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Social distancing: Measures to increase the space between people and decrease contact among people in order to reduce the spread of an infectious disease like influenza spasms sleep cheap ponstel american express, such as school closures muscle relaxant drugs side effects purchase generic ponstel online, work closures muscle relaxant 750 ponstel 500 mg visa, and cancellation of public gatherings spasms in lower left abdomen ponstel 250 mg mastercard. Spokesperson: Person who communicates with the media and the public on behalf of a government or organization. There are many different strains of influenza viruses, which change constantly and create new strains that replace older ones. Surge capacity: the ability of an organization to provide more services than usual for a limited period of time in order to meet increased demand during a crisis such as a pandemic. For example, the ability of medical laboratories to provide greater numbers of vaccines, or the ability of a hospital to care for more patients than usual. Surgical mask: Disposable face mask that covers the mouth and nose, used to prevent the transmission of germs. Surveillance: Continuous monitoring of a disease (both cases of illness and its spread) with the goal of controlling the disease. Sympathy: the feeling or expression of pity or sorrow for the pain or distress of somebody else. Target audience: the people to whom a message, communication, or information is directed. Triage: A way to prioritize medical treatment for patients based on the severity of their conditions-in order to save the most lives-when it is not possible to treat all patients immediately. Virulence: the ability of a virus or bacteria to cause illness, and the severity of the illness caused. Waves: Unlike most disasters, which tend to happen as a single event that ends within a day or so (such as a hurricane or an earthquake), a pandemic may occur in a series of waves, each one lasting approximately 612 weeks. The very worst week of the first wave is likely to occur around the fourth or fifth week after the pandemic starts in your area. These categories usually are defined not just by financial wealth, but also by how people earn money and how much access they have to community services such as healthcare. Appendix 1: Glossary of terms, in Interim pre-pandemic planning guidance: Community strategy for pandemic influenza mitigation in the United States, 71-74. The H2P Website is a virtual store of pandemic preparedness resources-planning tools, training modules, guidance and policy documents, communication and advocacy tools, and reference materials for areas such as food security and livelihoods-all of which are downloadable free from this Website. Government-wide information on pandemic influenza for many audiences: the general public, health and emergency preparedness professionals, health communicators, policy makers, government and business leaders, school systems, and local communities. This Website provides the latest news and authoritative information on H1N1 influenza and pandemic influenza, health guidance for communities and individuals, and answers to frequently asked questions. This article identifies and describes the non-pharmaceutical public health interventions that would be most likely to reduce the impact of an influenza pandemic. It also provides background information about the use of nonpharmaceutical interventions in the past, and guidance for how to implement them. The purpose of this extensive guide is to help community planners plan for and respond to a "mass casualty event. This document provides interim planning guidance for communities focusing on several non-medical measures that might be useful during an influenza pandemic to reduce its harm. The document introduces a Pandemic Severity Index to characterize the severity of a pandemic, provides planning recommendations for specific interventions that communities may use to reduce illness and death for a given severity level, and suggests how long these interventions should be used. The appendices provide supplemental guides for pre-pandemic planning assistance designed for various community settings such as schools, universities, childcare programs, businesses, and faith-based and community organizations. These practical field-based guidelines are intended for use by humanitarian agencies and ministry of health staff working with refugee and displaced populations at local and national levels. They are intended both for camp settings and for open settings with displaced populations living dispersed among local communities. The document focuses primarily on response during an influenza pandemic, but also provides background information on pandemic influenza, strategies for dealing with each pandemic phase, and pre-pandemic preparedness activities. This handbook outlines the background and methodology of household livelihood security assessments and how they can be used in various circumstances. It provides step-by-step guidelines on how to conduct such an assessment, including data collection and analysis.
