Unsafe injection practices. Medical search. Frequent questions

The One & Only Campaign is a public health effort to eliminate unsafe medical injections. (cdc.gov)

Bloodborne fatal ailments such as hepatitis B or C and AIDS are transmitted through the reuse or overuse of injections. (mediarchitect.net)
Dangerous injection practices in hospitals can transmit infections, such as hepatitis B and C and HIV. (servicenation.org)
Unsafe injection practices put patients and healthcare personnel at risk of disease transmission, including bacterial infections like MRSA or bloodborne pathogens like hepatitis C virus. (cdc.gov)
When Dr. Evelyn McKnight was battling breast cancer in 2002, the last thing on her mind was hepatitis C. So when she and her husband Thomas learned she had contracted the virus from unsafe injection practices during her treatment, they were shocked. (cdcfoundation.org)
It is reported that unsafe practices and excessive injections cause more than 32% of hepatitis B and more than 40% of hepatitis C globally according to the WHO advocacy booklet on the "Safe Injection Global Network" produced in 2011. (who.int)
Acute Hepatitis C virus infections attributed to unsafe injection practices at an endoscopy clinic-Nevada, 2007. (ahrq.gov)
My experience contracting hepatitis C through unsafe healthcare practices led me to be an advocate for patient safety. (cdc.gov)
Practicing safe sex is also a great way to prevent the transmission of hepatitis B. If someone is living with hepatitis B and you don't know your partner's hepatitis B vaccine status, be sure to have sex with a condom to prevent the transmission of hepatitis B during intercourse. (hepb.org)
People with multiple sex partners should be advised to follow safe sex practices, which should protect against hepatitis C as well as hepatitis B, HIV, and other sexually transmitted diseases. (txliver.com)
In many areas of the world, unsafe injection practices in the delivery of health care are an important and common cause of hepatitis C (and hepatitis B as well). (txliver.com)
Use of inadequately sterilized equipment, reuse of needles and syringes, and inadvertent contamination of medical infusions are unfortunately well-documented causes of transmission of hepatitis C. Careful attention to universal precautions and injection techniques should prevent this type of spread. (txliver.com)
In one instance, the Colorado Department of Health notified 8000 patients that they were at risk for contracting Hepatitis B, Hepatitis C and HIV because their dentist's practice reused needles and syringes. (honoreform.org)
In developing nations, 10 billion syringes are used each year, but unfortunately, unsafe injection practices are common and cause at least 1.3 million deaths and 10 million cases of hepatitis annually. (pharmamanufacturing.com)
In 2000, a significant number of the 10 to 15,000 new cases of hepatitis B in Mozambique resulted from unsafe injections world-wide there are between eight to 16 million new cases each year. (vaccinealliance.org)
This precipitated the New Mexico Department of Health to offer free HIV and Hepatitis B and C screenings to anyone who was injected there for a specified period before the spa was ultimately shut down after a health inspection found thatÂ unsafe practices may have spread blood-borne infections, like HIV. (beautyinthebag.com)
Using \\\'Injections received\\\' data from the Pakistan Demographic Health Survey 2006-7 (N: 5429) and the National Hepatitis Survey (N: 47,043), the study estimated the number of injections received in Pakistan. (org.pk)
However, highly prevalent Hepatitis B and C viruses suggest that even this reuse is a major public health concern and measures directed at both providers and recipients of injections are needed to curtail high injection need and syringe reuse. (org.pk)
Unsafe injection practices, including excessive use of therapeutic injections and reuse of syringes, are major public health hazards and have likely contributed to the high prevalence of Hepatitis B and C 1-6 which now infect over 12 million people nationwide. (org.pk)
7,11,12 These practices are further perpetuated by limited awareness among patients (and possibly some providers) about the hazards of using unsterilised needles such as transmission of Hepatitis B or C and HIV infections. (org.pk)

