with some exceptions (see below). Prior to the policy, foreign NGOs could use non-U.S. Funds to engage in certain voluntary abortion-related activities as long seroquel 200mg side effects as they maintained segregated accounts for any U.S. Money received, but after the Mexico City Policy was in place, they were no longer permitted to do so if they wanted to receive U.S. Family planning assistance.The Trump administration’s application of seroquel 200mg side effects the policy to the vast majority of U.S.

Bilateral global health assistance, including funding for HIV under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), maternal and seroquel 200mg side effects child health, malaria, nutrition, and other programs, marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounted for approximately $600 million of that total). The Administration’s more recent extension of the policy to include any financial support (health or otherwise) provided by foreign NGOs for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning is likely to encompass significant additional funding.When has it been in effect?. The Mexico City Policy has been in effect for 19 of the past 34 years, primarily through executive action, and has been instated, rescinded, and reinstated by presidential administrations along party lines (see Table 1).The policy was first instituted in 1984 (taking effect in 1985) by President Ronald Reagan and continued to be in effect through President George H.W. Bush’s administration seroquel 200mg side effects.

It was rescinded by President Bill Clinton in 1993 (although it was reinstated legislatively for one year during his second term. See below) seroquel 200mg side effects. The policy was reinstated by President George W. Bush in 2001 and then rescinded by President Barack Obama in 2009 seroquel 200mg side effects. It is currently in effect, having been reinstated by President Trump in 2017.

YearsIn Effect? seroquel 200mg side effects. Presidential Administration (Party Affiliation)Executive (E) or Congressional (C) Action?. 1985-1989YesReagan (R)E1989-1993YesBush (R)E1993-1999 Sept.NoClinton (D)E1999 Oct.-2000 seroquel 200mg side effects Sept.Yes*Clinton (D)C2000 Oct.-2001NoClinton (D)E2001-2009YesBush (R)E2009-2017NoObama (D)E2017-presentYesTrump (R)ENOTES. Shaded blue indicate periods when policy was in effect. * There was a temporary, one-year legislative imposition of the policy, which included a portion of seroquel 200mg side effects the restrictions in effect in other years and an option for the president to waive these restrictions in part.

However, if the waiver option was exercised (for no more than $15 million in family planning assistance), then $12.5 million of this funding would be transferred to maternal and child health assistance. The president did exercise the waiver option.SOURCES seroquel 200mg side effects. €œPolicy Statement of the United States of America at the United Nations International Conference on Population (Second Session), Mexico City, Mexico, August 6-14, 1984,” undated. Bill Clinton Administration, seroquel 200mg side effects “Subject. AID Family Planning Grants/Mexico City Policy,” Memorandum for the Acting Administrator of the Agency for International Development, January 22, 1993, Clinton White House Archives, https://clintonwhitehouse6.archives.gov/1993/01/1993-01-22-aid-family-planning-grants-mexico-city-policy.html.

FY 2000 seroquel 200mg side effects Consolidated Appropriations Act, P.L. 106-113. George W seroquel 200mg side effects. Bush Administration, “Subject. Restoration of the Mexico City Policy,” Memorandum for the Administrator of the United States Agency for International Development, January seroquel 200mg side effects 22, 2001, Bush Administration White House Archives, https://georgewbush-whitehouse.archives.gov/news/releases/20010123-5.html.

€œSubject. Restoration of the Mexico City Policy,” Memorandum for the Administrator of the United seroquel 200mg side effects States Agency for International Development, March 28, 2001, Federal Register, https://www.federalregister.gov/documents/2001/03/29/01-8011/restoration-of-the-mexico-city-policy. George W. Bush Administration, seroquel 200mg side effects “Subject. Assistance for Voluntary Population Planning,” Memorandum for the Secretary of State, August 29, 2003, Bush Administration White House Archives, http://georgewbush-whitehouse.archives.gov/news/releases/2003/08/20030829-3.html.

Barack Obama Administration, “Mexico City Policy and Assistance for Voluntary Population Planning,” Memorandum for the Secretary of State, the Administrator of the United States Agency for International Development, January seroquel 200mg side effects 23, 2009, Obama White House Archives, https://obamawhitehouse.archives.gov/the-press-office/mexico-city-policy-and-assistance-voluntary-population-planning. White House, “The Mexico City Policy,” Memorandum for the Secretary of State, the Secretary of Health and Human Services, the Administrator of the Agency for International Development, Jan. 23, 2017, seroquel 200mg side effects https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.How is it instituted (and rescinded)?. The Mexico City Policy has, for the most part, been instituted or rescinded through executive branch action (typically via presidential memoranda). While Congress seroquel 200mg side effects has the ability to institute the policy through legislation, this has happened only once in the past.

A modified version of the policy was briefly applied by Congress during President Clinton’s last year in office as part of a broader arrangement to pay the U.S. Debt to the United Nations seroquel 200mg side effects. (At that time, President Clinton was able to partially waive the policy’s restrictions.) Other attempts to institute the policy through legislation have not been enacted into law, nor have legislative attempts to overturn the policy. See Table 1.Who does seroquel 200mg side effects the policy apply to?. The policy, when in effect, applies to foreign NGOs as a condition for receiving U.S.

Family planning support and, now, other global health assistance, either directly (as the main – or prime – recipient of U.S. Funding) or indirectly (as a recipient seroquel 200mg side effects of U.S. Funding through an agreement with the prime recipient. Referred to as a seroquel 200mg side effects sub-recipient). Specifically, a foreign NGO “recipient agrees that it will not, during the term of this award, perform or actively promote abortion as a method of family planning in foreign countries or provide financial support to any other foreign non-governmental organization that conducts such activities.”Foreign NGOs include:international NGOs that are based outside the U.S.,regional NGOs that are based outside the U.S., andlocal NGOs in assisted countries.U.S.

NGOs, while not directly subject to the Mexico City Policy, must also agree to ensure that they do not provide funding to any seroquel 200mg side effects foreign NGO sub-recipients unless those sub-recipients have first certified adherence to the policy. Specifically, a U.S. NGO “recipient (A) agrees that it will not furnish health assistance under this award to any foreign non-governmental organization that performs or actively promotes abortion as a method of family planning in foreign seroquel 200mg side effects countries. And (B) further agrees to require that such sub-recipients do not provide financial support to any other foreign non-governmental organization that conducts such activities.”As in the past, the current policy does not apply to funding provided by the U.S. Government to seroquel 200mg side effects foreign governments (national or sub-national), public international organizations, and other multilateral entities, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi, the treatment Alliance.

However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See “What is seroquel 200mg side effects ‘financial support’?. € below.To what assistance does it apply?. In the past, foreign NGOs have been required to seroquel 200mg side effects adhere to the Mexico City Policy – when it was in effect – as a condition of receiving support through certain U.S. International funding streams.

Family planning assistance through the U.S seroquel 200mg side effects. Agency for International Development (USAID) and, beginning in 2003, family planning assistance through the U.S. Department of seroquel 200mg side effects State. In the 2003 memorandum announcing the policy’s expansion to include the Department of State, President Bush stated that the policy did not apply to funding for global HIV/AIDS programs and that multilateral organizations that are associations of governments are not included among “foreign NGOs.”The current policy, reinstated in 2017, applies to the vast majority of U.S. Bilateral global health assistance furnished seroquel 200mg side effects by all agencies and departments.

