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In 1797, levitra online purchase canada English scientist Henry Cavendish measured the strength https://www.msamentoring.com/levitra-online-in-canada of gravity with a contraption made of lead spheres, wooden rods and wire. In the 21st century, scientists are doing something very similar with rather more sophisticated tools. Atoms. Gravity might be an early subject in introductory physics classes, but that doesn’t mean scientists aren’t still trying to measure it with ever-increasing precision. Now, a group of physicists has done it using the effects of time dilation—the slowing of time caused by increased velocity or gravitational force—on atoms.

In a paper published online today (Jan. 13) in the journal Science, the researchers announce that they’ve been able to measure the curvature of space-time. The experiment is part of an area of science called atom interferometry. It takes advantage of a principle of quantum mechanics. Just as a light wave can be represented as a particle, a particle (such as an atom) can be represented as a “wave packet.” And just as light waves can overlap and create interference, so too can matter wave packets.

In particular, if an atom’s wave packet is split in two, allowed to do something, and then recombined, the waves might not line up anymore—in other words, their phases have changed. €œOne tries to extract useful information from this phase shift,” Albert Roura, a physicist at the Institute of Quantum Technologies in Ulm, Germany, who was not involved in the new study, told Space.com. Roura wrote a “Perspectives” piece about the new research, which was published online in the same issue of Science today. Gravitational wave detectors work via a similar principle. By studying particles in this way, scientists can fine-tune the numbers behind some of the key workings of the universe, such as how electrons behave and how strong gravity really is—and how it subtly changes over even relatively small distances.

It’s that last effect that Chris Overstreet of Stanford University and his colleagues measured in the new study. To do this, they created an “atomic fountain,” consisting of a vacuum tube 33 feet (10 meters) tall ornamented with a ring around the very top. The researchers controlled the atomic fountain by shooting laser pulses through it. With one pulse, they launched two atoms up from the bottom. The two atoms reached different heights before a second pulse shot them back down.

A third pulse caught the atoms at the bottom, recombining the atoms’ wave packets. The researchers found that the two wave packets were out of phase—a sign that the gravitational field in the atomic fountain wasn’t completely uniform. €œThat … in general relativity, can be understood, actually, as the effect of space-time curvature,” Roura told Space.com, referring to one of Albert Einstein’s most famous theories. Since the atom that went higher was closer to the ring, it experienced more acceleration thanks to the ring’s gravity. In a perfectly uniform gravitational field, such effects would cancel out.

That isn’t what happened here. The atoms’ wave packets were out of phase instead, and thanks to the effects of time dilation, the atom that experienced more acceleration was ever so slightly out of time with its counterpart. The result is a minuscule change, but atom interferometry is sensitive enough to pick it up. And since the scientists can control the placement and the mass of the ring, Roura told Space.com, “they are able to measure and study these effects.” Although the technology behind this discovery—atom interferometry—might seem arcane, atom interferometry may one day be used to detect gravitational waves and help us navigate better than GPS, researchers have said. Copyright 2022 Space.com, a Future company.

All rights reserved. This material may not be published, broadcast, rewritten or redistributedAbout a million years ago a small mutation might have unlocked a big advantage for ancient humans. A recent study in Science Advances suggests that a variant of a critical stretch of DNA called the growth hormone receptor gene protected against starvation—in part by limiting individuals’ body size during periods of resource scarcity. The variant was widespread among Homo sapiens and their relatives, although it suddenly plummeted in frequency beginning around 40,000 years ago, especially in East Asia and Eurasia. Many people still carry it today.

Previous research had linked the variant, called GHRd3, to characteristics such as smaller birth size and earlier sexual maturity, as well as other qualities that can benefit organisms when food is scarce, says the study’s lead author Omer Gokcumen, an anthropologist at the University at Buffalo. Still, researchers wanted to know more precisely what role the mutation played in human evolution. To dig deeper, Gokcumen and his colleagues turned to mice. Or rather they turned some mice into analogues of early humans. Using the genetic editing tool CRISPR-Cas9, the team deleted a section of mice’s growth hormone receptor gene so it resembled the GHRd3 variant.

The modified mice were not especially different from ordinary ones when fed a regular diet. But when fed very little, the male carriers grew up to be smaller than their unmodified counterparts. Gokcumen’s team also found that among a group of 176 modern human children who survived malnutrition, symptoms were less severe in boys and girls with GHRd3. These findings could help explain why GHRd3 has persisted for so long. Perhaps it paid to be small in times of scarcity, the researchers speculate—but in times of abundance large size won out.

Changes in available resources could then have balanced the costs and benefits of different variants within a population. €œIt’s a trade-off,” Gokcumen says. €œI would probably fare better than Arnold Schwarzenegger if we [each] had 1,000 calories a day. The team’s explanation is “plausible,” says Megan Dennis, a geneticist at the University of California, Davis, who was not part of the study. She praises the functional experiments in mice but notes that the affected gene is involved in so many fundamental processes that it is difficult to pin down GHRd3’s most adaptive effects.

€œI was like, ‘Wow, there’s so much that could be happening here,’ ” Dennis says. And the study researchers continue to wonder what could have caused this variant’s decline around 40,000 years ago. Climate change, migration, and the advent of better hunting and fishing tools all could have had an impact. Or it could have been something else entirely, Gokcumen says. €œThat is a very strange time in human evolution.”ZERO-SUM SPACE?.

In “Lifting the Venus Curse,” Robin George Andrews writes about discoveries that expand our understanding of our close planetary neighbor Venus. Enormous sums of money are tossed about in that quest as if they were almost insubstantial. But explorations of outer space do more to satisfy our curiosity than advance the human condition on our own planet. One wonders if the gazillions spent on space exploration could instead have, at least in part, been focused on medical research and basic charitable work to help the still struggling human beings afflicted with illness and poverty. It would be of interest for a NASA scientist to convince a mother who just lost her infant daughter to malnutrition why it was more important to learn about potential organisms floating in the upper atmosphere of Venus than to invest just a fraction of those sums in providing sufficient sustenance to help her child survive.

Let’s be honest. These space explorations are exciting but represent a triumph of technology over purpose. They satisfy our curiosity while neglecting the very human needs we and our planet will require to solve our wearisome but crucial problems closer to the ground on which we tread. BARRY MALETZKY Portland, Ore. ANDREWS REPLIES.

The notion that we can spend grand sums of money only on either space exploration or remedying the myriad ills faced by billions on terra firma is a false dichotomy. Not only does improving our understanding of the cosmos benefit our species both intellectually and practically, but the world’s wealthiest nations are perfectly capable of funding both the exploration of our neighboring worlds and the amelioration of Earth’s most imperiled people. The cost of a single mission such as VERITAS or DAVINCI+, one that is designed to gather scientific data for many years, is roughly $600 million. That may sound like a lot, but it’s worth noting that the U.S. Military got $778 billion in 2020 alone.

So if there is a debate to be had on the federal government’s funding priorities, perhaps this is where its focus should be. DISASTER RESPONSE Thank you for pointing to the problems with the U.S.’s recent responses to disasters in “Fix Disaster Response Now” [Science Agenda]. I would suggest that cascading effects caused by both storms and other natural hazards, initiated by industrial and transportation failures and disease events, are responsible for a disproportionate number of serious outcomes with social and environmental justice consequences. They do this by triggering other failures that cause more failures. My colleagues and I have studied U.S.

Hazard-mitigation plans and find that only a few states and cities seriously consider them and even fewer develop their spending plans around them. We have proposed that this form of event receive special attention in risk assessment and management and be supported by special federal grants. MICHAEL R. GREENBERG Edward J. Bloustein School of Planning and Public Policy, Rutgers University RASH REFLECTION I read Claudia Wallis’s piece on a treatment for “Poison Ivy Relief” [The Science of Health] with great interest.

My wife loves gardening but has terrible reactions to poison ivy, whereas I am rarely able to prioritize horticulture but am immune to the plant’s effects. I wonder how common this kind of immunity is and how it develops. My father is also immune to poison ivy. Could the capacity for this trait be hereditary?. And is it possible to develop immunity through exposure?.

It’s not just poison ivy in my case. As a teenager, I moved to the U.S. From a somewhat rural area in Scotland. When I was younger, I played all day in orchards and fields and bushes near where we lived. I had many painful encounters with stinging nettles.

As I got older, however, I became immune to them. I assume it was through exposure. GEOFFREY P. PALMER via e-mail Wallis’s article brought me back to a few years ago, when I had somehow gotten a poison-ivy-like rash around my mouth, and it swelled and spread down my neck. This oozing and crusting rash was a very scary situation, so I saw my allergist.

He claimed to have never seen something this serious in his whole career and asked if I fell asleep in the woods!. I told him I had been nowhere near any wooded area. After a bit of research, we were able to conclude that the reaction was caused by the urushiol oil on the skin of a mango!. It was the first fresh mango I had ever eaten in my life. With a treatment such as the one detailed in this article, I might be able to enjoy mangos comfortably one day.

In the meantime, for those prone to poison ivy reactions, beware the mango skin!. ALLY BROWN Council Bluffs, Iowa I am in contact with poison ivy almost every day during my conservation work at a local park, where I teach my volunteers how to avoid it. While I did react to the plant with moderate intensity as a child, I have never gotten a rash or itch from poison ivy in the past 50 years. Did my body develop the equivalent of a treatment?. Or did my brain figure something out?.

MARC IMLAY Bryans Road, Md. WALLIS REPLIES. The Centers for Disease Control and Prevention estimates that 80 to 90 percent of adults react to urushiol, the irritating chemical in poison ivy. That leaves 10 to 20 percent who, like Palmer, appear to be unaffected. That said, sensitivity to poison ivy can develop at any point.

In fact, people often do not react to the plant the first time they are exposed to it. There is no good evidence that one can develop immunity to it through exposure. And there is so little research on poison ivy that we cannot explain Imlay’s unusual loss of sensitivity. Mangos, cashews and pistachios can contain small amounts of urushiol. Very sensitive people may have a reaction like that of Brown.

STUTTERING AND SINGING In “The Stuttering Mind” [August 2021], Lydia Denworth reports on how stuttering originates in neural wiring and genes. She does not mention an effect shown by my friend who stutters when speaking but not when singing. Is this common?. And if so, does the effect help us understand stuttering or suggest ways to reduce it?. RICHARD ARDEN SLOTTER Highlands Ranch, Colo.

DENWORTH REPLIES. Singing has been found to increase fluency in people who stutter, if only temporarily. It may be that singing enhances auditory feedback loops in the brain. It is also possible that singing changes articulation patterns in ways that reduce disfluencies. In addition, it seems that the familiarity of favorite songs reduces stuttering.

All these ideas are being explored therapeutically. ERRATUM “Lifting the Venus Curse,” by Robin George Andrews, should have said that many exoplanets have been found far from our solar system, not our galaxy. It also should have said that the surface pressure of Venus is equivalent to being more than half a mile underwater, not a mile or more.2022 is shaping up to be a solar boom. That is, if supply chain constraints don’t undercut the industry. The U.S.

Energy Information Administration projects U.S. Solar companies will install 21.5 gigawatts of utility-scale capacity this year, shattering the annual record of 15.5 GW set last year. But EIA’s projection comes amid a period of considerable uncertainty for the industry. The Solar Energy Industries Association, a trade group, warned last month that supply chain constraints were driving cost increases and could limit the industry growth in 2022 (Climatewire, Dec. 14, 2021).

€œDevelopers are very pessimistic about their ability to complete the projects they had slated for 2022,” said Sylvia Leyva Martinez, who tracks the utility solar industry in North America for Wood Mackenzie, a consulting firm. Such projections come amid shipping delays and rising equipment costs. Wood Mackenzie initially projected 22.5 GW of new solar capacity in 2022. But the consulting firm downgraded its estimate to 15 GW after conducting a survey last year with top developers, which found that almost a third of projects would be delayed. Developers increasingly are engaged in complex contract negotiations with potential buyers, Martinez said.

Where past contracts typically were set at fixed prices, new solar contracts now more often include price hedges, collars and other financial tools intended to limit risks to developers and prospective buyers. The contracts are a response to the price increases caused by levitra-induced supply chain constraints, she said. €œIt was taken for granted that market conditions were going to prevail, and that is not the case anymore,” she said. Some analysts are more bullish on solar’s outlook for 2022. BloombergNEF projections for 2022 are only slightly more conservative than EIA, said Tara Narayanan, a solar analyst there.

