Lithium and lasix interaction

Jun 112013
 

lasix hypokalemia is unpublished. It is scheduled to be published on 10/16/2020. Once it is published it will be available on this page where to get lasix in an official form. Until then, you can download the unpublished PDF version. Although we make a concerted effort to reproduce the original document in full on our Public Inspection pages, in some cases graphics may not be displayed, and non-substantive markup language may appear alongside substantive text.

If you are using public where to get lasix inspection listings for legal research, you should verify the contents of documents against a final, official edition of the Federal Register. Only official editions of the Federal Register provide legal notice to the public and judicial notice to the courts under 44 U.S.C. 1503 &. 1507. Learn more here.Today, the Centers for Medicare &.

Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the hypertension disease 2019 (hypertension medications) Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth. The actions reinforce President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care. €œResponding to President Trump’s Executive Order, CMS is taking action to increase telehealth adoption across the country,” said CMS Administrator Seema Verma. €œMedicaid patients should not be forgotten, and today’s announcement promotes telehealth for them as well.

This revolutionary method of improving access to care is transforming healthcare delivery in America. President Trump will not let the genie go back into the bottle.” Expanding Medicare Telehealth Services For the first time using a new expedited process, CMS is adding 11 new services to the Medicare telehealth services list since the publication of the May 1, 2020, hypertension medications Interim Final Rule with comment period (IFC). Medicare will begin paying eligible practitioners who furnish these newly added telehealth services effective immediately, and for the duration of the PHE. These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services. The list of these newly added services is available at.

Https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes. In the May 1 hypertension medications IFC, CMS modified the process for adding or deleting services from the Medicare telehealth services list to allow for expedited consideration of additional telehealth services during the PHE outside of rulemaking. This update to the Medicare telehealth services list builds on the efforts CMS has already taken to increase Medicare beneficiaries’ access to telehealth services during the hypertension medications PHE. Since the beginning of the PHE, CMS has added over 135 services to the Medicare telehealth services list – such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services. With today’s action, Medicare will pay for 144 services performed via telehealth.

Between mid-March and mid-August 2020, over 12.1 million Medicare beneficiaries – over 36 percent – of people with Medicare Fee-For-Service have received a telemedicine service. Preliminary Medicaid and CHIP Data Snapshot on Telehealth Utilization and Medicaid &. CHIP Telehealth Toolkit Supplement In an effort to provide greater transparency on telehealth access in Medicaid and CHIP, CMS is releasing, for the first time, a preliminary Medicaid and CHIP data snapshot on telehealth utilization during the PHE. This snapshot shows, among other things, that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year, representing an increase of more than 2,600% when compared to the same period from the prior year. The data also shows that adults ages 19-64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states.

To further drive telehealth, CMS is releasing a new supplement to its State Medicaid &. CHIP Telehealth Toolkit. Policy Considerations for States Expanding Use of Telehealth, hypertension medications Version that provides numerous new examples and insights into lessons learned from states that have implemented telehealth changes. The updated supplemental information is intended to help states strategically think through how they explain and clarify to providers and other stakeholders which policies are temporary or permanent. It also helps states identify services that can be accessed through telehealth, which providers may deliver those services, the ways providers may use in order to deliver services through telehealth, as well as the circumstances under which telehealth can be reimbursed once the PHE expires.

The toolkit includes approaches and tools states can use to communicate with providers on utilizing telehealth for patient care. It updates and consolidates in one place the Frequently Asked Questions (FAQs) and resources for states to consider as they begin planning beyond the temporary flexibilities provided in response to the lasix. To view the Medicaid and CHIP data snapshot on telehealth utilization during the PHE, please visit. Https://www.medicaid.gov/resources-for-states/downloads/medicaid-chip-beneficiaries-hypertension medications-snapshot-data-through-20200630.pdf. ### Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS and @CMSgov.

Lithium and lasix interaction

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A woman holding an umbrella walks in a street in the Seychelles' capital Victoria.Valery Sharifulin | TASS | Getty ImagesThe Seychelles is causing concern lithium and lasix interaction for world health experts after a rise of hypertension medications cases among fully vaccinated individuals.The World Health Organization said Tuesday that it would review hypertension data from the Seychelles, an archipelago of 115 islands in the Indian Ocean, after the health ministry said more than a third of people who tested positive for hypertension medications in the week to May 8 had been fully vaccinated.The Seychelles is viewed as having conducted a very successful vaccination rollout so far. It can boast having the highest share of people vaccinated against hypertension medications anywhere in the world, above Israel and the U.K.The majority of vaccinated lithium and lasix interaction people have received China's Sinopharm treatment (approved for emergency use by the WHO last Friday) as well as the AstraZeneca shot (known as Covishield locally, a version produced in India). In total, the Seychelles with a population of over 97,000 has recorded just under 8,200 cases and lithium and lasix interaction 28 deaths during the lasix.On Monday, the Seychelles' health ministry reported a steep rise in the number of cases. From 120 new cases reported on April 30, a week later over 300 cases per day were recorded on May 7 and May lithium and lasix interaction 8, respectively.Of all the positive cases, the health ministry said 63% had either not been vaccinated or had only received one dose of SinoPharm or Covishield, but 37% of the new s were in people who had received both doses.The ministry noted that, of the patients requiring hospital treatment, 80% had not been vaccinated and tended to be people with co-morbidities. It added that lithium and lasix interaction "almost all" of the critical and severe cases requiring intensive care treatment had not been vaccinated either.

To date, none of the patients who have died with hypertension medications have been fully vaccinated, it said.To date, among those who a have received two doses, 57% have received Sinopharm and 43% Covishield, the Seychelles' health ministry said. It's unclear which treatment had lithium and lasix interaction been given to individuals who had been fully immunized but then tested positive for hypertension medications.While there was a flattening of new cases on May 7 and May 8 (with 317 new cases reported and then 314 cases, respectively), the health ministry said "the rate of transmission remains high and is of concern."The situation has certainly alarmed experts, particularly as 60% of the Seychelles' total population has been fully vaccinated. What's more, 86% of the Seychelles' targeted population for vaccination — 70,000 people — have been lithium and lasix interaction fully vaccinated to date, ministry data shows.What the WHO thinksOn Monday, WHO's Director of Immunization, treatments and Biologicals, Dr. Kate O'Brien, said in a briefing that the WHO was in direct communication with the Seychelles' health ministry and that the situation was a "more complicated situation than the top-line messages.""As was noted, the treatments are highly lithium and lasix interaction efficacious against severe cases and deaths. Most of the cases which have occurred are mild lithium and lasix interaction cases.

However, what is also important is that a substantial fraction, over 80% of lithium and lasix interaction the population, has been vaccinated. But as we know .. lithium and lasix interaction. Some of the cases that are being reported are occurring either soon after a single dose, or soon after a second dose, or between the first and second doses."She said in this specific situation, a very detailed assessment was required "of what the situation is, first of all what the strains are that are circulating in the country, secondly when the cases occur relative to when somebody received doses, third what the severity of the cases is.""Only by doing that kind of evaluation can we make an assessment of whether or not these are treatment failures or whether it is more about the kinds of cases that are occurring, the milder end of cases and then the timing of the cases relative to when individuals received doses. That evaluation is ongoing lithium and lasix interaction and we're supporting and engaging with the country to understand the situation."CNBC has contacted the WHO for updated comment on the situation in the Seychelles but is yet to receive a reply.treatment efficacyThe WHO has repeatedly warned that vaccination alone would not be enough to stop the lasix in its tracks, but would rather be another weapon in the arsenal to fight the lasix.Restrictions on social contact as well as good personal hygiene are still seen as the basis of preventing the spread. Last week, the Seychelles re-imposed restrictions on some social gatherings and public spaces in a bid to curb the rise in s.The situation faced by islanders acts as a reminder that no hypertension treatment currently in use lithium and lasix interaction has been proven to be 100% effective at preventing hypertension medications .

Still, all the treatments currently authorized for use by the WHO have proven to be very, if not extremely, effective at preventing serious hypertension medications s, with cases, hospitalizations and deaths greatly reduced in countries with advanced vaccination programs, like the U.K.With a third wave of cases and new lasix variants having the potential to cause further loss of life and economic destruction, time is of the essence to approve and distribute life-saving treatments around the world, with the more available, the better.On Friday, the WHO granted emergency use authorization to the China's state-owned pharmaceutical firm SinoPharm, a move which could fast-track the shot's use in WHO's COVAX scheme, which aims to provide poorer countries with access to treatments.The WHO said the addition of the SinoPharm treatment had "the potential to rapidly accelerate hypertension medications treatment access for countries seeking to protect health workers and populations at risk."It noted that the lithium and lasix interaction WHO's Strategic Advisory Group of Experts on Immunization had completed a review of the treatment and, on the basis of all available evidence, recommended it for adults 18 years and older, in a two-dose schedule with a spacing of three to four weeks."treatment efficacy for symptomatic and hospitalized disease was estimated to be 79%, all age groups combined," it said. However it noted that "few older adults (over 60 years) were enrolled in clinical trials, so efficacy lithium and lasix interaction could not be estimated in this age group."In March, AstraZeneca released updated clinical trial date which showed its treatment was 76% effective at preventing against symptomatic hypertension medications . treatments by Pfizer-BioNTech and Moderna were found to be around 95% effective..

A woman holding an umbrella walks in a street in the Seychelles' capital Victoria.Valery Sharifulin | TASS | Getty ImagesThe Seychelles is causing concern for world health experts after a rise of hypertension medications cases among fully vaccinated individuals.The World Health Organization said Tuesday that it would review hypertension data from the Seychelles, an archipelago of 115 islands in the Indian Ocean, after the health ministry said more than a third of people who tested positive for hypertension medications in the week to May 8 had been fully where to get lasix vaccinated.The Seychelles is viewed as having conducted a very successful vaccination rollout so far. It can boast having the highest share where to get lasix of people vaccinated against hypertension medications anywhere in the world, above Israel and the U.K.The majority of vaccinated people have received China's Sinopharm treatment (approved for emergency use by the WHO last Friday) as well as the AstraZeneca shot (known as Covishield locally, a version produced in India). In total, the Seychelles with a where to get lasix population of over 97,000 has recorded just under 8,200 cases and 28 deaths during the lasix.On Monday, the Seychelles' health ministry reported a steep rise in the number of cases. From 120 new cases reported on April 30, a week later over 300 cases per day were recorded on where to get lasix May 7 and May 8, respectively.Of all the positive cases, the health ministry said 63% had either not been vaccinated or had only received one dose of SinoPharm or Covishield, but 37% of the new s were in people who had received both doses.The ministry noted that, of the patients requiring hospital treatment, 80% had not been vaccinated and tended to be people with co-morbidities.

It added that "almost all" of the critical and severe cases requiring intensive care treatment had not been where to get lasix vaccinated either. To date, none of the patients who have died with hypertension medications have been fully vaccinated, it said.To date, among those who a have received two doses, 57% have received Sinopharm and 43% Covishield, the Seychelles' health ministry said. It's unclear which treatment had been given to individuals who had been fully immunized but then tested positive for hypertension medications.While there was a flattening of new cases on May 7 and May 8 where to get lasix (with 317 new cases reported and then 314 cases, respectively), the health ministry said "the rate of transmission remains high and is of concern."The situation has certainly alarmed experts, particularly as 60% of the Seychelles' total population has been fully vaccinated. What's more, 86% of the Seychelles' targeted population for vaccination — 70,000 people — have been fully vaccinated to date, ministry data shows.What the where to get lasix WHO thinksOn Monday, WHO's Director of Immunization, treatments and Biologicals, Dr.

Kate O'Brien, said in a briefing that the WHO was in direct communication with the Seychelles' health ministry and that the situation was a "more complicated situation than the top-line messages.""As where to get lasix was noted, the treatments are highly efficacious against severe cases and deaths. Most of the cases where to get lasix which have occurred are mild cases. However, what is also important is that where to get lasix a substantial fraction, over 80% of the population, has been vaccinated. But as we where to get lasix know ...

Some of the cases that are being reported are occurring either soon after a single dose, or soon after a second dose, or between the first and second doses."She said in this specific situation, a very detailed assessment was required "of what the situation is, first of all what the strains are that are circulating in the country, secondly when the cases occur relative to when somebody received doses, third what the severity of the cases is.""Only by doing that kind of evaluation can we make an assessment of whether or not these are treatment failures or whether it is more about the kinds of cases that are occurring, the milder end of cases and then the timing of the cases relative to when individuals received doses. That evaluation is ongoing and we're supporting and engaging with the country to understand the situation."CNBC has contacted the WHO for updated comment on the situation in the Seychelles but is yet to receive where to get lasix a reply.treatment efficacyThe WHO has repeatedly warned that vaccination alone would not be enough to stop the lasix in its tracks, but would rather be another weapon in the arsenal to fight the lasix.Restrictions on social contact as well as good personal hygiene are still seen as the basis of preventing the spread. Last week, the Seychelles re-imposed restrictions on where to get lasix some social gatherings and public spaces in a bid to curb the rise in s.The situation faced by islanders acts as a reminder that no hypertension treatment currently in use has been proven to be 100% effective at preventing hypertension medications . Still, all the treatments currently authorized for use by the WHO have proven to be very, if not extremely, effective at preventing serious hypertension medications s, with cases, hospitalizations and deaths greatly reduced in countries with advanced vaccination programs, like the U.K.With a third wave of cases and new lasix variants having the potential to cause further where to get lasix loss of life and economic destruction, time is of the essence to approve and distribute life-saving treatments around the world, with the more available, the better.On Friday, the WHO granted emergency use authorization to the China's state-owned pharmaceutical firm SinoPharm, a move which could fast-track the shot's use in WHO's COVAX scheme, which aims to provide poorer countries with access to treatments.The WHO said the addition of the SinoPharm treatment had "the potential to rapidly accelerate hypertension medications treatment access for countries seeking to protect health workers and populations at risk."It noted that the WHO's Strategic Advisory Group of Experts on Immunization had completed a review of the treatment and, on the basis of all available evidence, recommended it for adults 18 years and older, in a two-dose schedule with a spacing of three to four weeks."treatment efficacy for symptomatic and hospitalized disease was estimated to be 79%, all age groups combined," it said.

However it noted that "few older adults (over 60 years) were enrolled in clinical trials, so efficacy could not be estimated in this age group."In March, AstraZeneca released updated clinical trial date which showed its where to get lasix treatment was 76% effective at preventing against symptomatic hypertension medications . treatments by Pfizer-BioNTech and Moderna were found to be around 95% effective..

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

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hypertension medications has http://ribbonebrewingcompany.com/?p=58 evolved rapidly into a lasix with global impacts lasix 240mg. However, as the lasix has developed, it has become increasingly evident that the risks of lasix 240mg hypertension medications, both in terms of rates and particularly of severe complications, are not equal across all members of society. While general risk factors for hospital admission with hypertension medications include age, male sex and specific comorbidities (eg, cardiovascular disease, hypertension and diabetes), there is increasing evidence that people identifying with Black, Asian and Minority Ethnic (BAME) groupsi have disproportionately higher risks of being adversely affected by hypertension medications in the UK and the USA. The ethnic disparities include lasix 240mg overall numbers of cases, as well as the relative numbers of critical care admissions and deaths.1In the area of mental health, for people from BAME groups, even before the current lasix there were already significant mental health inequalities.2 These inequalities have been increased by the lasix in several ways. The constraints of quarantine have made access to traditional face-to-face support from mental health services more difficult in general.