Unsafe transfusion practices, including unnecessary or unsuitable transmissions, increase the risk of patients suffering from severe adverse transfusion reactions as well as deadly infections that are transmissible through transfusion. (servicenation.org)
It is the responsibility of every provider who prepares and administers injections, or supervises those that prepare and administer injections, to make sure that patients are not exposed to life-threatening infections. (cdc.gov)
Unsafe safety practices such as reuse of syringes account for most of the infections, especially if not properly sanitized. (medgadget.com)
The campaign aims to eliminate infections resulting from unsafe injection practices. (rdhmag.com)
These infections may have come from exposure to the virus from cuts, wounds, or medical injections or procedures. (txliver.com)
The World Health Organization (WHO) estimates that nearly a quarter (23%) of the 1.7 million new HCV infections worldwide in 2015 were due to drug injection [ 7 ]. (biomedcentral.com)
However, combining those safer devices with a better awareness of the potential risks, along with aseptic infection control techniques, should ultimately be your goal, as thousands of infections occur each year in the U.S. as a result of unsafe injection practices. (probloodborne.com)

Many healthcare workers are unaware of the risks associated with unsafe injection practices. (mediarchitect.net)
These events indicate that some healthcare personnel do not adhere to safe practices and may be unaware of the risks these unsafe practices pose to patients. (cdc.gov)

Infection usually occurs through unsafe injection practices, or the transfusion of contaminated blood and blood products. (universaldrugstore.com)
This can be through injection, unsafe injection practices (drug use) transfusion of unscreened blood and blood products (red blood cells, plasma, platelets etc. (ndtv.com)
In addition, transfusion of HBV-contaminated blood and blood products, use of contaminated injections during medical procedures, and injectable drugs can transmit the infection. (afdpharma.com)

Re-usage of needles and syringes coupled with unnecessary use of injectable medications are common examples of unsafe injection practices in low-rated hospitals. (servicenation.org)
Fear of needles, also called needle phobia, is also common and may result in anxiety and fainting before, during, or after an injection. (wikipedia.org)
Furthermore, recreational drug users who use injections to administer the drugs commonly share or reuse needles after an injection. (wikipedia.org)
This has led to the development of needle exchange programs and safe injection sites as a public health measure, which may provide new, sterile syringes and needles to discourage the reuse of syringes and needles. (wikipedia.org)
Unsterilized needles are particularly a safety concern in poor or undeveloped areas where injections aren't usually given the guidance of a medical professional. (medgadget.com)
Therefore, disposable syringes are advised over reusable needles for any injection to prevent the risk of blood-borne diseases as it has been contaminated with infected blood. (medgadget.com)
NEPs aim to improve access to sterile syringes, needles, and other injection equipment for those who use injectable drugs. (medicalnewstoday.com)
Safe injection practices for dentistry emphasize the basic principles that when administering local anesthesia, all needles and anesthetic cartridges are used for one patient only and the dental syringe is cleaned and heat sterilized between patients. (rdhmag.com)
This has led to the argument that individuals with limited resources are unable to purchase and use fresh needles each time they require injections, resulting in widespread reuse of syringes for therapeutic injections. (org.pk)
The most common unsafe injection practices include re-using needles, using multiple-dose medications or bags of solutions, and administering the same intravenous medications to multiple patients. (probloodborne.com)
This includes washing your hands, using clean gloves, and using alcohol wipes to clean injection portals, the tops of vials, and the skin where needles will be inserted. (probloodborne.com)

Regardless of classification, injections require a puncture to be made, thus requiring sterile environments and procedures to minimize the risk of introducing pathogens into the body. (wikipedia.org)
Since 2001, discovery of unsafe injection practices, have prompted nearly 200,000 patients to seek testing for bloodborne pathogens. (cdc.gov)
Introduction: There is a risk of transmission of viruses and microbial pathogens during routine health care procedures due to improper injection, infusion, and medication-vial practices. (ivteam.com)

Intravenous injections, abbreviated as IV, involve inserting a needle into a vein, allowing a substance to be delivered directly into the bloodstream. (wikipedia.org)
An intravenous injection provides the quickest onset of the desired effects because the substance immediately enters the blood, and is quickly circulated to the rest of the body. (wikipedia.org)
A disposable syringe is a small, simple piston pump based medical tool used to administer injections of intravenous drugs into the bloodstream or to draw a blood sample from a patient's body. (medgadget.com)

Read the blog below, authored by Evelyn McKnight, to learn more about preventing unsafe injection practices. (cdc.gov)

It will also help to raise awareness of the importance of promoting safe injection practices. (who.int)
With an estimated 16 thousand million injections administered annually in developing and transitional countries alone, the importance of promoting safe injection practices is unprecedented. (who.int)

