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This primer is designed to help researchers, data scientists, and others who analyze health care claims or administrative data (herein referred to as Ã¢ÂÂclaimsÃ¢ÂÂ) quickly join the effort to better understand, track, and contain erectile dysfunction treatment. Readers can use this guidance viagra 100mg cost to help them assess data on health care use and costs linked to erectile dysfunction treatment, create models for risk identification, and pinpoint complications that may follow a erectile dysfunction treatment diagnosis. Related NewsNew findings published this month in two prominent journals provide insight into the characteristics and performance of health systems using the latest data from the Compendium of U.S. Health Systems, created by Mathematica for the Agency for Healthcare Research and Quality (AHRQ).Mathematica and AHRQ researchers reported in Health Affairs that there was substantial consolidation of physicians and hospitals into vertically integrated health systems from 2016 to 2018. This resulted in more than half of physicians and 72 percent of hospitals being affiliated with one of the 637 viagra 100mg cost health systems in the United States.

Among systems operating in both 2016 and 2018 years, the median number of physicians increased by 29 percent, from 285 to 369. This has implications for cost, access, and quality of care.Although most research on health systems suggests that consolidation is associated with higher prices, a new article published in Health Services Research suggests that vertically integrated health systems might provide greater value under payment models that provide incentives to improve value. In this study, the authors found lower costs and similar quality scores from system hospitals compared with non-system hospitals that were participating in MedicareÃ¢ÂÂs Comprehensive Care viagra 100mg cost for Joint Replacement, a mandatory episode payment model.These studies were conducted by researchers at Mathematica, which leads AHRQÃ¢ÂÂs Coordinating Center for Comparative Health System Performance. This initiative seeks to understand the factors that affect health systemsÃ¢ÂÂ use of patient-centered outcomes research in delivering care. Learn more about the Comparative Health System Performance Initiative..

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Start Preamble Federal Buy amoxil pill Transit Administration (FTA), bob dole viagra DOT. Notice of funding opportunity. The erectile dysfunction Disease bob dole viagra 2019 (erectile dysfunction treatment) public health emergency Start Printed Page 63654has had a significant impact on transit operations. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of erectile dysfunction treatment. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the erectile dysfunction treatment public health emergency.

Demonstration grants under this NOFO are bob dole viagra authorized under FTA's Public Transportation Innovation Program (49 U.S.C. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis bob dole viagra. (2) exposure mitigation measures.

(3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit services bob dole viagra. The total funding available for awards under this NOFO is $10,000,000. FTA may supplement this amount if bob dole viagra additional funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV Ã¢ÂÂAPPLYÃ¢ÂÂ function by 11:59 p.m.

Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure they can bob dole viagra complete the application process before the submission deadline. Application instructions are available on FTA's website at http://transit.dot.gov/Ã¢ÂÂhowtoapply and in the Ã¢ÂÂFINDÃ¢ÂÂ module of GRANTS.GOV. FTA will not accept mail and fax submissions. Start Further Info Please send any questions on bob dole viagra this notice to Jamel El-Hamri email.

Jamel.El-Hamri@dot.gov phone. 2020-366-8985. A Telecommunication Device bob dole viagra for the Deaf (TDD) is available for individuals who are deaf or hard of hearing at 1-800-877-8339. End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description bob dole viagra B.

Federal Award Information C. Eligibility Information D. Application and Submission Information bob dole viagra E. Application Review Information F. Federal Award Administration Information G.

Federal Awarding Agency Contact Information A bob dole viagra. Program Description The Public Transportation erectile dysfunction treatment Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the erectile dysfunction treatment public health emergency. Eligible projects will propose to develop and deploy innovative solutions bob dole viagra in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis.

(2) exposure bob dole viagra mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit. As required by bob dole viagra 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects.

B. Federal Award Information FTA makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation Program (49 bob dole viagra U.S.C. 5312) to finance the Public Transportation erectile dysfunction treatment Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant bob dole viagra pre-award authority starting on the date of the project award announcement for selected projects and should be completed within 24 months from the date of award.

Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information (1) Eligible Applicants Eligible applicants include State and local bob dole viagra governmental authorities, direct recipients of Urbanized Area (49 U.S.C. 5307) and Rural Area (49 U.S.C. 5311) formula funds, and Indian tribes bob dole viagra.

Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developedÃ¢ÂÂtypically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants also may submit consolidated proposals for projects in urbanized areas bob dole viagra. The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients.

Eligible subrecipients bob dole viagra include public agencies, private nonprofit organizations, and private providers engaged in public transportation. Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may give additional consideration bob dole viagra to applicants that propose a local share and may view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application.

For any applicants proposing match, eligible local match sources include the bob dole viagra following. Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated from value capture bob dole viagra financing mechanisms. Funds from an undistributed cash surplus.

Replacement or depreciation cash fund or reserve. New capital bob dole viagra. Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, bob dole viagra equipment and infrastructure cleaning and dis.

Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems bob dole viagra such as contactless payments. And measures that strengthen public confidence in transit. Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted bob dole viagra through GRANTS.GOV.

Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/Ã¢ÂÂhowtoapply, along with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted. (2) Content and Form of Application Submission bob dole viagra a. Proposal Submission A complete proposal submission consists of at least two forms. 1.

The SF-424 Mandatory Form (downloadable from GRANTS.GOV) bob dole viagra and 2. The supplemental form for the FY 2020 erectile dysfunction treatment Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA erectile dysfunction treatment Demonstration Program). The application must include responses to all sections of the SF-424 mandatory bob dole viagra form and the supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice. FTA will accept only one supplemental form per SF-424 submission.

FTA encourages applicants to consider submitting a single supplemental form that includes bob dole viagra multiple activities to be evaluated as a consolidated proposal. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed. Information such as applicant name, Federal amount requested, local match amount, description of areas served, etc., may be requested in varying bob dole viagra degrees of detail on both the SF-424 form and supplemental form. Applicants must fill in all fields unless stated otherwise on the forms.

If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should use both the Ã¢ÂÂCheck bob dole viagra Package for ErrorsÃ¢ÂÂ and the Ã¢ÂÂValidate FormÃ¢ÂÂ validation buttons on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent. Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S bob dole viagra.

Initiative, the Department encourages applicants to consider how the project will address the challenges faced by rural areas. B. Application Content The SF-424 Mandatory Form and the supplemental form will prompt applicants for the required information, including. I. Applicant Name ii.

Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number iii. Key contact information (contact name, address, email address, and phone number) iv. Congressional district(s) where project will take place v. Project Information (title, executive summary, and type) vi. A detailed description of the need for the project vii.

A detailed description of how the project will support the Program objectives viii. Evidence that the applicant can provide the local cost shares ix. A description of the technical, legal, and financial capacity of the applicant x. A detailed project budget xi. Details on the local matching funds xii.

A detailed project timeline xiii. Whether the project impacts an Opportunity Zone (3) Unique Entity Identifier and System for Award Management (SAM) Each applicant is required to. (1) Be registered in SAM before submitting an application. (2) provide a valid unique entity identifier in its application. And (3) continue to maintain an active SAM registration with current information at all times during which the applicant has an active Federal award or an application or plan under consideration by FTA.

These requirements do not apply if the applicant. (1) Is excepted from the requirements under 2 CFR 25.110(b) or (c). Or (2) has an exception approved by FTA under 2 CFR 25.110(d). FTA may not make an award until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time FTA is ready to make an award, FTA may determine that the applicant is not qualified to receive an award and use that determination as a basis for making a Federal award to another applicant.

All applicants must provide a unique entity identifier provided by SAM. Registration in SAM may take as little as 3-5 business days, but there can be unexpected steps or delays. For example, the applicant may need to obtain an Employer Identification Number. FTA recommends allowing ample time, up to several weeks, to complete all steps. For additional information on obtaining a unique entity identifier, please visit www.sam.gov.

(4) Submission Dates and Times Project proposals must be submitted electronically through GRANTS.GOV by 11:59 p.m. Eastern on November 2, 2020. Mail and fax submissions will not be accepted. FTA urges applicants to submit applications at least 72 hours prior to the due date to allow time to correct any problems that may have caused either GRANTS.GOV or FTA systems to reject the submission. Proposals submitted after the deadline will only be considered under extraordinary circumstances not within the applicant's control.

