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€œTrump is pushing to slash Medicare viagra 100mg price benefits.”— Digital and TV campaign ad, Oct. 9, 2020 This story was viagra 100mg price produced in partnership with PolitiFact. This story can be republished for free (details). It’s a tried-and-true campaign strategy.Candidates go on the attack, claiming their opponent will do harm to Medicare. After all, people 65 and older are viagra 100mg price good about making it to the polls on Election Day. These voters are also generally motivated to protect the federal health insurance program for seniors.It’s no surprise, then, that in an ad released this month, former Vice President Joe Biden’s campaign played the Medicare card.“Donald Trump is lying about Medicare and Social Security,” an ominous, mature, male voice warns viewers in the ad.

He goes on to say that “Trump’s pushing to viagra 100mg price slash Medicare benefits.”Clearly, we’ve heard this dire message before — from candidates of both parties through the years. Email Sign-Up Subscribe to KHN’s free Morning Briefing. We issued a skeptical rating of a claim that Trump promised to gut Social Security and Medicare if re-elected, noting that his deferral of payroll viagra 100mg price taxes did not mention Medicare at all. But Trump has not mentioned cuts to Medicare benefits on the trail, and he’s promised to make cuts to the program in the future. So what viagra 100mg price is Biden’s claim talking about?.

As a rationale for the statement, a Biden campaign spokesperson pointed us to the Trump administration’s support of Republicans’ efforts in a court case, California v. Texas, which seeks to overturn the Affordable Care Act viagra 100mg price. But the ad does not include any reference or explanation of how the case would affect Medicare benefits.The legal challenge, brought by a group of Republican attorneys general, is pegged to the 2017 tax bill, which zeroed out the tax that functioned as a penalty for not having health coverage — known as the individual mandate. Without this linchpin tax, the Republicans viagra 100mg price argue, the entire law should be struck down. They based that on the Supreme Court decision in 2012 that the law was constitutional because the penalty was a valid use of Congress’ ability to levy taxes.In the current case, lower courts have found the law unconstitutional, and a group of Democratic attorneys general appealed to the Supreme Court.Oral arguments are scheduled for Nov.

10. The Trump administration filed a brief in support of invalidating the entire law unconstitutional.Though best known for its vast expansion of health coverage through marketplace plans and Medicaid, the ACA also included a range of consumer protections — such as the ban on discrimination against people with preexisting conditions — and an estimated 165 Medicare-related provisions.The Biden spokesperson pointed to one, which ended Medicare’s so-called doughnut hole.We asked experts for their take. Immediately, we found differences in opinion.That’s a “perfectly fair claim,” said Nicholas Bagley, a professor at the University of Michigan Law School. Closing the doughnut hole matters to many people, he said.Case Western Reserve University law professor Jonathan Adler took a different view. The argument that Medicare would be affected “is a very aggressive reading of the filing in this case,” he said, referring to the Trump administration’s brief in support of nullifying the ACA.The next step seemed to be getting a better grasp of what’s at stake.A Quick Review of the Doughnut Hole, Other Medicare ProvisionsThe Medicare doughnut hole refers to the gap in Part D prescription drug coverage that begins after a beneficiary spends a set amount — usually a few thousand dollars.

Before the ACA, beneficiaries who reached that threshold were responsible for 100% of their medication costs until they spent enough for catastrophic coverage to kick in, which could be more than $1,000 in additional spending. Even with this coverage, beneficiaries were responsible for 5% of their drug expenditures. (If beneficiaries were responsible for 100% of costs today, people with high drug costs would obviously pay a lot more without the ACA provision.)The ACA would have gradually ended that coverage gap. But, in 2018, Congress adopted changes to expedite the process. As of 2019, the doughnut hole was closed.

Adler pointed to that congressional intervention as a step that could keep the doughnut hole closed if the ACA were overturned. Based on this legislative history, the argument could be made that closing the coverage gap was something Congress had an interest in apart from the ACA. Since the doughnut hole is officially closed, some analysts said this provision may not be vulnerable to the upcoming Supreme Court decision on the ACA. Sources: Biden campaign ad “Clear Choice,” released Oct. 9, 2020Email exchanges with Biden campaign spokesperson, Oct.

12, 2020Telephone interview, email correspondence with Tricia Neuman, KFF senior vice president and executive director of the KFF’s program on Medicare policy, Oct. 13, 2020Telephone interview with Nicholas Bagley, professor at the University of Michigan Law School, Oct. 15, 2020Telephone interview with Jonathan Adler, professor at the Case Western Reserve University School of Law, Oct.16, 2020Telephone interview with Paul Van de Water, senior fellow at the Center on Budget and Policy Priorities, Oct. 19, 2020Telephone interview with David Lipschutz, associate director of the Center for Medicare Advocacy, Oct. 20, 2020Telephone interview with Gail Wilensky, senior fellow at Project Hope, Oct.

20, 2020Medicare.gov, accessed Oct. 12KFF, Closing the Medicare Part D Coverage Gap. Trends, Recent Changes, and What’s Ahead, Aug. 21, 2018National Committee to Preserve Social Security and Medicare, Overturning the ACA Would Harm Medicare, June 29, 2020Center on Budget and Policy Priorities, Striking Down ACA Would Weaken Medicare, July 8, 2019KHN, Without Ginsburg, Judicial Threats to the ACA, Reproductive Rights Heighten, Sept. 21, 2020KHN, Doughnut Hole Is Gone, But Medicare’s Uncapped Drug Costs Still Bite Into Budgets, March 29, 2019U.S.

Census Bureau, Voter Turnout Rates Among All Voting Age and Major Racial and Ethnic Groups Were Higher Than in 2014, April 23, 2019U.S. Census Bureau, Voting in America. A Look at the 2016 Presidential Election, May 10, 2017Statista, Voter Turnout Rates* Among Selected Age Groups in U.S. Midterm Elections From 1966 to 2018, July 10, 2020U.S. News &.

World Report, Why Older Citizens Are More Likely to Vote, Oct. 5, 2020KFF, Health Tracking Poll — October 2020. The Future of the ACA and Biden’s Advantage on Health Care, Oct. 16, 2020State of California, et al., Petitioners v. State of Texas, et al., Brief for the Federal Respondents, June 25, 2020AARP, AARP Foundation, Center for Medicare Advocacy and Justice in Aging, Brief of Amici Curiae in Support of Petitioners in No.

19-840 and Non-Executive Branch Respondents in No. 19-1019 “You can make a lot of claims,” said Gail Wilensky, a former head of the Centers for Medicare &. Medicaid Services. €œThat one is really a stretch.”Other ACA provisions tied to Medicare benefits seem more at risk, such as the one that mandated annual wellness visits and certain preventive services, such as mammograms, bone mass measurement for those with osteoporosis, and depression and diabetes screening, with no patient cost sharing.“It’s not clear that the administration actively supports any change to the Medicare benefits with the case before SCOTUS,” said Tricia Neuman, KFF senior vice president and executive director of the KFF’s program on Medicare policy. €œBut if they didn’t explicitly seek to wall off certain provisions, it is at least conceivable — though maybe not likely — that Medicare benefits in the ACA could be collateral damage.” (KHN is an editorially independent program of KFF.)According to an amicus brief filed by the AARP, the Center for Medicare Advocacy and Justice in Aging in 2016, an estimated 40.1 million Medicare beneficiaries received at least one preventive service and 10.3 million had an annual wellness visit with no copay or deductible.Other experts pointed to a troubling implication for Medicare.

The nullification of the ACA provisions related to costs and slowing the growth of the program’s spending. Those efforts had been credited with extending the solvency of the Health Insurance Trust Fund and slowing the growth in Medicare premiums.It “would impair the financial fitness” of the trust fund, said Paul Van de Water, a senior fellow at the Center on Budget and Policy Priorities.Trump “may not say it is his intent to slash Medicare benefits,” agreed David Lipschutz, associate director of the Center for Medicare Advocacy, but overturning the ACA entirely would “cause chaos writ large.” And, because of the program’s size, that chaos “would upend the financial markets and the entire health care system,” according to the brief filed by Medicare advocates.What Comes Next Is ComplicatedEnter the concept of severability. Many court watchers are quick to say the high court’s decision could go beyond upholding the entire law or declaring it unconstitutional. Instead, the justices could separate or sever parts of it not directly related to the zeroed-out tax penalty, the so-called individual mandate.Of course, the Trump administration argued in its brief that the interwoven nature of the ACA’s provisions demanded that the entire law be invalidated.“If you just go on that basis, they are not arguing for severability,” said Van de Water.But others point out another layer that warrants consideration.“Everyone who comments on this focuses on the administration’s argument for inseverability,” Adler said. But he said it was more complicated than that.The Trump administration’s position is “simultaneously that the entire ACA should be invalidated” and also that relief should be provided only where injury to the plaintiffs is shown.

(The administration defines the plaintiffs as the two individuals who signed on to the original challenge.)Another view is that this point in the administration’s argument is not clear-cut, mostly because it gives no hint as to which programs or provisions would fit into the category of harming the plaintiffs.Ultimately, the fate of the sweeping health law is in the hands of the Supreme Court.“Legal analysts didn’t anticipate the case getting as far as it has,” said Lipschutz.But “the White House threw its weight behind the lawsuit,” said Bagley, at the University of Michigan. €œSo, they own the consequences. Especially in the context of this presidential campaign.”Our RulingAn attack ad by the Biden campaign states that Trump is “pushing to slash Medicare benefits” and ties this charge to the administration’s position on the pending legal challenge to the ACA.The Biden campaign pointed to an ACA provision that sought to close the Medicare doughnut hole to support this claim. It may not be the best example, though, because some experts suggest it may not be as vulnerable as other parts of the law.Experts outlined a range of other Medicare provisions that either provided new benefits or shored up the program’s financial fitness. If the whole law were to be nullified, as the administration has advocated, these changes could also be erased — a step that would affect benefits and potentially cause premiums to rise.Overall, the Biden ad seems plausible, even though the link between Trump’s position on the legal challenge and its impact on Medicare benefits is less straightforward than in similar claims we have checked regarding preexisting conditions.We rate the claim Half True.

Related Topics Elections Medicare The Health Law KHN &. PolitiFact HealthCheck Trump AdministrationSOBRE NOTICIAS EN ESPAÑOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles). Molly Wiese estaba perpleja. Sus padres y hermanos viven en el sur de California, y Wiese, abogada de 35 años, ha viajado cada Navidad desde que se mudó a Minnesota en 2007.Por la pandemia, Wiese pensó que esta vez sería más prudente quedarse.

Pero en junio, el padre de Wiese fue diagnosticado con cáncer en estadio 4 y la familia teme que éstas sean sus últimas fiestas. ¿Debería volar con su esposo y sus dos hijos pequeños a California, poniendo a su padre inmunodeprimido en riesgo de erectile dysfunction treatment?. ¿O quedarse en casa y perderse la oportunidad de crear recuerdos de estas fiestas?. Sus hijos están en la guardería y el marido de Wiese trabaja en una escuela. No tienen suficiente tiempo de vacaciones para ponerse en cuarentena antes o después de un vuelo, y conducir ocho días de ida y vuelta está fuera de discusión.Teme transmitirle el erectile dysfunction a su padre.

Pero sus padres, que viven en la ciudad de Yucaipa de Inland Empire, creen que vale la pena correr el riesgo de ver a sus nietos y tener “nuestra Navidad normal”, contó Wiese.“Idealmente, tendríamos una vacuna”, dijo. €œPero no creo que sea una expectativa realista”. Pfizer, el aparente líder en la carrera para una vacuna contra erectile dysfunction treatment, dice que ni siquiera estará listo para solicitar la aprobación hasta fines de noviembre, como muy pronto.El padre de Molly Wiese tiene cáncer avanzado y Wiese teme que ésta sea su última temporada de fiestas. Pero duda en viajar al sur de California para visitar a su familia, por temor de ponerlo en riesgo de contraer erectile dysfunction treatment. De izquierda a derecha.

