Treatment comes first in HHS antiviral guidance

first_img Risk of resistanceHHS also says that several comments focused on risks and uncertainties related to antiviral use, including the possibility of resistant viruses and adverse events. In addition, in response to a suggestion that families should be able to stockpile antivirals, HHS says that any recommendations on home stockpiling will depend on the results of pending studies. In the revised guidance, school dormitories may be considered a “closed setting for post-exposure prophylaxis during an outbreak,” if the students have not been dismissed HHS is buying antiviral drugs for the Strategic National Stockpile, and states are stockpiling the drugs with a 25% federal subsidy. The overall goal for public stockpiles is 81 million treatment courses, including 75 million courses for treatment and 6 million for containment and for delaying the spread of pandemic flu into the United States. Prophylaxis of high-risk healthcare and emergency services personnel for the duration of community pandemic outbreaks Roche and GlaxoSmithKline, the makers of oseltamivir and zanamivir, respectively, are developing home kits designed for stockpiling, HHS says. “Approval of these ‘medkits’ by the Food and Drug Administration will depend on studies showing that the kits can be appropriately maintained, the instructions understood, and the drug used appropriately at the correct time,” the agency says. “Any HHS guidance on home stockpiling will depend on the results of these studies and FDA approval of these products.” Containing or suppressing initial pandemic outbreaks overseas and in the United States with treatment and postexposure prophylaxis (PEP) among individuals identified as exposed to pandemic flu and for geographically targeted prophylaxis in areas where exposure may occur Reducing introduction of infection into the United States early in an influenza pandemic as part of a risk-based policy at US borders Like the draft version, the revised guidance says that antivirals for preventive treatment of healthcare workers and others will have to come mostly from supplies bought by private organizations and businesses for their employees. About 73 million courses are currently in federal and state stockpiles, according to HHS’s response to comments on the guidance. It also says “many federal agencies” are “acquiring additional stockpiles to support prophylaxis as recommended in the guidance,” but it does not list the amounts of these supplies. Dec 16, 2008 (CIDRAP News) – A revised federal guidance document on the use of antiviral drugs in an influenza pandemic reaffirms that public supplies of the drugs should be reserved mainly for treating the sick and that preventive treatment for high-risk workers should rely on private supplies. HHS also released a separate document summarizing the 28 comments it received on the draft version and presenting responses to them. At the same time, HHS released a revision of its guidance on employer stockpiling of antivirals, with no major changes. Despite the risks related to antiviral stockpiling, the working group that wrote the recommendations considers them appropriate and the pandemic threat great enough to justify the investment in the context of other preparedness measures, the document says. Providing antiviral prophylaxis to the families of healthcare and emergency workers is not recommended, because they have no greater risk of pandemic flu than the general population The problems of cost and limited shelf-life may be reduced through programs recently announced by the antiviral manufacturers, whereby organizations can reserve an up-to-date supply of the drugs by paying a small annual per-regimen fee, the revised guidance says. At the time of a pandemic, organizations could pay for the drugs and receive them within 48 hours. The agency added two significant pieces to the guidance in response to comments. One addresses implementation difficulties, mainly concerning barriers to the stockpiling of antivirals for health and emergency workers; the other deals with risks and uncertainties, such as antiviral resistance and treatment effectiveness. Its recommendations are just that—not standards of care or requirements HHS says the 28 comments it received on the draft guidance came from public health workers, healthcare providers, healthcare organizations, the pharmaceutical industry, business associations, public health organizations, and labor groups, among others. See also: “Antiviral resistance does represent a threat to the potential effectiveness of treatment and prophylaxis,” HHS acknowledges in its responses to the comments. The emergence of oseltamivir resistance in some influenza A/H1N1 viruses last winter illustrated this. But there is no evidence that use of oseltamivir induced this resistance, and H1N1 and other seasonal flu viruses remain susceptible to zanamivir, the agency adds. Editor’s note: This story was revised Dec 17 to include an item that was mistakenly left out of the list of five main recommendations on antiviral use in a pandemic. In addition, the guidance says that a recent declaration by HHS Secretary Mike Leavitt provides that state and local governments will be immune to liability related to the use of oseltamivir and zanamivir only to the extent the drugs are obtained by voluntary means, not confiscation. The Public Readiness and Emergency Preparedness (PREP) Act gives the HHS secretary the authority to do that, the document states. Some other comments addressed several of the same difficulties mentioned by those who commented on the general