This difficulty will increase pre-existing inequalities where there are challenges to engaging people in lasix 240mg care and in providing early access to services. The restrictions may also reduce the flexibility of care offers, given the need for social isolation, limiting non-essential travel and closure of routine clinics. The service impacts are compounded by constraints on the use of non-traditional or alternative routes to care and support.In addition, there is growing evidence of specific mental health consequences from significant hypertension medications , lasix 240mg with increased rates of not only post-traumatic stress disorder, anxiety and depression, but also specific neuropsychiatric symptoms.3 Given the higher risks of mental illnesses and complex care needs among ethnic minorities and also in deprived inner city areas, hypertension medications seems to deliver a double blow. Physical and mental health vulnerabilities are inextricably linked, especially as a significant proportion of healthcare workers (including in mental health services) in the UK are from BAME groups.Focusing on mental health, there is very little hypertension medications-specific guidance on the needs of patients in the BAME group. The risk to staff in general healthcare (including lasix 240mg mental healthcare) is a particular concern, and in response, the Royal College of Psychiatrists and NHS England have produced a report on the impact of hypertension medications on BAME staff in mental healthcare settings, with guidance on assessment and management of risk using an associated risk assessment tool for staff.4 5However, there is little formal guidance for the busy clinician in balancing different risks for individual mental health patients and treating appropriately.

Thus, for example, an inpatient clinician may want to know whether a patient who is older, has additional comorbidities and is from an ethnic background, should be started on one antipsychotic medication or another, or whether treatments such as vitamin D prophylaxis or treatment and venous thromboembolism prevention should be started earlier in the context of the hypertension medications lasix. While syntheses of the existing guidelines are available about hypertension medications and mental health,6 7 there is nothing specific about the healthcare needs of patients from ethnic minorities during the lasix.To where can i get lasix fill this gap, we propose three core actions that may help:Ensure good information and psychoeducation packages are made available to those with English as a second language, and ensure health beliefs and knowledge are based on the lasix 240mg best evidence available. Address culturally grounded explanatory models and illness perceptions to allay fears and lasix 240mg worry, and ensure timely access to testing and care if needed.Maintain levels of service, flexibility in care packages, and personal relationships with patients and carers from ethnic minority backgrounds in order to continue existing care and to identify changes needed to respond to worsening of mental health.Consider modifications to existing interventions such as psychological therapies and pharmacotherapy. Have a high index of suspicion to take into account emerging physical health problems and the greater risk of serious consequences of hypertension medications in ethnic minority people with pre-existing chronic conditions and vulnerability factors.These actions are based on clinical common sense, but guidance in this area should be provided on the basis of good evidence. There has already been a call for urgent research in the area of hypertension medications and mental health8 lasix 240mg and also a clear need for specific research focusing on the post-hypertension medications mental health needs of people from the BAME group.

Research also needs to recognise the diverse range of different people, with different needs and vulnerabilities, who are grouped under the multidimensional term BAME, including people from different generations, first-time migrants, people from Africa, India, the Caribbean and, more recently, migrants from Eastern Europe. Application of a race equality impact assessment to all research questions and methodology has recently been proposed as a first step in this process.2 At this early lasix 240mg stage, the guidance for assessing risks of hypertension medications for health professionals is also useful for patients, until more refined decision support and prediction tools are developed. A recent Public Health England report on ethnic minorities and hypertension medications9 recommends better recording of ethnicity data in health and social care, and goes further to suggest this should also apply to death certificates. Furthermore, the report recommends more participatory and experience-based research to understand causes and lasix 240mg consequences of pre-existing multimorbidity and hypertension medications , integrated care systems that work well for susceptible and marginalised groups, culturally competent health promotion, prevention and occupational risk assessments, and recovery strategies to mitigate the risks of widening inequalities as we come out of restrictions.Primary data collection will need to cover not only hospital admissions but also data from primary care, linking information on mental health, hypertension medications and ethnicity. We already have research and specific guidance emerging on other risk factors, such as age and gender.

Now we also need to focus on an equally important aspect of lasix 240mg vulnerability. As clinicians, we need to balance the relative risks for each of our patients, so that we can act promptly and proactively in response to their individual needs.10 For this, we need evidence-based guidance to ensure we are balancing every risk appropriately and without bias.Footnotei While we have used the term ‘people identifying with BAME groups’, we recognise that this is a multidimensional group and includes vast differences in culture, identity, heritage and histories contained within this abbreviated term..

hypertension medications has evolved rapidly how much does lasix medication cost into a lasix with global impacts where to get lasix. However, as the lasix has developed, it has become increasingly evident that the risks of hypertension medications, both in terms of rates and particularly of where to get lasix severe complications, are not equal across all members of society. While general risk factors for hospital admission with hypertension medications include age, male sex and specific comorbidities (eg, cardiovascular disease, hypertension and diabetes), there is increasing evidence that people identifying with Black, Asian and Minority Ethnic (BAME) groupsi have disproportionately higher risks of being adversely affected by hypertension medications in the UK and the USA.

The ethnic disparities include overall numbers of cases, where to get lasix as well as the relative numbers of critical care admissions and deaths.1In the area of mental health, for people from BAME groups, even before the current lasix there were already significant mental health inequalities.2 These inequalities have been increased by the lasix in several ways. The constraints of quarantine have made access to traditional face-to-face support from mental health services more difficult in general. This difficulty will increase pre-existing where to get lasix inequalities where there are challenges to engaging people in care and in providing early access to services.

The restrictions may also reduce the flexibility of care offers, given the need for social isolation, limiting non-essential travel and closure of routine clinics. The service impacts are compounded by constraints on the use of non-traditional or alternative routes to care and support.In where to get lasix addition, there is growing evidence of specific mental health consequences from significant hypertension medications , with increased rates of not only post-traumatic stress disorder, anxiety and depression, but also specific neuropsychiatric symptoms.3 Given the higher risks of mental illnesses and complex care needs among ethnic minorities and also in deprived inner city areas, hypertension medications seems to deliver a double blow. Physical and mental health vulnerabilities are inextricably linked, especially as a significant proportion of healthcare workers (including in mental health services) in the UK are from BAME groups.Focusing on mental health, there is very little hypertension medications-specific guidance on the needs of patients in the BAME group.

The risk to staff in general healthcare (including mental healthcare) is a particular concern, and in response, the Royal College of Psychiatrists and NHS England have produced a report on the impact where to get lasix of hypertension medications on BAME staff in mental healthcare settings, with guidance on assessment and management of risk using an associated risk assessment tool for staff.4 5However, there is little formal guidance for the busy clinician in balancing different risks for individual mental health patients and treating appropriately. Thus, for example, an inpatient clinician may want to know whether a patient who is older, has additional comorbidities and is from an ethnic background, should be started on one antipsychotic medication or another, or whether treatments such as vitamin D prophylaxis or treatment and venous thromboembolism prevention should be started earlier in the context of the hypertension medications lasix. While syntheses of the existing guidelines are available about hypertension medications and mental health,6 7 there is nothing specific about the healthcare needs of patients where to get lasix from ethnic minorities during the lasix.To fill this gap, we propose three core actions that may help:Ensure good information and psychoeducation packages are made available to those with English as a second language, and ensure health beliefs and knowledge are based on the best evidence visit this site available.

Address culturally grounded explanatory models and illness perceptions to allay where to get lasix fears and worry, and ensure timely access to testing and care if needed.Maintain levels of service, flexibility in care packages, and personal relationships with patients and carers from ethnic minority backgrounds in order to continue existing care and to identify changes needed to respond to worsening of mental health.Consider modifications to existing interventions such as psychological therapies and pharmacotherapy. Have a high index of suspicion to take into account emerging physical health problems and the greater risk of serious consequences of hypertension medications in ethnic minority people with pre-existing chronic conditions and vulnerability factors.These actions are based on clinical common sense, but guidance in this area should be provided on the basis of good evidence. There has already been a call for urgent research where to get lasix in the area of hypertension medications and mental health8 and also a clear need for specific research focusing on the post-hypertension medications mental health needs of people from the BAME group.

Research also needs to recognise the diverse range of different people, with different needs and vulnerabilities, who are grouped under the multidimensional term BAME, including people from different generations, first-time migrants, people from Africa, India, the Caribbean and, more recently, migrants from Eastern Europe. Application of a where to get lasix race equality impact assessment to all research questions and methodology has recently been proposed as a first step in this process.2 At this early stage, the guidance for assessing risks of hypertension medications for health professionals is also useful for patients, until more refined decision support and prediction tools are developed. A recent Public Health England report on ethnic minorities and hypertension medications9 recommends better recording of ethnicity data in health and social care, and goes further to suggest this should also apply to death certificates.

Furthermore, the report recommends more participatory and experience-based research to understand causes and consequences of pre-existing multimorbidity and hypertension medications , integrated care systems that work well for susceptible and marginalised groups, culturally competent health promotion, prevention and occupational risk assessments, and recovery strategies to mitigate the risks of widening inequalities as we come out of restrictions.Primary data collection will need to cover not only hospital admissions but also data from primary care, linking where to get lasix information on mental health, hypertension medications and ethnicity. We already have research and specific guidance emerging on other risk factors, such as age and gender. Now we also need to focus on where to get lasix an equally important aspect of vulnerability.

As clinicians, we need to balance the relative risks for each of our patients, so that we can act promptly and proactively in response to their individual needs.10 For this, we need evidence-based guidance to ensure we are balancing every risk appropriately and without bias.Footnotei While we have used the term ‘people identifying with BAME groups’, we recognise that this is a multidimensional group and includes vast differences in culture, identity, heritage and histories contained within this abbreviated term..

Does lasix help you lose weight

Drawing on peer-reviewed and grey literature, Powell et al argue the dominant narrative of personal self-care during the hypertension medications lasix must be supplemented with a collectivist approach that addresses structural inequalities and does lasix help you lose weight fosters a more equitable society.Compliance with self-care and risk mitigation strategies to tackle Buy viagra online cheap hypertension medications has been chequered in the UK, fuelled partly by social media hoaxes and misinformation, lasix denialism, and policy leaders contravening their own public health messaging. Exploring individual non-compliance, and reflecting on wider societal inequities that can impact it, can help build critical normative resilience to future lasixs.From the does lasix help you lose weight outset, hypertension medications public health messaging was, and remains, primarily aimed at modifying individual lifestyles and behaviours to flatten the infectivity curve by following ‘common sense’ approaches captured by the hands–face–space mantra.1 A culture of practice and new social norms of acceptable behaviour subsequently emerged,2 with concordance premised on cooperation between the public and government. However, as the lasix worsened and movement restrictions continued, norms were contested by a small but vocal segment of society.This normative contestation was founded on conflict between individual agency, government does lasix help you lose weight paternalism and regulatory diktat, and echoed Kant’s epistemology of auism and the need to sacrifice individual liberties for the ‘greater good’. This conflict was exacerbated by multiple lockdowns that significantly impacted individuals’ daily lives, and dissidence within a post-Brexit body politic characterised by distrust of politicians3 and strong personal beliefs about rights, does lasix help you lose weight responsibilities and sovereignty.Émile Durkeim's sociological concept of anomie, however, widens our understanding further.

Anomie characterises a dissolution or absence of established moral values, standards or mores that create a resulting normlessness.4 5 Discordance does lasix help you lose weight between personal and group norms—the absence of a shared social ethic—weakens communal bonds, impacting individual stress, frustration, anxiety, confusion and powerlessness. During hypertension medications, segments of society experienced powerlessness and loss of agency as daily routines were disrupted and further compounded by financial and mental distress as morbidity and mortality data dominated daily news headlines.A visible minority began disregarding public health does lasix help you lose weight messaging, challenging norms needed to ensure a successful preventative response to the lasix (eg, hoarding of restricted supermarket items). That such behaviour was limited to a relative minority neither undermines the existence of anomie—self-interest remains juxtaposed to collective duty—nor weakens the contestation of existing dominant normative paradigms.6 Contesting ideas can reach a tipping point of popularity, establishing a new dominant social norm.7 This can trigger detrimental behaviour (eg, for rates) if the once dominant paradigm supported laudable public health messaging.In addressing this threat, it is vital to reinforce public health messaging by bolstering the underpinning social norms. Durkheim’s remedy was moral education, by which the collective consciousness—shared knowledge, ideas, beliefs and attitudes—is nurtured by supporting the does lasix help you lose weight collectivist tendencies of individuals,8 which can be achieved by various means.9 While using injunctions against those who transgress (eg, monetary fines) can supplement positive public health measures, Durkheim crucially counselled that the imposition of norms does not bind individuals to the collective as strongly as consensus.

Such a didactic approach can undermine solidarity, potentially nurturing a scapegoat culture that can exacerbate existing and historical inequities (eg, enforcing treatment uptake among ethnic minority populations).Indeed, does lasix help you lose weight disruption of the social order, and the emergence of new policy prescriptions to tackle the lasix, re-exposed chronic inequalities.10 11 ‘Stay at home’ advice had different connotations to a large segment of society. Those who were victims of domestic abuse, or struggling to pay the rent, provide for their family, or who could not afford broadband, a personal laptop or access to a does lasix help you lose weight garden.An effective public health strategy is a holistic one that creates an open and inclusive dialogue with diverse community groups to identify shared values. This inclusive dialogue can help create a normative system that encourages the adoption and diffusion of initiatives addressing structural inequalities and injustices.Scrutiny of the UK’s response to hypertension medications has made the case for self-care as a public health measure to tackle communicable diseases, while also highlighting its limitations vis-à-vis individual rights and does lasix help you lose weight responsibilities and extant structural inequalities. These challenges does lasix help you lose weight have not undermined the self-care agenda.

Rather, they have highlighted the need to reinforce it, to shore up the normative elements that underpin it to ensure success.Although the sustained adoption of health-seeking behaviours is crucial, individual self-care alone is insufficient to tackle the lasix. Societal responsibility is does lasix help you lose weight also required whereby (1) individuals act in responsible and rational ways to prevent hypertension medications spread until pharmacological interventions to prevent or manage the lasix become widely available and (2) communities and governing institutions work together to build a more equal society. In the UK, the current political climate is characterised by discourse in does lasix help you lose weight which individuals are the source of, and the solution to, social problems. Policies and practices continue to focus on individual rather than does lasix help you lose weight collective responsibility.

Both aspects need to be addressed when does lasix help you lose weight tackling national emergencies, including global lasixs. As Durkheim recognised,12 social justice and equality are necessary to sustain solidarity—they are the bond connecting individuals in society that ensures stability and social order.Key messagesSelf-care has been, and continues to be, critical to tackling the hypertension medications lasix.The concept of anomie—an uprooting, dissolution or absence of established moral values, guiding standards, or social mores, creating normlessness—cannot be overlooked when planning an integrated social response.The dominant narrative of personal self-care must be supplemented does lasix help you lose weight with a collectivist approach that addresses structural inequalities for the future.Ethics statementsPatient consent for publicationNot required.AcknowledgmentsRAP's and AE-O's independent contribution to this article is supported by the National Institute for Health Research Applied Research Collaboration Northwest London. The views expressed in this publication are those of RAP and AE-O and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.The Global Burden of Disease Study reported that from 1990 to 2019, cardiovascular diseases (CVDs) emerged as a leading cause of disability-adjusted life-years (DALYs) in South Asians of both genders (15.2% of total DALYs in men and 11.9% in women).1 South Asia is largely rural with a population of approximately 1.2 billion people and projected to remain rural through to 2050, with a similar number of people.2 In 2014, the multi-country Prospective Urban Rural Epidemiology (PURE) cohort study found that rural South Asians experienced higher incidence rates for CVD mortality and morbidity (7.2 per 1000 person-years) compared with their urban counterparts (5.6 per 1000 person-years), from myocardial infarction, heart failure and stroke.3 This is despite rural South Asians having a comparatively better CVD risk profile, an INTERHEART risk score of 7.6 compared with 9.1.3 Over the past 30 years (1985–2017), the increase in age-standardised mean body mass index (BMI) in the adult rural population has outpaced urban counterparts.4 It follows that ….