Molly Wiese, su hijo Calvin, su esposo Phil Wiese, su hijo Bennett, y sus padres, Becky y Bill Miller. (Molly Wiese)Si bien el enigma de Wiese es especialmente importante, su historia ilustra la difícil decisión a la que se enfrentan millones de estadounidenses sobre si viajar o no durante las vacaciones de invierno, y cómo hacerlo.La mejor forma de evitar la propagación de enfermedades sería evitar los viajes o ampliar los círculos sociales. Para las celebraciones locales, la cuarentena durante dos semanas antes de un evento festivo minimizaría el riesgo, pero solo si todos los comensales se comprometieran a seguirla. Pero algunas personas tienen que trabajar fuera de casa.Después de al menos siete meses de estar prácticamente encerrados, las vacaciones de invierno representan una tentación casi insuperable. Incluso expertos en salud pública y enfermedades infecciosas reconocen el dilema.“Hay mucho que ganar con el contacto físico, en la misma sala y no en una pantalla de Zoom o FaceTime”, dijo el doctor Peter Chin-Hong, especialista en enfermedades infecciosas y profesor de medicina en la Universidad de California-San Francisco.El doctor Anthony Fauci, la autoridad nacional en enfermedades infecciosas en los Institutos Nacionales de Salud, no es inmune al problema.

El 13 de octubre, le dijo a “The World” que él y sus tres hijas adultas, que viven en distintos estados, todavía estaban decidiendo si estar juntos “valdría la pena”.Al día siguiente, Fauci le dijo a “CBS Evening News” que la reunión de Acción de Gracias de su familia estaba cancelada, dados los riesgos que plantean los vuelos. €œPuede que tenga que sacrificar esa reunión social, a menos que esté bastante seguro de que las personas con las que está tratando no están infectadas”, dijo.El doctor Robert Redfield, director de los Centros para el Control y Prevención de Enfermedades (CDC), y la doctora Deborah Birx, coordinadora del equipo de respuesta a erectile dysfunction treatment de la administración Trump, advirtieron que las reuniones de Thanksgiving podrían propagar el viagra.En California, funcionarios de salud pública están adoptando un enfoque de “reducción de daño”. No están fomentando las reuniones de varias familias, pero han emitido pautas para hacer que las reuniones sean más seguras si se realizan al aire libre y duran menos de dos horas.Funcionarios del condado de Los Ángeles, que ha visto un aumento en las tasas de transmisión en las últimas semanas, publicaron una guía similar, reconociendo que las personas separadas de sus seres queridos durante meses anhelan cada vez más ese contacto.“Estamos tratando de encontrar un balance, pero creo que es apropiado que intentemos llevar a cabo algunas de las actividades que la gente está desesperada por poder hacer, con total apego a la guía”, dijo Barbara Ferrer, directora de del departamento de salud pública del condado, en una conferencia de prensa el 14 de octubre.En todo el mundo, los feriados nacionales han impulsado la propagación de erectile dysfunction treatment de manera explosiva. En China, donde comenzó la pandemia, se estima que 5 millones de personas que viajaban por el Año Nuevo chino abandonaron Wuhan, el epicentro del brote, antes de que se promulgara una prohibición de viajar.En Irán, la pandemia se impulsó por Nowruz, una celebración de primavera de dos semanas durante la que viajan millones. En Israel, las fiestas y reuniones religiosas de Purim provocaron una transmisión generalizada a fines de marzo.Las celebraciones de Memorial Day, el 4 de julio y el Día del Trabajo impulsaron aumentos repentinos de casos en los Estados Unidos, por eso el Día de Acción de Gracias asusta a los funcionarios de salud pública.El año pasado, viajaron más de 55 millones de personas durante los días que rodearon ese cuarto jueves de noviembre.Sin embargo, funcionarios de todo el país están siendo suaves cuando se trata de advertencias.En Minnesota, donde vive Wiese y los casos están alcanzando niveles récord, funcionarios instan al público a evitar las tiendas abarrotadas y las grandes reuniones en interiores con varias familias.Pero dicen que las cenas de Acción de Gracias al aire libre con amigos y familiares locales son menos riesgosas.

Su guía no explica cómo tolerar un Día de Acción de Gracias al aire libre en Minnesota. La temperatura máxima promedio en Minneapolis el 26 de noviembre es de 33 grados.Michael Osterholm, director del Centro de Investigación y Política de Enfermedades Infecciosas de la Universidad de Minnesota, dice “paremos un poco”.Osterholm explicó que si no puedes ponerte en cuarentena durante 10 a 14 días antes del evento, es decir, sin contacto con personas además de los miembros de tu hogar que también están en cuarentena, no vayas a la cena de Acción de Gracias en otra casa. El estado ya ha visto demasiados ejemplos de personas vulnerables que se enferman y mueren después de asistir a bodas, funerales y cumpleaños.“Que este sea tu año erectile dysfunction treatment”, dijo Osterholm. €œEs un año muy desafiante, pero no quieres introducir este viagra en entornos familiares y experimentar las consecuencias”.Osterholm y su pareja pasarán el Día de Acción de Gracias y la Navidad sin familiares, a pesar de que sus hijos y nietos son todos locales. Debido a que todos sus nietos están en la guardería o en la escuela, no hay suficiente tiempo para que sus familias se pongan en cuarentena antes de disfrutar juntos de una comida navideña.Sintió empatía con la difícil situación de Wiese.

Si decide volar a California, dijo, debería acuartelar a su familia lo más posible durante 10 días antes, y luego no pasar más de dos días con su padre.“Incluso si se infectara, no sería más contagiosa hasta probablemente el tercer día”, dijo. €œEntonces, si ella pasa esos dos días con él, puede sentirse relativamente bien por el hecho de que no los puso en riesgo”.Para aquellos que viajan, conducir es mucho más seguro que volar porque los conductores pueden estar aislados en un compartimento doméstico y evitar la exposición al erectile dysfunction renunciando a los restaurantes y desinfectando las manijas del baño y la bomba de gasolina antes de tocarlos.El doctor Iahn Gonsenhauser, director de calidad y seguridad del paciente del Centro Médico Wexner de la Universidad Estatal de Ohio, dijo que planea conducir con su familia, pasando la noche en un hotel en el camino, para pasar el Día de Acción de Gracias con la familia de su hermana en Colorado.Él y su familia se mantienen aislados y trabajan desde casa tanto como sea posible, dejando la casa solo para compras y mandados básicos mientras evitan restaurantes y centros comerciales, dijo. Si alguien en cualquiera de las familias comenzara a mostrar síntomas de erectile dysfunction treatment, o confirmara la exposición a una persona con erectile dysfunction treatment positivo, todo el viaje se cancelaría instantáneamente.“Es por eso que hacemos todos los planes con una reserva reembolsable”, dijo. €œSi las personas no tienen forma de salirse de sus reservas, están más inclinadas a tomar un riesgo aparente”.Chin-Hong ofreció este consejo para los viajeros de vacaciones. Házte la prueba antes del vuelo para tu tranquilidad, compra boletos en un avión que deje los asientos del medio vacíos, usa máscaras N95 altamente protectoras y escudos faciales, y coloca las rejillas de ventilación individuales del avión directamente sobre cada miembro de la familia para romper las posibles partículas de viagra.

Y, por supuesto, lávate las manos con frecuencia.Chin-Hong está adoptando ese enfoque en un viaje familiar planificado a la ciudad de Nueva York para visitar a su madre, que tiene más de 80 años y quiere ver a su hijo, nuera y nietos. Cada visita podría ser la última, dijo Chin-Hong.“Para mí, la relación riesgo-beneficio apoya la idea ir a verla”.Después de escuchar los consejos de Chin-Hong y otros expertos en enfermedades infecciosas, Wiese decidió el fin de semana pasado comprar boletos de avión para visitar a sus padres.“Realmente nos ayudó a tomar una decisión que me estaba dando mucha ansiedad”, expresó. Anna Almendrala. aalmendrala@kff.org, @annaalmendrala Related Topics Noticias En Español Public Health States erectile dysfunction treatment Latinos“They have 180 million people, families under what he wants to do, which will basically be socialized medicine — you won’t even have a choice — they want to terminate 180 million plans.”President Donald Trump during the presidential debate, Oct. 22, 2020 During the final presidential debate, President Donald Trump claimed that 180 million people would lose their private health insurance to socialized medicine if the Democratic presidential nominee, former Vice President Joe Biden, is elected president.“They have 180 million people, families under what he wants to do, which will basically be socialized medicine — you won’t even have a choice — they want to terminate 180 million plans,” said Trump.Trump has repeated this claim throughout the week, and we thought the linkage of Biden’s proposed health care plan with socialism was something we needed to check out.

Especially since Biden opposed “Medicare for All,” the proposal by Sen. Bernie Sanders (I-Vt.) that would have created a single-payer health system run completely by the federal government, and has long been attacked by Republicans as “socialist.” Email Sign-Up Subscribe to KHN’s free Morning Briefing. The Trump campaign did not respond to our request asking where the evidence for this claim came from. Experts called it a distortion of Biden’s plan.Where the Number Comes FromExperts agreed the number of people who have private health insurance either through an employer-sponsored plan or purchased on the Affordable Care Act’s health insurance marketplace is around 180 million people.KFF, a nonpartisan health policy organization, estimated in 2018 that about 157 million Americans had health insurance through their employer, while almost 20 million had insurance they purchased for themselves. Together, that adds up to about 177 million with private health insurance.

(KHN is an editorially independent program of KFF.)What Does Biden Support?. Biden supports expanding the ACA through several measures, including a public option. Under his plan, this public option would be a health insurance plan run by the federal government that would be offered alongside other private health insurance plans on the insurance marketplace.“The marketplace is made up of multiple insurers in areas,” said Linda Blumberg, a health policy fellow at the Urban Institute. €œSometimes there are five or more [plans]. Sometimes there is only one.

Biden is talking about adding a public option in the marketplace. You could pick between these private insurers or you could pick the public option.”Getting rid of the so-called employer firewall is also part of Biden’s proposal.This firewall was implemented during the rollout of the ACA. It was designed to maintain balance in the insurance risk pools by preventing too many healthy people who have work-based coverage from opting instead to move to a marketplace plan. And it all came down to who qualified for the subsidies that made these plans more affordable.Currently, those who are offered a health insurance plan through their employer that meets certain minimum federal standards aren’t eligible to receive these subsidies, which come in the form of tax credits. But that leaves many low-income workers with health care plans that aren’t as affordable or comprehensive as marketplace plans.Biden’s plan would eliminate that firewall, meaning anyone could choose to get health insurance either through their employer or through the marketplace.

That’s where many Republicans argue that we could start to see leakage from private health insurance plans to the public option.“The problem is healthy people leaving employer plans,” said Joseph Antos, a scholar in health care at the conservative-leaning American Enterprise Institute. That could mean the entire workplace plan’s premiums would go up. €œYou could easily imagine a plan where it spirals, the premiums go up, and then even more people start leaving the plans to go to the public option.”Blumberg, though, said that because the marketplace would still include private health insurance plans alongside the public option, it doesn’t mean everyone who chooses to leave their employer plan would go straight to the public option.She has done estimates based on a plan similar to the one Biden is proposing. She estimates that only about 10% to 12% of Americans would choose to leave their employer-sponsored plans, which translates to about 15 million to 18 million Americans. Source List: Email interview with Cynthia Cox, vice president and director for the Program on the ACA at KFF, Oct.

22, 2020Email interview with Larry Levitt, executive vice president for health policy at KFF, Oct. 22, 2020Email interview with Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, Oct. 22, 2020KFF, “Health Insurance Coverage of the Total Population,” Accessed Oct. 22, 2020KFF, “Affordability in the ACA Marketplace Under a Proposal Like Joe Biden’s Health Plan,” Sept. 28, 2020Phone interview with Joseph Antos, Wilson H.

Taylor resident scholar in health care and retirement policy at the American Enterprise Institute, Oct. 22, 2020Phone interview with Linda Blumberg, institute fellow in the Health Policy Center at the Urban Institute, Oct. 22, 2020Rev.com, “Donald Trump &. Joe Biden Final Presidential Debate Transcript 2020,” Accessed Oct. 23, 2020Twitter, Donald Trump tweet, Oct.