She predicted developers would overcome the supply chain constraints to achieve record installations this year, though she noted some delays are likely. €œTwenty GW or anything more than that is huge,” Narayanan said. €œThe fact you could get to such numbers and could say it could be even bigger should tell you where the sector is going.” Indeed, there was broad consensus that solar’s difficulties are temporary. Developers will benefit from improved purchasing strategies and a ramp-up of manufacturing output to meet increased demand for solar installations, Martinez said. Both Martinez and Narayanan said they expected annual installations of at least 20 GW in the coming years.

The projections reflect the industry’s massive growth in recent years. The United States installed a combined total of 15.6 GW of solar between 2017 and 2019 before installing 10.4 GW and 15.5 GW in 2020 and 2021, respectively, according to EIA figures. By comparison, EIA said it expects the United States will add 7.6 GW of wind this year after registering a record 17.1 GW of new capacity in 2021. Natural gas additions were 6.3 GW in 2021 and are projected to reach 9.6 GW in 2022. The solar boom has the potential to be particularly significant in states such as Texas, where the industry has exploded.

The Lone Star State boasted less than 1 GW of installed solar capacity as recently as 2017. Texas then installed 2.4 GW and 3.6 GW in 2020 and 2021, respectively. EIA projects the state will install 6.1 GW of solar in 2022, leading the country in utility-scale installations for the third consecutive year. Texas power plants have long led the country in greenhouse gas emissions, thanks to the state’s large coal fleet. In 2020, Texas power plants emitted more than 200 million tons of carbon dioxide, or about 12 percent of total U.S.

Power-sector emissions, according to EPA data. But the solar boom has the potential to erode coal’s footprint in Texas, said Daniel Cohan, who tracks electricity markets at Rice University. That is because many coal plants rely on high power prices during periods of increased electricity demand in the summer to make money. Solar generation matches those periods of high demand, which will put downward pressure on wholesale electricity prices. €œSolar has the potential to be a coal killer because it is generating at the very time that was most profitable for coal plants to operate,” Cohan said.

Reprinted from E&E News with permission from POLITICO, LLC. Copyright 2022. E&E News provides essential news for energy and environment professionals.In November, Russia ignited an international uproar with a weapon test that launched an interceptor against a defunct military satellite. When it hit, that deliberate collision shattered the satellite into more than 1,500 trackable pieces of debris. This space debris is dangerous.

It could hit and severely damage an orbiting space station, akin to the opening scenes of the movie Gravity. The debris from this test could knock out any of dozens of satellites working to monitor climate and weather, not to mention those that provide critical national security information and perform other vital services for us on Earth. The debris could threaten the tens of thousands of new satellites planned for launch in the coming years and intended to provide global broadband access and other in-space activities as part of a growing space economy. And some of this orbital debris is long-lived, meaning that it could pose a future risk to anything that might launch into the same altitude for years to come. It is past time for the global community to put an end to such antisatellite testing—but doing so will not be easy.

Antisatellite weapons have been part of the superpower rivalry from the beginning of the space age. And, to be fair, Russia is not the only country to carry out a test that created significant amounts of orbital debris. Between 1959 and 1995, the United States and Soviet Union conducted more than 50 antisatellite (ASAT) tests in space, in which a dozen weapons hit satellites, creating more than 1,200 pieces of trackable orbital debris. Although decades have passed, nearly 400 trackable pieces of that debris are still on orbit, not to mention many more still-dangerous pieces too small to be tracked with current systems. Since 2005, the United States, Russia, China, and India have conducted another 26 ASAT tests in space, five of which have destroyed satellites and created more than 5,300 pieces of trackable orbital debris that will remain in orbit for decades to come.

The latest Russian venture is the first time in seven years of testing that the nation has attempted to use this weapon—a ground-based interceptor called Nudol or A-235—against an actual satellite as a target. And it happened at an altitude of approximately 480 kilometers. Both the International Space Station and China’s Tiangong space station orbit at an altitude of around 400 kilometers. With this much possibility of calamity, it is unfortunate that policy makers have had such little success in trying to prevent such tests, let alone in addressing the broader issue of space weapons. The international community has been trying for decades to limit the development or use of space weapons, such as ASATs, through discussions of what has been called the Prevention of an Arms Race in Outer Space (PAROS) at the United Nations General Assembly (UNGA).

PAROS has been an annual agenda item there since the 1980s. However, this item has become a pro forma vote with little actual resulting action. The other main multilateral body where one might expect to see negotiations on space arms control, the Conference on Disarmament in Geneva, has been bogged down in disagreement over what the real threat to space is. Russia, China and their allies argue that the focus should be on banning the placement of space-to-Earth weapons in orbit. The United States and its allies instead argue that threatening behavior in space—such as uncoordinated close approaches to another country’s satellite, or the deliberate creation of large amounts of debris—is what is destabilizing.

Furthermore, the two sides are split over whether the steps taken should be a legally binding treaty or voluntary guidelines and political norms of behavior. Despite the disagreements that have prevented a ban on ASAT testing to date, there is perhaps a glimmer of hope. In December 2020, the UNGA passed Resolution 75/36, calling on countries to submit reports on what they saw as the most pressing threats to space security and recommend steps on how to move forward. More than 30 countries replied, with many supporting the idea of limiting specific technologies in space rather than enacting any bans, and working towards identifying and promoting responsible behavior in space. In October 2021, the U.N.

First Committee voted to hold a new Open-Ended Working Group (OEWG) on space threats (and formalized it in the UNGA with a vote in December 2021). The OEWG would be open to all countries and would meet in 2022 and 2023 to develop concrete proposals for addressing space threats. Although the prospects of a new multilateral treaty banning the existence of space weapons are dim, there are other things that can be done to minimize the dangerous consequences of these weapons. First and foremost, the countries that are developing and testing such weapons—China, India, Russia, and the United States—can unilaterally declare a moratorium on further testing that creates orbital debris. Doing so would send a strong signal to the international community that they are committed to the long-term sustainability of space and for delegitimizing the testing of these weapons against satellites.

Second, all countries should participate in and contribute to the OEWG on space threats to discuss how to move towards a global ban on destructive ASAT testing. Countries should come to the table with ideas for addressing other pressing threats to space security. This includes nonconsensual close encounters with another country’s satellites and attempts to disrupt satellite operations by targeting them with ground-based lasers. Although less obviously threatening than kinetic attacks where a satellite is physically destroyed, such acts are increasing in frequency and could inflame tensions, potentially leading to misperceptions or mistakes that then spark actual armed, hostile conflict in space. That would be devastating to the entire planet.

There is much work that still needs to be done to establish the foundations for any new space arms control agreement. One unresolved issue is that there is no agreed-upon space arms control lexicon. One is needed to overcome the existing cultural, language, and geopolitical differences amongst the major space powers. Another is a better understanding of what incentives are driving the testing of ASAT weapons and how those can be shifted. Finally, a verification regime needs to be developed that will enable all countries to monitor whether or not the conditions of any agreement are being followed.

Improving space situational awareness data collection and sharing will be a key part of this monitoring. Russia’s most recent ASAT test, like earlier tests conducted by it and the United States, China and India, has made operating in low Earth orbit more dangerous for years to come. All satellite operators and crewed vehicles will need to spend time, effort and fuel on avoiding collisions as the debris from these tests gradually reenters the Earth’s atmosphere. But if the international community can leverage this test as the wake-up call to enact an ASAT test moratorium and enter into space arms control discussions in good faith, some good may still be salvaged. By establishing agreed-upon norms of behavior in space and generating binding restrictions on ASAT testing, the international community can ensure that space is stable, secure and accessible to all for generations to come..

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In an ambitious levitra long term effects move to widen access to its medical products, Pfizer said Wednesday that levitra online it plans to provide nearly two dozen patent-protected medicines and treatments, which are already available in the U.S. Or European Union, at not-for-profit prices to 45 poor countries.Under the initiative, Pfizer will start shipping its products — including its erectile dysfunction treatment and antiviral pill — to Rwanda, Ghana, Malawi, Senegal, and Uganda later this year, although the effort will eventually focus on 27 low-income countries and another 18 lower-middle-income countries, most of which are located in Africa. Also on levitra long term effects the list are Haiti, Bangladesh, how to get levitra without a doctor and Tajikistan. Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!.

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Annette McGivney, writer, outdoors enthusiast and anxiety sufferer, summarizes this research in her 2018 Backpacker Magazine how long does it take for levitra to take effect article. “In an effort to make this brand of wilderness medicine a reality, the Sierra Club has teamed up with scientists at the University of California, Berkeley, to create the Great Outdoors Lab, which compiles research to quantify the effects nature has on chronic health conditions. €˜We hope to make public lands part of a common health care prescription,’ says Sierra Club Outdoors director Stacy Bare, who is also an Iraq War veteran diagnosed with PTSD.” Over a three-year period, researchers took 180 people, war veterans and children from underserved communities, and took them on whitewater rafting trips. They measured participants’ how long does it take for levitra to take effect stress hormones, immune function, dopamine regulators and proteins that control inflammation, before, during and after the trips. All of these physiological markers for PTSD showed improvements.

One week later, participants reported continued reduction in PTSD symptoms and an increase how long does it take for levitra to take effect in feelings of well-being. The greater the level of awe that a person experienced, the longer the positive results lasted. McGivney quotes UC Berkeley psychology professor Dacher Keltner, who co-authored the GO Lab study, “Time outdoors changes people’s nervous systems. It is as how long does it take for levitra to take effect effective as any PTSD interventions we have.” The results of the GO Lab study were published in Emotions, a publication of the American Psychological Association. In a separate study, Nooshin Razani, a pediatrician and director of the Center of Nature and Health at Children’s Hospital Oakland in California, took 78 pairs of parents and traumatized children into nature for one full day three times a week for three weeks.

They saw positive changes on the participants’ how long does it take for levitra to take effect responses on surveys on psychological wellbeing, as well as parasympathetic nervous system markers such as cortisol and alpha amylase (obtained through saliva samples), heart rate and blood pressure, before, during, and after the outings. Razani is calling it the “park prescription,” and says that it decreases the trauma response, improves cognitive function, promotes healing and increases resilience in children. For anyone who has spent much time in nature these results are not surprising. Best of all, no how long does it take for levitra to take effect one needs a doctor’s prescription to use this treatment for anxiety, and, if appropriate footwear and good judgement about one’s ability are used, there are little to no negative side effects. Nature is waiting to help in the healing process.

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“In an effort to make this brand of wilderness medicine a reality, the Sierra Club has teamed up with scientists at the University of California, Berkeley, to create the Great Outdoors Lab, which compiles research to quantify the effects nature has on chronic health conditions. €˜We hope to make public lands part of a common health care prescription,’ says Sierra Club Outdoors director Stacy Bare, who is also an Iraq War veteran diagnosed with PTSD.” Over a three-year period, researchers took 180 people, war veterans and children from underserved communities, and took them on whitewater rafting trips. They measured participants’ stress hormones, immune function, dopamine regulators and proteins that control inflammation, before, during and after the levitra online purchase canada trips.

All of these physiological markers for PTSD showed improvements. One week later, participants reported continued reduction in PTSD symptoms and an increase in feelings of well-being levitra online purchase canada. The greater the level of awe that a person experienced, the longer the positive results lasted.

McGivney quotes UC Berkeley psychology professor Dacher Keltner, who co-authored the GO Lab study, “Time outdoors changes people’s nervous systems. It is as levitra online purchase canada effective as any PTSD interventions we have.” The results of the GO Lab study were published in Emotions, a publication of the American Psychological Association. In a separate study, Nooshin Razani, a pediatrician and director of the Center of Nature and Health at Children’s Hospital Oakland in California, took 78 pairs of parents and traumatized children into nature for one full day three times a week for three weeks.

They saw positive changes on the participants’ responses on surveys on psychological wellbeing, as well as parasympathetic nervous system markers such as cortisol and levitra online purchase canada alpha amylase (obtained through saliva samples), heart rate and blood pressure, before, during, and after the outings. Razani is calling it the “park prescription,” and says that it decreases the trauma response, improves cognitive function, promotes healing and increases resilience in children. For anyone who has spent much time in nature these results are not surprising.

Best of levitra online purchase canada all, no one needs a doctor’s prescription to use this treatment for anxiety, and, if appropriate footwear and good judgement about one’s ability are used, there are little to no negative side effects. Nature is waiting to help in the healing process. If those in need can get out in nature on a regular basis, they will likely feel more at ease.

