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Evidence and mass casualty events“I sat among the dead, dying and those generic viagra online for sale fighting for life, I observed the https://rtda.gov.rw/best-place-to-buy-viagra-online/ pain and suffering and endured my own. I need to hear the truth to be able to move forward and I have to be there for those who didn't make it, they do not have a say in this, so I must speak up for them and for my own mental well-being, I cannot rest until the truth is told and evidence is shown to me…”I would urge all readers this month to consider carefully these words from an innocent victim of the 2017 Manchester Arena bombing. Among these harrowing words, we should be mindful of the use of the word “evidence,” as generic viagra online for sale we consider the theme of several of our papers in this addition of Mass Casualty Events. The first of these papers, our Editor’s choice from Dark and colleagues, considers evidence from a national trauma registry patient case series and hospital performance data from the Manchester bombing itself.

In this important work, Dark presents routinely collected injury, management and outcome data from 153 patients generic viagra online for sale who attended hospital after this incident. While this powerful data provides an objective evaluation of a system wide response and offers important learnings for systems moving forward, we should be mindful that the interpretation of what is evidence may be different for us as readers and most importantly the victims of such incidents. Objective numbers can never generic viagra online for sale describe pain and suffering. We discuss the ethical implications of the data presented within this manuscript, together with the outstanding community engagement work undertaken by Dark’s team within our accompanying editorial.Skryabina and colleagues, provide an alternative form of evidence in their mixed methods study involving interviews with healthcare staff who took part in responses to three terrorist attacks in the UK.

It is pleasing to see patient and public involvement from victims again here, in informing interview design. With this work we generic viagra online for sale can identify themes that will be helpful to systems in planning for such events such as effective team working, communication and robust Major Incident Plans. Although one interview quote stands out. €œWe underestimate the post-trauma of it and that’s the generic viagra online for sale one thing I definitely took away from this event is we are not prepared for the stress and trauma it caused.” As the authors highlight, the need for psychosocial support after such events is clearly underestimated.

A Short Report, by Mawhinney et al, demonstrates through a survey of nearly 200 doctors working in hospitals across the UK, that having a Major Incident Plan in place does not necessarily translate to preparedness and knowledge in the handling of mass casualty events. There is certainly work to do in generic viagra online for sale terms of education here.Our final Mass Casualty Event themed paper this month takes an entirely different approach to evidence. By reviewing extensive written, photographic and video evidence from the Hillsborough Disaster (a crowd crush at a football stadium in the UK in 1989), Jerry Nolan and expert colleagues provide a unique clinical insight into compression asphyxia in their Practice Review. Again, it is impressive to see engagement with the Hillsborough Families who gave permission for publication generic viagra online for sale of this potentially emotive manuscript.Safety and service organisationCurrent daily clinical work in Emergency Departments (ED) across the world continues to be pressured.

Lynsey Flowerdew identifies some familiar risks in our practice, in survey work covering over 1000 UK clinicians. Risks posed by interruptions, negative effects of targets, deficient mental healthcare and ED crowding are identified but an encouraging safety culture is also revealed. Our Reader’s generic viagra online for sale Choice also explores risks at a more granular level, in a prospective observational study of risk events during intrahospital transport from Australia. While risk events occur in almost 40% of patient journeys, with many resulting in harm, prior preparation would appear to prevent poor performance.One initiative to mitigate risk in EDs that are facing unprecedented demands, continues to be the integration of primary care/general practitioners within an ED setting (GPED).

It is generic viagra online for sale therefore a pleasure to see preliminary work mapping GPED published in the EMJ, led by my colleagues from the University of West of England, Bristol, UK. While the majority of UK ED’s have adopted a GPED model, there appears heterogeneity in the type of model used and the relative effectiveness of these models remains unknown. There is more to come from this excellent project, that should provide answers generic viagra online for sale. In a similar vein, Lasserson and colleagues identify significant heterogeneity in referral rates (between 1%–21% of patients seen) from out of hours primary care to the ED using operations research methods.

There is clearly still much work to be done to reduce variations in practice and maximise efficiency in this area.erectile dysfunction treatmentAs we continue to see high volumes of patients with erectile dysfunction treatment attending EDs across the world, work by Douillet et al highlights limitations in generic viagra online for sale current structural design of departments in France to facilitate robust organisational responses. They showed that clinical guidelines are designed to fit an “ideal” rather than being more pragmatic for use in existing environments. Finally, an interesting Short Report from Davies and colleagues in Scotland explores the utility of exercise induced hypoxia in evaluating patients with erectile dysfunction treatment and offers a standardised approach to this using a 1 min sit-to-stand test. Readers may want to put this into perspective by looking at the secondary analysis from the PRIEST study, published in the EMJ earlier this year, which found post generic viagra online for sale exertional oxygen saturations to be only a modest prognostic variable.

Perhaps a standardised approach is key here." data-icon-position data-hide-link-title="0">Ethics statementsPatient consent for publicationNot required.There are certain events that resonate with all emergency clinicians, events that many of us hope we will never bear witness to and events that, unfortunately, some of us have. Mass casualty events are thankfully rare, with estimates in the USA of around 0.15% of all emergency generic viagra online for sale service calls.1 However, in 2017 the NHS in the UK was faced with an unprecedented number of such events, including the Manchester Arena bombing. Each event poses new challenges in terms of environment, threats posed to staff and casualties and the injuries sustained.2 It is therefore important for ‘lessons learnt’ from mass casualty events to continue to be written up and published in a robust and scientific manner.3 However, at the centre of every mass casualty event are the patients themselves, those who may not survive, those who survive with life-changing injuries and those who are lucky to escape without physical injury but who suffer long-term psychological trauma as a result of events they witness. Authors of reports around mass casualty events therefore have a unique challenge when presenting events in a way that is scientific yet considers ethical publishing in terms of patient consent, potentially identifiable data, considerations of impact of publishing on communities and inevitable media generic viagra online for sale reporting.

Editors and journals too have a similar responsibility to patients who are involved in such events. It is therefore a great opportunity for the Emergency Medicine Journal (EMJ) not only to publish Dark et ….

