濮阳东方医院男科割包皮评价比较高(濮阳东方妇科医院导航) (今日更新中)

When the Trump administration required nursing homes to report their COVID-19 cases, it also promised to make the data available to residents, families and the public in a user-friendly way.But some facilities that have had coronavirus cases and deaths turn up as having none on Medicare’s COVID-19 nursing home website. Those data may be incomplete because the reporting requirements don’t reach back to the start of the pandemic. Numbers don’t necessarily portray the full picture.“The biggest thing that needs to be taken away ... is in its current form, it is really leaving consumers in the dark,” Sam Brooks, project manager for Consumer Voice, said of Medicare’s data website. Consumer Voice is a national advocacy group for improved quality in long-term care.Nursing homes are only required to provide the government with data on coronavirus cases and deaths among residents and staff as of May 8, or more than two months after the first outbreak in a U.S. facility was reported. Nursing homes have the option of full disclosure, but not all have taken it, and there is no penalty for withholding older data that may reflect poorly.The missing information from early in the pandemic leads to some puzzling results on the website.For example, a nursing home that had one of the first major reported outbreaks in the country — Life Care Center of Kirkland, Washington — shows no confirmed COVID cases and no deaths on the CMS data page.A spokesman for Life Care Centers of America, a major chain, said the company is providing the information the government requested.“We are reporting what CMS is asking us to report to them,” said Tim Killian. “We are not evading them in any way.“The Kirkland facility is now COVID-free and it has been for some time,” Killian added. The data showing no cases “is a snapshot of what is currently in the facility.”The company said its cumulative count shows 100 residents tested positive, and 34 died. “You can ask us directly and we’ll give you the exact numbers,” said Killian.But consumer advocate Brooks said that information should be on the CMS site.As it stands, the site “doesn’t tell the whole picture,” he said. “You are not going to be able to look at a home and make an informed decision.”The federal Centers for Medicare and Medicaid Services, which sets standards for nursing homes, said protecting nursing home residents is a top priority, and “transparency and information sharing has proven to be one of the keys to the battle against this pandemic.”But CMS said it lacked the legal authority to require nursing homes to disclose COVID information from before the effective date of its reporting rule in May.On Capitol Hill, there is pressure for more information.Sen. Chuck Grassley, R-Iowa, recently introduced legislation that would require nursing homes to report coronavirus cases and deaths going back to Jan. 1, a push that has bipartisan support.The estimated 1.4 million people living in some 15,500 nursing homes represent a tiny share of the U.S. population, but they have borne a disproportionate share of coronavirus deaths. Nursing homes are only now starting to emerge from a national lockdown that took effect in mid-March.According to the latest CMS figures, more than 33,000 nursing home residents have died in the pandemic. A running tally by The Associated Press, which also includes other long-term care facilities and staff as well as residents, shows more than 55,000 deaths.Depending on the total count, that translates from about one-fourth of the deaths to more than 40%, strikingly high proportions in either case.Coronavirus data for nursing homes do not appear directly on Medicare’s NursingHomeCompare website, the main portal for consumers trying to research a facility on behalf of a family member or friend. Instead, a link takes users to a different COVID-19 site that features statistics and a national nursing home locator map.Finding information on individual nursing homes via the data website can be confusing.If users type in a ZIP code or the name of a nursing home, the website’s locator map will display some small red dots near a larger marker icon, which also has a big dot in the middle.Instructions say click on one of the dots. But which one?The data is under the small red dots, not the larger locator, which instinctively draws the user’s eye.“I would click on the big dot,” said policy attorney Toby Edelman of the Center for Medicare Advocacy, which represents enrollees. “Why would I look for this thing that I can barely see?”CMS said it has received no reports related to search problems although more than 100,000 individuals accessed the site in June.The agency says it will continue to evaluate the usability of the website to ensure it meets consumer needs. 4782

While scientists work to come up with a safe and effective COVID-19 vaccine, doctors across the country are watching closely. Many are helping guide their patients in making an informed decision about getting a vaccine."This was indeed a surprise to see that there would vaccines available by the 1st of November. It’s clearly an aspirational goal, because we all would like to see a safe and effective COVID-19 vaccine as soon as possible, but I think testing vaccines to make sure they’re safe and effective is of paramount importance," said Dr. Bali Pulendran, a microbiology and immunology professor at Stanford University.Dr. Pulendran says the process of developing a vaccine involves numerous steps, and scientists are getting closer to the end. Still, it's hard to put an end date on the third and final phase of a vaccine trial. This last phase determines whether the vaccine actually works."The way in which you can assess whether a vaccine works is to see how many of these people acquire the disease or become infected with COVID at some period of time," explained Dr. Pulendran.Phase three divides the trial participants into two groups. One group is given the vaccine, and the other is given a placebo."And then, you calculate the efficacy based on those numbers. So, if there were 200 people affected in the placebo group but there were only 100 people who were infected in the vaccinated group, then the efficacy is 50 percent" said Dr. Pulendran.The third phase is hard to time, as it depends on how quickly some of the trial participants become infected. If they live in areas where COVID-19 infection rates are higher, the phase will be completed faster.But there are some other ways to speed up the vaccine trial.Dr. Darria Long, an emergency room physician and clinical assistant professor at the University of Tennessee-Erlanger, says one way is by doing two of the phases at the same time. Another way is if officials prepare for the manufacturing and logistics side of producing the vaccine during the third phase of the trial."This is what we see the CDC saying is to get ready on the manufacturing and logistics side because even if you come up with the perfect target drug, making sure you can manufacture hundreds of millions and that you have the little glass vials that can keep it at the right temperature, those are all things that can be hang-ups,” said Dr. Long. “So, they're wanting to expedite that process, because the last thing you want is to say is we have the vaccine, but we can’t get it to people.”Dr. Long is already answering her patients' questions as news of a possible COVID-19 vaccine continues to be publicized."I do think a lot of people are wondering about this vaccine and it runs the gamut. There are those that say they really want the vaccine because they see it as this gateway to getting back to life as we know it," said Dr. Long.There are also those who are really concerned about the efficacy and safety of a COVID-19 vaccine. Doctors say a key piece in evaluating a vaccine when it does come out is the data surrounding it."The data that comes out in the public domain: is a particular vaccine efficacious? How effective is it what is the efficacy data? Is a particular vaccine safe? What are the side reactions? And they should talk with their physicians to ask each question. Ask doctors, ‘Could you tell me what the safety part of this vaccine is?" recommended Dr. Pulendran.And above all, doctors and scientists hope politics will stay out of the development of a COVID-19 vaccine in order to ease any concerns or hopes for a vaccine to be available as soon as possible. 3644