For those who need levitra online purchase canada more intense treatment for mental health conditions, MyMichigan Health provides an intensive outpatient program called Psychiatric Partial Hospitalization Program at MyMichigan Medical Center Gratiot. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MyMichigan’s comprehensive behavioral health programs may visit http://www.mymichigan.org/mentalhealth..

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Best price for levitra 20mg

The federal “test-to-treat” program, announced in March, is best price for levitra 20mg meant to reduce erectile dysfunction treatment hospitalizations and deaths by quickly getting antiviral pills to people who test positive. But even as cases rise again, many Americans don’t have access to the program. Pfizer’s Paxlovid and Merck’s Lagevrio are both designed to be started within five best price for levitra 20mg days of someone’s first symptoms. They’re for people who are at high risk of developing severe illness but are not currently hospitalized because of erectile dysfunction treatment.

Millions of chronically ill, disabled, and older Americans are eligible for the treatments, and Dr. Anthony Fauci of best price for levitra 20mg the National Institutes of Health said April 11 that more people may qualify soon. The program allows people with erectile dysfunction treatment symptoms to get tested, be prescribed antiviral pills, and fill the prescription all in one visit. The federal government and many state and local health departments direct residents to an online national map where people can find test-to-treat sites and other pharmacies where they can fill prescriptions.

But large best price for levitra 20mg swaths of the country had no test-to-treat pharmacies or health centers listed as of April 14. And the website of the largest participant, CVS, has significant technical issues that make booking an appointment difficult. Even people who regularly see a doctor may be unable to get a prescription in time, and that’s where the program comes in. Before the levitra, 28% best price for levitra 20mg of Americans didn’t have a regular source of medical care, with rates even higher for Black and Hispanic Americans.

€œAll of our public health response relies on lowering the barrier to getting treatments to the right people,” said Dr. Kirsten Bibbins-Domingo, chair of the Department of Epidemiology and Biostatistics at the University of California-San Francisco. She said the fragmented federal, state, and local best price for levitra 20mg public health systems, the U.S. Department of Health and Human Services’ reliance on partners that charge high prices for appointments, and the lack of clear information are stymieing the effort.

€œThe best tools that we have are not going to reach the people who most need them,” she said. Bibbins-Domingo is best price for levitra 20mg also a practicing physician at Zuckerberg San Francisco General Hospital, which she says is not only testing patients for erectile dysfunction treatment and prescribing them antivirals, but also delivering them medications — all the elements of test-to-treat. But the hospital, which largely treats low-income and uninsured patients, doesn’t appear on the federal map. It shows just three locations in San Francisco.

Two community health centers and best price for levitra 20mg one CVS. Ninety-one percent of the sites listed on the national map are federal partners. Pharmacy chains like CVS, federally qualified health centers, and military and Indian Health Service clinics. HHS has asked state and local best price for levitra 20mg health departments to identify other potential participants, like San Francisco General Hospital, so they can be added.

Most states have none of those partners listed yet. Nationally, CVS MinuteClinics make up more than half of all test-to-treat locations, according to the federal data. The roughly 1,200 clinics, in 35 states and Washington, D.C., are housed under the same roof as CVS best price for levitra 20mg pharmacies, where patients can pick up prescriptions for erectile dysfunction treatment antivirals. Walgreens drugstores and Kroger grocery store affiliates run about 400 more sites.

The federal government has set aside nearly 400,000 courses of the antivirals for its federal pharmacy partners — about a quarter of the total supply since the program began in March. Although the cost of the pills is covered by the federal government, obtaining a prescription at the pharmacies that dominate the best price for levitra 20mg program can be expensive. Though CVS does not charge symptomatic uninsured people for on-site erectile dysfunction treatment tests, MinuteClinics charge upwards of $100 for in-person or telehealth appointments to examine patients and prescribe an antiviral, if needed. People without insurance, whose health plans don’t cover visits to the clinics, or who have high-deductible plans must shoulder the full cost of the appointment.

Even if they can afford it, finding treatment might be impossible best price for levitra 20mg. KHN aimed to find out how easy or hard booking a test-to-treat appointment at a CVS would be. Reporters searched online and in person for erectile dysfunction treatment testing and treatment appointments in April. It took a KHN reporter in the Washington, D.C., area three hours driving between stores to figure out whether testing best price for levitra 20mg was available and antivirals in stock across four MinuteClinic locations — time that few people can afford in general, let alone when they’re sick.

Each store provided test-to-treat services, which could be booked through a kiosk. But three of the stores either didn’t have same-day appointments available or didn’t have the antiviral pills in stock that day. A KHN reporter also tried to best price for levitra 20mg book appointments online at clinics in several states, listing upper respiratory symptoms. After the reporter marked a positive erectile dysfunction treatment test on the screening form, a message appeared — “For the safety of our patients and staff, we can’t allow you into the clinic at this time” — and the patient was then directed to book a telehealth visit.

KHN also searched CVS’ website for testing appointments at all MinuteClinics shown on the federal map in the District of Columbia, Maryland, and Virginia, just over 100 clinics total. Only half listed any future testing appointments best price for levitra 20mg available. Amy Thibault, a CVS spokesperson, said that all MinuteClinics provide in-person test-to-treat services and that a software glitch made it appear they don’t. She said CVS is working to fix that.

Thibault said erectile dysfunction treatment patients are “encouraged” to use telehealth best price for levitra 20mg. Some Americans, especially seniors, don’t have the devices, internet connection, or technology skills needed for virtual visits. The program requires participants like CVS to provide options for in-person appointments, said HHS spokesperson Suzanne Sellman. KHN also searched best price for levitra 20mg online for appointments at participating Kroger and Walgreens clinics in several states and found many available in-person appointments.

Another complication. The FDA requires doctors, advanced practice registered nurses, or physician assistants to write the prescriptions. A pharmacist best price for levitra 20mg can’t do it. Many of the nation’s leading pharmacy organizations have asked the Biden administration to remove the restriction, which would expand the program to scores of rural and underserved communities.

Because of this rule, the program requires clinics and pharmacies to be under the same roof — a setup that doesn’t exist in many regions, particularly in rural areas. The federal map best price for levitra 20mg shows no sites in Wyoming or South Dakota other than military clinics, which don’t serve the public. People in dozens of other regions would have to drive more than 100 miles to reach the nearest clinic, according to a KHN review of participating locations. The Wyoming Department of Health is working to enroll providers in the program, spokesperson Kim Deti said.

Montana has four public-facing test-to-treat clinics, according to best price for levitra 20mg the federal website and Jon Ebelt, a spokesperson for Montana’s Department of Public Health and Human Services. He said that seven Defense Department and Indian Health Service facilities also provide test-to-treat services, but those aren’t open to most people. Billings, the state’s most populous city, is more than a three-hour drive from the nearest site shown on the map. Ebelt said the agency is working with a local primary-care nonprofit to find more facilities to best price for levitra 20mg enroll.

We have to get this right, said Bibbins-Domingo, the San Francisco professor. She said that as the U.S. Moves away from restrictions like mask mandates, the public health system must ensure that everyone can get these new treatments, which can get people back to work sooner, prevent serious illnesses, and best price for levitra 20mg even save lives. For those far from clinics, people with disabilities, and people too sick to leave home, telehealth could be the easiest way to get treated.

A few local governments, including Los Angeles County and New York City, have launched virtual care initiatives. Truepill, a company that provides telehealth and pharmacy best price for levitra 20mg technology, offers online erectile dysfunction treatment assessments through its website finderectile dysfunction treatmentcare.com for a fraction of the cost of CVS’ in-person or telehealth operations. The company has filled more than 10 million prescriptions in the past five years. The service, available in all 50 states and Washington, D.C., costs $25 to $55.

Though insurance best price for levitra 20mg isn’t accepted, the cost is comparable to insurance copays for in-person doctor appointments. Prescriptions can be sent to a local pharmacy for no additional charge or shipped to a home overnight via FedEx for a $20 fee. HHS didn't respond best price for levitra 20mg to requests for data on antiviral use and has repeatedly declined to allow KHN to observe weekly virtual meetings about the program held with state health officials, clinic directors, and other health care providers. Bibbins-Domingo said that to be effective, the federal government must make it easier to get testing and treatment, especially when the program is geared toward those at highest risk of devastating complications from erectile dysfunction treatment.

€œIf you're just an average person trying to navigate this,” she said, “it’s actually completely impossible.” KHN correspondents Katheryn Houghton and Rachana Pradhan contributed to this report. Hannah Recht best price for levitra 20mg. hrecht@kff.org, @hannah_recht Related Topics Contact Us Submit a Story TipIf you or someone you know is considering suicide, please call the National Suicide Prevention Lifeline. 1-800-273-TALK (8255).

At the park near Duboce Triangle in San Francisco, best price for levitra 20mg 5 p.m. Is canine happy hour. About 40 dogs run around, chasing balls and wrestling, as their owners coo and ’90s hip-hop bumps out of a portable speaker. One best price for levitra 20mg recent afternoon, a Chihuahua mix named Honey lounged on a bench wearing a blue tutu and a string of pearls.

Her owner, Diana McAllister, fed her homemade treats from a zip-close bag, then popped one into her own mouth. After spending two years at home through the levitra, it’s clear that for a lot of these owners, their dogs are their children. €œI always best price for levitra 20mg say, dogs are people, so I love him,” said Yves Dudley, looking on as her 9-month-old collie-schnauzer mix played in the grass. Across the country, about 23 million families adopted a pet in the first year of the levitra.

Other pet owners, working from home, started paying more attention to their animals’ daily routines, noticing symptoms like vomiting or coughing. The resulting spike in pet health concerns has been straining a best price for levitra 20mg corner of the medical world that doesn’t get as much attention as doctors and nurses. Veterinarians. The overwork and staffing shortages of the levitra have affected veterinarians as much as other doctors and nurses, and dealing with the constant moral dilemmas and emotional output was driving many to burn out even before 2020.

The mean salary best price for levitra 20mg for vets is about $110,000 per year, according to the Bureau of Labor Statistics, about half that of physicians catering to people. At the Society for the Prevention of Cruelty to Animals’ veterinary hospital in San Francisco, so many vets and technicians have left that the clinic has had to cut back its hours, said veterinarian Kathy Gervais. Dog owners say they’ve had to wait months for vet appointments or drive to vets far from home to get care. €œGetting your dog in to see best price for levitra 20mg the vet is as competitive as trying to buy Coachella tickets online,” said Laura Vittet, whose golden retriever, Gertrude, is 1½ years old.

€œYou have to wait by the phone, you have to be ready to refresh your browser. It’s a very intense experience.” Gervais said she works 12-hour days, constantly zigzagging from new puppies to dying cats. And the best price for levitra 20mg whole time, she takes care of their humans, too. €œTo these people, and especially in these times, this is their love,” she said, thinking especially of the owners who dress and coif and cook for their dogs.

€œThis is their being, this is what they live for. And for vets, it’s very hard for us to draw the line.” Veterinarian Kathy Gervais says she works 12-hour days not only caring for animals, but also helping humans emotionally cope with a sick pet.(Susan Janin) Empathy overload and compassion fatigue affect veterinarians’ mental health best price for levitra 20mg. They carry the weight of having to euthanize animals that could be saved but whose owners can’t afford the care. Gervais said her practice euthanizes about five animals every day.

Some upset owners become downright abusive when a pet best price for levitra 20mg is in distress, berating vets or later bullying them online. €œI dare you to try to talk to a veterinarian who’s been in practice more than five years who doesn’t know somebody who has committed suicide,” said Gervais. €œI, unfortunately, can count on more than 10 fingers. Classmates, colleagues, people I’ve dated.” One in best price for levitra 20mg 6 veterinarians have considered suicide, according to studies from the Centers for Disease Control and Prevention.

While male vets are 1.6 times as likely to die by suicide as the general population, female vets are 2.4 times as likely, and 80% of vets are women. In the early months of the levitra, Gervais could see things getting worse. She helped organize the Veterinary Mental Health Initiative, which offers free support groups and best price for levitra 20mg one-on-one help to vets across the country. All the facilitators have doctorate-level training, said founder and director Katie Lawlor, also a psychologist, and they’re all familiar with the issues troubling vets.

€œBurnout, compassion fatigue, managing panic attacks, how to communicate with both supervisors, colleagues, and clients when you’re under extreme deadlines or very intense stress,” she said. €œAnd the loss of their own companion animals.” best price for levitra 20mg The initiative helped Dr. Razyeeh Mazaheri work through the anxiety she was feeling every day caring for animals at a clinic outside Chicago last year. The clinic was regularly double- or triple-booked.

