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So remember that time Tori and I posted our first TWTT? Well, we’re back in action! Katherine, Julia and I wanted to share a few quick photos we snapped at our team picnic from yesterday. Some weeks we may have a fun craft, recipe or adventure to share so you can all keep up with us in our personal lives in between the brilliant sessions and weddings we will be posting! I am so excited about these two girls and the stories their hearts have to share. It was so fun meeting at Longs Park, collaborating a fun little meal, talking about photography/the business and just chatting about life and what’s going on for all of us. I’m also so glad the weather is deciding to take a break from the rain and give us some nice sunshine!

Enjoy our little picnic while I head back to editing for the day!

Meagan Nicole

 photo blog001-33.jpg photo blog002-32.jpg photo blog003-29.jpg photo blog004-27.jpg

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Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! buy zithromax online usa. GET STARTED Log In | Learn More What is it?. STAT+ is STAT's premium subscription buy zithromax online usa service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What's included?.

Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The buy zithromax online usa most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.Like many people, I was shocked when the Food and Drug Administration ignored the advice of its neurological drugs advisory panel and broadly approved Biogen’s new drug, Aduhelm, even for populations never included in the clinical trials to assess the drug.I am not a casual bystander to this controversial decision. I am a physician who has been treating people with Alzheimer’s since 1982. An early researcher into buy zithromax online usa the biology of amyloid, the brain protein that Aduhelm targets. Someone with a strong personal family history of dementia — I have shared the responsibility of caring for seven relatives who died from Alzheimer’s disease over the past 40 years. And have personally undergone biomarker assessment for an amyloid-lowering drug trial.From all of these perspectives, the approval of Aduhelm was a mistake.advertisement Slightly more than a week has passed since the FDA made its decision public.

Since then, three members of the FDA’s advisory committee have resigned in protest over the decision to approve buy zithromax online usa the drug for far broader use than intended and without as much as courtesy notification of its expert advisers. The FDA was not acting here as a tiebreaker. 10 of 11 advisers voted to reject Biogen’s application and the 11th was undecided on how to interpret the data.As I formulate my responses to my own patients, here are six recurring themes:advertisement Pull of desperation. Even the most sophisticated patients in my private practice who have enrolled in clinical trials of donanemab or lecanemab, experimental Alzheimer’s drugs that work in similar ways as Aduhelm, are unable to resist the pull of desperation potentiated by the false buy zithromax online usa hope engendered by Aduhelm’s approval. They are rushing to resign from their current trials and queuing up to start Aduhelm infusions.I mentioned to them months ago that this might happen, but I never dreamed that the approval of Aduhelm would be as indefensible as has now been revealed.

There are no direct comparison trial data upon which to base a comparison of Aduhelm to donanemab or to lecanemab, so it is difficult to begrudge individuals in trials of these treatments who buy zithromax online usa prefer immediate access to Aduhelm rather than the possibility of getting placebo for at least 18 months if they remain in their double-blinded trials. After those 18 months, those on placebo would likely be offered donanemab or lecanemab — assuming they work — but in the meantime, they wake up every morning asking themselves whether they can endure the possibility they are in the placebo arm. The improper approval of Aduhelm poses an immediate and permanent threat to the discovery of real effective disease modifiers for dementia.Elbowing aside existing treatments. The harm posed by Aduhelm’s approval to the detriment buy zithromax online usa of more promising drugs is not merely theoretical. This is already happening with galantamine — an inexpensive oral drug approved to treat Alzheimer’s two decades ago — that operates on a different principle than Aduhelm.A report from Maria Eriksdotter and colleagues in Sweden, published online in the journal Neurology in March 2021, showed that galantamine is far and away the most promising tool in the current armamentarium aimed at slowing the progression of dementia.

In a study of thousands of people over many years, these researchers observed that people with Alzheimer’s dementia who took galantamine virtually never declined past moderate-stage dementia. Almost no one taking the drug developed end-stage dementia.All three major drugs in this class, known as cholinesterase inhibitors, were associated with benefits for cognitive outcomes and death, but galantamine was singular in what looks precisely like what buy zithromax online usa we are chasing when it comes to desirable properties for a drug that slows dementia progression.The performance of galantamine over decades is far superior to the uninterpretable data package upon which the FDA relied in approving Aduhelm.The FDA’s baseless decision has served to focus patients, families, and clinicians on how to operationalize the approval of a costly, unreimbursed, intravenous infusion drug as patients by the hundreds or thousands reach out to their doctors asking when and how can they begin receiving it. At almost the same moment, far superior data pointing to a safe, affordable, orally active, immediately available medication are almost totally ignored.In the interest of full disclosure, galantamine was developed by a member of the board of trustees at the Icahn School of Medicine at Mount Sinai, where I work, but the drug was not developed at Mount Sinai, and I was not involved in its discovery, development, or post-market research. Amyloid buy zithromax online usa reduction alone is no help. For its approval of Aduhelm, the FDA said that reducing amyloid in the brain could be reasonably expected to benefit brain function.

This is the same rationale that drove Pfizer’s development of bapineuzumab, the first anti-amyloid antibody subjected to clinical trials. Those trials were reported in The Lancet Neurology in 2010 by buy zithromax online usa Juha Rinne and colleagues, and I wrote the accompanying editorial summarizing some possible next steps. Fast forward to 2021. Though bapineuzumab (which Pfizer ultimately abandoned) had reduced amyloid accumulation over the course of the trials but showed no meaningful impact on clinical outcome, here we go again. Approval of the anti-amyloid antibody aducanumab, which rapidly purges the brain of detectable fibrillar amyloid and for which there is still no evidence of consistent meaningful clinical benefit.Since then, the failure of amyloid reduction buy zithromax online usa to predict meaningful clinical benefit has been noted by many experts, myself included, as my colleague Mary Sano and I wrote in Nature Reviews Neurology in 2015 when solanezumab, another amyloid-clearing drug, was under consideration for FDA approval.

Today we have solanezumab déjà vu — but worse.The FDA’s opinion that amyloid reduction should lead to meaningful clinical benefit, an opinion shared by many dementia researchers, flies in the face of a decade of failures with bapineuzumab, solanezumab, and others. It is possible that personal polygenic risk scores might point to individuals in whom some early initiation buy zithromax online usa of amyloid reduction might yield meaningful benefit, but that science is not yet in hand. Moreover, current data suggest that this early age of initiation of amyloid reduction might be the third or fourth decade of life, far earlier than the Aduhelm approval anticipates.It is possible that when mildly impaired patients are treated for five years or 10 years or more with Aduhelm, a meaningful clinical benefit will be obvious. I hope this will occur. But FDA approvals should be based on data not buy zithromax online usa speculation.Finally, there is convincing evidence that the most readily detectable form of amyloid, known as a fibril, is not the worst type.

The title of most harmful form of amyloid goes to what’s known as a toxic oligomer, which is currently undetectable in the living human brain. Developing a means of establishing which oligomer types and how much of each is in the brain of a patient, and how her or his oligomer type and level responds to intervention, will be required to resolve the question of whether oligomers have important clinical correlates and, if so, which ones. An uninterpretable trial buy zithromax online usa. Biogen launched two identically designed Phase 3 trials for aducanumab, one called ENGAGE, the other EMERGE. One of them, ENGAGE, buy zithromax online usa has been called a “failed” or “negative” trial.

A better description is uninterpretable. The main problem with that trial was that the participants receiving placebo failed to decline as rapidly as expected.The Alzheimer’s Disease Neuroimaging Initiative recently reported that measurements of plasma neurofilament-light chain (NfL) can predict the trajectory of decline. Biogen should report the NfL levels from its various cohorts since those measurements might enable a reanalysis that offers compelling support for buy zithromax online usa Aduhelm.Trials and labeling disconnect. There is an inexplicable disconnect between the criteria Biogen employed for its Aduhelm trials and the company’s statements about the types of patients for whom the FDA approved the drug, known as the indication or product labeling.The aducanumab trials were restricted to participants who met these conditions. They had the mildest of symptoms.

Amyloid biomarkers were buy zithromax online usa present at baseline. Each patient’s genetic risk factors, such as APOE4, were known. And periodic brain MRIs were performed to detect the most potentially serious side effect, the brain swelling and bleeding known as amyloid-related imaging abnormalities (ARIA).In the trials, surveillance MRIs almost always enabled early detection of ARIA before symptoms or buy zithromax online usa brain bleeding appeared. In such cases, when dosing was reduced, skipped, or stopped, ARIA often resolved with no important consequences in response to care that is supportive in nature. Individuals who were taking blood thinners were excluded from the trials because they had the highest risk for major bleeds from ARIA, a potentially fatal complication.

In the trials, once the red line of 10 microhemorrhages had been reached, study participants were excluded and offered no further Aduhelm infusions.The product labeling does not recommend stopping Aduhelm after 10 microhemorrhages, but instead to proceed “cautiously after radiographic stabilization,” another buy zithromax online usa instance of how the Aduhelm drug label, which is intended to educate clinicians and patients about how to use the drug safely, does not provide adequate recognition for a possible serious adverse event. Nor does it advise clinicians about exactly what steps to take after a patient has their 10th brain microhemorrhage.None of the standard features of the Aduhelm trials have been included in the product labeling. These might soon appear among best-practice recommendations from expert panels, but as the situation stands now, this just looks like another affront to the FDA’s neurological drugs advisory panel.Decisions that ought to be science-based are being increasingly driven by politics, wishful thinking, and even delusion. A favorite phrase used in several of the past week’s position statements has been “this is a new day in buy zithromax online usa the fight against Alzheimer’s.” What is new is that the FDA has apparently applied what I can only speculate to have been bias, wishful thinking, and/or delusion as substitutes for science and data. Amazingly, major research agencies and foundations are rushing to say that they, too, see the emperor’s new clothes.

The American Academy of Neurology’s Neurology Today website is buy zithromax online usa the exception in having characterized the FDA’s decision as mixed at best. Cost and equity issues. In any discussion of Aduhelm, the linked issues of cost and inequity of access to care immediately arise. Biogen has announced its intention to ship Aduhelm to 900 infusion sites over the next two weeks, sparking families to call for infusion appointments while local stakeholder committees (like the one at my hospital in Manhattan) convene urgently buy zithromax online usa and add Aduhelm to their health system infusion formularies. The cost Biogen announced for Aduhelm, $56,000 a year, represents only about half of the actual yearly cost once physician, infusion center, and imaging costs are factored in.While some seeking help at our center can afford the cost, most cannot.

I hope that Biogen will make good on its promise to help patients seeking Aduhelm therapy find a way to afford it. In the absence of guidance (and in a comparable situation to that in place for amyloid imaging for several years), I must ask my patients to be sure to bring their credit cards or checkbooks when they arrive buy zithromax online usa for their appointments, because prepayment out of pocket is the current standard.Bottom line. The FDA’s approval of Aduhelm raises more questions and creates more problems than a new drug approval should. It’s time for governmental, professional, and advocacy entities to step in where Biogen and the FDA have failed and explain to patients, caregivers, and clinicians how this drug is not the “new day” in the fight against Alzheimer’s disease buy zithromax online usa and needs to be approached cautiously, if at all.Sam Gandy is a neurologist. Professor of neurology and of psychiatry at the Icahn School of Medicine at Mount Sinai where he holds the Mount Sinai Chair in Alzheimer’s Research.

The founding and current director of the Mount Sinai Center for Cognitive Health and NFL Neurological Care. And associate director of buy zithromax online usa the National Institute on Aging-Designated Mount Sinai Alzheimer’s Disease Research Center. He reports founding companies based on immunotherapeutic strategies for dementia. Receiving personal or laboratory support from Wyeth, DiaGenic, Pfizer, Baxter, and Polyphenolics/Constellation Wines. And recently joined the scientific advisory board of Ritrova Therapeutics.Centene (CNC), a major buy zithromax online usa health insurer, agreed to pay a combined $143 million to Ohio and Mississippi to settle allegations that a pharmacy benefits subsidiary overcharged the state Medicaid programs.In addition, the company set aside $1.1 billion for future settlements with several other unnamed states, which reportedly include Kansas and Arkansas.

We asked Centene, which denied any liability, for comment concerning those negotiations and will update you accordingly. Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! buy zithromax online usa. GET STARTED Log In | Learn More What is it?. STAT+ is STAT's premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond.

What's included?. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr..

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Aug how to get zithromax online alternative to zithromax. 23, 2021 -- An Afghan woman went into labor while aboard an evacuation flight that landed in Germany on Saturday U.S. Airmen helped to deliver the baby on the alternative to zithromax C-17 aircraft. The woman and her baby, whose identities were not revealed, were taken to a nearby medical facility. They’re both in good condition.