Wildfires continue to rip through the Western United States, destroying homes, businesses, and parks.“We know that they can get exponentially large very quickly,” James Marugg, division chief for San Miguel Fire and Rescue in California, said.Those on the front lines like Marugg say each year, the blazes seem to get more destructive.“Prevention is key and it’s defensible space, and the extra few minutes that defensible space gives us to be able to set up a perimeter, be able to get in and make the difference for someone's home," Marugg said.Defensible space is the area closest to a building, which is cleared of vegetation to help slow the spread of the flames.“Defensible space equals time,” Marugg said. Now, firefighters out west are getting some much-needed assistance in getting rid of some of that vegetation, from a team that’s hungry to help."Fifteen years ago, I’d say people need to wake up,” said Johnny Gonzales, the field operations manager for Environmental Land Management.Gonzales showed us a herd of almost 300 goats. It's not a petting zoo, but a work zone. “I see it as a work zone,” he said. “They’re coming in here and eating what we consider flash fuels. And that's basically broadleaf weeds, grasses, brush.”It's all that stuff you can see in between the trees in a field. The difference between before and after is noticeable.“Our goal is to bring back nature into the equation of fire control,” Gonzales said. “We’re not raising these goats to go to the market. These goats are true urban foresters if you will.”Hundreds of goats, right near the road and adjacent to homes.“Goats, depending on the time of year, can eat about 7 to 12 percent of their body weight,” Gonzales said. On this current project next to Cuyamaca College, the goats are getting through about an acre a day.“Our college actually sits on 165 acres of wildlife, and yet, you can see it’s completely overgrown. There’s non-native dry brush, and just a few weeks ago before the goats were here, we actually had a fire on campus,” Nicole Salgado, interim vice president of administrative services at Cuyamaca College, explained. “It poses a risk not only to our college but the surrounding community.”Hiring the goats just made sense for them, cost-wise.“To have the goats here, it’s 30 percent less than that of a human crew,” Salgado said.“You're as safe as your neighbor, and then it turns into you’re as safe as the block and your community. We’re now a whole state that's in need of fire fuel mitigation,” Gonzales explained.It helps out firefighters when it comes time to put out flames. Less dry brush means slower spread of flames.“You harden your house to keep a burglar from coming in, you need to do the same with wildfire. You need to look at it and think what are my vulnerabilities,” Marugg said.There’s also another trend he said is impacting the number of homes we lose to fire.“There’s more houses in the woodland area and we have to respond to them quicker, otherwise we lose more homes,” Marugg said.“Each year, the limits for the development lines still get higher and higher. More homes are being built in the mountains, Essam Heggy, a research scientist at the University of Southern California, said.“Our visual understanding of the environment we’ve been living in, in many places have been [associated] to the malls we visit and not to the environment that’s surrounding us. This disbelief in the complexity of our environment is the main driver of these hazards."As we near the end of wildfire season, Gonzales and his herders continue to clear up the spaces they can year-round, in a sustainable way.“I see this in the future becoming as common as trash pick up,” Gonzales said. “They really may be historically, and in the future, one of the greatest things of all time for fire fuel mitigation.” 3832

White House national security adviser Lt. Gen. H.R. McMaster could leave his position in the White House by the end of the month, according to an administration official.Multiple sources familiar with the matter have said McMaster's departure is likely in the near future.The administration official and a source familiar with the matter say it is becoming more likely that McMaster will not return to the military and ultimately will retire as a three-star general.Among the names being considered to replace him are: 526

When Sen. Bernie Sanders did this in 2013, he did it alone.On Wednesday, nearly four years later, Sanders introduced a new "Medicare for all" health care bill with a third of the Senate Democratic caucus by his side.Flanked at first by New York Sen. Kirsten Gillibrand and Connecticut Sen. Richard Blumenthal, Sanders called the costs of the current system "insane and unaffordable," promising that the average family would benefit financially under his plan "because you will no longer be writing checks to private insurance companies."For those whose taxes would go up, he added, "that expense will be more than offset by the money are you are saving with the elimination of private insurance costs." 710

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