Barcelona vs. Osasuna (1:30 p.m.) In Munich, the Delta variant has also led to arrivals from the U.K. being forced to quarantine for 10 days. Euro 2020 is a year late, but from UEFA's perspective, it is better late than never. ICU Clinical Coordinator Ash Caretti, RN, CCRN, explains how the ICU flexed early in the pandemic, as volumes increased and staff learned along the way. This message provides an update on COVID-19 and our preparations for the fall. Spain's Sergio Busquets is also in isolation after testing positive, meaning the under-21 squad will have to fulfil Tuesday's friendly against Lithuania. Latest Updates In alignment with the California Department of Public Health (CDPH) and local counties, as well as the Centers for Medicare and Medicaid Services (CMS), booster shots are no longer required for health care workers. Supporting governments and frontline workers. You can also use the CDC tool to determine whether it is advisable for you or your child to receive one or more boosters at COVID-19 Vaccine Boosters. For instance in Budapest, a valid match ticket and negative test or proof of vaccination are required to secure a COVID-19 wristband. England could play a quarterfinal in St. Petersburg on July 2, which would prove problematic for fans, as they'd be unable to successfully isolate that long before the potential last-eight fixture. The hope within UEFA is that the existing protocols of secure bubbles including players, staff and key personnel, as used throughout the club game last season, will ensure minimal disruption. Learn More about Video Visits , Get the iPhone MyHealth app This is a Stanford Health Care job. Specific functions pertaining to the Service, Clinic or Department are established by the PA and his/her supervising physician . McCreary EK, Pogue JM. Stanfords COVID dashboards provide daily and weekly updates about COVID surveillance testing, isolation, and prevalence in the Stanford community. A negative test, doctors note, or clearance letter is not required for you to return to work and Toronto Public Health does not provide return-to-work letters. Effective treatment of severe COVID-19 patients with tocilizumab. But with commitments to supporters, broadcasters and national associations, UEFA had to get the tournament on in whatever shape or form possible. Food and beverage: New standards and service approach to buffets, banquets, room service and catering. To support those involved in worthy causes, weve also created a global volunteering resource for corporate colleagues, which is updated with new opportunities around the world so that people can make the most of their two days of volunteering leave each year. This site provides the Stanford community with important updates related to COVID-19. A Brief Overview. J Biol Chem. We have already seen one significant change designed to reduce any potential impact of a COVID-19 outbreak, with UEFA increasing squad sizes from 23 players to 26. Follow this advice whether you have tested for COVID-19 or not. Have your older child sleep in their own room if possible. COVID-19 survivability on surfaces ranges and its survivability depends on the type of surface. Identification / isolation and for whom to order testing: COVID-19 Specimen Collection and Handling for Testing at SHC(last updated 3/17/20)- guidance on who should be tested for COVID (see 1st page), SHC ED Flowchart for Identifying, Isolating, and Assessing Patients for COVID-19(last updated 3/5/20)-EDworkflow (both nursing and provider) for identifying and isolating PUI (changes in progress), SHC Ambulatory Clinics Flowchart for Identifying, Isolating, and Assessing Patients for COVID-19(last updated 3/13/20)-Ambulatoryworkflow for identifying/isolating/testing patients, COVID19 Screening Criteria to Identify, Isolate, Assess & Test Patientsat SHCCancer Center Clinics, Imaging(last updated 3/17/20)- Workflow forCancer Center / Imaging clinicsfor isolation and testing of PUI, COVID-19 Oral Specimen Collection One Point Lesson(last updated 3/21/20), COVID-19 Nasal Specimen Collection One Point Lesson(last updated 3/21/20). The information on this page provides the direction on what you need to do; see the self-isolate section for how long you should self-isolate. two new protocols regarding face coverings, and student parties on a short-term basis, that we are introducing to further inhibit transmission of the virus; and information on how positive cases will be managed when they occur. Open Forum Infect Dis. 50, Man United in pole position for top four, but can't take their eyes off Liverpool, Transfer Talk: Manchester United see Lautaro Martinez as a striker option, The VAR Review: Red cards for Jota, Skipp; Richarlison penalty claim, When goal celebrations go bad: Liverpool boss Klopp pulls hamstring, Liga MX review: Dominant Monterrey clinch top playoff seed ahead of America, Chivas, How Premier League clubs can qualify for Europe this season, U.S. viewers can stream the game LIVE on ESPN+, Euro 2020: Fixtures, ESPN live, match dates, times and venues, European Soccer Pick 'Em: Compete to win $10,000, Do Not Sell or Share My Personal Information. 