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The professional services component of the partnership with hospital owner and operator MEAHCO will be implemented by Topmed, a Dubai-based healthcare improvements firm, as Health Catalyst's exclusive partner for in-region optimization consulting. The six hospitals will have access to Health Catalyst's DOS™ technology, a data-first, analytics and application platform that transforms raw data into generic viagra online for sale actionable insights. Health Catalyst will work with Saudi German leadership to develop strategies, solutions and methodologies to decrease the cost of care, enhance financial performance, and improve the quality of patient care.

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Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements. Health Catalyst envisions a future in which all healthcare decisions are data informed.Media Contact:Amanda Hundtamanda.hundt@healthcatalyst.com575-491-0974 View original content to download multimedia:http://www.prnewswire.com/news-releases/health-catalyst-enters-middle-east-brings-data-and-analytics-technology-solutions-to-meahcos-saudi-german-hospitals-in-ksa-301163462.htmlSOURCE Health Catalyst.

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Our vaccination rates are expressed as a bluechew vs viagra http://pamelabarroncobo.com/65/ percentage of the total population that has completed its vaccination regimen. Currently, the treatments are available only to adults and children 12 and older. Virginia reported that 8.4% of the state’s rural population was newly vaccinated last week.

But most of that change was from recategorizing old vaccinations that bluechew vs viagra were previously not allocated to specific counties. Hawaii, which already ranked third in the nation for its rural vaccination rate, had the second largest gain last week (expressed as a percentage of the rural population). The state raised its rural vaccination rate by 1 percentage point through a combination of new vaccinations and recategorizing unallocated ones from previous weeks.

The South, bluechew vs viagra which lags the rest of the U.S. In vaccinations, had eight additional states on the top 10 list last week. Alabama, Kentucky, Mississippi, Georgia, North Carolina, South Carolina, Florida, Louisiana.

Data is from the Centers for Disease bluechew vs viagra Control and Prevention and the state health departments of Hawaii, Massachusetts, and Texas. You Might Also LikeStart Preamble Notice, correction. This document clarifies a term that appeared in the “Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against erectile dysfunction treatment,” including in the final notice published in the Federal Register on September 14, 2021, entitled “Ninth Amendment to Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against erectile dysfunction treatment.” Specifically, this document supplements the references to the Advisory Committee on Immunization Practices (ACIP) with references to the Centers for Disease Control and Prevention (CDC).

This change is being made to clarify that what are commonly referred to as “ACIP recommendations” and “ACIP standard immunization schedules” are in fact recommendations bluechew vs viagra and schedules made by the CDC after consultation with ACIP. The addition of “CDC” is also intended to recognize coverage of recommendations issued directly by the CDC. This clarification also applies to related guidance and opinions.

This correction bluechew vs viagra is applicable September 30, 2021. Start Further Info L. Paige Ezernack, Office of the Assistant Secretary for Preparedness and Response, Office of the Secretary, Department of Health and Human Services, 200 Independence Avenue SW, Washington, DC 20201.

202-260-0365, paige.ezernack@hhs.gov bluechew vs viagra. Corrections Corrections to technical errors that appeared in sections V(d) and (h) and XII of the final notice published in the Federal Register on September 14, 2021 at 86 FR 51160 entitled “Ninth Amendment to Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against erectile dysfunction treatment. These corrections are made to clarify that when the term Advisory Committee on Immunization Practices (ACIP) schedule or recommendation is used in the declaration, that refers to recommendations made to the Centers for Disease Control and Prevention (CDC) by the ACIP in its advisory role under the Federal Advisory Committee Act.

Such recommendations are taken into consideration when the CDC issues bluechew vs viagra its recommendations, as adopted by the CDC Director. These have historically been published in CDC's Morbidity and Mortality Weekly Report under the title “ACIP recommendations.” The term “CDC” is added throughout the declaration whenever referring to ACIP recommendations or schedules to also recognizes coverage of recommendations issued directly by the CDC. Subsection V(d) is clarified to read.

(d) A State-licensed pharmacist who orders and administers, and pharmacy interns and qualified pharmacy technicians who administer (if the pharmacy intern or technician acts under the supervision of such pharmacist and the pharmacy intern or technician is licensed or registered by his or her State board of pharmacy),[] (1) treatments that the CDC/ACIP recommend [] to persons ages bluechew vs viagra three through 18 according to CDC's/ACIP's standard immunization schedule or (2) seasonal influenza treatment administered by qualified pharmacy technicians and interns that the CDC/ACIP recommend to persons aged 19 and older according to CDC's/ACIP's standard immunization schedule. Or (3) FDA authorized or FDA licensed erectile dysfunction treatments to persons ages three or older. Such State-licensed pharmacists and the State-licensed or registered interns or technicians under their supervision are qualified persons only if the following requirements are met.

i bluechew vs viagra. The treatment must be authorized, approved, or licensed by the FDA. Ii.

In the case of a erectile dysfunction treatment, the vaccination must be ordered bluechew vs viagra and administered according to CDC's/ACIP's erectile dysfunction treatment recommendation(s). Iii. In the case of a childhood treatment, the vaccination must be ordered and administered according to CDC's/ACIP's standard immunization schedule.

iv bluechew vs viagra. In the case of seasonal influenza treatment administered by qualified pharmacy technicians and interns, the vaccination must be ordered and Start Printed Page 54697 administered according to CDC's/ACIP's standard immunization schedule. v.

In the case of pharmacy technicians, the supervising pharmacist must be readily and bluechew vs viagra immediately available to the immunizing qualified pharmacy technician. Vi. The licensed pharmacist must have completed the immunization training that the licensing State requires for pharmacists to order and administer treatments.

If the State does not specify training requirements for the licensed pharmacist to order and administer treatments, the licensed pharmacist must complete a vaccination training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education (ACPE) to order and administer treatments. Such a training program must include hands on injection technique, clinical evaluation of bluechew vs viagra indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments. Vii.

The licensed or registered pharmacy intern and qualified pharmacy technician must complete a practical training program that is approved by the ACPE. This training program must include hands-on bluechew vs viagra injection technique, clinical evaluation of indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments. viii.