This session of Grand Rounds explored how unsafe injection practices which put patients at risk of infection have been associated with a wide variety of procedures and settings. (cdc.gov)
Unsafe injections also increase the burden on patients, healthcare providers, and medical care and public health systems. (cdc.gov)
Millions of patients are injured or killed every year due to unsafe or inadequate care . (servicenation.org)
Unsafe surgical care procedures leave many patients severely injured or dead. (servicenation.org)
Led by CDC and the Safe Injection Practices Coalition (SIPC), the campaign seeks to raise awareness among patients and healthcare providers about safe injection practices, which are critical to the overall safety of healthcare delivery. (cdc.gov)
Through targeted education and awareness efforts, the campaign empowers patients and healthcare providers to insist on nothing less than safe injections-every time, for every patient. (cdc.gov)
Patients should be encouraged to start a dialogue with their healthcare team and ask questions about safe injection practices. (cdc.gov)
The injection safety policy will guide health professionals to provide a safe injection and protect patients and health care providers from medical injuries. (who.int)
Pharmacologically inappropriate prescriptions for elderly patients in general practice: how common? (ahrq.gov)
The goal is to raise awareness among patients and health-care providers about safe injection practices. (rdhmag.com)
The goal of the campaign is to ensure patients are protected each and every time they receive a medical injection. (rdhmag.com)
Between 2001 and 2011, there were 35 reports of injection safety violations, affecting more than 130,000 patients across 17 states and Washington, DC. (eurekalert.org)
Unsafe practices lead to outbreaks of infection resulting in unacceptable and devastating events in patients. (ivteam.com)
For these reasons, changes in sexual practices are not recommended for monogamous patients. (txliver.com)
Since 2012 thousands of patients have been put at significant risk of acquiring infectious disease from dental practices in four states. (honoreform.org)
This overuse is driven by a popular belief among healthcare providers and patients that injections are more effective and provide quicker relief than orally administered medicines. (org.pk)
6,9,10 Some patients even feel that a doctor\\\'s fee is unjustified unless an injection is given. (org.pk)
Additionally, there is a strong belief that the \\\'doctor knows best\\\', hence, when injections are prescribed or syringes are reused by doctors, patients seldom object. (org.pk)
Objective: The main objectives were to determine the incidence of Traumatic Injection Neuropathy (TIN) and hospital outcome of patients within 60 days of admission. (scirp.org)

Many HIV and narcotic prevention programs are working globlly to spread awareness about the fatal health issues associated with unsafe injection practices. (mediarchitect.net)
In Western Europe and elsewhere, medically supervised safer injection facilities (SIFs) are increasingly being implemented for the prevention of health- and community-related harms among injection drug users (IDUs), although few evaluations have been conducted, and there have been questions regarding SIFs' ability to attract high-risk IDUs. (researchgate.net)
One support system that I have found to be invaluable is the One & Only campaign that is put together by a coalition led by the Centers for Disease Control and Prevention (CDC) and the Safe Injection Practices Coalition (SIPC). (rdhmag.com)
Currently, the campaign has several organizations that represent dental settings and practices, including the American Association of Women Dentists (AAWD), Organization for Safety, Asepsis, and Prevention (OSAP), and Ammari Dental in Aurora, CO. The campaign aims to raise awareness about injection safety, including updates related to the intersection of injection safety and dental care. (rdhmag.com)
CDC recently revised and released 'Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. (rdhmag.com)
How does this program fit in with 'The Summary for Infection Prevention Practices in Dental Settings: Basic Expectation for Safe Care? (rdhmag.com)
The comprehensive but user-friendly document, 'Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care,' features several new tools to help personnel understand and follow infection prevention guidelines. (rdhmag.com)
During these onsite visits, health department staff assist healthcare facilities in reviewing current infection prevention practices and provide recommendations for improvement. (virginia.gov)
Completion of an ICAR assessment and site visit, along with a facility commitment to take measures to implement VDH recommendations to improve infection prevention and control practices. (virginia.gov)
Poor vaccination practices can lead to the spread of disease, rather than its prevention. (vaccinealliance.org)
For employers, the Needlestick and Prevention Act requires that they provide appropriate, effective, safe, and commercially available medical devices that are designed to eliminate or minimize your occupational exposure if ever unsafe injection practices occur. (probloodborne.com)
An infection prevention and control (IPC) team conducted site visits and reviewed IPC practices. (who.int)
(12) . The Sindh Provincial Department of Health, in Pakistan has faced challenges in infection prevention coordination with the District Commissioner in Larkana and control (IPC), particularly with unsafe injections. (who.int)