The flight alternative to zithromax left from an “intermediate staging base in the Middle East,” according to a statement on the U.S. Air Mobility Command’s Facebook page. It wasn’t revealed when the woman left Afghanistan alternative to zithromax. During the flight, the woman went into labor and had complications due to low blood pressure. €œThe aircraft commander made the decision to descend in altitude to increase air pressure in the aircraft, which helped stabilize and save the mother’s life,” according to the Facebook post.

Once the plane landed at Ramstein Air Base alternative to zithromax in southwest Germany, medical personnel from the 86th Medical Group boarded the plane and delivered the baby in the cargo bay. Then the mother and baby were taken to a medical facility for further care. As of Sunday, more than 6,000 evacuees from Afghanistan have been flown to Ramstein Air Base, with more flights expected in coming days, said a spokesperson for the air base, according alternative to zithromax to NBC News. Overall, 25,000 people have been evacuated since Aug. 15.

Thousands more alternative to zithromax are waiting to flee, NBC News reported. The U.S. Will use commercial aircraft to transport people once they have been evacuated from Afghanistan, the Defense Department said Sunday. The 18 aircraft -- from American, Atlas, Delta, Hawaiian, Omni, and United airlines -- won’t fly into Hamid Karzai International Airport in Kabul alternative to zithromax. Instead, they will be used for the “onward movement of passengers from temporary safe havens and interim staging bases,” John Kirby, press secretary for the Pentagon, said in a statement on Sunday.

This is the third time that the alternative to zithromax Civil Reserve Air Fleet has been activated. The first time was in support of Operations Desert Shield/Storm between August 1990 and May 1991 during the Persian Gulf War. The second was for Operation Iraqi Freedom between February 2002 and June 2003 after the invasion of Iraq. €œWe’ve reached agreements with about two dozen countries over four continents who are now helping or soon going to help with alternative to zithromax the transit of people out of Kabul,” Secretary of State Antony Blinken said on Fox News Sunday. €œThis is one way to make sure we have enough flight capacity to move people from those places to their ultimate destinations,” he said.Food and mood often go together.

You might reach for a comforting bag of chips alternative to zithromax when you feel down. Or feel so stressed that you can’t even think about eating.It’s normal for difficult emotions to make you overeat or eat too little. But if you live with clinical depression, changes in eating can be long-term and lead to drastic weight gain or loss.The Link Between Depression and WeightWeight gain and depression can stem from social, environmental, and biological causes, says Roger McIntyre, MD, a professor of psychiatry and pharmacology at the University of Toronto. For example, people alternative to zithromax with financial insecurity or who’ve had troubled childhoods are at a higher risk of both obesity and depression.Things in the environment also can play a role for those who live in “food deserts or food swamps,” McIntyre says. Living amid fast-food joints and convenience stores and far from grocery stores with fresh produce makes it harder to eat healthy.The depression-weight link cuts both ways.

People who are depressed are more likely to be obese. And people alternative to zithromax with obesity are at higher risk of depression. It’s the classic “chicken and egg question,” says Rodrigo Mansur, MD, a psychiatrist at the University of Toronto. Scientists are still trying to parse the complex web of factors behind those relationships.“It's not as simple as people develop depression, alternative to zithromax they are less motivated to exercise and they eat more, therefore they gain weight,” Mansur says. €œThere's obviously some truth to that.

But that is an oversimplification of what actually happens.”One of the classic symptoms of depression is the loss of interest and pleasure in activities. The clinical name for this is anhedonia alternative to zithromax. Scientists say it is rooted in the brain’s reward system and can make once enjoyable activities suddenly seem mundane.Take food, for example. Your mouth alternative to zithromax detects tastes such as sweetness and satisfying umami. But the pleasure you get from eating is processed by your brain.

If that reward system goes haywire, it can lead you to seek more food in order to make up for the dull or absent pleasure. €œWhen they ingest food, it doesn’t satisfy the alternative to zithromax anticipated reward,” McIntyre says. This can lead to food addiction, “terrible cravings for food that are uncontrollable.”Depression also can interfere with your impulse control. Studies have shown that people who are depressed are more likely alternative to zithromax to take risks, such as having unsafe sex. Similar cognitive impairments can result in eating disorders like binge eating and bulimia.And the stress hormone cortisol can also play a role because it is linked to insulin resistance and obesity.

At first, stress can dampen your appetite. But long-term stress can lead to higher insulin levels that alternative to zithromax drive down blood sugar and cause cravings for sugary and fatty foods.In rare cases, people who are depressed can have cognitive distortions or thoughts that change their worldview in a way that leads to changes in weight, says Elizabeth Prince, DO, a psychiatrist at Johns Hopkins University. Prince says she checks her patients for signs that they aren’t purposely avoiding food because of a belief that “they aren’t deserving of food,” for example. If that is the case, it is a sign their depression has become severe.Breaking the LinkYour depression symptoms may be very different from those of someone else. So your alternative to zithromax treatments should be tailored for you.“There’s not one thing that will always treat depression.

It’s really individualized and something people should work on with their doctor who knows them best,” Prince says. She says a comprehensive treatment plan that alternative to zithromax addresses both the depression and the weight issue is best “because they clearly impact one another.”For McIntyre, the first question is whether his patients are sleeping well. He sometimes prescribes medication if he thinks it might help. He also stresses the basics of healthy eating. Finally, he urges people to alternative to zithromax get some kind of physical activity.

In his research, he has shown that people who remain active, even just by going to work, school, or volunteering in the community, have much better outcomes with anti-depression treatment. €œWe are not suggesting running a marathon, but there has to be some activity,” he says.The fact is that there are no universal rules alternative to zithromax for treating depression and weight issues. €œThere is no silver bullet,” McIntyre says. Still, he’s is hopeful that more research and data in this area will lead to better, evidence-based approaches. €I think alternative to zithromax the future holds a ton of promise in improving outcomes.”Aug.

23, 2021 -- Did your parents light up when you were a kid?. If so, you may have a higher risk of having rheumatoid arthritis as an adult, a new study suggests. Researchers found alternative to zithromax evidence that women whose parents smoked had a 75% higher risk of having the disorder. In people with rheumatoid arthritis (RA), the immune system attacks and damages joints, causing pain. The disease is fairly uncommon, affecting 1% or less of people, and most won’t develop it regardless of whether their alternative to zithromax parents smoked.

Still, experts say the study matters because it provides more evidence of how being around secondhand smoke in childhood can have a lifelong impact on the immune system. €œThe findings drive home the importance of reducing cigarette smoke exposure to reduce risk of disease,” said Milena A. Gianfrancesco, PhD, an epidemiologist at the University of California, San Francisco alternative to zithromax. €œThey highlight the need to not only focus on one’s http://treorisoft.com/?page_id=2 personal smoking habits, but also other sources of secondhand smoke exposure.” The researchers, whose study appeared Aug. 18 in the journal Arthritis & alternative to zithromax.

Rheumatology, tracked more than 90,000 women who joined the Nurses’ Health Study II in 1989 when they were between the ages of 25 and 42. At the study’s start, the average age of the participants was 35, and 93% were white. Almost two-thirds had never smoked themselves, and 65% said their parents had smoked alternative to zithromax during their childhoods. The researchers discovered that about 350 of the women had developed RA over the next 3 decades. The researchers then tried to figure out if these alternative to zithromax women were more likely to have had parents who smoked.

The study authors estimated that childhood exposure to parental smoking boosted their risk of RA by 41%. The researchers also tried another statistical strategy, this one designed to account for the fact that many kids whose parents smoke go on to smoke themselves. This analysis suggested that having parents who smoked might alternative to zithromax raise the risk of RA by 75%. So does this mean that women whose parents smoked are doomed to develop arthritis?. Not at all.

The overall alternative to zithromax rate of RA in the women in the study was around half of 1%, says Kazuki Yoshida, MD, the study’s lead author and an epidemiologist at Brigham and Women’s Hospital. And most of these women had parents who smoked when they were kids. Why Might Exposure to Secondhand Smoke Boost the Risk of RA? alternative to zithromax. Exposure to secondhand smoke may irritate the lungs and cause abnormal proteins to form, Yoshida says. €œThe immune system produces antibodies in an attempt to attack such abnormal proteins.

This immune reaction can spread to other body sites and attack normal tissues, including the joints.” In addition, “smoking increases the risk of s, which could in turn increase the risk of RA,” says Gianfrancesco, who wrote a alternative to zithromax commentary that went with the study. €œSmoking is also known to result in changes surrounding the genome, which could trigger RA in susceptible people.” Other studies have linked smoking exposure to autoimmune disorders. Earlier this year, researchers who tracked almost 80,000 French women reported that they found a link between exposure to smoking during childhood or adulthood and higher rates of alternative to zithromax RA. The new study has limits. It says nothing about whether a similar risk exists for males.

And the nurse subjects are overwhelmingly white, which means the results may not alternative to zithromax apply to women of other ethnicities. Still, Gianfrancesco praised the study and says it relies on extensive data and strong statistical methods. How can the findings be useful?. According to Gianfrancesco, it’s important to understand that children with a family history of RA or other autoimmune alternative to zithromax disorders are especially vulnerable to the effects of secondhand smoke, because they already may be more susceptible to developing the diseases. €œParents should keep their children away from secondhand smoke in the home or other environments in which smoke is prevalent, such as the home of another caregiver or a workplace if the child accompanies their parent to work,” she says.

WebMD Health News Sources alternative to zithromax Arthritis &. Rheumatology. €œPassive Smoking Throughout the Life Course and the Risk of Incident Rheumatoid Arthritis in Adulthood Among Women,” “Where There’s Smoke, There’s a Joint. Passive Smoking and Rheumatoid Arthritis.” © 2021 WebMD, LLC alternative to zithromax. All rights reserved.MONDAY, Aug.

23, 2021 (HealthDay News) -- Taking a drug meant for horses and cattle to prevent or treat buy antibiotics is dangerous and alternative to zithromax could be fatal, the U.S Food and Drug Administration warns. The agency has received multiple reports of people who have been hospitalized after "self-medicating with ivermectin intended for horses," the agency said in a consumer update. Ivermectin, which is not an anti-viral drug, is generally used to treat or prevent parasites in animals, NBC News reported. "You are alternative to zithromax not a horse. You are not a cow.

Seriously, y'all alternative to zithromax. Stop it," the FDA tweeted on Saturday. No form of ivermectin has been approved to treat or prevent buy antibiotics, the agency emphasized. It said it was compelled to issue a warning due to "a lot of misinformation" around the drug, alternative to zithromax according to the update. "You may have heard that it's okay to take large doses of ivermectin.

That is wrong," the FDA said. The agency clarified that the FDA-approved ivermectin tablets that treat people with certain conditions caused by parasitic worms as well as topical formulations used for head lice and skin conditions like rosacea are different alternative to zithromax from the drug used on animals. Ivermectin tablets and topical formulations for humans have "very specific doses" that are significantly smaller than the doses meant for animals, the agency explained. Also, "many inactive ingredients found in animal products aren't evaluated for use in people," the alternative to zithromax FDA warned. "In some cases, we don't know how those inactive ingredients will affect how ivermectin is absorbed in the human body." "These animal drugs are often highly concentrated because they are used for large animals like horses and cows, which can weigh a lot more than" a human, the FDA added.

"Such high doses can be highly toxic in humans." The FDA said that ivermectin overdoses can cause nausea, vomiting, diarrhea, low blood pressure, allergic reactions, dizziness, problems with balance, seizures, coma and even death, NBC News reported. More information Visit the U.S alternative to zithromax. Centers for Disease Control and Prevention for more on buy antibiotics treatments. SOURCE. NBC NewsBy Robert Preidt and Robin Foster HealthDay Reporter MONDAY, Aug.

23, 2021 (HealthDay News) -- Conservative radio talk show host Phil Valentine, a buy antibiotics treatment skeptic and mask mandate opponent, has died at age 61 of buy antibiotics. "We are saddened to report that our host and friend Phil Valentine has passed away," his station, SuperTalk 99.7 WTN, tweeted Saturday afternoon. "Please keep the Valentine family in your thoughts and prayers." Prior to his diagnosis with buy antibiotics last month, Valentine voiced doubts about antibiotics treatments, CBS News reported. For example, in December of 2020, he tweeted, "I have a very low risk of A) Getting buy antibiotics and B) dying of it if I do. Why would I risk getting a heart attack or paralysis by getting the treatment?.