“Assistance” includes “the provision of funds, commodities, equipment, or other in-kind global health assistance.” Specifically, the expanded policy applies to nearly all bilateral global health assistance, including. family planning and reproductive healthfor the first time:maternal and child health (including household-level water, sanitation, and hygiene (WASH))nutritionHIV under PEPFARtuberculosismalaria seroquel 200mg side effects under the President’s Malaria Initiative (PMI)neglected tropical diseasesglobal health securitycertain types of research activitiesThe policy applies to the assistance described above that is appropriated directly to three agencies and departments. USAID. The Department of State, including the Office of the Global seroquel 200mg side effects AIDS Coordinator, which oversees and coordinates U.S. Global HIV funding under PEPFAR.

And for the first time, the seroquel 200mg side effects Department of Defense (DoD). When such funding is transferred to another agency, including the Centers for Disease Control (CDC) and the National Institutes of Health (NIH), it remains subject to the policy, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly.The policy applies to three types of funding agreements for such assistance. Grants. Cooperative agreements. And, for the first time, contracts, pending necessary rule-making that would be needed to do so (a proposed rule to accomplish this was published in September 2020).The policy does not apply to U.S.

Assistance for. Water supply and sanitation activities, which is usually focused on infrastructure and systems. Humanitarian assistance, including activities related to migration and refugee assistance activities as well as disaster and humanitarian relief activities. The American Schools and Hospitals Abroad (ASHA) program. And Food for Peace (FFP).

However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See “What is ‘financial support’?. € below.What activities are prohibited?. The policy prohibits foreign NGOs that receive U.S. Family planning assistance and, now, most other U.S.

Bilateral global health assistance from using funds from any source (including non-U.S. Funds) to “perform or actively promote abortion as a method of family planning.” In addition to providing abortions with non-U.S. Funds, restricted activities also include the following:providing advice and information about and offering referral for abortion – where legal – as part of the full range of family planning options,promoting changes in a country’s laws or policies related to abortion as a method of family planning (i.e., engaging in lobbying), andconducting public information campaigns about abortion as a method of family planning.The prohibition of these activities are why the policy has been referred to by its critics as the “Global Gag Rule.”Additionally, for the first time, the policy prohibits foreign NGOs from providing any financial support with any source of funds (including non-U.S. Funding) and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning. See “What is “financial support?.

€ below.The policy, however, does not prohibit foreign NGOs from:providing advice and information about, performing, or offering referral for abortion in cases where the pregnancy has either posed a risk to the life of the mother or resulted from incest or rape. Andresponding to a question about where a safe, legal abortion may be obtained when a woman who is already pregnant clearly states that she has already decided to have a legal abortion (passively providing information, versus actively providing medically-appropriate information).In addition, the expanded policy does not apply to healthcare providers who have an affirmative duty required under local law to provide counseling about and referrals for abortion as a method of family planning.Does it restrict direct U.S. Funding for abortion overseas?. U.S. Funding for abortion is already restricted under several provisions of the law.

Specifically, before the Mexico City Policy was first announced in 1984, U.S. Law already prohibited the use of U.S. Aid:to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion (the Helms Amendment, 1973, to the Foreign Assistance Act);for biomedical research related to methods of or the performance of abortion as a means of family planning (the Biden Amendment, 1981, to the Foreign Assistance Act). Andto lobby for or against abortion (the Siljander Amendment, first included in annual appropriations in 1981 and included each year thereafter).Then, shortly after the policy was announced in 1984, the Kemp-Kasten Amendment was passed in 1985, prohibiting the use of U.S. Aid to fund any organization or program, as determined by the president, that supports or participates in the management of a program of coercive abortion or involuntary sterilization (it is now included in annual appropriations).Before the Mexico City Policy, U.S.

Aid recipients could use non-U.S. Funds to engage in certain abortion-related activities but were required to maintain segregated accounts for U.S. Assistance. The Mexico City Policy reversed this practice. No longer were foreign NGOs allowed to use non-U.S.

Funds, maintained in segregated accounts, for voluntary abortion-related activities if they wished to continue to receive or be able to receive U.S. Family planning funds.Does the policy prohibit post-abortion care?. The Mexico City Policy does not restrict the provision of post-abortion care, which is a supported activity of U.S. Family planning assistance. Whether or not the Mexico City Policy is in effect, recipients of U.S.

Family planning assistance are allowed to use U.S. And non-U.S. Funding to support post-abortion care, no matter the circumstances of the abortion (whether it was legal or illegal).What has been the impact of the policy?. Several studies have looked at the impact of the policy. A 2011 quantitative analysis by Bendavid, et.

Al, found a strong association between the Mexico City Policy and abortion rates in sub-Saharan Africa. This study was recently updated to include several more years of data, again identifying a strong association. Specifically, the updated study found that during periods when the policy was in place, abortion rates rose by 40% in countries with high exposure to the Mexico City Policy compared to those with low exposure, while the use of modern contraceptives declined by 14% and pregnancies increased by 12% in high exposure compared to low exposure countries. In other words, it found patterns that “strengthen the case for the role played by the policy” in “a substantial increase in abortions across sub-Saharan Africa among women affected by the U.S. Mexico City Policy … [and] a corresponding decline in the use of modern contraception and increase in pregnancies,” likely because foreign NGOs that declined U.S.

Funding as a result of the Mexico City Policy – often key providers of women’s health services in these areas – had fewer resources to support family planning services, particularly contraceptives. Increased access to and use of contraception have been shown to be key to preventing unintended pregnancies and thereby reducing abortion, including unsafe abortion. The study also found patterns that “suggest that the effects of the policy are reversible” when the policy is not in place.Additionally, there has been anecdotal evidence and qualitative data on the impact of the policy, when it has been in force in the past, on the work of organizations that have chosen not to agree to the policy and, therefore, forgo U.S. Funding that had previously supported their activities. For example, they have reported that they have fewer resources to support family planning and reproductive health services, including family planning counseling, contraceptive commodities, condoms, and reproductive cancer screenings.While it is likely too early to assess the full effects of the current policy on NGOs and the individuals they serve, as the policy is applied on a rolling basis as new funding agreements or modifications to existing agreements are made, some early data are available.

Several early qualitative and quantitative studies have been released, and at least one long-term, quantitative assessment is underway. Additionally, an official assessment by the U.S. Department of State on implementation during the first six months of the policy has been released (see below). This review acknowledged that it took “place early in the policy’s implementation, when affected U.S. Government departments and agencies have added a significant portion of the funding affected by the policy to grants and cooperative agreements only recently [i.e., after the period the review examined].

A follow-on analysis would allow an opportunity to address one of the primary concerns presented in feedback from third-party stakeholder organizations, namely that six months is insufficient time to gauge the impacts of” the policy.Nonetheless, it is already clear that the reinstated and expanded version of the policy applies to a much greater amount of U.S. Global health assistance, and greater number of foreign NGOs, across many program areas. KFF has found that more than half (37) of the 64 countries that received U.S. Bilateral global health assistance in FY 2016 allow for legal abortion in at least one case not permitted by the policy and that had the expanded Mexico City Policy been in effect during the FY 2013 – FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy. In addition, at least 469 U.S.

