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Definitions of Terms We Use in this Brochure Accidental injury An injury caused by an external force or element such as a blow or fall that requires immediate medical attention cholesterol with eggs buy zetia 10mg low price. Also included are animal bites definition cholesterol total purchase zetia discount, poisonings cholesterol yahoo answers buy cheap zetia 10mg line, and dental care required to repair injuries to sound natural teeth as a result of an accidental injury cholesterol test instructions zetia 10mg with amex, not from biting or chewing. The period from entry (admission) into a hospital or other covered facility until discharge. In counting days of inpatient care, the date of entry and the date of discharge are counted as the same day. An authorization by an enrollee or spouse for the Plan to issue payment of benefits directly to the provider. For new enrollees, the calendar year begins on the effective date of their enrollment and ends on December 31 of the same year. A condition existing at or from birth which is a significant deviation from the common form or norm. For purposes of this Plan, congenital anomalies include cleft lips, cleft palates, birthmarks, webbed fingers or toes and other conditions that the Plan may determine to be congenital anomalies. Surgical correction of congenital anomalies is limited to children under the age of 18 unless there is a functional deficit. In no event will the term congenital anomaly include conditions relating to teeth or intra-oral structures supporting the teeth. Any procedure or any portion of a procedure performed primarily to improve physical appearance and/or treat a mental condition through change in bodily form. Treatment or services, regardless of who recommends them or where they are provided, that could be rendered safely and reasonably by a person not medically skilled, or that are designed mainly to help the patient with daily living activities. Under the telehealth benefit, dermatologic conditions seen and treated include but are not limited to acne, rashes, eczema, suspicious spots/moles, warts and other abnormal bumps, rosacea, inflamed or enlarged hair follicles, psoriasis, cold sore, alopecia, insect bites. A drug, device, or biological product is experimental or investigational if the drug, device, or biological product cannot be lawfully marketed without approval of the U. Determination of experimental/investigational status may require review of appropriate government publications such as those of the National Institute of Health, National Cancer Institute, Agency for Health Care Policy and Research, Food and Drug Administration, and National Library of Medicine. Independent evaluation and opinion by Board Certified Physicians who are professors, associate professors, or assistant professors of medicine at recognized United States Medical Schools may be obtained for their expertise in subspecialty areas. A physician or other health care professional licensed, accredited, or certified to perform specified health services consistent with state law. The condition of an individual who is unable to conceive or produce conception during a period of one year. Inpatient care is care rendered to a person who has been admitted to a hospital for bed occupancy for purposes of receiving inpatient hospital services. Generally, a patient is considered an inpatient if formally admitted as an inpatient with the expectation that he or she will remain at least overnight and occupy a bed even if it later develops that the patient can be safely discharged or transferred to another hospital and not actually use a hospital bed overnight. This Plan uses Milliman Care Guidelines to evaluate the appropriateness of observation services. See Section 3, How you get care, Covered facilities, for the definition of an Acute Inpatient and Residential Treatment Center. The fact that a covered provider has prescribed, recommended, or approved a service, supply, drug or equipment does not, in itself, make it medically necessary. Precertification is required for all of the following services and must be provided by a covered facility or covered provider as defined in section 3: How you get care. It is an intermediate level of care between traditional outpatient therapy and partial hospitalization, delivered in an outpatient facility or outpatient professional office setting. Minor acute conditions Never event policies Observation care Common, non-emergent conditions. Examples of common conditions include sinus problems, rashes, allergies, cold and flu symptoms, etc. Federal or State policies that bar health care providers from charging patients for care that is attributable to certain avoidable complications or errors, such as wrong site surgery.