" Before he was hospitalized with buy antibiotics, Valentine told listeners he was "taking vitamin D like crazy" and that a doctor agreed to prescribe him the anti-parasite drug ivermectin, according to the Associated Press. The U.S. Food and Drug Administration has warned Americans against taking ivermectin to treat or prevent buy antibiotics, and there's no evidence that vitamin D provides any benefits, CBS News reported. After Valentine's condition began to worsen, his brother Mark Valentine went on the radio to say that Phil Valentine was "regretful that he wasn't a more vocal advocate of the vaccination," according to the AP. "For those listening, I know if he were able to tell you this, he would tell you, 'Go get vaccinated.

Quit worrying about the politics. Quit worrying about all the conspiracy theories," his brother said on the air. More information Visit the U.S. Centers for Disease Control and Prevention for more on buy antibiotics treatments. SOURCE.

CBS News WebMD News from HealthDay Copyright © 2013-2020 HealthDay. All rights reserved..

Aug zithromax tablet online buy zithromax online usa. 23, 2021 -- An Afghan woman went into labor while aboard an evacuation flight that landed in Germany on Saturday U.S. Airmen helped to deliver the baby on the C-17 aircraft buy zithromax online usa. The woman and her baby, whose identities were not revealed, were taken to a nearby medical facility.

They’re both in good condition. The flight left from an “intermediate staging base in the Middle East,” according to buy zithromax online usa a statement on the U.S. Air Mobility Command’s Facebook page. It wasn’t revealed when the woman buy zithromax online usa left Afghanistan.

During the flight, the woman went into labor and had complications due to low blood pressure. €œThe aircraft commander made the decision to descend in altitude to increase air pressure in the aircraft, which helped stabilize and save the mother’s life,” according to the Facebook post. Once the plane landed at Ramstein Air Base in southwest Germany, medical personnel from the 86th Medical Group boarded the plane and delivered the baby buy zithromax online usa in the cargo bay. Then the mother and baby were taken to a medical facility for further care.

As of Sunday, more than 6,000 evacuees from Afghanistan have been flown to Ramstein Air Base, with more flights expected in coming days, said a spokesperson for the air base, buy zithromax online usa according to NBC News. Overall, 25,000 people have been evacuated since Aug. 15. Thousands more buy zithromax online usa are waiting to flee, NBC News reported.

The U.S. Will use commercial aircraft to transport people once they have been evacuated from Afghanistan, the Defense Department said Sunday. The 18 aircraft -- from American, Atlas, Delta, Hawaiian, Omni, and United airlines -- buy zithromax online usa won’t fly into Hamid Karzai International Airport in Kabul. Instead, they will be used for the “onward movement of passengers from temporary safe havens and interim staging bases,” John Kirby, press secretary for the Pentagon, said in a statement on Sunday.

This is the third time that buy zithromax online usa the Civil Reserve Air Fleet has been activated. The first time was in support of Operations Desert Shield/Storm between August 1990 and May 1991 during the Persian Gulf War. The second was for Operation Iraqi Freedom between February 2002 and June 2003 after the invasion of Iraq. €œWe’ve reached agreements with about two dozen countries over four continents who are buy zithromax online usa now helping or soon going to help with the transit of people out of Kabul,” Secretary of State Antony Blinken said on Fox News Sunday.

€œThis is one way to make sure we have enough flight capacity to move people from those places to their ultimate destinations,” he said.Food and mood often go together. You might reach for a comforting bag of buy zithromax online usa chips when you feel down. Or feel so stressed that you can’t even think about eating.It’s normal for difficult emotions to make you overeat or eat too little. But if you live with clinical depression, changes in eating can be long-term and lead to drastic weight gain or loss.The Link Between Depression and WeightWeight gain and depression can stem from social, environmental, and biological causes, says Roger McIntyre, MD, a professor of psychiatry and pharmacology at the University of Toronto.

For example, people with financial insecurity or who’ve had troubled childhoods are buy zithromax online usa at a higher risk of both obesity and depression.Things in the environment also can play a role for those who live in “food deserts or food swamps,” McIntyre says. Living amid fast-food joints and convenience stores and far from grocery stores with fresh produce makes it harder to eat healthy.The depression-weight link cuts both ways. People who are depressed are more likely to be obese. And people buy zithromax online usa with obesity are at higher risk of depression.

It’s the classic “chicken and egg question,” says Rodrigo Mansur, MD, a psychiatrist at the University of Toronto. Scientists are still trying to parse the buy zithromax online usa complex web of factors behind those relationships.“It's not as simple as people develop depression, they are less motivated to exercise and they eat more, therefore they gain weight,” Mansur says. €œThere's obviously some truth to that. But that is an oversimplification of what actually happens.”One of the classic symptoms of depression is the loss of interest and pleasure in activities.

The clinical name for this is anhedonia buy zithromax online usa. Scientists say it is rooted in the brain’s reward system and can make once enjoyable activities suddenly seem mundane.Take food, for example. Your mouth buy zithromax online usa detects tastes such as sweetness and satisfying umami. But the pleasure you get from eating is processed by your brain.

If that reward system goes haywire, it can lead you to seek more food in order to make up for the dull or absent pleasure. €œWhen they ingest food, it doesn’t satisfy buy zithromax online usa the anticipated reward,” McIntyre says. This can lead to food addiction, “terrible cravings for food that are uncontrollable.”Depression also can interfere with your impulse control. Studies have shown that buy zithromax online usa people who are depressed are more likely to take risks, such as having unsafe sex.

Similar cognitive impairments can result in eating disorders like binge eating and bulimia.And the stress hormone cortisol can also play a role because it is linked to insulin resistance and obesity. At first, stress can dampen your appetite. But long-term stress can lead to higher insulin levels that drive down blood sugar and cause cravings for sugary and fatty foods.In rare cases, people who are depressed buy zithromax online usa can have cognitive distortions or thoughts that change their worldview in a way that leads to changes in weight, says Elizabeth Prince, DO, a psychiatrist at Johns Hopkins University. Prince says she checks her patients for signs that they aren’t purposely avoiding food because of a belief that “they aren’t deserving of food,” for example.

If that is the case, it is a sign their depression has become severe.Breaking the LinkYour depression symptoms may be very different from those of someone else. So your treatments should be tailored for you.“There’s not one buy zithromax online usa thing that will always treat depression. It’s really individualized and something people should work on with their doctor who knows them best,” Prince says. She says a comprehensive treatment plan that addresses both the depression and the weight issue is best “because they clearly impact one another.”For McIntyre, the first question is whether his patients are sleeping buy zithromax online usa well.

He sometimes prescribes medication if he thinks it might help. He also stresses the basics of healthy eating. Finally, he urges people to get some buy zithromax online usa kind of physical activity. In his research, he has shown that people who remain active, even just by going to work, school, or volunteering in the community, have much better outcomes with anti-depression treatment.

€œWe are not buy zithromax online usa suggesting running a marathon, but there has to be some activity,” he says.The fact is that there are no universal rules for treating depression and weight issues. €œThere is no silver bullet,” McIntyre says. Still, he’s is hopeful that more research and data in this area will lead to better, evidence-based approaches. €I think the buy zithromax online usa future holds a ton of promise in improving outcomes.”Aug.

23, 2021 -- Did your parents light up when you were a kid?. If so, you may have a higher risk of having rheumatoid arthritis as an adult, a new study suggests. Researchers found evidence that women whose parents smoked had a buy zithromax online usa 75% higher risk of having the disorder. In people with rheumatoid arthritis (RA), the immune system attacks and damages joints, causing pain.

The disease is fairly uncommon, affecting 1% or less of people, and most won’t develop it regardless of whether their parents buy zithromax online usa smoked. Still, experts say the study matters because it provides more evidence of how being around secondhand smoke in childhood can have a lifelong impact on the immune system. €œThe findings drive home the importance of reducing cigarette smoke exposure to reduce risk of disease,” said Milena A. Gianfrancesco, PhD, an epidemiologist at the buy zithromax online usa University of California, San Francisco.

€œThey highlight the need to not only focus on one’s personal smoking habits, but also other important site sources of secondhand smoke exposure.” The researchers, whose study appeared Aug. 18 in buy zithromax online usa the journal Arthritis &. Rheumatology, tracked more than 90,000 women who joined the Nurses’ Health Study II in 1989 when they were between the ages of 25 and 42. At the study’s start, the average age of the participants was 35, and 93% were white.

Almost two-thirds had never smoked themselves, and 65% said their parents buy zithromax online usa had smoked during their childhoods. The researchers discovered that about 350 of the women had developed RA over the next 3 decades. The researchers then tried to figure out if these women were buy zithromax online usa more likely to have had parents who smoked. The study authors estimated that childhood exposure to parental smoking boosted their risk of RA by 41%.

The researchers also tried another statistical strategy, this one designed to account for the fact that many kids whose parents smoke go on to smoke themselves. This analysis suggested that having parents who smoked might raise the risk of RA by buy zithromax online usa 75%. So does this mean that women whose parents smoked are doomed to develop arthritis?. Not at all.

The overall rate of RA in the women in the study was around half of 1%, says Kazuki Yoshida, MD, the buy zithromax online usa study’s lead author and an epidemiologist at Brigham and Women’s Hospital. And most of these women had parents who smoked when they were kids. Why buy zithromax online usa Might Exposure to Secondhand Smoke Boost the Risk of RA?. Exposure to secondhand smoke may irritate the lungs and cause abnormal proteins to form, Yoshida says.

€œThe immune system produces antibodies in an attempt to attack such abnormal proteins. This immune reaction can spread to other body sites and attack normal tissues, including the joints.” In addition, “smoking increases the risk of s, which could in turn increase the risk of RA,” says Gianfrancesco, buy zithromax online usa who wrote a commentary that went with the study. €œSmoking is also known to result in changes surrounding the genome, which could trigger RA in susceptible people.” Other studies have linked smoking exposure to autoimmune disorders. Earlier this year, researchers who tracked almost 80,000 French women reported that they found a link between exposure to smoking during childhood or adulthood and higher buy zithromax online usa rates of RA.

The new study has limits. It says nothing about whether a similar risk exists for males. And the nurse subjects are overwhelmingly white, which means the results may not apply buy zithromax online usa to women of other ethnicities. Still, Gianfrancesco praised the study and says it relies on extensive data and strong statistical methods.

How can the findings be useful?. According to Gianfrancesco, it’s important to understand that children with a family history of RA or other autoimmune disorders are especially vulnerable to the effects of buy zithromax online usa secondhand smoke, because they already may be more susceptible to developing the diseases. €œParents should keep their children away from secondhand smoke in the home or other environments in which smoke is prevalent, such as the home of another caregiver or a workplace if the child accompanies their parent to work,” she says. WebMD buy zithromax online usa Health News Sources Arthritis &.

Rheumatology. €œPassive Smoking Throughout the Life Course and the Risk of Incident Rheumatoid Arthritis in Adulthood Among Women,” “Where There’s Smoke, There’s a Joint. Passive Smoking buy zithromax online usa and Rheumatoid Arthritis.” © 2021 WebMD, LLC. All rights reserved.MONDAY, Aug.

23, 2021 (HealthDay News) -- Taking a drug meant for horses buy zithromax online usa and cattle to prevent or treat buy antibiotics is dangerous and could be fatal, the U.S Food and Drug Administration warns. The agency has received multiple reports of people who have been hospitalized after "self-medicating with ivermectin intended for horses," the agency said in a consumer update. Ivermectin, which is not an anti-viral drug, is generally used to treat or prevent parasites in animals, NBC News reported. "You are not a horse buy zithromax online usa.

You are not a cow. Seriously, y'all buy zithromax online usa. Stop it," the FDA tweeted on Saturday. No form of ivermectin has been approved to treat or prevent buy antibiotics, the agency emphasized.

It said it was compelled to issue a warning buy zithromax online usa due to "a lot of misinformation" around the drug, according to the update. "You may have heard that it's okay to take large doses of ivermectin. That is wrong," the FDA said. The agency buy zithromax online usa clarified that the FDA-approved ivermectin tablets that treat people with certain conditions caused by parasitic worms as well as topical formulations used for head lice and skin conditions like rosacea are different from the drug used on animals.

Ivermectin tablets and topical formulations for humans have "very specific doses" that are significantly smaller than the doses meant for animals, the agency explained. Also, "many inactive ingredients found in buy zithromax online usa animal products aren't evaluated for use in people," the FDA warned. "In some cases, we don't know how those inactive ingredients will affect how ivermectin is absorbed in the human body." "These animal drugs are often highly concentrated because they are used for large animals like horses and cows, which can weigh a lot more than" a human, the FDA added. "Such high doses can be highly toxic in humans." The FDA said that ivermectin overdoses can cause nausea, vomiting, diarrhea, low blood pressure, allergic reactions, dizziness, problems with balance, seizures, coma and even death, NBC News reported.