Drawing on peer-reviewed and grey literature, Powell et al argue the dominant narrative of personal self-care during the hypertension medications lasix must be supplemented with a collectivist approach that addresses structural inequalities and fosters a more equitable society.Compliance with self-care and risk mitigation strategies to tackle hypertension medications has been where to get lasix chequered in the UK, fuelled partly by social media hoaxes and misinformation, lasix denialism, and policy leaders contravening their own public health messaging. Exploring individual non-compliance, and reflecting on wider societal inequities that can impact it, can help build critical normative resilience to future lasixs.From the outset, hypertension medications public health messaging was, and remains, primarily aimed where to get lasix at modifying individual lifestyles and behaviours to flatten the infectivity curve by following ‘common sense’ approaches captured by the hands–face–space mantra.1 A culture of practice and new social norms of acceptable behaviour subsequently emerged,2 with concordance premised on cooperation between the public and government. However, as the lasix worsened and movement restrictions continued, norms were contested by a small but vocal segment of society.This normative contestation was founded on conflict between individual agency, government paternalism and regulatory diktat, and echoed Kant’s epistemology of auism and the where to get lasix need to sacrifice individual liberties for the ‘greater good’. This conflict was exacerbated by multiple lockdowns that significantly impacted individuals’ daily lives, and dissidence within a post-Brexit body politic characterised by distrust of politicians3 and strong personal beliefs where to get lasix about rights, responsibilities and sovereignty.Émile Durkeim's sociological concept of anomie, however, widens our understanding further.

Anomie characterises a dissolution or absence of established moral values, standards or mores that create a resulting normlessness.4 5 Discordance between personal and group norms—the absence of a where to get lasix shared social ethic—weakens communal bonds, impacting individual stress, frustration, anxiety, confusion and powerlessness. During hypertension medications, segments of society experienced powerlessness and loss of agency as daily routines were disrupted and further compounded by financial and mental distress as morbidity and mortality data dominated daily news headlines.A visible where to get lasix minority began disregarding public health messaging, challenging norms needed to ensure a successful preventative response to the lasix (eg, hoarding of restricted supermarket items). That such behaviour was limited to a relative minority neither undermines the existence of anomie—self-interest remains juxtaposed to collective duty—nor weakens the contestation of existing dominant normative paradigms.6 Contesting ideas can reach a tipping point of popularity, establishing a new dominant social norm.7 This can trigger detrimental behaviour (eg, for rates) if the once dominant paradigm supported laudable public health messaging.In addressing this threat, it is vital to reinforce public health messaging by bolstering the underpinning social norms. Durkheim’s remedy was moral education, by which the collective consciousness—shared knowledge, ideas, beliefs and attitudes—is nurtured by supporting the collectivist tendencies where to get lasix of individuals,8 which can be achieved by various means.9 While using injunctions against those who transgress (eg, monetary fines) can supplement positive public health measures, Durkheim crucially counselled that the imposition of norms does not bind individuals to the collective as strongly as consensus.

Such a didactic approach can undermine solidarity, potentially nurturing a scapegoat culture that can exacerbate existing and historical inequities (eg, enforcing treatment uptake among ethnic minority populations).Indeed, disruption of the social order, and the emergence of new policy prescriptions to tackle the lasix, re-exposed chronic inequalities.10 11 ‘Stay at home’ advice had different connotations to a large segment where to get lasix of society. Those who where to get lasix were victims of domestic abuse, or struggling to pay the rent, provide for their family, or who could not afford broadband, a personal laptop or access to a garden.An effective public health strategy is a holistic one that creates an open and inclusive dialogue with diverse community groups to identify shared values. This inclusive dialogue can help create a normative system that encourages the adoption and diffusion of initiatives addressing structural inequalities and injustices.Scrutiny of the UK’s response to hypertension medications has made the case for self-care as a public health measure to tackle communicable diseases, while also highlighting its limitations vis-à-vis individual where to get lasix rights and responsibilities and extant structural inequalities. These challenges have not undermined the self-care where to get lasix agenda.

Rather, they have highlighted the need to reinforce it, to shore up the normative elements that underpin it to ensure success.Although the sustained adoption of health-seeking behaviours is crucial, individual self-care alone is insufficient to tackle the lasix. Societal responsibility is also required whereby (1) individuals act where to get lasix in responsible and rational ways to prevent hypertension medications spread until pharmacological interventions to prevent or manage the lasix become widely available and (2) communities and governing institutions work together to build a more equal society. In the UK, the current political climate is characterised by discourse in which individuals are the source of, and the solution to, social where to get lasix problems. Policies and practices continue where to get lasix to focus on individual rather than collective responsibility.

Both aspects where to get lasix need to be addressed when tackling national emergencies, including global lasixs. As Durkheim recognised,12 social justice and equality are necessary to sustain solidarity—they are the bond connecting individuals in society that ensures stability and social order.Key messagesSelf-care has been, and continues to be, critical to tackling the hypertension medications lasix.The concept of anomie—an uprooting, dissolution or absence of established moral where to get lasix values, guiding standards, or social mores, creating normlessness—cannot be overlooked when planning an integrated social response.The dominant narrative of personal self-care must be supplemented with a collectivist approach that addresses structural inequalities for the future.Ethics statementsPatient consent for publicationNot required.AcknowledgmentsRAP's and AE-O's independent contribution to this article is supported by the National Institute for Health Research Applied Research Collaboration Northwest London. The views expressed in this publication are those of RAP and AE-O and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.The Global Burden of Disease Study reported that from 1990 to 2019, cardiovascular diseases (CVDs) emerged as a leading cause of disability-adjusted life-years (DALYs) in South Asians of both genders (15.2% of total DALYs in men and 11.9% in women).1 South Asia is largely rural with a population of approximately 1.2 billion people and projected to remain rural through to 2050, with a similar number of people.2 In 2014, the multi-country Prospective Urban Rural Epidemiology (PURE) cohort study found that rural South Asians experienced higher incidence rates for CVD mortality and morbidity (7.2 per 1000 person-years) compared with their urban counterparts (5.6 per 1000 person-years), from myocardial infarction, heart failure and stroke.3 This is despite rural South Asians having a comparatively better CVD risk profile, an INTERHEART risk score of 7.6 compared with 9.1.3 Over the past 30 years (1985–2017), the increase in age-standardised mean body mass index (BMI) in the adult rural population has outpaced urban counterparts.4 It follows that ….

Lasix bula

Start Preamble Symbicort 400mcg 6mcg price online Food and Drug Administration, HHS lasix bula. Notice of availability. The Food and Drug Administration (FDA) is announcing the availability of a revised draft guidance for industry entitled “Hospital and Health System Compounding Under Section 503A lasix bula of the Federal Food, Drug, and Cosmetic Act” (“revised draft guidance”). This revised draft guidance, when finalized, will describe how FDA intends to apply certain provisions of the Federal Food, Drug, and Cosmetic Act (FD&C Act) to human drug products compounded by State-licensed pharmacies that are not outsourcing facilities and distributed for use within a hospital or health system. First, it addresses the requirement that compounding be based on the receipt of a valid prescription order for an identified individual patient lasix bula.

Second, it addresses the provision concerning compounded drug products that are essentially copies of a commercially available drug product. This draft guidance revises the draft guidance issued in 2016 entitled, “Hospital and Health System Compounding Under the Federal Food, Drug, and Cosmetic lasix bula Act” (“draft guidance”). FDA is revising the draft guidance to address stakeholder feedback and provide further clarification on policies regarding hospital and health system compounding. This revised draft guidance is not final nor is it in effect lasix bula at this time. Submit either electronic or written comments on the revised draft guidance by December 6, 2021 to ensure that the Agency considers your comment on this revised draft guidance before it begins work on the final version of the guidance.

Submit electronic or written comments on the proposed collection of information in the revised draft guidance by December 6, 2021. You may submit comments on any lasix bula guidance at any time as follows. Electronic Submissions Submit electronic comments in the following way. Start Printed Page 55848 • Federal eRulemaking Portal lasix bula. Https://www.regulations.gov.

Follow the instructions for submitting lasix bula comments. Comments submitted electronically, including attachments, to https://www.regulations.gov will be posted to the docket unchanged. Because your comment will be made public, you are solely responsible for ensuring that your comment does not include any confidential information that you or a third party may not wish to be posted, such as medical information, your lasix bula or anyone else's Social Security number, or confidential business information, such as a manufacturing process. Please note that if you include your name, contact information, or other information that identifies you in the body of your comments, that information will be posted on https://www.regulations.gov. If you want to submit a comment with confidential information that you do not wish to be made available to the public, submit the comment as a written/paper submission and in the manner detailed (see “Written/Paper Submissions” and “Instructions”).

Written/Paper lasix bula Submissions Submit written/paper submissions as follows. • Mail/Hand Delivery/Courier (for written/paper submissions). Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers lasix bula Lane, Rm. 1061, Rockville, MD 20852. For written/paper comments submitted to the Dockets Management Staff, FDA will post your comment, as well as any attachments, except for information submitted, marked and identified, as confidential, if submitted as lasix bula detailed in “Instructions.” Instructions.

All submissions received must include the Docket No. FDA-2016-D-0271 for “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act.” Received comments will be placed in the docket and, except for lasix bula those submitted as “Confidential Submissions,” publicly viewable at https://www.regulations.gov or at the Dockets Management Staff between 9 a.m. And 4 p.m., Monday through Friday, 240-402-7500. • Confidential Submissions—To submit a comment with confidential information that you do not wish to be made publicly available, submit your comments only as a written/paper submission. You should submit two lasix bula copies total.

One copy will include the information you claim to be confidential with a heading or cover note that states “THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.” The Agency will review this copy, including the claimed confidential information, in its consideration of comments. The second copy, which will have the claimed confidential information redacted/blacked out, will be available for public viewing and posted on lasix bula https://www.regulations.gov. Submit both copies to the Dockets Management Staff. If you do not wish your name and contact information to be made publicly available, you can provide this information on the cover sheet and not in the body of your comments and you must identify this information as “confidential.” Any information marked lasix bula as “confidential” will not be disclosed except in accordance with 21 CFR 10.20 and other applicable disclosure law. For more information about FDA's posting of comments to public dockets, see 80 FR 56469, September 18, 2015, or access the information at.

Https://www.govinfo.gov/​content/​pkg/​FR-2015-09-18/​pdf/​2015-23389.pdf. Docket. For access to the docket to read background documents or the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in the heading of this document, into the “Search” box and follow the prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852, 240-402-7500. You may submit comments on any guidance at any time (see 21 CFR 10.115(g)(5)).

Submit written requests for single copies of this revised draft guidance to the Division of Drug Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10001 New Hampshire Ave., Hillandale Building, 4th Floor, Silver Spring, MD 20993-0002. Send one self-addressed adhesive label to assist that office in processing your request or include a fax number to which the revised draft guidance may be sent. See the SUPPLEMENTARY INFORMATION section for information on electronic access to the revised draft guidance. Start Further Info With regard to the revised draft guidance. Tracy Rupp, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg.

51, Silver Spring, MD 20993, 301-796-3100. With regard to the proposed collection of information. Domini Bean, Office of Operations, Food and Drug Administration, Three White Flint North, 10A-12M, 11601 Landsdown St., North Bethesda, MD 20852, 301-796-5733, PRAStaff@fda.hhs.gov. End Further Info End Preamble Start Supplemental Information I. Background FDA is announcing the availability of a revised draft guidance for industry entitled “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act.” Pharmacies located within a hospital, or standalone pharmacies that are part of a health system, frequently provide compounded drug products for administration within the hospital or health system.

Some of these compounders seek to compound under section 503A of the FD&C Act (21 U.S.C. 353a) and others have registered with FDA as outsourcing facilities and are subject to section 503B of the FD&C Act (21 U.S.C. 353b). Section 503A of the FD&C Act describes the conditions that must be satisfied for human drug products compounded by a licensed pharmacist in a State-licensed pharmacy or Federal facility, or by a licensed physician, to be exempt from the following three sections of the FD&C Act. Section 501(a)(2)(B) (21 U.S.C.

351(a)(2)(B)) (concerning current good manufacturing practice (CGMP) requirements). Section 502(f)(1) (21 U.S.C. 352(f)(1)) (concerning the labeling of drugs with adequate directions for use). And Section 505 (21 U.S.C. 355) (concerning the approval of drugs under new drug applications or abbreviated new drug applications).

This revised draft guidance proposes policies for FDA's application of certain provisions of section 503A of the FD&C Act to human drug products compounded by State-licensed pharmacies that are not outsourcing facilities and distributed for use within a hospital or health system. First, the revised draft guidance addresses the requirement that compounding be based on the receipt of a valid prescription order for an identified individual patient. Second, it addresses the provision concerning compounded drug products that are essentially copies of a commercially available drug product. This revised draft guidance does not apply to human drug products compounded by outsourcing facilities under section 503B of the FD&C Act, compounded drug products that are not distributed for use within a hospital or health system, or drug products compounded for use in animals. In the Federal Register of April 18, 2016 (81 FR 22610), FDA announced the availability of a draft guidance for industry entitled, “Hospital and Health System Compounding Under the Federal Food, Drug, and Cosmetic Act” Start Printed Page 55849 (“draft guidance”).

The draft guidance proposed new policies for the application of section 503A of the FD&C Act to drug products compounded by licensed pharmacists or physicians in State-licensed hospital or health system pharmacies. In particular, the draft guidance described certain circumstances under which FDA generally would not intend to take action if a hospital or health system pharmacy distributed compounded drug products without first receiving a patient-specific prescription or order. The comment period on the initial draft guidance ended on July 18, 2016. FDA received approximately 76 comments on the draft guidance. FDA is issuing a revised draft guidance with certain changes made in response to received comments or on its own initiative.

For example, the prescription requirement enforcement policy described in the revised draft guidance does not consider whether the drug products are distributed only to healthcare facilities that are located within a 1-mile radius of the compounding pharmacy (“1-mile radius policy”). Instead, the Agency is proposing a two-part, risk-based compliance policy. In addition, the revised draft guidance proposes new policies for hospital and health system pharmacies regarding the provision in section 503A of the FD&C Act which states that to qualify for the exemptions under section 503A of the FD&C Act, among other conditions, a drug product must be compounded by a licensed pharmacist or physician who does not compound regularly or in inordinate amounts any drug products that are essentially copies of a commercially available drug product. FDA is issuing this revised draft guidance to address stakeholders' feedback, reflect additional Agency consideration of the proposed policies, and enable the public to further review and comment before finalization. This revised draft guidance is being issued consistent with FDA's good guidance practices regulation (21 CFR 10.115).