NGOs that received U.S. Global health assistance during this period would have been required to ensure that their foreign NGO sub-recipients were in compliance. Additional foreign NGOs are likely to be impacted by the policy due to the revised interpretation of “financial support” announced in March 2019 and implemented beginning June 2019. See “What is ‘financial support’?. € below.A report released in March 2020 by the U.S.

Government Accountability Office (GAO) provided new information on the number of projects (awards) and NGOs affected. It found that from May 2017 through FY 2018:the policy had been applied to over 1,300 global health projects, with the vast majority of these through USAID and CDC, andNGOs declined to accept the policy in 54 instances, totaling $153 million in declined funding – specifically, seven prime awards amounting to $102 million and 47 sub-awards amounting to $51 million (more than two-thirds of sub-awards were intended for Africa) – across USAID and CDC. The Department of State and DoD did not identify any instances where NGOs declined to accept the policy conditions.What have the U.S. Government’s reviews of the policy found?. The U.S.

Government has published two reviews of the policy to date, with the first examining the initial six months of the policy released in February 2018 and the second examining the first 18 months of the policy released in August 2020.First ReviewIn February 2018, the Department of State announced the findings of an initial six-month review of implementation of the policy through the end of FY 2017 (September 2017). The report directed agencies to provide greater support for improving understanding of implementation among affected organizations and provided guidance to clarify terms included in standard provisions of grants and cooperative agreements. In the six-month review report, the Department of State report identified a number of “actions” for implementing agencies, such as a need for:more central and field-based training and implementation tools,a clearer explanation of termination of awards for NGOs found to be in violation of the policy, anda clarification of “financial support,” which was not defined in the standard provisions (see “What is financial support?. € below).The six month review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2017 (see Table 2). U.S.

Agency or DepartmentPolicy Implementation DateOverall # of Grants and Cooperative Agreements with Global Health Assistance FundingOf Overall #:(From the Policy Implementation Date through 9/30/2017)# That Received New Funding and Accepted Policy# That Received New Funding and Declined to Accept Policy^# That Had Not Received New Funding YetUSAIDMay 15, 20175804193158State*May 15, 2017142108034HHS+May 31, 20174991600339DoDMay 15, 20177742134TOTAL12987294565NOTES. * reflects PEPFAR funding implemented through the Department of State. Other departments and agencies implement the majority of PEPFAR funding. + At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2017, USAID reported it was aware of three centrally funded prime partners, and 12 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards.

DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries. And HHS reported that no HHS partners declined to agree.SOURCES. KFF analysis of data from Department of State, “Protecting Life in Global Health Assistance Six-Month Review,” report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Second ReviewOn August 17, 2020, the Department of State released its second review of the policy, updating its initial six-month review (as an action item in the six-month review report, the department stated it would “conduct a further review of implementation of the policy by December 15, 2018, when more extensive experience will enable a more thorough examination of the benefits and challenges”).

The long-anticipated review, which examines the period from May 2017 through September 2018, found:the awards declined spanned a variety of program areas, including family planning and reproductive health (FP/RH), HIV and AIDS (HIV/AIDS), maternal and child health (MCH), tuberculosis (TB), and nutrition, in addition to cross-cutting awards;the awards declined spanned geographic areas but many were for activities in sub-Saharan Africa;agencies and departments made efforts to transition projects to another implementer in order to minimize disruption. Butnevertheless, among USAID awards involving health service delivery where prime and sub-award recipients declined to accept the policy, gaps or disruptions in service delivery were sometimes reported.The second review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2018 (see Table 3). U.S. Agency or DepartmentPolicy Implementation Date# of Grants and Cooperative Agreements with Global Health Assistance Funding# of Prime Awardees That Declined to Accept Policy^USAIDMay 15, 20174866State*May 15, 20173350HHS+May 31, 20174661DoDMay 15, 2017531TOTAL13408NOTES. * reflects PEPFAR funding implemented through the Department of State.

Other departments and agencies implement the majority of PEPFAR funding. + At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2018, USAID reported it was aware of six centrally funded prime partners, and 47 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards. DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries.

And HHS reported that one HHS partner declined to agree.SOURCES. KFF analysis of data from Department of State, “Review of the Implementation of the Protecting Life in Global Health Assistance Policy ,” report, Aug. 17, 2020, https://www.state.gov/wp-content/uploads/2020/08/PLGHA-2019-Review-Final-8.17.2020-508.pdf, and Department of State, “Protecting Life in Global Health Assistance Six-Month Review,” report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Additionally, the review reports that 47 sub-awardees, all under USAID awards, declined to accept the policy. It is important to note that the review also states that information on sub-awards is not systematically collected by departments and agencies and that DoD was not able to collect information on sub-awards.What is “financial support”?.

In February 2018, in the initial six-month review issued when Secretary of State Tillerson led the department, the Department of State report included an “action” statement to clarify the definition of “financial support” as used in the standard provisions for grants and cooperative agreements. At issue was whether it applied more narrowly to certain funding provided by foreign NGOs (i.e., funding other than U.S. Global health funding) to other foreign NGOs specifically for the purpose of performing or actively promoting abortion as a method of family planning or if it applied more broadly to certain funding provided by foreign NGOs to other foreign NGOs for any purpose, if that foreign NGO happened to perform or actively promote abortion as a method of family planning. The State Department clarified that it was the more narrow interpretation.However, on March 26, 2019, Secretary of State Pompeo reversed this interpretation, announcing further “refinements” to the policy to clarify that it applied to the broader definition of financial support. Specifically, under the policy, U.S.-supported foreign NGOs agree to not provide any financial support (global health-related as well as other support), no matter the source of funds, to any other foreign NGO that performs or actively promotes abortion as a method of family planning.

In June 2019, USAID provided additional information to reflect this broader interpretation of the standard provisions.This marks the first time the policy has been applied this broadly, as it can now affect funding provided by other donors (such as other governments and foundations) and non-global health funding provided by the U.S. Government for a wide range of purposes if this funding is first provided to foreign NGOs who have accepted the policy (as recipients of U.S. Global health assistance) that then in turn provide that donor or U.S. Non global health funding for any purpose to foreign NGOs that perform or actively promote abortion as a method of family planning. For example, under the prior interpretation, a foreign NGO recipient of U.S.

Global health funding could not provide any non-U.S. Funding to another foreign NGO to perform or actively promote abortion as a method of family planning but could provide funding for other activities, such as education, even if the foreign NGO carried out prohibited activities. Under the broader interpretation, a foreign NGO could not provide any non-U.S. Funding for any activity to a foreign NGO that carried out prohibited activities. Similarly, while under the prior interpretation a foreign NGO recipient of U.S.

Global health funding could provide other U.S. Funding (such as humanitarian assistance) to another foreign NGO for non-prohibited activities, even if the foreign NGO carried out prohibited activities, now under the broader interpretation, it could not do so.What are the next steps in implementing the expanded policy?. The policy went into effect in May 2017 (see Table 2), although it is applied on a rolling basis, as new funding agreements and modifications to existing agreements occur. While it applies to all grants and cooperative agreements, the Trump administration has indicated that it intends the policy to apply to contracts, which would require a rule-making process (it began this process by publishing a proposed rule in September 2020)..