Crisis & emergency risk communication: By leaders for leaders back spasms 33 weeks pregnant purchase 500mg ponstel free shipping, with accompanying participant manual muscle relaxant natural remedies order ponstel 250 mg otc. The document covers a broad range of topics: how communicating in a crisis is different muscle relaxant zolpidem purchase ponstel without a prescription, what the public seeks from its leaders spasms under breastbone discount 250 mg ponstel otc, communication failures, communication steps for success, expected behaviors that must be confronted, perceptions of risk, the first message in a crisis, and much more. The second document, a 36-page participant manual, is comprised primarily of PowerPoint slides that can be used in communicating this information to others. Simply put: Scientific and technical information: Tips for creating easy-to-read print materials your audience will want to read and use. This 48-page guide shows how to translate complicated scientific and technical information into material that captures and holds the interest of the intended reader. It provides tips for creating easy-to-read print material (brochures, booklets, pamphlets, etc. This book is a long-trusted friend to many health communicators in the United States and provides a practical approach represented visually as "the communications wheel. The book provides an overview of health communication; the communication process; planning and strategy development; developing and pre-testing concepts, messages, and materials; implementing the program; assessing effectiveness and making refinements; description of communication research methods; and more. This handbook is an excellent reference for the health communicator who is participating in the development of a national, regional, or local preparedness and response plan for an influenza pandemic. It includes a seven-step process for planning and implementing effective media communications. A succinct companion field guide highlights the practical aspects of the seven-step approach, and contains a wall chart of these steps with key information and advice. This handy book covers all aspects of working with the media and getting good media coverage, including: writing for the media, preparing broadcast publicity, working with broadcasters, responding to media inquiries, and working with online (internet) media. Each section includes an extensive checklist, and the book also includes an indispensable directory of sources and services available to those working with the media-databases, media directories, Websites, and more. This manual aims to promote the proper and dignified management of dead bodies, and to maximize their identification. It provides practical, simple instructions for local organizations, municipal employees, and/or volunteers who may be responsible for managing dead bodies in disaster situations. The manual is organized in an easy-to-use format, with one chapter for each key task, so that local coordinators can copy and distribute the relevant chapters to individuals responsible for those tasks. This Website is designed to assist business continuity planning for influenza pandemics. The information is divided into two sections: (1) a downloadable Business Continuity Planning Guide, which contains information designed for general use by businesses and other organizations and (2) a Pandemic Planning Information Kit tailored for infrastructure providers in the energy, communications, transport, water, and waste sectors. This contains a version of the Planning Guide and some associated documents to assist in planning. It provides the technical information needed to support government authorities in the proper management of dead bodies. The manual should be useful for local authorities who are responsible for ensuring that bodies are treated in a dignified manner and that the human rights of those affected by disasters are respected. This checklist identifies important, specific activities large businesses can do now to prepare for a possible influenza pandemic, many of which will also help you in other emergencies. The checklist includes actions in the following categories: planning for the impact of the pandemic on your business, employees, and customers; establishing policies to be implemented during a pandemic; allocating resources to protect employees and customers; communicating to and educating employees; and coordinating with external organizations to help your community. The pandemic influenza preparedness, response, and recovery guide serves as a tool for businesses to develop continuity of operations plans specifically for catastrophic health emergencies such as pandemic influenza. Periodic Guideline Review and Update this particular report is an update and expansion of guidelines published by A. Once completed, each group operated separately in its interpretation of the studies and derivation of guideline recommendations. Although the committee was aware of landmark studies published after this date, these data were not included in this manuscript. The process by which the literature was evaluated necessitated a common end date for the search review. Adding a last-minute landmark trial would have introduced bias unless a formalized literature search was reconducted for all sections of the manuscript.