Deadlines will not be extended due to scheduled website maintenance. GRANTS.GOV scheduled maintenance and outage times are announced on the GRANTS.GOV website. Within 48 hours after submitting an electronic application, the applicant should receive two email messages from GRANTS.GOV. (1) Confirmation of successful transmission to GRANTS.GOV. And (2) confirmation of successful validation by GRANTS.GOV.

If the applicant does not receive confirmation of successful validation or receives a notice of failed validation or incomplete materials, the applicant must address the reason for the failed validation, as described in the email notice, and resubmit before the submission deadline. If making a resubmission for any reason, applicants must include all original attachments regardless of which attachments were updated and check the box on the supplemental form indicating this is a resubmission. Applicants are encouraged to begin the process of registration on the GRANTS.GOV site well in advance of the submission deadline. Registration is Start Printed Page 63656a multi-step process, which may take several weeks to complete before an application can be submitted. Registered applicants may still be required to update their registration before submitting an application.

Registration in SAM is renewed annually and persons making submissions on behalf of the Authorized Organization Representative (AOR) must be authorized in GRANTS.GOV by the AOR to make submissions. (5) Funding Restrictions Funds may be used for post-award expenditures only. Funds under this NOFO cannot be used to reimburse projects for otherwise eligible expenses incurred prior to the date of project award announcements. (6) Other Submission Requirements FTA encourages applicants to identify scaled funding options in case insufficient funding is available to fund a project at the full requested amount. If an applicant indicates that a project is scalable, the applicant must provide an appropriate minimum funding amount that will fund an eligible project that achieves the objectives of the program and meets all relevant program requirements.

The applicant must provide a clear explanation of how a reduced award would affect the project budget and scope. FTA may award a lesser amount whether or not the applicant provides a scalable option. E. Application Review Information (1) Project Evaluation Criteria Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with the R.O.U.T.E.S.

Initiative, the Department will consider how the project will address the challenges faced by rural areas. In addition, the Department will review and consider applications for funding pursuant to this Notice in accordance with the President's September 2, 2020 memorandum, entitled Memorandum on Reviewing Funding to State and Local Government Recipients of Federal Funds that Are Permitting Anarchy, Violence, and Destruction in American Cities, consistent with guidance from the Office of Management and Budget and the Attorney General and with all applicable laws. FTA will evaluate proposals submitted according to the following criteria. (a) Project Innovation and Impact. (b) Project Approach.

(c) National Applicability. (d) Commercialization and/or Knowledge Transfer. And (e) Technical, Legal and Financial Capacity. FTA encourages each applicant to demonstrate how a project supports all criteria with the most relevant information the applicant can provide, regardless of whether such information has been specifically requested or identified in this notice. A.

Project Innovation and Impact i. Effectiveness of the project in achieving and demonstrating the specific objectives of this program. Ii. Demonstration of benefits in addressing the needs of the transit agency and industry and impacts to infrastructure, equipment, transit workforce, and riders. Iii.

Degree of improvement over current and existing technologies, designs, and/or practices applicable to the transit industry. B. Project Approach i. Quality of the project approach such as existing partnerships, collaboration strategies and level of commitment of the project partners. Ii.

Proposal is realistic in its approach to fulfill the milestones/deliverables, schedule and goals. C. National Applicability i. Degree to which the project could be replicated by other transit agencies regionally or nationally. Ii.

Ability to evaluate technologies, designs and/or practices in a wide variety of conditions and locales. Iii. Degree to which the technology, designs and/or practices can be replicated by other transportation modes. D. Commercialization and/or Knowledge Transfer i.

Demonstrates a realistic plan for moving the results of the project into the transit marketplace (patents, conferences, articles in trade magazines, webinar, site visits, etc.). Ii. How the project team plans to work with the industry on improving best practices, guidance and/or standards, if applicable. Iii. Demonstrate a clear understanding and robust approach to data collection, access and management.

E. Technical, Legal and Financial Capacity Capacity of the applicant and any partners to successfully execute the project effort. There should be no outstanding legal, technical, or financial issues with the applicant that would make this a high-risk project. (2) Review and Selection Process An FTA technical evaluation committee will evaluate proposals based on the published project evaluation criteria. Members of the technical evaluation committee will rate the applications and may seek clarification about any statement in an application.

The FTA Administrator will determine the final selection and amount of funding for each project after consideration of the findings of the technical evaluation committee. Geographic diversity, diversity of the project type, the amount of local match to be provided, and the applicant's receipt and management of other Federal transit funds may be considered in FTA's award decisions. Prior fare payment innovation efforts may receive priority consideration. The FTA Administrator will consider the following key DOT objectives. A.

Utilizing alternative funding sources and innovative financing models to attract non-Federal sources of investment. B. Whether the project is located in or supports public transportation service in a qualified opportunity zone designated pursuant to 26.U.S.C. 1400Z-1. And c.

The extent to which the project addresses challenges specific to the provision of rural public transportation. (3) FAPIIS Review Prior to making a grant award, FTA is required to review and consider any information about the applicant that is in the Federal Awardee Performance and Integrity Information System (FAPIIS) accessible through SAM. An applicant may review and comment on information about itself that a Federal awarding agency previously entered. FTA will consider any comments by the applicant, in addition to the other information in FAPIIS, in making a judgment about the applicant's integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.205 Federal Awarding Agency Review of Risk Posed by Applicants. F.

Federal Award Administration Information (1) Federal Award Notices FTA will announce the final project selections on the FTA website. Project recipients should contact their FTA Regional Office for additional information regarding allocations for Start Printed Page 63657projects. At the time project selections are announced, FTA will extend pre-award authority for the selected projects. There is no blanket pre-award authority for these projects before announcement. There is no minimum or maximum grant award amount, but FTA intends to fund as many meritorious projects as possible.

FTA only will consider proposals from eligible recipients for eligible activities. Due to funding limitations, projects selected for funding may receive less than the amount originally requested. In those cases, applicants must be able to demonstrate that the proposed projects are still viable and can be completed with the amount awarded. (2) Administrative and National Policy Requirements a. Pre-Award Authority FTA will issue specific guidance to recipients regarding pre-award authority at the time of selection.

FTA does not provide pre-award authority for competitive funds until projects are selected, and there are Federal requirements that must be met before costs are incurred. For more information about FTA's policy on pre-award authority, see the FY 2020 Apportionments Notice published on June 3, 2020, at https://www.govinfo.gov/Ã¢ÂÂcontent/Ã¢ÂÂpkg/Ã¢ÂÂFR-2020-06-03/Ã¢ÂÂpdf/Ã¢ÂÂ2020-11946.pdf. b. Grant Requirements Selected applicants will submit a grant application through FTA's electronic grant management system and adhere to the customary FTA grant requirements for research project (insert Circular name). All competitive grants, regardless of award amount, will be subject to the Congressional notification and release process.

FTA emphasizes that third-party procurement applies to all funding awards, as described in FTA Circular 4220.1F, Ã¢ÂÂThird Party Contracting Guidance.Ã¢ÂÂ However, FTA may approve applications that include a specifically identified partnering organization(s) (2 CFR 200.302(f)). When included, the application, budget, and budget narrative should provide a clear understanding of how the selection of these organizations is critical for the project and give sufficient detail about the costs involved. C. Planning FTA encourages applicants to engage the appropriate State Departments of Transportation, Regional Transportation Planning Organizations, or Metropolitan Planning Organizations in areas to be served by the project funds available under this program. D.

Standard Assurances The applicant assures that it will comply with all applicable Federal statutes, regulations, executive orders, FTA circulars, and other Federal administrative requirements in carrying out any project supported by the FTA grant. The applicant acknowledges that it is under a continuing obligation to comply with the terms and conditions of the grant agreement issued for its project with FTA. The applicant understands that Federal laws, regulations, policies, and administrative practices might be modified from time to time and may affect the implementation of the project. The applicant agrees that the most recent Federal requirements will apply to the project unless FTA issues a written determination otherwise. The applicant must submit the Certifications and Assurances before receiving a grant if it does not have current certifications on file.

E. Free Speech and Religious Liberty In connection with any program or activity conducted with or benefiting from funds awarded under this notice, recipients of funds must comply with all applicable requirements of Federal law, including, without limitation, the Constitution of the United States. Statutory, regulatory, and public policy requirements, including without limitation, those protecting free speech, religious liberty, public welfare, the environment, and prohibiting discrimination. The conditions of performance, non-discrimination requirements, and other assurances made applicable to the award of funds in accordance with regulations of the Department of Transportation. And applicable Federal financial assistance and contracting principles promulgated by the Office of Management and Budget.