More information Visit buy zithromax online usa the U.S. Centers for Disease Control and Prevention for more on buy antibiotics treatments. SOURCE. NBC NewsBy Robert Preidt and Robin Foster HealthDay Reporter MONDAY, Aug.

23, 2021 (HealthDay News) -- Conservative radio talk show host Phil Valentine, a buy antibiotics treatment skeptic and mask mandate opponent, has died at age 61 of buy antibiotics. "We are saddened to report that our host and friend Phil Valentine has passed away," his station, SuperTalk 99.7 WTN, tweeted Saturday afternoon. "Please keep the Valentine family in your thoughts and prayers." Prior to his diagnosis with buy antibiotics last month, Valentine voiced doubts about antibiotics treatments, CBS News reported. For example, in December of 2020, he tweeted, "I have a very low risk of A) Getting buy antibiotics and B) dying of it if I do.

Why would I risk getting a heart attack or paralysis by getting the treatment?. " Before he was hospitalized with buy antibiotics, Valentine told listeners he was "taking vitamin D like crazy" and that a doctor agreed to prescribe him the anti-parasite drug ivermectin, according to the Associated Press. The U.S. Food and Drug Administration has warned Americans against taking ivermectin to treat or prevent buy antibiotics, and there's no evidence that vitamin D provides any benefits, CBS News reported.

After Valentine's condition began to worsen, his brother Mark Valentine went on the radio to say that Phil Valentine was "regretful that he wasn't a more vocal advocate of the vaccination," according to the AP. "For those listening, I know if he were able to tell you this, he would tell you, 'Go get vaccinated. Quit worrying about the politics. Quit worrying about all the conspiracy theories," his brother said on the air.

More information Visit the U.S. Centers for Disease Control and Prevention for more on buy antibiotics treatments. SOURCE. CBS News WebMD News from HealthDay Copyright © 2013-2020 HealthDay.

What should my health care professional know before I take Zithromax?

They need to know if you have any of these conditions:;

  • kidney disease; liver disease
  • pneumonia
  • stomach problems (especially colitis)
  • other chronic illness; an unusual or allergic reaction to azithromycin
  • other macrolide antibiotics (such as erythromycin), foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

Where can i get zithromax over the counter

Start Preamble Office of Infectious Disease and HIV/AIDS Policy (OIDP), Office of the Assistant Secretary for Health, Office of where can i get zithromax over the counter the Secretary, Department of Health and Human Services (HHS). Notice. The Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS where can i get zithromax over the counter Policy (OIDP) in the Office of the Assistant Secretary for Health (OASH) announces the draft treatments National Strategic Plan 2021-2025 (treatment Plan) available for public comment. The draft treatment Plan may be reviewed at www.hhs.gov/​oidp. All comments must be received by 5:00 p.m.

ET on where can i get zithromax over the counter December 3, 2020 to be considered. All comments must be submitted electronically to NVP.RFI@hhs.gov to be considered. Start Further Info David Kim, OIDP, David.Kim@hhs.gov, 202-795-7636 where can i get zithromax over the counter. End Further Info End Preamble Start Supplemental Information The development of a National treatment Plan was mandated by Congress as a mechanism for the Director of the National treatment Program (as delegated by the Assistant Secretary for Health) to communicate priorities for achieving the Program's responsibilities of ensuring adequate supply of and access to treatments and ensuring the effective and optimal use of treatments. The most recent Plan, released in 2010, provided a comprehensive 10-year national strategy for enhancing all aspects of the plan, including treatment research and development, supply, financing, distribution, and safety.

Informed decision-making by where can i get zithromax over the counter consumers and health care providers. treatment-preventable disease surveillance. treatment effectiveness and where can i get zithromax over the counter use monitoring. And global cooperation (http://www.hhs.gov/​nvpo/​vacc_​plan/​index.html). The 2010 Plan and the associated implementation plan (https://www.hhs.gov/​sites/​default/​files/​nvpo/​vacc_​plan/​2010-2015-Plan/​implementationplan.pdf) have played an important role in guiding strategies and allocations of resources with respect to treatments and vaccination.

However, since the publication of where can i get zithromax over the counter the 2010 Plan, there have been many changes in the treatment landscape. With U.S. Vaccination rates above 90% for many childhood treatments, most individuals have not witnessed firsthand the devastating illnesses against which treatments offer protection, such as polio or diphtheria. According to a recent study, routine childhood immunizations among where can i get zithromax over the counter U.S. Children born in 2009 will prevent 20 million cases of disease and 42,000 premature deaths, with a net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs.[] In contrast, adult vaccination coverage rates have remained persistently low, with only modest gains for certain populations in the past few years.[] As a result, the standards for adult immunization practice were updated in 2014 to promote integration of treatments into routine clinical care for adults.[] Start Printed Page 74739 Despite the widespread availability of effective treatments, treatment-preventable diseases (VPDs) remain a significant public health challenge.

In particular, rates of non-medical exemptions for childhood treatments are increasing,[] and there have been recent measles outbreaks in the U.S.[] and globally, due to growing treatment hesitancy and where can i get zithromax over the counter coverage levels below the threshold needed for herd immunity. With an estimated cost of $20,000 per case of measles to the public sector in 2016,[] the economic consequences of this and other VPDs, as well as the health consequences, are significant. Furthermore, few adults in any age group are fully vaccinated as recommended by the Advisory Committee on Immunization Practices.[] Large disparities in treatment coverage by race/ethnicity persist, with African Americans, Hispanics, and Asian Americans lagging behind whites in nearly all vaccination coverage rates.[] VPDs such as pertussis and hepatitis B continue to take a heavy toll on public health,[] with 18,975 cases of pertussis and 3,409 (22,000 estimated) cases of hepatitis B s reported in the United States in 2017.[] In light of these challenges, strengthening the treatment and immunization enterprise is a priority for HHS. To respond to the public health challenges of VPDs, OIDP in collaboration with other federal partners is leading the development of the treatments National Strategic Plan (treatment where can i get zithromax over the counter Plan). This updated plan will recommend treatment strategies across the lifespan and guide priority actions for the period 2021-2025.

While buy antibiotics and antibiotics treatment where can i get zithromax over the counter development are currently changing the landscape of the treatment enterprise, the treatment Plan has a broad focus on the entire treatment enterprise and is not focused specifically on any one treatment or the zithromax response. HHS, through OIDP, seeks input regarding the draft of the treatment Plan from subject matter experts and nonfederal partners and stakeholders such as health care providers, national professional organizations, health departments, school administrators, community-based and faith-based organizations, manufacturers, researchers, advocates, and persons affected by VPDs. The following are the treatment Plan's vision and goals. Vision. United States will be a place where treatment-preventable diseases are eliminated through safe and effective vaccination over the lifespan.

Goals. 1. Foster innovation in treatment development and related technologies. 2. Maintain the highest possible levels of treatment safety.

3. Increase knowledge of and confidence in routinely recommended. 4. Increase access to and use of all routinely recommended treatments. 5.

Protect the health of the American public by supporting global immunization efforts. Information Needs The draft treatment Plan may be reviewed at www.hhs.gov/​oidp. OIDP seeks to obtain feedback from external stakeholders on the following. 1. Do the draft treatment Plan's goals, objectives, and strategies appropriately address the treatment landscape?.

2. Are there any critical gaps in the treatment Plan's goals, objectives, and strategies?. If so, please specify the gaps. 3. Do any of the treatment Plan's goals, objectives and strategies cause concern?.

If so, please specify the goal, objective or strategy, and describe the concern regarding it. Please be succinct and limit your comments to a maximum of seven pages. Start Authority 42 U.S.C. Section 300aa-3. End Authority Start Signature Dated.

November 17, 2020. B. Kaye Hayes, Acting Director, Office of Infectious Disease and HIV/AIDS Policy. End Signature End Supplemental Information [FR Doc. 2020-25842 Filed 11-20-20.

8:45 am]BILLING CODE 4150-43-PIntroductionWith the U.S. Still in the midst of an escalating buy antibiotics zithromax, attention to the race for a safe and effective buy antibiotics treatment has intensified. What is clear is that when treatments do become available, ensuring equitable and rapid distribution to the U.S. Population will present an unprecedented challenge. The Trump Administration, under Operation Warp Speed, has already purchased in advance hundreds of million doses of several treatment candidates, two of which have already demonstrated significant efficacy in Phase 3 clinical trials, and has begun planning for what will be the largest scale vaccination distribution effort ever undertaken in the U.S.

This task will soon be inherited by the incoming Biden Administration, which has established a buy antibiotics Task Force and is already planning its response.A limited number of buy antibiotics treatment doses may start to become available as early as December, with more doses available over time. State, territorial, and local governments, who already have primary authority over routine vaccination, will play an increasingly important role in the distribution of these treatments as more doses become available. In preparation, the federal government has asked the 64 jurisdictional immunization programs (all 50 states and DC, 8 U.S. Territories and freely associated Pacific states and five cities) that the Centers for Disease Control and Prevention (CDC) funds and works with to develop buy antibiotics treatment distribution plans based on an Interim Playbook. The Playbook includes planning assumptions for jurisdictions to follow and requested information in 15 key areas (see Box).

First drafts of these plans were due by October 16. In its Interim Playbook CDC provided states with a set of planning assumptions as they developed their treatment distribution plans. For example, CDC outlined how treatment distribution will likely proceed in phases:Phase 1 – there is an initial limited supply of treatment doses that will be prioritized for certain groups and distribution more tightly controlled and limited number of providers administering the treatment;Phase 2 – supply would increase and access expand to include a broader set of the population, with more providers involved, and;Phase 3 – there would likely be sufficient supply to meet demand and distribution would be integrated into routine vaccination programs.CDC requested each state outline its capacities for distributing buy antibiotics treatments across a broad set of 15 critical areas. Public health preparedness planning. Organizational structure.

Plans for a phased approach. Identifying and reaching critical populations to be prioritized for treatment access. Identifying and recruiting providers to administer the treatment. treatment administration capacity. Allocating, distributing, and managing its inventory of treatments.

Storage and handling. Collecting, tracking, and reporting key measures of progress. Second dose reminders. Immunization information system requirements. Developing a comprehensive communications plan around vaccination.

Regulatory considerations. Safety monitoring. And program monitoring.CDC guidance and federal oversight could evolve over the next several months as treatments become available and distribution begins. The Biden campaign and transition team have planned for a more prominent role for the federal government in the U.S. buy antibiotics response, which would likely include more detailed federal guidance and a stronger federal hand in treatment distribution, planning and implementation, even as state and local jurisdictions will remain responsible for much of this effort.

A critical challenge facing treatment distribution efforts will be funding. To date, only $200 million has been distributed to state, territorial, and local jurisdictions for treatment preparedness, though it is estimated that at least $6-8 billion is needed. President-elect Biden has said his administration would seek to invest $25 billion in manufacturing and distribution, which would require Congressional action.While the CDC has made executive summaries of these plans available, there is no central repository for the full plans. We therefore sought to collect plans available from all 50 states and DC, as of November 13, identifying 47 full state plans in total (linked in the “State Plans” tab). We then reviewed each plan to gauge how states described their treatment distribution planning progress to date.

Rather than assess every single component of these plans in detail we identified common themes and concerns across the state plans, in particular focusing on what states reported regarding their progress in the following key areas:identifying priority populations for vaccination in their state;identifying the network of providers in their state that will be responsible for administering treatments;developing the data collection and reporting systems needed to track treatment distribution progress. Andlaying out a communications strategy for the period before and during vaccination.Where are States in their Planning?. Based on the information in their plans, states are in varying stages of preparation for distributing a buy antibiotics treatment. While all have established a task force or planning committee to steer these efforts, which include representatives from different sectors, some have been planning for several months while other states’ planning efforts have started more recently. Some states have already begun the process of signing up providers to administer buy antibiotics treatments and building out existing immunization registries, while others are still just developing plans to do the same.

All reported, however, that these initial plans are to be considered drafts only, to be updated as more information from the federal government and about a treatment itself was available. Specifically, almost all cited the need to know which treatment(s) would be authorized or approved, and that they will look to further federal guidance and recommendations before some key decisions are made, such as finalizing which individuals will be targeted as priority populations. Several raised concerns about the lack of visibility regarding treatment distributions that will be made directly from the federal government to certain providers in their states, such as large pharmacy chains. These concerns were raised before the November 12 announcement by the federal government that it will be distributing future buy antibiotics treatments directly to some independent pharmacies and multi-state pharmacy chains across the U.S., in parallel to state efforts to recruit vaccination providers. States also discussed lessons learned from previous treatment distribution efforts such as H1N1 zithromax influenza, including the need to build flexibility into distribution plans when supply is unpredictable and tailoring messages and outreach to diverse populations, which are certain to be challenges for a buy antibiotics treatment as well.