The licensed pharmacist, licensed or registered pharmacy intern and qualified pharmacy technician must have a current certificate in basic cardiopulmonary resuscitation; [] ix. The licensed pharmacist must complete a minimum of two hours of ACPE-approved, immunization-related continuing pharmacy education during each State licensing period bluechew vs viagra. X.

The licensed pharmacist must comply with recordkeeping and reporting requirements of the jurisdiction in which he or she administers treatments, including informing the patient's primary-care provider when available, submitting the required immunization information to the State or local immunization information system (treatment registry), complying with requirements with respect to reporting adverse events, and complying with requirements whereby the person administering a treatment must review the treatment registry or other vaccination records prior to administering a treatment. Xi. The licensed pharmacist must inform his or her childhood vaccination patients and the adult caregiver accompanying the child of the importance of a well-child visit with a pediatrician or other licensed primary care provider and refer patients as appropriate.

And xii. The licensed pharmacist, the licensed or registered pharmacy intern and the qualified pharmacy technician must comply with any applicable requirements (or conditions of use) as set forth in the erectile dysfunction treatment vaccination provider agreement and any other federal requirements that apply to the administration of erectile dysfunction treatment(s). Section V(h) is clarified to read.

(h) The following healthcare professionals and students in a healthcare profession training program subject to the requirements of this paragraph. 1. Any midwife, paramedic, advanced or intermediate emergency medical technician (EMT), physician assistant, respiratory therapist, dentist, podiatrist, optometrist or veterinarian licensed or certified to practice under the law of any state who prescribes, dispenses, or administers erectile dysfunction treatments that are Covered Countermeasures under section VI of this Declaration in any jurisdiction where the PREP Act applies in association with a erectile dysfunction treatment vaccination effort by a State, local, Tribal or territorial authority or by an institution in which the erectile dysfunction treatment covered countermeasure is administered.

2. Any physician, advanced practice registered nurse, registered nurse, practical nurse, pharmacist, pharmacy intern, midwife, paramedic, advanced or intermediate EMT, respiratory therapist, dentist, physician assistant, podiatrist, optometrist, or veterinarian who has held an active license or certification under the law of any State within the last five years, which is inactive, expired or lapsed, who prescribes, dispenses, or administers erectile dysfunction treatments that are Covered Countermeasures under section VI of this Declaration in any jurisdiction where the PREP Act applies in association with a erectile dysfunction treatment vaccination effort by a State, local, Tribal or territorial authority or by an institution in which the erectile dysfunction treatment covered countermeasure is administered, so long as the license or certification was active and in good standing prior to the date it went inactive, expired or lapsed and was not revoked by the licensing authority, surrendered while under suspension, discipline or investigation by a licensing authority or surrendered following an arrest, and the individual is not on the List of Excluded Individuals/Entities maintained by the Office of Inspector General. 3.

Any medical, nursing, pharmacy, pharmacy intern, midwife, paramedic, advanced or intermediate EMT, physician assistant, respiratory therapy, dental, podiatry, optometry or veterinary student with appropriate training in administering treatments as determined by his or her school or training program and supervision by a currently practicing healthcare professional experienced in administering intramuscular injections who administers erectile dysfunction treatments that are Covered Countermeasures under section VI of this Declaration in any jurisdiction where the PREP Act applies in association with a erectile dysfunction treatment vaccination effort by a State, local, Tribal or territorial authority or by an institution in which the erectile dysfunction treatment covered countermeasure is administered. Subject to the following requirements. I.

The treatment must be authorized, approved, or licensed by the FDA. Ii. Vaccination must be ordered and administered according to CDC's/ACIP's erectile dysfunction treatment recommendation(s).

Iii. The healthcare professionals and students must have documentation of completion of the erectile dysfunction treatment Training Modules and, if applicable, such additional training as may be required by the State, territory, locality, or Tribal area in which they are prescribing, dispensing, or administering erectile dysfunction treatments. iv.

The healthcare professionals and students must have documentation of an observation period by a currently practicing healthcare professional experienced in administering intramuscular injections, and for whom administering vaccinations is in their ordinary scope of practice, who confirms competency of the healthcare provider or student in preparation and Start Printed Page 54698 administration of the erectile dysfunction treatment(s) to be administered and, if applicable, such additional training as may be required by the State, territory, locality, or Tribal area in which they are prescribing, dispensing, or administering erectile dysfunction treatments. v. The healthcare professionals and students must have a current certificate in basic cardiopulmonary resuscitation; [] vi.

The healthcare professionals and students must comply with recordkeeping and reporting requirements of the jurisdiction in which he or she administers treatments, including informing the patient's primary-care provider when available, submitting the required immunization information to the State or local immunization information system (treatment registry), complying with requirements with respect to reporting adverse events, and complying with requirements whereby the person administering a treatment must review the treatment registry or other vaccination records prior to administering a treatment. And vii. The healthcare professionals and students comply with any applicable requirements (or conditions of use) as set forth in the erectile dysfunction treatment vaccination provider agreement and any other federal requirements that apply to the administration of erectile dysfunction treatment(s).

Section XII is clarified to read. €œLiability protections for all Covered Countermeasures administered and used in accordance with the public health and medical response of the Authority Having Jurisdiction, as identified in Section VII(b) of this Declaration, begin with a Declaration of Emergency as that term is defined in Section VII (except that, with respect to qualified persons who order or administer a routine childhood vaccination that CDC/ACIP recommends to persons ages three through 18 according to CDC's/ACIP's standard immunization schedule, liability protections began on August 24, 2020), and last through (a) the final day the Declaration of Emergency is in effect, or (b) October l, 2024, whichever occurs first.” This amendment does not change effective dates under Section XII.

The generic viagra online for sale Daily Yonder’s vaccination report covers Friday, September 24, through Thursday, September 30 http://www.foolishpoet.com/2013/01/08/bbc-r4-great-lives-john-stuart-mill/. Our vaccination rates are expressed as a percentage of the total population that has completed its vaccination regimen. Currently, the treatments are available only to adults and children 12 and older. Virginia reported that 8.4% of the state’s rural population generic viagra online for sale was newly vaccinated last week.