In complying with these requirements, recipients must ensure that no concession agreements are denied or other contracting decisions made on the basis of speech or other activities protected by the First Amendment. If the Department determines that a recipient has failed to comply with applicable Federal requirements, the Department may terminate the award of funds and disallow previously incurred costs, requiring the recipient to reimburse any expended award funds. (3) Reporting The post-award reporting requirements include submission of the Federal Financial Report (FFR) and Milestone Progress Report in TrAMS. An evaluation of the grant will occur at various points in the demonstration process and at the end of the project. In addition, FTA is responsible for producing an Annual Report to Congress that compiles evaluation of selected projects, including an evaluation of the performance measures identified by the applicants.

All applicants must develop an evaluation plan to measure the success or failure of their projects and describe any plans for broad-based implementation of successful projects. FTA may request data and reports to support the evaluation and Annual Report. A. Independent Evaluation To achieve a comprehensive understanding of the impacts and implications of each proposed erectile dysfunction treatment Research Demonstration Program, projects funded under this announcement will require the recipient to conduct a third party independent evaluation of their project. Recipients will be required to contract with a third party independent evaluator to assist in developing an evaluation plan, and collecting, storing and managing data required to fulfill the evaluation requirement.

No more than 10 percent of the Federal share of the project may be used to hire the third-party independent evaluator and the inclusion of a third-party independent evaluation should be described in the grant application. If the project duration is more than two years, an interim evaluation report would need to be submitted to FTA, otherwise the evaluation report should be included as part of the final project report. B. erectile dysfunction treatment Research Demonstration Grant Program Evaluation Projects funded under this announcement will be required to establish a set of performance metrics set by the third-party independent evaluator and shared with FTA. G.

Federal Awarding Agency Contacts Information For questions about applying, please contact Jamel El-Hamri email. Jamel.El-Hamri@dot.gov phone. 202-366-8985. A TDD is available at 1-800-877-8339 (TDDFIRS). To ensure that applicants receive accurate information about eligibility or the program, applicants are encouraged to contact FTA directly with questions, rather than through intermediaries or third parties.Start Printed Page 63658 FTA staff also may conduct briefings on the competitive grants selection and award process upon request.

Start Signature K. Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20. 8:45 am]BILLING CODE 4910-57-P.

Start Preamble website here Federal Transit Administration (FTA), DOT viagra 100mg cost. Notice of funding opportunity. The erectile dysfunction Disease 2019 (erectile dysfunction treatment) public health emergency Start Printed Page 63654has had a significant impact viagra 100mg cost on transit operations. During a series of FTA listening sessions held over the last three months, transit agencies asked FTA to support research to identify solutions to address the operational challenges that they are facing as a result of erectile dysfunction treatment. In response, FTA makes available through this Notice of Funding Opportunity (NOFO) funding to support research demonstration grants to public transit agencies to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the erectile dysfunction treatment public health emergency.

Demonstration grants under this NOFO are authorized under FTA's Public Transportation Innovation Program (49 viagra 100mg cost U.S.C. 5312). Eligible projects will demonstrate innovative solutions to improve the operational efficiencies of transit systems and enhance mobility for their communities in four major areas. (1) Vehicle, viagra 100mg cost facility, equipment and infrastructure cleaning and dis. (2) exposure mitigation measures.

(3) innovative mobility such as contactless payments. And (4) measures that viagra 100mg cost strengthen public confidence in transit services. The total funding available for awards under this NOFO is $10,000,000. FTA may supplement this amount if additional viagra 100mg cost funding becomes available. Applicants must submit completed proposals for funding opportunity FTA-2020-015-TRI through the GRANTS.GOV Ã¢ÂÂAPPLYÃ¢ÂÂ function by 11:59 p.m.

Eastern Time on November 2, 2020. Prospective applicants should register as soon as possible on the GRANTS.GOV website to ensure viagra 100mg cost they can complete the application process before the submission deadline. Application instructions are available on FTA's website at http://transit.dot.gov/Ã¢ÂÂhowtoapply and in the Ã¢ÂÂFINDÃ¢ÂÂ module of GRANTS.GOV. FTA will not accept mail and fax submissions. Start Further Info Please send any questions viagra 100mg cost on this notice to Jamel El-Hamri email.

Jamel.El-Hamri@dot.gov phone. 2020-366-8985. A Telecommunication Device for the Deaf (TDD) is available for individuals who are deaf or hard of hearing at 1-800-877-8339 viagra 100mg cost. End Further Info End Preamble Start Supplemental Information Table of Contents A. Program Description viagra 100mg cost B.

Federal Award Information C. Eligibility Information D. Application and Submission viagra 100mg cost Information E. Application Review Information F. Federal Award Administration Information G.

Federal Awarding viagra 100mg cost Agency Contact Information A. Program Description The Public Transportation erectile dysfunction treatment Research Demonstration Grant Program is funded through the Public Transportation Innovation Program (49 U.S.C. 5312), with the goal to develop, deploy, and demonstrate innovative solutions that improve the operational efficiency of transit agencies, as well as enhance the mobility of transit users affected by the erectile dysfunction treatment public health emergency. Eligible projects will propose to develop and viagra 100mg cost deploy innovative solutions in four major areas. (1) Vehicle, facility, equipment and infrastructure cleaning and dis.

(2) exposure viagra 100mg cost mitigation measures. (3) innovative mobility such as contactless payments. And (4) measures that strengthen public confidence in transit. As required viagra 100mg cost by 49 U.S.C. 5312(e)(4), projects funded under this NOFO must participate in an evaluation by an independent outside entity that will conduct a comprehensive evaluation of the success or failure of the projects funded under this subsection and any plan for broad-based implementation of the innovation promoted by successful projects.

B. Federal Award Information FTA viagra 100mg cost makes available $10,000,000 in fiscal year (FY) 2020 funds under the Public Transportation Innovation Program (49 U.S.C. 5312) to finance the Public Transportation erectile dysfunction treatment Research Demonstration Grant Program. FTA may supplement the total funds available if additional funding becomes available at the time project selections are made. FTA will grant pre-award authority starting on the date of the project award announcement for selected projects and should be completed within 24 months from the viagra 100mg cost date of award.

Funds are available only for eligible expenses incurred after the announcement of project selections. C. Eligibility Information (1) Eligible Applicants Eligible applicants include State and local viagra 100mg cost governmental authorities, direct recipients of Urbanized Area (49 U.S.C. 5307) and Rural Area (49 U.S.C. 5311) formula funds, viagra 100mg cost and Indian tribes.

Eligible applicants are limited to FTA grantees or subrecipients who would be the primary beneficiaries of the innovative products and services that are developedÃ¢ÂÂtypically public transit agencies. Except for projects proposed by Indian tribes, proposals for projects in rural (non-urbanized) areas must be submitted as part of a consolidated State proposal. States and other eligible applicants viagra 100mg cost also may submit consolidated proposals for projects in urbanized areas. The submission of the Statewide application will not preclude the submission and consideration of any application from other eligible recipients in an urbanized area in a State. Proposals may contain projects to be implemented by the recipient or its subrecipients.

Eligible subrecipients include public agencies, private nonprofit organizations, and private providers viagra 100mg cost engaged in public transportation. Eligible applicants may submit consolidated proposals for projects. (2) Cost Sharing or Matching The maximum Federal share of project costs is 100 percent. FTA may give additional consideration to applicants that propose a local share and may viagra 100mg cost view these applicants as more competitive. The applicant must document the source(s) of the local match, if any, in the grant application.

For any applicants proposing match, eligible viagra 100mg cost local match sources include the following. Cash from non-Government sources other than revenues from providing public transportation services. Revenues derived from the sale of advertising and concessions. Revenues generated viagra 100mg cost from value capture financing mechanisms. Funds from an undistributed cash surplus.

Replacement or depreciation cash fund or reserve. New capital viagra 100mg cost. Or in-kind contributions. (3) Eligible Projects Eligible projects will propose innovative solutions to improve operational efficiencies of transit agencies and enhance the mobility of transit users, through projects that demonstrate innovative solutions for. Vehicle, facility, equipment and infrastructure cleaning viagra 100mg cost and dis.

Exposure mitigation measures such a real-time notification of rail and bus passenger loads. New multi-modal payment innovative mobility systems such as viagra 100mg cost contactless payments. And measures that strengthen public confidence in transit. Each applicant may only submit one proposal.Start Printed Page 63655 D. Application and Submission Information (1) Address and Form of Application Submission Applications must be submitted through GRANTS.GOV viagra 100mg cost.

