🧵.@ama_media GPs will soon be able to access new telehealth Medicare items for smoking cessation consults where they can write scripts for nicotine e-cigarettes.

From October, a doctor’s prescription will be required before a person can legally import nicotine e-cigarettes and

liquid nicotine.

The move is designed to curtail use of e-cigarettes, particularly among the young.

But it will also mean more GPs will be able to prescribe them to patients as a smoking cessation product of last resort, and potentially without having to go through the TGA’s
special access scheme.

To support the change new telehealth MBS items will be rolled out from March — although as yet there are few details on which patients will be eligible, what the consults will involve or the rebates.

The AMA says it fears they could be used by a small
group of doctors happy to prescribe e-cigarettes long-term to individual patients.

It has called on the Federal Government to prevent patients claiming the item without an existing face-to-face relationship to their usual GP or their practice.

“We are very concerned about the
idea of a specific item number that would be purely there to facilitate vaping to people with no intention to quit,” @amapresident president @omarkhorshid82 Dr Omar Khorshid said.

“The normal telehealth item numbers are linked to a patient’s usual GP and we wouldn’t want this
to be a way around that.”

Dr Khorshid said GPs were already offering smoking cessation advice and prescriptions to patients in consultations funded with existing Medicare items.

“If you just ended up with an online service that basically made vaping products freely and easily
available without providing proper care, that would be a policy failure.”

Currently, it is illegal to sell nicotine-containing e-cigarettes in Australia and possession in all states and territories except SA is illegal without a valid medical prescription.
Under reforms introduced last year, nicotine-containing e-cigarettes are being down scheduled from S7 products — a dangerous poison — to S4 products to ensure medical oversight of their use.

The TGA’s scheduling delegate said restrictions on e-cigarettes were necessary
to mitigate the potential uptake of smoking in young adults who would otherwise be at low risk of nicotine addiction.

They also argued the evidence did not support the claim that e-cigarettes were a safer alternative to smoking cessions aids currently available.
According to Dr Khorshid, the TGA is indicating it will reduce the paperwork demands on GPs seeking to become authorised prescribers of e-cigarettes.

“They have said it will be a minimal approach, where doctors will only need to provide a prescriber number and contact details,”
he said.

“Whether that will be tightened to include some basic education on the product is still being discussed but it certainly won’t be an onerous process for doctors.”

Read more: RACGP backs vaping as second-line smoking cessation therapy

The @AMAGenPractice @ama_media
AMA has long opposed the sale of nicotine e-cigarettes without a doctor’s prescription, arguing there are unknown long-term health effects and insufficient evidence on their efficacy as a treatment.
However, the @rcgp RACGP gave qualified support for the products last year as second-line treatment for patients who wanted to quit smoking but only as a last resort.
Its updated guidelines stressed that doctors should only make the recommendation after the patient had raised
the subject themselves, and it said patients must be given enough context to make an informed decision.
---
So GPs instructed not to recommend vaping but instead the least effective, most expensive pharmaceutical methods & every time they shop, death sticks will be in their face.
Instead of following @PHE_uk @RCPLondon 95% harm reduced sans cancer, @rcgp & @AMAGenPractice @ama_media @amapresident @TGAgovau @healthgovau @CancerCouncilOz @LungFoundation @smokefreetas @tobaccofreeaust @msh_wa et all in @SimonChapmans6 against graphic he smugly parades;
would rather you quit vaping, even though you know you'll just end up smoking again? These bodies wouldn't have to look hard to see past the propaganda and misinformation to find the real experts to #KnowNicotine & #RethinkNicotine
@threadreaderapp unroll

More from Health

I think @SamAdlerBell in his quest to be the contrarian on Fauci gets several things wrong here. 1/


First, the failure last year actually was driven by the White House, the #Trump inner circle. Watch what's happening now, the US' scientific and public health infrastructure is creaking back to life. 2/