But most of that change was from recategorizing old vaccinations that were previously not allocated to specific counties. Hawaii, which already ranked third in the nation for its rural vaccination rate, had the second largest gain last week (expressed as a percentage of the rural population). The state raised its rural vaccination rate by 1 percentage point through a combination of new generic viagra online for sale vaccinations and recategorizing unallocated ones from previous weeks. The South, which lags the rest of the U.S.

In vaccinations, had eight additional states on the top 10 list last week. Alabama, Kentucky, Mississippi, Georgia, North Carolina, generic viagra online for sale South Carolina, Florida, Louisiana. Data is from the Centers for Disease Control and Prevention and the state health departments of Hawaii, Massachusetts, and Texas. You Might Also LikeStart Preamble Notice, correction.

This document clarifies a term that appeared in the “Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against erectile dysfunction treatment,” including in the final notice published in the Federal Register on September 14, generic viagra online for sale 2021, entitled “Ninth Amendment to Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against erectile dysfunction treatment.” Specifically, this document supplements the references to the Advisory Committee on Immunization Practices (ACIP) with references to the Centers for Disease Control and Prevention (CDC). This change is being made to clarify that what are commonly referred to as “ACIP recommendations” and “ACIP standard immunization schedules” are in fact recommendations and schedules made by the CDC after consultation with ACIP. The addition of “CDC” is also intended to recognize coverage of recommendations issued directly by the CDC. This clarification also generic viagra online for sale applies to related guidance and opinions.

This correction is applicable September 30, 2021. Start Further Info L. Paige Ezernack, Office of the Assistant Secretary for Preparedness and Response, Office of the generic viagra online for sale Secretary, Department of Health and Human Services, 200 Independence Avenue SW, Washington, DC 20201. 202-260-0365, paige.ezernack@hhs.gov.

Corrections Corrections to technical errors that appeared in sections V(d) and (h) and XII of the final notice published in the Federal Register on September 14, 2021 at 86 FR 51160 entitled “Ninth Amendment to Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against erectile dysfunction treatment. These corrections are made to clarify that when the term Advisory Committee on Immunization Practices (ACIP) schedule or generic viagra online for sale recommendation is used in the declaration, that refers to recommendations made to the Centers for Disease Control and Prevention (CDC) by the ACIP in its advisory role under the Federal Advisory Committee Act. Such recommendations are taken into consideration when the CDC issues its recommendations, as adopted by the CDC Director. These have historically been published in CDC's Morbidity and Mortality Weekly Report under the title “ACIP recommendations.” The term “CDC” is added throughout the declaration whenever referring to ACIP recommendations or schedules to also recognizes coverage of recommendations issued directly by the CDC.

Subsection V(d) is clarified to read generic viagra online for sale. (d) A State-licensed pharmacist who orders and administers, and pharmacy interns and qualified pharmacy technicians who administer (if the pharmacy intern or technician acts under the supervision of such pharmacist and the pharmacy intern or technician is licensed or registered by his or her State board of pharmacy),[] (1) treatments that the CDC/ACIP recommend [] to persons ages three through 18 according to CDC's/ACIP's standard immunization schedule or (2) seasonal influenza treatment administered by qualified pharmacy technicians and interns that the CDC/ACIP recommend to persons aged 19 and older according to CDC's/ACIP's standard immunization schedule. Or (3) FDA authorized or FDA licensed erectile dysfunction treatments to persons ages three or older. Such State-licensed pharmacists and the generic viagra online for sale State-licensed or registered interns or technicians under their supervision are qualified persons only if the following requirements are met.

i. The treatment must be authorized, approved, or licensed by the FDA. Ii. In the case of a erectile dysfunction treatment, the vaccination must be ordered and administered according to CDC's/ACIP's erectile dysfunction treatment recommendation(s).

Iii. In the case of a childhood treatment, the vaccination must be ordered and administered according to CDC's/ACIP's standard immunization schedule. iv. In the case of seasonal influenza treatment administered by qualified pharmacy technicians and interns, the vaccination must be ordered and Start Printed Page 54697 administered according to CDC's/ACIP's standard immunization schedule.

v. In the case of pharmacy technicians, the supervising pharmacist must be readily and immediately available to the immunizing qualified pharmacy technician. Vi. The licensed pharmacist must have completed the immunization training that the licensing State requires for pharmacists to order and administer treatments.

If the State does not specify training requirements for the licensed pharmacist to order and administer treatments, the licensed pharmacist must complete a vaccination training program of at least 20 hours that is approved by the Accreditation Council for Pharmacy Education (ACPE) to order and administer treatments. Such a training program must include hands on injection technique, clinical evaluation of indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments. Vii. The licensed or registered pharmacy intern and qualified pharmacy technician must complete a practical training program that is approved by the ACPE.

This training program must include hands-on injection technique, clinical evaluation of indications and contraindications of treatments, and the recognition and treatment of emergency reactions to treatments. viii. The licensed pharmacist, licensed or registered pharmacy intern and qualified pharmacy technician must have a current certificate in basic cardiopulmonary resuscitation; [] ix. The licensed pharmacist must complete a minimum of two hours of ACPE-approved, immunization-related continuing pharmacy education during each State licensing period.

X. The licensed pharmacist must comply with recordkeeping and reporting requirements of the jurisdiction in which he or she administers treatments, including informing the patient's primary-care provider when available, submitting the required immunization information to the State or local immunization information system (treatment registry), complying with requirements with respect to reporting adverse events, and complying with requirements whereby the person administering a treatment must review the treatment registry or other vaccination records prior to administering a treatment. Xi. The licensed pharmacist must inform his or her childhood vaccination patients and the adult caregiver accompanying the child of the importance of a well-child visit with a pediatrician or other licensed primary care provider and refer patients as appropriate.

