vania-janet/multiturn-rag-retrieval-data huggingface dataset:
Over-the-counter drug
A similar regulation applies to some forms of emergency contraception . The FDA considers them to be OTC substances for females 17 or over but prescription drugs for younger women . To enforce the restriction and to provide counseling and education on proper use , an agreement between the manufacturer and the FDA requires the drugs are stored behind the pharmacy counter . Women may obtain the medication without a prescription after providing proof of age to pharmacy staff and receiving any necessary patient education .
Medicare Advantage
Sicker people and people with higher medical expenditures are more likely to switch from Medicare Advantage plans to Original Medicare . This statistic is primarily driven by people on Medicaid in custodial care at nursing home ; such people no longer have need of any Medicare supplement , either a public Part C plan or a private Medigap or group retirement plan . The Part C risk adjusted payments to Medicare Advantage plans are designed to limit this churn between types of Medicare ( managed vs. FFS ) , but it is unclear how effective that policy is .
National Flood Insurance Program
Moreover , certain provisions within the NFIP increase the likelihood that flood - prone properties will be occupied by the people least likely to be in a position to recover from flood disasters , which further increases demand for aid . This is an example of adverse selection . Some factors contributing to increased demand for aid are :
Health care in the United States
A large demographic shift in the United States is putting pressure on the medical system , and the industries that support it . Roughly 10,000 baby boomers retire every day in the United States which removes many talented and experienced workers from the medical field each year . The demographic shift to an older population is projected to increase medical spending in North America by at least 5 % , creating a funding crunch that the government ( through medicare and other social services ) , insurance companies , and individual savings accounts are straining to absorb . Finally , the older population is rapidly increasing demand for healthcare services despite the tight budgets and reduced workforce . All of these factors put pressure on wages and working conditions , with the majority of healthcare jobs seeing salary reductions between 2009 and 2011 .
Flint water crisis
On February 12 , the USDA extended their nutrition programs for Flint children diagnosed with high blood lead levels . On the next day , Governor Snyder asked for additional help from Medicaid and the State Children 's Health Insurance Program for affected Flint children . The Department of Health and Human Services granted his request on February 18 , providing an additional $500,000 in Medicaid expansion for affected Flint children and pregnant women . On March 3 , a waiver request to include pregnant women and people up to 21 years of age was approved .
Indigenous Australians
Successive Federal Governments have responded to these issues by implementing programs such as the Office of Aboriginal and Torres Strait Islander Health ( OATSIH ) .
Ultraviolet
The impact of ultraviolet radiation on human health has implications for the risks and benefits of sun exposure and is also implicated in issues such as fluorescent lamps and health . Getting too much sun exposure can be harmful , but in moderation , sun exposure is beneficial .
Air pollution in the United States
Prenatal exposures to air pollution have influenced respiratory health starts in utero . Mothers who were exposed to PM2. 5 weekly during gestation , were likely to have a child diagnosed with asthma by the age 6 years . Many of the mothers exposed to PM2. 5 were ethnic minorities ( 54 % Hispanic , 30 % black ) , had 12 or fewer years of education ( 66 % ) , and did not smoke in pregnancy ( 80 % ) . Inner - city children from the age of 5 -- 11 years old were diagnosed with Asthma , due to prenatal exposure to phthalates , butylbenzyl phthalate ( BBzP ) , di - n - butyl phthalate ( DnBP ) , di ( 2 - ethylhexyl ) phthalate ( DEHP ) , and diethyl phthalate ( DEP ) . These phthalates were detected in urine samples from 300 pregnant women .
Over-the-counter drug
If it is not appropriate to sell a ' P ' medication -- i.e. the condition is not suitable for self - management and requires referral to a medical prescriber -- then a sale should not occur and the pharmacist has a legal and professional obligation to refer this on to an appropriate service .
Medicare (United States)
There are other proposals for savings on prescription drugs that do not require such fundamental changes to Medicare Part D 's payment and coverage policies . Manufacturers who supply drugs to Medicaid are required to offer a 15 percent rebate on the average manufacturer 's price . Low - income elderly individuals who qualify for both Medicare and Medicaid receive drug coverage through Medicare Part D , and no reimbursement is paid for the drugs the government purchases for them . Reinstating that rebate would yield savings of $112 billion , according to a recent CBO estimate .