As a new vet — Mazaheri graduated from veterinary school last spring best price for levitra 20mg — juggling so many cases was terrifying. €œI just feel like if I make a mistake, that is a problem. And if I make a mistake and kill something, that is my fault,” she said, tearing up. €œI just knew that I was burned out.” Through the support groups, Mazaheri was able to see that others shared her concerns and she learned coping best price for levitra 20mg tools.

The initiative, housed under the nonprofit Shanti Project, has groups specifically for emergency vets, vet technicians, recent grads like Mazaheri, and longtime vets like Kathy Gervais who have more than 20 or 30 years of experience. The Veterinary Mental Health Initiative, which offers free support groups and one-on-one help to veterinarians nationwide, has helped Dr. Razyeeh Mazaheri work through the anxiety she experiences caring for animals.(Mark best price for levitra 20mg Primiano) “I’ve had people look at me sometimes when they’ve seen me really tired, going, ‘Kathy, walk away,’” she said. €œI’m not ready to do it because, bottom line, I love my job.

It is a vocation. It is best price for levitra 20mg a passion. And it’s hard to walk away from that,” she said. €œBut if it’s going to kill me on the flip side, I would hope I could just say, ‘OK, that’s it.

I’m done.’” This story is part of a partnership that includes KQED, NPR best price for levitra 20mg and KHN. April Dembosky, KQED. @adembosky Related Topics Contact Us Submit a Story TipLetters to the Editor is a periodic feature. We welcome best price for levitra 20mg all comments and will publish a selection.

We edit for length and clarity and require full names. Nursing on Trial It’s about time that nurses are held accountable for their jobs (“As a Nurse Faces Prison for a Deadly Error, Her Colleagues Worry. Could I Be best price for levitra 20mg Next?. € March 22).

Several measures, training, and computer systems are already in place to try to ensure that nurses do not make medication errors. But they best price for levitra 20mg just ignore them or manually override the computer. Medication errors were rampant at my last hospital job. Every hospital has an anonymous system where any employee can report these kinds of errors.

I reported several medication errors, and nothing was ever done best price for levitra 20mg about it. No meetings, no emails, no “here is an example and we need to do better.” So I gave up reporting them on the system. A few days before I retired, I was telling the night nurse about a med error I prevented on a new patient admitted the night before. Turns out she was the best price for levitra 20mg one who made the error!.

Her response was, “Shouldn’t pharmacy have caught that?. € She took best price for levitra 20mg no responsibility for not clarifying the order. And she had been a nurse for over two decades. And the med error was close to an overdose amount, according to the pharmacy.

My experience was best price for levitra 20mg that there is very little accountability in nursing unless a manager doesn’t like you. It has nothing to do with the ability to do the job or patient safety. €” Phyllis Mitchell, Laguna Woods, California — Tom Wriggins, Naples, Florida I’ve been a registered nurse for two years and was a licensed practical nurse for 10 years. What RaDonda best price for levitra 20mg Vaught did is abysmally wrong on so many levels.

I cannot believe the number of licensed professionals trying to defend pure malpractice and negligence (“Reaction to the RaDonda Vaught Verdict. KHN Wants to Hear From Nurses,” March 30). This is not best price for levitra 20mg a “system problem,” it’s a RaDonda problem. You’re telling me she should be exonerated after blowing past 10 huge red flags?.

!. They said “Stop best price for levitra 20mg what you’re doing and make sure it’s correct. This is a PARALYTIC drug.” No more system checks would have made a difference because she ignored every single one that came up. Medical professionals rely way too much on technology.

Blaming technology best price for levitra 20mg and “the system” are poor excuses for what happened. If I was drinking, then decided to drive my car at 80 mph through a neighborhood, blast through stop signs and red lights and kill a child, should I be forgiven with a slap on the wrist?. Pure and simple negligence. These people trying to defend Vaught are all about professional responsibility, and want RNs to be respected, but best price for levitra 20mg think this is OK?.

The RN is a professional, licensed nurse and is the bottom line against errors that slip through the system. If she would have taken two seconds to think about the five rights, this never would have happened, regardless of whether there were problems with the automated medication-dispensing system. This is basic best price for levitra 20mg Nursing 101. This case really upsets me.

The fact nurses are trying to shift blame away from her is alarming. And if best price for levitra 20mg they’re worried it could happen to them, then maybe they shouldn’t be practicing. €” Paul Dziejman, Depew, New York this trial that resulted in the criminalization of medical errors also revealed systemic issues in the hospital setting. If unaddressed, the precedence of this ruling will have negative impacts on the nursing profession.

#RaDondaVaught #PM760https://t.co/KKFOyEPtKv— Katie Wee (@wee_insun) March 29, 2022 — Katie Wee, Boston One important cause of best price for levitra 20mg potential nursing errors not mentioned in the article is understaffing. My RN sister’s intensive care unit expects as many as six nurses gone soon, from her shift alone. And the worse conditions are, the less likely even agency nurses will accept a position. Do dedicated RNs stay for the patients’ sake, or leave best price for levitra 20mg to protect themselves?.

You can help both patients and nurses by supporting safe staffing legislation in your state. €” Gloria Kohut, Grand Rapids, Michigan — Sunny Ro, Philadelphia The Fallout of Prosecuting Medical Errors In the article “Nurse Convicted of Neglect and Negligent Homicide for Fatal Drug Error” (March 25), I found myself reflecting on my future nursing career. Although it is clear best price for levitra 20mg RaDonda Vaught was guilty of a medication error that led to the death of a patient, I can sympathize. The hateful public ridicule she has been given and the defaming comments from the prosecutors regarding her nursing character being “uncaring … and abandoning her patient” are alarming.

It creates an alternative narrative of what has taken place, and that is that Vaught intentionally harmed a patient, not accidentally. Reporting any type of medical error whether it is small or large is crucial in identifying safety issues in nursing care and, with the handling of the Vaught case, some nurses may feel that admitting to a mistake can cost them their job and/or their life best price for levitra 20mg. To build progress toward improving health care delivery, the handling of medical errors should be judged fairly, and without shaming nurses who have dedicated their lives to protecting and healing patients. As stated in the article, “Health care just changed forever,” and this creates an environment of fear and mistrust, and an unsupportive system for nurses to come.

€” Katarina Velardez, San Francisco Be best price for levitra 20mg frightened. For those of you involved in making medical care safer and more reliable, a recent prosecution of a nurse for a medical error may set our efforts for "Just Culture" back a few decades. We learn, not blame. @AAPneonatal @D8Neonatal https://t.co/NpWqS5gfBh— james barry (@skideepowder) April 1, 2022 — James Barry, Denver I best price for levitra 20mg am saddened that with all the efforts made to advance patient safety that RaDonda Vaught was prosecuted versus Vanderbilt University Medical Center and/or the drug-dispensing vendor.

We know that medication errors occur every day and we need to continuously work to reengineer things to make it hard to make an error. Having been a nurse for many years, I am appalled at the manipulation of calling nurses who work in challenging conditions heroes until something goes wrong. This error best price for levitra 20mg was completely understandable and predictable. First of all, after decades, why are these systems still not programmed to recognize both generic and brand names?.

That alone would have prevented this medication error. Secondly, as with all broken systems, when there were known dispensing issues with the drug-dispensing system, best price for levitra 20mg why wasn’t Vanderbilt proactive?. If nurses needed to override the system routinely, why didn’t a patient-safety expert conduct an FMEA (failure mode event analysis) and remove all high-risk drugs from the drug-dispensing machine?. Vanderbilt has failed patients and nurses and should step up.

Without focusing on investigating what went wrong and sharing the findings with other organizations, health best price for levitra 20mg care cannot learn. Vendors for these systems are also failing patients and nurses. Shouldn’t there be requirements by now for all searches on these systems to include both brand and generic drug names?. We have created a best price for levitra 20mg distraction with this trial to mistakenly help Americans feel safe.

We removed this “bad” nurse, so we are safe now. The truth is patients are now less safe than before this verdict. Nurses always live in fear best price for levitra 20mg of making a mistake and causing harm. We struggle to continue to work in environments where our voices for patient safety are not heard and are silenced.

This is a step backward for all of American health care in which medication errors remain the No. 1 type best price for levitra 20mg of error. We have neglected to be transparent and learn how to prevent another nurse from making the same mistake. This has reaffirmed for me and other nurses that you will be asked to work yourself to exhaustion, give all your mental and physical strength and be called a hero so long as it benefits an organization or society, but when something goes wrong you will be unsympathetically discarded and made a villain.

How sad best price for levitra 20mg. €” Carole Cassidy, Newtown Square, Pennsylvania She made a critical mistake, but is she deserving of serving time in prison?. Nurse Convicted of Neglect and Negligent Homicide for Fatal Drug Error https://t.co/8DjvYVrolr via @khnews— Garry Klein (@GarryfromIowa) April 6, 2022 — Garry Klein, Iowa City, Iowa A Family Caregiver’s Plea Another essential part of family caregivers should be a requirement for medical records to be able to be accessed by the family (“To Families’ Dismay, Biden Nursing Home Reform Doesn’t View Them as Essential Caregivers,” March 22). I am the legal guardian of best price for levitra 20mg my sister-in-law and have no access to her medical records.

She is not capable of answering my questions accurately. I need to be able to see those records to monitor her medications and follow best price for levitra 20mg what care is being provided. It isn’t as if they don’t use computers. It would require no extra work on the staff’s part.

And we should have also access best price for levitra 20mg to the same info the staff sees. Because I have no access to her records, it made no sense for me to continue to take her to her own doctor or psychiatrist because I can no longer answer the questions they ask about her activity and her health and eating. I visit twice a week and do some of the little things that the staff misses. There are times I suspect best price for levitra 20mg a missed dose of medication or a medication change, but there is no way to know for sure.

I am considering moving her to a different facility for this reason. I just think this is a vital part of including family, especially if they have guardianship. €” Theresa Smith, St best price for levitra 20mg. Joseph, Missouri Really?.

There is nothing "informal" about family caregiving. Family/close friends best price for levitra 20mg are the most trusted allies &. Care coordinators for residents of LTC facilities. They are essential to the well-being of vulnerable older adults.

Https://t.co/TI60SRGrmR via @khnews— Lynn Friss Feinberg best price for levitra 20mg (@FeinbergLynn) March 22, 2022 — Lynn Friss Feinberg, Washington, D.C. Concerns About an Autism Therapy I’m concerned about the article “Delays for Autism Diagnosis and Treatment Grew Even Longer During the levitra” (March 30) because it does not include any input from an actually autistic adult and it supports ABA [applied behavioral analysis] therapy as the gold standard for autism treatment, a theory dethroned by several recent studies. I was recently diagnosed as autistic as an adult and have done thousands of hours of research on what is the best treatment for myself and an underage family member under my care. ABA is extremely expensive and time-consuming and not proved effective, according to a recent study by the Department best price for levitra 20mg of Defense, and could be actively harmful to children receiving the therapy.

In addition, the therapy practice is ethically questionable, as it was founded by Ole Ivar Lovaas — yes, the same guy who founded gay conversion therapy. And forcing an autistic kid to “convert” to looking “normal” is equally harmful. Therapies that should be recommended for recently diagnosed children should be occupational therapy, best price for levitra 20mg to determine sensory issues and a sensory routine to support those needs. Speech therapy (if needed).

And training in the collaborative problem-solving method by Dr. Ross Greene best price for levitra 20mg. For more expert knowledge than mine on the harms of ABA, see the work of the Therapist Neurodiversity Collective. Thank you for your attention.

€” Andrea Hebert, Nashville, Tennessee You know whats more heartbreaking for parents who best price for levitra 20mg have children with autism?. Nothing will be done to help them at all. They were abandoned, and CNN article is a fake concern considering they incited lockdowns and erectile dysfunction treatment hysteria.https://t.co/QcgoA9rZhA— Ndee -Jkid- Okeh (@Jkid4) March 29, 2022 — Ndubuisi Okeh, Capitol Heights, Maryland More on treatments and erectile dysfunction treatment Transmission As one of your readers, I value your overall mission. I am writing with concern about the article by Aaron Bolton, called “Patients With Vulnerable Immune Systems Worry best price for levitra 20mg treatment Exemptions May Put Them in Peril” (March 22).