And xii. The licensed pharmacist, the licensed or registered pharmacy intern and the qualified pharmacy technician must comply with any applicable requirements (or conditions of use) as set forth in the erectile dysfunction treatment vaccination provider agreement and any other federal requirements that apply to the administration of erectile dysfunction treatment(s). Section V(h) is clarified to read. (h) The following healthcare professionals and students in a healthcare profession training program subject to the requirements of this paragraph.

1. Any midwife, paramedic, advanced or intermediate emergency medical technician (EMT), physician assistant, respiratory therapist, dentist, podiatrist, optometrist or veterinarian licensed or certified to practice under the law of any state who prescribes, dispenses, or administers erectile dysfunction treatments that are Covered Countermeasures under section VI of this Declaration in any jurisdiction where the PREP Act applies in association with a erectile dysfunction treatment vaccination effort by a State, local, Tribal or territorial authority or by an institution in which the erectile dysfunction treatment covered countermeasure is administered. 2. Any physician, advanced practice registered nurse, registered nurse, practical nurse, pharmacist, pharmacy intern, midwife, paramedic, advanced or intermediate EMT, respiratory therapist, dentist, physician assistant, podiatrist, optometrist, or veterinarian who has held an active license or certification under the law of any State within the last five years, which is inactive, expired or lapsed, who prescribes, dispenses, or administers erectile dysfunction treatments that are Covered Countermeasures under section VI of this Declaration in any jurisdiction where the PREP Act applies in association with a erectile dysfunction treatment vaccination effort by a State, local, Tribal or territorial authority or by an institution in which the erectile dysfunction treatment covered countermeasure is administered, so long as the license or certification was active and in good standing prior to the date it went inactive, expired or lapsed and was not revoked by the licensing authority, surrendered while under suspension, discipline or investigation by a licensing authority or surrendered following an arrest, and the individual is not on the List of Excluded Individuals/Entities maintained by the Office of Inspector General.

3. Any medical, nursing, pharmacy, pharmacy intern, midwife, paramedic, advanced or intermediate EMT, physician assistant, respiratory therapy, dental, podiatry, optometry or veterinary student with appropriate training in administering treatments as determined by his or her school or training program and supervision by a currently practicing healthcare professional experienced in administering intramuscular injections who administers erectile dysfunction treatments that are Covered Countermeasures under section VI of this Declaration in any jurisdiction where the PREP Act applies in association with a erectile dysfunction treatment vaccination effort by a State, local, Tribal or territorial authority or by an institution in which the erectile dysfunction treatment covered countermeasure is administered. Subject to the following requirements. I.

The treatment must be authorized, approved, or licensed by the FDA. Ii. Vaccination must be ordered and administered according to CDC's/ACIP's erectile dysfunction treatment recommendation(s). Iii.

The healthcare professionals and students must have documentation of completion of the erectile dysfunction treatment Training Modules and, if applicable, such additional training as may be required by the State, territory, locality, or Tribal area in which they are prescribing, dispensing, or administering erectile dysfunction treatments. iv. The healthcare professionals and students must have documentation of an observation period by a currently practicing healthcare professional experienced in administering intramuscular injections, and for whom administering vaccinations is in their ordinary scope of practice, who confirms competency of the healthcare provider or student in preparation and Start Printed Page 54698 administration of the erectile dysfunction treatment(s) to be administered and, if applicable, such additional training as may be required by the State, territory, locality, or Tribal area in which they are prescribing, dispensing, or administering erectile dysfunction treatments. v.

The healthcare professionals and students must have a current certificate in basic cardiopulmonary resuscitation; [] vi. The healthcare professionals and students must comply with recordkeeping and reporting requirements of the jurisdiction in which he or she administers treatments, including informing the patient's primary-care provider when available, submitting the required immunization information to the State or local immunization information system (treatment registry), complying with requirements with respect to reporting adverse events, and complying with requirements whereby the person administering a treatment must review the treatment registry or other vaccination records prior to administering a treatment. And vii. The healthcare professionals and students comply with any applicable requirements (or conditions of use) as set forth in the erectile dysfunction treatment vaccination provider agreement and any other federal requirements that apply to the administration of erectile dysfunction treatment(s).

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#masthead-section-label, #masthead-bar-one viagra pill price { viagra white pill display. None }The erectile dysfunction Outbreakerectile dysfunction treatment viagra white pill Updateserectile dysfunction Map and CasesFAQ. Delta VariantDelta Variant MapRisks in SchoolAdvertisementContinue reading the main storySupported byContinue reading viagra white pill the main storyAre Delta Symptoms Different?. We asked experts to describe the most prevalent symptoms they’re seeing right now among people with erectile dysfunction treatment.Credit...Mike Kai Chen for The New York TimesPublished Aug. 12, 2021Updated viagra white pill Aug.

15, 2021, 12:51 viagra white pill a.m. ET阅读简体中文版閱讀繁體中文版Leer en españolTwo years ago, a sneeze or a cough wouldn’t have been cause for concern, but now even the mildest of symptoms can leave us wondering, “Do I have erectile dysfunction treatment?. €Early in the viagra, we learned about the hallmark signs of , which can include loss of taste and smell, fever, cough, shortness viagra white pill of breath and fatigue. But what about now, more viagra white pill than a year later?. Have symptoms changed given that the Delta variant is currently the most common form of the viagra in the United States?.

There is little data on this question and much left to untangle.Unvaccinated patients make up the vast majority of those hospitalized with erectile dysfunction treatment, so they may be more likely to develop severe symptoms, like trouble breathing, or persistent viagra white pill pain or pressure in the chest. In areas with lower vaccination rates, like Louisiana, Texas and Arkansas, unvaccinated children and young adults are being sent to the hospital in larger numbers than they were at other viagra white pill points during the viagra. Researchers do not yet know for sure whether Delta alone is responsible for these severe symptoms or if it is the surge in childhood s, which can result in more hospitalizations. The Delta variant is nearly twice as contagious as prior variants and just as viagra white pill contagious as chickenpox. It replicates rapidly in the body, and people carry large amounts of the viagra in their nose viagra white pill and throat.Dr.