The revised draft guidance, when finalized, will represent the current thinking of FDA on “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act.” It does not establish any rights for any person and is not binding on FDA or the public. You can use an alternative approach if it satisfies the requirements of the applicable statutes and regulations. II. Paperwork Reduction Act of 1995 Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-3521), Federal Agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor.

€œCollection of information” is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes Agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires Federal Agencies to provide a 60-day notice in the Federal Register concerning each proposed collection of information before submitting the collection to OMB for approval. To comply with this requirement, FDA is publishing notice of the proposed collection of information set forth in this document.

We are consolidating the information collection in the revised draft guidance with the information collections and approvals under OMB control number 0910-0800. With respect to the following collection of information, FDA invites comments on these topics. (1) Whether the proposed collection of information is necessary for the proper performance of FDA's functions, including whether the information will have practical utility. (2) the accuracy of FDA's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used. (3) ways to enhance the quality, utility, and clarity of the information to be collected.

And (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques, when appropriate, and other forms of information technology. Human Drug Compounding Under Sections 503A and 503B the Federal Food, Drug, and Cosmetic Act OMB Control Number 0910-0800—Revision This notice solicits comments on certain information collections found in the revised draft guidance entitled “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act” (“revised draft guidance”). This guidance, when finalized, will support implementation of the copies provisions of the 1997 Food and Drug Administration Modernization Act (FDAMA) (Pub. L. 105-115) discussed in section 503A of the FD&C Act, which were maintained by the 2013 Drug Quality and Security Act (DQSA) (Title I of Pub.

L. 113-54). For efficiency of Agency operations, we are revising OMB control number 0910-0800 to include information collections relating to the copies policies for hospital and health system pharmacies that are not outsourcing facilities, as proposed in the revised draft guidance document. As proposed in section III.B of the revised draft guidance, among other conditions, we generally would not intend to take action against a hospital or health system pharmacy that is not an outsourcing facility for compounding a drug product regularly or in inordinate amounts that is essentially a copy of a commercially available drug product, if the compounded drug product is administered only to patients within the hospital or health system and the pharmacy obtains from the prescriber a statement that. (1) Specifies a change between the compounded drug product and the commercially available drug product.

(2) indicates that the compounded drug product will be administered only to patients for whom the change produces a significant difference from the commercially available drug product. And (3) describes the intended patient population for the compounded drug product. In addition, the revised draft guidance specifies that the statement would be maintained in the hospital or health system pharmacy to address routine orders for patients for whom the change produces a significant difference, and a statement would be on file for each prescriber that covers each drug product that is compounded. As provided in section III.B of the revised draft guidance, except for the policy proposed above regarding the documentation of a prescriber's determination of significant difference, we propose to apply the policies described in the guidance, “Compounded Drug Products That Are Essentially Copies of a Commercially Available Drug Product Under Section 503A of the Federal Food, Drug, and Cosmetic Act” (“503A copies guidance”) to drug products compounded by hospital and health system pharmacies that are not outsourcing facilities. As described in section III.B.2 of the 503A copies guidance, and proposed in the revised draft guidance to apply to hospital and health system pharmacies, if a compounder intends to rely on a prescriber determination of significant difference to establish that a compounded drug is not essentially a copy of a commercially available drug product, the compounder should ensure that the determination is documented on the prescription.

If a prescription Start Printed Page 55850 does not make clear that the prescriber made the determination required by section 503A(b)(2) of the FD&C Act, or a compounded drug is substituted for the commercially available drug product, the compounder can contact the prescriber and if the prescriber confirms it, make a notation on the prescription that the compounded drug product contains a change that makes a significant difference for the patient. The notations should be as specific as those described in the 503A copies guidance, and the date of the conversation with the prescriber should be included on the prescription. With respect to the determination of significant difference described above, we estimate that, annually, a total of approximately 3,075 hospital or health system pharmacies (table 1) will obtain a prescriber determination of significant difference. This estimate represents approximately half of the hospitals in the United States, including those that are in health systems. Of these, we estimate that approximately half (1,538) will have hospital or health system pharmacies that will follow the policy in the revised draft guidance, obtaining a statement of significant difference for the intended patient population, and approximately half (1,537) will have hospital or health system pharmacies that will follow the policy with respect to prescriber determination of significant difference in the 503A copies guidance, documenting the notation on the individual patient prescription.

This estimate assumes that most pharmacies in smaller hospitals and health systems will follow the policy in the 503A copies guidance because a prescriber determination of significant difference will not be routinely needed and can be most efficiently managed on a patient-by-patient basis. On the other hand, this estimate assumes that most pharmacies in larger hospitals and health systems will follow the policy in the revised draft guidance because the need for a prescriber determination of significant difference is more routinely necessary and, therefore, most efficiently managed with a statement of significant difference that is maintained in the hospital or health system pharmacy to address routine orders for patients for whom the change produces a significant difference. We estimate that, annually, approximately 1,538 hospital or health system pharmacies following the policy in the revised draft guidance will obtain approximately 30 statements of significant difference for compounded drug products, for a total of approximately 46,140 statements (table 1, row 1). We estimate that the consultation between the hospital or health system pharmacy and the prescriber to obtain the statement of significant difference will require approximately 5 minutes per statement (table 1, row 1). We estimate that, annually, approximately 1,537 hospital or health pharmacies following the policy in the 503A copies guidance will consult a prescriber to determine whether the prescriber has made a determination that the compounded drug product has a change that produces a significant difference for a patient as compared to the comparable commercially available drug and that the compounders will document this determination on approximately 76,850 prescription orders for compounded drug products (table 1, row 2).

We estimate that the consultation between the compounder and the prescriber and adding a notation to each prescription that does not already document this determination will take approximately 3 minutes per prescription order (table 1, row 2). The average burden per consultation and notation for pharmacies following the significant difference policy in the 503A copies guidance, compared to pharmacies following the significant difference policy in the revised draft guidance, is estimated to be less (3 minutes) because the significant difference determination described in the 503A copies policy is specific to one patient, whereas the statement of significant difference in the revised draft guidance describes the intended patient population. In addition, as described in section III.B.3 of the 503A copies guidance, and proposed in the revised draft guidance to apply to hospital and health system pharmacies, if the drug product was compounded because the approved drug product was not commercially available because it was on the FDA drug shortage list, the prescription or a notation on the prescription should note that it was on the drug shortage list and note the date the list was checked. We estimate that a total of approximately 4,613 hospital or health system pharmacies will document this information on approximately 922,600 prescription orders for compounded drug products (table 1, row 3). We estimate that checking FDA's drug shortage list and documenting this information will require approximately 2 minutes per prescription order (table 1, row 3).

With respect to maintaining records of the statement of significant difference proposed in section III.B of the revised draft guidance, we estimate that a total of approximately 1,538 hospital or health system pharmacies will maintain approximately 46,140 statements of significant difference (table 2, row 1). We estimate that maintaining the records will require approximately 2 minutes per record (table 2, row 1). With respect to maintaining records of the significant difference determination, as provided in section III.B.5 of the 503A copies guidance, we estimate that a total of approximately 1,537 hospital or health system pharmacies will maintain approximately 76,850 records (table 2, row 2). We estimate that maintaining records will require approximately 2 minutes per record (table 2, row 2). Also with respect to maintenance of records, as described in section III.B.5 of the 503A copies guidance, and proposed in the revised draft guidance to apply to hospital and health system pharmacies, compounders under section 503A should maintain records of (1) the frequency in which they have compounded drug products that are essentially copies of commercially available drug products and (2) the number of prescriptions that they have filled for compounded drug products that are essentially copies of commercially available drug products.

We estimate that a total of approximately 3,075 hospital or health system pharmacies will maintain approximately 61,500 records of prescriptions that they have filled for compounded drug products that are essentially copies of commercially available drug products (table 2, row 3). We estimate that maintaining the records will require approximately 2 minutes per record (table 2, row 3). We estimate the burden of this collection of information as follows. Start Printed Page 55851 Table 1—Estimated Annual Third-Party Disclosure Burden 1ActivityNumber of respondentsNumber of disclosures per respondentTotal annual disclosuresAverage burden per disclosureTotal hoursConsultation between the hospital or health system pharmacy and the prescriber to document the statement of significant difference (revised draft guidance)1,5383046,140.08 (5 minutes)3,691Consultation between the hospital or health system pharmacy and prescriber and the notation on the prescription documenting the prescriber's determination of significant difference (503A copies guidance)1,5375076,850.05 (3 minutes)3,843Hospital or health system pharmacy checking FDA's drug shortage list and documenting on the prescription that the drug is in shortage (503A copies guidance)4,613200922,600.03 (2 minutes)27,678Total35,2121  There are no capital costs or operating and maintenance costs associated with this collection of information. Table 2—Estimated Annual Recordkeeping Burden 1ActivityNumber of recordkeepersNumber of records per recordkeeperTotal annual recordsAverage burden per recordkeepingTotal hoursRecords of the statement of significant difference (revised draft guidance)1,5383046,140.03 (2 minutes)1,384Records of documentation of significant difference (503A copies guidance)1,5375076,850.03 (2 minutes)2,306Records of frequency and number of prescriptions filled for compounded drug products that are essentially a copy (503A copies guidance)3,0752061,500.03 (2 minutes)1,845Total5,5351  There are no capital costs or operating and maintenance costs associated with this collection of information.

IV. Electronic Access Persons with access to the internet may obtain an electronic version of the revised draft guidance at either https://www.fda.gov/​Drugs/​GuidanceComplianceRegulatoryInformation/​Guidances/​default.htm or https://www.regulations.gov. Start Signature Dated. October 4, 2021. Lauren K.

Roth, Associate Commissioner for Policy. End Signature End Supplemental Information [FR Doc. 2021-21970 Filed 10-6-21. 8:45 am]BILLING CODE 4164-01-P.

Start Preamble Food click here for more info and Drug Administration, HHS where to get lasix. Notice of availability. The Food and Drug Administration (FDA) is announcing the availability of where to get lasix a revised draft guidance for industry entitled “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act” (“revised draft guidance”). This revised draft guidance, when finalized, will describe how FDA intends to apply certain provisions of the Federal Food, Drug, and Cosmetic Act (FD&C Act) to human drug products compounded by State-licensed pharmacies that are not outsourcing facilities and distributed for use within a hospital or health system.

First, it addresses the requirement that where to get lasix compounding be based on the receipt of a valid prescription order for an identified individual patient. Second, it addresses the provision concerning compounded drug products that are essentially copies of a commercially available drug product. This draft guidance revises the draft guidance issued in 2016 entitled, “Hospital and Health System Compounding Under the where to get lasix Federal Food, Drug, and Cosmetic Act” (“draft guidance”). FDA is revising the draft guidance to address stakeholder feedback and provide further clarification on policies regarding hospital and health system compounding.

This revised draft guidance is not final nor is it in where to get lasix effect at this time. Submit either electronic or written comments on the revised draft guidance by December 6, 2021 to ensure that the Agency considers your comment on this revised draft guidance before it begins work on the final version of the guidance. Submit electronic or written comments on the proposed collection of information in the revised draft guidance by December 6, 2021. You may submit comments where to get lasix on any guidance at any time as follows.

Electronic Submissions Submit electronic comments in the following way. Start Printed where to get lasix Page 55848 • Federal eRulemaking Portal. Https://www.regulations.gov. Follow the instructions for where to get lasix submitting comments.

Comments submitted electronically, including attachments, to https://www.regulations.gov will be posted to the docket unchanged. Because your comment will be made public, you are solely responsible for ensuring that your comment does not include any confidential information that you or a third party may not wish to be posted, such as medical information, your or anyone else's Social Security number, or confidential business information, where to get lasix such as a manufacturing process. Please note that if you include your name, contact information, or other information that identifies you in the body of your comments, that information will be posted on https://www.regulations.gov. If you want to submit a comment with confidential information that you do not wish to be made available to the public, submit the comment as a written/paper submission and in the manner detailed (see “Written/Paper Submissions” and “Instructions”).

Written/Paper Submissions where to get lasix Submit written/paper submissions as follows. • Mail/Hand Delivery/Courier (for written/paper submissions). Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm where to get lasix. 1061, Rockville, MD 20852.

For written/paper comments submitted to the Dockets Management Staff, FDA will post your comment, as well as where to get lasix any attachments, except for information submitted, marked and identified, as confidential, if submitted as detailed in “Instructions.” Instructions. All submissions received must include the Docket No. FDA-2016-D-0271 for “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act.” Received comments will be placed in the docket and, except for those submitted as “Confidential Submissions,” publicly viewable at https://www.regulations.gov or at where to get lasix the Dockets Management Staff between 9 a.m. And 4 p.m., Monday through Friday, 240-402-7500.

• Confidential Submissions—To submit a comment with confidential information that you do not wish to be made publicly available, submit your comments only as a written/paper submission. You should submit two where to get lasix copies total. One copy will include the information you claim to be confidential with a heading or cover note that states “THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.” The Agency will review this copy, including the claimed confidential information, in its consideration of comments. The second copy, which will have the claimed where to get lasix confidential information redacted/blacked out, will be available for public viewing and posted on https://www.regulations.gov.

Submit both copies to the Dockets Management Staff. If you do not wish your name and contact information to be made publicly available, you can provide where to get lasix this information on the cover sheet and not in the body of your comments and you must identify this information as “confidential.” Any information marked as “confidential” will not be disclosed except in accordance with 21 CFR 10.20 and other applicable disclosure law. For more information about FDA's posting of comments to public dockets, see 80 FR 56469, September 18, 2015, or access the information at. Https://www.govinfo.gov/​content/​pkg/​FR-2015-09-18/​pdf/​2015-23389.pdf.

Docket. For access to the docket to read background documents or the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in the heading of this document, into the “Search” box and follow the prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852, 240-402-7500. You may submit comments on any guidance at any time (see 21 CFR 10.115(g)(5)).

Submit written requests for single copies of this revised draft guidance to the Division of Drug Information, Center for Drug Evaluation and Research, Food and Drug Administration, 10001 New Hampshire Ave., Hillandale Building, 4th Floor, Silver Spring, MD 20993-0002. Send one self-addressed adhesive label to assist that office in processing your request or include a fax number to which the revised draft guidance may be sent. See the SUPPLEMENTARY INFORMATION section for information on electronic access to the revised draft guidance. Start Further Info With regard to the revised draft guidance.

Tracy Rupp, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 51, Silver Spring, MD 20993, 301-796-3100. With regard to the proposed collection of information. Domini Bean, Office of Operations, Food and Drug Administration, Three White Flint North, 10A-12M, 11601 Landsdown St., North Bethesda, MD 20852, 301-796-5733, PRAStaff@fda.hhs.gov.

End Further Info End Preamble Start Supplemental Information I. Background FDA is announcing the availability of a revised draft guidance for industry entitled “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act.” Pharmacies located within a hospital, or standalone pharmacies that are part of a health system, frequently provide compounded drug products for administration within the hospital or health system. Some of these compounders seek to compound under section 503A of the FD&C Act (21 U.S.C. 353a) and others have registered with FDA as outsourcing facilities and are subject to section 503B of the FD&C Act (21 U.S.C.

353b). Section 503A of the FD&C Act describes the conditions that must be satisfied for human drug products compounded by a licensed pharmacist in a State-licensed pharmacy or Federal facility, or by a licensed physician, to be exempt from the following three sections of the FD&C Act. Section 501(a)(2)(B) (21 U.S.C. 351(a)(2)(B)) (concerning current good manufacturing practice (CGMP) requirements).