About This TrackerThis tracker provides the number of confirmed cases and deaths from cheap generic seroquel novel antidepressants by country, the trend in confirmed case and death counts by country, and a http://rabbitsunlimited.org/?p=49 global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) antidepressants Resource Center’s antidepressant drugs Map and the World Health Organization’s (WHO) antidepressants Disease (antidepressant drugs-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About antidepressant drugs antidepressantsIn late 2019, cheap generic seroquel a new antidepressants emerged in central China to cause disease in humans. Cases of this disease, known as antidepressant drugs, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the seroquel represents cheap generic seroquel a public health emergency of international concern, and on January 31, 2020, the U.S.

Department of Health and Human Services declared it to be a health emergency for the United States.Key PointsOn January 23, 2017, President Donald Trump reinstated and expanded the Mexico City Policy via presidential memorandum, renaming it “Protecting Life in Global Health Assistance.” This explainer provides an overview of the policy, including its history, changes over time, and current application.First announced in 1984 by the Reagan administration, the policy has been rescinded and reinstated by subsequent administrations along party lines and has now been in effect for 19 of the past 34 years.The policy requires foreign non-governmental organizations (NGOs) to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. Funds) as a condition of receiving U.S cheap generic seroquel. Government global family planning assistance and, as of Jan. 23, 2017, cheap generic seroquel most other U.S. Global health assistance.The Trump administration’s application of the policy extends to the vast majority of U.S.

Bilateral global health assistance, including funding for HIV under PEPFAR, maternal cheap generic seroquel and child health, malaria, nutrition, and other programs. This marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounts for approximately $600 million of that total).Additionally, as a result of a March 2019 policy announcement and subsequent information released in June 2019, the policy, for the first time, prohibits foreign NGOs who accept the policy from providing any financial support using any source of funds and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning. This greatly extends its cheap generic seroquel reach to other areas of U.S. Development assistance beyond global health and to other non-U.S. Funding streams.More recently, in September cheap generic seroquel 2020, a proposed rule to extend the policy to contracts was published.

If finalized, it would greatly extend the reach of the policy beyond grants and cooperative agreements to also include contracts.KFF analyses have found that:more than half of the countries in which the U.S. Provides bilateral global health assistance allow for legal abortion in at least one case not cheap generic seroquel permitted by the policy (analysis). Andhad the expanded policy been in effect during the FY 2013 – FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy (analysis).What is the Mexico City Policy?. The Mexico cheap generic seroquel City Policy is a U.S. Government policy that – when in effect – has required foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S.

Funds) as cheap generic seroquel a condition of receiving U.S. Global family planning assistance and, as of Jan. 23, 2017, cheap generic seroquel most other U.S. Global health assistance.The policy was first announced by the Reagan administration at the 2nd International Conference on Population, which was held in Mexico City, Mexico, on August 6-14, 1984 (hence its name. See Box 1) cheap generic seroquel.

Under the Trump administration, the policy has been renamed “Protecting Life in Global Health Assistance” (PLGHA). Among opponents, it is also cheap generic seroquel known as the “Global Gag Rule,” because among other activities, it prohibits foreign NGOs from using any funds (including non-U.S. Funds) to provide information about abortion as a method of family planning and to lobby a foreign government to legalize abortion. €œ[T]he United States does not consider abortion an acceptable element of cheap generic seroquel family planning programs and will no longer contribute to those of which it is a part. €¦[T]he United States will no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations.”When first instituted in 1984, the Mexico City Policy marked an expansion of existing legislative restrictions that already prohibited U.S.

Funding for abortion internationally, with some exceptions (see cheap generic seroquel below). Prior to the policy, foreign NGOs could use non-U.S. Funds to engage in certain voluntary abortion-related activities as long as they maintained segregated accounts cheap generic seroquel for any U.S. Money received, but after the Mexico City Policy was in place, they were no longer permitted to do so if they wanted to receive U.S. Family planning assistance.The Trump administration’s application of the policy to the vast majority of U.S cheap generic seroquel.

Bilateral global health assistance, including funding for HIV under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), maternal and child cheap generic seroquel health, malaria, nutrition, and other programs, marks a significant expansion of its scope, potentially encompassing $7.3 billion in FY 2020, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly (family planning assistance accounted for approximately $600 million of that total). The Administration’s more recent extension of the policy to include any financial support (health or otherwise) provided by foreign NGOs for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning is likely to encompass significant additional funding.When has it been in effect?. The Mexico City Policy has been in effect for 19 of the past 34 years, primarily through executive action, and has been instated, rescinded, and reinstated by presidential administrations along party lines (see Table 1).The policy was first instituted in 1984 (taking effect in 1985) by President Ronald Reagan and continued to be in effect through President George H.W. Bush’s administration cheap generic seroquel.

It was rescinded by President Bill Clinton in 1993 (although it was reinstated legislatively for one year during his second term. See below) cheap generic seroquel. The policy was reinstated by President George W. Bush in 2001 and then rescinded by President Barack Obama cheap generic seroquel in 2009. It is currently in effect, having been reinstated by President Trump in 2017.

YearsIn Effect? cheap generic seroquel. Presidential Administration (Party Affiliation)Executive (E) or Congressional (C) Action?. 1985-1989YesReagan (R)E1989-1993YesBush (R)E1993-1999 Sept.NoClinton (D)E1999 Oct.-2000 Sept.Yes*Clinton (D)C2000 Oct.-2001NoClinton (D)E2001-2009YesBush (R)E2009-2017NoObama cheap generic seroquel (D)E2017-presentYesTrump (R)ENOTES. Shaded blue indicate periods when policy was in effect. * There was a temporary, one-year legislative imposition of the policy, which included a portion of the restrictions in effect in other years cheap generic seroquel and an option for the president to waive these restrictions in part.

However, if the waiver option was exercised (for no more than $15 million in family planning assistance), then $12.5 million of this funding would be transferred to maternal and child health assistance. The president did exercise cheap generic seroquel the waiver option.SOURCES. €œPolicy Statement of the United States of America at the United Nations International Conference on Population (Second Session), Mexico City, Mexico, August 6-14, 1984,” undated. Bill Clinton Administration, cheap generic seroquel “Subject. AID Family Planning Grants/Mexico City Policy,” Memorandum for the Acting Administrator of the Agency for International Development, January 22, 1993, Clinton White House Archives, https://clintonwhitehouse6.archives.gov/1993/01/1993-01-22-aid-family-planning-grants-mexico-city-policy.html.

FY 2000 Consolidated Appropriations Act, P.L cheap generic seroquel. 106-113. George W cheap generic seroquel. Bush Administration, “Subject. Restoration of the Mexico City Policy,” Memorandum for the Administrator of cheap generic seroquel the United States Agency for International Development, January 22, 2001, Bush Administration White House Archives, https://georgewbush-whitehouse.archives.gov/news/releases/20010123-5.html.

€œSubject. Restoration of the Mexico cheap generic seroquel City Policy,” Memorandum for the Administrator of the United States Agency for International Development, March 28, 2001, Federal Register, https://www.federalregister.gov/documents/2001/03/29/01-8011/restoration-of-the-mexico-city-policy. George W. Bush Administration, cheap generic seroquel “Subject. Assistance for Voluntary Population Planning,” Memorandum for the Secretary of State, August 29, 2003, Bush Administration White House Archives, http://georgewbush-whitehouse.archives.gov/news/releases/2003/08/20030829-3.html.