guidance: the cost of antivirals, limited shelf-life of the drugs, and the possibility of government confiscation. In its response, HHS makes generally the same points as in its response to comments on the general guidance. The PREP Act provides immunity from tort liability for both public and private groups that make, distribute, and administer antivirals in accordance with the HHS secretary’s declaration, the guidance says. In addition, the guidance document says that mathematical modeling studies suggest that “antiviral treatment and prophylaxis would remain beneficial overall unless some of the pandemic viruses introduced into the U.S. at the beginning of a pandemic are both resistant and fully transmissible.” Lowering barriers to implementationSeveral commentators said private organizations are unlikely to buy antivirals for their employees because of the cost, and several suggested that the federal government should buy the additional supplies needed to implement the guidance, according to HHS. Others said more information and materials were needed to support implementation. Treating people with pandemic flu who present for care early during their illness and would benefit from such treatment As for the possibility of government seizure of private antiviral supplies, the revised guidance says this would be very unlikely. Health officials who participated in a working group convened by the Association of State and Territorial Health Officials (ASTHO) “recognized the benefits of enhanced preparedness and coordination between public and private sectors and emphasized that this authority would be very unlikely to be used,” HHS says. The thrust of the general guidance is that, in a pandemic, antivirals should primarily be used to treat the sick, but they should also be used to prevent illness in high-risk healthcare and emergency workers and to both prevent and treat illness in the context of initial outbreaks both in the Untied States and overseas. The guidance pertains mainly to the two licensed neuraminidase inhibitors, oseltamivir (Tamiflu) and zanamivir (Relenza). Leavitt made the declaration on Oct 10 on grounds that governmental seizure of antivirals “would undermine national preparedness efforts and should be discouraged,” it adds. The Department of Health and Human Services (HHS) issued its draft guidance on the topic in June. A revision released yesterday includes no major changes but does have some new material added in response to comments, particularly on implementation problems and risks and uncertainties. No members of the interagency working group that wrote the guidance had ties to the antiviral drug manufacturers, and the latter were not included or consulted in developing the guidance The guidance also states that the antivirals may be less effective if “the usual dose and duration of therapy are not optimal for a pandemic virus.” In the responses to comments, HHS says that side effects of oseltamivir and zanamivir are uncommon. However, the guidance says that widespread use of the drugs may lead to the identification of new side effects. It notes that neurobehavioral problems have been seen in a few people treated with oseltamivir The revised guidance says that barriers to antiviral stockpiling for healthcare workers include not only the cost, but also drug shelf-life, the potential for seizure of private stockpiles by state health departments, and liability concerns. These problems were identified in the stakeholder meetings conducted in developing the guidance. Prophylaxis of healthcare and emergency services workers who are not at high exposure risk, people with compromised immune systems who are less likely to be protected by pandemic vaccination, and people living in group settings such as nursing homes and prisons if outbreaks occur in their facilities The five main recommendations are unchanged in the revised guidance. It calls for using antivirals for the following purposes: Revised guidance for employersThe revised guidance on employer stockpiling of antivirals, like the draft released in June, recommends that businesses providing frontline healthcare and emergency services plan to provide preventive antivirals for employees who will be exposed to sick people in a pandemic. It also says that critical infrastructure employers should “strongly consider” providing antiviral prophylaxis for essential workers. In its responses to the comments, HHS also states that: In a separate document, HHS says it received comments on the draft employer guidance from 31 stakeholders, ranging from academics and labor unions to critical infrastructure companies and public health groups. Several of the comments focused on whether antiviral stockpiling would be considered a “standard of care.” In its response, HHS says its recommendations are only guidance and do not establish a requirement, but rather represent a prudent approach. The revised version also reiterates that employers will have to acquire their own antiviral stockpiles for preventive use, since there are no plans for major expansion of public stockpiles. Despite the various measures designed to facilitate implementation of the guidance, some organizations will probably not have “the capacity or willingness to comply,” the document states. “In such settings, it is important to emphasize that antiviral drugs are only one component of a comprehensive program to protect workers and maintain essential services.” HHS report “Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic” Jun 3 CIDRAP News story “HHS offers pandemic guidance on masks, antivirals”last_img read more

