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Dear Reader, Thank you buy generic kamagra online for following the Me&MyDoctor blog. I'm writing to let you know we are moving the public health stories authored by Texas physicians, residents, and medical students, and patients to the Texas Medical Association's social media channels. Be sure to follow us on all buy generic kamagra online our social media accounts (Facebook, Twitter, Instagram) as well as Texas Medicine Today to access these stories and more. We look forward to seeing you there.Best, Olivia Suarez Me&My Doctor EditorSravya Reddy, MDPediatric Resident at The University of Texas at Austin Dell Medical SchoolMember, Texas Medical AssociationHow does the erectile dysfunction treatment kamagra factor into potentially abusive situations?. To stop the spread of erectile dysfunction treatment, we have isolated ourselves into small family units to avoid catching and transmitting the kamagra.

While saving so many from succumbing to a severe illness, socially isolating has unfortunately posed its own buy generic kamagra online problems. Among those is the increased threat of harm from intimate partner violence, which includes physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse. Potential child abuse is an increased threat as well. The impact of this kamagra happened so rapidly that society did not buy generic kamagra online have time to think about all the consequences of social isolation before implementing it. Now those consequences are becoming clear.Social isolation due to the kamagra is forcing victims to stay home indefinitely with their abusers.

Children and adolescents also have been forced to stay at home since many school districts have made education virtual to keep everyone safe from the kamagra. Caregivers are also home because they buy generic kamagra online are working remotely or because they are unemployed. With the increase in the number of erectile dysfunction treatment cases, financial strain due to the economic downturn, and concerns of contracting the kamagra and potentially spreading it to family members, these are highly stressful times. Stress leads to an increase in the rate of intimate partner violence. Even those who suffer from it can begin to become abusive to other household members, thus amplifying the abuse in the household buy generic kamagra online.

Some abuse may go unrecognized by the victims themselves. For example, one important and less well-known type of abuse is coercive control buy generic kamagra online. Itâs the type of abuse that doesnât leave a physical mark, but itâs emotional, verbal, and controlling. Victims often know that something is wrong â but canât quite identify what it is. Coercive control can buy generic kamagra online still lead to violent physical abuse, and murder.

The way in which people report abuse has also been altered by the kamagra.People lacking usual in-person contacts (with teachers, co-workers, or doctors) and the fact that some types of coercive abuse are less recognized lead to fewer people reporting that type of abuse. Child abuse often is discovered during pediatriciansâ well-child visits, but the kamagra has limited those visits. Many teachers, who might also notice signs of abuse, also buy generic kamagra online are not able to see their students on a daily basis. Some abuse victims visit emergency departments (EDs) in normal times, but ED visits are also down due to erectile dysfunction treatment.Local police in China report that intimate partner violence has tripled in the Hubei province. The United Nations reports it also increased 30% in France as of March 2020 and increased 25% in Argentina.

In the buy generic kamagra online U.S. The conversation about increased intimate partner violence during these times has just now started, and we are beginning to gather data. Preliminary analysis shows police reports of intimate partner violence have increased by 18% to 27% across several U.S. Cities. Individuals affected by addiction have additional stressors and cannot meet with support groups.

Children and adolescents who might otherwise use school as a form of escape from addicted caregivers are no longer able to do so. Financial distress can also play a factor. According to research, the rate of violence among couples with more financial struggles is nearly three and a half times higher than couples with fewer financial concerns.Abuse also can come from siblings. Any child or adolescent with preexisting behavioral issues is more likely to act out due to seclusion, decreased physical activity, or fewer positive distractions. This could increase risk for others in the household, especially in foster home situations.

These other residents might be subject to increased sexual and physical abuse with fewer easy ways to report it. What can we do about this while abiding by the rules of the kamagra?. How can physicians help?. Patients who are victims of intimate partner violence are encouraged to reach out to their doctor. A doctor visit may be either in person or virtual due to the safety precautions many doctorsâ offices are enforcing due to erectile dysfunction treatment.

During telehealth visits, physicians should always ask standard questions to screen for potential abuse. They can offer information to all patients, regardless of whether they suspect abuse.People could receive more support if we were to expand access to virtual addiction counseling, increase abuse counseling, and launch more campaigns against intimate partner violence. The best solution might involve a multidisciplinary team, including psychiatrists, social workers, child abuse teams and Child Protective Services, and local school boards. Physicians can help in other ways, too. Doctors can focus on assessing mental health during well-child and acute clinic visits and telehealth visits.