21, 2020Urban Institute, “The Healthy America Program, an Update and Additional Options,” Sept. 2019Urban Institute, “From Incremental to Comprehensive Health Insurance Reform. How Various Reform Options Compare on Coverage and Costs,” Oct. 2019 KFF also did an estimate and found that 12.3 million people with employer coverage could save money by buying on the exchange under the Biden plan.But “it’s not clear all of those people would choose to leave their employer coverage, though, as there are other reasons besides costs that people might want to have job-based insurance,” Cynthia Cox, vice president and director of the program on the ACA at KFF, wrote in an email.Either way, none of the estimates are anywhere close to the 180 million that Trump claimed.Is This Type of Public Option Socialism?. Overall, experts said no, what Biden supports isn’t socialized medicine.“Socialized medicine means that the government runs hospitals and employs doctors, and that is not part of Biden’s plan,” Larry Levitt, executive vice president for health policy at KFF, wrote in an email.

€œUnder Biden’s plans, doctors and hospitals would remain in the private sector just like they are today.”However, Antos said that, in his view, the definition of socialism can really vary when it comes to health care.“I would argue in one sense, we would already have socialized medicine. We have massive federal subsidies for everybody, so in that sense, we’re already there,” said Antos. €œBut, if socialized medicine means the government is going to dictate how doctors practice or how health care is delivered, we are obviously not in that situation. I don’t think the Biden plan would lead you that way.”And in the end, Antos said, invoking socialism is a scare tactic that politicians have been using for years.“It’s just a political slur,” said Antos. €œIt’s meant to inflame the emotions of those who will vote for Trump and meant to annoy the people who will vote for Biden.”Our Ruling Trump said 180 million people would lose their private health insurance plans to socialized medicine under Biden.While about 180 million people do have private health insurance, there is no evidence that all of them would lose their private plans if Biden were elected president.Biden supports implementing a public option on the health insurance marketplace.

It would exist alongside private health insurance plans, and Americans would have the option to buy either the private plan or the public plan. While estimates show that a number of Americans would likely leave their employer-sponsored coverage for the public plan, they would be doing that by choice and the estimates are nowhere near Trump’s 180 million figure.Experts also agree that the public option is not socialized medicine, and it’s ridiculous to conflate Biden’s plan with Medicare for All.We rate this claim Pants on Fire. Victoria Knight. vknight@kff.org, @victoriaregisk Related Topics Elections Insurance The Health Law KHN &. PolitiFact HealthCheck Obamacare Plans Private InsuranceIn the second and final debate of the 2020 presidential race, President Donald Trump and former Vice President Joe Biden sparred over Trump’s handling of the viagra and Biden’s plan to reform health care.

In stark contrast to the first debate, there was more policy talk. There was also less interrupting.Trump said a erectile dysfunction treatment is “ready” and will be announced “within weeks,” shortly before conceding that it is “not a guarantee.”Biden said Trump still has no comprehensive plan to deal with the viagra, even as case counts continue to climb. €œWe’re about to go into a dark winter, and he has no clear plan,” Biden said.Trump claimed Biden’s health care plan would lead to “socialized medicine,” conflating Biden’s proposal to introduce a government insurance option with more progressive proposals that would eliminate private insurance. €œI support private insurance,” Biden said, promising, “Not a single person with private insurance would lose their insurance under my plan.” Email Sign-Up Subscribe to KHN’s free Morning Briefing. You can read a full fact check for the evening, done in partnership with PolitiFact, here.Meanwhile, we broke down the candidates’ closing erectile dysfunction and other health-related claims so you can do your part.

Vote.Here are the highlights:Trump. €œWe are rounding the turn [on the viagra]. We are rounding the corner.”False.“Rounding the corner” suggests that significant and sustained progress is being made in the fight against the erectile dysfunction, and that’s not the case, according to the data.The number of erectile dysfunction treatment cases is climbing once again, after falling consistently between late July and mid-September. Cases are now at their highest point since early August, with almost 60,000 new confirmed s a day. That’s only about 10% lower than the peak in late July.New daily hospitalizations today are lower than in previous spikes, but in the past few weeks there has been a modest increase.

The positivity rate, which measures the percentage of tests that come up positive for the viagra, has also been going up again in the past few weeks. Higher positivity rates are an indicator of community spread.The one encouraging change is that, since a peak in August, deaths have fallen fairly consistently. That’s due to a combination of factors, including improved understanding of how to treat the disease. Yet erectile dysfunction treatment deaths have settled in at about 800 a day, keeping total deaths per week in the U.S. Above normal levels.Trump.

His administration has done “everything” Biden suggested to address erectile dysfunction treatment. €œHe was way behind us.”We rated a similar claim Pants on Fire. While there are some similarities between Biden’s and Trump’s plans to combat erectile dysfunction treatment, experts told us any viagra response plan should have certain core strategies. The Trump administration has released no comprehensive plan to battle the disease, except with regard to the development and distribution of treatments. Trump’s main intervention was implementing travel restrictions, while efforts to roll out a widespread testing plan faced difficulties.Biden released a public erectile dysfunction treatment plan.

The first draft was published March 12. It included public health measures such as deploying free testing and personal protective equipment, as well as implementing economic measures such as emergency paid leave and a state and local emergency fund.Trump. €œAs you know, 2.2 million people were expected to die. We closed the greatest economy in the world to fight this horrible disease that came from China.”His claim about the estimated deaths rates Mostly False. Trump frequently refers to this number to claim that his administration’s moves saved 2 million lives.

However, the number is from a mathematical model that hypothesized what would happen if, during the viagra in the U.S., neither people nor governments changed their behaviors, a scenario that experts considered unrealistic. The U.S. Has the highest death toll from erectile dysfunction treatment of any country, and one of the highest death rates. Also, credit for shutting down the economy doesn’t go primarily to Trump, but rather to states and local jurisdictions. In fact, Trump encouraged states to open back up beginning in May, even when there were high rates of erectile dysfunction treatment transmission in those areas.Trump.

€œWe cannot lock ourselves in a basement like Joe does.”We rated a similar claim False. It is one of Trump’s favored shots to say Biden isolated himself in his basement. In the first few months of the viagra, Biden did run much of his campaign from his Delaware home. He built a TV studio in his basement to interact with voters virtually. But that changed.In September alone, Biden gave remarks and held events in, among other places, Kenosha, Wisconsin.

Lancaster, Pennsylvania. Warren, Michigan. Tampa, Florida. And Charlotte, North Carolina. We counted 14 locations.Trump.

Said of Dr. Anthony Fauci, “I think he’s a Democrat, but that’s OK.”This is wrong. Fauci, director of the National Institute of Allergy and Infectious Diseases, is not affiliated with a political party. He hasn’t endorsed any parties or candidates.Biden. €œWe are in a circumstance where the president still has no plan, no comprehensive plan.”This is largely accurate.

When Biden claimed during the first debate that Trump “still won’t offer a plan,” we noted the Trump administration’s “Operation Warp Speed” for treatment development as well as its more detailed plan for treatment distribution. But the administration has not released a comprehensive plan to address erectile dysfunction treatment.Trump. €œThere was a spike in Florida. That is gone. There was a spike in Texas.

That is gone. There was a spike in Arizona. It is gone.” This is inaccurate. Over the summer, Florida, Texas and Arizona experienced record surges in cases that later eased — but now they are all seeing new surges. Over the past week, The New York Times’ tracker notes, as of Friday, new s are up 37% in Florida, 13% in Texas and 47% in Arizona, from the average two weeks earlier.Trump.

€œWhen I closed [travel from China], he said I should not have closed. €¦ He said this is a terrible thing, you are a xenophobe. I think he called me racist. Now he says I should have closed it earlier.”Mostly False. Joe Biden did not directly say he thought Trump shouldn’t have restricted travel from China to stem the spread of the erectile dysfunction.Biden did accuse Trump of “xenophobia” in an Iowa campaign speech the same day the administration announced the travel restrictions — Jan.

31 — but his campaign said that his remarks were not related and that he made similar comments before the restrictions were imposed. Biden didn’t take a definitive stance on the subject until April 3, when his campaign said he supported Trump’s decision to impose travel restrictions on China.Trump. €œThey have 180 million people, families under what he wants to do, which will basically be socialized medicine — you won’t even have a choice — they want to terminate 180 million plans.” Pants on Fire. About 180 million people have private health insurance. But there is absolutely no evidence that under Biden’s health care proposal all 180 million would be removed from their insurance plans.

Biden supports creating a public option, which would be a government-run insurance program that would exist alongside and compete with other private plans on the health insurance marketplace.Under Biden’s plan, even people with employer-sponsored coverage could choose a public plan if they wanted to. And estimates show that only a small percentage of Americans would likely leave their employer-sponsored coverage if a public option were available, and certainly not all 180 million. Experts said it is not socialized medicine.Biden. €œNot one single person with private insurance” lost their insurance “under Obamacare … unless they chose they wanted to go to something else.”This is inaccurate. This is a variation of a claim that earned President Barack Obama our Lie of the Year in 2013.

The Affordable Care Act tried to allow existing health plans to continue under a complicated process called “grandfathering,” but if the plans deviated even a little, they would lose their grandfathered status. And if that happened, insurers canceled plans that didn’t meet the new standards.No one determined with any certainty how many people got cancellation notices, but analysts estimated that about 4 million or more had their plans canceled. Many found insurance elsewhere, and the percentage was small — out of a total insured population of about 262 million, fewer than 2% lost their plans. However, that still amounted to 4 million people who faced the difficulty of finding a new plan and the hassle of switching their coverage.This story includes reporting by KHN reporters Victoria Knight and Emmarie Huetteman, and Jon Greenberg, Louis Jacobson, Amy Sherman, Miriam Valverde, Bill McCarthy, Samantha Putterman, Daniel Funke and Noah Y. Kim of PolitiFact.

Related Topics Elections Insurance Public Health The Health Law erectile dysfunction treatment KHN &. PolitiFact HealthCheck Obamacare Plans Private Insurance Trump AdministrationThis story also ran on MinnPost. This story can be republished for free (details). Molly Wiese was truly stumped. Her parents and siblings live in Southern California, and Wiese, a 35-year-old lawyer, has returned home every Christmas since she moved to Minnesota in 2007.Because of the viagra, Wiese thought it would be wiser to stay put for once. But in June, Wiese’s father was diagnosed with stage 4 cancer, and they feared this could be his final holiday season.Should she fly with her husband and two young sons to California, putting her immunocompromised father at risk of erectile dysfunction treatment?. Or stay home and miss out on making treasured holiday memories with her parents and children?.

Her children are in day care, and Wiese’s husband works at a school. They don’t have enough vacation time to self-quarantine before or after a flight, and driving eight days round trip isn’t practical.She fears giving her father erectile dysfunction. But her parents, who live in the Inland Empire city of Yucaipa, believe it’s worth the risk to see Wiese’s children and have “our normal Christmas,” she said.“Ideally, we’d have a treatment,” she said. €œBut I don’t think that’s a realistic expectation.” Pfizer, the apparent leader in the erectile dysfunction treatment race, says it won’t even be ready to apply for treatment approval until late November at the earliest.Molly Wiese’s father has late-stage cancer and she fears this could be his last holiday season. She struggled with whether she and her family should fly to Southern California to visit him for Christmas because she doesn’t want to put him at risk of contracting erectile dysfunction treatment.

From left. Molly Wiese, son Calvin, husband Phil Wiese, son Bennett, and Wiese’s parents, Becky and Bill Miller. (Molly Wiese)While Wiese’s conundrum is especially high-stakes, her story illustrates the tough decision millions of Americans are facing about whether and how to travel for the winter holidays.The best way to avoid spreading disease would be to avoid traveling or widening one’s social circles. For local celebrations, self-quarantining for two weeks before a holiday event would minimize risk if all those invited committed to doing the same. But some people have to work outside the home.For everyone, after at least seven months of being mostly sequestered, the winter holidays pose an almost insurmountable temptation.

Even public health and infectious disease experts recognize the dilemma.“There’s so much to be gained by physical touch, by being in that room and not in a two-dimensional Zoom or FaceTime screen,” said Dr. Peter Chin-Hong, an infectious disease specialist and professor of medicine at the University of California-San Francisco. €œAnd even to embrace, with the right preparation.”Dr. Anthony Fauci, the nation’s authority on infectious diseases at the National Institutes of Health, isn’t immune to the problem. He told PRI’s “The World” on Oct.