3.1.1 The Protocol's preventive measures constitute to the primary line of defense. Valencia vs. Villarreal (1:30 p.m.) Our drive-thru testing and vaccination sites have closed for the season. They are recommended for most people. For the most current information on COVID-19 vaccinations and boosters, including where to obtain them, visit theVaccinations page. For student residences, we will continue to follow the notifications we have used over the last year: If there is a positive case on a students floor with a shared bathroom, the students on the floor will be notified of the positive case via email; if there are multiple positive cases in a dorm/building within 14 days, all dorm/building residents will be notified via email. Review the COVID-19 Vaccination and Surveillance Testing policy page for details, including information about the medical and religious accommodation criteria and process, as well as frequently asked questions. Mainz vs. Schalke (2:30 p.m.). 3 . Wear a high-quality mask if you must be around others at home and in public. However, if a team can't fulfil a fixture within 48 hours of its original kick-off time, the game will not be played and the team with the positive tests will forfeit the game 3-0. Treatments can help you from getting very sick, and may also help you feel better sooner. We have also provided support for food bank and food provision charities in more than 70 countries, working with partners such as No Kid Hungry in the US and the Trussell Trust in the UK, while supporting the European Federation of Food Banks (FEBA) and The Global FoodBanking Network (GFN). You can also use the CDC tool to determine whether it is advisable for you or your child to receive one or more boosters at COVID-19 Vaccine Boosters. Stay at home until you have no fever and symptoms are improving for at least 24 hours (or 48 hours for gastrointestinal symptoms such as vomiting and/or diarrhea). In addition to one dose of Peginterferon Lambda-1a or placebo, patients will receive serial testing to detect length of viral shedding in respiratory secretions, monitoring of clinical signs and symptoms, and will receive compensation for each visit. March 2020:105933. doi:10.1016/j.ijantimicag.2020.105933, Gordon CJ, Tchesnokov EP, Feng JY, Porter DP, Gotte M. The antiviral compound remdesivir potently inhibits RNA-dependent RNA polymerase from Middle East respiratory syndrome coronavirus. Learn about health and safety policies, and appointments with primary and specialty care providers by video and in person. 1/19/23The LA County Dept. Welcome to Campus. For guidance, refer to our. Dashboardsprovide aggregated results for the Stanford community. Dear Stanford community, We are writing to share an update on campus masking guidelines. 1. Please speak with your health care provider or call Health Connect Ontario at 811 if you need further care. Video visits are available through the MyHealth app and web portal. On December 29, 2022, the Consolidated Appropriations Act of 2023 was signed, which ends the Medicaid program's continuous coverage requirement as of April 1, 2023. COVID-19 Resource Center | Stanford Health Care Doctors, Clinics & Locations, Conditions & Treatments COVID-19 Resource Center Your Visit Vaccines & Testing Treatment & Research Daily Living FAQ Health Care Provider Your COVID-19 Resource Center Care, Guidance, and Discoveries Like the hospital's new COVID-19 treatment protocols, telehealth procedures were implemented in a matter of weeks. WhileIHGHotels & Resortshas a long-standing commitment to rigorous cleaning, all of our hotels are now delivering an enhancedIHG Way of Clean programme. Giving for Good and supporting volunteers. With the Delta variant, we continue to see some COVID-positive cases among vaccinated individuals. We are proud to be supporting government-led programmes around the world, which sees a small number of our hotels being used as vaccination centres, while others are providing accommodation for isolation and quarantine. One year on, the 24-team pan-European tournament has one fewer host city, reduced stadium capacities, strictly enforced coronavirus protocols and a labyrinth of travel restrictions and testing requirements. You do not need a test to show you have recovered from COVID-19 or to end your isolation. SU Occupational Health Center (for employees), U.S. Centers for Disease Control and Prevention. Such an environment highly vaccinated, with mask wearing in many settings is what we expect to have at Stanford this fall. Seeking participants for our Long COVID-19 Therapy Study, Infected with COVID-19 without testing positive, SARS-CoV-2 infects fat tissues, causing inflammatory storm, Antibodies in blood soon after COVID-19 onset may predict severity, COVID-19 vaccine effective in people with cancer, study finds. Date: 8/10/22. Also see information aboutvaccinations while breastfeeding. If you have any questions about text messages from Toronto Public Health, you can call Toronto Public Health at 416-338-7600. Some venues may increase their numbers as the tournament progresses, depending on the easing of restrictions in each country. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Protective antibodies are in the breastmilk of people who got the COVID-19 vaccine. Learn More about MyHealth Never has this been more needed than since the outbreak of Covid-19 and we have stepped up in many ways, including organising donation drives and food deliveries, providing hotel rooms for frontline workers and the homeless, and supporting the invaluable work of our charity partners. In addition, early evidence suggests that treatments may make. Wear a well-fitted, high quality mask when in public settings, especially if they are crowded or have poor ventilation, and avoid non-essential visits to vulnerable individuals (e.g. I hope you find this information useful. Travelers who are experiencing symptoms of illness should mask until receiving a negative rapid COVID test on day 5. You may receive either a text message, a call, or both in some cases. If you still can't find the answer to your question, email vphumanresources@stanford.edu. Get the facts about COVID-19from the basics to a few that might surprise you. Avoid crowded settings where people may be unmasked. Can I get a COVID-19 antibody test at Stanford Health Care? The university will continue to be attentive and realistic in our COVID-19 approach, focusing on shared responsibility, respect, and support for fellow community members. Limit your risk of catching and spreading COVID-19 as you pursue daily activities. (1:14). You can message your clinic, view lab results, schedule an appointment, and pay your bill. However, we will still require health care workers to receive the primary series of the COVID-19 vaccine. The FLCCC protocol includes first-, second- and third-line therapies, along with "optional adjunctive therapies." Ivermectin is at the top of the list of first-line treatments, along with the steroid prednisone, the opioid antagonist naltrexone, omega-3 fatty acids and vitamin D. 3.1 Participants' protection against COVID-19 is served by 2 (two) consecutive lines of defense. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Provided with information about what to tell any close contacts. The Stanford Department of Music is presenting in-person events in our venues as we . COVID-19 Health . We want to assure you that we are taking steps to protect everyone's health and safety, and we invite you to join us in minimizing the prevalence and reducing the spread of COVID-19 on our campus. Effective Monday, April 10, the university no longer requires but continues to strongly recommend COVID vaccinations and boosters for faculty, staff, postdoctoral scholars, and students. COVID-19 Staff FAQs(last updated 3/23/20)- general FAQ including working from home, occupational health and exposure related questions, SHC Zoom Patient Video Conferencing(last updated 3/20/20). Public spaces and facilities: Additional deep cleaning of high-touch surfaces, physical distancing, last cleaned charts, best practices for pools, fitness centres and lounges. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. COVID-19 Adult Quick Clinical Guide: Initial Considerations and Workup Clinical Manifestations* Fever 44-98% (less common earlier in course) Cough 46-82% Myalgias 35% Shortness of breath 20-64% URI symptoms 5-25%*Note: a wide spectrum of symptoms and presentations has been reported High Risk Groups Demographics: Age > 65, male Getting booster doses is an important part of protecting yourself from becoming seriously ill from COVID-19. The new facility has, indeed, proved to be an adaptable and effective facility for handling the pandemic and, Entwistle said, a demonstration of exactly what the new building was meant to handle. Getting COVID-19 while you are pregnant puts you at higher risk of getting very sick and being hospitalized, Preventing COVID-19 is even more important when you are pregnant follow. Make sure you know if you are eligible for. In alignment with the California Department of Public Health (CDPH) and local counties, as well as the Centers for Medicare and Medicaid Services (CMS), booster shots are no longer required for health care workers. In 2020, our Giving for Good Awards celebrated the efforts of more than 28,000 IHG colleagues, who provided 212,000 hours of support to their communities in response to Covid-19. We opened our new Main hospital building in December 2017, making it one of the most technically advanced