The premise of the article is that unvaccinated health care workers are putting patients at risk, ignoring the widely acknowledged fact that vaccination does not prevent, or even reduce, transmission. I would expect greater diligence in demanding objectivity from your featured authors, rather than perpetuating fear-based claims that unfairly target those front-line workers who have been working overtime for the health of the public. This article offers information on the transmission of erectile dysfunction treatment that may help inform which pieces you choose to best price for levitra 20mg run in the future. €” Hannah Miller, Missoula, Montana — Barbara Katz-Chobert, Philadelphia Removing the Stigma of Miscarriage I am a student nurse at California State University-East Bay and am writing regarding the article “After Miscarriages, Workers Have Few Guarantees for Time off or Job-Based Help” (Jan.

26). I would best price for levitra 20mg like to start off by simply saying thank you. You discussed a topic that has gone ignored for so long. It is disheartening to read that not even half of our country has enacted laws that provide paid sick leave for miscarriages.

My hope is that articles like yours will allow us to have deeper, meaningful, and destigmatized discussions about miscarriages — and, more so, to acknowledge the emotional, mental, and physical impact best price for levitra 20mg on anyone who may have experienced such loss. €” Catherine Zelidon-Sarcos, Pittsburg, California Excellent essay on how we can honor women in the workplace. If we want more kids, then we have to value women at work.After Miscarriages, Workers Have Few Guarantees for Time Off or Job-Based Help | Kaiser Health News https://t.co/5oaNdqqAFR— dacortright🇺🇦 (@david_cort7) March 22, 2022 — David Cortright, Austin, Texas Countering the ‘Abortifacients’ Argument The morning-after pill and IUDs work by preventing conception, not by preventing implantation (HealthBent. €œAs Red States Push Strident Abortion Bans, Other Restrictions best price for levitra 20mg Suddenly Look Less Extreme,” March 30).

The hormonal IUDs create a mucus plug that prevents the passage of sperm. Copper IUDs create a sterile inflammatory reaction that essentially neutralizes the ability of the sperm to penetrate the egg. Emergency contraception pills prevent best price for levitra 20mg ovulation. By perpetuating the anti-choice narrative that these methods work by preventing implantation, you are discouraging and stigmatizing their use.

€” Amy O’Meara, Kamuela, Hawaii You cannot completely ban abortion, because the far-right can’t even agree on what an abortion is. 18 weeks, 6 weeks, conception, birth control, masturbation, best price for levitra 20mg IVF. Every new restriction opens the door to an even more draconian law. Https://t.co/0BUiRIC9xQ— Trojan Horse News (@realTHNews) March 30, 2022 — Kate Woods, Atlanta The Cost of Treating Troubled Kids The $400-plus-a-day average reimbursement per child equates to almost $148,000 a year.

That seems like plenty to best price for levitra 20mg accommodate one of these children (“Montana Is Sending Troubled Kids to Out-of-State Programs That Have Been Accused of Abuse,” March 25). I also think the story glosses over the challenges that these children present to the schools. €” Mike Morgan, Bozeman, Montana — Ian O’Neil, Boston Before you write an article about out-of-state abuse and quote someone … “Shipping those kids out of state for treatment for behavioral and substance use disorders comes with a high price tag, and often the children’s issues are not resolved or are even worse, said Michael Chavers, CEO of Yellowstone Boys and Girls Ranch. €˜When they return to us, they return with worse outcomes and for higher cost,’ Chavers told best price for levitra 20mg Montana lawmakers last fall.” … you might want to look at the background of the Yellowstone Boys and Girls Ranch, as it had to pay out $300,000 in a boy’s sexual abuse case in 2018.

Let’s clean up our backyard first. Do some research before throwing stones. The author best price for levitra 20mg of the article should have done better research on the business or people they were using as “experts.” Shame on YBGR and Chavers for making comments as if they are without problems. €” Kim Hover, Stevensville, Montana Embracing Personalized Medicine In the article “Big Pharma Is Betting on Bigger Political Ambitions From Sen.

Tim Scott” (March 28), KHN describes the Personalized Medicine Coalition and its work inaccurately for a second time (see also “A Senator From Arizona Emerges As a Pharma Favorite,” May 29, 2020). PMC, a 501(c)(3) nonprofit organization comprising 14 best price for levitra 20mg distinct stakeholder groups within health care, with the largest segment made up of “research, education, and clinical care institutions,” is not a trade association and does not represent any single industry or business model. Moreover, your implication that personalized or precision medicine jacks up the costs of pharmaceutical products misses the mark. Its goal, in addition to promising better outcomes for patients, is to lower systemic costs for health care by making it more efficient.

Personalized medicine best price for levitra 20mg has been shown to save health systems money while improving patient care. The Teachers’ Retirement System of the state of Kentucky, for example, has found that integrating genetic testing into prescribing decisions saved the system $5,176 per enrolled member by targeting treatments to only those patients who will benefit, sparing expenses and side effects for those who will not. For cancer patients, Intermountain Healthcare has also found that genomic testing can lengthen progression-free survival rates without increasing costs. Sen.

Scott may or may not have his eye on higher office, but he is correct that we could do a lot worse than embrace personalized medicine. €” Edward Abrahams, president of the Personalized Medicine Coalition, Washington, D.C. The Long Arm of Big Pharma I just learned about your website, thanks to a recent daily current events analysis done by American history professor Heather Cox Richardson, which cited a link to the amazing webpage providing insight into Big Pharma’s deep-pocket reach into Congress. I have nothing but admiration and appreciation for the work that went into making such a page.

And I say that despite the unfortunate personal surprise and bummer it was to see my congressman listed prominently as the “Freshman Favorite,” Rep. Frank J. Mrvan. Living here in Indiana means Eli Lilly has always had an outsize influence on societal affairs.

So the fact that it is at the very top of his list of pharma donors is not surprising. But then there were all the other pharma companies underneath Eli Lilly — an eyebrow-soaring number, actually. Because the dates go back to 2007, I had been hoping to compare his reputation against his predecessor for this district, Pete Visclosky. The man was highly esteemed and as such remained incumbent here since I can remember, at least since I was in high school in 2000.

I hope your project can fill in data on predecessor representatives. It would help folks like me contextualize just how much pharma donations may have already been a problem. The underlying reality is that each individual receiving donations does so on behalf of a particular office — therefore, my interests as a citizen are aggressively bought out. I’d like to know if my say with my previous congressional representative was diluted at all.

Particularly when it comes to certain personal aspects of the pharmaceutical industry, like the $16,000-a-month medication that kept my mother alive for a while longer in her years-long fight against cancer, which she maintained until one day she couldn’t anymore. (Without the Affordable Care Act’s insurance having “arrived in time” for her finding a lump and being diagnosed, our ability to afford such a treatment would have been nonexistent.) In other words. I would very much appreciate the possibility to know how angry and resentful, and therefore politically active, I should be when it comes to the donation-driven influence pharma has had on this small bit of democracy assigned to me, my family, my friends, and my home community by and large. Thanks again for the outstanding work.

It is very, very appreciated!. — Tomas Feher, Chesterton, Indiana — Dr. George Monks, Tulsa, Oklahoma Combating Congenital Syphilis It’s heartbreaking, yet unsurprising, that the rates of congenital syphilis are increasing in the U.S. (“Babies Die as Congenital Syphilis Continues a Decade-Long Surge Across the US,” April 12).

Public health departments are underfunded and reproductive rights have been under attack for many years, especially since Donald Trump’s presidency. The defunding of clinics, like Planned Parenthood, due to anti-abortion legislation across the country, also means that many people seeking STD screening and treatment are losing places to do so. As a birth worker in Los Angeles, I witnessed firsthand how lack of access to health care impacts communities of color through structural racism. It is unacceptable that babies are dying from a totally treatable illness, due to a lack of staff and resources to help pregnant people with syphilis receive the diagnosis and treatment they need.

Just as we had to get creative during the levitra, this health problem requires creative solutions, partnership, and technology. How great would it be if a patient could receive their STD results and directories of places to pick up medications to get treatment, just as they can with erectile dysfunction treatment. A solution must be found quickly. The health and well-being of babies, especially babies of color who are being affected at higher rates, depends on it.

€” Candy Ramirez-Hale, Oakland, California Related Topics Contact Us Submit a Story TipCan’t see the audio player?. Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Click here for a transcript of the episode.

It’s been extra busy on the health policy beat lately, so a congressional recess provides a chance to explore some of the important stories that people might have missed, like Medicare’s decision to dramatically limit coverage of Aduhelm, the controversial new drug to treat Alzheimer’s disease. And even with Congress out, states are rushing to either restrict or expand access to abortion, ahead of a key Supreme Court ruling expected later this spring or summer. This week’s panelists are Julie Rovner of KHN, Margot Sanger-Katz of The New York Times, Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, and Alice Miranda Ollstein of Politico. Among the takeaways from this week’s episode.

The decision by the Centers for Medicare &. Medicaid Services to limit Medicare’s coverage of Aduhelm only to beneficiaries who also enroll in clinical studies of the new Alzheimer’s drug came despite intense pressure from patients and advocacy groups who are frustrated by the lack of new therapies for this devastating disease. But the federal agency also appears to have been swayed by arguments by some researchers and public health experts that the earlier research on the drug was faulty.The dust-up over Medicare coverage for Aduhelm points to a source of tension in the U.S. Health system.

Different government agencies have overlapping authorities. This dispute is between the FDA, which approved the drug despite serious questions about its effectiveness and safety, and CMS, which had to decide whether to cover the cost of a very controversial drug that is also very expensive. But similar tensions also have played out between the FDA and the Centers for Disease Control and Prevention over erectile dysfunction treatment schedules and eligibility.A recent Bloomberg report looked at concerns that the federal government is overpaying for beneficiaries enrolled in private Medicare Advantage plans. More progressive Democratic members of Congress have long complained about this, but Republicans are strong supporters of the Medicare Advantage program.Despite the complaints of some on the left about the excess funding of these Medicare plans, they have been growing.

That is, in part, because the traditional Medicare program has many holes and cost-sharing responsibilities that people with modest incomes are nervous about shouldering, and Medicare Advantage has become attractive to them. That has complicated the formerly partisan politics over the program.The Biden administration is reportedly in discussions with several states about setting up programs to import cheaper drugs from Canada. For the Democrats, this could be a strong campaign talking point — much like efforts on Capitol Hill to cap the price of insulin — about trying to help people with a serious pocketbook issue. Drug prices have consistently been a consumer concern.However, it’s not clear whether Canada is interested in helping the U.S.

With a drug import program and, even if it did, there’s no indication that the amount of drugs Canadians could provide would significantly influence prices in this country.Oklahoma’s governor has signed a bill that would make it a felony to perform an abortion, and Florida’s governor on Thursday approved a bill moving the limit for an abortion from 24 weeks to 15 weeks. As the country waits for the Supreme Court to rule on a case this summer that could overturn or weaken the landmark Roe v. Wade decision, conservative states are racing to find ways to limit or ban abortions.If the Supreme Court does upend protections guaranteed under the Roe decision, it is unlikely that clinics in states that are preserving the right to an abortion will be able to fill the need.Yet even with the growing movement in conservative states, abortion-rights supporters were stunned this week when a Texas prosecutor filed murder charges against a woman who had an abortion. The charges, however, were quickly dismissed.The CDC this week released new data showing a rise in 2020 in the number of cases of gonorrhea and syphilis — likely the byproduct of less access to health care during the early stages of the levitra.

Although the diseases can easily be cured with antibiotics, the public may not realize the need to seek medical care or the devastating consequences of letting the diseases go untreated.The CDC also reported that drug overdose deaths reached a record high last year. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too. Julie Rovner. Politico’s “Mice Occupy FDA Offices After Food Left Behind in levitra,” by David Lim and Lauren Gardner Margot Sanger-Katz.

Health Affairs’ “Many Medicare Beneficiaries Do Not Fill High-Price Specialty Drug Prescriptions,” by Stacie B. Dusetzina et. Al Joanne Kenen. Vox’s “America Needs More Doctors and Nurses to Survive the Next levitra,” by Dylan Scott Alice Miranda Ollstein.

Politico’s “Republicans See CDC’s Policy Change as ‘Massive Political Loser for Democrats,’” by Alice Miranda Ollstein and Krista Mahr Also discussed on this week’s podcast. Bloomberg’s “Major Insurers Are Scamming Billions From Medicare, Whistle-Blowers Say,” by John Tozzi KHN’s “Researcher. Medicare Advantage Plans Costing Billions More Than They Should,” by Fred Schulte KHN’s “‘What the Health?. €™.