Now look out over the next three to five years cholesterol eggs everyday discount 10mg zetia, and write down specific accomplishments you would like to achieve in terms of your development as a leader or the leadership development of those around you cholesterol xe2ed purchase 10 mg zetia free shipping. Organizational leadership is a complex issue free cholesterol test ottawa generic zetia 10 mg visa, as previous chapters of this book have hopefully demonstrated cholesterol in boiled shrimp discount 10 mg zetia with mastercard. Leadership in nonprofits is provided by stakeholders, by Board members, by senior management, and by staff working on their assignments. In government agencies, state and local government is headed by a governor or mayor, with important leadership often provided by county commissioners, city councilmen, or legislators. Senior management takes its lead from these leaders, translating their vision into the leading and managing of their area of governmental responsibility. Mid-management further pursues that vision, managing and leading their department and staff. Finally, staff has the responsibility for leading and managing in their areas of responsibility. All nonprofit and government organizations have to deal with their leadership "pipeline. Many organizations and agencies initially focused on the talent supply for senior management positions. However, these efforts are changing and expanding for a variety of reasons: the need to ensure the availability of effective leaders to take the place of those who will be leaving; Employee demand for developing new skills that will enable them to retain their jobs or move into new positions; and, Emerging understanding of leadership as a set of behaviors, competencies, and skills that employees at all levels are expected to develop and demonstrate. Unfortunately, leadership development in an organization has tended to focus on a narrow segment of the workforce, such as middle-managers who are in line to be promoted, high-potential recruits to the organization, or new top management. As a result, the leadership pipeline is short and relatively narrow, since it has been built for limited capacity. Given the rapid escalation in the complexity of demands on nonprofit and government organizations, this "build it when you need it" approach no longer works. Certainly, the pressure on training budgets has made it difficult to allocate funds for longer-term leadership development programs. However, it has become increasingly difficult to find the talent to replace aging or departing leaders in a typical organization. The demands on senior management time often results in less time being spent in developing potential leaders. Furthermore, many agencies and organizations in recent years have increased their outsourcing of various functions and activities, which has resulted in a hollowing-out of the middle management tier that has shrunk the potential succession pool. This includes both those individuals who are highly visible as well as those less obvious. It also involves assessing who among these leaders may resist collaborative efforts, how strongly, and why. Finally, it includes developing working relationships with these individuals to facilitate their development. Furthermore, the Board or other key stakeholders have the responsibility of recruiting other Board members or stakeholders who have the desired leadership qualities. A major factor in the success of getting the people on board that are wanted is as much about the abilities of those individuals as the qualities of the top leadership doing the seeking. Too much commonality among the staff and members of the organization can lead to a loss of innovative thinking and failure to uncover new approaches to old problems. However, everyone can grow and develop their leadership potential to a varying extent, increasing their leadership ability. One of the key advantages of developing leaders internally is that they achieve productivity almost 50 percent faster than new hires. In order to evaluate potential leaders within the organization, a leadership program needs to identify the expected leadership skills and competencies. Once those are identified, competency models can be used to identify leadership potential during performance review and career counseling sessions. Because people learn and develop new skills both inside and outside the classroom, a development program needs to support both traditional and non-traditional learning.
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In an effort to combat the opioid epidemic in the United States cholesterol levels webmd purchase zetia online now, law enforcement and prosecutors are levying more severe penalties against those drug dealers who dispense illicit narcotics that result in the death of the purchaser cholesterol test wiki order genuine zetia on line. The subjects trafficked firearms and distributed heroin cholesterol screening guidelines order zetia online, fentanyl cholesterol test wiki cheap zetia 10 mg fast delivery, cocaine, and marijuana. The $1 milliona-year enterprise operated in New York, Arizona, and the Carolinas, and included secondary suppliers of heroin and furanyl fentanyl, known as "China White. The subject, who had a prior felony drug offense on his record, furnished a lethal dose of fentanyl to the woman, and, as a result, could face a mandatory sentence of life in prison. Seven of the gang members were charged with drug sales resulting in death or serious bodily injury. The high demand for diverted prescription opioids and other prescription drugs has driven up their street price, making the drugs an extremely valuable commodity for dealers. To capitalize on the growing market for prescription opioids and other prescription drugs, street gang members are committing pharmacy burglaries and robberies in order to obtain these drugs. Three alleged ringleaders of the operation belong to the Down the Way street gang, which orchestrated the spread of drugs across Columbiana County through mid-level traffickers who purchased drugs from the gang. The indictment includes one count of murder and alleges the Mob used social media threats to prevent people in the neighborhood from assisting the police. The subjects also distributed prescription drugs, marijuana, synthetic marijuana, oxycodone, morphine, hydrocodone, Adderall, and other controlled substances, recruiting juveniles as young as 12 years old to sell the pills on the street. Besides drug trafficking, street gangs near the Southwest Border engage in a multitude of crimes, including weapons trafficking, alien smuggling, human trafficking, prostitution, extortion, robbery, auto theft, assault, murder, racketeering, and money laundering. Four of the individuals included in the conspiracy were involved in the theft of thousands of oxycodone pills from a southeast Memphis pharmaceutical warehouse where they worked. The gang member later attempted to mail 240 stolen tablets of 80 milligram oxycodone and pay for the shipment with counterfeit currency. The 5th Ward Circle gang was previously implicated in pharmacy burglaries in states throughout the country including Texas, Kansas, Virginia, Ohio, and Minnesota. One of the three subjects arrested along with the 5th Ward Circle member was a Black Disciples gang member. The gang operated mainly in Shelby County, Memphis, and north Mississippi, Tennessee, selling the stolen opioids on the street. These gangs are considered the greatest gang threat in Texas because of their consistent transnational criminal activity, relationships with Mexican cartels, statewide presence, and high propensity for violence. Source: Federal Bureau of Prisons members, friends, or prison associates, and not a contract between the gang as a whole and a specific cartel. The street gangs generally remain opportunistic and will work with any organization that will provide them the greatest profit. Several of the locations used by the gang to stockpile weapons and drugs were located just feet away from elementary and middle schools. The Mexican Mafia members distributed heroin, methamphetamine, and fentanyl acquired from drug cartel contacts in Tijuana, Baja California. Chicago is home to several street gangs that are heavily involved in drug distribution, and collectively these gangs serve as the primary midlevel and retail-level drug distributors for the cartels. The operation arrested 57 members or business associates of various white supremacists gangs, including Aryan Circle, Aryan Brotherhood of Texas, Aryan Brotherhood (see Figure 126), Peckerwoods, Soldiers of Aryan Culture, Dirty White Boys, and Tango Blast. The defendants conspired together to commit kidnapping and traffic methamphetamine and other illegal narcotics throughout north Texas and elsewhere. Marshals mount each year in coordination with local law enforcement in cities around the country to leverage resources Aryan Brotherhood Aryan Brotherhood of Texas Source: Federal Bureau of Prisons Figure 127. The anti-gang campaign focuses on tracking down fugitive gang members, increasing street patrols in neighborhoods with gang activities, prosecuting gang members, and seizing gang assets. The operation was part of Project Safe Neighborhoods, which brings together all levels of law enforcement and the communities to reduce violent crime. The gang allegedly annexed a residential neighborhood, including two playgrounds, and made a virtual open-air bazaar for dangerous and potentially lethal drugs. Some members of the gang traveled to Kentucky, West Virginia, and Ohio to sell narcotics.