and sustainable designed children's hospitals in the nation. This begins at the booking stage when those staying with us can see Hotel Cleanliness Ratings, and there is detailed cleanliness information on our websites, apps and in our hotels. March 2020. doi:10.3785/j.issn.1008-9292.2020.03.03, Yao X, Ye F, Zhang M, et al. Pre-Procedure Routine COVID Workflows (updated: 5/13) COVID Intraop OR Protocols : In-patient . A pilot of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19). Cao B, Wang Y, Wen D, et al. - European Soccer Pick 'Em: Compete to win $10,000. Dear Stanford community, Stanford is updating its protocols for those who tested positive for COVID-19 and are preparing to either come out of isolation or return to in-person work. In general, you can return to work, school, and your everyday activities when you have no fever and your symptoms have been improving for at least 24 hours (48 hours if you have gastrointestinal symptoms such as vomiting or diarrhea). Find health and wellness tips, news on treatment advances, event announcements, and more in our monthly newsletter. As youve read before, vaccination and face coverings together offer a high degree of protection against COVID-19. Sign up for ESPN+, TUESDAY, May 2 (all times ET) Clin Infect Dis. You are likely most infectious during these first 5 days. Learn about health and safety policies, and appointments with primary and specialty care providers by video and in person. New to the clinic? This is ideal for treating COVID-19, since the most severe damage is caused by the inflammatory effects. About the Lab Gordon CJ, Tchesnokov EP, Feng JY, Porter DP, Gotte M. The antiviral compound remdesivir potently inhibits RNA-dependent RNA polymerase from Middle East respiratory syndrome coronavirus. For questions related to Stanford's response to COVID-19 or other health concerns, please fill out this EH&S Health Guidance form. If you work in a high-risk setting, you can return to work after 10 days from positive test date or symptom onset (whichever is earlier), or sooner in some instances. Get the Android MyHealth app . This is aphase 2, open-label, single-blinded, randomized trial of a single dose of Peginterferon Lambda-1a compared with placebo in outpatients with mild COVID-19. We have also made it possible for IHG Rewards members to turn their loyalty points into financial donations for the International Federation of Red Cross and Crescent Societies Covid-19 Emergency Appeal, with around 7.5 million points having been donated so far. Collaborating with governments, trade bodies and peers to help secure relief packages, and working to protect industry jobs and ensure a quicker and stronger recovery. However, sources have told ESPN that, even without government-imposed restrictions, it is unlikely that Wembley will stage the final with a full stadium. In terms of accessing stadiums for games, each venue has different testing requirements for fans. Transmission from person to person increases the likelihood that the virus will grow into a stronger or more contagious strain, like the Delta variant. The chance to earn and redeem points at more than 400 stunning hotels, thanks to our exclusive partnership with Mr & Mrs Smith. Self-isolate for your required isolation period and until you have no fever and your symptoms have been improving for 24 hours (or 48 hours if gastrointestinal symptoms such as vomiting and/or diarrhea). chinaXiv:20200300026v1. For feedback about this website, please email digital-strategy@stanford.edu. If you require support, please call 211. These include hand washing and physical distancing, where possible. (updated: 11/16) Protocol for Preoperative Patients Who Test Positive For COVID-19 (updated: 11/2) COVID-19 RT-PCR Specimen Collection and Handling (updated: 8/31) . February 2020. doi:10.1074/jbc.AC120.013056, Chen J, Liu D, Liu L, et al. This position is considered a healthcare worker and will need to comply with the Stanford Medicine vaccination requirements including the primary series of COVID 19 vaccine. Get the Android MyHealth app , COVID-19 Resource Center/ Safe Patient Care. Telehealth video visits are available for primary care, follow-up visits, mental health services, and many specialty care appointments. We are located at 725 Welch Road in Palo Alto, California. Int J Antimicrob Agents. Learn more aboutbreastfeedingandCOVID-19 and breastfeeding. Ritonavir-Boosted Nirmatrelvir (Paxlovid) Global COVID-19 Prevention From an accredited medical school Watch on This video illustrates how the novel coronavirus -- the virus that causes the respiratory disease COVID-19 -- is transmitted among people and how transmission can be prevented. The information below covers three topics: I hope you find this information useful. This includes: We know how incredibly difficult this time has been for our hotel teams and corporate colleagues. School of Medicine employees who are patient-facing, work in, or frequent clinical and hospital areas for work purposes are considered as healthcare workers. If you do not have COVID-19 symptoms, your infectious period began 48 hours before your positive COVID-19 test date. Follow the isolation direction provided by the setting. - Euro 2020: Fixtures, ESPN live, match dates, times and venues Hospitals (including complex continuing care facilities), Congregate living settings, e.g. The physical and emotional wellbeing of our corporate colleagues is incredibly important to us and we understand the many new challenges they have encountered during the pandemic as they have had to work remotely. 