A temporary screening tool for behavioral health during the kamagra might be beneficial. Governments could consider allocating resources to telepsychiatry. Many paths can be taken to reduce the burden of mental health issues, and this is an ongoing discussion. How should physicians approach patients who have or may have experienced intimate partner violence?. Victims of domestic assault can always turn to their physician for guidance on next steps.

In response, doctors can:Learn about local resources and have those resources available to your patients;Review safety practices, such as deleting internet browsing history or text messages. Saving abuse hotline information under other listings, such as a grocery store or pharmacy listing. And creating a new, confidential email account for receiving information about resources or communicating with physicians.If the patient discloses abuse, the clinician and patient can establish signals to identify the presence of an abusive partner during telemedicine appointments.To my fellow physicians, I suggest recognizing and talking about the issue with families.Medical professionals take certain steps if they suspect their patientâs injuries are a result of family violence, or if the patient discloses family violence. Physicians will likely screen a patient, document their conversation with the patient, and offer support and inform the patient of the health risks of staying in an abusive environment, such as severe injuries or even death. A doctorâs priority is his or her patientâs safety, regardless of why the victim might feel forced to remain in an abusive environment.

While physicians only report child and elderly abuse, they should encourage any abused patient to report her or his own case, while also understanding the complexity of the issue. Under no circumstance should any form of abuse be tolerated or suffered. Any intimate partner violence should be avoided, and reported if possible and safe. My hope is that with more awareness of this rising public health concern, potential victims can better deal with the threat of abuse during this stressful kamagra â and hopefully avoid it..

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Physicians and advanced practice providers at MidMichigan Health were recently recognized by national health care research kamagra thailand pharmacy leader Professional Research Consultants, Inc. (PRC), as 5-Star Performers.Physicians who were recognized include kamagra thailand pharmacy Odoma Achor, M.D., Miguel Alvelo-Rivera, M.D., Danielle Bennett, D.O., Paul Berg, M.D., Andrzej Boguszewski, M.D., Kristin Busch, M.D., David Buzanoski, M.D., Thomas Claringbold, II, D.O., Daniel Diaz, D.O., Jeanine Ernest, M.D., William Felten, M.D., Renee Fuller, M.D., Steven Gellman, M.D., Mark Goethe, M.D., Monika Herdzik, M.D., Kelly Hill, M.D., Nilofar Islam, M.D., Thomas Johnson, M.D., Egle Klugiene, M.D., Natalie Kroll, D.O., Shane Martin, D.O., Shannon Martin, D.O., M.P.H., Jeffrey Martindale, D.O., Kristalyn Mauch, M.D., Ben Mayne, III., M.D., Patrick Morse, M.D., John Murphy, D.O., Tammy Phillips, M.D., Robert Reichmann, M.D., M.P.H., Asma Saboor, M.D., Tannu Sahay, M.D., Susan Sallach, M.D., Sasha Savage, M.D., Michael Stack, M.D., Denise Stadelmaier, D.O., Jacob Trombley, D.O., M.P.H., Mark Weber, M.D, and Kyle Williams, M.D.In addition, there were advanced practice providers from MidMichigan Physicians Group recognized as 5-Star Performers. They are Vickie Bannister, M.S.N., W.H.N.P.-B.C., Stacy Carstensen, M.S.N., C.F.N.P., Trisha DesChamps, M.S.N., F.N.P., Devon Fenner, P.A.-C., Matthew Flegel, P.A.-C., Alison Funka, D.N.P., A.G.N.P.-.C., Jenifer Garcia, P.A.-C., Cynthia Lamb, kamagra thailand pharmacy P.A.-C., Brandi McConnell, M.S.N., F.N.P.-B.C., Crystal Morrissey, P.A.-C., Cora Pavlik, M.S.N., F.N.P.-B.C., Blaine Price, P.A.-C., Jennifer Schlitzkus, P.A.-C., and Kenneth VanSumeren, P.A.-C.âWe are thrilled to see our medical staff recognized by PRC for providing top quality care to their patients,â said Paul Berg, M.D., president, MidMichigan Physicians Group. ÂItâs our goal for all of our patients to receive excellent care each time they come through our doors, and this recognition is a testament that weâre working toward achieving that goal.âThe Excellence in Healthcare Awards recognize organizations and individuals who achieve excellence throughout the year by improving patient experiences, health care employee engagement and/or physician alignment and engagement based on surveys of their patients, employees and physicians.âIt is an honor to kamagra thailand pharmacy recognize MidMichiganâs physicians and advanced practice providers with these Excellence in Healthcare Awards for their deserving work,â said Joe M. Inguanzo, Ph.D., kamagra thailand pharmacy president and CEO of PRC.