Finally, even recognizing the that states are in different states of readiness in terms of their distribution planning efforts, it is clear all state health departments are taking this responsibility seriously and are overseeing significant efforts to make progress in their preparations.Priority PopulationsEach state will have to determine exactly who will be first in line to receive the likely limited number of treatment doses that will be made available initially. In their plans, almost every state reports they are relying heavily on guidance from the federal government to define who these priority populations are, drawing on recommendations from the National Academies of Medicine and also expecting additional guidance from the CDC’s Advisory Committee on Immunization Practices. Many states report they will shape their prioritization plans using locally-defined criteria as well. Every state plan highlights the following broad categories as being priority populations for Phase 1 efforts. Health care workers, essential workers, and those at high risk (older people and those with pre-disposing health risk factors).

Most plans recognize (and CDC indicated in its guidance) that there will likely not be enough treatments at first for all individuals identified in these Phase 1 priority groups. Even so, plans show that some states are much further along in defining prioritization categories and enumerating the number of people that fall into those categories. For example:Less than half (19 of 47, or 40%) of state plans reviewed include a numerical estimate of the number of individuals in different priority populations. The majority of states report they are still developing their data sources and methodology to calculate the number in their priority groups.Some states report already developing specific estimates of the numbers of health care workers likely among the first individuals targeted for vaccination, while other states do not include these estimates, or mention that they are working on developing methods to identify the numbers to be targeted in this group.A majority of states (25 of 47, or 53%) have at least one mention of incorporating racial and/or ethnic minorities or health equity considerations in their targeting of priority populations. Some states expect to make racial and ethnic minorities an explicit priority population group, while others report using more general or indirect methods to do so, such as through use of the social vulnerability index (as was recommended by the NAM) and/or a Health Equity Team or Framework, as in the case of Arizona, California, Georgia, Louisiana, New Jersey, Ohio, and Vermont.ProvidersEach state will rely on a network of providers to administer the treatments to individuals.

These providers will likely include hospitals and doctors’ offices, pharmacies, health departments, federally qualified health centers, and other clinics that play a role in administering treatments today. However, given the need to quickly vaccinate most residents, states will need to include additional partners, such as long-term care facilities, in the network and will potentially establish mass vaccination sites in public locations like schools and community centers. Prior to distribution and administration of treatments, states will have to identify, vet, and approve hundreds to thousands of partners and site locations for treatment delivery. According to the draft plans, states are at different points in the process of identifying these providers and expanding their network of providers needed to deliver treatments to priority population groups. States that require providers to participate in immunization registries or those that already have most providers participating in these registries are further along in developing their provider networks, while other states report that they still need to start the process of enrolling providers.Less than a third (13 of 47, or 28%) of states’ plans provide an estimate of the number of treatment providers in the state, and only six provide some estimate of the number of providers by type (though some of these are limited to only one provider type).About half (24 of 47, or 51%) report an estimate of the number of providers already participating in their immunization registries.

A few states have also begun specific outreach to register as buy antibiotics providers, although these efforts are in their beginning phases. At the same time, some states, particularly rural states, raise concerns about the lack of personnel to carry out vaccination in some areas, or how they will be able to send small enough batches of treatments to be distributed by rural providers who may only be vaccinating a limited number of individuals.Only a subset (12 of 47, or 26%) of state plans specifically mention or consider providers that are needed to reach racial and ethnic minorities.Across plans, the most common types of providers that states report still needing to reach out to or incorporate as buy antibiotics treatment providers include. Tribal providers, long-term care facilities, correctional facilities, and other types of adult care providers.Data Collection and ReportingAll states have an immunization registry of one kind or another to track vaccinations administered by providers in their state. These registries range in terms of their comprehensiveness and reporting functionality. To incorporate the data collection and reporting needs for buy antibiotics vaccination, many states are relying on (and often expanding) existing state-level immunization registries, while other states are developing new systems or using systems provided by the federal government.

From the information in the draft plans, it is clear that some states are in a much better position in terms of their data collection and reporting capacity for buy antibiotics treatments, while others have more work to do to develop their systems, In addition, some common issues have been raised by states in their plans.Just over half (25 of 47, or 53% ) of state plans report having immunization registries/database systems in place that are described as being (at least fairly) comprehensive and reliable. In the other state plans that information is unclear. Most states report still having to develop or add functionality to their existing immunization registries to be prepared for buy antibiotics treatment administration.Most states report they will have no issues reporting the key data from their immunization registries to federal systems, though at least fifteen states report that data sharing agreements with federal partners are still being reviewed or remain in process.Several states raise concerns about the ability to report certain CDC-recommended data elements to federal systems or meet CDC time requirements for reporting. States also mention limitations in collecting race/ethnicity data on individuals vaccinated.Virtually all states’ plans incorporate expectations and procedures to report any treatment adverse events through federal reporting systems such as the treatment Adverse Events Reporting System (VAERS).CommunicationsDeveloping a communications plan before and during buy antibiotics vaccination will be critical component of state planning. CDC requested that states outline how they will proactively design communication plans that anticipate and respond to the needs and concerns of different population groups.

This includes the need to address misinformation and treatment hesitancy, as well as crisis communications. Some states’ plans have very detailed explanations of their approach to communications across the vaccination phases, while others provide very little detail. Additionally, some state plans recognize the need to develop targeted messaging for vulnerable populations, while others do not.About half (23 of 47, or 49%) of plans specifically mention racial/ethnic minorities or vulnerable populations when discussing buy antibiotics treatment communication.Just over a third (18 of 47, or 38%) of state plans include at least a mention of addressing treatment misinformation but most of these states do not provide specific strategies for countering misinformation. State Plans.

Start Preamble Office of Infectious Disease and HIV/AIDS Policy buy zithromax online usa (OIDP), Office of the Assistant Secretary for Health, Office of the Secretary, Department of Health and Human Services (HHS). Notice. The Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) in the Office of the Assistant Secretary for Health (OASH) buy zithromax online usa announces the draft treatments National Strategic Plan 2021-2025 (treatment Plan) available for public comment. The draft treatment Plan may be reviewed at www.hhs.gov/​oidp.

All comments must be received by 5:00 p.m. ET on December 3, 2020 to be buy zithromax online usa considered. All comments must be submitted electronically to NVP.RFI@hhs.gov to be considered. Start Further Info buy zithromax online usa David Kim, OIDP, David.Kim@hhs.gov, 202-795-7636.

End Further Info End Preamble Start Supplemental Information The development of a National treatment Plan was mandated by Congress as a mechanism for the Director of the National treatment Program (as delegated by the Assistant Secretary for Health) to communicate priorities for achieving the Program's responsibilities of ensuring adequate supply of and access to treatments and ensuring the effective and optimal use of treatments. The most recent Plan, released in 2010, provided a comprehensive 10-year national strategy for enhancing all aspects of the plan, including treatment research and development, supply, financing, distribution, and safety. Informed decision-making by consumers and health care providers buy zithromax online usa. treatment-preventable disease surveillance.

treatment effectiveness buy zithromax online usa and use monitoring. And global cooperation (http://www.hhs.gov/​nvpo/​vacc_​plan/​index.html). The 2010 Plan and the associated implementation plan (https://www.hhs.gov/​sites/​default/​files/​nvpo/​vacc_​plan/​2010-2015-Plan/​implementationplan.pdf) have played an important role in guiding strategies and allocations of resources with respect to treatments and vaccination. However, since the publication of the 2010 Plan, there have been many changes in the buy zithromax online usa treatment landscape.

With U.S. Vaccination rates above 90% for many childhood treatments, most individuals have not witnessed firsthand the devastating illnesses against which treatments offer protection, such as polio or diphtheria. According to a recent study, routine buy zithromax online usa childhood immunizations among U.S. Children born in 2009 will prevent 20 million cases of disease and 42,000 premature deaths, with a net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs.[] In contrast, adult vaccination coverage rates have remained persistently low, with only modest gains for certain populations in the past few years.[] As a result, the standards for adult immunization practice were updated in 2014 to promote integration of treatments into routine clinical care for adults.[] Start Printed Page 74739 Despite the widespread availability of effective treatments, treatment-preventable diseases (VPDs) remain a significant public health challenge.

In particular, rates of non-medical exemptions for childhood treatments are increasing,[] and there have been recent measles outbreaks in the U.S.[] and globally, due to growing treatment hesitancy and coverage levels below the threshold needed for herd buy zithromax online usa immunity. With an estimated cost of $20,000 per case of measles to the public sector in 2016,[] the economic consequences of this and other VPDs, as well as the health consequences, are significant. Furthermore, few adults in any age group are fully vaccinated as recommended by the Advisory Committee on Immunization Practices.[] Large disparities in treatment coverage by race/ethnicity persist, with African Americans, Hispanics, and Asian Americans lagging behind whites in nearly all vaccination coverage rates.[] VPDs such as pertussis and hepatitis B continue to take a heavy toll on public health,[] with 18,975 cases of pertussis and 3,409 (22,000 estimated) cases of hepatitis B s reported in the United States in 2017.[] In light of these challenges, strengthening the treatment and immunization enterprise is a priority for HHS. To respond to the public health challenges of VPDs, OIDP in collaboration with other federal partners is leading the development of the treatments National Strategic Plan (treatment Plan) buy zithromax online usa.

This updated plan will recommend treatment strategies across the lifespan and guide priority actions for the period 2021-2025. While buy antibiotics and antibiotics treatment development are currently changing the landscape of the treatment enterprise, the treatment Plan has a buy zithromax online usa broad focus on the entire treatment enterprise and is not focused specifically on any one treatment or the zithromax response. HHS, through OIDP, seeks input regarding the draft of the treatment Plan from subject matter experts and nonfederal partners and stakeholders such as health care providers, national professional organizations, health departments, school administrators, community-based and faith-based organizations, manufacturers, researchers, advocates, and persons affected by VPDs. The following are the treatment Plan's vision and goals.

Vision. United States will be a place where treatment-preventable diseases are eliminated through safe and effective vaccination over the lifespan. Goals. 1.

Foster innovation in treatment development and related technologies. 2. Maintain the highest possible levels of treatment safety. 3.

Increase knowledge of and confidence in routinely recommended. 4. Increase access to and use of all routinely recommended treatments. 5.

Protect the health of the American public by supporting global immunization efforts. Information Needs The draft treatment Plan may be reviewed at www.hhs.gov/​oidp. OIDP seeks to obtain feedback from external stakeholders on the following. 1.

Do the draft treatment Plan's goals, objectives, and strategies appropriately address the treatment landscape?. 2. Are there any critical gaps in the treatment Plan's goals, objectives, and strategies?. If so, please specify the gaps.

3. Do any of the treatment Plan's goals, objectives and strategies cause concern?. If so, please specify the goal, objective or strategy, and describe the concern regarding it. Please be succinct and limit your comments to a maximum of seven pages.

Start Authority 42 U.S.C. Section 300aa-3. End Authority Start Signature Dated. November 17, 2020.

B. Kaye Hayes, Acting Director, Office of Infectious Disease and HIV/AIDS Policy. End Signature End Supplemental Information [FR Doc. 2020-25842 Filed 11-20-20.

8:45 am]BILLING CODE 4150-43-PIntroductionWith the U.S. Still in the midst of an escalating buy antibiotics zithromax, attention to the race for a safe and effective buy antibiotics treatment has intensified. What is clear is that when treatments do become available, ensuring equitable and rapid distribution to the U.S. Population will present an unprecedented challenge.

The Trump Administration, under Operation Warp Speed, has already purchased in advance hundreds of million doses of several treatment candidates, two of which have already demonstrated significant efficacy in Phase 3 clinical trials, and has begun planning for what will be the largest scale vaccination distribution effort ever undertaken in the U.S. This task will soon be inherited by the incoming Biden Administration, which has established a buy antibiotics Task Force and is already planning its response.A limited number of buy antibiotics treatment doses may start to become available as early as December, with more doses available over time. State, territorial, and local governments, who already have primary authority over routine vaccination, will play an increasingly important role in the distribution of these treatments as more doses become available. In preparation, the federal government has asked the 64 jurisdictional immunization programs (all 50 states and DC, 8 U.S.