Applicants can find general information for submitting applications through GRANTS.GOV at www.fta.dot.gov/Ã¢ÂÂhowtoapply, along with specific instructions for the forms and attachments required for submission. Mail and fax submissions will not be accepted. (2) Content viagra 100mg cost and Form of Application Submission a. Proposal Submission A complete proposal submission consists of at least two forms. 1.

The SF-424 viagra 100mg cost Mandatory Form (downloadable from GRANTS.GOV) and 2. The supplemental form for the FY 2020 erectile dysfunction treatment Demonstration Program (downloadable from GRANTS.GOV), which is available on FTA's website at (placeholder for FTA erectile dysfunction treatment Demonstration Program). The application must include responses to all sections of the SF-424 mandatory form and the viagra 100mg cost supplemental form unless a section is indicated as optional. FTA will use the information on the supplemental form to determine applicant and project eligibility for the program and to evaluate the proposal against the selection criteria described in part E of this notice. FTA will accept only one supplemental form per SF-424 submission.

FTA encourages applicants to consider submitting a single supplemental form that includes multiple activities to be evaluated as a consolidated proposal viagra 100mg cost. Applicants may attach additional supporting information to the SF-424 submission, including but not limited to letters of support, project budgets, or excerpts from relevant planning documents. Supporting documentation must be described and referenced by file name in the appropriate response section of the supplemental form, or it may not be reviewed. Information such as applicant name, Federal amount requested, viagra 100mg cost local match amount, description of areas served, etc., may be requested in varying degrees of detail on both the SF-424 form and supplemental form. Applicants must fill in all fields unless stated otherwise on the forms.

If applicants copy information into the supplemental form from another source, they should verify that the supplemental form has fully captured pasted text and that it has not truncated the text due to character limits built into the form. Applicants should use both the Ã¢ÂÂCheck Package for ErrorsÃ¢ÂÂ and the Ã¢ÂÂValidate FormÃ¢ÂÂ viagra 100mg cost validation buttons on both forms to check all required fields. Applicants should also ensure that the Federal and local amounts specified are consistent. Addressing the deteriorating conditions and disproportionately high fatality rates on our rural transportation infrastructure is of critical interest to the Department, as rural transportation networks face unique challenges in safety, infrastructure condition, and passenger and freight usage. Consistent with viagra 100mg cost the R.O.U.T.E.S.

Start Signature K. Jane Williams, Deputy Administrator. End Signature End Supplemental Information [FR Doc. 2020-22316 Filed 10-7-20. 8:45 am]BILLING CODE 4910-57-P.

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Viagra vs cialis forum

Erik Gerritsen departed from his role as secretary-general of the Dutch Ministry of Health, Welfare and viagra vs cialis forum Buy flagyl pill Sport on 1 June 2021, after six years in the role. Described by his peers as the 'ambassador' of digitisation in the healthcare sector, Gerritsen has overseen various social and healthcare digital implementations during his term. He is set to start a new role as the chairman of the board of the Ymere housing corporation, one of the largest and oldest housing associations in viagra vs cialis forum the Netherlands, where he aims to continue delivering his social mission of improving the lives of vulnerable groups. During this transitional period, he spoke to Healthcare IT News about the ambitions of the Ministry of Health, the digital health strategies he has admired in other regions, and words of advice for other nations at the beginning their digital health journey.This interview has been edited for length and clarity. HITN.

Can you talk us through the viagra vs cialis forum ambitions of the MoH and how it has delivered on these aims?. Gerritsen. In the Netherlands, it always starts with a why viagra vs cialis forum. So why do we have to do anything at all?. That's because if we think of ourselves as still being one of the best healthcare systems in the world, but if we keep doing the things as we always did, then we will move to a kind of big crisis, because we are one of the best healthcare systems, demand for care will grow because people get older and sicker.But they can still more and more live with these chronic illnesses.

In the labour market, there are growing shortages of labour, and also viagra vs cialis forum the number of informal caretakers is going down. So, that's the big challenge we face.The good news is, there's a way out of it, we can transform and innovate out of this. We call this the right care at viagra vs cialis forum the right place. Also, the right data in the right format, for the right person too.We have to put more emphasis on prevention and lifestyle. Digital possibilities are just waiting to be used.

So you have this urgency, and viagra vs cialis forum this vision of right care at the right place. The possibilities of digital technology play a very important role in implementing this new vision.If you look at this vision, we call it cold technology to deliver warm care. It's the same everywhere in viagra vs cialis forum the world. In the Netherlands, there's a big consensus that this is the way forward. So that's good news.

If you travel around in the Netherlands, you see all those things already in pilots already implemented viagra vs cialis forum with success. But the big challenge is scaling up.As I said, in one of my HIMSS Europe keynotes, the devil is in the implementation. There is viagra vs cialis forum no lack of vision strategy. We know from practice-based evidence that things are working with happy doctors, happy nurses, happy caretakers, happy patients. However, the scale is still not a national scale or, or even an international scale.

So it's viagra vs cialis forum the implementation. In essence, we developed a policy in the Netherlands aimed at this, we call it a flourishing health ecosystem. For this, you need two things, you need a positive climate and fertile ground."We have to put more emphasis on prevention and lifestyle. Digital possibilities are just waiting viagra vs cialis forum to be used."For the positive climate part, we as a government took the role as a convening power, making health deals when everybody wants to change, but they're pointing it towards each other. We put the whole system in the room and helped them jump together.HITN.

How has the viagra vs cialis forum focus of the Netherlands transformed during the viagra?. Gerritsen. We did a lot of skill development. We had the health innovation school that started on a national scale, and brings together all the innovators from the hospitals, the pharmacies, the primary caretakers, the general practitioners and viagra vs cialis forum long-term care.We are working on making learning communities. We work on removing obstacles, when they say we want to innovate but we cannot get paid for it, then we made that happen.

Of course, we increased the subsidies to stimulate many of these developments.Of course erectile dysfunction treatment, viagra vs cialis forum made it all go faster. You can look at it from the point of view of, this is a bad crisis, never waste a bad crisis. I don't like the term never waste a good crisis, because it's a really bad crisis.Even if it's a bad crisis, don't let it go to waste, use the momentum to speed up the scaling up. On the viagra vs cialis forum other hand, you could say we should be a bit ashamed that we needed this crisis to make the acceleration happen.Then again, the good news is, because I'm an optimist and optimism is a moral duty issue. The good news, again, is that the same people, the same hospital governors, the same professionals, the same doctors, nurses, patients, politicians from municipalities that are facing challenges with implementation, are doing it because of the crisis.What we have to remember is that when the crisis is not there anymore, that the same people without any legislations or other big structural reforms, were able to innovate, to implement, to cooperate beyond their own domains.We also organised eHealth weeks and launched the Smart Care Relay.

We did a lot on making people conscious of all the viagra vs cialis forum good things that digital healthcare brings. The second pillar is about the fertile ground. If you have a good climate, you do a lot to make digital health grow and flourish. It can only grow and flourish if viagra vs cialis forum the ground is fertile. This is another way of saying we need interoperability."We did a lot of skill development.

We had the health innovation school that started on a national scale, and brings together all the innovators from the hospitals, the pharmacies, the primary caretakers, the general practitioners and long-term care."We need a good infrastructure that makes it possible that all the digital information systems can communicate with each other viagra vs cialis forum. This includes hospital systems, pharmacy systems, GP systems, but also with our programme MedMij. This has created a trust framework for personal health data that enable all the digital information to flow into the personal health environments so that the patient is the owner of the medical information that is available for him or her.We have this national health information council I chaired. The whole system in the room on viagra vs cialis forum a national basis, and we worked on making this thing happen partly on a voluntary basis, using a lot of temptation, tactics and using the positive intrinsic motivation, that's always there. We have many subsidy programmes aimed at freeing up the data from different silos.

And as a kind of a cherry on the cake, many people in the field told the ministry, this is viagra vs cialis forum all great and we love it when we do this on a voluntary basis. But still, it's so difficult because we have a lot of players, nobody has the authority to rule in this complicated healthcare system.We need a law that makes it mandatory for all the information systems to be interoperable. A few weeks ago, our Cabinet agreed on this law that made the digital exchange of information interoperability mandatory. It's been sent to the viagra vs cialis forum parliament. As far as I know, this is unique in the world, having a law that makes it part of the quality of care that doctors, hospitals, pharmacists, and general practitioners work with information systems that are interoperable with the other systems.