13 that he and his three adult daughters, each living in a different state, were still deciding whether being together would be “worth it.”The next day, Fauci told “CBS Evening News” that his family’s Thanksgiving reunion was off, given the risks posed by air travel. €œYou may have to bite the bullet and sacrifice that social gathering, unless you’re pretty certain that the people that you’re dealing with are not infected,” he said.Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, and Dr. Deborah Birx, the Trump administration’s senior coordinator in the erectile dysfunction treatment fight, have both warned that Thanksgiving gatherings could spread the viagra. Email Sign-Up Subscribe to KHN’s free Morning Briefing.

In California, public health officials are taking a “harm reduction” approach. They aren’t encouraging multi-household gatherings, but they’ve issued guidelines to make get-togethers safer if they happen outdoors and last less than two hours.Officials in Los Angeles County, which has seen transmission rates increase in recent weeks, released similar guidance, acknowledging that people separated from their loved ones for months increasingly yearn for that contact.“We are threading the needle here, but I think it is appropriate for us to try to do some of the activities that people are desperate to be able to do, with absolute adherence to the guidance,” Barbara Ferrer, director of the county’s public health department, said at an Oct. 14 news conference.Around the world, national holidays have fueled the spread of erectile dysfunction treatment in explosive ways. In China, where the viagra started, an estimated 5 million people traveling for Chinese New Year left Wuhan, the epicenter of the outbreak, before a travel ban was enacted. In Iran, the viagra was aided by Nowruz, a two-week spring celebration that prompted millions to travel.

In Israel, parties and religious gatherings for Purim caused widespread transmission in late March.Memorial Day, Fourth of July and Labor Day celebrations fueled surges in the United States, which is why Thanksgiving frightens public health officials. Last year, more than 55 million people were expected to travel during the days surrounding that fourth Thursday in November.Nevertheless, officials across the nation are using a light touch when it comes to warnings.In Minnesota, where Wiese lives and cases are hitting record highs, officials urge the public to avoid crowded stores and large indoor gatherings with other households, but say outdoor Thanksgiving dinners with local friends and family are less risky. Their guidance doesn’t explain how to endure an outdoor Thanksgiving in Minnesota. The average high in Minneapolis on Nov. 26 is 33 degrees.Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, is waving his hands to stop the game.If you can’t self-quarantine for 10 to 14 days before the event — that is, no contact with people besides members of your household who are also quarantining — don’t go to another household’s Thanksgiving dinner, he said.

The state has already seen too many examples of vulnerable people becoming sick and dying after attending weddings, funerals and birthday parties.“Let this be your erectile dysfunction treatment year,” Osterholm said. €œIt’s a very challenging year, but you don’t want to introduce this viagra into family settings and experience the consequences.”Osterholm and his partner will spend Thanksgiving and Christmas without extended family, even though their children and grandchildren are all local. Because all his grandchildren are in day care or school, there isn’t enough time for their families to self-quarantine before enjoying a holiday meal together.He was sympathetic to Wiese’s “compelling” plight. If she decides to fly to California, he said, she should sequester her family as much as possible for 10 days beforehand, then spend no more than two days with her father.“Even if she got infected, she wouldn’t be most infectious until probably day three,” he said. €œSo if she spends those two days with him, she can feel relatively good about the fact that she didn’t put them at risk.”For those who do travel, driving is much safer than flying because drivers can be isolated in a household pod and avoid exposure to the erectile dysfunction by forgoing restaurants and by disinfecting bathroom and gas pump handles before touching them.Dr.

Iahn Gonsenhauser, chief quality and patient safety officer for the Ohio State University’s Wexner Medical Center, said he plans to drive with his family — overnighting at a hotel on the way — to spend Thanksgiving with his sister’s family in Colorado.He and his family keep to themselves and work from home as much as possible, leaving the house only for groceries and basic errands while eschewing restaurants and malls, he said. If anyone in either family began showing erectile dysfunction treatment symptoms, or had confirmed exposure to a erectile dysfunction treatment-positive person, the whole trip would be called off instantly.“This is why we make all plans with a refundable reservation,” he said. €œIf people have no way of backing out of their reservations, they’re more inclined to push through an apparent risk.”Chin-Hong offered this advice for holiday flyers. Get tested before the flight for peace of mind, buy tickets on a plane that is leaving middle seats empty, use highly protective N95 masks and possibly face shields, and blast the individual airplane vents directly onto each family member to disrupt potential viagra particles. And, of course, wash your hands frequently.Chin-Hong is taking that approach on a planned family trip to New York City to visit his mother, who is in her 80s and wants to see her son, daughter-in-law and grandchildren.

Every visit they have could be their last, Chin-Hong said.“To me, the risk-benefit ratio really supports me going to see her.”After hearing the advice from Chin-Hong and other infectious disease experts, Wiese decided last weekend to buy plane tickets to visit her parents.“It really did help us make a decision that was giving me a lot of anxiety,” she said. Anna Almendrala. aalmendrala@kff.org, @annaalmendrala Related Topics Public Health States erectile dysfunction treatment.

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Runners at the 20th Aliferis Memorial RaceMidMichigan Health Foundation’s can you buy viagra Business Relations Committee hosted the 20th annual Aliferis Memorial Race on Saturday, Sept. 4. More than 165 cyclists, runners and walkers of all ages from the Alpena area and across the state turned out to participate in one or more of four events, including a half marathon. Individuals from all over Michigan enjoyed the event taking home awards, medals, and other prizes. All proceeds benefit the scholarship program, the Cancer Center and the Patient Tower project at MidMichigan Medical Center – Alpena.Drs.

Brendan and Leah Conboy and family served as the Honorary Race Chairs, passing out medals for top finishers in each event, as well as trophies for overall top performances. Drawings were also held for University of Michigan football tickets, apparel and race gear.Bikers at the 20th Aliferis Memorial RaceThe Aliferis Memorial Race was named in memory of longtime Alpena General Hospital Pathologist Peter Aliferis, M.D., in appreciation of his many contributions during his 37 years at the Medical Center and his steadfast dedication to health and wellness. Dr. Aliferis retired in July 2000 and passed away from cancer March 13, 2002.MidMichigan Health is offering a new training opportunity for individuals interested in becoming a phlebotomist. In collaboration with Mid Michigan College, beginning Monday, Sept.

20, 2021, MidMichigan Medical Center – Alpena will host a nine-week Mid Michigan College Phlebotomy Short-Term Training program.Phlebotomists are responsible for drawing blood, distributing samples to proper departments and preparing samples for diagnostic testing. Upon completion of the training program, students will be offered a part-time or full-time position as a phlebotomist at MidMichigan Health. With a two-year commitment, students will be reimbursed for all costs of the short-term training program, including tuition, fees and course materials.“Phlebotomists are an important part of our health care team,” said Colleen Markel, M.S.N., R.N., S.H.R.M.-C.P., director of talent acquisition and workforce development, MidMichigan Health. €œWe’re excited about partnering with Mid Michigan College to offer this unique opportunity to students, to help us fill a need in our health care system. The program will consist of traditional classroom instruction, combined with hands-on experience at one of MidMichigan’s labs.”The Phlebotomy Short-Term Training Program at Mid Michigan College is one of three programs in the state of Michigan accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS).Those who are interested in registering for the program may visit www.midmichigan.org/phlebreg..

Runners at the 20th Aliferis Memorial RaceMidMichigan Health Foundation’s Business Relations Committee hosted the linked here 20th annual Aliferis Memorial viagra 100mg price Race on Saturday, Sept. 4. More than 165 cyclists, runners and walkers of all ages from the Alpena area and across the state turned out to participate in one or more of four events, including a half marathon. Individuals from all over Michigan enjoyed the event taking home awards, medals, and other prizes.

All proceeds benefit the scholarship program, the Cancer Center and the Patient Tower project at MidMichigan Medical Center – Alpena.Drs. Brendan and Leah Conboy and family served as the Honorary Race Chairs, passing out medals for top finishers in each event, as well as trophies for overall top performances. Drawings were also held for University of Michigan football tickets, apparel and race gear.Bikers at the 20th Aliferis Memorial RaceThe Aliferis Memorial Race was named in memory of longtime Alpena General Hospital Pathologist Peter Aliferis, M.D., in appreciation of his many contributions during his 37 years at the Medical Center and his steadfast dedication to health and wellness. Dr.

Aliferis retired in July 2000 and passed away from cancer March 13, 2002.MidMichigan Health is offering a new training opportunity for individuals interested in becoming a phlebotomist. In collaboration with Mid Michigan College, beginning Monday, Sept. 20, 2021, MidMichigan Medical Center – Alpena will host a nine-week Mid Michigan College Phlebotomy Short-Term Training program.Phlebotomists are responsible for drawing blood, distributing samples to proper departments and preparing samples for diagnostic testing. Upon completion of the training program, students will be offered a part-time or full-time position as a phlebotomist at MidMichigan Health.

With a two-year commitment, students will be reimbursed for all costs of the short-term training program, including tuition, fees and course materials.“Phlebotomists are an important part of our health care team,” said Colleen Markel, M.S.N., R.N., S.H.R.M.-C.P., director of talent acquisition and workforce development, MidMichigan Health. €œWe’re excited about partnering with Mid Michigan College to offer this unique opportunity to students, to help us fill a need in our health care system. The program will consist of traditional classroom instruction, combined with hands-on experience at one of MidMichigan’s labs.”The Phlebotomy Short-Term Training Program at Mid Michigan College is one of three programs in the state of Michigan accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS).Those who are interested in registering for the program may visit www.midmichigan.org/phlebreg..

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Low grade intraventricular haemorrhage Cost of cialis at cvs and cerebral palsyNicky Hollebrandse and colleagues describe the neurodevelopmental outcomes at 8 years of almost 500 extremely preterm infants born how can i get viagra before 28 week’s gestation and relate these to the presence and severity of intraventricular haemorrhage (IVH) that was identified in the newborn period. It is particularly valuable that they achieved 91.4% follow-up of so many patients and to an age when assessments can be more detailed. When no IVH was identified, cerebral palsy was observed in 8% of the infants and impaired academic how can i get viagra ability in 16%.

With grade 1 and 2 IVH, cerebral palsy increased to 15% and 18% respectively, with no increase in the risk of impaired cognitive outcomes. With more severe IVH, risks of cerebral palsy and cognitive impairment increased further. Around 5% of the infants with grade 1 and 2 IVH developed cystic periventricular leukomalacia how can i get viagra (PVL) later.

The authors did not control for this and they considered it possible that IVH could be part of the causal pathway for this lesion. The infants did not have MRI scans. Later ultrasound how can i get viagra detectable PVL could account for some but not most of the observed cerebral palsy in infants with low grade IVH.

Nohaa Gorma and Stephen Miller highlight the prime importance of school age outcomes over earlier measures. They emphasise the need to investigate interventions during and beyond the neonatal period, including the social environment and how can i get viagra support provided to families, if we are to optimise the outcomes for these children. See pages F4 and F2Diffuse excessive high signal intensity (DEHSI) on term equivalent MRI scan is not predictive of later cognitive abnormality or cerebral palsyThere have been a number of papers in the journal recently looking at the relationship between MRI scan findings at term and outcome in preterm infants.

Chandra Prakash Rath and colleagues performed a meta-analysis of studies evaluating the significance of DEHSI. They included 1832 preterm infants who had MRI scans at how can i get viagra term equivalent age and assessments of cognitive ability and cerebral palsy using validated instruments. At 1 year of age or older.

DEHSI was common and was not a useful predictor of either cognitive outcome or cerebral palsy. See page F9Opaque wraps and pulse oximeter readingsPrakash Kannan Loganathan and colleagues investigated whether the use of an opaque wrap over the pulse oximeter probe affected the performance of the pulse oximeter in 96 clinically stable newborn how can i get viagra infants. They were interested in the speed with which the oximeter displayed valid data and the distribution of the SpO2 readings obtained.

They evaluated this for Masimo how can i get viagra and Nellcor oximeters. The use of the opaque wrap had no important effect on the performance of either oximeter type. For the study period the infants were monitored simultaneously using both a Nellcor and a Masimo oximter, permitting a comparison of the readings between the two devices as an interesting additional finding.