Section 502(f)(1) (21 U.S.C. 352(f)(1)) (concerning the labeling of drugs with adequate directions for use). And Section 505 (21 U.S.C. 355) (concerning the approval of drugs under new drug applications or abbreviated new drug applications).

This revised draft guidance proposes policies for FDA's application of certain provisions of section 503A of the FD&C Act to human drug products compounded by State-licensed pharmacies that are not outsourcing facilities and distributed for use within a hospital or health system. First, the revised draft guidance addresses the requirement that compounding be based on the receipt of a valid prescription order for an identified individual patient. Second, it addresses the provision concerning compounded drug products that are essentially copies of a commercially available drug product. This revised draft guidance does not apply to human drug products compounded by outsourcing facilities under section 503B of the FD&C Act, compounded drug products that are not distributed for use within a hospital or health system, or drug products compounded for use in animals.

In the Federal Register of April 18, 2016 (81 FR 22610), FDA announced the availability of a draft guidance for industry entitled, “Hospital and Health System Compounding Under the Federal Food, Drug, and Cosmetic Act” Start Printed Page 55849 (“draft guidance”). The draft guidance proposed new policies for the application of section 503A of the FD&C Act to drug products compounded by licensed pharmacists or physicians in State-licensed hospital or health system pharmacies. In particular, the draft guidance described certain circumstances under which FDA generally would not intend to take action if a hospital or health system pharmacy distributed compounded drug products without first receiving a patient-specific prescription or order. The comment period on the initial draft guidance ended on July 18, 2016.

FDA received approximately 76 comments on the draft guidance. FDA is issuing a revised draft guidance with certain changes made in response to received comments or on its own initiative. For example, the prescription requirement enforcement policy described in the revised draft guidance does not consider whether the drug products are distributed only to healthcare facilities that are located within a 1-mile radius of the compounding pharmacy (“1-mile radius policy”). Instead, the Agency is proposing a two-part, risk-based compliance policy.

In addition, the revised draft guidance proposes new policies for hospital and health system pharmacies regarding the provision in section 503A of the FD&C Act which states that to qualify for the exemptions under section 503A of the FD&C Act, among other conditions, a drug product must be compounded by a licensed pharmacist or physician who does not compound regularly or in inordinate amounts any drug products that are essentially copies of a commercially available drug product. FDA is issuing this revised draft guidance to address stakeholders' feedback, reflect additional Agency consideration of the proposed policies, and enable the public to further review and comment before finalization. This revised draft guidance is being issued consistent with FDA's good guidance practices regulation (21 CFR 10.115). The revised draft guidance, when finalized, will represent the current thinking of FDA on “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act.” It does not establish any rights for any person and is not binding on FDA or the public.

You can use an alternative approach if it satisfies the requirements of the applicable statutes and regulations. II. Paperwork Reduction Act of 1995 Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-3521), Federal Agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor.

€œCollection of information” is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes Agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires Federal Agencies to provide a 60-day notice in the Federal Register concerning each proposed collection of information before submitting the collection to OMB for approval.

To comply with this requirement, FDA is publishing notice of the proposed collection of information set forth in this document. We are consolidating the information collection in the revised draft guidance with the information collections and approvals under OMB control number 0910-0800. With respect to the following collection of information, FDA invites comments on these topics. (1) Whether the proposed collection of information is necessary for the proper performance of FDA's functions, including whether the information will have practical utility.

(2) the accuracy of FDA's estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used. (3) ways to enhance the quality, utility, and clarity of the information to be collected. And (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques, when appropriate, and other forms of information technology. Human Drug Compounding Under Sections 503A and 503B the Federal Food, Drug, and Cosmetic Act OMB Control Number 0910-0800—Revision This notice solicits comments on certain information collections found in the revised draft guidance entitled “Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act” (“revised draft guidance”).

This guidance, when finalized, will support implementation of the copies provisions of the 1997 Food and Drug Administration Modernization Act (FDAMA) (Pub. L. 105-115) discussed in section 503A of the FD&C Act, which were maintained by the 2013 Drug Quality and Security Act (DQSA) (Title I of Pub. L.

113-54). For efficiency of Agency operations, we are revising OMB control number 0910-0800 to include information collections relating to the copies policies for hospital and health system pharmacies that are not outsourcing facilities, as proposed in the revised draft guidance document. As proposed in section III.B of the revised draft guidance, among other conditions, we generally would not intend to take action against a hospital or health system pharmacy that is not an outsourcing facility for compounding a drug product regularly or in inordinate amounts that is essentially a copy of a commercially available drug product, if the compounded drug product is administered only to patients within the hospital or health system and the pharmacy obtains from the prescriber a statement that. (1) Specifies a change between the compounded drug product and the commercially available drug product.

(2) indicates that the compounded drug product will be administered only to patients for whom the change produces a significant difference from the commercially available drug product. And (3) describes the intended patient population for the compounded drug product. In addition, the revised draft guidance specifies that the statement would be maintained in the hospital or health system pharmacy to address routine orders for patients for whom the change produces a significant difference, and a statement would be on file for each prescriber that covers each drug product that is compounded. As provided in section III.B of the revised draft guidance, except for the policy proposed above regarding the documentation of a prescriber's determination of significant difference, we propose to apply the policies described in the guidance, “Compounded Drug Products That Are Essentially Copies of a Commercially Available Drug Product Under Section 503A of the Federal Food, Drug, and Cosmetic Act” (“503A copies guidance”) to drug products compounded by hospital and health system pharmacies that are not outsourcing facilities.

As described in section III.B.2 of the 503A copies guidance, and proposed in the revised draft guidance to apply to hospital and health system pharmacies, if a compounder intends to rely on a prescriber determination of significant difference to establish that a compounded drug is not essentially a copy of a commercially available drug product, the compounder should ensure that the determination is documented on the prescription. If a prescription Start Printed Page 55850 does not make clear that the prescriber made the determination required by section 503A(b)(2) of the FD&C Act, or a compounded drug is substituted for the commercially available drug product, the compounder can contact the prescriber and if the prescriber confirms it, make a notation on the prescription that the compounded drug product contains a change that makes a significant difference for the patient. The notations should be as specific as those described in the 503A copies guidance, and the date of the conversation with the prescriber should be included on the prescription. With respect to the determination of significant difference described above, we estimate that, annually, a total of approximately 3,075 hospital or health system pharmacies (table 1) will obtain a prescriber determination of significant difference.

This estimate represents approximately half of the hospitals in the United States, including those that are in health systems. Of these, we estimate that approximately half (1,538) will have hospital or health system pharmacies that will follow the policy in the revised draft guidance, obtaining a statement of significant difference for the intended patient population, and approximately half (1,537) will have hospital or health system pharmacies that will follow the policy with respect to prescriber determination of significant difference in the 503A copies guidance, documenting the notation on the individual patient prescription. This estimate assumes that most pharmacies in smaller hospitals and health systems will follow the policy in the 503A copies guidance because a prescriber determination of significant difference will not be routinely needed and can be most efficiently managed on a patient-by-patient basis. On the other hand, this estimate assumes that most pharmacies in larger hospitals and health systems will follow the policy in the revised draft guidance because the need for a prescriber determination of significant difference is more routinely necessary and, therefore, most efficiently managed with a statement of significant difference that is maintained in the hospital or health system pharmacy to address routine orders for patients for whom the change produces a significant difference.

We estimate that, annually, approximately 1,538 hospital or health system pharmacies following the policy in the revised draft guidance will obtain approximately 30 statements of significant difference for compounded drug products, for a total of approximately 46,140 statements (table 1, row 1). We estimate that the consultation between the hospital or health system pharmacy and the prescriber to obtain the statement of significant difference will require approximately 5 minutes per statement (table 1, row 1). We estimate that, annually, approximately 1,537 hospital or health pharmacies following the policy in the 503A copies guidance will consult a prescriber to determine whether the prescriber has made a determination that the compounded drug product has a change that produces a significant difference for a patient as compared to the comparable commercially available drug and that the compounders will document this determination on approximately 76,850 prescription orders for compounded drug products (table 1, row 2). We estimate that the consultation between the compounder and the prescriber and adding a notation to each prescription that does not already document this determination will take approximately 3 minutes per prescription order (table 1, row 2).

The average burden per consultation and notation for pharmacies following the significant difference policy in the 503A copies guidance, compared to pharmacies following the significant difference policy in the revised draft guidance, is estimated to be less (3 minutes) because the significant difference determination described in the 503A copies policy is specific to one patient, whereas the statement of significant difference in the revised draft guidance describes the intended patient population. In addition, as described in section III.B.3 of the 503A copies guidance, and proposed in the revised draft guidance to apply to hospital and health system pharmacies, if the drug product was compounded because the approved drug product was not commercially available because it was on the FDA drug shortage list, the prescription or a notation on the prescription should note that it was on the drug shortage list and note the date the list was checked. We estimate that a total of approximately 4,613 hospital or health system pharmacies will document this information on approximately 922,600 prescription orders for compounded drug products (table 1, row 3). We estimate that checking FDA's drug shortage list and documenting this information will require approximately 2 minutes per prescription order (table 1, row 3).

With respect to maintaining records of the statement of significant difference proposed in section III.B of the revised draft guidance, we estimate that a total of approximately 1,538 hospital or health system pharmacies will maintain approximately 46,140 statements of significant difference (table 2, row 1). We estimate that maintaining the records will require approximately 2 minutes per record (table 2, row 1). With respect to maintaining records of the significant difference determination, as provided in section III.B.5 of the 503A copies guidance, we estimate that a total of approximately 1,537 hospital or health system pharmacies will maintain approximately 76,850 records (table 2, row 2). We estimate that maintaining records will require approximately 2 minutes per record (table 2, row 2).

Also with respect to maintenance of records, as described in section III.B.5 of the 503A copies guidance, and proposed in the revised draft guidance to apply to hospital and health system pharmacies, compounders under section 503A should maintain records of (1) the frequency in which they have compounded drug products that are essentially copies of commercially available drug products and (2) the number of prescriptions that they have filled for compounded drug products that are essentially copies of commercially available drug products. We estimate that a total of approximately 3,075 hospital or health system pharmacies will maintain approximately 61,500 records of prescriptions that they have filled for compounded drug products that are essentially copies of commercially available drug products (table 2, row 3). We estimate that maintaining the records will require approximately 2 minutes per record (table 2, row 3). We estimate the burden of this collection of information as follows.

Start Printed Page 55851 Table 1—Estimated Annual Third-Party Disclosure Burden 1ActivityNumber of respondentsNumber of disclosures per respondentTotal annual disclosuresAverage burden per disclosureTotal hoursConsultation between the hospital or health system pharmacy and the prescriber to document the statement of significant difference (revised draft guidance)1,5383046,140.08 (5 minutes)3,691Consultation between the hospital or health system pharmacy and prescriber and the notation on the prescription documenting the prescriber's determination of significant difference (503A copies guidance)1,5375076,850.05 (3 minutes)3,843Hospital or health system pharmacy checking FDA's drug shortage list and documenting on the prescription that the drug is in shortage (503A copies guidance)4,613200922,600.03 (2 minutes)27,678Total35,2121  There are no capital costs or operating and maintenance costs associated with this collection of information. Table 2—Estimated Annual Recordkeeping Burden 1ActivityNumber of recordkeepersNumber of records per recordkeeperTotal annual recordsAverage burden per recordkeepingTotal hoursRecords of the statement of significant difference (revised draft guidance)1,5383046,140.03 (2 minutes)1,384Records of documentation of significant difference (503A copies guidance)1,5375076,850.03 (2 minutes)2,306Records of frequency and number of prescriptions filled for compounded drug products that are essentially a copy (503A copies guidance)3,0752061,500.03 (2 minutes)1,845Total5,5351  There are no capital costs or operating and maintenance costs associated with this collection of information. IV. Electronic Access Persons with access to the internet may obtain an electronic version of the revised draft guidance at either https://www.fda.gov/​Drugs/​GuidanceComplianceRegulatoryInformation/​Guidances/​default.htm or https://www.regulations.gov.

Start Signature Dated. October 4, 2021. Lauren K. Roth, Associate Commissioner for Policy.

End Signature End Supplemental Information [FR Doc. 2021-21970 Filed 10-6-21. 8:45 am]BILLING CODE 4164-01-P.

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Lauren Gambill, MDPediatrician, AustinMember, Texas Medical Association (TMA) Committee on Child and Adolescent HealthExecutive Board Member, Texas homeopathic alternative to lasix Pediatric SocietyDoctors are community leaders. This role has become even more important during the hypertension medications lasix. As patients navigate our new reality, they are looking to us to determine what is safe, how to protect their families, and the future of their health care homeopathic alternative to lasix.

As more Texans lose their jobs, their health insurance, or even their homes, it is crucial that Texas receives the resources it needs to uphold our social safety net. The U.S. Census helps determine funding for those resources, and that is why it is of the upmost importance that homeopathic alternative to lasix each and every Texan, no matter address, immigration status, or age, respond to the 2020 U.S.

Census. The deadline has been cut short one month and homeopathic alternative to lasix now closes Sept. 30.hypertension medications has only increased the importance of completing the census to help our local communities and economies recover.

The novel hypertension has inflicted unprecedented strain on patients and exacerbated inequality as more people are out of work and are many in need of help with food, health care, housing, and more. Schools also homeopathic alternative to lasix have been stretched thin, with teachers scrambling to teach students online. Yet, the amount of federal funding Texas has available today to help weather this emergency was driven in part by the census responses made a decade ago.

Getting an accurate count in 2020 will help Texans prepare for the decade to follow, the first few years of which most certainly will be spent rebuilding from the lasix’s fallout. Therefore, it is vital that all Texans be counted.The federal dollars Texas receives generally depends on our homeopathic alternative to lasix population. A George Washington University study recently found that even a 1% undercount can lead to a $300 million loss in funding.Take Medicaid, for example.

Federal funds pay for 60% of the state’s program, which provides health coverage for two out of five Texas homeopathic alternative to lasix children, one in three individuals with disabilities, and 53% of all births. The complicated formula used to calculate the federal portion of this funding depends on accurate census data. If Texas’ population is undercounted, Texans may appear better off financially than they really are, resulting in Texas getting fewer federal Medicaid dollars.

If that happens, lawmakers will have to make up the difference, with cuts in services, program eligibility, or physician homeopathic alternative to lasix and provider payments, any of which are potentially detrimental.The census data also is key to funding other aspects of a community’s social safety net:Health careThe Children’s Health Insurance Program (CHIP) provides low-cost health insurance to children whose parents make too much to qualify for Medicaid, but not enough to afford quality coverage. Like Medicaid, how much money the federal government reimburses the state for the program depends in part on the census.Maternal and child health programs that promote public health and help ensure children are vaccinated relies on data from the census. Texas also uses this federal funding to study and respond to maternal homeopathic alternative to lasix mortality and perinatal depression.Food and housing As unemployment rises and families struggle financially, many live with uncertainty as to where they will find their next meal.

Already, one in seven Texans experiences food insecurity, and 20% of Texas children experience hunger. Food insecurity is rising in Texas as the lasix continues. The Central Texas Food Bank saw a homeopathic alternative to lasix 206% rise in clients in March.