If a healthcare professional doesn't, then they don't have a complete picture of a patient. You are per definition not able to give the quality of care that is required and we can revoke your practicing license.In our country where we donÃ¢ÂÂt have these national health data exchange systems and the government has no viagra vs cialis forum direct authority, we used the ecosystem approach. The proposed law is a big step forward in this. We are proud of it viagra vs cialis forum. This is a long-term project.

In a few years, it will be made mandatory that these gold bars of medical information will have to be interoperable.HITN. Are there viagra vs cialis forum any digital health strategies you have admired in other countries?. Gerritsen. On the one hand, it's primarily about inspiration, because viagra vs cialis forum the other healthcare systems are so different. Then when you get inspired by great things other countries are doing such as in the Scandinavian and Nordic countries - they are a big example for us.

Also the Baltics, but sometimes also the United States or Australia or India and even sometimes, African countries because they are leapfrogging. There's an amazing amount of inspiration viagra vs cialis forum in other countries. On the other hand, you have to go through your own learning cycle and implementation cycle, feeding to the healthcare system that you're having in your country. Estonia has a truly amazing digital infrastructure viagra vs cialis forum. I love that digital identity card, for example.

Which by the way shows the importance of international standards. Finland is doing amazing things viagra vs cialis forum with health data for research and development."What we have to remember is that when the crisis is not there anymore, that the same people without any legislations or other big structural reforms, were able to innovate, to implement, to cooperate beyond their own domains."I've been to the US and seen what amazing things are developed and used there. Again, our main theme, when we were abroad, not only inspiring and getting inspired but also expanding our own agenda of interoperability. For interoperability, we need the US, we need Australia, viagra vs cialis forum we need India, and Europe - especially the countries where the big IT suppliers are because when the Netherlands itself is a mouse and you know when we stamp our feet, the elephant is not going to dance.I especially have warm feelings looking back on the cooperation. Also, making strides in interoperability has been facilitated by HIMSS many times, because this is not a national question.

This is not a European question. It's an international question.HITN viagra vs cialis forum. What are some words of advice you would give to other nations at the beginning of their healthcare digital transformation?. Gerritsen. I would say don't be viagra vs cialis forum too modest.

Just realise that when you're lagging behind, especially with digital healthcare, you are in an eminent position to leapfrog and show us our backs within maybe five or 10 years.I already saw great things, for example, in Kenya, where, because there are no hospitals, but they have 4G, and they have digital things. They can do a lot more online, with viagra vs cialis forum all the distance in ways that make me even a little bit jealous.If you're not there yet, if you still at the beginning, make sure that from the beginning you use the international standards, and also focus on interoperability. HITN. In your opinion, what are the best ways to create meaningful impact in healthcare systems?. Gerritsen.

It's about the implementation, it's about change management. It's not about the quality of the individual doctor or nurse, they're great already. It's not about vision, it's there in abundance. It's not about practical evidence, it's already there.It's this scaling thing. It's in a situation where there are a lot of players but nobody is boss.

Everybody's very busy with surviving and keeping their head above water because of the challenges not only from erectile dysfunction treatment but also those already present before erectile dysfunction treatment, and the lack of personnel.If you are either a professional, a patient, a director or minister, or a state secretary, you can work on simple principles. Think big, act small, start today. Do that every day and then after two years, you look back and notice you made huge progress. But that's only what you can do as a person."Just realise that when you're lagging behind, especially with digital healthcare, you are in an eminent position to leapfrog and show us our backs within maybe five or 10 years."Also, ask for help. Everybody that is remotely successful in healthcare already has the competence of taking care of himself or knowing how to get things done.

But the competence of asking for help is a bit underdeveloped. If you cannot do it alone, ask your colleagues, your friends and your network partners.The last one is also a very personal one because a lot of challenges do not just have one problem owner. Take responsibility for things you're not responsible for, without taking over responsibility. If everybody starts doing this, we'll be having a sustainable healthcare system within five years. Otherwise, it will take 10 or 15 years.Learn more about the Netherland's digital health strategy at the upcoming HIMSS21 European Digital Health Conference on 7-9 June 2021.

Click here to find out more information and register. The event is free of charge for employees of health and research institutions.Healthcare IT News is a HIMSS Media publication..

Erik Gerritsen departed from his role as secretary-general of the viagra 100mg cost Dutch Ministry of Health, Welfare and Sport on 1 June 2021, after six years in the role. Described by his peers as the 'ambassador' of digitisation in the healthcare sector, Gerritsen has overseen various social and healthcare digital implementations during his term. He is set to start a new role as viagra 100mg cost the chairman of the board of the Ymere housing corporation, one of the largest and oldest housing associations in the Netherlands, where he aims to continue delivering his social mission of improving the lives of vulnerable groups.

During this transitional period, he spoke to Healthcare IT News about the ambitions of the Ministry of Health, the digital health strategies he has admired in other regions, and words of advice for other nations at the beginning their digital health journey.This interview has been edited for length and clarity. HITN. Can you talk us through the ambitions of the MoH and how it viagra 100mg cost has delivered on these aims?.

Gerritsen. In the Netherlands, it always starts with viagra 100mg cost a why. So why do we have to do anything at all?.

That's because if we think of ourselves as still being one of the best healthcare systems in the world, but if we keep doing the things as we always did, then we will move to a kind of big crisis, because we are one of the best healthcare systems, demand for care will grow because people get older and sicker.But they can still more and more live with these chronic illnesses. In the labour market, there are growing shortages of labour, viagra 100mg cost and also the number of informal caretakers is going down. So, that's the big challenge we face.The good news is, there's a way out of it, we can transform and innovate out of this.

We call this the right care at viagra 100mg cost the right place. Also, the right data in the right format, for the right person too.We have to put more emphasis on prevention and lifestyle. Digital possibilities are just waiting to be used.

So you have this urgency, and viagra 100mg cost this vision of right care at the right place. The possibilities of digital technology play a very important role in implementing this new vision.If you look at this vision, we call it cold technology to deliver warm care. It's the same everywhere in viagra 100mg cost the world.

In the Netherlands, there's a big consensus that this is the way forward. So that's good news. If you travel around in the Netherlands, you see all those things already in viagra 100mg cost pilots already implemented with success.

But the big challenge is scaling up.As I said, in one of my HIMSS Europe keynotes, the devil is in the implementation. There is viagra 100mg cost no lack of vision strategy. We know from practice-based evidence that things are working with happy doctors, happy nurses, happy caretakers, happy patients.

However, the scale is still not a national scale or, or even an international scale. So it's viagra 100mg cost the implementation. In essence, we developed a policy in the Netherlands aimed at this, we call it a flourishing health ecosystem.

For this, you need two things, you need a positive climate and fertile ground."We have to put more emphasis on prevention and lifestyle. Digital possibilities are just waiting to be used."For the positive climate part, we as a government took viagra 100mg cost the role as a convening power, making health deals when everybody wants to change, but they're pointing it towards each other. We put the whole system in the room and helped them jump together.HITN.

How has the focus of the viagra 100mg cost Netherlands transformed during the viagra?. Gerritsen. We did a lot of skill development.

We had the health innovation school that started on a national scale, and brings together all the innovators from the hospitals, the pharmacies, the primary caretakers, the general practitioners and long-term care.We are working viagra 100mg cost on making learning communities. We work on removing obstacles, when they say we want to innovate but we cannot get paid for it, then we made that happen. Of course, we increased the subsidies to stimulate many of these developments.Of course viagra 100mg cost erectile dysfunction treatment, made it all go faster.

You can look at it from the point of view of, this is a bad crisis, never waste a bad crisis. I don't like the term never waste a good crisis, because it's a really bad crisis.Even if it's a bad crisis, don't let it go to waste, use the momentum to speed up the scaling up. On the other hand, you could say we should be a bit viagra 100mg cost ashamed that we needed this crisis to make the acceleration happen.Then again, the good news is, because I'm an optimist and optimism is a moral duty issue.

The good news, again, is that the same people, the same hospital governors, the same professionals, the same doctors, nurses, patients, politicians from municipalities that are facing challenges with implementation, are doing it because of the crisis.What we have to remember is that when the crisis is not there anymore, that the same people without any legislations or other big structural reforms, were able to innovate, to implement, to cooperate beyond their own domains.We also organised eHealth weeks and launched the Smart Care Relay. We did viagra 100mg cost a lot on making people conscious of all the good things that digital healthcare brings. The second pillar is about the fertile ground.