The mean SpO2 obtained with the Masimo how can i get viagra oximiter was 2.85% higher than the mean SpO2 simultaneously obtained with the Nellcor oximeter. The infants were clinically stable and this difference was observed when readings were typically in the low to mid 90 s. Both devices are providing an estimate of the arterial oxygen saturation and neither should be considered a gold standard over the other.

However a difference in the apparent calibration of the two devices of this magnitude demonstrated in a reasonably large comparison in the key region of clinical interest for newborn infants could have important clinical implications how can i get viagra as the devices are used interchangeably for a range of clinical indications related to specific SpO2 ranges. See page F57Preterm births during lockdownGitte Hedermann and colleagues were among the first to report observational data from the erectile dysfunction treatment lockdown period suggesting a reduction in the number of extremely preterm births. In comparison with the same time period during the preceding how can i get viagra 5 years there were significantly fewer extremely preterm deliveries in Denmark during lockdown, with no change in total deliveries.

Similar observations have been reported from elsewhere and raise questions about the contributing factors, which will be a rich source of new research as larger population datasets become available for analysis. Wouldn’t it be nice if slowing the pace of life for pregnant women is enough to improve pregnancy outcomes?. It is unlikely that the findings will be the same in all datasets because the degree of lockdown will be variable and how can i get viagra the extent to which important healthcare delivery is disrupted could have an adverse impact.

See page F93Fetal haemoglobin levels and bronchopulmonary dysplasiaWilliam Hellstrom and colleagues analysed the fetal haemoglobin (HbF) levels on almost 12 000 blood gas samples taken during the first week of life in 452 preterm infants born before 30 week’s gestation. They found that infants whose HbF levels fell the most during week one after birth were at highest risk of bronchopulmonary dysplasia (BPD). They also analysed arterial PO2 levels and these were significantly lower in the infants who developed BPD, suggesting that the observation does not relate to simply to how can i get viagra an effect mediated through changes in oxygenation.

They hypothesise that the higher falls in HbF reflect sampling losses and replacement by transfusion and that there is a loss of endogenous blood components that are essential for normal organ development, such as insulin-like growth factor 1. The authors are investigating the potential beneficial role of minimising the loss of endogenous blood components how can i get viagra in an ongoing multicentre randomised trial using microsampling methods to greatly reduce sampling losses. See page F88Bowel ultrasound in the management of necrotising enterocolitisKaren Alexander and Colleagues provide a comprehensive overview of the use of bowel ultrasound scanning in the investigation and management of infants with suspected or confirmed necrotising enterocolitis.

There are lots of images of key features and the article will be of value to anyone increasing their use of this technique or introducing it. See page F96Despite significant advances in perinatal and neonatal care, intraventricular haemorrhage (IVH)—bleeding from blood vessels within the germinal matrix of the developing brain into the ventricular system—continues to affect 15%–20% of very preterm neonates and 45% of those born extremely preterm (EP).1 More how can i get viagra than half of very preterm neonates will exhibit neurodevelopmental challenges as a consequence of IVH that range widely in severity across motor and cognitive domains.2 Such disabilities place a significant toll on affected children and their families, as well as on the education and healthcare system, highlighting the need for timely interventions in the neonatal intensive care unit (NICU) and beyond.The study reported by Hollebrandse et al3 assesses the relationship between IVH and neurodevelopmental outcomes at 8 years of age in children born EP, using a population-based sample of 546 EP neonates and 679 matched term-born controls. This cohort is distinguished by remarkably high follow-up rates from three different timepoints.

In their study, Hollebrandse et al raise three critical issues in the investigation of the impact of IVH on neurodevelopmental outcomes. First is the importance of the age at which neurodevelopmental assessment occurs and its implications to understanding the how can i get viagra long-term impacts of IVH. Second is the extent to which different grades of IVH contribute to the spectrum of neurodevelopmental outcomes.

Third is identifying interventions within NICU practice and postdischarge that can help mitigate the adverse impacts of IVH with attention to the timepoints at which these therapies are most supportive of neurodevelopmental outcomes.The age at which neurodevelopmental ….

Low grade intraventricular haemorrhage http://dandgparts.com/cost-of-cialis-at-cvs/ and cerebral palsyNicky Hollebrandse and colleagues describe the neurodevelopmental outcomes at viagra 100mg price 8 years of almost 500 extremely preterm infants born before 28 week’s gestation and relate these to the presence and severity of intraventricular haemorrhage (IVH) that was identified in the newborn period. It is particularly valuable that they achieved 91.4% follow-up of so many patients and to an age when assessments can be more detailed. When no IVH was identified, cerebral palsy was observed in 8% of the infants viagra 100mg price and impaired academic ability in 16%. With grade 1 and 2 IVH, cerebral palsy increased to 15% and 18% respectively, with no increase in the risk of impaired cognitive outcomes.

With more severe IVH, risks of cerebral palsy and cognitive impairment increased further. Around 5% of viagra 100mg price the infants with grade 1 and 2 IVH developed cystic periventricular leukomalacia (PVL) later. The authors did not control for this and they considered it possible that IVH could be part of the causal pathway for this lesion. The infants did not have MRI scans.

Later ultrasound detectable PVL could account for some but not viagra 100mg price most of the observed cerebral palsy in infants with low grade IVH. Nohaa Gorma and Stephen Miller highlight the prime importance of school age outcomes over earlier measures. They emphasise the need to investigate interventions during and beyond the neonatal period, viagra 100mg price including the social environment and support provided to families, if we are to optimise the outcomes for these children. See pages F4 and F2Diffuse excessive high signal intensity (DEHSI) on term equivalent MRI scan is not predictive of later cognitive abnormality or cerebral palsyThere have been a number of papers in the journal recently looking at the relationship between MRI scan findings at term and outcome in preterm infants.

Chandra Prakash Rath and colleagues performed a meta-analysis of studies evaluating the significance of DEHSI. They included 1832 preterm infants who had MRI scans at term equivalent age and assessments of cognitive viagra 100mg price ability and cerebral palsy using validated instruments. At 1 year of age or older. DEHSI was common and was not a useful predictor of either cognitive outcome or cerebral palsy.

See page F9Opaque wraps and pulse oximeter readingsPrakash Kannan Loganathan and colleagues viagra 100mg price investigated whether the use of an opaque wrap over the pulse oximeter probe affected the performance of the pulse oximeter in 96 clinically stable newborn infants. They were interested in the speed with which the oximeter displayed valid data and the distribution of the SpO2 readings obtained. They evaluated this for Masimo viagra 100mg price and Nellcor oximeters. The use of the opaque wrap had no important effect on the performance of either oximeter type.

For the study period the infants were monitored simultaneously using both a Nellcor and a Masimo oximter, permitting a comparison of the readings between the two devices as an interesting additional finding. The mean SpO2 obtained with the Masimo oximiter was 2.85% higher viagra 100mg price than the mean SpO2 simultaneously obtained with the Nellcor oximeter. The infants were clinically stable and this difference was observed when readings were typically in the low to mid 90 s. Both devices are providing an estimate of the arterial oxygen saturation and neither should be considered a gold standard over the other.

However a difference in the apparent calibration of the two devices of this magnitude demonstrated in a reasonably large comparison in the key region of viagra 100mg price clinical interest for newborn infants could have important clinical implications as the devices are used interchangeably for a range of clinical indications related to specific SpO2 ranges. See page F57Preterm births during lockdownGitte Hedermann and colleagues were among the first to report observational data from the erectile dysfunction treatment lockdown period suggesting a reduction in the number of extremely preterm births. In comparison with the same time period during the preceding 5 years there were significantly fewer extremely preterm deliveries in Denmark during lockdown, with no change in total deliveries viagra 100mg price. Similar observations have been reported from elsewhere and raise questions about the contributing factors, which will be a rich source of new research as larger population datasets become available for analysis.

Wouldn’t it be nice if slowing the pace of life for pregnant women is enough to improve pregnancy outcomes?. It is unlikely that the findings will be the same in viagra 100mg price all datasets because the degree of lockdown will be variable and the extent to which important healthcare delivery is disrupted could have an adverse impact. See page F93Fetal haemoglobin levels and bronchopulmonary dysplasiaWilliam Hellstrom and colleagues analysed the fetal haemoglobin (HbF) levels on almost 12 000 blood gas samples taken during the first week of life in 452 preterm infants born before 30 week’s gestation. They found that infants whose HbF levels fell the most during week one after birth were at highest risk of bronchopulmonary dysplasia (BPD).

They also analysed arterial PO2 levels and these were significantly lower in the infants who developed BPD, suggesting that the observation does not relate to simply to an effect mediated through changes in viagra 100mg price oxygenation. They hypothesise that the higher falls in HbF reflect sampling losses and replacement by transfusion and that there is a loss of endogenous blood components that are essential for normal organ development, such as insulin-like growth factor 1. The authors are investigating the potential beneficial role of minimising the loss of endogenous blood components in an ongoing multicentre viagra 100mg price randomised trial using microsampling methods to greatly reduce sampling losses. See page F88Bowel ultrasound in the management of necrotising enterocolitisKaren Alexander and Colleagues provide a comprehensive overview of the use of bowel ultrasound scanning in the investigation and management of infants with suspected or confirmed necrotising enterocolitis.

There are lots of images of key features and the article will be of value to anyone increasing their use of this technique or introducing it. See page F96Despite significant advances in perinatal and neonatal care, intraventricular haemorrhage (IVH)—bleeding from blood vessels within the germinal matrix of the developing brain into the ventricular system—continues to affect 15%–20% of very preterm neonates and 45% of those born extremely preterm (EP).1 More than half of very preterm neonates will exhibit neurodevelopmental challenges as a consequence of IVH that range widely in severity across motor and cognitive domains.2 Such disabilities place a significant toll on affected children and their families, as well as on the education and healthcare system, highlighting the need for timely interventions in the neonatal intensive care unit (NICU) and beyond.The study reported by Hollebrandse et al3 assesses the relationship between viagra 100mg price IVH and neurodevelopmental outcomes at 8 years of age in children born EP, using a population-based sample of 546 EP neonates and 679 matched term-born controls. This cohort is distinguished by remarkably high follow-up rates from three different timepoints. In their study, Hollebrandse et al raise three critical issues in the investigation of the impact of IVH on neurodevelopmental outcomes.

First is the importance of the age at which neurodevelopmental assessment occurs viagra 100mg price and its implications to understanding the long-term impacts of IVH. Second is the extent to which different grades of IVH contribute to the spectrum of neurodevelopmental outcomes. Third is identifying interventions within NICU practice and postdischarge that can help mitigate the adverse impacts of IVH with attention to the timepoints at which these therapies are most supportive of neurodevelopmental outcomes.The age at which neurodevelopmental ….

What is the difference between viagra and cialis

Why is it Going Here that birth is celebrated, what is the difference between viagra and cialis but death is taboo?. When a friend was expecting her first child, she needed additional support through her pregnancy, so she hired a birth doula. The idea of women helping other women during childbirth is not new.

Since the what is the difference between viagra and cialis beginning of time, women have labored and birthed at home, attended by a midwife and their female friends and kin. This camaraderie of women, once universal, was a way to provide birth support and also to pass on knowledge about pregnancy, childbirth and parenting. The natural birth movement of the 1960s begged a return to this approach with women demanding unmedicated, less interventional births.

Hence, the inception of the birth doula—a what is the difference between viagra and cialis nonmedical caregiver who assisted pregnant women in the transition to motherhood. Can the same idea apply to death?. The evolution of death care has followed a similar trajectory to that of childbirth care.

For most of human history, people were cared for and died at home, with corpses even displayed on the dining room table for what is the difference between viagra and cialis mourning. This began to change in the mid-20th century as society saw great advancements in medical technology for diagnosis and treatment of illnesses. These developments moved health care away from the local doctor, who made house calls, to inpatient stays at hospitals.

When people fell ill, they went to the hospital and what is the difference between viagra and cialis eventually died there. In 1980, 60.5 percent of people died in hospitals. This number peaked in the mid-1980’s, but has since steadily decreased in response to a growing movement for death to be less medicalized, less institutionalized, and more natural.

By 2016, half as many people (29.4 percent) were dying what is the difference between viagra and cialis in hospitals, roughly equaling the number of people dying at home (30.5 percent). While this trend is encouraging, these numbers still do not reflect the fact that 71 percent of people would prefer to die at home. I am a death doula, or what is now more commonly termed an end-of-life doula.