Territories and freely associated Pacific states and five cities) that the Centers for Disease Control and Prevention (CDC) funds and works with to develop buy antibiotics treatment distribution plans based on an Interim Playbook. The Playbook includes planning assumptions for jurisdictions to follow and requested information in 15 key areas (see Box). First drafts of these plans were due by October 16. In its Interim Playbook CDC provided states with a set of planning assumptions as they developed their treatment distribution plans.

For example, CDC outlined how treatment distribution will likely proceed in phases:Phase 1 – there is an initial limited supply of treatment doses that will be prioritized for certain groups and distribution more tightly controlled and limited number of providers administering the treatment;Phase 2 – supply would increase and access expand to include a broader set of the population, with more providers involved, and;Phase 3 – there would likely be sufficient supply to meet demand and distribution would be integrated into routine vaccination programs.CDC requested each state outline its capacities for distributing buy antibiotics treatments across a broad set of 15 critical areas. Public health preparedness planning. Organizational structure. Plans for a phased approach.

Identifying and reaching critical populations to be prioritized for treatment access. Identifying and recruiting providers to administer the treatment. treatment administration capacity. Allocating, distributing, and managing its inventory of treatments.

Storage and handling. Collecting, tracking, and reporting key measures of progress. Second dose reminders. Immunization information system requirements.

Developing a comprehensive communications plan around vaccination. Regulatory considerations. Safety monitoring. And program monitoring.CDC guidance and federal oversight could evolve over the next several months as treatments become available and distribution begins.

The Biden campaign and transition team have planned for a more prominent role for the federal government in the U.S. buy antibiotics response, which would likely include more detailed federal guidance and a stronger federal hand in treatment distribution, planning and implementation, even as state and local jurisdictions will remain responsible for much of this effort. A critical challenge facing treatment distribution efforts will be funding. To date, only $200 million has been distributed to state, territorial, and local jurisdictions for treatment preparedness, though it is estimated that at least $6-8 billion is needed.

President-elect Biden has said his administration would seek to invest $25 billion in manufacturing and distribution, which would require Congressional action.While the CDC has made executive summaries of these plans available, there is no central repository for the full plans. We therefore sought to collect plans available from all 50 states and DC, as of November 13, identifying 47 full state plans in total (linked in the “State Plans” tab). We then reviewed each plan to gauge how states described their treatment distribution planning progress to date. Rather than assess every single component of these plans in detail we identified common themes and concerns across the state plans, in particular focusing on what states reported regarding their progress in the following key areas:identifying priority populations for vaccination in their state;identifying the network of providers in their state that will be responsible for administering treatments;developing the data collection and reporting systems needed to track treatment distribution progress.

Andlaying out a communications strategy for the period before and during vaccination.Where are States in their Planning?. Based on the information in their plans, states are in varying stages of preparation for distributing a buy antibiotics treatment. While all have established a task force or planning committee to steer these efforts, which include representatives from different sectors, some have been planning for several months while other states’ planning efforts have started more recently. Some states have already begun the process of signing up providers to administer buy antibiotics treatments and building out existing immunization registries, while others are still just developing plans to do the same.

All reported, however, that these initial plans are to be considered drafts only, to be updated as more information from the federal government and about a treatment itself was available. Specifically, almost all cited the need to know which treatment(s) would be authorized or approved, and that they will look to further federal guidance and recommendations before some key decisions are made, such as finalizing which individuals will be targeted as priority populations. Several raised concerns about the lack of visibility regarding treatment distributions that will be made directly from the federal government to certain providers in their states, such as large pharmacy chains. These concerns were raised before the November 12 announcement by the federal government that it will be distributing future buy antibiotics treatments directly to some independent pharmacies and multi-state pharmacy chains across the U.S., in parallel to state efforts to recruit vaccination providers.

States also discussed lessons learned from previous treatment distribution efforts such as H1N1 zithromax influenza, including the need to build flexibility into distribution plans when supply is unpredictable and tailoring messages and outreach to diverse populations, which are certain to be challenges for a buy antibiotics treatment as well. Finally, even recognizing the that states are in different states of readiness in terms of their distribution planning efforts, it is clear all state health departments are taking this responsibility seriously and are overseeing significant efforts to make progress in their preparations.Priority PopulationsEach state will have to determine exactly who will be first in line to receive the likely limited number of treatment doses that will be made available initially. In their plans, almost every state reports they are relying heavily on guidance from the federal government to define who these priority populations are, drawing on recommendations from the National Academies of Medicine and also expecting additional guidance from the CDC’s Advisory Committee on Immunization Practices. Many states report they will shape their prioritization plans using locally-defined criteria as well.

Every state plan highlights the following broad categories as being priority populations for Phase 1 efforts. Health care workers, essential workers, and those at high risk (older people and those with pre-disposing health risk factors). Most plans recognize (and CDC indicated in its guidance) that there will likely not be enough treatments at first for all individuals identified in these Phase 1 priority groups. Even so, plans show that some states are much further along in defining prioritization categories and enumerating the number of people that fall into those categories.

For example:Less than half (19 of 47, or 40%) of state plans reviewed include a numerical estimate of the number of individuals in different priority populations. The majority of states report they are still developing their data sources and methodology to calculate the number in their priority groups.Some states report already developing specific estimates of the numbers of health care workers likely among the first individuals targeted for vaccination, while other states do not include these estimates, or mention that they are working on developing methods to identify the numbers to be targeted in this group.A majority of states (25 of 47, or 53%) have at least one mention of incorporating racial and/or ethnic minorities or health equity considerations in their targeting of priority populations. Some states expect to make racial and ethnic minorities an explicit priority population group, while others report using more general or indirect methods to do so, such as through use of the social vulnerability index (as was recommended by the NAM) and/or a Health Equity Team or Framework, as in the case of Arizona, California, Georgia, Louisiana, New Jersey, Ohio, and Vermont.ProvidersEach state will rely on a network of providers to administer the treatments to individuals. These providers will likely include hospitals and doctors’ offices, pharmacies, health departments, federally qualified health centers, and other clinics that play a role in administering treatments today.

However, given the need to quickly vaccinate most residents, states will need to include additional partners, such as long-term care facilities, in the network and will potentially establish mass vaccination sites in public locations like schools and community centers. Prior to distribution and administration of treatments, states will have to identify, vet, and approve hundreds to thousands of partners and site locations for treatment delivery. According to the draft plans, states are at different points in the process of identifying these providers and expanding their network of providers needed to deliver treatments to priority population groups. States that require providers to participate in immunization registries or those that already have most providers participating in these registries are further along in developing their provider networks, while other states report that they still need to start the process of enrolling providers.Less than a third (13 of 47, or 28%) of states’ plans provide an estimate of the number of treatment providers in the state, and only six provide some estimate of the number of providers by type (though some of these are limited to only one provider type).About half (24 of 47, or 51%) report an estimate of the number of providers already participating in their immunization registries.

A few states have also begun specific outreach to register as buy antibiotics providers, although these efforts are in their beginning phases. At the same time, some states, particularly rural states, raise concerns about the lack of personnel to carry out vaccination in some areas, or how they will be able to send small enough batches of treatments to be distributed by rural providers who may only be vaccinating a limited number of individuals.Only a subset (12 of 47, or 26%) of state plans specifically mention or consider providers that are needed to reach racial and ethnic minorities.Across plans, the most common types of providers that states report still needing to reach out to or incorporate as buy antibiotics treatment providers include. Tribal providers, long-term care facilities, correctional facilities, and other types of adult care providers.Data Collection and ReportingAll states have an immunization registry of one kind or another to track vaccinations administered by providers in their state. These registries range in terms of their comprehensiveness and reporting functionality.

To incorporate the data collection and reporting needs for buy antibiotics vaccination, many states are relying on (and often expanding) existing state-level immunization registries, while other states are developing new systems or using systems provided by the federal government. From the information in the draft plans, it is clear that some states are in a much better position in terms of their data collection and reporting capacity for buy antibiotics treatments, while others have more work to do to develop their systems, In addition, some common issues have been raised by states in their plans.Just over half (25 of 47, or 53% ) of state plans report having immunization registries/database systems in place that are described as being (at least fairly) comprehensive and reliable. In the other state plans that information is unclear. Most states report still having to develop or add functionality to their existing immunization registries to be prepared for buy antibiotics treatment administration.Most states report they will have no issues reporting the key data from their immunization registries to federal systems, though at least fifteen states report that data sharing agreements with federal partners are still being reviewed or remain in process.Several states raise concerns about the ability to report certain CDC-recommended data elements to federal systems or meet CDC time requirements for reporting.

States also mention limitations in collecting race/ethnicity data on individuals vaccinated.Virtually all states’ plans incorporate expectations and procedures to report any treatment adverse events through federal reporting systems such as the treatment Adverse Events Reporting System (VAERS).CommunicationsDeveloping a communications plan before and during buy antibiotics vaccination will be critical component of state planning. CDC requested that states outline how they will proactively design communication plans that anticipate and respond to the needs and concerns of different population groups. This includes the need to address misinformation and treatment hesitancy, as well as crisis communications. Some states’ plans have very detailed explanations of their approach to communications across the vaccination phases, while others provide very little detail.

Additionally, some state plans recognize the need to develop targeted messaging for vulnerable populations, while others do not.About half (23 of 47, or 49%) of plans specifically mention racial/ethnic minorities or vulnerable populations when discussing buy antibiotics treatment communication.Just over a third (18 of 47, or 38%) of state plans include at least a mention of addressing treatment misinformation but most of these states do not provide specific strategies for countering misinformation. State Plans.

Zithromax and flagyl

Share this story Published August 25th, 2021 at 6:00 zithromax and flagyl AM http://jamessmithc21.com/?p=1 Above image credit. Jason and Keri Medows during a recording for Illinois Farm Bureau Women in Ag. Jason launched the "Ag State of Mind" podcast to discuss mental zithromax and flagyl health issues in rural America. (Contributed | Jason Medows) A couple of years ago, Jason Medows, a farmer and pharmacist who works in Rolla, Missouri, was desperate for mental health care. Finding that care was nearly impossible.

€œI called not one, not two, not three providers in Rolla, but four and was zithromax and flagyl not able to be seen,” he said. Two of the lines he called were even disconnected. €œI’m a health care worker. I understand (the system) zithromax and flagyl and I was frustrated,” he said. €œSo I could not imagine what it would be like for someone who is not in my shoes, who doesn’t have an understanding of the system, how they would be discouraged.” Ask someone in rural America what the biggest challenge is to mental health care and they’ll most likely say “access.” Not only is there a lack of mental health professionals in rural communities, experts say, but people often have to travel long distances to find those professionals.

Even then, there are issues with getting it covered by insurance. According to the University of zithromax and flagyl Missouri Extension, all of the 99 rural counties in Missouri have a shortage of mental health professionals. In 57 of those counties there are no mental health professionals. This isn’t just a rural problem, either. Less than 6% zithromax and flagyl of mental health needs are met in Missouri, according to a 2021 report by the Bureau of Health Workforce, Health Resources and Services Administration and the U.S.

Department of Health &. Human Services. That’s less zithromax and flagyl than any other state. In Kansas, about 32% of needs are met. Changing a Rural Mindset Garret Hawkins, president of the Missouri Farm Bureau, said the first obstacle to mental health care for farmers is acknowledging its need.

As a farmer himself, Hawkins said he knows the physically demanding lifestyle of a farmer or zithromax and flagyl rancher encourages a do-it-yourself mentality. And not in a Pinterest, make-your-own-coffee-table type of way, but in a way that stigmatizes asking for help. €œWe’re known for being tough and resilient, yet at the same time, we’re not always the best about asking for help when we need it,” Hawkins said. €œAnd so one of the roles that we have taken on as the state’s largest farm organization is to work with others to tear down the stigma, to let our members know it’s okay to not be okay.” Garrett Hawkins, president of zithromax and flagyl the Missouri Farm Bureau. (Courtesy | Missouri Farm Bureau) Hawkins said Missouri Farm Bureau has been working with the University of Missouri and other partners to normalize conversations around mental health amongst its members.

While others might be able to admit they need help, they might feel a social stigma around entering a mental health care facility or trying to seek help. Kansas Farm Bureau (KFB) and K-State Research zithromax and flagyl and Extension for Farm Stress are also working on bringing more mental health awareness in rural Kansas. Erin Petersilie, assistant director of health plans at KFB, said in a town where common knowledge travels fast it can be uncomfortable to seek care. €œWe also need to think about the fact that there is still very much a stigma surrounding mental health and it is very hard in those small towns when we think about how everybody knows everybody,” Petersilie said. €œSo the last thing people want to have happen is to have a vehicle parked in front of a mental health zithromax and flagyl office, because they are going to get talked about.” KFB and K-State Research and Extension have teamed up to provide more education on mental health warning signs and different numbers and hotlines people can call if they need help.