The particular vulnerability of children illustrates the importance of a human security approach muscle relaxant depression buy 500 mg ponstel free shipping. However muscle relaxant elderly cheap ponstel 250mg on-line, tsunamis muscle relaxant reversal agents generic ponstel 250mg, droughts muscle relaxant spray 250mg ponstel with mastercard, and conflict show little respect for borders, and many of the most vulnerable communities live in countries where the state is extremely weak, and may well be part of the threat rather than the solution. In such situations, the international community is obliged to act to save lives, be it through development assistance, emergency aid, diplomacy, or international peacekeeping, a role addressed more fully in Part 5. As is true regarding poverty, for issues such as conflict or climate change only simultaneous action at national and international levels will suffice. Unfortunately, security is not currently conceived this way in most international discussions. However, in South Africa and Brazil monthly cheques enable elderly people both to look after themselves and support their grandchildren, conferring dignity in old age and preparing the citizens of tomorrow to play an active and productive role. Social protection describes all public and private initiatives that: · Provide income or consumption transfers to poor people; · Protect vulnerable people against livelihood risks; and · Enhance the social status and rights of those who are marginalised. Its overall objective is to reduce the economic and social vulnerability of poor and marginalised groups. In Brazil, the Bolsa Familia (Family Stipend) scheme provides financial aid to some 11 million poor Brazilian families, on condition that their children attend school and are vaccinated. Social assistance transfers resources to vulnerable groups in the form of direct resource transfers (cash or food) to poor people, indirect transfers such as food subsidies, and pensions and benefits (both contributory and non-contributory), while social insurance allows individuals and households to protect themselves against risks by pooling resources with others. It tackles head-on a central aspect of poverty, arguing that the state in particular has a duty to seek to reduce vulnerability by guaranteeing the basic rights set out in the Universal Declaration of Human Rights. In 2007, a combination of child support, disability payments, and pensions was reaching approximately 13 million South Africans, out of a total population of 48 million. World Bank analysis suggests that, without the system, the extreme poverty headcount would have increased by 24 per cent, the poverty gap by 42 per cent, and the severity of poverty by 57 per cent. These typically reached only a portion of their target groups, and could not be introduced fast enough to deal with unexpected crises such as the Asian financial crash of 1998, or the global financial crisis a decade later. At the same time, it became increasingly clear that emergency relief such as food aid, designed to deal with short-term shortfalls in food supply, was obscuring the real nature of chronic. A maturing understanding of the nature of poverty, with its growing attention to issues of rights, dignity, and empowerment, and the recognition that inequality and social exclusion are not just damaging in themselves but hold back economic progress, have also played a part in this process. Progressive political leaders in countries such as South Africa and Brazil have seen how popular such policies can be, addressing directly the need for the state and others to guarantee basic human rights and to include less active groups, such as elderly or disabled people, who are often sidelined in development policies that focus solely on economic growth. Increasingly, cash transfers are supplanting in-kind transfers for example, cash for work is replacing food-for-work programmes, and school subsidies are starting to displace school feeding programmes. In response to predictions of acute food insecurity across parts of Southern Africa in 20056, Oxfam decided to implement cash transfer programmes as an alternative to emergency food aid in Malawi and Zambia, covering a total of about 20,000 households. Subsequent evaluations showed that neither project encountered any major security problems: the cash was delivered and spent safely. In both countries, the vast majority of the cash transfers were spent on food, mainly maize. In Malawi, the cash enabled people to purchase the subsidised inputs provided through a government agricultural input voucher scheme. The top six uses were clearing debts (thereby freeing up future income from the burden of debt repayments), buying livestock, repairing and building houses, paying for school fees and books, buying seeds and fertilisers for agriculture, and paying for health care. These results demonstrate how, given the chance, poor people invest in the future, and how varied and unpredictable their needs are: a dozen elderly people opted to spend the money on buying coffins, thereby ensuring that they could live out their days in the knowledge that they would have a dignified funeral. These have reduced present vulnerability and have also increased school attendance, thereby improving long-term security for the next generation. This is serious money, but much of it would be recouped by avoiding emergency spending when things go wrong. In 2004, the government of Lesotho introduced a non-contributory pension for all over-70s (against advice from aid donors that it was unaffordable), becoming the fourth country in southern Africa to do so, after South Africa, Namibia, and Botswana. Oxfam, like most other aid organisations, deals separately with sudden disasters (where it specialises in providing water and sanitation, restoring food security, usually by transferring cash rather than giving out food, and providing emergency shelter) and with long-term development issues. Social protection offers a way to move from an inevitably chaotic emergency response to long-term protection based on the rights of poor people. If social protection systems are in place before an emergency hits, they also provide a ready-made delivery channel, for example by allowing pensions or child support to be stepped up to help families cope. This can be a huge benefit when delays in creating payment systems can cost lives, as became clear in the global financial crisis of 20089.