This role grew out of the increasing awareness of and desire for more humane and compassionate what is the difference between viagra and cialis ways to die. Similar to birth doulas, end-of-life doulas are nonmedical professionals offering emotional, spiritual, informational and physical support—not at birth, but at the other end of the spectrum of life—at death. An elderly man with a terminal illness is afraid to die.

He fears for the family he will leave behind—his what is the difference between viagra and cialis wife, children and grandchildren—and how they will cope after he is gone. He has not expressed this fear to his doctors or to his wife, who is already handling so much. I listen.

I hold space for his despair and angst what is the difference between viagra and cialis. He realizes the fear is based on his immense love for his family. He drinks champagne with them on his deathbed.

Reconciliation with the what is the difference between viagra and cialis things that are important can allow one the peace to let go. End-of-life doulas work with those with serious illnesses who are facing death—and also for those who are healthy and just want to prepare for death. On practical matters, doulas can advise on advance care directives, vigil planning and postdeath options, and assist with life review and legacy.

On more emotional matters, doulas can facilitate conversations about unresolved issues or what is the difference between viagra and cialis complex family dynamics and offer space for the fears and uncertainties around death and dying. When we are prepared for death, we are better able to face it when the time comes. Despite her wish to die at home, an elderly woman is taken to the hospital by her son, who can no longer bear to watch his mother die in excruciating pain.

The hospital wants to discharge her, finding nothing wrong, and, at what is the difference between viagra and cialis her age, what can be done anyhow?. The family is distressed by the hospital’s response and calls me. I suggest that they ask for a palliative care consultation.

Eventually, the mother is placed on a proper pain management plan and discharged to hospice care what is the difference between viagra and cialis. How do you know what to ask for, if you don’t know the choices?. Palliative and hospice care are philosophies of care that focus on comfort and symptom management to alleviate pain and suffering.

Both are available what is the difference between viagra and cialis to persons with serious illnesses. While palliative care can be given concurrently with curative care, hospice is typically for those who no longer seek curative treatments. End-of-life doulas advocate for the wishes and needs of the dying person.

We work with the health care team in ongoing care what is the difference between viagra and cialis and coordinate with the support network of family and friends in place or help to establish a needed support system. We fill gaps in care and tackle tasks that are difficult to do or face. All the while, we can be a calming presence for loved ones and the dying person, especially for those who are facing death all alone.

A middle-aged man lies actively dying, completely nonresponsive, in what is the difference between viagra and cialis his bed. He displays “death rattle” breathing, and his body has occasional violent spasms. At his bedside, a petite woman sits, his aunt, pained to watch her nephew die this way.

After creating rapport with the aunt, I seek to allay her distress what is the difference between viagra and cialis and encourage her to speak to him. The aunt responds gratefully, awakened to the possibility of making a difference for her nephew. He dies peacefully, immersed in soft light, music and love.

Sometimes all a loved one needs is permission to be an active participant in what is the difference between viagra and cialis the process, to turn helplessness into empowerment. While death brings sadness and loss, there can also be positive emotions of love, honor and pride. It is possible to feel seemingly contradictory emotions all at the same time—because death is loss, and grief is the natural expression of love.

On the end-of-life journey, we doulas are your personal advocate, cheerleader, companion, guide, ear, rock—whatever you need us to be to face a difficult, intense and emotional time, because what is the difference between viagra and cialis no one who wants support at the end of life should have to go without. This is an opinion and analysis article.The items below are highlights from the free newsletter, “Smart, useful, science stuff about erectile dysfunction treatment.” To receive newsletter issues daily in your inbox, sign up here. Novavax reports that its two-dose protein-based treatment against erectile dysfunction treatment has been 100% effective in preventing severe illness, hospitalization and death due to erectile dysfunction treatment, as well as 90.4% effective against erectile dysfunction treatment symptoms in large-scale human studies.

These studies, which involved thousands of what is the difference between viagra and cialis people in the U.S. And Mexico, showed that the treatment also was highly effective against “Alpha,” the erectile dysfunction variant first identified in Great Britain, reports Carl Zimmer at The New York Times (6/14/21). €œNovavax plans to apply for authorization in UK, EU, India, South Korea, and possibly the U.S.,” according to an Unbiased SciPod post (6/15/21).

A 6/17/21 story by Tanya Lewis at Scientific American describes some of the incentives being offered to people for getting vaccinated against erectile dysfunction treatment — including lottery what is the difference between viagra and cialis tickets, college scholarships, train tickets, firearms, cash pay-outs, cannabis joints, doughnuts, free trips, cruises, and gift certificates. €œPublic health experts use incentives all the time to get people to quit smoking, exercise more, and so on,” the story describes the director of the Health Decision Sciences Center at Massachusetts General Hospital’s general medicine division as saying. An unpublished study by the Mass General researcher suggests that incentives might effectively induce people to get a erectile dysfunction treatment, Lewis reports.

But for what is the difference between viagra and cialis some people the best inducement is an opportunity to stop wearing a mask and a general return to normalcy, the story suggests. Some positive news for people who have transplanted organs and thus take immune-suppressing drugs. A third dose of a mRNA treatment against erectile dysfunction treatment provoked a stronger immune response, at least in the form of antibodies, in organ transplant patients than the standard two doses did, per various reports.

The findings, from a small study of patients who received a third what is the difference between viagra and cialis dose this spring, were published 6/15/21 in Annals of Internal Medicine. The findings are “part of a broader discussion about whether and when to offer extra doses to vulnerable individuals,” writes Jennifer Couzin-Frankel at Science (6/14/21). In past studies, organ transplant patients who got a two-dose erectile dysfunction treatment were far less likely to make protective antibodies against erectile dysfunction than the general population was.

Some larger three-dose studies among people what is the difference between viagra and cialis with compromised immune systems are under way, Couzin-Frankel reports. A medical oncologist at the University of Pennsylvania is not very worried about the effectiveness of erectile dysfunction treatments among people with cancer, the story states. The story then describes two recent studies of cancer patients showing that they produced antibodies against erectile dysfunction after receiving a erectile dysfunction treatment.

However, a third study found much lower antibody levels among vaccinated cancer patients what is the difference between viagra and cialis than it did among their healthy family members who also were vaccinated, Couzin-Frankel reports. The Unbiased SciPod posted some helpful informational graphics about Pfizer’s ongoing studies of its erectile dysfunction treatment in children under 12 (6/11/21). The post states that dosages have been set based on initial smaller studies in children (one-third the adult dose for ages 5-11 and one-tenth the adult dose for ages 6 months to 5 years), and that researchers will enroll 4,500 children across 90 sites globally for the larger safety and effectiveness studies.

€œChildren have immune system components that are more potent compared to adults what is the difference between viagra and cialis. They may not need as high a dose for protection. Age criteria are related to immune system development, not physical size,” the post states.

The results will what is the difference between viagra and cialis likely become available this fall for review by the U.S. Food and Drug Administration, with a first batch — from studies in children ages 5 to 11 — expected in early September, the post states. Nearly one quarter of all people in the U.S.

Who were infected with erectile dysfunction last year, including 19% of those who never reported erectile dysfunction treatment what is the difference between viagra and cialis symptoms from their , had new medical problems within a month or more of recovering from the viagra, according to a large study covered by Pam Belluck at The New York Times (6/15/21). Belluck writes. €œThose affected were all ages, including children.

Their most common new health what is the difference between viagra and cialis problems were pain, including in nerves and muscles. Breathing difficulties. High cholesterol.

Malaise and fatigue what is the difference between viagra and cialis. And high blood pressure. Other issues included intestinal symptoms.

Migraines. Skin problems. Heart abnormalities.

Sleep disorders. And mental health conditions like anxiety and depression.” The study, conducted by non-profit organization FAIR Health and not formally reviewed by experts for flaws, involved evaluating electronic health-insurance records. A 6/11/21 story by Emily Anthes at The New York Times runs down some evidence-based approaches that employers can take to reduce the risk of erectile dysfunction s and other health problems as workers return to offices nationwide.

Employers should flush unused taps and other plumbing to clear any metals or Legionella bacteria colonies that accumulated, the story states. Employers also should upgrade their ventilation and fiation systems, the story states. The goal is four to six air changes per hour, the story states, which is equivalent to completely refreshing air every 10 to 15 minutes in a room.

Portable air purifiers or even “desktop level HEPA http://karenthefengshuilady.com/2011/03/19/yin-yang/ filters” can help. And continue to wash your hands routinely, for at least 20 seconds each time, advises a Northwestern University environmental microbiologist who is quoted in the story. Not solutions.

Desk shields (plexiglass barriers are a good idea in grocery stores though), foggers, fumigators, ionizers, ozone generators and other ‘air cleaning’ devices,’ the story states. In most non-medical or non-lab settings, wiping down surfaces with bleach solutions or disinfectant solutions or wipes does little to prevent erectile dysfunction transmission. Besides, inhaling these substances is harmful.

€œThe no. 1 thing is to get vaccinated,” the story quotes Joseph Allen at the Harvard School of Public Health as saying. A debate among scientists about whether erectile dysfunction spreads mainly by fallen respiratory droplets on surfaces that people touch or spreads in air hampered public health efforts to control the viagra and to prevent deaths.

The implications for this debate were crucial, as Megan Molteni at Wired writes (5/13/21) — officials need to know whether public-health messages should focus on hand washing or on masking and isolation or both, particularly before treatments become available. The general debate is over, as you probably know — the viagra is mostly spread in indoor air. But why did researchers disagree until recently?.

In part, it’s because the arguments against airborne erectile dysfunction all rested on an assumption that only particles smaller than 5 microns could hang in the air. Larger ones, aka droplets, fall to surfaces. But in reality, larger particles can stay afloat and behave like aerosols, many scientists and engineers have known, including aerosols expert Linsey Marr of Virginia Tech, Molteni and others have written.

Molteni’s story masterfully traces the events, conversations, and research that came to expose the “fallacy of the 5-micron boundary.” The hero of this engaging story is Katie Randall, a graduate student who specializes in detective work to figure out how bits of knowledge are passed along through published research papers over time. Guidance from the U.S. Centers for Disease Control in April stated that international and domestic travel are low-risk activities for people vaccinated against erectile dysfunction treatment (so, this does not pertain, unfortunately, to U.S.

Children under 12, for whom erectile dysfunction treatments are not yet authorized). In response to that update, Ceylan Yeginsu at The New York Times has written up answers to some of the questions that vaccinated travelers have these days (6/15/21). A summary of the answers (again, this information is all for vaccinated people in the U.S.).

1) Yes, you must still wear a mask at the airport and on flights. 2) No, you don’t have to quarantine or test if you travel domestically, unless it is required by a state or territory. 3) No, you don’t have to take a erectile dysfunction test before departure to international destinations — not for the U.S.

At least. Check for your destination. 4) Yes, you have to test, even if vaccinated, three days before you return by air to the U.S..

5) Check lists of countries that will accept people from the U.S. Under certain conditions, including some destinations in Europe and the Caribbean. Scientists at the Walter Reed Army Institute of Research in Maryland are working on a treatment that could protect us against all erectile dysfunctiones.

In this 6/9/21 podcast at Scientific American, Emily Mullins interviews Dr. Kayvon Modjarrad who is leading the effort at Walter Reed to develop a so-called universal erectile dysfunction treatment. The treatment candidate that is being tested "combines nanoparticles from a blood protein called ferritin with erectile dysfunction proteins.” (Sorry, I’m not sure what that means either.) Modjarrad says 200 different combinations of spike proteins (a type of complex molecules that are found on the surface of all erectile dysfunctiones), types of ferritin, and ways to link them eventually yielded a treatment candidate that repeatedly provoked a strong immune response against SARS-CoV-1, erectile dysfunction and three of its variants in several species of animals ranging from rodents to sharks.

The treatment now is being tested in a small group of humans. €œIf it works and is safe, it could provide a foundation for a universal erectile dysfunction treatment,” Mullin says. You might enjoy, “A lexicon for the late viagra,” by Jay Martel for The New Yorker (6/14/21).Here is our next installment of a new pop-up podcast miniseries that takes your ears into the deep sound of nature.