The Drug Price Dilemma,” featuring Stacie B. Dusetzina To hear all our podcasts, click here. And subscribe to KHN’s What the Health?. on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts.

Related Topics Contact Us Submit a Story Tip.

The federal “test-to-treat” program, announced in March, is meant to 20mg levitra price reduce erectile dysfunction treatment hospitalizations and deaths by quickly levitra online purchase canada getting antiviral pills to people who test positive. But even as cases rise again, many Americans don’t have access to the program. Pfizer’s Paxlovid and levitra online purchase canada Merck’s Lagevrio are both designed to be started within five days of someone’s first symptoms.

They’re for people who are at high risk of developing severe illness but are not currently hospitalized because of erectile dysfunction treatment. Millions of chronically ill, disabled, and older Americans are eligible for the treatments, and Dr. Anthony Fauci of the National levitra online purchase canada Institutes of Health said April 11 that more people may qualify soon.

The program allows people with erectile dysfunction treatment symptoms to get tested, be prescribed antiviral pills, and fill the prescription all in one visit. The federal government and many state and local health departments direct residents to an online national map where people can find test-to-treat sites and other pharmacies where they can fill prescriptions. But large swaths of the country levitra online purchase canada had no test-to-treat pharmacies or health centers listed as of April 14.

And the website of the largest participant, CVS, has significant technical issues that make booking an appointment difficult. Even people who regularly see a doctor may be unable to get a prescription in time, and that’s where the program comes in. Before the levitra, 28% of Americans didn’t levitra online purchase canada have a regular source of medical care, with rates even higher for Black and Hispanic Americans.

€œAll of our public health response relies on lowering the barrier to getting treatments to the right people,” said Dr. Kirsten Bibbins-Domingo, chair of the Department of Epidemiology and Biostatistics at the University of California-San Francisco. She said the fragmented federal, state, and local levitra online purchase canada public health systems, the U.S.

Department of Health and Human Services’ reliance on partners that charge high prices for appointments, and the lack of clear information are stymieing the effort. €œThe best tools that we have are not going to reach the people who most need them,” she said. Bibbins-Domingo is also a practicing physician at Zuckerberg San Francisco General Hospital, which she says is not only testing patients for erectile dysfunction treatment and prescribing levitra online purchase canada them antivirals, but also delivering them medications — all the elements of test-to-treat.

But the hospital, which largely treats low-income and uninsured patients, doesn’t appear on the federal map. It shows just three locations in San Francisco. Two community health centers and levitra online purchase canada one CVS.

Ninety-one percent of the sites listed on the national map are federal partners. Pharmacy chains like CVS, federally qualified health centers, and military and Indian Health Service clinics. HHS has asked levitra online purchase canada state and local health departments to identify other potential participants, like San Francisco General Hospital, so they can be added.

Most states have none of those partners listed yet. Nationally, CVS MinuteClinics make up more than half of all test-to-treat locations, according to the federal data. The roughly 1,200 clinics, in 35 states and Washington, D.C., are housed under the same roof as CVS pharmacies, where patients can pick levitra online purchase canada up prescriptions for erectile dysfunction treatment antivirals.

Walgreens drugstores and Kroger grocery store affiliates run about 400 more sites. The federal government has set aside nearly 400,000 courses of the antivirals for its federal pharmacy partners — about a quarter of the total supply since the program began in March. Although the cost of the pills is covered by the federal government, obtaining a prescription at the pharmacies that dominate levitra online purchase canada the program can be expensive.

Though CVS does not charge symptomatic uninsured people for on-site erectile dysfunction treatment tests, MinuteClinics charge upwards of $100 for in-person or telehealth appointments to examine patients and prescribe an antiviral, if needed. People without insurance, whose health plans don’t cover visits to the clinics, or who have high-deductible plans must shoulder the full cost of the appointment. Even if levitra online purchase canada they can afford it, finding treatment might be impossible.

KHN aimed to find out how easy or hard booking a test-to-treat appointment at a CVS would be. Reporters searched online and in person for erectile dysfunction treatment testing and treatment appointments in April. It took a KHN reporter in the Washington, D.C., area three hours driving between stores to figure out whether testing was available and antivirals in stock across four MinuteClinic locations — time levitra online purchase canada that few people can afford in general, let alone when they’re sick.

Each store provided test-to-treat services, which could be booked through a kiosk. But three of the stores either didn’t have same-day appointments available or didn’t have the antiviral pills in stock that day. A KHN reporter also tried levitra online purchase canada to book appointments online at clinics in several states, listing upper respiratory symptoms.

After the reporter marked a positive erectile dysfunction treatment test on the screening form, a message appeared — “For the safety of our patients and staff, we can’t allow you into the clinic at this time” — and the patient was then directed to book a telehealth visit. KHN also searched CVS’ website for testing appointments at all MinuteClinics shown on the federal map in the District of Columbia, Maryland, and Virginia, just over 100 clinics total. Only half listed any levitra online purchase canada future testing appointments available.

Amy Thibault, a CVS spokesperson, said that all MinuteClinics provide in-person test-to-treat services and that a software glitch made it appear they don’t. She said CVS is working to fix that. Thibault said erectile dysfunction treatment patients are “encouraged” to levitra online purchase canada use telehealth.

Some Americans, especially seniors, don’t have the devices, internet connection, or technology skills needed for virtual visits. The program requires participants like CVS to provide options for in-person appointments, said HHS spokesperson Suzanne Sellman. KHN also levitra online purchase canada searched online for appointments at participating Kroger and Walgreens clinics in several states and found many available in-person appointments.

Another complication. The FDA requires doctors, advanced practice registered nurses, or physician assistants to write the prescriptions. A pharmacist can’t do it levitra online purchase canada.

Many of the nation’s leading pharmacy organizations have asked the Biden administration to remove the restriction, which would expand the program to scores of rural and underserved communities. Because of this rule, the program requires clinics and pharmacies to be under the same roof — a setup that doesn’t exist in many regions, particularly in rural areas. The federal map shows no sites in Wyoming or South Dakota other than military clinics, which don’t serve levitra online purchase canada the public.

People in dozens of other regions would have to drive more than 100 miles to reach the nearest clinic, according to a KHN review of participating locations. The Wyoming Department of Health is working to enroll providers in the program, spokesperson Kim Deti said. Montana has levitra online purchase canada four public-facing test-to-treat clinics, according to the federal website and Jon Ebelt, a spokesperson for Montana’s Department of Public Health and Human Services.

He said that seven Defense Department and Indian Health Service facilities also provide test-to-treat services, but those aren’t open to most people. Billings, the state’s most populous city, is more than a three-hour drive from the nearest site shown on the map. Ebelt said the agency is working with a local primary-care nonprofit to find more facilities to enroll levitra online purchase canada.

We have to get this right, said Bibbins-Domingo, the San Francisco professor. She said that as the U.S. Moves away from restrictions like mask mandates, the public health system must levitra online purchase canada ensure that everyone can get these new treatments, which can get people back to work sooner, prevent serious illnesses, and even save lives.

For those far from clinics, people with disabilities, and people too sick to leave home, telehealth could be the easiest way to get treated. A few local governments, including Los Angeles County and New York City, have launched virtual care initiatives. Truepill, a company that provides telehealth and pharmacy levitra online purchase canada technology, offers online erectile dysfunction treatment assessments through its website finderectile dysfunction treatmentcare.com for a fraction of the cost of CVS’ in-person or telehealth operations.

The company has filled more than 10 million prescriptions in the past five years. The service, available in all 50 states and Washington, D.C., costs $25 to $55. Though insurance isn’t accepted, the cost is levitra online purchase canada comparable to insurance copays for in-person doctor appointments.

Prescriptions can be sent to a local pharmacy for no additional charge or shipped to a home overnight via FedEx for a $20 fee. HHS didn't respond to requests for data on antiviral use and has repeatedly declined to allow KHN to observe levitra online purchase canada weekly virtual meetings about the program held with state health officials, clinic directors, and other health care providers. Bibbins-Domingo said that to be effective, the federal government must make it easier to get testing and treatment, especially when the program is geared toward those at highest risk of devastating complications from erectile dysfunction treatment.

€œIf you're just an average person trying to navigate this,” she said, “it’s actually completely impossible.” KHN correspondents Katheryn Houghton and Rachana Pradhan contributed to this report. Hannah levitra online purchase canada Recht. hrecht@kff.org, @hannah_recht Related Topics Contact Us Submit a Story TipIf you or someone you know is considering suicide, please call the National Suicide Prevention Lifeline.

1-800-273-TALK (8255). At the park near Duboce Triangle in San Francisco, levitra online purchase canada 5 p.m. Is canine happy hour.

About 40 dogs run around, chasing balls and wrestling, as their owners coo and ’90s hip-hop bumps out of a portable speaker. One recent afternoon, a Chihuahua mix named Honey lounged on a bench wearing a blue tutu and a string of pearls levitra online purchase canada. Her owner, Diana McAllister, fed her homemade treats from a zip-close bag, then popped one into her own mouth.

After spending two years at home through the levitra, it’s clear that for a lot of these owners, their dogs are their children. €œI always say, dogs are people, so I love levitra online purchase canada him,” said Yves Dudley, looking on as her 9-month-old collie-schnauzer mix played in the grass. Across the country, about 23 million families adopted a pet in the first year of the levitra.

Other pet owners, working from home, started paying more attention to their animals’ daily routines, noticing symptoms like vomiting or coughing. The resulting spike in pet health concerns has been straining a levitra online purchase canada corner of the medical world that doesn’t get as much attention as doctors and nurses. Veterinarians.

The overwork and staffing shortages of the levitra have affected veterinarians as much as other doctors and nurses, and dealing with the constant moral dilemmas and emotional output was driving many to burn out even before 2020. The mean salary for vets is about $110,000 per year, according to the Bureau of Labor Statistics, about half that of physicians catering levitra online purchase canada to people. At the Society for the Prevention of Cruelty to Animals’ veterinary hospital in San Francisco, so many vets and technicians have left that the clinic has had to cut back its hours, said veterinarian Kathy Gervais.

Dog owners say they’ve had to wait months for vet appointments or drive to vets far from home to get care. €œGetting your dog in to see the vet is as competitive as trying to buy Coachella tickets online,” said Laura Vittet, whose golden retriever, Gertrude, is 1½ years levitra online purchase canada old. €œYou have to wait by the phone, you have to be ready to refresh your browser.

It’s a very intense experience.” Gervais said she works 12-hour days, constantly zigzagging from new puppies to dying cats. And the whole time, levitra online purchase canada she takes care of their humans, too. €œTo these people, and especially in these times, this is their love,” she said, thinking especially of the owners who dress and coif and cook for their dogs.

€œThis is their being, this is what they live for. And for vets, it’s very hard for us levitra online purchase canada to draw the line.” Veterinarian Kathy Gervais says she works 12-hour days not only caring for animals, but also helping humans emotionally cope with a sick pet.(Susan Janin) Empathy overload and compassion fatigue affect veterinarians’ mental health. They carry the weight of having to euthanize animals that could be saved but whose owners can’t afford the care.

Gervais said her practice euthanizes about five animals every day. Some upset owners become downright abusive when a pet is in distress, berating vets or later bullying them online levitra online purchase canada. €œI dare you to try to talk to a veterinarian who’s been in practice more than five years who doesn’t know somebody who has committed suicide,” said Gervais.

€œI, unfortunately, can count on more than 10 fingers. Classmates, colleagues, people I’ve dated.” levitra online purchase canada One in 6 veterinarians have considered suicide, according to studies from the Centers for Disease Control and Prevention. While male vets are 1.6 times as likely to die by suicide as the general population, female vets are 2.4 times as likely, and 80% of vets are women.

In the early months of the levitra, Gervais could see things getting worse. She helped organize the Veterinary Mental Health Initiative, which offers free support groups and one-on-one levitra online purchase canada help to vets across the country. All the facilitators have doctorate-level training, said founder and director Katie Lawlor, also a psychologist, and they’re all familiar with the issues troubling vets.

€œBurnout, compassion fatigue, managing panic attacks, how to communicate with both supervisors, colleagues, and clients when you’re under extreme deadlines or very intense stress,” she said. €œAnd the loss of their own companion animals.” The initiative helped Dr levitra online purchase canada. Razyeeh Mazaheri work through the anxiety she was feeling every day caring for animals at a clinic outside Chicago last year.