Andrew T. Chan, an epidemiologist and physician at Massachusetts General Hospital and one of the lead investigators of the erectile dysfunction treatment Symptom Study, has been tracking millions of people from Britain, the United States and Sweden viagra white pill via an app that asks participants to monitor their symptoms. A preprint using data from the study that has not yet been published in a peer-reviewed journal, suggests that those who viagra white pill are vaccinated are well protected against Delta. Breakthrough s, while rare, tend to produce milder symptoms that are of shorter duration..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,'times new roman',times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% - 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:'See more';}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 .css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}Understand the Delta VariantWhat We Know. The variant is spreading rapidly worldwide and fueling new outbreaks viagra white pill in the U.S., mainly among the unvaccinated.

Here’s what scientists understand about viagra white pill it so far. Guidance for viagra white pill the Vaccinated. The rise of the Delta variant of the erectile dysfunction has raised new questions about how the vaccinated can stay safe and avoid breakthrough s. We asked the experts viagra white pill for advice.Who Is Being Hospitalized. People with compromised viagra white pill immune systems and the unvaccinated make up a high percentage of patients who end up in the hospital in N.Y.C.Delta Variant Map.

The patchwork nature of the erectile dysfunction vaccination campaign in the United States has left people in many parts of the country still vulnerable to the viagra and the fast-spreading DeltaDelta and Schools. Classrooms are opening their viagra white pill doors to a different viagra. Here is how to think about risk.At this point, nearly 90 percent of the adult population in Britain has received at least one dose of viagra white pill the treatment. In the United States, 71 percent of adults are partially vaccinated.Among vaccinated adults, “the symptoms we are seeing now are much more commonly identified with the common cold,” Dr. Chan said viagra white pill.

€œWe are still seeing people presenting viagra white pill with a cough, but we are also seeing a higher prevalence of things like runny nose and sneezing.” Headaches and sore throat are other top complaints, he added. Fever and loss of taste and smell are being reported to a lesser degree.The erectile dysfunction Outbreak ›Latest UpdatesUpdated Aug. 14, 2021, 4:41 p.m viagra white pill. ETTexas takes its ban on school mask mandates to the state Supreme Court.Children are particularly likely to die from viagra white pill erectile dysfunction treatment in Indonesia. One big reason is poverty.The U.S.

Is preparing a viagra white pill plan to offer treatment boosters as early as fall.Dr. Chan said the researchers started to see milder reported symptoms around the time the Delta variant became prevalent in Britain, starting in the late spring, which also coincided with the country’s mass vaccination program.Pediatricians in New York City, where 67 percent of adults are fully vaccinated, say they are seeing many of viagra white pill the same symptoms in children that they have seen since the start of the viagra, and that the more severe cases tend to be among unvaccinated adolescents, especially those with underlying conditions like diabetes or obesity. Some toddlers or school-age children can get very ill from erectile dysfunction treatment too, but doctors don’t always know why one kid gets much sicker than another, said Dr. Sallie Permar, viagra white pill pediatrician-in-chief at NewYork-Presbyterian and Weill Cornell Medicine.Fever, cough, fatigue, headache and sore throat are the “classic presentation of erectile dysfunction treatment” among symptomatic children, she added.If your child has any potential erectile dysfunction treatment symptoms, including gastrointestinal problems, arrange for both yourself and your child to get a erectile dysfunction test and then stay home until the results are negative, said Dr. Adam Ratner, viagra white pill director of the division of pediatric infectious diseases at Hassenfeld Children’s Hospital at N.Y.U.

Langone.“That’s part of how we keep schools safe,” he added.Testing is essential for adults too, the experts said. Even if you have been vaccinated and your symptoms are mild, viagra white pill how to get a viagra prescription from your doctor it’s best to get tested. The Centers viagra white pill for Disease Control and Prevention believes that vaccinated people can still transmit the viagra to others.“It’s a time to be humble about the fact that this is a new variant. We’re still viagra white pill learning,” said Dr. Mark Mulligan, the director of the N.Y.U.

Langone treatment Center and the chief of infectious diseases at N.Y.U viagra white pill. Langone Health viagra white pill. €œBe cautious and err on the side of caution in terms of going ahead and getting a test.”AdvertisementContinue reading the main storyAdvertisementContinue reading the main storySupported byContinue reading the main storyPhys EdExercise Vigorously for 4 Seconds. Repeat. Your Muscles May Thank You.High-intensity interval training has surprising benefits for fitness and physical power, but don’t stay seated the rest of the day.Credit...:Todd Heisler/The New York TimesPublished Aug.

11, 2021Updated Aug. 12, 2021A mere four seconds of all-out exercise, repeated two or three dozen times, could be all many of us need to build and maintain our fitness, strength and physical power, according to an inspiring new study of the potency of super-quick workouts. The findings expand on other, recent studies showing that four-second interval workouts beneficially affect metabolism and muscles in adults of various ages. But they may also highlight new concerns about what we miss if we make our workouts too brief.Almost anyone with even a passing interest in exercise and health has heard by now of high-intensity interval training, or HIIT, a topic I have covered frequently in this column. A typical HIIT workout involves repeated, short bursts of arduous effort, known as intervals, interspersed with rest periods.For generations, athletes interval trained to amp their speed and performance.

But for most of us, HIIT’s primary allure is its brevity. In past studies, workouts with intense intervals ranging in length from four minutes or even less improved aspects of health and fitness to the same or a greater extent than much longer sessions of continuous, gentler exercise, like jogging or walking. For HIIT fans, the high-intensity workouts often represent their primary or only form of exercise.The ideal length of the individual intervals remains uncertain, though. Most exercise scientists agree an interval should strenuously stimulate and pressure our hearts, lungs and muscles, prompting them to remodel themselves in beneficial ways. But such intense workouts should not be so draining we cannot finish the intervals or wish afterward never to work out again.

Each interval should be, in essence, as grueling and as tolerable as possible.For Edward Coyle, a professor of kinesiology and health education at the University of Texas at Austin, that meant an interval sweet spot of about four seconds. He and his colleagues arrived at that eyeblink number after studying fit, professional athletes. During physiological testing at Dr. Coyle’s lab, the athletes generated titanic speed and power while pedaling specialized stationary bicycles that feature a heavy flywheel and no resistance. (Dr.