Amy May, clinical director at North Central Missouri Mental Health, said her rural offices have typically only dealt with severe mental health illnesses like schizophrenia or bipolar disorder. But in the past year or so she’s seen more patients dealing with suicide and depression. Despite the increase in patients, May said many still feel zithromax and flagyl uncomfortable in seeking mental health care. €œI still feel like there is this stigma of we still just don’t want to talk about it. Or we don’t want people to know we’re getting services, especially here,” May said.

“I feel like our offices are kind of in outlying locations and yet I still have clients … they’ll drive to another office just because they don’t want, and they flat out said, zithromax and flagyl ‘I don’t want people to see my car in your parking lot.’ ” Even at the school level, Polo R-VII school counselor Rebecca Chambers-Arway said the invisible illness can be hard for her students to take seriously. She worked with a student for a while who said her friends would make jokes about her counseling sessions. Chambers-Arway’s advice was to remind them that mental well-being is a serious health issue even though it’s not always visible. Someone goes zithromax and flagyl to the doctor for a broken bone, Chambers-Arway noted. How is it any different to seek help for a broken spirit?.

“It’s hard because I still think kids think that a mental illness is a weakness, but so many of us deal with it on a daily basis,” Chambers-Arway said. €œIt’s just zithromax and flagyl (that) it’s hidden. You can’t see it.” Chambers-Arway said she works to simplify complex emotions, like anxiety, and instead helps children to recognize the things they are worried about. Those simplified conversations can evolve as the students age to better understand the way they are feeling. €œI think so many times those feelings aren’t normalized when they’re little, so that’s what they grow up learning,” Chambers-Arway said zithromax and flagyl.

It’s not an issue that can be solved or normalized overnight. Chambers-Arway said she hopes to see more involvement with mental health first aid training both at school and in the community. These sessions can zithromax and flagyl help instructors and parents to recognize signs of mental health issues and know how to intervene, but she said the response in Polo hasn’t been huge. “I think it’s just going to be a constant battle until people, not people, society, embraces it and recognizes that it is something that needs to be addressed,” Chambers-Arway said. In the same vein, Hawkins said the Missouri Farm Bureau is working to teach people the warning signs of mental illness.

In early 2020, the bureau was part of a study noting the effect of economic changes, congressional action zithromax and flagyl and severe weather conditions on the mental well-being of Missouri agriculture producers. Since then, Hawkins said the buy antibiotics zithromax exacerbated mental health conditions as supply chain disruptions and increased isolation caused more stress to farmers. €œJust knowing that family and friends are facing issues makes it even more imperative that maybe we do check-ins more frequently, just to see how folks are doing,” Hawkins said, “Just asking the question, ‘How are you doing?. €™ It’s really that simple.” Thankfully, as studies emerge about this issue, zithromax and flagyl Hawkins said more resources have been made available through the University of Missouri Extension and through the USDA’s Farm and Ranch Stress Assistance Network. Telehealth Counseling Out of Reach After someone in a rural area has identified the signs of mental illness and decided to seek help, where do they turn?.

Hawkins serves on his local hospital board and said the number one issue it is currently faced with, and doesn’t provide, is mental health counseling. €œOne of the challenges that we have as a critical access zithromax and flagyl hospital is how to provide all the services that are needed in our community and the outlying rural areas for our farm and ranch families,” Hawkins said. Telehealth presents itself as a golden solution to reaching rural communities, but access to strong internet connection remains an obstacle. €œIn my hometown of Appleton City, we have the technology to do telehealth, but we don’t have strong enough bandwidth to provide telehealth on a consistent basis that is adequate for the provider, as well as the patient,” Hawkins said. Because Missouri has such a shortage of mental health zithromax and flagyl professionals, Hawkins said telehealth is logistically the best way to reach communities far and wide.

€œIf we have that physical shortage it only makes sense that opportunities provided with telehealth allow us to cast a wider net to try to reach more providers to improve accessibility for farm, ranch and rural families,” Hawkins said. Medows is a big proponent zithromax and flagyl for telehealth counseling. After his unsuccessful search for in-person care, Medows went online, where he was finally able to get help. He now uses a virtual service called Better Health, which allows him to instant message and video conference with licensed professionals. Medows is fortunate because he has access to zithromax and flagyl high-speed internet, but that’s not the case for many in rural communities.

According to the Federal Communications Commission (FCC), just one-fourth of the rural population in America has broadband access. But even this data has been criticized for not being granular enough, meaning that ratio is likely even smaller. Jason Medows, host of the “Ag State of Mind” zithromax and flagyl podcast. (Contributed | Jason Medows) “There is no such thing as affordable high speed internet out here,” Medows said. €œI mean, that’s like a unicorn, as far as I’m concerned.

We’re fortunate to zithromax and flagyl where we can afford it, but even what we afford isn’t very good. We pay $190 a month for internet and it’s not even that good.” Petersilie of KFB said that the bureau has some initiatives to improve broadband access and stressed the importance of making care as accessible as possible. €œHow do farmers access this system?. € Petersilie zithromax and flagyl said. €œWe also need to look at the flip side of that point.

How does that system access the farmers?. € Elaine Johannes of K-State Research and Extension for Farm Stress said not only does there need to be more telehealth zithromax and flagyl options, but quality therapists who understand the unique stressors of rural America and farming. €œWe need to talk about telehealth,” she said. €œWe need top talent. We need to have people understand that therapies can be done online, they can even be done through a cell phone zithromax and flagyl.

Now, that doesn’t replace the human and the interaction between folks. But again, we need to understand what’s going on with mental health care in the United States and especially in rural areas, so we could be allies with it.” Schools are typically reliable locations with stable internet in rural areas, meaning it could be possible to have students take telehealth counseling from the building. Chambers-Arway said her district has started zithromax and flagyl a program like this. €œ(Telehealth therapy) would be an ideal situation. It’s just, I feel like sometimes the insurance hoops are harder to get through than the parents and students agreeing to the support,” Chambers-Arway said.

Insurance hoops were a barrier to students even zithromax and flagyl when the school had an in-person therapist. This program, through Northwest Behavioral Health, designated a therapist to split time between Gallatin, Polo and Hamilton school districts each week. Chambers-Arway said the program was successful and generated a lot of interest, but because it was free to the school and paid for by a student’s insurance, the enrollment paperwork was immense. It sounds like a small inconvenience to fill out the forms and meet with the therapist, but Chambers-Arway said it meant a day off from work and a lot of parents in Polo couldn’t afford that time zithromax and flagyl. €œAs soon as we got that going we had students coming in, and parents, to us and asking, ‘Okay, can we get ours set up with her?.

€™â€ Chambers-Arway said. When the therapist left Northwest Behavioral, zithromax and flagyl Gallatin and Polo were without a replacement, but a well-established need. Chambers-Arway said she tried to get a different person to come to the school, but said it never reached fruition. €œIn my opinion, that’s the only way we’ll be able to secure some mental health support, outside of what I can do as a (school) counselor,” Chambers-Arway said. €œI can’t do some of that deep-seeded counseling in a school setting.” Jennifer Kline, program manager at Northwest Behavioral, said all of the school outreach programs like this have zithromax and flagyl ended because of a shortage in behavioral health providers.

€œIt’s challenging for us to fill vacancies and meet the demand even in urban areas across the board,” Kline said. €œIt’s just not enough people to go around and fill all of the positions.” Providers in rural areas, and especially those working in schools, require specialized knowledge in aiding those populations, making their roles especially difficult to fill. Few and Far Between Local behavioral and mental health facilities zithromax and flagyl like Northwest and North Central Missouri Mental Health are stretched thin, serving four and nine counties, respectively, with outreach offices. Even with these local offices, that leaves a lot unreached or with a significant drive to reach care. A map by the University of Missouri Extension shows all of the mental health facilities in the state.

Many counties are left with just one facility and others are completely zithromax and flagyl barren. Mental Health Support in Missouri A map by the University of Missouri Extension shows that the vast majority of counties in the state (shaded in gray) are experiencing a shortage of mental health professionals. (Courtesy | University of Missouri Extension) May said she sees transportation as a major issue to clients seeking mental health care. “Transportation is a huge barrier for our clients,” zithromax and flagyl May said. €œWe do have a lot of satellite offices.

However, for prescribers and therapists, they may not be able to get to all the offices. So the clients have to travel to a certain office location to get to our services.” Getting care is important, but Medows said for many farmers who work with the daylight, an hour and half trip can be too zithromax and flagyl much time away. €œDouble that drive time and whatever time that you’re there and that’s all time that is lost in whatever else you want to do, working a job, spending time with the family,” Medows said. His passion for mental health awareness led Medows to create his podcast, “Ag State of Mind.” For Medows, it’s important to have farmers and ranchers talking about mental health so others struggling with the same problems know they’re not alone. €œThere needs zithromax and flagyl to be more real people talking about it.

More people sharing their own experience with it and not having the fear of ridicule,” Medows said. By “real people” Medows means the people living with feelings of independence and isolation often associated with rural life. €œPeople who are zithromax and flagyl residents of the rural community. People like me who live in the rural community and share their certain experience in the challenges and are relatable. People who just as easily could be their neighbor, people who people could see being their neighbor.” Marissa Plescia is a Dow Jones summer intern at Kansas City PBS.

Vicky Diaz-Camacho covers community zithromax and flagyl affairs for Kansas City PBS. Cami Koons covers rural affairs for Kansas City PBS in cooperation with Report for America. Like what you are reading?. Discover more zithromax and flagyl unheard stories about Kansas City, every Thursday. Thank you for subscribing!.

Check your inbox, you should see something from us. Your support lets our boots-on-the-ground journalists produce stories like this one. If you believe in local journalism, please donate today. Related Stories.

Share this story Published August 25th, 2021 at 6:00 AM buy zithromax online usa Above image credit. Jason and Keri Medows during a recording for Illinois Farm Bureau Women in Ag. Jason launched the buy zithromax online usa "Ag State of Mind" podcast to discuss mental health issues in rural America. (Contributed | Jason Medows) A couple of years ago, Jason Medows, a farmer and pharmacist who works in Rolla, Missouri, was desperate for mental health care.

Finding that care was nearly impossible. €œI called not one, not two, not three providers buy zithromax online usa in Rolla, but four and was not able to be seen,” he said. Two of the lines he called were even disconnected. €œI’m a health care worker.

I understand buy zithromax online usa (the system) and I was frustrated,” he said. €œSo I could not imagine what it would be like for someone who is not in my shoes, who doesn’t have an understanding of the system, how they would be discouraged.” Ask someone in rural America what the biggest challenge is to mental health care and they’ll most likely say “access.” Not only is there a lack of mental health professionals in rural communities, experts say, but people often have to travel long distances to find those professionals. Even then, there are issues with getting it covered by insurance. According to the University of buy zithromax online usa Missouri Extension, all of the 99 rural counties in Missouri have a shortage of mental health professionals.

In 57 of those counties there are no mental health professionals. This isn’t just a rural problem, either. Less than 6% of mental health needs are met in Missouri, according to a 2021 report by the Bureau of Health Workforce, Health buy zithromax online usa Resources and Services Administration and the U.S. Department of Health &.

Human Services. That’s less than any buy zithromax online usa other state. In Kansas, about 32% of needs are met. Changing a Rural Mindset Garret Hawkins, president of the Missouri Farm Bureau, said the first obstacle to mental health care for farmers is acknowledging its need.

As a farmer himself, buy zithromax online usa Hawkins said he knows the physically demanding lifestyle of a farmer or rancher encourages a do-it-yourself mentality. And not in a Pinterest, make-your-own-coffee-table type of way, but in a way that stigmatizes asking for help. €œWe’re known for being tough and resilient, yet at the same time, we’re not always the best about asking for help when we need it,” Hawkins said. €œAnd so one of the roles that we have taken on as the state’s largest farm organization is to work with others to buy zithromax online usa tear down the stigma, to let our members know it’s okay to not be okay.” Garrett Hawkins, president of the Missouri Farm Bureau.

(Courtesy | Missouri Farm Bureau) Hawkins said Missouri Farm Bureau has been working with the University of Missouri and other partners to normalize conversations around mental health amongst its members. While others might be able to admit they need help, they might feel a social stigma around entering a mental health care facility or trying to seek help. Kansas Farm Bureau (KFB) and K-State Research and Extension for Farm Stress are also working on bringing more mental health awareness in rural Kansas buy zithromax online usa. Erin Petersilie, assistant director of health plans at KFB, said in a town where common knowledge travels fast it can be uncomfortable to seek care.