Host Jacob Job, an ecologist and audiophile, brings you inches away from a multitude of creatures, great and small, amid the sonic grandeur of nature. You may not be easily able to access these places amid the viagra, but after you take this acoustic journey, you will be longing to get back outside.Strap on some headphones, find a quiet place and prepare to experience a thunderstorm—and a lazy day of waiting that storm out—inside the Boundary Waters Canoe Area Wilderness in northern Minnesota. Catch additional episodes in the series here.Listen to the mockingbird.

This bird makes a lot of noise. He copies all sorts of other bird songs, repeating, repeating, over and over, sometimes for hours. People must have thought this behavior was vaguely insulting to other birds, else we wouldn’t have named this one the mockingbird.

But now, listen more closely. You’ll hear that this virtuoso bird isn’t just copying other species’ tunes. He’s sampling them like a DJ and transposing, bending, tweaking them into his own quite deliberate form.

We can always tell it’s a mockingbird, not because of his copying, but because of his unique and specific way of composing music out of the material he hears in the world around him. It turned out that no humans had specifically articulated what these birds were doing, so my colleagues and I decided to delve deep into the mockingbird’s process, using the analytical tools of three different disciplines at once. Biology, music and neuroscience.

Our paper, published in early May in Frontiers in Psychology, argues that the mockingbird, one of the American birds with the most complex of songs, uses musical techniques familiar to composers from many kinds of human music. Our thesis is that mockingbirds use four compositional strategies to create their melodious song. Timbre change, pitch change, stretch and squeeze.

This allows the birds to transition from one sound to the next in ways that tickle the ears of both songbirds and people. We called this overall activity morphing, a phrase more familiar in imagery but that works for audio just the same. I’m a philosopher and musician, a person who does not usually work on scientific papers.

But I have written about scientific method many times, in popular books like Why Birds Sing, Bug Music and Survival of the Beautiful. All of these works put science in the context of culture, and most deal with the music of the animal world in one way or another. Long fascinated with the compositional methods of the mockingbird, I finally decided to dig deep into his sense of form and structure.

For that I needed the help of the greatest expert on listening to these birds, Dave Gammon, professor of biology at Elon University, who has studied the large population of mockers on his campus for many years now. He knows about 20 individual singing males by name, and can identify by ear most of the species each one imitates and which sounds are not imitations at all. €¦â€œWhen you listen to a mockingbird,” he says, “they repeat an individual phrase three or four times, and then they're doing something new, and then doing something new again.” “And after you've listened to them for just a minute,” Dave adds, “you've heard 20 to 25 different song phrases and they're still pulling out new ones.

If you listened to them for 10 minutes, you might be hard pressed to recognize anything that was repeated. The diversity is huge, and it's so loud, so conspicuous. I always felt they were composing with these diverse sounds, and that the organization of their song phrases might be perceived by humans.” [embedded content] Dave also insisted that we compare these songs to human music.

As someone who’s studied a lot of ethnomusicology, I was a bit afraid to do that. Immediately opens a can of worms!. Which human music?.

But I was impressed by his examples. Beethoven’s Fifth symphony for pitch change. The Tuvan throat-singing ensemble Huun-Huur-Tu for timbre change.

And Idina Menzel from Disney's Frozen II for stretch. All we needed is an example for squeeze, so I immediately thought we needed something from hip-hop, and I was sure Kendrick Lamar’s album Damn would have something. It really had everything, and the last piece on the album, “Duckworth,” sounded more mockingbirdesque than anything we found.

It didn’t win the Pulitzer Prize in composition for nothing. Okay, we had all these cool examples. Look, mockingbirds play with sounds just like humans do.

We call what humans do music, so why can’t the birds be making music?. “It’s all fine to propose the bird is doing something,” says lead author Tina Roeske of the Max Planck Institute for Empirical Aesthetics in Frankfurt. €œBut for science, we must analyze the data to show that our assertions fit the data.” She designed the algorithms that tested the paper’s hypotheses.

The statistics support our hypotheses, and that is what it takes for something to become science." She explains her methods. €œI'm the kind of scientist who just loves the really not so sexy stuff. I really just sit in front of the computer and listen to stuff and try to recognize structure.” She continues.

€œI mean, I love when I can show that a pattern that I perceive and perhaps find beautiful is truly there. It's like finding a proof that this is real. It's not a random thing.

It's really there. Start thinking about why is it that we also have this strong, subjective response to the mockingbird’s song. And that's really interesting.

And I don't think the analysis takes away from the beauty of the song itself.” In my books, I have long argued that for humans to best understand any phenomenon, we have to combine all the different forms of knowledge at our disposal. Poetry says one thing about mockingbirds, as in Walt Whitman’s “Out of the Cradle Endlessly Rocking.” Music says another. €œListen to the Mockingbird.” Ornithology says.

Here are all the species the mockingbird copies. Neuroscience says. Look at these numbers that prove our intuitions about pitch, timbre, stretch and squeeze are correct.

Each form of human knowledge has different criteria for truth. None reduces to the others or cancels each other out. But all can be impressed by beauty in a bird’s song, albeit in different ways.

Charles Darwin knew this full well, observing in The Descent of Man that birds have a natural aesthetic sense. €œThat’s why they evolved such beautiful songs,” I told a reporter at Elon University. €œIt takes the full range of human forms of knowledge to figure out what they are up to.

The idea of women helping other women during childbirth is not viagra 100mg price new. Since the beginning of time, women have labored and birthed at home, attended by a midwife and their female friends and kin. This camaraderie of women, once universal, was a way to provide birth support and also to pass on knowledge about pregnancy, childbirth and parenting.

The natural birth movement of the 1960s begged a return to this viagra 100mg price approach with women demanding unmedicated, less interventional births. Hence, the inception of the birth doula—a nonmedical caregiver who assisted pregnant women in the transition to motherhood. Can the same idea apply to death?.

The evolution of death care has followed a similar trajectory to viagra 100mg price that of childbirth care. For most of human history, people were cared for and died at home, with corpses even displayed on the dining room table for mourning. This began to change in the mid-20th century as society saw great advancements in medical technology for diagnosis and treatment of illnesses.

These developments moved health care away from the local doctor, who made house calls, to inpatient viagra 100mg price stays at hospitals. When people fell ill, they went to the hospital and eventually died there. In 1980, 60.5 percent of people died in hospitals.

This number peaked in the mid-1980’s, but has since steadily decreased in response to a growing movement viagra 100mg price for death to be less medicalized, less institutionalized, and more natural. By 2016, half as many people (29.4 percent) were dying in hospitals, roughly equaling the number of people dying at home (30.5 percent). While this trend is encouraging, these numbers still do not reflect the fact that 71 percent of people would prefer to die at home.

I am viagra 100mg price a death doula, or what is now more commonly termed an end-of-life doula. This role grew out of the increasing awareness of and desire for more humane and compassionate ways to die. Similar to birth doulas, end-of-life doulas are nonmedical professionals offering emotional, spiritual, informational and physical support—not at birth, but at the other end of the spectrum of life—at death.

An elderly man viagra 100mg price with a terminal illness is afraid to die. He fears for the family he will leave behind—his wife, children and grandchildren—and how they will cope after he is gone. He has not expressed this fear to his doctors or to his wife, who is already handling so much.

I listen viagra 100mg price. I hold space for his despair and angst. He realizes the fear is based on his immense love for his family.

He drinks champagne with them on his deathbed viagra 100mg price. Reconciliation with the things that are important can allow one the peace to let go. End-of-life doulas work with those with serious illnesses who are facing death—and also for those who are healthy and just want to prepare for death.

On practical matters, doulas can advise on advance care directives, vigil planning and postdeath options, and assist viagra 100mg price with life review and legacy. On more emotional matters, doulas can facilitate conversations about unresolved issues or complex family dynamics and offer space for the fears and uncertainties around death and dying. When we are prepared for death, we are better able to face it when the time comes.

Despite her wish to die at home, an elderly woman is taken to the hospital by her son, who can no longer bear to watch his mother die in excruciating pain viagra 100mg price. The hospital wants to discharge her, finding nothing wrong, and, at her age, what can be done anyhow?. The family is distressed by the hospital’s response and calls me.

I suggest that they ask for a palliative care consultation viagra 100mg price. Eventually, the mother is placed on a proper pain management plan and discharged to hospice care. How do you know what to ask for, if you don’t know the choices?.

Palliative and hospice care are philosophies of care that focus on comfort and symptom management to alleviate viagra 100mg price pain and suffering. Both are available to persons with serious illnesses. While palliative care can be given concurrently with curative care, hospice is typically for those who no longer seek curative treatments.

End-of-life doulas advocate for the viagra 100mg price wishes and needs of the dying person. We work with the health care team in ongoing care and coordinate with the support network of family and friends in place or help to establish a needed support system. We fill gaps in care and tackle tasks that are difficult to do or face.

All the while, viagra 100mg price we can be a calming presence for loved ones and the dying person, especially for those who are facing death all alone. A middle-aged man lies actively dying, completely nonresponsive, in his bed. He displays “death rattle” breathing, and his body has occasional violent spasms.

At his bedside, a petite woman sits, his aunt, pained to watch her nephew viagra 100mg price die this way. After creating rapport with the aunt, I seek to allay her distress and encourage her to speak to him. The aunt responds gratefully, awakened to the possibility of making a difference for her nephew.

He dies peacefully, immersed viagra 100mg price in soft light, music and love. Sometimes all a loved one needs is permission to be an active participant in the process, to turn helplessness into empowerment. While death brings sadness and loss, there can also be positive emotions of love, honor and pride.

It is possible to feel seemingly contradictory emotions all at the same time—because death is loss, and grief is the natural expression of viagra 100mg price love. On the end-of-life journey, we doulas are your personal advocate, cheerleader, companion, guide, ear, rock—whatever you need us to be to face a difficult, intense and emotional time, because no one who wants support at the end of life should have to go without. This is an opinion and analysis article.The items below are highlights from the free newsletter, “Smart, useful, science stuff about erectile dysfunction treatment.” To receive newsletter issues daily in your inbox, sign up here.

Novavax reports that its two-dose protein-based treatment against erectile dysfunction treatment has been 100% effective in preventing severe illness, hospitalization and death viagra 100mg price due to erectile dysfunction treatment, as well as 90.4% effective against erectile dysfunction treatment symptoms in large-scale human studies. These studies, which involved thousands of people in the U.S. And Mexico, showed that the treatment also was highly effective against “Alpha,” the erectile dysfunction variant first identified in Great Britain, reports Carl Zimmer at The New York Times (6/14/21).

€œNovavax plans to apply for authorization in UK, EU, India, South Korea, and possibly the U.S.,” according to an Unbiased viagra 100mg price SciPod post (6/15/21). A 6/17/21 story by Tanya Lewis at Scientific American describes some of the incentives being offered to people for getting vaccinated against erectile dysfunction treatment — including lottery tickets, college scholarships, train tickets, firearms, cash pay-outs, cannabis joints, doughnuts, free trips, cruises, and gift certificates. €œPublic health experts use incentives all the time to get people to quit smoking, exercise more, and so on,” the story describes the director of the Health Decision Sciences Center at Massachusetts General Hospital’s general medicine division as saying.

An unpublished study by the Mass General researcher suggests that incentives might effectively induce people to viagra 100mg price get a erectile dysfunction treatment, Lewis reports. But for some people the best inducement is an opportunity to stop wearing a mask and a general return to normalcy, the story suggests. Some positive news for people who have transplanted organs and thus take immune-suppressing drugs.

A third dose of a mRNA viagra 100mg price treatment against erectile dysfunction treatment provoked a stronger immune response, at least in the form of antibodies, in organ transplant patients than the standard two doses did, per various reports. The findings, from a small study of patients who received a third dose this spring, were published 6/15/21 in Annals of Internal Medicine. The findings are “part of a broader discussion about whether and when to offer extra doses to vulnerable individuals,” writes Jennifer Couzin-Frankel at Science (6/14/21).

In past studies, organ transplant patients who got a two-dose erectile dysfunction treatment were far less likely to make protective antibodies against erectile dysfunction than the general population viagra 100mg price was. Some larger three-dose studies among people with compromised immune systems are under way, Couzin-Frankel reports. A medical oncologist at the University of Pennsylvania is not very worried about the effectiveness of erectile dysfunction treatments among people with cancer, the story states.