Pretty 6 Pack Hair Sectioning Clips, A bit flimsy. One of them was broken when

first_imgHolds my hair but since i have locs i cannot utilise the full duration of the clip because my hair is thick.Really great delighted with my obtain and it arrived seriously promptly in advance of the believed day x.Incredibly remember to with the products. Good high-quality for a cut price cost. Do the position properly to section of hair for dying, drying and straightening.Key specs for Pretty 6 Pack Hair Sectioning Clips:Make styling your hair easy with these 6 Pack Of Sectioning Clips,  ideal for sectioning areas of hair so you can work on different part without getting tangled up in a great messy hair massPerfect for styling, cutting or trimmingComments from buyers“Good for the price., If I ever found I needed something like this however, A bit flimsy. One of them was broken when , Sturdy Hair Clips, Just what i was looking for, Ok but not strong enough for thick hair”Does specifically what they are intended to.Do the job just as explained i have thick hair and these do the job perfectly to retain sections divided whilst styling.These are very good for the price tag. I prefer the metal kinds as they feel to keep my hair improved. I place a person in and it broke straight absent thanks to the body weight of my hair so now i have to set them up in masses of unique sections rather than lower, center and top rated. Even so for the selling price of them i can not definitely complain. Great for folks with limited to mid length hair.Okay but not potent plenty of for thick hair. Alright but not too fantastic a keep on thick hair – you can only use modest sections.Just what i was on the lookout for. Arrived right now delivery was quick, just what i was looking for at an economical value way too.If i at any time identified i essential something like this nonetheless. I haven’t seriously employed these a great deal, but they are solid and perform properly. I wont be getting yet again, but only because i have no use for them. If i at any time located i essential anything like this however, i would undoubtedly advocate these.Just what was needed, thank you.Properly really worth the money, does the career that i wanted for very well.These are fantastic despite the fact that to be trustworthy have not used much. Likely much easier to dry my hair if i did.Not a great deal can be reported about these but they do the career well.They arrived really swiftly, with bare minimum fuss and packaging. All in tactas a product they do the job great, but really don’t open primarily extensively but are great after you get the hang of them. If you have thicker hair 6 may possibly not be more than enough.The item would not performs as i envisioned. But it has arrived on time in pretty fantastic situations.A person of them was damaged when. One particular of them was damaged when it arrived. The phrase ‘you get what you pay out for’ springs to intellect.Arrived previously than anticipated.Pack of durable hair sectioner’s that do the occupation.Just what was marketed, terrific worth for cash.last_img read more

Explore Canada’s Beautiful Parks by Geocaching during Canadian Environment Week

first_imgFor the first time, Canadian Environment Week uses the GPS enabled treasure-hunt of geocaching to share the beauty of Canadian Parks.The Canadian Environment Week geocaching contest runs from April 30 to June 11, 2011. During this time, geocaches containing a password can be found in National Parks, at National Historic Sites and on National Wildlife Areas throughout Canada. It’s an opportunity for geocachers to explore these areas and even have a chance to win prizes. Adventurers wishing to participate in the contest must collect a password from the selected geocaches and submit it on the Canadian Environment Week website. Contest participation and the password are not required in order to simply log your finds on any of these great caches.Click here to view the bookmark list of the Canadian Environment Week geocaches that are listed on, thanks to the Atlantic Canada Geocaching Association. A few others can be found through Environment Canada directly.Even without prizes, geocaching during Canadian Environment Week is a great opportunity to explore Canada’s natural beauty. Canadian National Parks, National Historic Sites and National Wildlife Areas are located on the Atlantic, Pacific and Arctic coasts, across the interior mountains and plains and Great Lakes, reaching as far north and south as Canada goes!Geocachers will enjoy the breathtaking scenery and inspiring natural surroundings of Canada. National Parks provide the perfect setting for tuning into nature, learning about it, appreciating it, respecting it and pledging to protect it. Celebrate Canadian Environment Week by doing just that, and don’t forget to CITO to help preserve the environment. SharePrint RelatedFeatured Geocacher of the Month Award WinnersAugust 25, 2011In “Community”Environmental initiatives of geocachingMarch 19, 2019In “News”Sky House – Geocache of the WeekMarch 28, 2018In “Community” Share with your Friends:Morelast_img read more

Draw It Out, and Other Tips for Success from Twitter Co-founder Jack Dorsey

first_imgTags:#start#tips audrey watters Top Reasons to Go With Managed WordPress Hosting Having a great idea is one thing. But being able to realize and execute on that idea is what matters. At the 99% Conference last month in San Francisco, Twitter creator and co-founder Jack Dorsey gave a talk on how he was able to do just that: take a good idea and turn it into a flourishing company. In his talk, Dorsey identifies the three keys to success as he built and launched both Twitter and his latest project Square: 1. Draw out your ideas2. Take advantage of luck and good timing3. IterateDrawCommit your ideas to paper before you worry about committing them to code. Get your idea out of your head so you can see it from a different perspective. And just as importantly, share it with others. Dorsey speaks about an idea he’d had in 2000 when working as a dispatcher in New York, seeing people always reporting where they are and what they’re doing in various locations. Dorsey put the idea on paper, but put it aside.LuckThis doesn’t mean relying on luck or good fortune. Rather you need to be able to recognize “luck.” Learn to recognize good timing and good situations that make it practical for you to execute your idea. Dorsey notes that it was the rise of certain technologies, along with working with Biz Stone and Evan Williams that allowed him to return to those ideas he’d sketched out in 2000 and to develop them more thoroughly, eventually into what became Twitter. Dorsey also notes that the recent economic crisis has made it a good timing for his latest project Square, a device that allows anyone to make or accept a credit card payments via their phone or computer. As the business and financial sectors were in “survival mode,” they were looking for innovation, according to Dorsey, and he was able to capitalize on this.IterateTake feedback. Learn to be an editor, listening to others’ input and shaping those ideas as they are put into practice.Dorsey points to all the changes that Twitter has undergone since his initial idea, noting that many of things that are commonly accepted Twitter practices, including use of the @-symbol, the hashtag and the RT, were generated by users, not by the founding team themselves. Rather than being the sole creator of ideas, Dorsey says that Twitter has embraced the iterative process, becoming the editor of customer usage. Despite initially resisting some of these user practices, now it helps implement these user ideas and practices more smoothly.Of course, Dorsey argues, you must know when to stop. If you draw and share your ideas, you will get instant feedback on what works and what doesn’t work. And if an idea doesn’t seem to work, put it aside. You can come back to it, or some part of it, later. The entire video is available on the conference website, along with others from the 2010 and 2009 events. A Web Developer’s New Best Friend is the AI Wai…center_img 8 Best WordPress Hosting Solutions on the Market Related Posts Why Tech Companies Need Simpler Terms of Servic…last_img read more