2. Guidance for faculty, staff, and postdocs who are experiencing COVID-like symptoms or have been in close contact with an individual who tested positive for COVID-19 has been updated here. Once you are feeling well and have finished isolating, the best way to protect yourself and your child is to ensure your entire household. o Hydroxychloroquine (or Chloroquine) Masks are still required in some settings. Learn when and where masking is recommended. Hungary has an identical policy for the games in Budapest. Get the latest news on COVID-19 testing, treatment, tracking data, and medical research. Stanford Health Care is rapidly resuming elective surgeries, diagnostic tests and other procedures, with more than 800 scheduled for this week at the main Stanford Hospital and outpatient. Share price 5380.44p 28 April 2023 at 17:01. Across the board, ticket holders will be given 30-minute time slots to enter the stadium, with temperature checks or rapid COVID tests also possible, depending on the venue. To make sure our guests enjoyconsistently clean, safe stays, our evolved procedures also include: Wherever in the world a guest stays with us, they can rely onthe IHG Clean Promise that their room meets industry-leading levels of cleanliness. Note: The Toronto Voluntary Isolation Centre is closed. seniors) and high risk settings for 10 days from your positive test date. Cortegiani A, Ingoglia G, Ippolito M, Giarratano A, Einav S. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. School of Medicine employees who are patient-facing, work in, or frequent clinical and hospital areas for work purposes are considered as healthcare workers. Delivering sophisticated digital solutions so owners can manage costs and assess steps to improve performance at the touch of a button. N Engl J Med. Do not go places where you are unable to wear a mask. March 2020. doi:10.1001/jama.2020.4742, McCreary EK, Pogue JM. Doctors, Clinics & Locations, Conditions & Treatments, View All Information for Patients & Visitors , Resources and Testing for First Responders and Essential Workers, Advice on Personal Protective Equipment (PPE), Emergency Medical Services (EMS) Information, COVID-19 Outpatient Therapeutics - Health Care Professionals, Protections Against Surprise Medical Bills. added: January 13, 2022, Casirivimab/Imdevimab Compassionate Use Procedure Reception: The rollout of digital check-in to minimise contact on arrival, front-desk screens, sanitiser stations, sanitised key cards and paperless check-out. Breastfeeding (also known as chest feeding) your baby is recommended even if you have COVID-19. In alignment with the California Department of Public Health (CDPH) and local counties, as well as the Centers for Medicare and Medicaid Services (CMS), booster shots are no longer required for health care workers. For help, call guest services at 650-498-3333. If you are admitting or visiting a child in . While competing teams have sporting exemptions enabling all accredited players and staff to travel freely between venues, movement between games is likely to be the most problematic area for fans due to the differing regulations in each of the 11 host cities. Arguments in favour of remdesivir for treating SARS-CoV-2 infections. So weve created our Stay TRUE service initiative to help team members understand how they can meet new standards and guidelines for cleanliness and safety, while still providing the memorable guest experiences and touches that come naturally to them. COVID-19 is rapidly spreading across the globe and all providers must be prepared to recognize, stabilize and treat patients with novel coronavirus infection. Following completion of this short course physicians, nurses, and other healthcare professionals will have a unified, evidenced-based approach to saving the lives of patients with COVID . HCW who have had close contact with a COVID-19 positive patient while the HCW is wearing appropriate PPE and following masking protocols for staff and patients are not considered exposed. Participants must be 18-64 years of age and in generally good health. You may feel lingering effects of your illness even after your self-isolation period ends. Found the perfect role and ready to