Background: Traumatic Injection Neuropathy (TIN) can occur because of unsafe intramuscular injection practices. (scirp.org)
Traumatic Injection Neuropathy (TIN) can occur because of unsafe intramuscular injection practices. (scirp.org)

In this episode, Dr. McKnight shares her story, which inspired her advocacy work with safe injection practices and the Evelyn and Thomas McKnight Family Fund for Patient Safety. (cdcfoundation.org)
The campaign publishes a weekly newsletter about injection safety and other patient safety news, and also has an injection safety e-mail listserv and RSS feed. (rdhmag.com)
If someone sees unsafe practices, they need to report it for patient safety. (ascrubslife.com)
Remind everyone in your staff meetings and in-services that injection safety = patient safety. (ascrubslife.com)

The growing incidences of chronic illness that require injections is the key factor that accelerates the market growth during the forecast period across all regions. (medgadget.com)

There is a high burden of HIV/HBV co-infection in African countries because both diseases share similar transmission routes such as mother-to-child, unsafe medical and injection practices, and unscreened blood transfusions. (hepb.org)

Injections generally administer a medication as a bolus (or one-time) dose, but can also be used for continuous drug administration. (wikipedia.org)
Many injections are designed to administer a medication which has an effect throughout the body. (wikipedia.org)

A major problem is that two out of three times, we're not learning about unsafe medical practices until it's too late," says Charles Defendorf, DO, an internal medicine resident trained at Rowan University School of Osteopathic Medicine and lead researcher on this review. (eurekalert.org)

Evelyn tells her story with compassion and purpose with the intention to educate listeners about the egregious unsafe practices that continue unabated in healthcare practice sites. (honoreform.org)

Investigations indicate that unsafe healthcare practices in formal and informal healthcare settings as the most likely cause of the 2019 outbreak of HIV infection in Larkana, Pakistan. (who.int)

To reduce the risk of infection from injections, proper aseptic technique should be followed to clean the injection site before administration. (wikipedia.org)
Make sure to always use aseptic techniques to avoid the contamination of sterile injection equipment. (probloodborne.com)

Correct disposal of injections is crucial to avoid the spread of health risks associated with unsafe injection practices. (mediarchitect.net)
Make sure the injection disposal area is only accessible to authorized staff to ensure complete safety. (mediarchitect.net)
This study indicated that the SIF attracted IDUs who have been shown to be at elevated risk of blood-borne disease infection and overdose, and IDUs who were contributing to the public drug use problem and unsafe syringe disposal problems stemming from public injection drug use. (researchgate.net)
Safe injection practices are instrumental to following the standard precautions and include safe sharps disposal practices - such as using leak-proof, puncture-resistant appropriate sharps containers - along with using sharps and needle devices that have been engineered with injection protections. (probloodborne.com)

The World Health Organization (WHO), the Red Cross and the Safe Injection Global Network (SIGN) are supporting programs to improve injection safety worldwide. (pharmamanufacturing.com)

To prevent the localized pain that occurs with injections the injection site may be numbed or cooled before injection and the person receiving the injection may be distracted by a conversation or similar means. (wikipedia.org)

Go for oral or tropical medicine to avoid the risks associated with injections altogether. (mediarchitect.net)

Regurgitation of blood into the insulin cartridge can occur after injection [ 1 ] creating a risk of bloodborne pathogen transmission if the pen is used for more than one person, even when the needle is changed. (cdc.gov)

A cursory review of the ture indexed in bibliographic databases and search en- literature, however, did not identify peer-reviewed gines and a focused gray literature review to collate and publications on all of these referenced outbreaks. (cdc.gov)
Every year, unsafe injection practices by US healthcare providers-like syringe reuse and misuse of medications vials- cause outbreaks. (cdc.gov)
Over the past few decades failures to follow safe injection practices have burdened many developing, as well as developed countries, with outbreaks of infectious diseases. (who.int)
Conclusion: Adherence to safe injection and infusion practices is very important to prevent outbreaks of infection in health care settings. (ivteam.com)
These outbreaks reflected major challenges in Joint United Nations Programme on HIV/AIDS (UNAIDS) basic infection control practices. (who.int)