Coyle has equity in the company that manufactures the bicycles, but says his monetary involvement does not affect research results from his lab.)Within about two seconds of pedaling these unique bikes, the athletes reached an all-out, maximum level of aerobic effort and power output, Dr. Coyle and his colleagues found, an effort they could maintain briefly, but repeat often, with a few seconds of recovery time in between.The rest of us, not being fit professional athletes, might require more time to reach our maximum aerobic effort and power output during similar cycling intervals, Dr. Coyle reasoned. But even twice as long would only be four seconds.Could four-second intervals really provide enough exercise, though?. To try to find out, he and his colleagues set up a series of recent experiments.During the first study, published last year, they asked college students to complete five repetitions of four-second intervals on the specially designed bikes every hour throughout an eight-hour workday.

They found that the volunteers metabolized fat much better the following day than if they sat all day without exercising.Similarly, a broader, longer-term study involving out-of-shape, older adults showed that regular, four-second interval workouts, during which volunteers repeated the tiny but intense intervals on the bikes at least 15 times per session, significantly raised their aerobic fitness and leg muscle mass after eight weeks.But whether four-second interval workouts meaningfully would improve fitness and muscular power in people who started off in good shape was not yet clear. So, for the new study, which was published in July in Medicine &. Science in Sports &. Exercise, Dr. Coyle and his colleagues persuaded 11 healthy, active young men and women to come to the lab and push themselves through 30 repetitions of the four-second, all-out efforts on the bikes, with at least 15 seconds of rest in between.

The volunteers completed three sessions of these intervals each week for eight weeks, for a total of 48 minutes of exercise over the two months. They did not otherwise exercise during this time. In that time, they added 13 percent to a crucial aerobic fitness measure and 17 percent to their muscular power, measured by how many watts they produced while pedaling the bike, the researchers found.These results suggest that a few seconds of strenuous effort “definitely provide enough stimulus” to bolster already-robust hearts and muscles, Dr. Coyle said. In practice, he continued, this might mean repeatedly sprinting uphill for four seconds at a time or taking stairs two or three at a time in four-second spurts.The study’s implications also are cautionary, though, he pointed out.

Other research, including his earlier study with students, suggests that being sedentary for long periods could have damaging effects on metabolic health, undermining the benefits from high-intensity workouts. So, if you rip through multiple four-second intervals in the morning and then sit, almost unmoving, for the remaining seconds of your day, you may wind up with metabolic problems related to being sedentary, despite those earlier four-second spurts of motion.“In general, it’s going to be a good idea to get up and move around throughout the day,” he said, “and then sometimes, also, to move around in a way that is physically intense,” even if it lasts as little as four seconds.AdvertisementContinue reading the main story.

#masthead-section-label, #masthead-bar-one { generic viagra online for sale order viagra from canada display. None }The erectile dysfunction Outbreakerectile dysfunction treatment Updateserectile dysfunction Map and generic viagra online for sale CasesFAQ. Delta VariantDelta Variant MapRisks in SchoolAdvertisementContinue reading the main generic viagra online for sale storySupported byContinue reading the main storyAre Delta Symptoms Different?. We asked experts to describe the most prevalent symptoms they’re seeing right now among people with erectile dysfunction treatment.Credit...Mike Kai Chen for The New York TimesPublished Aug. 12, 2021Updated generic viagra online for sale Aug.

15, 2021, 12:51 generic viagra online for sale a.m. ET阅读简体中文版閱讀繁體中文版Leer en españolTwo years ago, a sneeze or a cough wouldn’t have been cause for concern, but now even the mildest of symptoms can leave us wondering, “Do I have erectile dysfunction treatment?. €Early in the viagra, we learned about the hallmark signs of , generic viagra online for sale which can include loss of taste and smell, fever, cough, shortness of breath and fatigue. But what about now, more than a year generic viagra online for sale later?. Have symptoms changed given that the Delta variant is currently the most common form of the viagra in the United States?.

There is little data on this question and much left to untangle.Unvaccinated patients make up the vast majority of those generic viagra online for sale hospitalized with erectile dysfunction treatment, so they may be more likely to develop severe symptoms, like trouble breathing, or persistent pain or pressure in the chest. In areas with lower vaccination rates, like Louisiana, Texas and Arkansas, unvaccinated children and young adults are being sent to the hospital in larger numbers than they were at other generic viagra online for sale points during the viagra. Researchers do not yet know for sure whether Delta alone is responsible for these severe symptoms or if it is the surge in childhood s, which can result in more hospitalizations. The Delta variant is generic viagra online for sale nearly twice as contagious as prior variants and just as contagious as chickenpox. It replicates rapidly in the body, and people carry large amounts of the viagra in their nose and generic viagra online for sale throat.Dr.

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€œWe are still seeing people presenting with a cough, but we are also seeing a higher prevalence of things like runny nose and sneezing.” Headaches and sore throat are other top complaints, he added generic viagra online for sale. Fever and loss of taste and smell are being reported to a lesser degree.The erectile dysfunction Outbreak ›Latest UpdatesUpdated Aug. 14, 2021, generic viagra online for sale 4:41 p.m. ETTexas takes its ban on school mask mandates to the state Supreme Court.Children are particularly likely to die from erectile dysfunction treatment in Indonesia generic viagra online for sale. One big reason is poverty.The U.S.

Is preparing a plan to offer treatment boosters generic viagra online for sale as early as fall.Dr. Chan said the researchers started to see milder reported symptoms around the time the Delta variant became prevalent in Britain, starting in the late spring, which also coincided with the country’s mass vaccination program.Pediatricians in New York City, where 67 percent of adults are fully vaccinated, say they are seeing many of the same symptoms in children that they have seen since the start of the viagra, and that the more severe cases tend to be among unvaccinated adolescents, especially those with underlying conditions like generic viagra online for sale diabetes or obesity. Some toddlers or school-age children can get very ill from erectile dysfunction treatment too, but doctors don’t always know why one kid gets much sicker than another, said Dr. Sallie Permar, pediatrician-in-chief at NewYork-Presbyterian and Weill Cornell Medicine.Fever, cough, fatigue, headache and sore throat are the “classic presentation of erectile dysfunction treatment” among symptomatic children, she added.If your child has any potential erectile dysfunction treatment symptoms, including gastrointestinal problems, arrange for both yourself and your child to get a erectile dysfunction generic viagra online for sale test and then stay home until the results are negative, said Dr. Adam Ratner, director of the division of pediatric generic viagra online for sale infectious diseases at Hassenfeld Children’s Hospital at N.Y.U.