The clinic was regularly double- or triple-booked. As a new vet — Mazaheri levitra online purchase canada graduated from veterinary school last spring — juggling so many cases was terrifying. €œI just feel like if I make a mistake, that is a problem.

And if I make a mistake and kill something, that is my fault,” she said, tearing up. €œI just knew that I was burned out.” Through the support groups, Mazaheri was able to see that others shared her concerns levitra online purchase canada and she learned coping tools. The initiative, housed under the nonprofit Shanti Project, has groups specifically for emergency vets, vet technicians, recent grads like Mazaheri, and longtime vets like Kathy Gervais who have more than 20 or 30 years of experience.

The Veterinary Mental Health Initiative, which offers free support groups and one-on-one help to veterinarians nationwide, has helped Dr. Razyeeh Mazaheri work through the anxiety she experiences caring levitra online purchase canada for animals.(Mark Primiano) “I’ve had people look at me sometimes when they’ve seen me really tired, going, ‘Kathy, walk away,’” she said. €œI’m not ready to do it because, bottom line, I love my job.

It is a vocation. It is a levitra online purchase canada passion. And it’s hard to walk away from that,” she said.

€œBut if it’s going to kill me on the flip side, I would hope I could just say, ‘OK, that’s it. I’m done.’” levitra online purchase canada This story is part of a partnership that includes KQED, NPR and KHN. April Dembosky, KQED.

@adembosky Related Topics Contact Us Submit a Story TipLetters to the Editor is a periodic feature. We welcome all comments levitra online purchase canada and will publish a selection. We edit for length and clarity and require full names.

Nursing on Trial It’s about time that nurses are held accountable for their jobs (“As a Nurse Faces Prison for a Deadly Error, Her Colleagues Worry. Could I Be Next? levitra online purchase canada. € March 22).

Several measures, training, and computer systems are already in place to try to ensure that nurses do not make medication errors. But they just ignore them or levitra online purchase canada manually override the computer. Medication errors were rampant at my last hospital job.

Every hospital has an anonymous system where any employee can report these kinds of errors. I reported several medication errors, levitra online purchase canada and nothing was ever done about it. No meetings, no emails, no “here is an example and we need to do better.” So I gave up reporting them on the system.

A few days before I retired, I was telling the night nurse about a med error I prevented on a new patient admitted the night before. Turns out she was the levitra online purchase canada one who made the error!. Her response was, “Shouldn’t pharmacy have caught that?.

€ She levitra online purchase canada took no responsibility for not clarifying the order. And she had been a nurse for over two decades. And the med error was close to an overdose amount, according to the pharmacy.

My experience was that there is very little accountability in levitra online purchase canada nursing unless a manager doesn’t like you. It has nothing to do with the ability to do the job or patient safety. €” Phyllis Mitchell, Laguna Woods, California — Tom Wriggins, Naples, Florida I’ve been a registered nurse for two years and was a licensed practical nurse for 10 years.

What RaDonda Vaught did is abysmally wrong levitra online purchase canada on so many levels. I cannot believe the number of licensed professionals trying to defend pure malpractice and negligence (“Reaction to the RaDonda Vaught Verdict. KHN Wants to Hear From Nurses,” March 30).

This is not a “system problem,” it’s a RaDonda levitra online purchase canada problem. You’re telling me she should be exonerated after blowing past 10 huge red flags?. !.

They said “Stop what you’re levitra online purchase canada doing and make sure it’s correct. This is a PARALYTIC drug.” No more system checks would have made a difference because she ignored every single one that came up. Medical professionals rely way too much on technology.

Blaming technology and “the system” are levitra online purchase canada poor excuses for what happened. If I was drinking, then decided to drive my car at 80 mph through a neighborhood, blast through stop signs and red lights and kill a child, should I be forgiven with a slap on the wrist?. Pure and simple negligence.

These people trying levitra online purchase canada to defend Vaught are all about professional responsibility, and want RNs to be respected, but think this is OK?. The RN is a professional, licensed nurse and is the bottom line against errors that slip through the system. If she would have taken two seconds to think about the five rights, this never would have happened, regardless of whether there were problems with the automated medication-dispensing system.

This is basic Nursing 101 levitra online purchase canada. This case really upsets me. The fact nurses are trying to shift blame away from her is alarming.

And if they’re worried it could happen to them, levitra online purchase canada then maybe they shouldn’t be practicing. €” Paul Dziejman, Depew, New York this trial that resulted in the criminalization of medical errors also revealed systemic issues in the hospital setting. If unaddressed, the precedence of this ruling will have negative impacts on the nursing profession.

#RaDondaVaught #PM760https://t.co/KKFOyEPtKv— Katie levitra online purchase canada Wee (@wee_insun) March 29, 2022 — Katie Wee, Boston One important cause of potential nursing errors not mentioned in the article is understaffing. My RN sister’s intensive care unit expects as many as six nurses gone soon, from her shift alone. And the worse conditions are, the less likely even agency nurses will accept a position.

Do dedicated RNs stay levitra online purchase canada for the patients’ sake, or leave to protect themselves?. You can help both patients and nurses by supporting safe staffing legislation in your state. €” Gloria Kohut, Grand Rapids, Michigan — Sunny Ro, Philadelphia The Fallout of Prosecuting Medical Errors In the article “Nurse Convicted of Neglect and Negligent Homicide for Fatal Drug Error” (March 25), I found myself reflecting on my future nursing career.

Although it see this site is clear RaDonda Vaught was guilty of a levitra online purchase canada medication error that led to the death of a patient, I can sympathize. The hateful public ridicule she has been given and the defaming comments from the prosecutors regarding her nursing character being “uncaring … and abandoning her patient” are alarming. It creates an alternative narrative of what has taken place, and that is that Vaught intentionally harmed a patient, not accidentally.

Reporting any type of medical error levitra online purchase canada whether it is small or large is crucial in identifying safety issues in nursing care and, with the handling of the Vaught case, some nurses may feel that admitting to a mistake can cost them their job and/or their life. To build progress toward improving health care delivery, the handling of medical errors should be judged fairly, and without shaming nurses who have dedicated their lives to protecting and healing patients. As stated in the article, “Health care just changed forever,” and this creates an environment of fear and mistrust, and an unsupportive system for nurses to come.

€” Katarina Velardez, San Francisco levitra online purchase canada Be frightened. For those of you involved in making medical care safer and more reliable, a recent prosecution of a nurse for a medical error may set our efforts for "Just Culture" back a few decades. We learn, not blame.

@AAPneonatal @D8Neonatal https://t.co/NpWqS5gfBh— james barry (@skideepowder) April 1, 2022 — James Barry, Denver I am saddened levitra online purchase canada that with all the efforts made to advance patient safety that RaDonda Vaught was prosecuted versus Vanderbilt University Medical Center and/or the drug-dispensing vendor. We know that medication errors occur every day and we need to continuously work to reengineer things to make it hard to make an error. Having been a nurse for many years, I am appalled at the manipulation of calling nurses who work in challenging conditions heroes until something goes wrong.

This error was completely levitra online purchase canada understandable and predictable. First of all, after decades, why are these systems still not programmed to recognize both generic and brand names?. That alone would have prevented this medication error.

Secondly, as with all broken systems, when there were known dispensing issues with the drug-dispensing levitra online purchase canada system, why wasn’t Vanderbilt proactive?. If nurses needed to override the system routinely, why didn’t a patient-safety expert conduct an FMEA (failure mode event analysis) and remove all high-risk drugs from the drug-dispensing machine?. Vanderbilt has failed patients and nurses and should step up.

Without focusing on investigating what went wrong levitra online purchase canada and sharing the findings with other organizations, health care cannot learn. Vendors for these systems are also failing patients and nurses. Shouldn’t there be requirements by now for all searches on these systems to include both brand and generic drug names?.

We have created a distraction with this trial to levitra online purchase canada mistakenly help Americans feel safe. We removed this “bad” nurse, so we are safe now. The truth is patients are now less safe than before this verdict.

Nurses always live in fear levitra online purchase canada of making a mistake and causing harm. We struggle to continue to work in environments where our voices for patient safety are not heard and are silenced. This is a step backward for all of American health care in which medication errors remain the No.

1 type levitra online purchase canada of error. We have neglected to be transparent and learn how to prevent another nurse from making the same mistake. This has reaffirmed for me and other nurses that you will be asked to work yourself to exhaustion, give all your mental and physical strength and be called a hero so long as it benefits an organization or society, but when something goes wrong you will be unsympathetically discarded and made a villain.

How sad levitra online purchase canada. €” Carole Cassidy, Newtown Square, Pennsylvania She made a critical mistake, but is she deserving of serving time in prison?. Nurse Convicted of Neglect and Negligent Homicide for Fatal Drug Error https://t.co/8DjvYVrolr via @khnews— Garry Klein (@GarryfromIowa) April 6, 2022 — Garry Klein, Iowa City, Iowa A Family Caregiver’s Plea Another essential part of family caregivers should be a requirement for medical records to be able to be accessed by the family (“To Families’ Dismay, Biden Nursing Home Reform Doesn’t View Them as Essential Caregivers,” March 22).

I am the legal levitra online purchase canada guardian of my sister-in-law and have no access to her medical records. She is not capable of answering my questions accurately. I need to be able to see those records to monitor her levitra online purchase canada medications and follow what care is being provided.

It isn’t as if they don’t use computers. It would require no extra work on the staff’s part. And we should have also access levitra online purchase canada to the same info the staff sees.

Because I have no access to her records, it made no sense for me to continue to take her to her own doctor or psychiatrist because I can no longer answer the questions they ask about her activity and her health and eating. I visit twice a week and do some of the little things that the staff misses. There are times I suspect levitra online purchase canada a missed dose of medication or a medication change, but there is no way to know for sure.

I am considering moving her to a different facility for this reason. I just think this is a vital part of including family, especially if they have guardianship. €” Theresa levitra online purchase canada Smith, St.

Joseph, Missouri Really?. There is nothing "informal" about family caregiving. Family/close friends are the levitra online purchase canada most trusted allies &.

Care coordinators for residents of LTC facilities. They are essential to the well-being of vulnerable older adults. Https://t.co/TI60SRGrmR via @khnews— Lynn Friss Feinberg (@FeinbergLynn) March 22, 2022 — Lynn levitra online purchase canada Friss Feinberg, Washington, D.C.

Concerns About an Autism Therapy I’m concerned about the article “Delays for Autism Diagnosis and Treatment Grew Even Longer During the levitra” (March 30) because it does not include any input from an actually autistic adult and it supports ABA [applied behavioral analysis] therapy as the gold standard for autism treatment, a theory dethroned by several recent studies. I was recently diagnosed as autistic as an adult and have done thousands of hours of research on what is the best treatment for myself and an underage family member under my care. ABA is extremely expensive and time-consuming and not proved effective, according to levitra online purchase canada a recent study by the Department of Defense, and could be actively harmful to children receiving the therapy.

In addition, the therapy practice is ethically questionable, as it was founded by Ole Ivar Lovaas — yes, the same guy who founded gay conversion therapy. And forcing an autistic kid to “convert” to looking “normal” is equally harmful. Therapies that should be recommended for recently diagnosed children should be occupational therapy, to determine sensory issues and a sensory routine to levitra online purchase canada support those needs.

Speech therapy (if needed). And training in the collaborative problem-solving method by Dr. Ross Greene levitra online purchase canada.

For more expert knowledge than mine on the harms of ABA, see the work of the Therapist Neurodiversity Collective. Thank you for your attention. €” Andrea Hebert, Nashville, Tennessee You know whats more heartbreaking for parents who have children with levitra online purchase canada autism?.

Nothing will be done to help them at all. They were abandoned, and CNN article is a fake concern considering they incited lockdowns and erectile dysfunction treatment hysteria.https://t.co/QcgoA9rZhA— Ndee -Jkid- Okeh (@Jkid4) March 29, 2022 — Ndubuisi Okeh, Capitol Heights, Maryland More on treatments and erectile dysfunction treatment Transmission As one of your readers, I value your overall mission. I am writing with concern about the article by Aaron Bolton, called levitra online purchase canada “Patients With Vulnerable Immune Systems Worry treatment Exemptions May Put Them in Peril” (March 22).

The premise of the article is that unvaccinated health care workers are putting patients at risk, ignoring the widely acknowledged fact that vaccination does not prevent, or even reduce, transmission. I would expect greater diligence in demanding objectivity from your featured authors, rather than perpetuating fear-based claims that unfairly target those front-line workers who have been working overtime for the health of the public. This article offers information on the transmission of erectile dysfunction treatment that may help inform levitra online purchase canada which pieces you choose to run in the future.

