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The RitualMovie | 2017



The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is most favorable for treatment of bothersome VMS and for those at elevated risk for bone loss or fracture. For women who initiate HT more than 10 or 20 years from menopause onset or are aged 60 years or older, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS or bone loss, with shared decision making and periodic reevaluation. For bothersome GSM symptoms not relieved with over-the-counter therapies and without indications for use of systemic HT, low-dose vaginal estrogen therapy or other therapies are recommended.This NAMS position statement has been endorsed by Academy of Women's Health, American Association of Clinical Endocrinologists, American Association of Nurse Practitioners, American Medical Women's Association, American Society for Reproductive Medicine, Asociación Mexicana para el Estudio del Climaterio, Association of Reproductive Health Professionals, Australasian Menopause Society, Chinese Menopause Society, Colegio Mexicano de Especialistas en Ginecologia y Obstetricia, Czech Menopause and Andropause Society, Dominican Menopause Society, European Menopause and Andropause Society, German Menopause Society, Groupe d'études de la ménopause et du vieillissement Hormonal, HealthyWomen, Indian Menopause Society, International Menopause Society, International Osteoporosis Foundation, International Society for the Study of Women's Sexual Health, Israeli Menopause Society, Japan Society of Menopause and Women's Health, Korean Society of Menopause, Menopause Research Society of Singapore, National Association of Nurse Practitioners in Women's Health, SOBRAC and FEBRASGO, SIGMA Canadian Menopause Society, Società Italiana della Menopausa, Society of Obstetricians and Gynaecologists of Canada, South African Menopause Society, Taiwanese Menopause Society, and the Thai Menopause Society. The American College of Obstetricians and Gynecologists supports the value of this clinical document as an educational tool, June 2017. The British Menopause Society supports this Position Statement.




The RitualMovie | 2017



On October 1, 2017, Stephen Paddock, a 64-year-old man from Mesquite, Nevada, opened fire on the crowd attending the Route 91 Harvest music festival on the Las Vegas Strip in Nevada. From his 32nd-floor suites in the Mandalay Bay hotel, he fired more than 1,000 bullets, killing 60 people[a] and wounding at least 413. The ensuing panic brought the total number of injured to approximately 867. About an hour later, he was found dead in his room from a self-inflicted gunshot wound. The motive for the mass shooting is officially undetermined.


Las Vegas Village, a 15-acre (6-hectare) lot used for outdoor performances, was located diagonally across the intersection to the northeast.[6][7] From 2014 onward, the venue hosted the annual Route 91 Harvest country music festival. The 2017 festival ran from September 29 to October 1, with over 22,000 attendees on the final day.[7][8][b]


According to his girlfriend, Paddock repeatedly cased Las Vegas Village from different windows in their room when they stayed at the Mandalay Bay a month before the shooting.[9] Paddock also may have considered attacking previous events. He had researched large-scale venues in cities such as Boston since at least May 2017,[10] and had reserved a room overlooking the August 2017 Lollapalooza festival in Chicago, but did not use it.[11] From September 17, Paddock stayed at The Ogden in Downtown Las Vegas, which overlooked the open-air Life is Beautiful festival that ran from September 22 to 24.[9][8] Paddock's Internet search terms from mid-September included "swat weapons", "ballistics chart 308", "SWAT Las Vegas", and "do police use explosives".[9]


The mass shooting occurred between 10:05 p.m. and 10:15 p.m. on October 1, 2017, which was the third and final night of the festival. When the shooting began, country music singer Jason Aldean was giving the closing performance.[17]


In November 2017, a lawsuit was filed on behalf of 450 of the victims of the shooting, which claimed that the Mandalay Bay Hotel had shown negligence by allowing Paddock to bring a large amount of weaponry into the building.[96][97] In July 2018, MGM Resorts International countersued hundreds of victims, claiming that it had "no liability of any kind" for the attack.[98] On October 3, 2019, MGM Resorts reached a settlement of $800 million with the victims of the shooting, which was approved by a judge on September 30, 2020.[99][100]


On November 6, 2017, Massachusetts became the first state to ban the sale, possession, or use of the devices.[133] In December 2018, Acting United States Attorney General Matthew Whitaker signed a regulation banning bump stocks in the U.S., effective March 2019. The regulation bans new sales and requires current owners to surrender or destroy existing bump stocks.[134]


Background: The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults provides recommendations for the definition of hypertension, systolic and diastolic blood pressure (BP) thresholds for initiation of antihypertensive medication, and BP target goals.


Objectives: This study sought to determine the prevalence of hypertension, implications of recommendations for antihypertensive medication, and prevalence of BP above the treatment goal among US adults using criteria from the 2017 ACC/AHA guideline and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7).


Results: According to the 2017 ACC/AHA and JNC7 guidelines, the crude prevalence of hypertension among US adults was 45.6% (95% confidence interval [CI]: 43.6% to 47.6%) and 31.9% (95% CI: 30.1% to 33.7%), respectively, and antihypertensive medication was recommended for 36.2% (95% CI: 34.2% to 38.2%) and 34.3% (95% CI: 32.5% to 36.2%) of US adults, respectively. Nonpharmacological intervention is advised for the 9.4% of US adults with hypertension who are not recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. Among US adults taking antihypertensive medication, 53.4% (95% CI: 49.9% to 56.8%) and 39.0% (95% CI: 36.4% to 41.6%) had BP above the treatment goal according to the 2017 ACC/AHA and JNC7 guidelines, respectively.


Conclusions: Compared with the JNC7 guideline, the 2017 ACC/AHA guideline results in a substantial increase in the prevalence of hypertension, a small increase in the percentage of US adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.


The 2017 OASDI Trustees Report, officially called "The 2017 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds," presents the current and projected financial status of the trust funds. The report is available in PDF, a printer-friendly format.


FDA encourages its state, local, tribal, and territorial partners to adopt the latest version of the FDA Food Code. The benefits associated with complete and widespread adoption of the 2017 Food Code as statutes, codes and ordinances include:


The 2017 series updates the prior series released in 2014, which was the first to incorporate separate assumptions about the fertility of native and foreign-born women living in the United States, since the latter tend to have higher fertility rates. The 2017 series extends this work and for the first time accounts for the generally lower mortality rates and longer life expectancy of the foreign-born. By including assumptions about the mortality of native and foreign-born people, the 2017 projections better account for the effects of international migration on the population of the United States.


This projections series uses the official estimates of the resident population on July 1, 2016 as the base for projecting the U.S. population from 2017 to 2060. The series uses the cohort-component method and historical trends in births, deaths, and international migration to project the future size and composition of the national population.


The 2017 National Population Projections include a main series and three alternative scenarios. The main series was released with updates in September 2018 [See Errata Note]. The alternative scenarios, released in February 2020, were based on assumptions of low, high, and zero levels of immigration. All other methodology and assumptions, including fertility and mortality, are the same as those used in the main series. The three alternative scenarios are useful for analyzing potential outcomes of different levels of immigration. 041b061a72


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