Although all interviewees in Haiti were aware of the "minimum humanitarian standards" established by the Sphere Project (2011) (for example cholesterol medication side effects muscle pain discount 10mg zetia otc, 15 liters/person/day) cholesterol levels shrimp scallops discount generic zetia uk, none spontaneously mentioned them in our interviews cholesterol busting foods 10 mg zetia visa. Instead cholesterol/hdl ratio blood test discount zetia 10 mg with amex, they focused on slowly raising the initial amount of drinking water to be made available to all (from 3 liters to 5 liters of drinking water) over a matter of weeks and months. This approach is a considerable improvement on the frequent misuse of Sphere standards by donors as compulsory, quantified goals to be achieved under risk of penalty. This was observed in other disasters (natural or human-caused) where agencies opted to limit the number of their beneficiaries receiving an unrealistically high "minimum" standard or requirement in order to avoid criticism by evaluators or donors for not being in compliance. This was in fact exactly the contrary of the triage principle: the best benefit for the greatest number. Rapidly, the provision of latrines rather than the distribution of water became the preeminent priority and challenge. Normal overcrowding in Port-au-Prince is such that few open spaces (parks, squares, green spaces, etc. In an urban environment, installing traditional latrines (trenches, for instance) at a safe distance from tents and shelters was not possible. The major challenges were to find unoccupied spaces where they could be positioned, and to organize an ongoing system of collection and disposal of urban excreta. Despite efforts to install latrines, progress was slow 30 days after impact: "Sanitation continues to be a major challenge of utmost concern. It is currently estimated that less than 5% of the needs for latrines is being met (one latrine per 50 people). However, for many of those interviewed, it appears that the services provided by the international community were ultimately better than those available to the general population, although far short of the "minimum" standard of one latrine for 20 people as set internationally. The figure of one latrine for 50 persons was seen as too optimistic by some interviewees who believed that the number of users actually was around 200 per latrine for at least three months. The need for safe water in hospitals (existing or new facilities) was brought to the attention of decision makers at a very early stage. The provision of medical care by thousands of health professionals or volunteers created a significant need for safe disposal of human as well as medical waste (dressings, syringes, needles, expired drugs, etc. The need for "a clear strategy for dealing with health care waste" was identified as a priority from Day 6 and remained so for weeks. On Day 13, a system was launched to collect medical wastes and dispose of them in a landfill. Progress was noted in the main hospitals but the issue lingered due to the carelessness of some independent teams or facilities. Lack of prior planning for safe disposal of medical waste is a recurrent problem in disasters and need not be rediscovered by humanitarian organizations in each emergency situation. This may be due in part to the massive food distribution and strengthening of nutritionalactivitiesbutalsotothefactthatearthquakesdonotaffectfoodavailabilityat thenationallevel. They may have an indirect and delayed impact on nutritional levels by reducing the access of some of the affected population to existing stocks because of lost income or logistical problems. Prices increased but not to the point of affecting those lucky enough to have maintained their business and income. The destruction of the harbor in Port-au-Prince and other logistical challenges (blocked roads) were only temporary, aggravating problems affecting both the humanitarian and commercial flow of goods. Loss of meager livelihoods was only partially compensated by the sharp increase in remittances from abroad, and 89% of the recipients used those remittances before the earthquake to procure food. Yet prevention of acute malnutrition in the aftermath of a geological disaster, the end result of food insecurity, is mostly beyond the responsibility of the health sector. Only 25 of them had professional nutritional expertise while some 15 were regarded as "amateurs, without any idea of the nutritional value of food. The department of the Ministry dealing with nutrition was the only one that had updated guidelines in an electronic version, which were generally respected by all partners.