Funding for the Supplemental Nutrition Assistance Program and school lunch programs are both determined by the census. Funding for local housing programs also is calculated via the census. An accurate count will help ensure that people who lose homeopathic alternative to lasix their homes during this economic crisis have better hope of finding shelter while our communities recover.

Homelessness is closely connected with declines in overall physical and mental health.Childcare and educationAs we navigate the new reality brought on by hypertension, more parents are taking on roles as breadwinner, parent, teacher, and caretaker. This stress homeopathic alternative to lasix highlights the desperate need for affordable childcare. The census determines funding for programs like Head Start that provide comprehensive early childhood education to low-income families.

The good news is you still have time to complete the census. Visit 2020census.gov homeopathic alternative to lasix to take it. It takes less than five minutes to complete.

Then talk to your homeopathic alternative to lasix family, neighbors, and colleagues about doing the same. If you are wondering who counts, the answer is everyone, whether it’s a newborn baby, child in foster care, undocumented immigrant, or an individual experiencing homelessness.Completing the census is one of the best things that you can do for the health of your community, especially during the lasix. Thank you for helping Texas heal and for supporting these essential safety net programs.(L to R).

UTHSA medical students Swetha Maddipudi, homeopathic alternative to lasix Brittany Hansen, Charles Wang, Carson Cortino, faculty advisor Kaparaboyna Kumar, MD, Ryan Wealther, Sidney Akabogu, Irma Ruiz, and Frank Jung pose with the TMA Be Wise Immunize banner. Photo courtesy by Ryan WealtherRyan WealtherMedical Student, UT Health San Antonio Long School of MedicineStudent Member, Texas Medical AssociationEditor’s Note. August is National Immunization Awareness Month.

This article is part of a Me&My Doctor series highlighting and homeopathic alternative to lasix promoting the use of vaccinations.“Can the flu shot give you the flu?. €â€œIs it dangerous for pregnant women to get a flu shot?. €â€œCan treatments cause homeopathic alternative to lasix autism?.

€These were questions women at Alpha Home, a residential substance abuse rehabilitation center in San Antonio, asked my fellow medical students and me during a flu treatment discussion. It is easy to see why these questions were asked, as treatment misinformation is common today.UTHSA medical student Frank Jing (left) gets a treatment fromKaparaboyna Kumar, MD, (right).Photo courtesy of Ryan Wealther“No” is the answer to all the questions. These were exactly the types of myths we set out to dispel at our vaccination drive.UT Health San Antonio Long School of Medicine medical students (under the supervision of Kaparaboyna Ashok Kumar, MD, faculty homeopathic alternative to lasix advisor for the Texas Medical Association Medical Student Section at UT Health San Antonio) hosted the treatment drive at Alpha Home with the support of TMA’s Be Wise – Immunize℠ program, a public health initiative that aims to increase vaccinations and treatment awareness through shot clinics and education.

Our program consisted of a vaccination drive and an interactive, educational presentation that addressed influenza, common flu shot questions, and general treatment myths. The Alpha Home residents could ask us questions during the program.We were interested to see if our educational program could answer Alpha Home residents’ questions about homeopathic alternative to lasix vaccinations and allay their hesitations about getting a flu vaccination. To gauge this, we created a brief survey.(Before I discuss the results of the survey, I should define treatment hesitancy.

treatment hesitancy is a concept defined by the World Health Organization. It relates to when patients do not vaccinate despite having access homeopathic alternative to lasix to treatments. treatment hesitancy is a problem because it prevents individuals from receiving their vaccinations.

That makes them more susceptible to getting sick from treatment-preventable diseases.)We surveyed the residents’ opinions about vaccinations before and after our educational program. While opinions about shots improved with each survey question, we saw the most significant attitude change reflected in answers to homeopathic alternative to lasix the questions “I am concerned that vaccinations might not be safe,” and “How likely are you to receive a flu shot today?. € We had informed the residents and improved their understanding and acceptance of immunizations.Post-survey results show more residents at the Alpha Home shifted to more positive attitudes about treatments, after learning more about their effectiveness by trusted members of the medical community.

Graph by homeopathic alternative to lasix Ryan WealtherWhy is this important?. First, our findings confirm what we already knew. Education by a trusted member of the medical community can effect change.

In fact, it is widely known that physician recommendation of vaccination is one of the most critical factors affecting homeopathic alternative to lasix whether patients receive an influenza vaccination. Perhaps some added proof to this is that a few of the Alpha Home residents were calling me “Dr. Truth” by the end of homeopathic alternative to lasix the evening.Second, our findings add to our understanding of adult treatment hesitancy.

This is significant because most of what we know about treatment hesitancy is limited to parental attitudes toward their children’s vaccinations. Some parents question shots for their children, and many of the most deadly diseases we vaccinate against are given in childhood, including polio, tetanus, measles, and whooping cough shots. However, adults need some vaccinations as well, like homeopathic alternative to lasix the yearly influenza treatment.

After taking part in the UTHSA educational program, more residents at the Alpha Home shared more willingness to receive the flu treatment. Graph by Ryan WealtherAnother reason improving attitudes is important is that receiving a flu shot is even more timely during the hypertension medications lasix because it decreases illnesses and conserves health care resources. Thousands of people each year are hospitalized from the flu, and with hospitals filling up with hypertension patients, we could homeopathic alternative to lasix avoid adding dangerously ill flu patients to the mix.

Lastly, these findings are important because once a hypertension medications vaccination becomes available, more people might be willing to receive it if their overall attitude toward immunizations is positive. Though the hypertension medications treatment is homeopathic alternative to lasix still in development, it is not immune to treatment hesitancy. Recent polls have indicated up to one-third of Americans would not receive a hypertension medications treatment even if it were accessible and affordable.

Work is already being done to try to raise awareness and acceptance. In addition, misinformation about homeopathic alternative to lasix the hypertension medications treatment is circulating widely. (Someone recently asked me if the hypertension medications treatment will implant a microchip in people, and I have seen the same myth circulating on social media.

It will not.) This myth, however, illustrates the need for health care professionals to answer patients’ questions and to assuage their concerns.treatments work best when many homeopathic alternative to lasix people in a community receive them, and treatment hesitancy can diminish vaccination rates, leaving people who can't get certain treatments susceptible to these treatment-preventable diseases. For example, babies under 6 months of age should not receive a flu shot, so high community vaccination rates protect these babies from getting sick with the flu. Our educational program at Alpha Home is just one example of how health care professionals can increase awareness and acceptance of shots.

As the hypertension medications lasix progresses, we need to ensure children and adults receive their homeopathic alternative to lasix vaccinations as recommended by their physician and the Centers for Disease Control and Prevention. I encourage readers who have questions about the vaccinations they or their child may need to talk with their physician. As health care professionals, we’re more than happy to answer your questions..

Lauren Gambill, MDPediatrician, AustinMember, Texas Medical Association where to get lasix (TMA) Committee on Child and Adolescent HealthExecutive Board Member, Texas Pediatric SocietyDoctors are community leaders. This role has become even more important during the hypertension medications lasix. As patients navigate our new reality, they are looking to us to determine what is safe, how to where to get lasix protect their families, and the future of their health care.

As more Texans lose their jobs, their health insurance, or even their homes, it is crucial that Texas receives the resources it needs to uphold our social safety net. The U.S. Census helps determine funding for those resources, and that is why it where to get lasix is of the upmost importance that each and every Texan, no matter address, immigration status, or age, respond to the 2020 U.S.

Census. The deadline has been cut short one month and where to get lasix now closes Sept. 30.hypertension medications has only increased the importance of completing the census to help our local communities and economies recover.

The novel hypertension has inflicted unprecedented strain on patients and exacerbated inequality as more people are out of work and are many in need of help with food, health care, housing, and more. Schools also have where to get lasix been stretched thin, with teachers scrambling to teach students online. Yet, the amount of federal funding Texas has available today to help weather this emergency was driven in part by the census responses made a decade ago.

Getting an accurate count in 2020 will help Texans prepare for the decade to follow, the first few years of which most certainly will be spent rebuilding from the lasix’s fallout. Therefore, it is vital that all Texans be counted.The federal dollars where to get lasix Texas receives generally depends on our population. A George Washington University study recently found that even a 1% undercount can lead to a $300 million loss in funding.Take Medicaid, for example.

Federal funds pay for 60% of the where to get lasix state’s program, which provides health coverage for two out of five Texas children, one in three individuals with disabilities, and 53% of all births. The complicated formula used to calculate the federal portion of this funding depends on accurate census data. If Texas’ population is undercounted, Texans may appear better off financially than they really are, resulting in Texas getting fewer federal Medicaid dollars.

If that happens, lawmakers will have to make up the difference, with cuts in services, program eligibility, or physician and provider payments, any of which are potentially detrimental.The census data also is key to funding other aspects of a community’s social safety net:Health where to get lasix careThe Children’s Health Insurance Program (CHIP) provides low-cost health insurance to children whose parents make too much to qualify for Medicaid, but not enough to afford quality coverage. Like Medicaid, how much money the federal government reimburses the state for the program depends in part on the census.Maternal and child health programs that promote public health and help ensure children are vaccinated relies on data from the census. Texas also uses this federal funding to study and respond to maternal mortality and perinatal depression.Food and housing As unemployment rises and families struggle financially, many live with uncertainty as to where they will find where to get lasix their next meal.

Already, one in seven Texans experiences food insecurity, and 20% of Texas children experience hunger. Food insecurity is rising in Texas as the lasix continues. The Central where to get lasix Texas Food Bank saw a 206% rise in clients in March.

Funding for the Supplemental Nutrition Assistance Program and school lunch programs are both determined by the census. Funding for local housing programs also is calculated via the census. An accurate count will help ensure that people who lose their homes during this economic crisis have better hope of finding shelter where to get lasix while our communities recover.

Homelessness is closely connected with declines in overall physical and mental health.Childcare and educationAs we navigate the new reality brought on by hypertension, more parents are taking on roles as breadwinner, parent, teacher, and caretaker. This stress highlights the desperate where to get lasix need for affordable childcare. The census determines funding for programs like Head Start that provide comprehensive early childhood education to low-income families.

The good news is you still have time to complete the census. Visit 2020census.gov to where to get lasix take it. It takes less than five minutes to complete.

Then talk to your family, neighbors, and colleagues about where to get lasix doing the same. If you are wondering who counts, the answer is everyone, whether it’s a newborn baby, child in foster care, undocumented immigrant, or an individual experiencing homelessness.Completing the census is one of the best things that you can do for the health of your community, especially during the lasix. Thank you for helping Texas heal and for supporting these essential safety net programs.(L to R).

UTHSA medical students Swetha Maddipudi, Brittany Hansen, Charles Wang, Carson Cortino, faculty advisor Kaparaboyna Kumar, MD, Ryan Wealther, Sidney Akabogu, Irma where to get lasix Ruiz, and Frank Jung pose with the TMA Be Wise Immunize banner. Photo courtesy by Ryan WealtherRyan WealtherMedical Student, UT Health San Antonio Long School of MedicineStudent Member, Texas Medical AssociationEditor’s Note. August is National Immunization Awareness Month.

This article is part of a Me&My Doctor series highlighting and promoting the use of vaccinations.“Can the where to get lasix flu shot give you the flu?. €â€œIs it dangerous for pregnant women to get a flu shot?. €â€œCan treatments cause autism? where to get lasix.

€These were questions women at Alpha Home, a residential substance abuse rehabilitation center in San Antonio, asked my fellow medical students and me during a flu treatment discussion. It is easy to see why these questions were asked, as treatment misinformation is common today.UTHSA medical student Frank Jing (left) gets a treatment fromKaparaboyna Kumar, MD, (right).Photo courtesy of Ryan Wealther“No” is the answer to all the questions. These were exactly the types of myths we set out to dispel at our vaccination drive.UT Health San Antonio Long School of Medicine medical students (under the supervision of Kaparaboyna Ashok Kumar, MD, faculty advisor for the Texas Medical Association Medical Student Section at UT Health San Antonio) hosted the treatment drive at Alpha Home with the support of TMA’s Be Wise – Immunize℠ program, a public health initiative that aims to increase vaccinations and where to get lasix treatment awareness through shot clinics and education.

Our program consisted of a vaccination drive and an interactive, educational presentation that addressed influenza, common flu shot questions, and general treatment myths. The Alpha Home residents could ask us questions during the program.We were where to get lasix interested to see if our educational program could answer Alpha Home residents’ questions about vaccinations and allay their hesitations about getting a flu vaccination. To gauge this, we created a brief survey.(Before I discuss the results of the survey, I should define treatment hesitancy.

treatment hesitancy is a concept defined by the World Health Organization. It relates to when where to get lasix patients do not vaccinate despite having access to treatments. treatment hesitancy is a problem because it prevents individuals from receiving their vaccinations.

That makes them more susceptible to getting sick from treatment-preventable diseases.)We surveyed the residents’ opinions about vaccinations before and after our educational program. While opinions about shots improved with each survey question, we saw the most significant attitude change reflected in answers to the questions “I am concerned that vaccinations where to get lasix might not be safe,” and “How likely are you to receive a flu shot today?. € We had informed the residents and improved their understanding and acceptance of immunizations.Post-survey results show more residents at the Alpha Home shifted to more positive attitudes about treatments, after learning more about their effectiveness by trusted members of the medical community.

Graph by Ryan WealtherWhy where to get lasix is this important?. First, our findings confirm what we already knew. Education by a trusted member of the medical community can effect change.

In fact, it is widely known that physician recommendation of vaccination is one of the most critical factors affecting whether patients receive an influenza vaccination where to get lasix. Perhaps some added proof to this is that a few of the Alpha Home residents were calling me “Dr. Truth” by where to get lasix the end of the evening.Second, our findings add to our understanding of adult treatment hesitancy.

This is significant because most of what we know about treatment hesitancy is limited to parental attitudes toward their children’s vaccinations. Some parents question shots for their children, and many of the most deadly diseases we vaccinate against are given in childhood, including polio, tetanus, measles, and whooping cough shots. However, adults need some vaccinations as well, where to get lasix like the yearly influenza treatment.

After taking part in the UTHSA educational program, more residents at the Alpha Home shared more willingness to receive the flu treatment. Graph by Ryan WealtherAnother reason improving attitudes is important is that receiving a flu shot is even more timely during the hypertension medications lasix because it decreases illnesses and conserves health care resources. Thousands of people each year where to get lasix are hospitalized from the flu, and with hospitals filling up with hypertension patients, we could avoid adding dangerously ill flu patients to the mix.

Lastly, these findings are important because once a hypertension medications vaccination becomes available, more people might be willing to receive it if their overall attitude toward immunizations is positive. Though the hypertension medications treatment is still in development, it is where to get lasix not immune to treatment hesitancy. Recent polls have indicated up to one-third of Americans would not receive a hypertension medications treatment even if it were accessible and affordable.

Work is already being done to try to raise awareness and acceptance. In addition, misinformation where to get lasix about the hypertension medications treatment is circulating widely. (Someone recently asked me if the hypertension medications treatment will implant a microchip in people, and I have seen the same myth circulating on social media.

It will not.) This myth, however, illustrates the need for health care professionals to answer patients’ questions and to assuage their concerns.treatments work best when many people in a community receive them, and where to get lasix treatment hesitancy can diminish vaccination rates, leaving people who can't get certain treatments susceptible to these treatment-preventable diseases. For example, babies under 6 months of age should not receive a flu shot, so high community vaccination rates protect these babies from getting sick with the flu. Our educational program at Alpha Home is just one example of how health care professionals can increase awareness and acceptance of shots.