Indigenous Australians
Health problems with the highest disparity ( compared with the non-Indigenous population ) in incidence are outlined in the table below :
Iodine-131
The World Health Organizations daily recommended Dosage for Radiological Emergencies involving radioactive iodine Age KI in mg KIO in mg Over 12 years old 130 170 3 -- 12 years old 65 85 1 -- 36 months old 32 42 < 1 month old 16 21
Doctor of Public Health
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Poverty in the United Kingdom
Children become sick because they can not keep warm at home , overcrowding and damp worsens respiratory conditions . Alison Garnham , of the Child Poverty Action Group , said , `` Day in , day out , doctors see the damage rising poverty does to children 's health . Low family incomes , inadequate housing and cuts to support services are jeopardising the health of our most vulnerable children . ( ... ) Re-instating the UK 's poverty - reduction targets would be an obvious place to start . ''
Expenditures in the United States federal budget
Mandatory programs are affected by demographic trends . The number of workers continues declining relative to those receiving benefits . For example , the number of workers per retiree was 5.1 in 1960 ; this declined to 3.3 in 2007 and is projected to decline to 2.1 by 2040 . According to census data for 2011 , 16 % of the population lived in a household where at least one individual received Social Security and 15 % lived in a household where at least one individual received Medicare . From 2012 to 2027 , approximately 78 million individuals will retire and begin receiving Social Security and Medicare .
Over-the-counter drug
As of 2011 , around a third of older adults in the U.S. reportedly use OTC drugs .
Franchising
These are significant changes and it is important that franchisors , franchisees and potential franchises understand their rights and responsibilities under the Code .
Whole life insurance
Large debts , Temporary needs , such as children 's dependency years , Young families with large needs and limited income .
Medicare (United States)
The government added hospice benefits to aid the elderly on a temporary basis in 1982 , and made this permanent in 1984 . Congress further expanded Medicare in 2001 to cover younger people with amyotrophic lateral sclerosis ( ALS , or Lou Gehrig 's disease ) .
Medicare (United States)
They are 65 years or older and US citizens or have been permanent legal residents for five continuous years , and they or their spouse ( or qualifying ex-spouse ) has paid Medicare taxes for at least 10 years .
Chickenpox
Aspirin is highly contraindicated in children younger than 16 years , as it has been related to Reye syndrome .
Medicare (United States)
The PPACA also made some changes to Medicare enrollee 's ' benefits . By 2020 , it will close the so - called `` donut hole '' between Part D plans ' coverage limits and the catastrophic cap on out - of - pocket spending , reducing a Part D enrollee 's ' exposure to the cost of prescription drugs by an average of $2,000 a year . This lowered costs for about 5 % of the people on Medicare . Limits were also placed on out - of - pocket costs for in - network care for public Part C health plan enrollees . Most of these plans had such a limit but ACA formalized the annual out of pocket spend limit . Beneficiaries on traditional Medicare do not get such a limit but can effectively arrange for one through private insurance .
Flint water crisis
The federal response is being led by the Department of Health and Human Services , with assistance from FEMA , the Small Business Administration , the EPA , the Department of Housing and Urban Development , the Department of Agriculture , the Office of Preparedness and Response , and the Public Health Service Commissioned Corps . Dr. Nicole Lurie , Assistant Secretary of Health and Human Services for Preparedness and Response , was appointed to coordinate the federal response .
Doctor of Public Health
Barbara Rimer - Dean of the University of North Carolina at Chapel Hill Gillings School of Global Public Health .
Free clinic
A free clinic is a health care facility in the United States offering services to economically disadvantaged individuals for free or at a nominal cost . Core staff members may hold full - time paid positions , however , most of the staff a patient will encounter are volunteers drawn from the local medical community . Care is provided free of cost to persons who have limited incomes , no health insurance and do not qualify for Medicaid or Medicare . To offset costs , some clinics charge a nominal fee to those whose income is deemed sufficient to pay a fee . Many free clinics offer services to underinsured individuals ; meaning those who have only limited medical coverage ( such as catastrophic care coverage , but not regular coverage ) , or who have insurance , but their policies include high medical deductibles that they are unable to afford . Clinics often use the term `` underinsured '' to describe the working poor .
Diphtheria
Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae . Signs and symptoms may vary from mild to severe . They usually start two to five days after exposure . Symptoms often come on fairly gradually , beginning with a sore throat and fever . In severe cases , a grey or white patch develops in the throat . This can block the airway and create a barking cough as in croup . The neck may swell in part due to enlarged lymph nodes . A form of diphtheria that involves the skin , eyes , or genitals also exists . Complications may include myocarditis , inflammation of nerves , kidney problems , and bleeding problems due to low levels of platelets . Myocarditis may result in an abnormal heart rate and inflammation of the nerves may result in paralysis .
World Health Organization
The remaining two of WHO 's thirteen identified policy areas relate to the role of WHO itself :
Famine
Brazil 's 1877 -- 78 Grande Seca ( Great Drought ) , the worst in Brazil 's history , caused approximately half a million deaths . The one from 1915 was devastating too .