€œWe also need to think about the fact that there is still very much a stigma surrounding mental health and it is very hard in those small towns when we think about how everybody knows everybody,” Petersilie said. €œSo the last thing people want to have happen is to have a vehicle parked in front of a mental health office, because they are going to get talked about.” KFB and K-State Research and Extension have teamed up to provide more education on mental health warning signs and different buy zithromax online usa numbers and hotlines people can call if they need help. Amy May, clinical director at North Central Missouri Mental Health, said her rural offices have typically only dealt with severe mental health illnesses like schizophrenia or bipolar disorder. But in the past year or so she’s seen more patients dealing with suicide and depression.

Despite the increase in patients, May said many still feel uncomfortable in seeking mental health care buy zithromax online usa. €œI still feel like there is this stigma of we still just don’t want to talk about it. Or we don’t want people to know we’re getting services, especially here,” May said. “I feel like our offices are kind of in outlying locations and yet I still have clients … they’ll drive to another office just because buy zithromax online usa they don’t want, and they flat out said, ‘I don’t want people to see my car in your parking lot.’ ” Even at the school level, Polo R-VII school counselor Rebecca Chambers-Arway said the invisible illness can be hard for her students to take seriously.

She worked with a student for a while who said her friends would make jokes about her counseling sessions. Chambers-Arway’s advice was to remind them that mental well-being is a serious health issue even though it’s not always visible. Someone goes to the doctor buy zithromax online usa for a broken bone, Chambers-Arway noted. How is it any different to seek help for a broken spirit?.

“It’s hard because I still think kids think that a mental illness is a weakness, but so many of us deal with it on a daily basis,” Chambers-Arway said. €œIt’s just buy zithromax online usa (that) it’s hidden. You can’t see it.” Chambers-Arway said she works to simplify complex emotions, like anxiety, and instead helps children to recognize the things they are worried about. Those simplified conversations can evolve as the students age to better understand the way they are feeling.

€œI think so many times buy zithromax online usa those feelings aren’t normalized when they’re little, so that’s what they grow up learning,” Chambers-Arway said. It’s not an issue that can be solved or normalized overnight. Chambers-Arway said she hopes to see more involvement with mental health first aid training both at school and in the community. These sessions can help instructors and parents to recognize signs of mental health issues and buy zithromax online usa know how to intervene, but she said the response in Polo hasn’t been huge.

“I think it’s just going to be a constant battle until people, not people, society, embraces it and recognizes that it is something that needs to be addressed,” Chambers-Arway said. In the same vein, Hawkins said the Missouri Farm Bureau is working to teach people the warning signs of mental illness. In early 2020, the bureau was part of a study noting the effect of economic changes, congressional action and severe weather conditions on the buy zithromax online usa mental well-being of Missouri agriculture producers. Since then, Hawkins said the buy antibiotics zithromax exacerbated mental health conditions as supply chain disruptions and increased isolation caused more stress to farmers.

€œJust knowing that family and friends are facing issues makes it even more imperative that maybe we do check-ins more frequently, just to see how folks are doing,” Hawkins said, “Just asking the question, ‘How are you doing?. €™ It’s really that simple.” Thankfully, as studies emerge about this issue, Hawkins said more resources buy zithromax online usa have been made available through the University of Missouri Extension and through the USDA’s Farm and Ranch Stress Assistance Network. Telehealth Counseling Out of Reach After someone in a rural area has identified the signs of mental illness and decided to seek help, where do they turn?. Hawkins serves on his local hospital board and said the number one issue it is currently faced with, and doesn’t provide, is mental health counseling.

€œOne of the challenges that we have as a critical access hospital is how buy zithromax online usa to provide all the services that are needed in our community and the outlying rural areas for our farm and ranch families,” Hawkins said. Telehealth presents itself as a golden solution to reaching rural communities, but access to strong internet connection remains an obstacle. €œIn my hometown of Appleton City, we have the technology to do telehealth, but we don’t have strong enough bandwidth to provide telehealth on a consistent basis that is adequate for the provider, as well as the patient,” Hawkins said. Because Missouri has such a shortage of mental health professionals, Hawkins said telehealth buy zithromax online usa is logistically the best way to reach communities far and wide.

€œIf we have that physical shortage it only makes sense that opportunities provided with telehealth allow us to cast a wider net to try to reach more providers to improve accessibility for farm, ranch and rural families,” Hawkins said. Medows is a big proponent buy zithromax online usa for telehealth counseling. After his unsuccessful search for in-person care, Medows went online, where he was finally able to get help. He now uses a virtual service called Better Health, which allows him to instant message and video conference with licensed professionals.

Medows is buy zithromax online usa fortunate because he has access to high-speed internet, but that’s not the case for many in rural communities. According to the Federal Communications Commission (FCC), just one-fourth of the rural population in America has broadband access. But even this data has been criticized for not being granular enough, meaning that ratio is likely even smaller. Jason Medows, buy zithromax online usa host of the “Ag State of Mind” podcast.

(Contributed | Jason Medows) “There is no such thing as affordable high speed internet out here,” Medows said. €œI mean, that’s like a unicorn, as far as I’m concerned. We’re fortunate to where we can afford it, but even what we buy zithromax online usa afford isn’t very good. We pay $190 a month for internet and it’s not even that good.” Petersilie of KFB said that the bureau has some initiatives to improve broadband access and stressed the importance of making care as accessible as possible.

€œHow do farmers access this system?. € Petersilie buy zithromax online usa said. €œWe also need to look at the flip side of that point. How does that system access the farmers?.

€ Elaine Johannes of K-State Research buy zithromax online usa and Extension for Farm Stress said not only does there need to be more telehealth options, but quality therapists who understand the unique stressors of rural America and farming. €œWe need to talk about telehealth,” she said. €œWe need top talent. We need buy zithromax online usa to have people understand that therapies can be done online, they can even be done through a cell phone.

Now, that doesn’t replace the human and the interaction between folks. But again, we need to understand what’s going on with mental health care in the United States and especially in rural areas, so we could be allies with it.” Schools are typically reliable locations with stable internet in rural areas, meaning it could be possible to have students take telehealth counseling from the building. Chambers-Arway said buy zithromax online usa her district has started a program like this. €œ(Telehealth therapy) would be an ideal situation.

It’s just, I feel like sometimes the insurance hoops are harder to get through than the parents and students agreeing to the support,” Chambers-Arway said. Insurance hoops were a barrier to students even when the buy zithromax online usa school had an in-person therapist. This program, through Northwest Behavioral Health, designated a therapist to split time between Gallatin, Polo and Hamilton school districts each week. Chambers-Arway said the program was successful and generated a lot of interest, but because it was free to the school and paid for by a student’s insurance, the enrollment paperwork was immense.

It sounds buy zithromax online usa like a small inconvenience to fill out the forms and meet with the therapist, but Chambers-Arway said it meant a day off from work and a lot of parents in Polo couldn’t afford that time. €œAs soon as we got that going we had students coming in, and parents, to us and asking, ‘Okay, can we get ours set up with her?. €™â€ Chambers-Arway said. When the therapist left Northwest buy zithromax online usa Behavioral, Gallatin and Polo were without a replacement, but a well-established need.

Chambers-Arway said she tried to get a different person to come to the school, but said it never reached fruition. €œIn my opinion, that’s the only way we’ll be able to secure some mental health support, outside of what I can do as a (school) counselor,” Chambers-Arway said. €œI can’t do some of that deep-seeded counseling in a school setting.” Jennifer Kline, program manager buy zithromax online usa at Northwest Behavioral, said all of the school outreach programs like this have ended because of a shortage in behavioral health providers. €œIt’s challenging for us to fill vacancies and meet the demand even in urban areas across the board,” Kline said.

€œIt’s just not enough people to go around and fill all of the positions.” Providers in rural areas, and especially those working in schools, require specialized knowledge in aiding those populations, making their roles especially difficult to fill. Few and Far Between Local behavioral and mental health facilities like Northwest buy zithromax online usa and North Central Missouri Mental Health are stretched thin, serving four and nine counties, respectively, with outreach offices. Even with these local offices, that leaves a lot unreached or with a significant drive to reach care. A map by the University of Missouri Extension shows all of the mental health facilities in the state.

Many counties are left with just one facility and others buy zithromax online usa are completely barren. Mental Health Support in Missouri A map by the University of Missouri Extension shows that the vast majority of counties in the state (shaded in gray) are experiencing a shortage of mental health professionals. (Courtesy | University of Missouri Extension) May said she sees transportation as a major issue to clients seeking mental health care. “Transportation is a huge barrier for buy zithromax online usa our clients,” May said.

€œWe do have a lot of satellite offices. However, for prescribers and therapists, they may not be able to get to all the offices. So the clients have to travel to a certain office location to get to our services.” Getting care is important, but Medows said for many farmers who work with the daylight, an hour buy zithromax online usa and half trip can be too much time away. €œDouble that drive time and whatever time that you’re there and that’s all time that is lost in whatever else you want to do, working a job, spending time with the family,” Medows said.

His passion for mental health awareness led Medows to create his podcast, “Ag State of Mind.” For Medows, it’s important to have farmers and ranchers talking about mental health so others struggling with the same problems know they’re not alone. €œThere needs to be more real people talking about buy zithromax online usa it. More people sharing their own experience with it and not having the fear of ridicule,” Medows said. By “real people” Medows means the people living with feelings of independence and isolation often associated with rural life.

€œPeople who buy zithromax online usa are residents of the rural community. People like me who live in the rural community and share their certain experience in the challenges and are relatable. People who just as easily could be their neighbor, people who people could see being their neighbor.” Marissa Plescia is a Dow Jones summer intern at Kansas City PBS. Vicky Diaz-Camacho covers community affairs for Kansas buy zithromax online usa City PBS.

Cami Koons covers rural affairs for Kansas City PBS in cooperation with Report for America. Like what you are reading?. Discover more unheard stories about Kansas buy zithromax online usa City, every Thursday. Thank you for subscribing!.

Check your inbox, you should see something from us. Your support lets our boots-on-the-ground journalists produce stories like this one. If you believe in local journalism, please donate today. Related Stories.

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A few weeks ago my fiance Caleb and I ordered a custom table for our new, rustic home that sits in the woods. I came across Ben Shea through some mutual friends and immediately fell in love with his work! After I saw the finished product of our table, I was definitely NOT disappointed. Ben is an awesome guy, so easy to work with and he totally made our vision become a reality! It’s exactly what I wanted. Raw, rustic, knots and grain. I’m.. obsessed. Ben is constantly creating lots of amazing wood pieces for homes, offices and gifts! Check out his Facebook fan-page HERE, his Etsy shop HERE, and his website HERE.

Meagan Nicole

 


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This Sunday my mom and sister threw me a surprise bridal shower! I knew I was having the bridal shower, but I had absolutely nothing to do with the planning so I had no clue what to expect or who would be coming (although seeing random pieces of thrifted china and table clothes hidden around the house was getting me very excited!). It was more beautiful than I could’ve imaged and exactly what I hoped for. So many lovely faces came that I wasn’t expecting which made it all the sweeter. The theme was an outdoor garden party! My mom made her famous chicken salad recipe, a blueberry-raspberry-strawberry fruit medley, and greens with an olive oil lemon dressing (the one they use at Tomato Pie) YUM! The vintage dresser held two baskets- everyone brought their favorite kitchen spice or  cleaning item (which went in the awesome, wooden hamper my nana gifted us to the right of the dresser)! I loved the date night jar. Everyone wrote down date ideas on popcycle sticks for Caleb and I. We’ve been enjoying reading everyones recommendations.. especially the hilarious X-rated ones. haha!

If you’re wondering why my face looks so crazy in the opening-gifts photos it’s because we were playing the bubble gum game! Previously my sister had asked Caleb a bunch of random questions that he gave his answers to. While opening gifts, I was asked these questions as well and had to try and answer the same as Caleb did. For every question I got wrong I gad to put a piece of gum in my mouth. I actually did pretty good but still wound up with a few wads of gum, whoops. I never thought I could get tired of bubble gum until Sunday. HA! This was such a fun and exciting day! Huge thank you’s to my mom and sister for pulling it all together and getting so creative.. I know how much work and thought you put into everything to make it perfect for me and it means so much! To each and every lady that came to the party- you all made me feel so loved and blessed! Thank you for celebrating this time in my life; Caleb and I are beyond thankful for all of the amazing gifts and well wishes you showered us with. 🙂

*Beautiful cake by Wendy Hess at Oregon Dairy Bakery!

**All photographs taken by my amazing friend Rebekah of Rebekah Viola Photography! Thank you so much for capturing these memories for me.

Meagan Nicole


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