Injections are among the most common health care procedures, with at least 16 billion administered in developing and transitional countries each year. (wikipedia.org)
This type of injection is the most common and is used frequently for administration of medications in an inpatient setting. (wikipedia.org)
combined experience in training residents and medical students, enabling them to identify common unsafe practices in office-based surgery. (stanford.edu)
This approach is common animal husbandry practice in North America and elsewhere. (cpha.ca)
Conclusion: This study confirms that traumatic injection neuritis is the second most common cause of Acute Flaccid Paralysis in Yemen after Guillain-Barré Syndrome with high morbidity in children. (scirp.org)

How to Avoid Complications of Unsafe Injection Practices? (mediarchitect.net)
What are the possible complications of unsafe injection practices? (mediarchitect.net)

Project Firstline wants to ensure that all healthcare workers who give vaccines understand the importance of safe injection practices, and that they use multi-dose vaccine vials safely and correctly. (cdc.gov)
Injection devices meeting these standards can be used with multidose vials and, by their nature, will prevent re-use and the spread of blood-borne diseases.Mandating specifications for bulk purchases based on internationally accepted standards will allow organizations such as UNICEF to meet their goal and encourage innovation and market development. (pharmamanufacturing.com)

These harms are preventable through renewed attention to infection control and injection safety practices, which is a focus of the presentation at this Grand Rounds. (cdc.gov)
SIPC created these educational resources to remind healthcare providers-across all settings and specialties-about the basics of injection safety. (cdc.gov)
18 May 2017 - The WHO country office in Egypt, in collaboration with the Ministry of Health and Population, organized a joint workshop to review the injection safety draft policy. (who.int)
It is highly appropriate for use in immunization by improving injection safety. (medgadget.com)
To receive the SIPC Weekly Digest, e-mail updates, and/or subscribe to the injection safety RSS feed, please email [email protected] . (rdhmag.com)
Dental professionals can find relevant and timely information about injection safety and the campaign at OneandOnlyCampaign.org. (rdhmag.com)
Only 37 percent were identified after proactive reporting of injection safety violations. (eurekalert.org)
Safety in Office-Based Dermatologic Surgery is relevant to any healthcare professional who participates in office-based procedures, such as injections, biopsies, excisions, and laser surgery. (stanford.edu)
A worldwide effort to improve injection safety is being coordinated by SIGN with the guiding principle that a safe injection should not harm the recipient, the healthcare worker administering the injection, or the community at large. (pharmamanufacturing.com)
WHO, UNICEF, UNFPA and the Federation of Red Cross and Red Crescent Assocations have adopted a global policy on injection safety calling for the use of auto-disable syringes for all immunization by the end of 2003. (vaccinealliance.org)
2. Ensure that their comprehensive safety program includes training on hazard recognition and the avoidance of unsafe work practices and conditions by conducting a job safety analysis (JSA). (cdc.gov)
Consider revising standard ANSI/SPI B151 to require all plastic injection molding machine s, regardless of size, to have an additional safety device to protect workers from the moving parts in the mold processing area. (cdc.gov)
Describe the Injection Safety. (edu.pk)

The principle of harm reduction is that society should ensure that all dangerous, dysfunctional behavior-drug abuse, unsafe sexual practices, failure to comply with psychiatric medical orders, living on the street-happens in as safe a manner as possible. (city-journal.org)

Therapeutic injections are commonly sought and administered in Pakistan 4,7 and are often unnecessary. (org.pk)
This complication is of particular concern in countries with high rates of unnecessary injections. (scirp.org)
The World Health Organization (WHO) in 1999 reported that out of the 8 - 12 billion injections administered worldwide annually, the vast majority (90% - 95%) are for therapeutic purposes, and 50 percent are unsafe, and 75 percent are unnecessary. (scirp.org)

Medications administered via a systemic injection will enter into blood circulation, either directly or indirectly, and thus will have an effect on the entire body. (wikipedia.org)