ÂIt takes true dedication and determination to achieve this level of excellence kamagra thailand pharmacy in health care and MidMichigan has shown their commitment to making their hospital a better place to work, a better place to practice medicine and a better place for patients to be treated.âThose who would like to learn more about the 2021 Excellence in Healthcare Awards, including eligibility and criteria, may visit www.PRCCustomResearch.com.About PRCPRC, a leader in the healthcare intelligence space with the most comprehensive healthcare discovery platform, is taking surveys to a new level. PRCâs surveys and intuitive reporting focus on changing the way organizations manage and improve five key areas of the healthcare experienceâpatient, physician, employee, kamagra thailand pharmacy community, and brand. Over 2,800 healthcare organizations kamagra thailand pharmacy across the United States have used PRC to listen, understand, and take action to create cultures of excellence. To ensure clients have access to leading kamagra thailand pharmacy practices, coaches, and learning resources, PRC is partnered with Healthcare Experience Foundation (HXF) to accelerate paths to excellence. The PRC healthcare discovery platform is a system designed to drive action, optimize engagement, and increase loyalty while building a positive culture across the healthcare ecosystem.Henry HaleyHenry Haley, a third-year medical student at Central Michigan University, has been awarded the inaugural Philip A kamagra thailand pharmacy.

Harris Memorial Scholarship of $1,000.Haley has participated in several clerkships at MidMichigan Medical kamagra thailand pharmacy Center â Midland, including in family medicine, obstetrics and gynecology, psychiatry, surgery, hospital medicine and a comprehensive community clerkship. He hopes to one day practice medicine in the Midland area.âHenry truly embodies the spirit of kamagra thailand pharmacy Dr. Harris,â said Denise OâKeefe, executive director, MidMichigan Health Foundation kamagra thailand pharmacy. ÂLike Dr kamagra thailand pharmacy. Harris was, heâs focused on continuously learning kamagra thailand pharmacy and education.

He has a passion for helping others and we look forward kamagra thailand pharmacy to the day that he practices medicine in the communities that MidMichigan Health serves.âPhilip A. Harris, M.D.Dr kamagra thailand pharmacy. Harris worked as an otolaryngologist for MidMichigan Physicians Group, kamagra thailand pharmacy specializing in diseases of the ear, nose, throat and sinus. In February 2016, kamagra thailand pharmacy he was unexpectedly diagnosed with cancer. Over the course of the next four years, he continued working intermittently, while seeking cancer treatment and battling side kamagra thailand pharmacy effects.

In the spring of kamagra thailand pharmacy 2020, Dr. Harris resigned from his office practice to spend his last months at home with his loving wife and their three kamagra thailand pharmacy children.Dr. Harris considered it a privilege to treat every patient kamagra thailand pharmacy who presented for care. He worked with each patient to understand the nature of their medical condition and to choose a kamagra thailand pharmacy treatment option. He believed it was important that patients have local options and access to kamagra thailand pharmacy care.

Dr. Harris took pride in his work and was an active learner and educator. He was a teacher and participated in medical societies, multiple academies, educational courses and lectures in order to help educate medical residents and to assist referring doctors in providing advanced local care.Those who would like to learn more about this scholarship, or other scholarship opportunities available through the MidMichigan Health Foundation, may visit www.midmichigan.org/scholarships..