The story then describes two recent studies of cancer patients showing that they produced antibodies against erectile dysfunction after receiving a erectile dysfunction treatment viagra 100mg price treatment. However, a third study found much lower antibody levels among vaccinated cancer patients than it did among their healthy family members who also were vaccinated, Couzin-Frankel reports. The Unbiased SciPod posted some helpful informational graphics about Pfizer’s ongoing studies of its erectile dysfunction treatment in children under 12 (6/11/21).

The post states that dosages have been set based on initial smaller studies in children (one-third the adult dose for ages 5-11 and one-tenth the adult dose for ages 6 months to 5 years), and that researchers will enroll 4,500 children across 90 sites globally for viagra 100mg price the larger safety and effectiveness studies. €œChildren have immune system components that are more potent compared to adults. They may not need as high a dose for protection.

Age criteria are related to immune system development, not physical viagra 100mg price size,” the post states. The results will likely become available this fall for review by the U.S. Food and Drug Administration, with a first batch — from studies in children ages 5 to 11 — expected in early September, the post states.

Nearly one quarter of all viagra 100mg price people in the U.S. Who were infected with erectile dysfunction last year, including 19% of those who never reported erectile dysfunction treatment symptoms from their , had new medical problems within a month or more of recovering from the viagra, according to a large study covered by Pam Belluck at The New York Times (6/15/21). Belluck writes.

€œThose affected were all ages, viagra 100mg price including children. Their most common new health problems were pain, including in nerves and muscles. Breathing difficulties.

High cholesterol viagra 100mg price. Malaise and fatigue. And high blood pressure.

Other issues included viagra 100mg price intestinal symptoms. Migraines. Skin problems.

Heart abnormalities viagra 100mg price. Sleep disorders. And mental health conditions like anxiety and depression.” The study, conducted by non-profit organization FAIR Health and not formally reviewed by experts for flaws, involved evaluating electronic health-insurance records.

A 6/11/21 story by Emily Anthes at viagra 100mg price The New York Times runs down some evidence-based approaches that employers can take to reduce the risk of erectile dysfunction s and other health problems as workers return to offices nationwide. Employers should flush unused taps and other plumbing to clear any metals or Legionella bacteria colonies that accumulated, the story states. Employers also should upgrade their ventilation and fiation systems, the story states.

The goal is four to six air changes per hour, the story states, which is viagra 100mg price equivalent to completely refreshing air every 10 to 15 minutes in a room. Portable air purifiers or even “desktop level HEPA filters” can help. And continue to wash your hands routinely, for at least 20 seconds each time, advises a Northwestern University environmental microbiologist who is quoted in the story.

Not solutions viagra 100mg price. Desk shields (plexiglass barriers are a good idea in grocery stores though), foggers, fumigators, ionizers, ozone generators and other ‘air cleaning’ devices,’ the story states. In most non-medical or non-lab settings, wiping down surfaces with bleach solutions or disinfectant solutions or wipes does little to prevent erectile dysfunction transmission.

Besides, inhaling viagra 100mg price these substances is harmful. €œThe no. 1 thing is to get vaccinated,” the story quotes Joseph Allen at the Harvard School of Public Health as saying.

A debate among viagra 100mg price scientists about whether erectile dysfunction spreads mainly by fallen respiratory droplets on surfaces that people touch or spreads in air hampered public health efforts to control the viagra and to prevent deaths. The implications for this debate were crucial, as Megan Molteni at Wired writes (5/13/21) — officials need to know whether public-health messages should focus on hand washing or on masking and isolation or both, particularly before treatments become available. The general debate is over, as you probably know — the viagra is mostly spread in indoor air.

But why did researchers disagree until recently? viagra 100mg price. In part, it’s because the arguments against airborne erectile dysfunction all rested on an assumption that only particles smaller than 5 microns could hang in the air. Larger ones, aka droplets, fall to surfaces.

But in reality, larger viagra 100mg price particles can stay afloat and behave like aerosols, many scientists and engineers have known, including aerosols expert Linsey Marr of Virginia Tech, Molteni and others have written. Molteni’s story masterfully traces the events, conversations, and research that came to expose the “fallacy of the 5-micron boundary.” The hero of this engaging story is Katie Randall, a graduate student who specializes in detective work to figure out how bits of knowledge are passed along through published research papers over time. Guidance from the U.S.

Centers for Disease Control in April stated that international and domestic travel are low-risk activities for people vaccinated against erectile dysfunction treatment (so, this does not pertain, unfortunately, viagra 100mg price to U.S. Children under 12, for whom erectile dysfunction treatments are not yet authorized). In response to that update, Ceylan Yeginsu at The New York Times has written up answers to some of the questions that vaccinated travelers have these days (6/15/21).

A summary of viagra 100mg price the answers (again, this information is all for vaccinated people in the U.S.). 1) Yes, you must still wear a mask at the airport and on flights. 2) No, you don’t have to quarantine or test if you travel domestically, unless it is required by a state or territory.

3) No, you don’t have to take a viagra 100mg price erectile dysfunction test before departure to international destinations — not for the U.S. At least. Check for your destination.

4) Yes, you have to test, even if vaccinated, three days before viagra 100mg price you return by air to the U.S.. 5) Check lists of countries that will accept people from the U.S. Under certain conditions, including some destinations in Europe and the Caribbean.

Scientists at the Walter Reed Army Institute of viagra 100mg price Research in Maryland are working on a treatment that could protect us against all erectile dysfunctiones. In this 6/9/21 podcast at Scientific American, Emily Mullins interviews Dr. Kayvon Modjarrad who is leading the effort at Walter Reed to develop a so-called universal erectile dysfunction treatment.

The treatment candidate that is being tested "combines nanoparticles from a blood protein called ferritin with erectile dysfunction proteins.” (Sorry, I’m not sure what that means either.) Modjarrad says 200 viagra 100mg price different combinations of spike proteins (a type of complex molecules that are found on the surface of all erectile dysfunctiones), types of ferritin, and ways to link them eventually yielded a treatment candidate that repeatedly provoked a strong immune response against SARS-CoV-1, erectile dysfunction and three of its variants in several species of animals ranging from rodents to sharks. The treatment now is being tested in a small group of humans. €œIf it works and is safe, it could provide a foundation for a universal erectile dysfunction treatment,” Mullin says.

You might enjoy, “A lexicon for the viagra 100mg price late viagra,” by Jay Martel for The New Yorker (6/14/21).Here is our next installment of a new pop-up podcast miniseries that takes your ears into the deep sound of nature. Host Jacob Job, an ecologist and audiophile, brings you inches away from a multitude of creatures, great and small, amid the sonic grandeur of nature. You may not be easily able to access these places amid the viagra, but after you take this acoustic journey, you will be longing to get back outside.Strap on some headphones, find a quiet place and prepare to experience a thunderstorm—and a lazy day of waiting that storm out—inside the Boundary Waters Canoe Area Wilderness in northern Minnesota.

Catch additional episodes viagra 100mg price in the series here.Listen to the mockingbird. This bird makes a lot of noise. He copies all sorts of other bird songs, repeating, repeating, over and over, sometimes for hours.

People must have thought viagra 100mg price this behavior was vaguely insulting to other birds, else we wouldn’t have named this one the mockingbird. But now, listen more closely. You’ll hear that this virtuoso bird isn’t just copying other species’ tunes.

He’s sampling them like a DJ viagra 100mg price and transposing, bending, tweaking them into his own quite deliberate form. We can always tell it’s a mockingbird, not because of his copying, but because of his unique and specific way of composing music out of the material he hears in the world around him. It turned out that no humans had specifically articulated what these birds were doing, so my colleagues and I decided to delve deep into the mockingbird’s process, using the analytical tools of three different disciplines at once.

Biology, music viagra 100mg price and neuroscience. Our paper, published in early May in Frontiers in Psychology, argues that the mockingbird, one of the American birds with the most complex of songs, uses musical techniques familiar to composers from many kinds of human music. Our thesis is that mockingbirds use four compositional strategies to create their melodious song.

Timbre change, pitch change, stretch and viagra 100mg price squeeze. This allows the birds to transition from one sound to the next in ways that tickle the ears of both songbirds and people. We called this overall activity morphing, a phrase more familiar in imagery but that works for audio just the same.

I’m a philosopher and musician, a person who does not usually work viagra 100mg price on scientific papers. But I have written about scientific method many times, in popular books like Why Birds Sing, Bug Music and Survival of the Beautiful. All of these works put science in the context of culture, and most deal with the music of the animal world in one way or another.

Long fascinated viagra 100mg price with the compositional methods of the mockingbird, I finally decided to dig deep into his sense of form and structure. For that I needed the help of the greatest expert on listening to these birds, Dave Gammon, professor of biology at Elon University, who has studied the large population of mockers on his campus for many years now. He knows about 20 individual singing males by name, and can identify by ear most of the species each one imitates and which sounds are not imitations at all.

€¦â€œWhen you listen to a mockingbird,” he says, “they repeat an individual phrase three or viagra 100mg price four times, and then they're doing something new, and then doing something new again.” “And after you've listened to them for just a minute,” Dave adds, “you've heard 20 to 25 different song phrases and they're still pulling out new ones. If you listened to them for 10 minutes, you might be hard pressed to recognize anything that was repeated. The diversity is huge, and it's so loud, so conspicuous.

I always felt they were composing with these diverse sounds, and that the organization of their song phrases might be perceived by humans.” [embedded content] Dave also insisted that we compare viagra 100mg price these songs to human music. As someone who’s studied a lot of ethnomusicology, I was a bit afraid to do that. Immediately opens a can of worms!.

Which human music? viagra 100mg price. But I was impressed by his examples. Beethoven’s Fifth symphony for pitch change.

The Tuvan throat-singing ensemble Huun-Huur-Tu for viagra 100mg price timbre change. And Idina Menzel from Disney's Frozen II for stretch. All we needed is an example for squeeze, so I immediately thought we needed something from hip-hop, and I was sure Kendrick Lamar’s album Damn would have something.

It really had everything, and the last piece on the album, viagra 100mg price “Duckworth,” sounded more mockingbirdesque than anything we found. It didn’t win the Pulitzer Prize in composition for nothing. Okay, we had all these cool examples.

Look, mockingbirds play with sounds just like humans do viagra 100mg price. We call what humans do music, so why can’t the birds be making music?. “It’s all fine to propose the bird is doing something,” says lead author Tina Roeske of the Max Planck Institute for Empirical Aesthetics in Frankfurt.

€œBut for science, we must analyze the data to viagra 100mg price show that our assertions fit the data.” She designed the algorithms that tested the paper’s hypotheses. The statistics support our hypotheses, and that is what it takes for something to become science." She explains her methods. €œI'm the kind of scientist who just loves the really not so sexy stuff.

I really just sit in front of the viagra 100mg price computer and listen to stuff and try to recognize structure.” She continues. €œI mean, I love when I can show that a pattern that I perceive and perhaps find beautiful is truly there. It's like finding a proof that this is real.

It's not viagra 100mg price a random thing. It's really there. Start thinking about why is it that we also have this strong, subjective response to the mockingbird’s song.

And that's really viagra 100mg price interesting. And I don't think the analysis takes away from the beauty of the song itself.” In my books, I have long argued that for humans to best understand any phenomenon, we have to combine all the different forms of knowledge at our disposal. Poetry says one thing about mockingbirds, as in Walt Whitman’s “Out of the Cradle Endlessly Rocking.” Music says another.

€œListen to the Mockingbird.” viagra 100mg price Ornithology says. Here are all the species the mockingbird copies. Neuroscience says.

Look at these numbers that prove our intuitions about pitch, timbre, stretch and squeeze viagra 100mg price are correct. Each form of human knowledge has different criteria for truth. None reduces to the others or cancels each other out.

But all can be impressed by beauty in a bird’s song, albeit viagra 100mg price in different ways. Charles Darwin knew this full well, observing in The Descent of Man that birds have a natural aesthetic sense. €œThat’s why they evolved such beautiful songs,” I told a reporter at Elon University.

€œIt takes the full range of human forms of knowledge to figure out what they are up to. Not one of us could have done this research alone." The paper, and all its data, are free to view in the open-access journal Frontiers in Psychology. And this video version demonstrates how this bird makes such special music out of the songs of so many other birds in his habitat.

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