Langone.“That’s part of how we keep schools safe,” he added.Testing is essential for adults too, the experts said. Even if you generic viagra online for sale have been vaccinated and your symptoms are mild, it’s best to get tested. The Centers for Disease Control and Prevention believes that vaccinated generic viagra online for sale people can still transmit the viagra to others.“It’s a time to be humble about the fact that this is a new variant. We’re still learning,” generic viagra online for sale said Dr. Mark Mulligan, the director of the N.Y.U.

Langone treatment generic viagra online for sale Center and the chief of infectious diseases at N.Y.U. Langone Health generic viagra online for sale. €œBe cautious and err on the side of caution in terms of going ahead and getting a test.”AdvertisementContinue reading the main storyAdvertisementContinue reading the main storySupported byContinue reading the main storyPhys EdExercise Vigorously for 4 Seconds. Repeat. Your Muscles May Thank You.High-intensity interval training has surprising benefits for fitness and physical power, but don’t stay seated the rest of the day.Credit...:Todd Heisler/The New York TimesPublished Aug.

11, 2021Updated Aug. 12, 2021A mere four seconds of all-out exercise, repeated two or three dozen times, could be all many of us need to build and maintain our fitness, strength and physical power, according to an inspiring new study of the potency of super-quick workouts. The findings expand on other, recent studies showing that four-second interval workouts beneficially affect metabolism and muscles in adults of various ages. But they may also highlight new concerns about what we miss if we make our workouts too brief.Almost anyone with even a passing interest in exercise and health has heard by now of high-intensity interval training, or HIIT, a topic I have covered frequently in this column. A typical HIIT workout involves repeated, short bursts of arduous effort, known as intervals, interspersed with rest periods.For generations, athletes interval trained to amp their speed and performance.

But for most of us, HIIT’s primary allure is its brevity. In past studies, workouts with intense intervals ranging in length from four minutes or even less improved aspects of health and fitness to the same or a greater extent than much longer sessions of continuous, gentler exercise, like jogging or walking. For HIIT fans, the high-intensity workouts often represent their primary or only form of exercise.The ideal length of the individual intervals remains uncertain, though. Most exercise scientists agree an interval should strenuously stimulate and pressure our hearts, lungs and muscles, prompting them to remodel themselves in beneficial ways. But such intense workouts should not be so draining we cannot finish the intervals or wish afterward never to work out again.

Each interval should be, in essence, as grueling and as tolerable as possible.For Edward Coyle, a professor of kinesiology and health education at the University of Texas at Austin, that meant an interval sweet spot of about four seconds. He and his colleagues arrived at that eyeblink number after studying fit, professional athletes. During physiological testing at Dr. Coyle’s lab, the athletes generated titanic speed and power while pedaling specialized stationary bicycles that feature a heavy flywheel and no resistance. (Dr.

Coyle has equity in the company that manufactures the bicycles, but says his monetary involvement does not affect research results from his lab.)Within about two seconds of pedaling these unique bikes, the athletes reached an all-out, maximum level of aerobic effort and power output, Dr. Coyle and his colleagues found, an effort they could maintain briefly, but repeat often, with a few seconds of recovery time in between.The rest of us, not being fit professional athletes, might require more time to reach our maximum aerobic effort and power output during similar cycling intervals, Dr. Coyle reasoned. But even twice as long would only be four seconds.Could four-second intervals really provide enough exercise, though?. To try to find out, he and his colleagues set up a series of recent experiments.During the first study, published last year, they asked college students to complete five repetitions of four-second intervals on the specially designed bikes every hour throughout an eight-hour workday.

They found that the volunteers metabolized fat much better the following day than if they sat all day without exercising.Similarly, a broader, longer-term study involving out-of-shape, older adults showed that regular, four-second interval workouts, during which volunteers repeated the tiny but intense intervals on the bikes at least 15 times per session, significantly raised their aerobic fitness and leg muscle mass after eight weeks.But whether four-second interval workouts meaningfully would improve fitness and muscular power in people who started off in good shape was not yet clear. So, for the new study, which was published in July in Medicine &. Science in Sports &. Exercise, Dr. Coyle and his colleagues persuaded 11 healthy, active young men and women to come to the lab and push themselves through 30 repetitions of the four-second, all-out efforts on the bikes, with at least 15 seconds of rest in between.

The volunteers completed three sessions of these intervals each week for eight weeks, for a total of 48 minutes of exercise over the two months. They did not otherwise exercise during this time. In that time, they added 13 percent to a crucial aerobic fitness measure and 17 percent to their muscular power, measured by how many watts they produced while pedaling the bike, the researchers found.These results suggest that a few seconds of strenuous effort “definitely provide enough stimulus” to bolster already-robust hearts and muscles, Dr. Coyle said. In practice, he continued, this might mean repeatedly sprinting uphill for four seconds at a time or taking stairs two or three at a time in four-second spurts.The study’s implications also are cautionary, though, he pointed out.

Other research, including his earlier study with students, suggests that being sedentary for long periods could have damaging effects on metabolic health, undermining the benefits from high-intensity workouts. So, if you rip through multiple four-second intervals in the morning and then sit, almost unmoving, for the remaining seconds of your day, you may wind up with metabolic problems related to being sedentary, despite those earlier four-second spurts of motion.“In general, it’s going to be a good idea to get up and move around throughout the day,” he said, “and then sometimes, also, to move around in a way that is physically intense,” even if it lasts as little as four seconds.AdvertisementContinue reading the main story.

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