Physicians and advanced practice providers at MidMichigan buy generic kamagra online Health were recently https://2017.berlin-conferences.com/cheap-propecia-online/ recognized by national health care research leader Professional Research Consultants, Inc. (PRC), as 5-Star Performers.Physicians who were recognized include Odoma Achor, M.D., Miguel Alvelo-Rivera, M.D., Danielle Bennett, D.O., Paul Berg, buy generic kamagra online M.D., Andrzej Boguszewski, M.D., Kristin Busch, M.D., David Buzanoski, M.D., Thomas Claringbold, II, D.O., Daniel Diaz, D.O., Jeanine Ernest, M.D., William Felten, M.D., Renee Fuller, M.D., Steven Gellman, M.D., Mark Goethe, M.D., Monika Herdzik, M.D., Kelly Hill, M.D., Nilofar Islam, M.D., Thomas Johnson, M.D., Egle Klugiene, M.D., Natalie Kroll, D.O., Shane Martin, D.O., Shannon Martin, D.O., M.P.H., Jeffrey Martindale, D.O., Kristalyn Mauch, M.D., Ben Mayne, III., M.D., Patrick Morse, M.D., John Murphy, D.O., Tammy Phillips, M.D., Robert Reichmann, M.D., M.P.H., Asma Saboor, M.D., Tannu Sahay, M.D., Susan Sallach, M.D., Sasha Savage, M.D., Michael Stack, M.D., Denise Stadelmaier, D.O., Jacob Trombley, D.O., M.P.H., Mark Weber, M.D, and Kyle Williams, M.D.In addition, there were advanced practice providers from MidMichigan Physicians Group recognized as 5-Star Performers. They are Vickie Bannister, M.S.N., W.H.N.P.-B.C., Stacy Carstensen, M.S.N., C.F.N.P., Trisha DesChamps, M.S.N., F.N.P., Devon Fenner, P.A.-C., Matthew Flegel, P.A.-C., Alison Funka, D.N.P., A.G.N.P.-.C., Jenifer Garcia, P.A.-C., Cynthia Lamb, P.A.-C., Brandi McConnell, M.S.N., F.N.P.-B.C., Crystal Morrissey, P.A.-C., Cora Pavlik, M.S.N., F.N.P.-B.C., Blaine Price, P.A.-C., Jennifer Schlitzkus, P.A.-C., and Kenneth VanSumeren, P.A.-C.âWe are thrilled to see our medical staff recognized by PRC for providing top quality care to their patients,â said Paul Berg, M.D., president, MidMichigan buy generic kamagra online Physicians Group. ÂItâs our goal for all of our patients to receive excellent care each time they come through our doors, and this recognition is a testament that weâre working toward achieving that goal.âThe Excellence in Healthcare Awards recognize organizations and individuals who achieve excellence throughout the year by improving patient experiences, health care employee engagement and/or physician alignment and engagement based on surveys of their patients, employees and physicians.âIt is an honor to recognize MidMichiganâs physicians and advanced practice providers with these Excellence in Healthcare Awards for their deserving work,â said Joe buy generic kamagra online M. Inguanzo, Ph.D., president and CEO of buy generic kamagra online PRC.

ÂIt takes true dedication and determination to achieve this level of excellence in health care and MidMichigan has shown their commitment to making their hospital a better place to work, a better place to practice medicine and a better place for patients to be treated.âThose who would like to learn more about the 2021 Excellence in Healthcare Awards, including eligibility and criteria, may visit www.PRCCustomResearch.com.About PRCPRC, a leader in the healthcare intelligence space with the most comprehensive healthcare discovery buy generic kamagra online platform, is taking surveys to a new level. PRCâs surveys and intuitive reporting focus on changing the way buy generic kamagra online organizations manage and improve five key areas of the healthcare experienceâpatient, physician, employee, community, and brand. Over 2,800 healthcare organizations across the United States have used buy generic kamagra online PRC to listen, understand, and take action to create cultures of excellence. To ensure clients have access to leading practices, coaches, and buy generic kamagra online learning resources, PRC is partnered with Healthcare Experience Foundation (HXF) to accelerate paths to excellence. The PRC healthcare discovery platform is a buy generic kamagra online system designed to drive action, optimize engagement, and increase loyalty while building a positive culture across the healthcare ecosystem.Henry HaleyHenry Haley, a third-year medical student at Central Michigan University, has been awarded the inaugural Philip A.

Harris Memorial Scholarship of $1,000.Haley has participated in several clerkships buy generic kamagra online at MidMichigan Medical Center â Midland, including in family medicine, obstetrics and gynecology, psychiatry, surgery, hospital medicine and a comprehensive community clerkship. He hopes buy generic kamagra online to one day practice medicine in the Midland area.âHenry truly embodies the spirit of Dr. Harris,â said Denise OâKeefe, executive director, MidMichigan Health Foundation buy generic kamagra online. ÂLike Dr buy generic kamagra online. Harris was, heâs buy generic kamagra online focused on continuously learning and education.