apply? Chen J, Liu D, Liu L, et al. Protection against COVID-19 may be passed to baby through breastfeeding. Learn about the different vaccines available. March 2020. doi:10.1093/cid/ciaa237, Gautret P, Lagier J-C, Parola P, et al. Monitor your baby for symptoms of COVID-19. Keep track of your symptoms so you can tell a health care provider how you have been feeling. Interferons are a group of cytokines that have antiviral activity. Healthcare Providers with COVID exposures and/or respiratory symptoms: Protocol for the Management of Healthcare Personnel with COVID-19 Exposure(last updated 3/20/20), Protocol for the Management of Healthcare Personnel without COVID-19 Exposure(last updated 3/15/20). If any teams are hit by positive tests during the tournament, players or staff will have to just isolate as Fleck and Busquets have done. The U.K. government has adopted a strict testing regime for all arrivals, but with all Euro 2020 nations on the U.K.'s "amber list," visitors from those countries must quarantine for 10 days on arrival. Fan zones in each city are subject to local regulations. The university is transitioning away from the Color testing program. o Nitazoxanide Clean and disinfect frequently touched objects and surfaces in your home. But while English, Scottish and Welsh fans may find it difficult to travel to some venues, the U.K. is also a tough place for fans of competing teams to enter. Make picks throughout the European Championship for a shot at $10,000. As of March 24, 2023, Color testingwill no longer be available to faculty, staff, postdocs. hugging) without a well-fitted, high quality mask, People you had brief, close contact with while wearing a. This position is considered a healthcare worker and will need to comply with the Stanford Health Care COVID 19 vaccination requirements (completion of primary vaccine series). Many of our hotels around the world represent small, individually owned businesses, and the low demand and financial pressures presented by Covid-19 have created enormous challenges. o Lopinavir/Ritonavir, Remdesivir Randomized Control Trial COVID-19 Research. UEFA resisted calls to stage the tournament in one country, preferring to stick with the blueprint of a continent-wide competition, with the withdrawal of Irish capital Dublin ensuring that the 12-venue plan has been reduced to 11, with Seville stepping in to replace Bilbao as Spain's host city. We will resume in-person instruction Tuesday . Please be assured that the Department of Music is following guidelines issued by the Centers for Disease Control (CDC), Santa Clara County, and the state of California for increased health and safety procedures. And, a more detailed set ofFrequently Asked Questionshas been posted to the Teach Anywhere website. The Barcelona player is unlikely to be able to play against Sweden in Seville on Monday. We take great care over our decisions, so that we make responsible choices for bothtodayand the long term. For travel guidance, see CDC's Travel . Healthcare HR Goes Beyond the Call of Duty. If you have COVID-19 symptoms, your infectious period began 48 hours before your symptoms started. A 12,500-capacity fan zone at Trafalgar Square will be open for England games as well as the semis and final, but only fans with a ticket will be admitted. Doctors, Clinics & Locations, Conditions & Treatments, View All Information for Patients & Visitors , Resources and Testing for First Responders and Essential Workers, Advice on Personal Protective Equipment (PPE), Emergency Medical Services (EMS) Information, COVID-19 Outpatient Therapeutics - Health Care Professionals, Protections Against Surprise Medical Bills. Our Post-Acute COVID-19 Syndrome Clinic cares for patients with persistent symptoms as a consequence of SARS-CoV-2 infection. Weve created several initiatives and tools to help, including introducing Recharge days to ensure everyone has the chance to enjoy an uninterrupted break, keeping colleagues connected through regular Q&A sessions with our CEO and members of our leadership team, and providing digital resources to help colleagues look after their wellbeing and connect with others. Everything has been stripped back because of the pandemic. However, we will still require health care workers to receive the primary series of the COVID-19 vaccine. doi:10.1093/ofid/ofaa105, Wang M, Cao R, Zhang L, et al. Please refer your close contact to the what to do if you are a close contact webpage for more information. Update on COVID testing, travel and employee support, Compliance with new federal vaccination requirement. Through this co-ordinated effort, we are providing rooms for the homeless and travellers needing a home from home during a challenging time, along with nurses, doctors and other frontline workers. CDC recommends everyone stay up to date with COVID-19 vaccines for their age group: Adults ages 18 years and older.