Four Horsemen of the Apocalypse
According to Elliott , famine , the inevitable consequence of carnage and oppression , which demolished the produce of the present as well as the hope of future harvests , produced the environment for an epidemic of diseases , the effects of scanty and unwholesome food . That furious plague ( the Plague of Cyprian ) , which raged from the year 250 to the year 265 , continued without interruption in every province , city and almost every family in the empire . During a portion of this time , 5000 people died daily in Rome ; and many towns that escaped the attacks of barbarians were entirely depopulated .
Famine
The years around 1620 saw another period of famine sweep across Europe . These famines were generally less severe than the famines of twenty - five years earlier , but they were nonetheless quite serious in many areas . Perhaps the worst famine since 1600 , the great famine in Finland in 1696 , killed one - third of the population .
Famine
For the middle part of the 20th century , agriculturalists , economists and geographers did not consider Africa to be especially famine prone . From 1870 to 2010 , 87 per cent of deaths from famine occurred in Asia and Eastern Europe , with only 9.2 per cent in Africa . There were notable counter-examples , such as the famine in Rwanda during World War II and the Malawi famine of 1949 , but most famines were localized and brief food shortages . Although the drought was brief the main cause of death in Rwanda was due to Belgian prerogatives to acquisition grain from their colony ( Rwanda ) . The increased grain acquisition was related to WW2 . This and the drought caused 300,000 Rwandans to perish .
Famine
Many famines are caused by imbalance of food production compared to the large populations of countries whose population exceeds the regional carrying capacity . Historically , famines have occurred from agricultural problems such as drought , crop failure , or pestilence . Changing weather patterns , the ineffectiveness of medieval governments in dealing with crises , wars , and epidemic diseases such as the Black Death helped to cause hundreds of famines in Europe during the Middle Ages , including 95 in Britain and 75 in France . In France , the Hundred Years ' War , crop failures and epidemics reduced the population by two - thirds .
Famine
Other areas of Europe have known famines much more recently . France saw famines as recently as the 19th century . The Great Famine in Ireland , 1846 -- 1851 , caused by the failure of the potato crop over a few years , resulted in 1,000,000 dead and another 2,000,000 refugees fleeing to Britain , Australia and the United States .
Famine
Famines occurred in Sudan in the late - 1970s and again in 1990 and 1998 . The 1980 famine in Karamoja , Uganda was , in terms of mortality rates , one of the worst in history . 21 % of the population died , including 60 % of the infants . In the 1980s , large scale multilayer drought occurred in the Sudan and Sahelian regions of Africa . This caused famine because even though the Sudanese Government believed there was a surplus of grain , there were local deficits across the region .
Spanish conquest of the Aztec Empire
The Aztecs were struck by a smallpox plague starting in September 1520 , which lasted seventy days . Many were killed , including their new leader , the Emperor Cuitlahuac .
Famine
Today , famine is most widespread in Sub-Saharan Africa , but with exhaustion of food resources , overdrafting of groundwater , wars , internal struggles , and economic failure , famine continues to be a worldwide problem with hundreds of millions of people suffering . These famines cause widespread malnutrition and impoverishment . The famine in Ethiopia in the 1980s had an immense death toll , although Asian famines of the 20th century have also produced extensive death tolls . Modern African famines are characterized by widespread destitution and malnutrition , with heightened mortality confined to young children .
Tropical cyclone
Tropical cyclones that cause extreme destruction are rare , although when they occur , they can cause great amounts of damage or thousands of fatalities . The 1970 Bhola cyclone is the deadliest tropical cyclone on record , killing more than 300,000 people and potentially as many as 1 million after striking the densely populated Ganges Delta region of Bangladesh on November 13 , 1970 . Its powerful storm surge was responsible for the high death toll . The North Indian cyclone basin has historically been the deadliest basin . Elsewhere , Typhoon Nina killed nearly 100,000 in China in 1975 due to a 100 - year flood that caused 62 dams including the Banqiao Dam to fail . The Great Hurricane of 1780 is the deadliest North Atlantic hurricane on record , killing about 22,000 people in the Lesser Antilles . A tropical cyclone does not need to be particularly strong to cause memorable damage , primarily if the deaths are from rainfall or mudslides . Tropical Storm Thelma in November 1991 killed thousands in the Philippines , although the strongest typhoon to ever make landfall on record was Typhoon Haiyan on November 2013 , causing widespread devastation in Eastern Visayas and killing at least 6,300 people in that country alone . In 1982 , the unnamed tropical depression that eventually became Hurricane Paul killed around 1,000 people in Central America .
Famine
The Great Persian Famine of 1870 -- 1871 is believed to have caused the death of 1.5 million persons ( 20 -- 25 percent of the population ) in Persia ( present - day Iran ) .
Conquistador
Epidemic disease is commonly cited as the primary reason for the population collapse . The American natives lacked immunity to these infections . Most American native peoples lived in isolated communities , with only limited trade contact and no regular communication , further reducing their ability to build up immunity . Trading was the only ongoing contact between most New World cultures .