He has a passion for helping buy generic kamagra online others and we look forward to the day that he practices medicine in the communities that MidMichigan Health serves.âPhilip A. Harris, M.D.Dr buy generic kamagra online. Harris worked as an otolaryngologist for MidMichigan Physicians Group, specializing in buy generic kamagra online diseases of the ear, nose, throat and sinus. In February 2016, he was unexpectedly diagnosed with cancer buy generic kamagra online. Over the course of the next four years, he continued working intermittently, while seeking cancer buy generic kamagra online treatment and battling side effects.

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Credit. IStock Share Fast Facts New @HopkinsMedicine study finds African-American women with common form of hair loss at increased risk of uterine fibroids - Click to Tweet New study in @JAMADerm shows most common form of alopecia (hair loss) in African-American women associated with higher risks of uterine fibroids - Click to Tweet In a study of medical records gathered on hundreds of thousands of African-American women, Johns Hopkins researchers say they have evidence that women with a common form of hair loss have an increased chance of developing uterine leiomyomas, or fibroids.In a report on the research, published in the December 27 issue of JAMA Dermatology, the researchers call on physicians who treat women with central centrifugal cicatricial alopecia (CCCA) to make patients aware that they may be at increased risk for fibroids and should be screened for the condition, particularly if they have symptoms such as heavy bleeding and pain. CCCA predominantly affects black women and is the most common form of permanent alopecia in this population.

The excess scar tissue that forms as a result of this type of hair loss may also explain the higher risk for uterine fibroids, which are characterized by fibrous growths in the lining of the womb. Crystal Aguh, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine, says the scarring associated with CCCA is similar to the scarring associated with excess fibrous tissue elsewhere in the body, a situation that may explain why women with this type of hair loss are at a higher risk for fibroids.People of African descent, she notes, are more prone to develop other disorders of abnormal scarring, termed fibroproliferative disorders, such as keloids (a type of raised scar after trauma), scleroderma (an autoimmune disorder marked by thickening of the skin as well as internal organs), some types of lupus and clogged arteries. During a four-year period from 2013-2017, the researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women ages 18 and over.

The prevalence of those with fibroids was compared in patients with and without CCCA. Overall, the researchers found that 13.9 percent of women with CCCA also had a history of uterine fibroids compared to only 3.3 percent of black women without the condition. In absolute numbers, out of the 486,000 women who were reviewed, 16,212 had fibroids.Within that population, 447 had CCCA, of which 62 had fibroids.

The findings translate to a fivefold increased risk of uterine fibroids in women with CCCA, compared to age, sex and race matched controls. Aguh cautions that their study does not suggest any cause and effect relationship, or prove a common cause for both conditions. ÂThe cause of the link between the two conditions remains unclear,â she says.

However, the association was strong enough, she adds, to recommend that physicians and patients be made aware of it. Women with this type of scarring alopecia should be screened not only for fibroids, but also for other disorders associated with excess fibrous tissue, Aguh says. An estimated 70 percent of white women and between 80 and 90 percent of African-American women will develop fibroids by age 50, according to the NIH, and while CCCA is likely underdiagnosed, some estimates report a prevalence of rates as high as 17 percent of black women having this condition.

The other authors on this paper were Ginette A. Okoye, M.D. Of Johns Hopkins and Yemisi Dina of Meharry Medical College..

Crystal Aguh, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine, says the scarring associated with CCCA is similar to the scarring associated with excess fibrous tissue elsewhere in the body, a situation that may explain why women with this type of hair loss are at a higher risk for fibroids.People of African descent, she notes, are more prone to develop other disorders of abnormal scarring, termed fibroproliferative disorders, such as keloids (a type of raised scar after trauma), scleroderma (an autoimmune disorder marked by thickening of the skin as well as internal organs), some types of lupus and clogged arteries. During a four-year period from 2013-2017, the researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women ages 18 and over. The prevalence of those with fibroids was compared in patients with and without CCCA. Overall, the researchers found that 13.9 percent of women with CCCA also had a history of uterine fibroids compared to only 3.3 percent of black women without the condition.

In absolute numbers, out of the 486,000 women who were reviewed, 16,212 had fibroids.Within that population, 447 had CCCA, of which 62 had fibroids. The findings translate to a fivefold increased risk of uterine fibroids in women with CCCA, compared to age, sex and race matched controls. Aguh cautions that their study does not suggest any cause and effect relationship, or prove a common cause for both conditions. ÂThe cause of the link between the two conditions remains unclear,â she says.

Okoye, M.D. Of Johns Hopkins and Yemisi Dina of Meharry Medical College..