As the hypertension medications lasix progresses, we need to ensure children and adults receive their vaccinations as recommended by their physician and the Centers for where to get lasix Disease Control and Prevention. I encourage readers who have questions about the vaccinations they or their child may need to talk with their physician. As health care professionals, we’re more than happy to answer your questions..

!]


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Apr 292013
 

From Reveal: A Sacred Manual for Getting Spiritually Naked, by Meggan Watterson:

“The world of magic and of love that I secretly believed in was all around me, a part of me and a part of what it is to be human. As terrifying as it was to believe … I knew the time had come to surrender to the truth that I have the power to conjure what my soul longs for most.”

I really liked this book — a lot.

As a woman, I always enjoy learning about and applying ideas related to the Divine Feminine. It’s a rich and fascinating area.

I had the impression that’s what this book was about. As I eagerly cracked it open, I saw that it was.

And it’s also so much more.

Lift the veil that shrouds your strangeness. Dare to see how powerful you are.

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As a master theologian and scholar of the Divine Feminine, Meggan is able to share way more about this rich subject than I could possibly get into right here. I very much enjoyed the breadth of information she shared about all the various “incarnations” of the Divine Feminine.

I found it very interesting, and although she made her points about it, she did it in such a way that it often left me wanting even more.

Fortunately she cites various books and provides lots of references that we can follow up on for further reading.

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What I didn’t expect is that Meggan’s journey would be so expertly interwoven into that information. Not only the stories of her pilgrimages (which were really interesting) but also her own inner journeys as she discovered the Divinity within herself.

I really loved this aspect of the book and was able to identify. It’s really fun to be able to connect my experiences with the symbology and actuality of what the famous icons of the Divine Feminine represent.

It keeps the reading interesting and even though you’re learning a lot about the Divine Feminine as it’s existed throughout the ages, you’re always relating it to now and what it means to you in your life.

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And yet, Meggan takes it even another step farther.

The book is laid out in a way that we are peeled like an onion. Or rather, that “the veils” are lifted in succession. The subtitle is, after all: A Sacred Manual for Getting Spiritually Naked.

And it really is about embracing and honoring ourselves as women, and as spirit. As the Divine, and the Feminine.

The true human can remember the Divine within and use that consciousness to help create reality through the infinite grace and power of the “I Am.”

The 7 veils she helps remove are related to:

  • Our stories
  • Our bodies
  • Our soul-voice
  • Our worth
  • Our inner mystic
  • Our soul-work
  • Our spiritual community

In several of these chapters, I found myself highlighting almost everything!

I especially liked the soul-voice and soul-work chapters. They are both so rich in ideas and inspiration that we can apply meaningfully in these areas of our lives.

Meggan is masterful at making a genuine connection with your heart, so you really “get”, at a deep level, what she’s saying. She also includes beautiful transcendent poetry which, like her words, can reach out from the page and touch you.

We all have encounters with the sacred. We just have to cultivate the eye that can perceive them. We have to see what’s already here, interwoven with what we claim is human and mundane. We have to take inventory of the magic that conspires to love us in and through our ordinary lives.

So really, what you’ve got here, is:

  • This wonderfully rich source of interesting and relevant information
  • Meggan’s fascinating stories that go along with it and illuminate the principles
  • Compelling examples and ideas you can actually use to more fully enjoy your own spiritual journey and take it as deep as you dare.

It’s time to stop investing in the limits we’ve identified with and start believing in the impossible, the ineffable, that lives in and through us all the time. It’s time to come out of the spiritual closet. We need to let our own mystery breathe. It’s time to unlock the chains we have placed on the most magical aspect of our being and let our inner mystic go for a walk around the neighborhood in broad daylight.

This book, like the author, is a true celebration of the feminine … Divine or otherwise.

I highly recommend it.

(All quotes from  Reveal: A Sacred Manual for Getting Spiritually Naked, by Meggan Watterson.)

Disclaimer: I received this book for free from Hay House Publishing for review purposes, yet you can rest assured that this review reflects my honest evaluation.

Have you read this book? I’d love for you to leave a comment and let us know how it was for you! Or do you have any questions about it? Ask away!

Patti

Lithium and lasix interaction

Apr 052013
 

Frozen Shoulder - Healed!Welcome to the 2nd article in my new series about the Open State.

(Click here for the first article which introduces the series and covers why the heck you should even care about the Open State.)

★   ★   ★

I want to start with something kind of fun and amazing!

I’m going to show with an example why you want to care about this.

It involves a complete healing of my frozen shoulder.

I’m also including the audio from a private session I did on myself.

So you’ll not only see the usefulness of the Open State, but also open your mind to what’s possible, a super-helpful frame of mind to be in to really make use of the Open State.

If you haven’t been reading along up until now, you might enjoy perusing my last set of articles about the value and importance of an open mind.

It really is a prerequisite for making use of the Open State — at least when it comes to facilitating magic and miracles! (And who wouldn’t want to do that?)

If you can’t believe in *magical* possibilities, you’re not as likely to manifest them.
Open to the Possibilities and Emerge!

Can you let go of what you think you know and open your mind wide to all the possibilities?
Let Magic Be Your New Normal

This is about the dance between and open mind and the Open State, and how they both enhance each other.
Dance Your Way to an Expanded Reality

And here are some of my favorite books that can help immensely.
10 Books to Blow Your Mind Wide Open

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Actually … no.

Note I don’t say that “I” healed my shoulder. I simply accessed “The Field” (by entering the Open State) and let it do the rest.

Here’s the background.

Awhile back, I’d developed what’s known as a “frozen shoulder”, although I didn’t think about it that way. (Richard Bartlett says when we hook into a diagnosis, it’s like a curse. Think about it. You sort of set it in stone as your reality.)

I could barely lift it to be parallel to the ground, and for awhile, not even that. This was as good as it got, even after numerous intensive treatments by professionals. They had essentially given up on any significant improvement without expensive, ongoing physical therapy or surgery.

So that sets the stage, in a nutshell.

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Since I’ve already written about my healing process as it occurred, I’m listing the articles that contain the details.

Together these articles reveal the key to how it finally healed 100% using the Open State. (Search each one for “shoulder” to see what was going on at the time.)

They also have useful information and exercises you can apply right now.

This first might be outside your comfort zone about what our bodies even are, but it’s one of my very favorite posts. Even I still refer to it from time to time. 😉 Open your mind to the idea that our bodies may not be a “solid” thing. It has lots of great quotes by Deepak Chopra.
Your Magical Mind, Magical Body

Here’s a holistic view of what was going on with my shoulder. I took advantage of some amazing signs, synchronicities, and even a channeled message. They all played a part in some powerful guidance that helped get me on a healing track.
Does Your Guidance Have to Scream to Get Your Attention?

In this post I only mention it along with other things I’ve used Emergence for. I’m including it because you can see where the Open State fits into the entire Emergence process which is nicely summarized. (Pay attention to the section ”The Field” which is where I talk about “the state” which is what I now call the Open State. Toward the end is a link to a popular post that guides you into the Open State.
Activate Magic and Miracles With Me!

Here’s one where I use the “Magic Mirror” tool (suggested by my channeling guide) with much success — in fact my shoulder completed its healing as a result of this work, I’m sure of it. This post also tells exactly how you can do this too.
Heal Your Paired Body Part :: The Magic Mirror Tool

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And now … I’m sharing an audio with you of one of my private sessions with myself so you can get a feel for what transpires.

It was one of just a few sessions with my shoulder.

At that point, I could only lift my left arm about 45-90 degrees (so at best just parallel to the floor).

I was guided to stand in front of the mirror and do a session on “that person in the mirror” (oui, c’est moi!) as if for someone else.

You’ll hear me mention a two-point which is a Matrix Energetics technique.

I also have what I call “healing burps”. These started when I learned to channel and are indications that things are being processed and are shifting/healing.

Also, at one point (maybe two) you’ll hear me get suddenly emotional. That’s not uncommon and again, just shows that things are moving.

Patti does an Emergence session on her shoulder (Audio – 16 min.)
Listen below, or click here if you’re reading this in email.

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

In the audio, I refer to two books. Just FYI,

• When I talk about giving to the universe vs. taking — and using the mirror as part of an exercise for that — I’m referring to something I learned from The Presence Process by Michael Brown. It’s an excellent book that walks you through a powerful process.

• And then, I mention a book that my eyes fall upon during the session. It’s Byron Katie’s A Thousand Names for Joy, and one of my all-time favorites.

So … I hope the combination of reviewing the story of my healed – yes, healed! – shoulder along with listening to the session itself has opened your eyes to:

1. What’s possible, and

2. How the Open State (which is the foundation for Holographic Emergence™) is super useful!

Until next time … Namasté,

Patti

Any questions? Comments? Were all those posts a bit too much for you? Let me know! And if you liked this post, your sharing it on Twitter or Facebook is much appreciated! (Buttons below.)


Want a perfect summary of what Emergence is all aboutplus a session I did just for subscribers? You’ll receive the Emergence Primer + Tune-Up Session as a thank-you gift (it’s an instant download) when you subscribe to my free newsletter.


Lithium and lasix interaction

Feb 242013
 

In Western society, the rational mind rules.

We’re encouraged to develop and honor it above all else, even to the exclusion of all else.

It’s too bad.

Being purely rational — even predominantly rational — limits us more than we know.

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In my last post, I talked about the importance of having an open mind. And what I mean by this is not just being open to new, rational ideas.

It’s about opening your whole self, your larger “mind”, to the idea that you may not know it all; you may never know it all!

And it’s helpful to open to the possibility that there is more than we can ever know or understand.

What happens then is you allow some other parts of you to operate along with (or sometimes instead of) your rational mind.

It’s a more holistic, aware, intuitive, and in short, expanded way of being. (And so fun!)

This is an especially important foundation to build on if you want to be able to take advantage of the Open State that is critical to Emergence, allowing the magic that is you to unfold into your life.

As I’ve said before, if you believe there’s no such thing as magic, you’re not as likely to experience it.

Entering the Open State is easiest if you can expand your mind, or let go of your thoughts altogether (especially your thoughts of disbelief).

But in the meantime, you don’t have to be perfect.

Just make a start.

Open the door just a little.

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The Open State and an open mind work together (or play together).

It’s like a dance, where each interacts with and enlivens the other.

Expanding and strengthening each is an iterative process.

I know this to be true as I am doing the dance, and have been for a long time!

If you’re willing to do this, you’ll find that rather than build new beliefs, your mind will be fluid and open to whatever shows up in the moment.

Your perceptions will be spontaneous and dynamic. (Much more about what this means and how you can do it too in the upcoming Open State series.)

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During our last Activation, we did a quick and easy process together.

Afterward, I got a question that made the idea of this dance quite apparent.

It was about the questioner’s thoughts, and her beliefs — that rational mind, again! — and how they help or hurt the process.

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I wanted to share the question and answer with you.

After the call, a few more ideas came to me and I’ve added those also. (So those of you on the call and with the recording have not heard all of this yet.)

(For some context it might help you to first listen to the Opening + Emergence audio found in my post Open to the Possibilities and Emerge!)

Beliefs Question and Answers (Audio – 10 min.)
Listen below, or right-click here to download.

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Enjoy!

Note: In my answer, I recommend a book called The Field by Lynne McTaggart. It’s a great way to help open your mind, and is a fun read, besides. You can always find it and other books I recommend in my store.

I’ll be recommending more books that are specifically on this topic shortly.

In the meantime, if you want to know more about Emergence, sign up for my newsletter. As a free gift you’ll get the Emergence Primer plus a Tune-Up Session audio that you can use over and over.

Or check out the posts listed in my side-bar for an ordered introduction to this new and exciting way of being and manifesting.

Thanks for reading!

Until next time,

Patti

Lithium and lasix interaction

Feb 162013
 

Magic is the New NormalWOW, I sure enjoyed our recent January Activation!

It went well, and it was enlightening for me to interact with those of you who participated (thank you)!

I got a great question during the Q & A that made something I’d been considering even more apparent.

It’s the importance of developing an open mind.

It’s the very first step, even before learning about the Open State and how to be in it.

We need to get out of our own way so that we can take advantage of what the Open State offers.

(If you were on the call, you heard me announce a February blog series about the Open State, but this made me realize I first want/need to write awhile about an open mind. So here we go!)

Can you let go of what you think you know and open your mind wide to all the possibilities?

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I’ve been developing my magical thinking all my life, really. I didn’t think about it that way at the time, but that’s what I was doing. It’s perfectly natural to me.

It’s so natural, that I’m coming to the conclusion that magic is the new normal: Many of my friends live that way, as do many of you.

If the idea of an open mind sounds or feels foreign to you, know that you can develop one deliberately.

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And it’s not so much about learning something new. It’s more about UN-learning what you think you know.

UN-learning all your limiting beliefs.

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And it’s not about believing in magic and miracles.

It’s not about believing in anything!

It’s about letting go of beliefs and being willing to open to the possibilities!

Then you’ll be not only more able, but also more motivated to embrace the Open State which is an expanded way of perceiving and experiencing (and the state from which you can easily facilitate magic and miracles).

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In many ways, an open mind is the primary foundation of Emergence. But to be more accurate, it’s more of a non-foundation, since unlike most foundations, it’s an undefined element.

Rather than being “solid”, it’s malleable and always changeable.

That’s the beauty, the magic, and the fun of it.

In the world where magic is the new normal, you get to make it up as you go. (Stick with me and you’ll “get” what this means. ;-))

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So a truly open mind allows for a new mindset where your perspective remains fluid.

It enables you to open to the possibilities:

• Of the process

No rules!

• Of the results

No limits!

• Of reality

It may not be what you think it is — in fact, it’s probably not!

Your open mind will be much more open to possibilities than is the (old ;-)) norm.

So, are you open to becoming more open?

If so, keep an eye on this space.

In upcoming posts I’ll be presenting some new models to play with that will help you open your mind even more than it already is.

And if you want to know more about Emergence, sign up for my newsletter and as a free gift you’ll get the Emergence Primer plus a Tune-Up Session audio you can use over and over.

Thanks for reading! Until next time,

Patti

Lithium and lasix interaction

Feb 082013
 

Hello, magical creatures!

Here’s a short, easy-to-listen-to audio that sets the stage for several of my upcoming articles.

It’s an excerpt from our most recent live Activation (a group Holographic Emergence™ session).

In essence, it’s about opening to the possibilities of your reality:

If you can’t believe in *magical* possibilities, you’re not as likely to see or manifest them

• A brief, in-a-nutshell explanation of what I call “Emergence” and why

Listening will give you a better idea of what this blog is about, too.

Opening + Emergence (Audio – 10 min.)
Listen below, or right-click here to download.

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

I hope you enjoyed that! (Let me know!)

And if you want a bit more on Emergence, sign up for my newsletter and as a free gift you’ll get the Emergence Primer plus a Tune-Up Session audio you can use over and over.

Thanks for reading! Until next time,

Patti

Lithium and lasix interaction

Nov 022012
 

Life as a Doorway to the Field“Death is not the opposite of life. Life has no opposite. The opposite of death is birth. Life is eternal.”

~ Eckhart Tolle, Stillness Speaks

I LOVE this quote. It’s crossed my mind often since first reading it.