Hundred Years' War
Bubonic plague and warfare reduced population numbers throughout Europe during this period . France lost half its population during the Hundred Years ' War . Normandy lost three - quarters of its population , and Paris two - thirds . The population of England was reduced by 20 to 33 percent due to plague in the same period .
Famine
A famine is a widespread scarcity of food , caused by several factors including war , inflation , crop failure , population imbalance , or government policies . This phenomenon is usually accompanied or followed by regional malnutrition , starvation , epidemic , and increased mortality . Every inhabited continent in the world has experienced a period of famine throughout history . In the 19th and 20th century , it was generally Southeast and South Asia , as well as Eastern and Central Europe that suffered the most deaths from famine . The numbers dying from famine began to fall sharply from the 1970s .
Famine
Even though the theories of Thomas Malthus would predict that famines reduce the size of the population commensurate with available food resources , in fact even the most severe famines have rarely dented population growth for more than a few years . The mortality in China in 1958 -- 61 , Bengal in 1943 , and Ethiopia in 1983 -- 85 was all made up by a growing population over just a few years . Of greater long - term demographic impact is emigration : Ireland was chiefly depopulated after the 1840s famines by waves of emigration .
Famine
Famine still occurred in Eastern Europe during the 20th century . Droughts and famines in Imperial Russia are known to have happened every 10 to 13 years , with average droughts happening every 5 to 7 years . Russia experienced eleven major famines between 1845 and 1922 , one of the worst being the famine of 1891 -- 92 .
1854 Broad Street cholera outbreak
With regard to the deaths occurring in the locality belonging to the pump , there were 61 instances in which I was informed that the deceased persons used to drink the pump - water from Broad Street , either constantly or occasionally ...
Famine
Recent famines in Africa include the 2005 -- 06 Niger food crisis , the 2010 Sahel famine and the 2011 East Africa drought , where two consecutive missed rainy seasons precipitated the worst drought in East Africa in 60 years . An estimated 50,000 to 150,000 people are reported to have died during the period . In 2012 , the Sahel drought put more than 10 million people in the western Sahel at risk of famine ( according to a Methodist Relief & Development Fund ( MRDF ) aid expert ) , due to a month - long heat wave .
History of Australia (1788–1850)
`` In a thousand isolated places there were occasional shootings and spearings . Even worse , smallpox , measles , influenza and other new diseases swept from one Aboriginal camp to another ... The main conqueror of Aborigines was to be disease and its ally , demoralisation '' .
Renaissance
The Black Death caused greater upheaval to Florence 's social and political structure than later epidemics . Despite a significant number of deaths among members of the ruling classes , the government of Florence continued to function during this period . Formal meetings of elected representatives were suspended during the height of the epidemic due to the chaotic conditions in the city , but a small group of officials was appointed to conduct the affairs of the city , which ensured continuity of government .
Spanish conquest of the Inca Empire
The long - term effects of the arrival of the Spanish on the population of South America were simply catastrophic . While this is the case for every group of Native - Americans that encountered Europeans from the fifteenth century onwards , the Incan population suffered a dramatic and quick decline following contact . It is estimated that parts of the empire , notably the Central Andes , suffered a population decline ratio of 58 : 1 during the years of 1520 -- 1571 .
Four Horsemen of the Apocalypse
Under another interpretation , the first Horseman is called Pestilence , and is associated with infectious disease and plague . It appears at least as early as 1906 , when it is mentioned in the Jewish Encyclopedia . The interpretation is common in popular culture references to the Four Horsemen .
Great Depression
Other economic downturns have been called a `` great depression '' , but none had been as widespread , or lasted for so long . Various nations have experienced brief or extended periods of economic downturns , which were referred to as `` depressions '' , but none have had such a widespread global impact .
1854 Broad Street cholera outbreak
It will be observed , that the water of the companies of the Surrey Side of London , viz. , the Southwark , Vauxhall , and Lambeth , is by far the worst of all those who take their supply from the Thames
Famine
According to Scott and Duncan ( 2002 ) , `` Eastern Europe experienced more than 150 recorded famines between AD 1500 and 1700 and there were 100 hunger years and 121 famine years in Russia between AD 971 and 1974 . ''
Middle Ages
The first years of the 14th century were marked by famines , culminating in the Great Famine of 1315 -- 17 . The causes of the Great Famine included the slow transition from the Medieval Warm Period to the Little Ice Age , which left the population vulnerable when bad weather caused crop failures . The years 1313 -- 14 and 1317 -- 21 were excessively rainy throughout Europe , resulting in widespread crop failures . The climate change -- which resulted in a declining average annual temperature for Europe during the 14th century -- was accompanied by an economic downturn . Execution