Barack Obama Administration, “Mexico City Policy and Assistance for Voluntary Population Planning,” Memorandum for the Secretary of State, the Administrator of the United States cheap generic seroquel Agency for International Development, January 23, 2009, Obama White House Archives, https://obamawhitehouse.archives.gov/the-press-office/mexico-city-policy-and-assistance-voluntary-population-planning. White House, “The Mexico City Policy,” Memorandum for the Secretary of State, the Secretary of Health and Human Services, the Administrator of the Agency for International Development, Jan. 23, 2017, cheap generic seroquel https://www.whitehouse.gov/the-press-office/2017/01/23/presidential-memorandum-regarding-mexico-city-policy.How is it instituted (and rescinded)?. The Mexico City Policy has, for the most part, been instituted or rescinded through executive branch action (typically via presidential memoranda). While Congress has the ability to institute the policy through cheap generic seroquel legislation, this has happened only once in the past.

A modified version of the policy was briefly applied by Congress during President Clinton’s last year in office as part of a broader arrangement to pay the U.S. Debt to the United Nations cheap generic seroquel. (At that time, President Clinton was able to partially waive the policy’s restrictions.) Other attempts to institute the policy through legislation have not been enacted into law, nor have legislative attempts to overturn the policy. See Table 1.Who does the policy cheap generic seroquel apply to?. The policy, when in effect, applies to foreign NGOs as a condition for receiving U.S.

Family planning support and, now, other global health assistance, either directly (as the main – or prime – recipient of U.S. Funding) or cheap generic seroquel indirectly (as a recipient of U.S. Funding through an agreement with the prime recipient. Referred to cheap generic seroquel as a sub-recipient). Specifically, a foreign NGO “recipient agrees that it will not, during the term of this award, perform or actively promote abortion as a method of family planning in foreign countries or provide financial support to any other foreign non-governmental organization that conducts such activities.”Foreign NGOs include:international NGOs that are based outside the U.S.,regional NGOs that are based outside the U.S., andlocal NGOs in assisted countries.U.S.

NGOs, while not directly subject to the Mexico City Policy, must also agree to ensure that they do cheap generic seroquel not provide funding to any foreign NGO sub-recipients unless those sub-recipients have first certified adherence to the policy. Specifically, a U.S. NGO “recipient (A) agrees that it will not furnish health assistance under this award to any foreign non-governmental organization that performs or actively promotes abortion as a method cheap generic seroquel of family planning in foreign countries. And (B) further agrees to require that such sub-recipients do not provide financial support to any other foreign non-governmental organization that conducts such activities.”As in the past, the current policy does not apply to funding provided by the U.S. Government to foreign governments (national or sub-national), public international organizations, and other multilateral entities, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and Gavi, the treatment Alliance cheap generic seroquel.

However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See “What is ‘financial cheap generic seroquel support’?. € below.To what assistance does it apply?. In the past, foreign NGOs have been required to adhere to the Mexico City Policy – when it was in effect – as a condition cheap generic seroquel of receiving support through certain U.S. International funding streams.

Family planning assistance cheap generic seroquel through the U.S. Agency for International Development (USAID) and, beginning in 2003, family planning assistance through the U.S. Department of cheap generic seroquel State. In the 2003 memorandum announcing the policy’s expansion to include the Department of State, President Bush stated that the policy did not apply to funding for global HIV/AIDS programs and that multilateral organizations that are associations of governments are not included among “foreign NGOs.”The current policy, reinstated in 2017, applies to the vast majority of U.S. Bilateral global cheap generic seroquel health assistance furnished by all agencies and departments.

“Assistance” includes “the provision of funds, commodities, equipment, or other in-kind global health assistance.” Specifically, the expanded policy applies to nearly all bilateral global health assistance, including. family planning and reproductive healthfor the first time:maternal cheap generic seroquel and child health (including household-level water, sanitation, and hygiene (WASH))nutritionHIV under PEPFARtuberculosismalaria under the President’s Malaria Initiative (PMI)neglected tropical diseasesglobal health securitycertain types of research activitiesThe policy applies to the assistance described above that is appropriated directly to three agencies and departments. USAID. The Department of State, cheap generic seroquel including the Office of the Global AIDS Coordinator, which oversees and coordinates U.S. Global HIV funding under PEPFAR.

And for the first time, the Department of Defense cheap generic seroquel (DoD). When such funding is transferred to another agency, including the Centers for Disease Control (CDC) and the National Institutes of Health (NIH), it remains subject to the policy, to the extent that such funding is ultimately provided to foreign NGOs, directly or indirectly.The policy applies to three types of funding agreements for such assistance. Grants. Cooperative agreements. And, for the first time, contracts, pending necessary rule-making that would be needed to do so (a proposed rule to accomplish this was published in September 2020).The policy does not apply to U.S.

Assistance for. Water supply and sanitation activities, which is usually focused on infrastructure and systems. Humanitarian assistance, including activities related to migration and refugee assistance activities as well as disaster and humanitarian relief activities. The American Schools and Hospitals Abroad (ASHA) program. And Food for Peace (FFP).

However, this funding is subject to the policy if it flows through a foreign NGO that has accepted the policy. See “What is ‘financial support’?. € below.What activities are prohibited? can you buy over the counter seroquel. The policy prohibits foreign NGOs that receive U.S. Family planning assistance and, now, most other U.S.

Bilateral global health assistance from using funds from any source (including non-U.S. Funds) to “perform or actively promote abortion as a method of family planning.” In addition to providing abortions with non-U.S. Funds, restricted activities also include the following:providing advice and information about and offering referral for abortion – where legal – as part of the full range of family planning options,promoting changes in a country’s laws or policies related to abortion as a method of family planning (i.e., engaging in lobbying), andconducting public information campaigns about abortion as a method of family planning.The prohibition of these activities are why the policy has been referred to by its critics as the “Global Gag Rule.”Additionally, for the first time, the policy prohibits foreign NGOs from providing any financial support with any source of funds (including non-U.S. Funding) and for any purpose to other foreign NGOs that perform or actively promote abortion as a method of family planning. See “What is “financial support?.

€ below.The policy, however, does not prohibit foreign NGOs from:providing advice and information about, performing, or offering referral for abortion in cases where the pregnancy has either posed a risk to the life of the mother or resulted from incest or rape. Andresponding to a question about where a safe, legal abortion may be obtained when a woman who is already pregnant clearly states that she has already decided to have a legal abortion (passively providing information, versus actively providing medically-appropriate information).In addition, the expanded policy does not apply to healthcare providers who have an affirmative duty required under local law to provide counseling about and referrals for abortion as a method of family planning.Does it restrict direct U.S. Funding for abortion overseas?. U.S. Funding for abortion is already restricted under several provisions of the law.

Specifically, before the Mexico City Policy was first announced in 1984, U.S. Law already prohibited the use of U.S. Aid:to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortion (the Helms Amendment, 1973, to the Foreign Assistance Act);for biomedical research related to methods of or the performance of abortion as a means of family planning (the Biden Amendment, 1981, to the Foreign Assistance Act). Andto lobby for or against abortion (the Siljander Amendment, first included in annual appropriations in 1981 and included each year thereafter).Then, shortly after the policy was announced in 1984, the Kemp-Kasten Amendment was passed in 1985, prohibiting the use of U.S. Aid to fund any organization or program, as determined by the president, that supports or participates in the management of a program of coercive abortion or involuntary sterilization (it is now included in annual appropriations).Before the Mexico City Policy, U.S.