If you have a good climate, you do a lot to make digital health grow and flourish. It can only grow and viagra 100mg cost flourish if the ground is fertile. This is another way of saying we need interoperability."We did a lot of skill development.

We had the health innovation school viagra 100mg cost that started on a national scale, and brings together all the innovators from the hospitals, the pharmacies, the primary caretakers, the general practitioners and long-term care."We need a good infrastructure that makes it possible that all the digital information systems can communicate with each other. This includes hospital systems, pharmacy systems, GP systems, but also with our programme MedMij. This has created a trust framework for personal health data that enable all the digital information to flow into the personal health environments so that the patient is the owner of the medical information that is available for him or her.We have this national health information council I chaired.

The whole system in the room on a national basis, and we worked on making this thing happen partly on a voluntary basis, using a lot of temptation, tactics and viagra 100mg cost using the positive intrinsic motivation, that's always there. We have many subsidy programmes aimed at freeing up the data from different silos. And as a kind of a cherry on the cake, many people in the field told the ministry, this is all great and we viagra 100mg cost love it when we do this on a voluntary basis.

But still, it's so difficult because we have a lot of players, nobody has the authority to rule in this complicated healthcare system.We need a law that makes it mandatory for all the information systems to be interoperable. A few weeks ago, our Cabinet agreed on this law that made the digital exchange of information interoperability mandatory. It's been sent to the viagra 100mg cost parliament.

As far as I know, this is unique in the world, having a law that makes it part of the quality of care that doctors, hospitals, pharmacists, and general practitioners work with information systems that are interoperable with the other systems. If a healthcare professional doesn't, then they don't have a complete picture of a patient. You are per definition not able to give the quality of care that is required and we can revoke your practicing license.In our country where we viagra 100mg cost donÃ¢ÂÂt have these national health data exchange systems and the government has no direct authority, we used the ecosystem approach.

The proposed law is a big step forward in this. We are viagra 100mg cost proud of it. This is a long-term project.

In a few years, it will be made mandatory that these gold bars of medical information will have to be interoperable.HITN. Are there any digital health strategies viagra 100mg cost you have admired in other countries?. Gerritsen.

On the one hand, it's primarily about inspiration, because the other healthcare systems are so different viagra 100mg cost. Then when you get inspired by great things other countries are doing such as in the Scandinavian and Nordic countries - they are a big example for us. Also the Baltics, but sometimes also the United States or Australia or India and even sometimes, African countries because they are leapfrogging.

There's an amazing amount of inspiration in viagra 100mg cost other countries. On the other hand, you have to go through your own learning cycle and implementation cycle, feeding to the healthcare system that you're having in your country. Estonia has a viagra 100mg cost truly amazing digital infrastructure.

I love that digital identity card, for example. Which by the way shows the importance of international standards. Finland is doing amazing things with health data for research and development."What we have to remember is that when the crisis is not there anymore, that the same people without any legislations or other big structural reforms, were able to innovate, to implement, to cooperate beyond their own domains."I've been viagra 100mg cost to the US and seen what amazing things are developed and used there.

Again, our main theme, when we were abroad, not only inspiring and getting inspired but also expanding our own agenda of interoperability. For interoperability, we need the US, we viagra 100mg cost need Australia, we need India, and Europe - especially the countries where the big IT suppliers are because when the Netherlands itself is a mouse and you know when we stamp our feet, the elephant is not going to dance.I especially have warm feelings looking back on the cooperation. Also, making strides in interoperability has been facilitated by HIMSS many times, because this is not a national question.

This is not a European question. It's an international viagra 100mg cost question.HITN. What are some words of advice you would give to other nations at the beginning of their healthcare digital transformation?.

Gerritsen. I would say don't be viagra 100mg cost too modest. Just realise that when you're lagging behind, especially with digital healthcare, you are in an eminent position to leapfrog and show us our backs within maybe five or 10 years.I already saw great things, for example, in Kenya, where, because there are no hospitals, but they have 4G, and they have digital things.

They can do a lot more online, with all the distance in ways that make me even a little bit jealous.If you're not there yet, if you still at the beginning, make sure viagra 100mg cost that from the beginning you use the international standards, and also focus on interoperability. HITN. In your opinion, what are the best ways to create meaningful impact in healthcare systems?.

Gerritsen. It's about the implementation, it's about change management. It's not about the quality of the individual doctor or nurse, they're great already.

It's not about vision, it's there in abundance. It's not about practical evidence, it's already there.It's this scaling thing. It's in a situation where there are a lot of players but nobody is boss.

But that's only what you can do as a person."Just realise that when you're lagging behind, especially with digital healthcare, you are in an eminent position to leapfrog and show us our backs within maybe five or 10 years."Also, ask for help. Everybody that is remotely successful in healthcare already has the competence of taking care of himself or knowing how to get things done. But the competence of asking for help is a bit underdeveloped.

If you cannot do it alone, ask your colleagues, your friends and your network partners.The last one is also a very personal one because a lot of challenges do not just have one problem owner. Take responsibility for things you're not responsible for, without taking over responsibility. If everybody starts doing this, we'll be having a sustainable healthcare system within five years.

Otherwise, it will take 10 or 15 years.Learn more about the Netherland's digital health strategy at the upcoming HIMSS21 European Digital Health Conference on 7-9 June 2021. Click here to find out more information and register. The event is free of charge for employees of health and research institutions.Healthcare IT News is a HIMSS Media publication..

Female viagra home remedies

IntroductionThis paper is dedicated to Andrew Price Smith for his extensive analysis of the impact of the 1918 influenza female viagra home remedies and for being the first to investigate the Austrian Spanish Influenza Archives to demonstrate that the viagra struck the Axis troops prior to the Alliance, which forced Kaiser to opt for peace.The erectile dysfunction treatment viagra has altered the lives of people around the world, with significant death toll in addition to global social, political and economic impact. Many people have wondered how it compares to the seasonal influenza female viagra home remedies and prior viagras. In order to better understand and manage the current viagra, it is useful to compare it to historical viagras, such as the Spanish influenza of 1918.1Brief historical overview of 1918 Spanish influenzaThe 1918 Spanish influenza is caused by an H1N1 influenza A viagra postulated to be of avian origin.2 The 1918 Spanish influenza lasted from 1918 to 1920 and consisted of four waves. The first wave lasted female viagra home remedies approximately from 15 February 1918 to 1 June 1918. The second lasted approximately from 1 August 1918 to 2 December 1918.

The third female viagra home remedies lasted approximately from 3 December 1918 to 30 April 1919. And the fourth wave lasted approximately from 1 December 1919 to 30 April 1920.3 It infected about 500 million people, roughly one-third of the worldÃ¢ÂÂs population at that time, and resulted in the deaths of 50 female viagra home remedies million, including 675 000 Americans.2 The first public news of the epidemic appeared in Madrid on 22 May 1918 in MadridÃ¢ÂÂs ABC newspaper. Hence, it became known as the Spanish influenza.4 However, there is no definite evidence of origination, and most epidemiologists and virologists believe that the viagra originated in either the USA or France.4 A week later on 28 May 1918, King Alfonso XIII, the Prime Minister and some cabinet members became ill.4 As the influenza spread, basic services such as the postal service, telegraph services and some banks were forced to temporarily close operations.4Comparison between erectile dysfunction treatment and 1918 influenzaFirst, the patient population differs. While the 1918 influenza killed a disproportionate number of 25Ã¢ÂÂ40 year olds, erectile dysfunction treatment mostly affects those over the age of 65, especially those also with comorbidities.2 5 In particular, the mortality rate for the influenza rose to 8%Ã¢ÂÂ10% for younger people compared with a 2.5% overall mortality whereas the mortality rate for the 25Ã¢ÂÂ40-year-old age range is a mere 0.2% in contrast to the 2.4% overall mortality rate.2 5 Those aged 25Ã¢ÂÂ40 year olds accounted for 40% of deaths from female viagra home remedies the 1918 influenza, whereas those in the 18Ã¢ÂÂ44-year-old range account for only 3.9% of deaths from erectile dysfunction treatment.2 5 More countries were spared in the 1918 viagra, whereas only the smaller Pacific Islands (Soloman Islands and Vanuata) remain erectile dysfunction treatment free.2 6 The mortality rate for pregnant women with the Spanish influenza was 23%Ã¢ÂÂ37% and 26% of those who survived but lost their child, whereas the mortality rate of pregnant women with erectile dysfunction treatment is unknown.2 7 The Spanish influenza resulted in acute illness in 25%Ã¢ÂÂ30% of the world population, with over 50 million deaths, whereas erectile dysfunction treatment has infected nearly 55 million to date, with 1.3 million deaths.2 5 In the USA alone, erectile dysfunction treatment cases are at over 11 million as of 16 November 2020, which is nearly a 40% increase from the month prior.5Second, the two diseases kill via different mechanisms. While those with the influenza died of secondary bacterial pneumonia, those with erectile dysfunction treatment died from an overactive immune response that resulted in multiple organ failure.2 8 Acute respiratory distress syndrome (ARDS) can develop in both cases.2 8 As a complication from the influenza, ARDS had an 100% fatality rate compared with a 53.4% mortality rate as a complication from erectile dysfunction treatment.2 9The projected economic impact of erectile dysfunction treatment on the US economy is a $5.76Ã¢ÂÂ$6.17 trillion decrease in gross domestic product (GDP), based on Fitch Ratings and the US GDP according to the World Bank.