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Food and Viagra online no prescription mood often kamagra price per pill go together. You might reach for a comforting bag of chips when you feel down. Or feel so stressed that you canât even think kamagra price per pill about eating.Itâs normal for difficult emotions to make you overeat or eat too little. But if you live with clinical depression, changes in eating can be long-term and lead to drastic weight gain or loss.The Link Between Depression and WeightWeight gain and depression can stem from social, environmental, and biological causes, says Roger McIntyre, MD, a professor of psychiatry and pharmacology at the University of Toronto.

For example, people with kamagra price per pill financial insecurity or whoâve had troubled childhoods are at a higher risk of both obesity and depression.Things in the environment also can play a role for those who live in âfood deserts or food swamps,â McIntyre says. Living amid fast-food joints and convenience stores and far from grocery stores with fresh produce makes it harder to eat healthy.The depression-weight link cuts both ways. People who are depressed are more likely to be obese kamagra price per pill. And people with obesity are at higher risk of depression.

Itâs the classic âchicken and egg question,â says Rodrigo Mansur, MD, a kamagra price per pill psychiatrist at the University of Toronto. Scientists are still trying to parse the complex web of factors behind those relationships.âIt's not as simple as people develop depression, they are less motivated to exercise and they eat more, therefore they gain weight,â Mansur says. ÂThere's obviously some truth to kamagra price per pill that. But that is an oversimplification of what actually happens.âOne of the classic symptoms of depression is the loss of interest and pleasure in activities.

The clinical kamagra price per pill name for this is anhedonia. Scientists say it is rooted in the brainâs reward system and can make once enjoyable activities suddenly seem mundane.Take food, for example. Your mouth kamagra price per pill detects tastes such as sweetness and satisfying umami. But the pleasure you get from eating is processed by your brain.

If that kamagra price per pill reward system goes haywire, it can lead you to seek more food in order to make up for the dull or absent pleasure. ÂWhen they ingest food, it doesnât satisfy the anticipated reward,â McIntyre says. This can lead to food addiction, âterrible cravings for food that are uncontrollable.âDepression also can interfere with your impulse control. Studies have kamagra price per pill shown that people who are depressed are more likely to take risks, such as having unsafe sex.

Similar cognitive impairments can result in eating disorders like binge eating and bulimia.And the stress hormone cortisol can also play a role because it is linked to insulin resistance and obesity. At first, stress can dampen your appetite kamagra price per pill. But long-term stress can lead to higher insulin levels that drive down blood sugar and cause cravings for sugary and fatty foods.In rare cases, people who are depressed can have cognitive distortions or thoughts that change their worldview in a way that leads to changes in weight, says Elizabeth Prince, DO, a psychiatrist at Johns Hopkins University. Prince says she checks her patients for signs that they kamagra price per pill arenât purposely avoiding food because of a belief that âthey arenât deserving of food,â for example.

If that is the case, it is a sign their depression has become severe.Breaking the LinkYour depression symptoms may be very different from those of someone else. So your treatments should be tailored for kamagra price per pill you.âThereâs not one thing that will always treat depression. Itâs really individualized and something people should work on with their doctor who knows them best,â Prince says. She says a comprehensive treatment plan that addresses both the depression and the weight issue is best âbecause they clearly impact one another.âFor McIntyre, the first question is whether kamagra price per pill his patients are sleeping well.

He sometimes prescribes medication if he thinks it might help. He also stresses the basics of kamagra price per pill healthy eating. Finally, he urges people to get some kind of physical activity. In his research, he has shown that people who remain active, kamagra price per pill even just by going to work, school, or volunteering in the community, have much better outcomes with anti-depression treatment.

ÂWe are not suggesting running a marathon, but there has to be some activity,â he says.The fact is that there are no universal rules for treating depression and weight issues. ÂThere is no kamagra price per pill silver bullet,â McIntyre says. Still, heâs is hopeful that more research and data in this area will lead to better, evidence-based approaches. ÂI think the future holds a ton of promise in improving outcomes.â.

Food and mood often buy generic kamagra online go visite site together. You might reach for a comforting bag of chips when you feel down. Or feel so stressed that you canât even think about eating.Itâs normal for buy generic kamagra online difficult emotions to make you overeat or eat too little. But if you live with clinical depression, changes in eating can be long-term and lead to drastic weight gain or loss.The Link Between Depression and WeightWeight gain and depression can stem from social, environmental, and biological causes, says Roger McIntyre, MD, a professor of psychiatry and pharmacology at the University of Toronto. For example, people with financial insecurity or whoâve had troubled childhoods are at a higher risk of both obesity and depression.Things in the environment also can play a role for those who live buy generic kamagra online in âfood deserts or food swamps,â McIntyre says.