Aid recipients could use non-U.S. Funds to engage in certain abortion-related activities but were required to maintain segregated accounts for U.S. Assistance. The Mexico City Policy reversed this practice. No longer were foreign NGOs allowed to use non-U.S.

Funds, maintained in segregated accounts, for voluntary abortion-related activities if they wished to continue to receive or be able to receive U.S. Family planning funds.Does the policy prohibit post-abortion care?. The Mexico City Policy does not restrict the provision of post-abortion care, which is a supported activity of U.S. Family planning assistance. Whether or not the Mexico City Policy is in effect, recipients of U.S.

Family planning assistance are allowed to use U.S. And non-U.S. Funding to support post-abortion care, no matter the circumstances of the abortion (whether it was legal or illegal).What has been the impact of the policy?. Several studies have looked at the impact of the policy. A 2011 quantitative analysis by Bendavid, et.

Al, found a strong association between the Mexico City Policy and abortion rates in sub-Saharan Africa. This study was recently updated to include several more years of data, again identifying a strong association. Specifically, the updated study found that during periods when the policy was in place, abortion rates rose by 40% in countries with high exposure to the Mexico City Policy compared to those with low exposure, while the use of modern contraceptives declined by 14% and pregnancies increased by 12% in high exposure compared to low exposure countries. In other words, it found patterns that “strengthen the case for the role played by the policy” in “a substantial increase in abortions across sub-Saharan Africa among women affected by the U.S. Mexico City Policy … [and] a corresponding decline in the use of modern contraception and increase in pregnancies,” likely because foreign NGOs that declined U.S.

Funding as a result of the Mexico City Policy – often key providers of women’s health services in these areas – had fewer resources to support family planning services, particularly contraceptives. Increased access to and use of contraception have been shown to be key to preventing unintended pregnancies and thereby reducing abortion, including unsafe abortion. The study also found patterns that “suggest that the effects of the policy are reversible” when the policy is not in place.Additionally, there has been anecdotal evidence and qualitative data on the impact of the policy, when it has been in force in the past, on the work of organizations that have chosen not to agree to the policy and, therefore, forgo U.S. Funding that had previously supported their activities. For example, they have reported that they have fewer resources to support family planning and reproductive health services, including family planning counseling, contraceptive commodities, condoms, and reproductive cancer screenings.While it is likely too early to assess the full effects of the current policy on NGOs and the individuals they serve, as the policy is applied on a rolling basis as new funding agreements or modifications to existing agreements are made, some early data are available.

Several early qualitative and quantitative studies have been released, and at least one long-term, quantitative assessment is underway. Additionally, an official assessment by the U.S. Department of State on implementation during the first six months of the policy has been released (see below). This review acknowledged that it took “place early in the policy’s implementation, when affected U.S. Government departments and agencies have added a significant portion of the funding affected by the policy to grants and cooperative agreements only recently [i.e., after the period the review examined].

A follow-on analysis would allow an opportunity to address one of the primary concerns presented in feedback from third-party stakeholder organizations, namely that six months is insufficient time to gauge the impacts of” the policy.Nonetheless, it is already clear that the reinstated and expanded version of the policy applies to a much greater amount of U.S. Global health assistance, and greater number of foreign NGOs, across many program areas. KFF has found that more than half (37) of the 64 countries that received U.S. Bilateral global health assistance in FY 2016 allow for legal abortion in at least one case not permitted by the policy and that had the expanded Mexico City Policy been in effect during the FY 2013 – FY 2015 period, at least 1,275 foreign NGOs would have been subject to the policy. In addition, at least 469 U.S.

NGOs that received U.S. Global health assistance during this period would have been required to ensure that their foreign NGO sub-recipients were in compliance. Additional foreign NGOs are likely to be impacted by the policy due to the revised interpretation of “financial support” announced in March 2019 and implemented beginning June 2019. See “What is ‘financial support’?. € below.A report released in March 2020 by the U.S.

Government Accountability Office (GAO) provided new information on the number of projects (awards) and NGOs affected. It found that from May 2017 through FY 2018:the policy had been applied to over 1,300 global health projects, with the vast majority of these through USAID and CDC, andNGOs declined to accept the policy in 54 instances, totaling $153 million in declined funding – specifically, seven prime awards amounting to $102 million and 47 sub-awards amounting to $51 million (more than two-thirds of sub-awards were intended for Africa) – across USAID and CDC. The Department of State and DoD did not identify any instances where NGOs declined to accept the policy conditions.What have the U.S. Government’s reviews of the policy found?. The U.S.

Government has published two reviews of the policy to date, with the first examining the initial six months of the policy released in February 2018 and the second examining the first 18 months of the policy released in August 2020.First ReviewIn February 2018, the Department of State announced the findings of an initial six-month review of implementation of the policy through the end of FY 2017 (September 2017). The report directed agencies to provide greater support for improving understanding of implementation among affected organizations and provided guidance to clarify terms included in standard provisions of grants and cooperative agreements. In the six-month review report, the Department of State report identified a number of “actions” for implementing agencies, such as a need for:more central and field-based training and implementation tools,a clearer explanation of termination of awards for NGOs found to be in violation of the policy, anda clarification of “financial support,” which was not defined in the standard provisions (see “What is financial support?. € below).The six month review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2017 (see Table 2). U.S.

Agency or DepartmentPolicy Implementation DateOverall # of Grants and Cooperative Agreements with Global Health Assistance FundingOf Overall #:(From the Policy Implementation Date through 9/30/2017)# That Received New Funding and Accepted Policy# That Received New Funding and Declined to Accept Policy^# That Had Not Received New Funding YetUSAIDMay 15, 20175804193158State*May 15, 2017142108034HHS+May 31, 20174991600339DoDMay 15, 20177742134TOTAL12987294565NOTES. * reflects PEPFAR funding implemented through the Department of State. Other departments and agencies implement the majority of PEPFAR funding. + At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2017, USAID reported it was aware of three centrally funded prime partners, and 12 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards.

DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries. And HHS reported that no HHS partners declined to agree.SOURCES. KFF analysis of data from Department of State, “Protecting Life in Global Health Assistance Six-Month Review,” report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Second ReviewOn August 17, 2020, the Department of State released its second review of the policy, updating its initial six-month review (as an action item in the six-month review report, the department stated it would “conduct a further review of implementation of the policy by December 15, 2018, when more extensive experience will enable a more thorough examination of the benefits and challenges”).