Consider tapering patients in an outpatient setting if they are not on high dose opioids or do not have comorbid substance use disorder or an active mental health disorder spasms upper left quadrant generic ponstel 250mg with amex, as this can be done safely and they are at low risk for failing to complete the taper muscle relaxant generic names buy generic ponstel from india. Interagency Guideline on Prescribing Opioids for Pain [06-2015] 36 How to Discontinue Opioids Selecting the optimal timing and approach to tapering depends on multiple factors back spasms 38 weeks pregnant discount ponstel 250 mg free shipping. The rate of opioid taper should be based primarily on safety considerations muscle relaxant egypt purchase ponstel 250 mg overnight delivery, and special attention is needed for patients on high dose opioids, as too rapid a taper may precipitate withdrawal symptoms or drug-seeking behavior. In addition, behavioral issues or physical withdrawal symptoms can be a major obstacle during an opioid taper. Patients who feel overwhelmed or desperate may try to convince the provider to abandon the taper. Consider sequential tapers for patients who are on chronic benzodiazepines and opioids. Do not use ultra-rapid detoxification or antagonist-induced withdrawal under heavy sedation or anesthesia. Rapid taper (over a 2 to 3 week period) if the patient has had a severe adverse outcome such as overdose or substance use disorder, or c. Use validated tools to assess conditions (Appendix B: Validated Tools for Screening and Assessment). Consider the following factors when making a decision to continue, pause or discontinue the taper plan: a. Assess the patient behaviors that may be suggestive of a substance use disorder b. The rate may be slowed or paused while monitoring for and managing withdrawal symptoms. Use non-benzodiazepine adjunctive agents to treat opioid abstinence syndrome (withdrawal) if needed. Unlike benzodiazepine withdrawal, opioid withdrawal symptoms are rarely medically serious, although they may be extremely unpleasant. Symptoms of mild opioid withdrawal may persist for six months after opioids have been discontinued (Table 10). Refer to a crisis intervention system if a patient expresses serious suicidal ideation with plan or intent, or transfer to an emergency room where the patient can be closely monitored. Do not start or resume opioids or benzodiazepines once they have been discontinued, as they may trigger drug cravings and a return to use. Symptoms and Treatment of Opioid Abstinence Syndrome (withdrawal) Restlessness, sweating or tremors Nausea Diarrhea Muscle pain, neuropathic pain or myoclonus Insomnia Clonidine 0. Many pharmacologic therapies have been studied for use as adjunctive agents during opioid taper to palliate opioid abstinence syndrome (withdrawal) as well as emergent insomnia and anxiety. Multidisciplinary pain programs have strong clinical efficacy and empirical data supporting their cost-efficiency. Otherwise, the taper can precipitate doctor-shopping, illicit drug use, or other behaviors that pose a risk to patient safety. Although there are no fool-proof methods for preventing behavioral issues during an opioid taper, strategies implemented at the beginning of the opioid therapy are most likely to prevent later behavioral problems if an opioid taper becomes necessary. Patients who exhibit aberrant behaviors during the taper may have (Opioid Use Disorder). Surprisingly, opioid tapers rarely cause significant and long term increases in pain. If these occur, they tend to be during and immediately following completion of the opioid taper. In addition to antidepressant medications, anti-inflammatories and anticonvulsants can be used to address increased pain in patients who have no contraindications. Office-based buprenorphine treatment is an effective evidence-based option which should be considered for patients with both chronic pain and opioid use disorder. Recognition and Treatment of Opioid Use Disorder Opioid therapy can lead to the development of opioid use disorder. Although the true incidence is unknown, this risk ranges from 3-fold for acute low dose opioids to 122-fold for chronic high dose opioids. Examples include taking opioids in larger amounts than intended, spending a great deal of time trying to obtain opioids, strong craving for opioids, recurrent opioid use in situations where it is physically hazardous, social impairment such as withdrawal from family and friends, and conflict with medical providers over opioid use. These patients may experience an improvement in their quality of life if a transition can be made to medication-assisted treatment for opioid use disorder.
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