The economic data during the 1918 viagra is scarce, but it was noted that Mexico suffered a female viagra home remedies $9 billion loss.2Diagnoses, treatments and treatments were delayed in both cases. States developed different erectile dysfunction treatment diagnostic tests, since the initial one by Centers for Disease Control and Prevention (CDC) could not be confirmed. Currently, there are no erectile dysfunction treatments approved by the Food and Drug Administration, but antivirals female viagra home remedies like remdesivir, antibody and interleukin 33 blockers are currently under investigation. treatments are also female viagra home remedies in development. In 1918, bleeding was initially used as treatment, since such minimal progress had been made against pneumonia that even renowned William Osler still recommended it to relieve symptoms.2 In 1917, Dr Rufus Cole, Dr Oswald Avery and Dr Alphonse Dochez, with help from six other Rockefeller researchers, developed and tested a vaccination to prevent pneumonia caused by types I, II and III pneumococci.

In March 1918, this treatment was given to 12 000 troops on Long Island, with no vaccinated solder female viagra home remedies developing pneumonia from those strains. In contrast, 101 out of 19 000 soldiers serving as controls, developed pneumonia from those strains.2Yet, since neither an influenza treatment nor antibiotics to treat associated secondary bacterial s were available, worldwide containment efforts relied heavily on isolation and quarantine similar to the current efforts against erectile dysfunction treatment.2In terms of duration and origination, there is controversy over the origination of both viagraes, and both consist of multiple waves. The 1918 influenza lasted 25 months, and may have originated in Spain, France or the USA with no definite evidence of origination.3 4 The first wave lasted approximately from 15 February 1918 to 1 June female viagra home remedies 1918 and the fourth and final wave lasted approximately from 1 December 1919 to 30 April 1920.3 erectile dysfunction treatment originated in Wuhan China on 31 December 2019, with controversy over whether it originated in a wet market or at the Wuhan Institute of Virology. Unlike in 1918, DNA sequencing of erectile dysfunction treatment can predict whether infected individuals will be symptomatic or asymptomatic, based on a single base change (11 083G>T).10ConclusionsBoth the erectile dysfunction treatment and 1918 influenza viagra similarly caused significant negative impacts on the global economy, affecting international relations and had considerable female viagra home remedies delay in its diagnosis, treatment and treatments. The viagras largely differed in the highest risk population and the mechanism of death.

The 1918 influenza affected less than half of the countries and the most vulnerable groups are healthy adults between the ages of 25 years and 40 years, while erectile dysfunction treatment female viagra home remedies has affected nearly all countries and the most vulnerable group are adults above 65 years of age with comorbidities. Victims of the 1918 influenza mostly died from secondary bacterial pneumonia, while victims of erectile dysfunction treatment mostly died from an overactive immune response resulting in organ failure. The key female viagra home remedies major differences between the viagras are highlighted in table 1.View this table:Table 1 Summary of major differences. erectile dysfunction treatment versus 1918 influenzaThese comparisons are important to understanding and predicting the long-term effects of the new erectile dysfunction treatment viagra. The smaller number of deaths may be a result of our advances in the medical field over the century, such as diagnostic tools and extracorporeal membrane oxygenation machines.By using synthetic biology, diagnosis could be done using full sequencing of erectile dysfunction treatment strains, which female viagra home remedies would also reveal the number of strains.

Additionally, obtaining data on patient genotypes would determine female viagra home remedies its impact on viral expression. Furthermore, treatments developed with synthetic biology and then made with nanotechnology can be made in unlimited quantities compared with present methods of treatment production, which use fertilised chicken eggs. Synthetic treatments can be made to each strain with a unique sensor on each monoclonal antibody, which would indicate female viagra home remedies the presence of a particular strain, allowing efficient and timely vaccinations in each population.We should also be able to begin to unravel the mystery of this viagra. By studying each base of its positive-sense messenger RNA and determining its individual function, we can then predict patient prognosis and be better prepared to treat patients as they become ill. The prognosis of patients in the intensive care unit is currently poor, with high mortality rates and risk of permanent lung damage.As we better understand the functional phenotypic expression of the erectile dysfunction treatment, we can start female viagra home remedies to predict the expression of viral mRNA and begin treatment earlier.

This is a race between using our most advanced synthetic biology of the 21st female viagra home remedies century against a 21st-century viagra. We are 100 years away from 1918 and the tools that the scientists and clinicians had at their disposal in the last century. LetÃ¢ÂÂs hope that we can win this battle against female viagra home remedies this viagra. It is difficult to predict how long this battle will continue but with synthetic biology in conjunction with social distancing, we should achieve victory.Table 1 highlights the key differences between erectile dysfunction treatment and the 1918 influenza.AbstractMedical migration has become a global phenomenon, partly led by easier air travel, economic factors and the expansion of medical technology. New Zealand has gradually evolved from being Ã¢ÂÂbiculturalÃ¢ÂÂ to a multicultural, female viagra home remedies multitextured society.

The movement of the Indian people, particularly Indian physicians, will be the focus of this paper. In the last three decades, migration eligibility in New Zealand has changed from countries of origin or ability to speak English, to profession female viagra home remedies and skills. Despite struggling with its own issues, New Zealand has proven to be a female viagra home remedies preferred destination for Indian medical graduates (IMGs). India is widely recognised as the largest Ã¢ÂÂdonor countryÃ¢ÂÂ for doctors, many of whom go on to establish themselves as leaders and prominent figures in their field. This migration involves three parties female viagra home remedies.

India as a donor country, New Zealand as a recipient country and IMGs as the drivers of this process. Factors behind this growing phenomenon are examined and recommendations are female viagra home remedies made so that all three parties can benefit from it.Ethics (see medical ethics)health services administration &. Managementhealth policymedical law.

IntroductionThis paper is dedicated to Andrew Price Smith for his extensive viagra 100mg cost analysis of the impact of the 1918 influenza and for being the first to investigate the Austrian Spanish Influenza Archives to demonstrate that the viagra struck the Axis troops http://www.rosaleeclark.com.au/who-can-buy-renova-online/ prior to the Alliance, which forced Kaiser to opt for peace.The erectile dysfunction treatment viagra has altered the lives of people around the world, with significant death toll in addition to global social, political and economic impact. Many people have wondered how it compares to viagra 100mg cost the seasonal influenza and prior viagras. In order to better understand and manage the current viagra, it is useful to compare it to historical viagras, such as the Spanish influenza of 1918.1Brief historical overview of 1918 Spanish influenzaThe 1918 Spanish influenza is caused by an H1N1 influenza A viagra postulated to be of avian origin.2 The 1918 Spanish influenza lasted from 1918 to 1920 and consisted of four waves. The first viagra 100mg cost wave lasted approximately from 15 February 1918 to 1 June 1918. The second lasted approximately from 1 August 1918 to 2 December 1918.