The long-anticipated review, which examines the period from May 2017 through September 2018, found:the awards declined spanned a variety of program areas, including family planning and reproductive health (FP/RH), HIV and AIDS (HIV/AIDS), maternal and child health (MCH), tuberculosis (TB), and nutrition, in addition to cross-cutting awards;the awards declined spanned geographic areas but many were for activities in sub-Saharan Africa;agencies and departments made efforts to transition projects to another implementer in order to minimize disruption. Butnevertheless, among USAID awards involving health service delivery where prime and sub-award recipients declined to accept the policy, gaps or disruptions in service delivery were sometimes reported.The second review also identified the number of affected agreements with prime implementing partners and the number of those that have accepted the Mexico City Policy as part of their agreements through September 2018 (see Table 3). U.S. Agency or DepartmentPolicy Implementation Date# of Grants and Cooperative Agreements with Global Health Assistance Funding# of Prime Awardees That Declined to Accept Policy^USAIDMay 15, 20174866State*May 15, 20173350HHS+May 31, 20174661DoDMay 15, 2017531TOTAL13408NOTES. * reflects PEPFAR funding implemented through the Department of State.

Other departments and agencies implement the majority of PEPFAR funding. + At HHS agencies, only certain assistance funding transferred from USAID, State, and DoD are subject to the policy. ^ As of September 30, 2018, USAID reported it was aware of six centrally funded prime partners, and 47 sub-awardee implementing partners, that declined to agree to the Protecting Life in Global Health Assistance (PLGHA) terms in their awards. DoD reported that one DoD partner, a U.S. NGO, declined to agree in one country but accepted the PLGHA standard provision in other countries.

And HHS reported that one HHS partner declined to agree.SOURCES. KFF analysis of data from Department of State, “Review of the Implementation of the Protecting Life in Global Health Assistance Policy ,” report, Aug. 17, 2020, https://www.state.gov/wp-content/uploads/2020/08/PLGHA-2019-Review-Final-8.17.2020-508.pdf, and Department of State, “Protecting Life in Global Health Assistance Six-Month Review,” report, Feb. 6, 2018, https://www.state.gov/protecting-life-in-global-health-assistance-six-month-review/.Additionally, the review reports that 47 sub-awardees, all under USAID awards, declined to accept the policy. It is important to note that the review also states that information on sub-awards is not systematically collected by departments and agencies and that DoD was not able to collect information on sub-awards.What is “financial support”?.

In February 2018, in the initial six-month review issued when Secretary of State Tillerson led the department, the Department of State report included an “action” statement to clarify the definition of “financial support” as used in the standard provisions for grants and cooperative agreements. At issue was whether it applied more narrowly to certain funding provided by foreign NGOs (i.e., funding other than U.S. Global health funding) to other foreign NGOs specifically for the purpose of performing or actively promoting abortion as a method of family planning or if it applied more broadly to certain funding provided by foreign NGOs to other foreign NGOs for any purpose, if that foreign NGO happened to perform or actively promote abortion as a method of family planning. The State Department clarified that it was the more narrow interpretation.However, on March 26, 2019, Secretary of State Pompeo reversed this interpretation, announcing further “refinements” to the policy to clarify that it applied to the broader definition of financial support. Specifically, under the policy, U.S.-supported foreign NGOs agree to not provide any financial support (global health-related as well as other support), no matter the source of funds, to any other foreign NGO that performs or actively promotes abortion as a method of family planning.

In June 2019, USAID provided additional information to reflect this broader interpretation of the standard provisions.This marks the first time the policy has been applied this broadly, as it can now affect funding provided by other donors (such as other governments and foundations) and non-global health funding provided by the U.S. Government for a wide range of purposes if this funding is first provided to foreign NGOs who have accepted the policy (as recipients of U.S. Global health assistance) that then in turn provide that donor or U.S. Non global health funding for any purpose to foreign NGOs that perform or actively promote abortion as a method of family planning. For example, under the prior interpretation, a foreign NGO recipient of U.S.

Global health funding could not provide any non-U.S. Funding to another foreign NGO to perform or actively promote abortion as a method of family planning but could provide funding for other activities, such as education, even if the foreign NGO carried out prohibited activities. Under the broader interpretation, a foreign NGO could not provide any non-U.S. Funding for any activity to a foreign NGO that carried out prohibited activities. Similarly, while under the prior interpretation a foreign NGO recipient of U.S.

Global health funding could provide other U.S. Funding (such as humanitarian assistance) to another foreign NGO for non-prohibited activities, even if the foreign NGO carried out prohibited activities, now under the broader interpretation, it could not do so.What are the next steps in implementing the expanded policy?. The policy went into effect in May 2017 (see Table 2), although it is applied on a rolling basis, as new funding agreements and modifications to existing agreements occur. While it applies to all grants and cooperative agreements, the Trump administration has indicated that it intends the policy to apply to contracts, which would require a rule-making process (it began this process by publishing a proposed rule in September 2020)..