A List of Sales Improvement Frauds

first_img Essential Reading! Get my 2nd book: The Lost Art of Closing “In The Lost Art of Closing, Anthony proves that the final commitment can actually be one of the easiest parts of the sales process—if you’ve set it up properly with other commitments that have to happen long before the close. The key is to lead customers through a series of necessary steps designed to prevent a purchase stall.” Buy Now There are some who present ideas as if they are truths that one must follow to improve their sales. Here is a field guide to frauds.The “Is Dead” Fraud: Those who insist that some prospecting methods no longer work. The more one insists that some method of prospecting no longer works—or soon won’t—the truer it is that individual is a fraud. This fraud almost always gains attention for themselves for feeding a salesperson’s fear of cold calling. This is true even if they hedge, suggesting that cold calling still works now, but that its demise is imminent. The easiest way to spot this fraud is to notice the regularity in which they write posts about cold calling on LinkedIn, that frequency indicating how much they need attention, as they normally measure their success in likes and comments (all of which come from their fraud peer group or those whose fears they intend to feed). No prospecting method is dead.The “Social Only” Fraud: Those who insist that social channels produce better results than cold calling and one should exclude all others. Were this true, salespeople would already be experiencing the embarrassment of riches that these frauds promised were possible when they set up the mutual exclusivity of one medium outproducing any other. Let us call those who are not frauds “operators,” those people who actually produce results. Operators will tell you that you want to be omnichannel, using every prospecting method available. When results are necessary, more direct methods of asking to explore change outproduce the tools that nurture relationships (both of which are necessary, one taking more time to produce the outcome that is an opportunity). Frauds reject the idea that direct outreach is faster, suggesting instead that you write more blog posts and post more frequently to LinkedIn.The “Henny Penny” Fraud: Those who suggest that the salesperson is irrelevant and that the buyer has parity when it comes to information and insight. Let us call this type of fraud Henny Penny, after the chicken that was hit on the head by an acorn and worked up the rest of the barnyard animals by telling them the sky is falling (a fable that results in almost all the characters dying at the end). More than any other, this group of frauds seems to be made up of those who used to work in sales but found it difficult to create compelling differentiation and sincerely believe that their experience is every salesperson’s experience. In every industry. In every corner of the Earth.Let’s imagine you have sold what you sell now for 3 years. In that time, you have helped 36 companies buy what you sell and enjoy the benefit of the better outcomes you helped them generate. The buyers in each of these cases makes the decision to buy what you sell two or three times in their career. How could they know more, without the many and varied experiences it takes to really know how to produce results?The “Fake News” Fraud: Those who share fraudulent facts about sales that lack the smallest hint of credibility. There is zero credible evidence that buyers no longer take phone calls, that they reject some number over 90 percent of all attempts through a cold outreach, or that over 80 percent of all opportunities come from recommendations. Even some of the facts that are well researched are misinterpreted and being used to suggest a course of action that was never intended. It only takes a few clicks to discover that what is presented as a fact is really a blog post written by a person in a company that sells some sort of technology that is going to “change the way we sell forever.” They write these posts and share these fake facts as a way to make the case for their offerings by suggesting they provide the answer to “why change now?”The “Non-selling Expert” Fraud: Those who offer sales advice without ever having sold. There is a category of frauds made up of people who have never carried a quota, never had to create opportunities in white space, never sat across from a prospective client, and never had to win competitive deals in order to generate their income. They write about sales, some even being published on popular web sites and magazines.Ideas are infections. Once you believe that something is true and adjust your actions to those beliefs, the consequences of your actions follow, no matter the harm that comes to you. Avoid frauds.last_img read more