The third lasted approximately from 3 December 1918 to 30 April viagra 100mg cost 1919. And the fourth wave lasted approximately from 1 December 1919 to 30 April 1920.3 It infected about 500 million people, roughly one-third of the worldÃ¢ÂÂs population at that time, and resulted in the deaths of 50 million, including 675 viagra 100mg cost 000 Americans.2 The first public news of the epidemic appeared in Madrid on 22 May 1918 in MadridÃ¢ÂÂs ABC newspaper. Hence, it became known as the Spanish influenza.4 However, there is no definite evidence of origination, and most epidemiologists and virologists believe that the viagra originated in either the USA or France.4 A week later on 28 May 1918, King Alfonso XIII, the Prime Minister and some cabinet members became ill.4 As the influenza spread, basic services such as the postal service, telegraph services and some banks were forced to temporarily close operations.4Comparison between erectile dysfunction treatment and 1918 influenzaFirst, the patient population differs. While the 1918 influenza killed a viagra 100mg cost disproportionate number of 25Ã¢ÂÂ40 year olds, erectile dysfunction treatment mostly affects those over the age of 65, especially those also with comorbidities.2 5 In particular, the mortality rate for the influenza rose to 8%Ã¢ÂÂ10% for younger people compared with a 2.5% overall mortality whereas the mortality rate for the 25Ã¢ÂÂ40-year-old age range is a mere 0.2% in contrast to the 2.4% overall mortality rate.2 5 Those aged 25Ã¢ÂÂ40 year olds accounted for 40% of deaths from the 1918 influenza, whereas those in the 18Ã¢ÂÂ44-year-old range account for only 3.9% of deaths from erectile dysfunction treatment.2 5 More countries were spared in the 1918 viagra, whereas only the smaller Pacific Islands (Soloman Islands and Vanuata) remain erectile dysfunction treatment free.2 6 The mortality rate for pregnant women with the Spanish influenza was 23%Ã¢ÂÂ37% and 26% of those who survived but lost their child, whereas the mortality rate of pregnant women with erectile dysfunction treatment is unknown.2 7 The Spanish influenza resulted in acute illness in 25%Ã¢ÂÂ30% of the world population, with over 50 million deaths, whereas erectile dysfunction treatment has infected nearly 55 million to date, with 1.3 million deaths.2 5 In the USA alone, erectile dysfunction treatment cases are at over 11 million as of 16 November 2020, which is nearly a 40% increase from the month prior.5Second, the two diseases kill via different mechanisms. While those with the influenza died of secondary bacterial pneumonia, those with erectile dysfunction treatment died from an overactive immune response that resulted in multiple organ failure.2 8 Acute respiratory distress syndrome (ARDS) can develop in both cases.2 8 As a complication from the influenza, ARDS had an 100% fatality rate compared with a 53.4% mortality rate as a complication from erectile dysfunction treatment.2 9The projected economic impact of erectile dysfunction treatment on the US economy is a $5.76Ã¢ÂÂ$6.17 trillion decrease in gross domestic product (GDP), based on Fitch Ratings and the US GDP according to the World Bank.

The economic data during the 1918 viagra is scarce, but it was noted that Mexico suffered a $9 billion loss.2Diagnoses, treatments and treatments were delayed in both viagra 100mg cost cases. States developed different erectile dysfunction treatment diagnostic tests, since the initial one by Centers for Disease Control and Prevention (CDC) could not be confirmed. Currently, there are no erectile dysfunction treatments approved by the Food and Drug Administration, but antivirals like remdesivir, antibody and interleukin 33 blockers are currently under investigation viagra 100mg cost. treatments are also in development viagra 100mg cost. In 1918, bleeding was initially used as treatment, since such minimal progress had been made against pneumonia that even renowned William Osler still recommended it to relieve symptoms.2 In 1917, Dr Rufus Cole, Dr Oswald Avery and Dr Alphonse Dochez, with help from six other Rockefeller researchers, developed and tested a vaccination to prevent pneumonia caused by types I, II and III pneumococci.

In March viagra 100mg cost 1918, this treatment was given to 12 000 troops on Long Island, with no vaccinated solder developing pneumonia from those strains. In contrast, 101 out of 19 000 soldiers serving as controls, developed pneumonia from those strains.2Yet, since neither an influenza treatment nor antibiotics to treat associated secondary bacterial s were available, worldwide containment efforts relied heavily on isolation and quarantine similar to the current efforts against erectile dysfunction treatment.2In terms of duration and origination, there is controversy over the origination of both viagraes, and both consist of multiple waves. The 1918 influenza lasted 25 months, and may have originated in Spain, France or the USA with no definite evidence of origination.3 4 The first wave lasted approximately from 15 February 1918 to 1 June 1918 and the fourth viagra 100mg cost and final wave lasted approximately from 1 December 1919 to 30 April 1920.3 erectile dysfunction treatment originated in Wuhan China on 31 December 2019, with controversy over whether it originated in a wet market or at the Wuhan Institute of Virology. Unlike in 1918, DNA sequencing of erectile dysfunction treatment can predict whether infected individuals will be symptomatic or asymptomatic, based on a single base change (11 083G>T).10ConclusionsBoth the erectile dysfunction treatment and 1918 viagra 100mg cost influenza viagra similarly caused significant negative impacts on the global economy, affecting international relations and had considerable delay in its diagnosis, treatment and treatments. The viagras largely differed in the highest risk population and the mechanism of death.

The 1918 influenza affected less than half of the countries and the most vulnerable groups are healthy adults between the ages of 25 years and 40 years, while erectile dysfunction treatment viagra 100mg cost has affected nearly all countries and the most vulnerable group are adults above 65 years of age with comorbidities. Victims of the 1918 influenza mostly died from secondary bacterial pneumonia, while victims of erectile dysfunction treatment mostly died from an overactive immune response resulting in organ failure. The key major differences between the viagras are highlighted in table 1.View this table:Table 1 Summary viagra 100mg cost of major differences. erectile dysfunction treatment versus 1918 influenzaThese comparisons are important to understanding and predicting the long-term effects of the new erectile dysfunction treatment viagra. The smaller number of deaths may be a result of our advances in the viagra 100mg cost medical field over the century, such as diagnostic tools and extracorporeal membrane oxygenation machines.By using synthetic biology, diagnosis could be done using full sequencing of erectile dysfunction treatment strains, which would also reveal the number of strains.

Additionally, obtaining data on viagra 100mg cost patient genotypes would determine its impact on viral expression. Furthermore, treatments developed with synthetic biology and then made with nanotechnology can be made in unlimited quantities compared with present methods of treatment production, which use fertilised chicken eggs. Synthetic treatments can be made to each strain with a unique sensor on each monoclonal antibody, which would indicate the presence of a particular strain, allowing efficient and timely vaccinations in each population.We should also be able to begin to viagra 100mg cost unravel the mystery of this viagra. By studying each base of its positive-sense messenger RNA and determining its individual function, we can then predict patient prognosis and be better prepared to treat patients as they become ill. The prognosis of patients in viagra 100mg cost the intensive care unit is currently poor, with high mortality rates and risk of permanent lung damage.As we better understand the functional phenotypic expression of the erectile dysfunction treatment, we can start to predict the expression of viral mRNA and begin treatment earlier.

This is a race between using our most viagra 100mg cost advanced synthetic biology of the 21st century against a 21st-century viagra. We are 100 years away from 1918 and the tools that the scientists and clinicians had at their disposal in the last century. LetÃ¢ÂÂs hope that we can win this battle against this viagra viagra 100mg cost. It is difficult to predict how long this battle will continue but with synthetic biology in conjunction with social distancing, we should achieve victory.Table 1 highlights the key differences between erectile dysfunction treatment and the 1918 influenza.AbstractMedical migration has become a global phenomenon, partly led by easier air travel, economic factors and the expansion of medical technology. New Zealand has gradually evolved from being Ã¢ÂÂbiculturalÃ¢ÂÂ to viagra 100mg cost a multicultural, multitextured society.

The movement of the Indian people, particularly Indian physicians, will be the focus of this paper. In the last three decades, migration eligibility in New Zealand has changed viagra 100mg cost from countries of origin or ability to speak English, to profession and skills. Despite struggling with its own issues, New Zealand has proven to viagra 100mg cost be a preferred destination for Indian medical graduates (IMGs). India is widely recognised as the largest Ã¢ÂÂdonor countryÃ¢ÂÂ for doctors, many of whom go on to establish themselves as leaders and prominent figures in their field. This migration involves three viagra 100mg cost parties.

India as a donor country, New Zealand as a recipient country and IMGs as the drivers of this process. Factors behind this growing phenomenon are examined and recommendations are made so viagra 100mg cost that all three parties can benefit from it.Ethics (see medical ethics)health services administration &. Managementhealth policymedical law.

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