Proponents say that safe injection sites are an obvious solution to the horrific problem of drug overdoses, which now kill more than 90,000 Americans annually. (city-journal.org)
Approximately 731±867 million injections (5.1±12 injections per head) are received annually in Pakistan and around 861±961 million syringes are supplied to the open market. (org.pk)

Prevent disease transmission from unsafe injection practices. (cdc.gov)

Insite, which opened in Vancouver, British Columbia, in 2003 as North America's "first sanctioned supervised drug injection site," is considered the gold standard of care from the perspective of "harm reduction. (city-journal.org)
HCV is commonly spread during medical procedures or during drug injection by drug users, often exposing healthcare professionals and drug users to infected blood through transfusions of HCV-contaminated blood and blood products. (afdpharma.com)

Death from unsafe abortion was once a widespread problem but through the power of peer education, these have almost disappeared and community attitudes towards safe abortion has been transformed. (ippf.org)

In medical practice, unfamiliarity with procedures increases the likelihood of occupational exposures. (stanford.edu)

Insulin pens are designed to be used multiple times, for a single person, using a new needle for each injection. (cdc.gov)

Injection need in Pakistan is among the highest worldwide but is completely matched by available syringe supplies, suggesting lower reuse than previously considered. (org.pk)
The epidemic is concentrated among key led to improved national IPC practices in Pakistan. (who.int)

A basic expectation that exists in any healthcare setting is the protection from an infection (blood and other potentially infectious materials) while receiving an injection. (probloodborne.com)

Know the basics of standard infection control Practices. (edu.pk)

The biggest concern is the lack of awareness about the risks linked to reusing injections. (mediarchitect.net)
It continues to increase provider and patient awareness of the need for safe injection practices. (rdhmag.com)
We hope that Evelyn will continue to educate the public and bring more awareness on safe injection practices so an event like this never happens again. (honoreform.org)

Supporting countries to improve injection practices is part and parcel of GAVI s mission. (vaccinealliance.org)

Title : Patient Notification for Bloodborne Pathogen Testing due to Unsafe Injection Practices in the US Health Care Settings, 2001-2011 Personal Author(s) : Guh, Alice Y.;Thompson, Nicola D.;Schaefer, Melissa K.;Patel, Priti R.;Perz, Joseph F. (cdc.gov)
These are preventable deaths, easily reversible by a timely health intervention, such as an injection of live-saving naloxone (Shorter & Bingham, 2014). (bps.org.uk)
Unsafe injection practices on the part of health care workers may also cause an HBV infection. (disabled-world.com)
CDC Grand Rounds: preventing unsafe injection practices in the U.S. health-care system. (ahrq.gov)
SIPC is a partnership of health-care organizations that was formed to promote safe injections in all U.S. health-care settings. (rdhmag.com)
Epidural steroid injections (ESIs) have been endorsed by the North American Spine Society and the Agency for Healthcare Research and Quality (formerly, the Agency for Health Care Policy and Research) of the Department of Health and Human Services as an integral part of nonsurgical management of radicular pain from lumbar spine disorders. (medscape.com)

The present study was undertaken to assess the compliance of nurses with safe injection and infusion practices in our hospital and to identify staff education requirements in relation to the safe-injection and infusion practices policy. (ivteam.com)

Organisms1

Diseases6

Chemicals and Drugs1

Analytical, Diagnostic and Therapeutic Techniques and Equipment11

Psychiatry and Psychology4

Disciplines and Occupations2

Anthropology, Education, Sociology and Social Phenomena3

Information Science2

Health Care18

Geographicals1

Effort to eliminate unsafe medical injections1

Hepatitis19

Infections7

Unaware of the risks2

Transfusion3

Needles11

Pathogens3

Intravenous3

Evelyn McKnight1

Importance of promoting safe injection2

Patients19

Prevention13

Intramuscular2

Patient Safety4

Require injections1

Blood transfusions1

Administer2

Medical practices1

Unabated in healthcare1

Healthcare practices1

Aseptic2

Disposal4

Safe Injection Global Network1

Occurs1

Altogether1

Occur1

Outbreaks5

Common5

Complications2

Vials2

Safety13

Sexual practices1

Unnecessary3

Medications1

Annually2

Prevent1

Drug injection2

Widespread1

Procedures1

Insulin1

Pakistan2

Infectious1

Infection control practices1

Awareness3

Improve injection1

Health6

Assess1