And it’s come to mind most recently after losing our sweet lab, Ollie, especially because I had a lot of synchronicities that made me aware — at a deep level — of the same thing.

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It started just a few days after his death.

I was in the back yard and as I looked up I saw 2 mourning doves walking around the bush from his grave. Now, I never see mourning doves back there, even rarely see them at all around here. And that they should come right from his grave while I was there … Well, let’s just say I noticed.

Shortly after that, I was walking over to visit his grave and out hopped a bunny from behind it. It came right over to me, within about 3′, and stopped right at the grave. Again, I took notice.

Even funnier, the next morning I got up and there was the bunny lying in the backyard, all stretched out, right where Ollie used to lay all stretched out!

This was odd enough but this happened several days in a row.

This was getting a little strange, even for me!

Over the next week or two, the quote just kept coming back to mind.

And it seemed that everywhere I went, there was Life.

There were lizards, snakes, birds (ravens, baby flycatchers that hatched and flew the coop, and another mourning dove that flew right in front of me), a big moth that sat right on the post near me on the front porch while I worked, and of course, bunnies galore — to name a few.

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All of this made me sooo aware that Life goes on.

And I don’t mean “life goes on” like your life situation has to continue.

I mean Life just goes on! There is no end to it.

And I did revel in the fact that Ollie was still around. I felt him, not only as his presence, but as Life itself!

I recently did a book review of Dying To Be Me by Anita Moorjani about her near-death experience (NDE). But did you know I had my own NDE? I did … Not as involved as Anita’s, but enough for me to get a taste of what happens when we die. And I can tell you, Life goes on! It’s amazing.

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So you may wonder what this has to do with Emergence.

Well, experiencing the Life that you are — even your life force (which is a little bit of an abstraction of it but still a good stepping stone) — is a doorway to the state of consciousness you enter when you “do” Emergence.

It’s your conscious connection to a powerful field of magic and miracles.

In some ways, the state is impossible to speak of, but there are a lot of pointers that can help lead you to it.

This is one of them. (Note: For some instruction on experiencing your life force and using it to strengthen your immune system or even heal, see remedy #16 in Kiss Your Cold Goodbye Fast With These 20 Natural and Vibrational Remedies.)

And once you’re adept at entering the state … at being … and being life consciously, with awareness — the rest is a piece of cake. 😉

The truth is: you don’t have a life, you are life, the One Life, the one consciousness that pervades the entire universe and takes temporary form to experience itself as a stone or a blade of grass, as an animal, a person, a star or a galaxy.

Can you sense deep within that you already know that? Can you sense that you already are That?

~ Eckhart Tolle, Stillness Speaks

Thanks for reading, and here’s to you — as Life emerging!

Patti

 

 

As usual, I’d love to hear what you have to share about this topic, or any questions you might have. Just use the comment box! Thank you!


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Then sign up for my newsletter to qualify and be notified of our next free group Emergence session (aka “Activation”).

Of course, you can always get your own private Emergence session too. ;-) For more information, see my Holographic Emergence Sessions™ page.

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Apr 042012
 

Don’t you love a bargain?

I do too.

And I love activations, magical thinking, books, and all types of meditation.

They all have the potential to open you to new worlds, just like cracking the egg does for a little hatch-ling.

And oooo, combinations of all of the above are worth getting excited about!

Here are some valuable bargains that have come to my attention lately that I want to share with you.

(And they’re almost upon us so read this now!)

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If you didn’t see my tweets or Facebook postings and haven’t already registered, hop on over to Jo Dunning’s site and sign up for her “Activations of Awakening”.

It’s imminent! Tonight (Weds. ) at 6p PDT.

You write down your intentions for the session ahead of time, and then show up.

It’s different than what I did in my recent Spring Activation, and you can read all about Jo’s on her site.

I did it in Jan. ’11 and it was powerful! I swear, all kinds of things related to my intentions were suddenly on the move. So much so that it was a bit overwhelming for awhile.

Oh, and did I say it’s FREE? Yes!

And speaking of free, check out her brand new Wish Project while you’re there.

Thank you, Jo! 🙂

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I live in the high desert and over the years here have deeply connected with the ravens and all that Raven implies. S/he is magical, a messenger, and helps bring the subconscious into the light of awareness.

I recently had a friend pass away who was known far and wide as Raven. A gifted poet and otherwise remarkable man who was loved by many. So sad for us left behind without his bright light.

And then what flies into my life unexpectedly but a book about Raven. It’s beautifully written by my sweet and wise friend Christopher Foster of The Happy Seeker. I’m enjoying it little morsel by little morsel and can say that the love with which it obviously was written is almost palpable.

In Christopher’s words:

I’ve written four or five books over the years but am most proud of an animal fable entitled The Raven Who Spoke with God.

It’s a story about integrity and the unconquerable spirit in us all, and I mailed out the first copies on the morning of 9/11. The book was translated into 11 foreign-language editions but then it reached the end of its natural life, or so I thought.

Recently, however, my book has been published in Kindle format.

Oh, and did I say it’s FREE too?

Well, that is if you jump on it this Easter weekend, from this Friday thru Sunday, you can download a free Kindle edition. (And if you don’t have a Kindle it’s a snap to install the free software from Amazon so you can read Kindle books on your PC or Mac.)

You can get it here. And please help spread the word!

And of course it will still be available after this weekend, and well worth the little bit Christopher is asking for it.

Thank you, Christopher! 🙂

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And finally, someone I know is getting close to releasing an awesome meditation product.

[Update: This meditation product has launched! You can find out more about it here.]

It’s aimed at the busy individual (know anyone like that?) who wants to reawaken to their natural inner balance, their calm connection to spirit, and their body’s natural state of health. It helps awaken intuitive guidance, dreams and aspirations, and it enhances productivity and success.

I was lucky to be one of the reviewers and my gosh! I can’t say enough good things about it.

I was hugely impressed.

It consists of:

  • 1 instruction manual (how to use the system)
  • 3 beautiful (and beautifully written) books
  • 1 workbook, and
  • 20 guided meditations

I’m not normally much of a guided meditation gal, but I have to say, I absolutely loved them! Every day I looked so forward to my guided meditation time.

It seemed to me that it’s almost like 3 offerings in one, although tightly integrated so each supports the others.

It’s like a class on silent meditation, another on using guided meditations, and yet another with step-by-step instruction/exercises for creating your own guided meditations to visualize what it is you want to create in your life.

ON top of that, there are four bonuses included … and they’re BIG bonuses!

And then I found out the asking price. What?! I thought I must have read it wrong.

Surely the price was supposed to have a zero behind it or maybe in the middle.

But no.

Talk about value. It’s worth it for the versatile set of guided meditations alone.

I’m delighted to have an interview with the creator about it that I’ll post here for you once the product’s available.

[Update: It’s available! You can find the interview here.]

You’ll hear all about the (amazing!) bonuses and you’ll get a link to a special free download so you can try out a part of the system.

Note that the system is not available quite yet! But in the interview post I’ll include all the details about how to get your hot little hands on it once it’s available. (And just so you know, if I’m smart I’ll be an affiliate by then, because it’s a truly remarkable system and I highly recommend it.)

Thank you, Mystery Person! 🙂

That’s it for now. Signing off. Happy Easter, and namasté.

If you take advantage of any of these bargains, please let us know what you thought of them in the comments!

Lithium and lasix interaction

Mar 212012
 

This Friday I’m holding my first group Holographic Emergence Session, in the form of a Spring Activation teleconference.

And boy, do I keep wanting to control it!

I’m so trained. We all are. Trained to take charge, “make” it happen, be responsible. I want so badly for it to be beneficial for all the attendees that I keep feeling like I have to force it somehow. No unknowns. Not even “happy accidents”. I notice myself starting to worry that I need to be better prepared. That it ought to be structured.

But this new (cutting edge, truly) way of operating challenges all those old habits.

And it can be downright unnerving.

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The power of consciousness technology (such as Matrix Energetics, on which my Holographic Emergence sessions are based) is that you don’t need to “do” anything.

In fact, doing can be counterproductive.

In order to achieve success, first give up the idea that you are “the Doer.” Instead of constantly doing from the mere human or conscious level, become the “Open Door.”

– Dr. Richard Bartlett (founder of Matrix Energetics), The Physics of Miracles

Rather than “do” something, the main (and maybe only) skill involved is being able to access the state in which “it is done”. And even in this paradoxical statement, the word “done” is more an adjective than a verb.

The other main skill for some of us (as already mentioned) is to let go of being a control freak! Aach! Pant pant pant.

So how do I manage to step into this new way of operating? Or rather, NOT operating? This state of being, and allowing?

♦ I can only remind myself that a lot of people for whom I’ve done individual Holographic Emergence Sessions where I’ve let go of control have noticed positive results.

♦ I also remind myself that when this idea came to me just a few weeks ago, it already had a life of its own.

I was compelled and propelled to just do it.

It was kind of odd, actually.

It was as though I knew the doubts existed but I wasn’t able or inclined to even look at them. I often think it’s smart to examine doubts to see if they’re valid, but almost always I decide that they are — and then they are crippling.

And so, this time, I simply allowed myself to be moved.

Can it be that there is something, some force, some something (I know not what) that actually knows better than me?

Well, let’s hope so.

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So, I’m letting this be a lesson to me to live as that door instead of just be that door when I do Holographic Emergence Sessions (or LOL when I absolutely have to let go and surrender because I have no other choice).

That means I won’t just be the door during the Activation session, but am also being a door that opens for this and possibly future Activation sessions to enter my life as they will.

The trust required to be an open door also opens you to receive inner guidance easily. I’m noticing that certain inspirations are appearing to me about the sessions. Things that may or may not be a part of it. That’s all fine and is a part of the process. It’s “showing up” on its own — through the open door.

I’m choosing it this time. To not do. To trust.

Because I’ve learned that that’s how magic happens.

Want to join us for the Spring Activation? There’s still time! You can find the registration link here. (And it’s free!)

And a big thanks to those of you who’ve already registered. We’ve already got a group of wonderful people; I’m so excited!

How about you? How do you know if it’s time to DO or time to be a DOOR … or don’t you? Have you seen the door lead to magical results? Would love to hear your thoughts.

Lithium and lasix interaction

Aug 252011
 

Don’t you just love it when a chronic physical issue just goes away?

Me too.

So today I want to share a little *magic* with you that can increase the chances of that happening in your life. Auto-magically.

I hurt my shoulder a few months ago. My chiropractor says it’s my rotator cuff, and that I need to baby it so it can heal. So I’ve been doing that … But I don’t see much improvement. If anything, I keep re-injuring it.

The other day, I decided it’s time I work a little magic with it. That can mean a lot of things to me (as you may know), but in this case I mean that I’m going to practice some Holographic Emergence with it. (And I just finished an astonishing session. Very fun.)

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I have every confidence doing this will make a big difference.

Years back I developed bothersome TMJ (Temporomandibular Joint disorder; quite the mouthful). It was painful and had become chronic. After I’d had it for years it was recommended to me that I have surgery. Yikes. No way. I decided to get to work.

I used a combination of Matrix Energetics and Reiki on myself. Amazingly, I didn’t even have to do too many sessions (I did regular Reiki for awhile, maybe about 10 treatments, and about 3 or 4 Matrix sessions, all over about a 4 month period) before I simply forgot about it and later realized that the TMJ was gone. Completely gone! This was a few years ago and it’s never returned.

And so, it’s foolish of me not to do a similar thing with my shoulder.

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But here’s the cool thing. The morning I decided to do this–and to perhaps blog about the process–I was walking Ollie (our sweet old lab) and decided to listen to some Deepak Chopra on my MP3 player.

OMG! Talk about synchronicity! Everything he said was such an affirmation of what I’ve experienced ever since beginning my practice of Matrix Energetics. And to me it said “Do it!” It also said to share it.

It’s one thing to be familiar with the ideas, but when you live them, that’s when the real magic happens.

Lithium and lasix interaction

Lithium and lasix interaction

So, without further ado, I want to share some of Deepak’s statements with you. They’re from his 5 CD audio set “Magical Mind, Magical Body“, and I’m only 1/2 hr. into it but I can already recommend it. (And I love that he sounds so excited as he talks about these things. It makes for an involved listening experience.)

• Health is not just the absence of a disease, it’s a joyfulness that should be inside us all the time. It’s a state of positive well-being, which is not only physical but emotional and ultimately even psychological and spiritual.

[Note: You can use that simple idea with great effect. Every time you feel frumpy, repeat the idea to yourself that you are well and express well-being and you’ll feel an instant shift.]

The body is not a frozen sculpture, it’s a river of energy and information. … You can not step into the same flesh and bones twice.

• You replace 98% of all the items of your body in less than one year.

• There is a deeper reality to the body and that deeper reality is what we want to see because from that deeper reality comes both the mind and the body. Both come from that deeper level of existence.

• A physicist would say: “Our atoms are particles that are moving at lightening speeds around huge empty spaces, they emerge from something which is just a field of pure potentiality, just a field of pure energy, and from that field these particles emerge. They’re fluctuations of energy and information. They emerge from a void. They rebound, collide, and then disintegrate into the void.”

• We have a thinking body. And you can’t imprison the mind in the brain. That’s an old notion, that the mind is confined to the brain. The mind is in every cell of our body.

You can’t even confine the mind to your physical body because it extends beyond your physical body into the whole universe. We are part of a thinking conscious universe that is basically a non-local field of information. We can call the universe a non-local field of information and energy with which this local expression (which we call the physical body) is exchanging energy and information.

• It’s estimated that the average person thinks about 60,000 thoughts a day … and 95% of the thoughts you have today are the ones that you had yesterday. So you keep creating the same patterns that give rise to the same physical expression of the body. If you go to a deeper level, witness the whole process, become conscious of it, then you’d realize that in fact there are choices here.

What we do is we take that chaos of energy soup, we ingest it through our 5 senses, and then we convert that into a physical reality in our own awareness, in our own consciousness. And we do it unconsciously most of the time that results in certain interpretations that are part of a cultural indoctrination.

There’s one part of you that doesn’t change. If you find that part of you that doesn’t change then you’ll be able to cause transformations in that part of you that does change.

[Note: Deepak uses the word “you” but then goes on to complicate it. You can discover that part of you that doesn’t change easily and simply. Just visit  John Sherman’s website and take advantage of what he so generously offers.]

• Now if I said the mind is omniscient it would sound sort of mystical. That it knows everything, it’s omnipotent, it’s omnipresent, it would sound almost like I’m talking in mystical terms. But in fact, in scientific terms, that’s an accurate statement.

Now once we recognize that — even to have the insight — is to begin to cause transformations in your body. A person’s body is nothing but an expression of all the ideas they have about it.

• If there’s a fluctuation that changes at deeper levels of energy and information then it causes, spontaneously without having to do anything, you don’t have to brainwash yourself about this. You just have to have the insight. And the insight itself causes the changes.

Lithium and lasix interaction

So, these are some of the ideas I use — that have become a part of me — as I work with my shoulder. Or more accurately, this pattern of light and information that I perceive as a shoulder. 😉

Like Deepak says, recognizing this reality helps create a transformation all by itself. It’s what gives us a lot more power than we think we have otherwise.

And therein lies your magic.

So this is the world I get to play in every day.

Want to join me? Or have you already?

(Need some extra magic in your life? Consider booking a Holographic Emergence session.)

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