I think Sam underestimates the decimation of many of our health agencies over the past four years and the establishment of ideological control over them during the pandemic. 3/

I also am puzzled why Tony gets the blame for not speaking up, etc. Robert Redfield, Brett Giroir, Deb Birx, Jerome Adams, Alex Azar all could have done the same. 4/

Several of these people Bob Redfield, Brett Giroir, Alex Azar were led by craven ambition, Jerome Adams by cowardice, but I do think Deb Birx and Tony tried as institutionalists, insiders to make a difference. 5/
No-regret #hydrogen:
Charting early steps for H₂ infrastructure in Europe.

👉Summary of conclusions of a new study by @AgoraEW @AFRY_global @Ma_Deutsch @gnievchenko (1/17)
https://t.co/YA50FA57Em


The idea behind this study is that future hydrogen demand is highly uncertain and we don’t want to spend tens of billions of euros to repurpose a network which won’t be needed. For instance, hydrogen in ground transport is a hotly debated topic
https://t.co/RlnqDYVzpr (2/17)

Similar things can be said about heat. 40% of today’s industrial natural gas use in the EU goes to heat below 100°C and therefore is within range of electric heat pumps – whose performance factors far exceed 100%. (3/17)


Even for higher temperatures, a range of power-to-heat (PtH) options can be more energy-efficient than hydrogen and should be considered first. Available PtH technologies can cover all temperature levels needed in industrial production (e.g. electric arc furnace: 3500°C). (4/17)


In our view, hydrogen use for feedstock and chemical reactions is the only inescapable source of industrial hydrogen demand in Europe that does not lend itself to electrification. Examples include ammonia, steel, and petrochemical industries. (5/17)

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#ज्योतिष_विज्ञान #मंत्र_विज्ञान

ज्योतिषाचार्य अक्सर ग्रहों के दुष्प्रभाव के समाधान के लिए मंत्र जप, अनुष्ठान इत्यादि बताते हैं।

व्यक्ति के जन्म के समय ग्रहों की स्थिति ही उसकी कुंडली बन जाती है जैसे कि फ़ोटो खींच लिया हो और एडिट करना सम्भव नही है। इसे ही "लग्न" कुंडली कहते हैं।


लग्न के समय ग्रहों की इस स्थिति से ही जीवन भर आपको किस ग्रह की ऊर्जा कैसे प्रभावित करेगी का निर्धारिण होता है। साथ साथ दशाएँ, गोचर इत्यादि चलते हैं पर लग्न कुंडली का रोल सबसे महत्वपूर्ण है।


पृथ्वी से अरबों खरबों दूर ये ग्रह अपनी ऊर्जा से पृथ्वी/व्यक्ति को प्रभावित करते हैं जैसे हमारे सबसे निकट ग्रह चंद्रमा जोकि जल का कारक है पृथ्वी और शरीर के जलतत्व पर पूर्ण प्रभाव रखता है।
पूर्णिमा में उछाल मारता समुद्र का जल इसकी ऊर्जा के प्रभाव को दिखाता है।


अमावस्या में ऊर्जा का स्तर कम होने पर वही समुद्र शांत होकर पीछे चला जाता है। जिसे ज्वार-भाटा कहते हैं। इसी तरह अन्य ग्रहों की ऊर्जा के प्रभाव होते हैं जिन्हें यहां समझाना संभव नहीं।
चंद्रमा की ये ऊर्जा शरीर को (अगर खराब है) water retention, बैचेनी, नींद न आना आदि लक्षण दिखाती है


मंत्र क्या हैं-
मंत्र इन ऊर्जाओं के सटीक प्रयोग करने के पासवर्ड हैं। जिनके जप से संबंधित ग्रह की ऊर्जा को जातक की ऊर्जा से कनेक्ट करके उन ग्रहों के दुष्प्रभाव को कम किया और शुभ प्रभाव को बढ़ाया जाता है।