Standard dimensioner og legeringer
Teoretisk vægt for standard dimensioner kg/m

D x d mm

JM 1-15 Rødgods

JM 3-15
Tin-bronze

JM 5-15
Bly-tin-bronze

JM 7-15/20 Aluminiumbronze

10x0

EXT 0,6

13x0

1.2

1.2

EXT 1,0

16x0

1.8

1.8

EXT 1,5

19x0

2.5

2.5

EXT 2,2

21x0

3.1

3.1

3.1

EXT 2,6

23x0

3,7

*3,7

EXT 3,2

26x0

4.7

4.7

4.7

EXT 4,0

26x14

3.5

3.5

3.5

26x18

2.5

28x0

5,9

5,9

EXT 4,7

29x13

4.7

4.7

4.7

29x19

3.6

31x0

6.7

6.7

6.7

EXT 5,7

31x14

5.5

*5,5

5.5

31x19

*4,5

33x0

7.6

7.6

EXT 6,5

33x13

6.4

*6,4

33x19

5.3

5.3

4.6

33x23

3.9

36x0

9.1

9.1

EXT 7,7

36x14

7.9

36x19

6.8

6.8

6.8

36x24

5.4

38x0

10.6

*10,6

EXT 9,1

39x26

5.9

39x28

5.2

41x0

11.8

11.8

11.8

EXT 10,0

41x13

10.6

10.6

41x18

9.5

9.5

9.5

41x23

8.1

41x28

6.3

42x28

5.9

43x0

12.9

12.9

43x26

*8.2

8.2

8.2

43x33

5.3

46x0

14.8

14.8

EXT 12,6

46x13

13.6

13.6

46x18

12.5

46x23

11.1

11.1

11.1

46x28

9.3

46x33

7.2

7.2

7.2

47x23

10.0

47x28

8.5

51x0

18.2

18.2

18.2

15.5

51x18

15.9

15.9

15.9

51x23

14.5

51x28

12.7

12.7

12.7

51x33

10.6

51x38

8.1

8.1

52x18

14.2

52x23

13.0

52x28

11.5

52x38

7.5

56x0

21.9

21.9

18.7

56x18

*19.6

56x23

18.2

56x28

16.4

56x33

14.3

14.3

56x38

11.8

56x43

9,0

57x43

8.4

61x0

26.0

26.0

26.0

22.2

61x18

23.7

23.7

61x23

22.3

61x28

20.5

20.5

61x33

18.4

61x38

15.9

15.9

61x43

13.1

61x48

9.9

9.9

9.9

62x18

21.0

62x28

18.3

62x38

14.3

62x48

9.2

67x0

31.0

31.0

26.8

67x18

29.1

67x23

*27,7

67x28

25.9

67x33

*23,8

67x38

21.3

67x43

18.5

18.5

15.8

67x48

15.3

67x53

11.7

72x0

35.8

35.8

35.8

30.9

72x18

34.0

34.0

72x23

*32,5

27.8

72x28

30.8

30.8

72x33

28.6

72x38

26.1

26.1

22.3

72x43

23.3

72x48

20.1

20.1

17.2

72x53

16.6

16.6

72x58

12.7

10.9

77x0

41.0

41.0

35.4

77x23

37.7

77x28

*35,9

77x33

33.8

77x38

31.4

31.4

77x43

28.5

77x48

25.3

77x53

21.8

21.8

77x58

17.9

15.3

77x63

*13.7

82x0

46.4

46.4

46.4

40.1

82x28

41.5

41.5

41.5

82x33

*39,4

82x38

36.9

31.5

82x43

34.1

34.1

82x48

30.9

26.4

82x53

27.4

82x58

23.5

23.5

20.1

82x63

19.3

82x68

14.7

12.5

87x0

52.3

52.3

45.2

87x28

47.4

*47,4

87x33

*45,3

87x38

*42,8

36.6

87x43

*40,0

87x48

36.8

87x53

33.3

87x58

29.4

29.4

25.1

87x63

25.2

87x68

20.6

87x73

15.7

92x0

58.5

58.5

58.5

50.5

92x28

53.7

92x33

*51,5

*51,5

92x38

49.0

92x43

*46.2

92x48

43.1

43.1

36.8

92x53

*39.5

92x58

35.6

30.4

92x63

31.4

92x68

26.8

26.8

22.9

92x73

21.9

92x78

16.6

97x0

65.8

65.8

56.2

97x38

55.6

97x43

*52,8

97x48

49.6

97x53

*46,1

97x58

*42,3

97x63

38.0

97x68

33.4

33.4

97x73

28.5

97x78

23.2

97x83

*17.6

102x0

72.7

72.7

72.7

62.1

102x38

62.6

102x48

56.6

56.6

48.4

102x58

49.2

49.2

42.0

102x68

40.4

34.5

102x73

35.0

102x78

30.2

25.8

102x83

*24.6

102x88

18.6

107x58

56.7

107x63

52.2

52.2

107x73

*42.8

107x78

37.5

107x83

31.9

107x88

25.9

112x0

87.7

87.7

87.7

74.9

112x38

77.6

112x48

71.5

71.5

61.1

112x58

64.1

54.8

112x63

60.0

112x68

55.3

47.3

112x78

45.1

45.1

112x88

33.6

28.7

112x93

27.2

117x63

67.9

117x73

58.4

58.4

117x83

47.5

117x93

*35.2

117x98

28.6

122x0

104.0

104.0

104.0

88.9

122x68

71.7

71.7

61.2

122x78

61.5

122x88

49.2

42.6

122x98

36.9

31.5

122x103

*29,9

127x63

85.0

85.0

85.0

127x73

75.5

127x83

64.6

127x93

52.3

127x103

38.6

127x108

31.2

132x0

121.8

121.8

122.0

104.0

132x68

89.1

132x78

79.2

67.7

132x88

67.6

132x98

53.9

132x108

40.2

135x0

108.7

137x73

93.9

137x93

*70,7

137x103

57.0

142x0

140.9

140.9

141.5

120.4

142x58

117.4

142x78

98.4

98.4

142x88

74.1

142x98

73.0

142x108

58.7

142x118

43.6

147x103

76.9

147x123

45.3

152x0

161.5

161.5

162.0

137.9

152x88

107.3

152x98

94.3

94.3

80.6

152x108

79.9

152x118

64.1

64.1

152x128

47.0

162x0

183.4

183.4

183.5

156.7

162x98

116.3

116.3

116.3

162x118

86.1

73.5

162x128

68.9

162x138

50.3

50.3

172x0

207.0

207.0

172x108

125.2

*107,0

172x128

92.2

172x138

73.6

172x148

53.7

53.7

182x0

232.0

232.0

EXT 197.8

182x118

134.1

182x128

117.5

*99,9

182x138

98.4

182x148

78.4

182x158

57.0

57.0

192x0

258.0

258.0

EXT 220.1

192x128

143.1

192x148

104.5

*89,3

192x168

60.4

202x0

285.0

285.0

202x98

218.0

218.0

218.0

202x138

152.0

152.0

202x148

*112,8

202x158

110.7

202x178

63.7

205x82

*246,8

212x138

180.4

212x148

161.0

212x158

*119,2

212x168

116.8

212x178

92.6

212x188

66.0

222x0

344.0

344.0

222x98

277.2

277.2

222x148

191.3

222x168

147.1

*125,7

222x178

123.0

222x188

97.4

232x158

201.6

201.6

232x178

154.7

*132,1

232x188

129.1

232x198

102.1

242x168

212.0

212.0

242x188

162.2

*138,6

242x198

135.3

242x208

106.9

252x0

444.0

444.0

252x178

222.3

*189,9

252x198

169.8

252x208

141.4

252x218

111.6

262x198

*175,7

262x218

147.6

262x228

116.4

272x168

319.7

319.7

272x228

153.7

272x238

121.1

276x0

*532,5

282x218

*191,0

282x238

159.9

282x248

125.9

292x188

348.8

292x248

166.0

302x148

484.4

302x198

363.3

363.3

*310,4

302x258

172.1

322x238

*280,8

332x248

*290,9

332x273

249.4

352x148

713.0

362x293

315.8

*269,8

392x343

251.6

402x148

976.5

402x348

*241,8

Firkant stænger
Standard dimensioner og legeringer
Standardlængder: 500, 1000, 2000 mm

A x B mm

JM 1-15 Rødgods

JM 3-15
Tin-bronze

JM 7-15/20 Aluminiumbronze

30x30

*6,8

32x32

9,1

9,1

40x40

*12,0

42x42

15,7

15,7

45x45

*15,2

52x12

5,6

5,6

52x14

6,5

6,5

52x18

8,3

8,3

52x22

10,2

10,2

52x52

24,1

24,1

55x55

*22,7

60x60

*27,4

67x12

7,2

7,2

67x14

8,3

8,3

67x18

10,7

10,7

67x22

13,1

13,1

67x32

19,1

19,1

16,3

70x70

*43,6

80x42

25,8

80x51

31.3

82x12

8,8

8,8

82x14

10,2

10,2

82x18

13,1

13,1

82x22

16,1

16,1

102x12

10,9

10,9

102x14

12,7

12,7

102x18

16,3

16,3

102x22

20,2

20,2

102x52

47

103x30

*23,5

105x55

44.2

122x18

19,5

19,5

122x22

23,9

23,9

130x63

62.6

130x65

74,7

142x18

22,7

22,7

142x22

27,8

27,8

150x70

*79,8

150x90

102,6

162x18

26

26

162x22

31,7

31,7

162x72

103

182x18

29,2

29,2

182x22

35,6

35,6

185x90

*126,5

202x18

32,4

32,4

202x22

39,6

39,6

202x30

*46,1

Sekskant stænger
Standard dimensioner og legeringer
Standardlængder: 500, 1000, 2000, 3000 mm. Sekskantstænger m/ hul fremstilles på bestilling

NV mm

JM 1-15 Rødgods

17

2,2

18

2,5

22

3,7

24

4,4

26

5,2

28

6

32

7,9

36

10

44

14,9

50

19,3