€” Hannah Miller, Missoula, Montana — Barbara Katz-Chobert, Philadelphia Removing the Stigma of Miscarriage I am a student nurse at California State University-East Bay and am writing regarding the article “After Miscarriages, Workers Have Few Guarantees for Time off or Job-Based Help” (Jan. 26). I would like to start levitra online purchase canada off by simply saying thank you.

You discussed a topic that has gone ignored for so long. It is disheartening to read that not even half of our country has enacted laws that provide paid sick leave for miscarriages. My hope is that articles like yours will allow us to have deeper, meaningful, and destigmatized discussions about miscarriages — and, more so, to acknowledge the emotional, mental, and physical impact on anyone who may have experienced levitra online purchase canada such loss.

€” Catherine Zelidon-Sarcos, Pittsburg, California Excellent essay on how we can honor women in the workplace. If we want more kids, then we have to value women at work.After Miscarriages, Workers Have Few Guarantees for Time Off or Job-Based Help | Kaiser Health News https://t.co/5oaNdqqAFR— dacortright🇺🇦 (@david_cort7) March 22, 2022 — David Cortright, Austin, Texas Countering the ‘Abortifacients’ Argument The morning-after pill and IUDs work by preventing conception, not by preventing implantation (HealthBent. €œAs Red States Push Strident Abortion Bans, Other Restrictions Suddenly Look levitra online purchase canada Less Extreme,” March 30).

The hormonal IUDs create a mucus plug that prevents the passage of sperm. Copper IUDs create a sterile inflammatory reaction that essentially neutralizes the ability of the sperm to penetrate the egg. Emergency contraception levitra online purchase canada pills prevent ovulation.

By perpetuating the anti-choice narrative that these methods work by preventing implantation, you are discouraging and stigmatizing their use. €” Amy O’Meara, Kamuela, Hawaii You cannot completely ban abortion, because the far-right can’t even agree on what an abortion is. 18 weeks, 6 weeks, conception, levitra online purchase canada birth control, masturbation, IVF.

Every new restriction opens the door to an even more draconian law. Https://t.co/0BUiRIC9xQ— Trojan Horse News (@realTHNews) March 30, 2022 — Kate Woods, Atlanta The Cost of Treating Troubled Kids The $400-plus-a-day average reimbursement per child equates to almost $148,000 a year. That seems like plenty to accommodate one of these children (“Montana Is Sending Troubled Kids to Out-of-State Programs That Have Been levitra online purchase canada Accused of Abuse,” March 25).

I also think the story glosses over the challenges that these children present to the schools. €” Mike Morgan, Bozeman, Montana — Ian O’Neil, Boston Before you write an article about out-of-state abuse and quote someone … “Shipping those kids out of state for treatment for behavioral and substance use disorders comes with a high price tag, and often the children’s issues are not resolved or are even worse, said Michael Chavers, CEO of Yellowstone Boys and Girls Ranch. €˜When they return to us, they return with worse outcomes and for higher cost,’ Chavers told Montana lawmakers last fall.” … you might want to levitra online purchase canada look at the background of the Yellowstone Boys and Girls Ranch, as it had to pay out $300,000 in a boy’s sexual abuse case in 2018.

Let’s clean up our backyard first. Do some research before throwing stones. The author of the article should have done better research on the business or people they were using as “experts.” Shame on YBGR and Chavers for making comments as if they are levitra online purchase canada without problems.

€” Kim Hover, Stevensville, Montana Embracing Personalized Medicine In the article “Big Pharma Is Betting on Bigger Political Ambitions From Sen. Tim Scott” (March 28), KHN describes the Personalized Medicine Coalition and its work inaccurately for a second time (see also “A Senator From Arizona Emerges As a Pharma Favorite,” May 29, 2020). PMC, a 501(c)(3) nonprofit organization comprising 14 distinct stakeholder groups within health care, with the largest segment made up of “research, education, and clinical care institutions,” is not a trade association and does not represent any single levitra online purchase canada industry or business model.

Moreover, your implication that personalized or precision medicine jacks up the costs of pharmaceutical products misses the mark. Its goal, in addition to promising better outcomes for patients, is to lower systemic costs for health care by making it more efficient. Personalized medicine levitra online purchase canada has been shown to save health systems money while improving patient care.

The Teachers’ Retirement System of the state of Kentucky, for example, has found that integrating genetic testing into prescribing decisions saved the system $5,176 per enrolled member by targeting treatments to only those patients who will benefit, sparing expenses and side effects for those who will not. For cancer patients, Intermountain Healthcare has also found that genomic testing can lengthen progression-free survival rates without increasing costs. Sen.

Scott may or may not have his eye on higher office, but he is correct that we could do a lot worse than embrace personalized medicine. €” Edward Abrahams, president of the Personalized Medicine Coalition, Washington, D.C. The Long Arm of Big Pharma I just learned about your website, thanks to a recent daily current events analysis done by American history professor Heather Cox Richardson, which cited a link to the amazing webpage providing insight into Big Pharma’s deep-pocket reach into Congress.

I have nothing but admiration and appreciation for the work that went into making such a page. And I say that despite the unfortunate personal surprise and bummer it was to see my congressman listed prominently as the “Freshman Favorite,” Rep. Frank J.

Mrvan. Living here in Indiana means Eli Lilly has always had an outsize influence on societal affairs. So the fact that it is at the very top of his list of pharma donors is not surprising.

But then there were all the other pharma companies underneath Eli Lilly — an eyebrow-soaring number, actually. Because the dates go back to 2007, I had been hoping to compare his reputation against his predecessor for this district, Pete Visclosky. The man was highly esteemed and as such remained incumbent here since I can remember, at least since I was in high school in 2000.

I hope your project can fill in data on predecessor representatives. It would help folks like me contextualize just how much pharma donations may have already been a problem. The underlying reality is that each individual receiving donations does so on behalf of a particular office — therefore, my interests as a citizen are aggressively bought out.

I’d like to know if my say with my previous congressional representative was diluted at all. Particularly when it comes to certain personal aspects of the pharmaceutical industry, like the $16,000-a-month medication that kept my mother alive for a while longer in her years-long fight against cancer, which she maintained until one day she couldn’t anymore. (Without the Affordable Care Act’s insurance having “arrived in time” for her finding a lump and being diagnosed, our ability to afford such a treatment would have been nonexistent.) In other words.

I would very much appreciate the possibility to know how angry and resentful, and therefore politically active, I should be when it comes to the donation-driven influence pharma has had on this small bit of democracy assigned to me, my family, my friends, and my home community by and large. Thanks again for the outstanding work. It is very, very appreciated!.

— Tomas Feher, Chesterton, Indiana — Dr. George Monks, Tulsa, Oklahoma Combating Congenital Syphilis It’s heartbreaking, yet unsurprising, that the rates of congenital syphilis are increasing in the U.S. (“Babies Die as Congenital Syphilis Continues a Decade-Long Surge Across the US,” April 12).

Public health departments are underfunded and reproductive rights have been under attack for many years, especially since Donald Trump’s presidency. The defunding of clinics, like Planned Parenthood, due to anti-abortion legislation across the country, also means that many people seeking STD screening and treatment are losing places to do so. As a birth worker in Los Angeles, I witnessed firsthand how lack of access to health care impacts communities of color through structural racism.

It is unacceptable that babies are dying from a totally treatable illness, due to a lack of staff and resources to help pregnant people with syphilis receive the diagnosis and treatment they need. Just as we had to get creative during the levitra, this health problem requires creative solutions, partnership, and technology. How great would it be if a patient could receive their STD results and directories of places to pick up medications to get treatment, just as they can with erectile dysfunction treatment.

A solution must be found quickly. The health and well-being of babies, especially babies of color who are being affected at higher rates, depends on it. €” Candy Ramirez-Hale, Oakland, California Related Topics Contact Us Submit a Story TipCan’t see the audio player?.

Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Click here for a transcript of the episode.

It’s been extra busy on the health policy beat lately, so a congressional recess provides a chance to explore some of the important stories that people might have missed, like Medicare’s decision to dramatically limit coverage of Aduhelm, the controversial new drug to treat Alzheimer’s disease. And even with Congress out, states are rushing to either restrict or expand access to abortion, ahead of a key Supreme Court ruling expected later this spring or summer. This week’s panelists are Julie Rovner of KHN, Margot Sanger-Katz of The New York Times, Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, and Alice Miranda Ollstein of Politico.

Among the takeaways from this week’s episode. The decision by the Centers for Medicare &. Medicaid Services to limit Medicare’s coverage of Aduhelm only to beneficiaries who also enroll in clinical studies of the new Alzheimer’s drug came despite intense pressure from patients and advocacy groups who are frustrated by the lack of new therapies for this devastating disease.

But the federal agency also appears to have been swayed by arguments by some researchers and public health experts that the earlier research on the drug was faulty.The dust-up over Medicare coverage for Aduhelm points to a source of tension in the U.S. Health system. Different government agencies have overlapping authorities.

This dispute is between the FDA, which approved the drug despite serious questions about its effectiveness and safety, and CMS, which had to decide whether to cover the cost of a very controversial drug that is also very expensive. But similar tensions also have played out between the FDA and the Centers for Disease Control and Prevention over erectile dysfunction treatment schedules and eligibility.A recent Bloomberg report looked at concerns that the federal government is overpaying for beneficiaries enrolled in private Medicare Advantage plans. More progressive Democratic members of Congress have long complained about this, but Republicans are strong supporters of the Medicare Advantage program.Despite the complaints of some on the left about the excess funding of these Medicare plans, they have been growing.

That is, in part, because the traditional Medicare program has many holes and cost-sharing responsibilities that people with modest incomes are nervous about shouldering, and Medicare Advantage has become attractive to them. That has complicated the formerly partisan politics over the program.The Biden administration is reportedly in discussions with several states about setting up programs to import cheaper drugs from Canada. For the Democrats, this could be a strong campaign talking point — much like efforts on Capitol Hill to cap the price of insulin — about trying to help people with a serious pocketbook issue.

Drug prices have consistently been a consumer concern.However, it’s not clear whether Canada is interested in helping the U.S. With a drug import program and, even if it did, there’s no indication that the amount of drugs Canadians could provide would significantly influence prices in this country.Oklahoma’s governor has signed a bill that would make it a felony to perform an abortion, and Florida’s governor on Thursday approved a bill moving the limit for an abortion from 24 weeks to 15 weeks. As the country waits for the Supreme Court to rule on a case this summer that could overturn or weaken the landmark Roe v.

Wade decision, conservative states are racing to find ways to limit or ban abortions.If the Supreme Court does upend protections guaranteed under the Roe decision, it is unlikely that clinics in states that are preserving the right to an abortion will be able to fill the need.Yet even with the growing movement in conservative states, abortion-rights supporters were stunned this week when a Texas prosecutor filed murder charges against a woman who had an abortion. The charges, however, were quickly dismissed.The CDC this week released new data showing a rise in 2020 in the number of cases of gonorrhea and syphilis — likely the byproduct of less access to health care during the early stages of the levitra. Although the diseases can easily be cured with antibiotics, the public may not realize the need to seek medical care or the devastating consequences of letting the diseases go untreated.The CDC also reported that drug overdose deaths reached a record high last year.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too. Julie Rovner. Politico’s “Mice Occupy FDA Offices After Food Left Behind in levitra,” by David Lim and Lauren Gardner Margot Sanger-Katz.

Health Affairs’ “Many Medicare Beneficiaries Do Not Fill High-Price Specialty Drug Prescriptions,” by Stacie B. Dusetzina et. Al Joanne Kenen.

Vox’s “America Needs More Doctors and Nurses to Survive the Next levitra,” by Dylan Scott Alice Miranda Ollstein. Politico’s “Republicans See CDC’s Policy Change as ‘Massive Political Loser for Democrats,’” by Alice Miranda Ollstein and Krista Mahr Also discussed on this week’s podcast. Bloomberg’s “Major Insurers Are Scamming Billions From Medicare, Whistle-Blowers Say,” by John Tozzi KHN’s “Researcher.

Medicare Advantage Plans Costing Billions More Than They Should,” by Fred Schulte KHN’s “‘What the Health?. €™. The Drug Price Dilemma,” featuring Stacie B.

Dusetzina To hear all our podcasts, click here. And subscribe to KHN’s What the Health?. on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts.

Related Topics Contact Us Submit a Story Tip.