Living amid fast-food joints and convenience stores and far from grocery stores with fresh produce makes it harder to eat healthy.The depression-weight link cuts both ways. People who buy generic kamagra online are depressed are more likely to be obese. And people with obesity are at higher risk of depression. Itâs the classic âchicken and egg question,â says Rodrigo Mansur, MD, a psychiatrist buy generic kamagra online at the University of Toronto. Scientists are still trying to parse the complex web of factors behind those relationships.âIt's not as simple as people develop depression, they are less motivated to exercise and they eat more, therefore they gain weight,â Mansur says.

ÂThere's obviously buy generic kamagra online some truth to that. But that is an oversimplification of what actually happens.âOne of the classic symptoms of depression is the loss of interest and pleasure in activities. The clinical name for this is buy generic kamagra online anhedonia. Scientists say it is rooted in the brainâs reward system and can make once enjoyable activities suddenly seem mundane.Take food, for example. Your mouth buy generic kamagra online detects tastes such as sweetness and satisfying umami.

But the pleasure you get from eating is processed by your brain. If that reward system goes haywire, it can lead you to seek more food in order to make up buy generic kamagra online for the dull or absent pleasure. ÂWhen they ingest food, it doesnât satisfy the anticipated reward,â McIntyre says. This can lead to food addiction, âterrible cravings for food that are uncontrollable.âDepression also can interfere with your impulse control. Studies have shown that people who are depressed are more likely to take risks, buy generic kamagra online such as having unsafe sex.

Similar cognitive impairments can result in eating disorders like binge eating and bulimia.And the stress hormone cortisol can also play a role because it is linked to insulin resistance and obesity. At first, stress can dampen your appetite buy generic kamagra online. But long-term stress can lead to higher insulin levels that drive down blood sugar and cause cravings for sugary and fatty foods.In rare cases, people who are depressed can have cognitive distortions or thoughts that change their worldview in a way that leads to changes in weight, says Elizabeth Prince, DO, a psychiatrist at Johns Hopkins University. Prince says she checks her patients for signs that they arenât purposely avoiding food because of a belief buy generic kamagra online that âthey arenât deserving of food,â for example. If that is the case, it is a sign their depression has become severe.Breaking the LinkYour depression symptoms may be very different from those of someone else.

So your buy generic kamagra online treatments should be tailored for you.âThereâs not one thing that will always treat depression. Itâs really individualized and something people should work on with their doctor who knows them best,â Prince says. She says a comprehensive treatment plan that addresses both the depression and the weight buy generic kamagra online issue is best âbecause they clearly impact one another.âFor McIntyre, the first question is whether his patients are sleeping well. He sometimes prescribes medication if he thinks it might help. He also stresses the basics of healthy eating buy generic kamagra online.

Finally, he urges people to get some kind of physical activity. In his buy generic kamagra online research, he has shown that people who remain active, even just by going to work, school, or volunteering in the community, have much better outcomes with anti-depression treatment. ÂWe are not suggesting running a marathon, but there has to be some activity,â he says.The fact is that there are no universal rules for treating depression and weight issues. ÂThere is no silver bullet,â buy generic kamagra online McIntyre says. Still, heâs is hopeful that more research and data in this area will lead to better, evidence-based approaches.

ÂI think the future holds a ton of promise in improving outcomes.â.

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October is kamagra liquid Mental Health Awareness Month and World Mental Health Day takes place on 10 October 2020. This year, the erectile dysfunction treatment kamagra has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of peopleâs experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the kamagra.1â3 Job losses, financial and housing insecurity, the challenges of working from home, home schooling, restricted access to health and kamagra liquid social care services and social isolation coupled with reduced support and contact with family and friends have all impacted peopleâs well-being. There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care.

These factors have significant potential for negative repercussions on the mental health and well-being of healthcare kamagra liquid staff.4 5 There have been reports of high levels of stress, depression and even suicides,6 and long-term effects include a higher risk for post-traumatic stress disorder or moral injury.5Healthcare organisations need to plan for the inevitable consequence of this kamagra and ensure that resources are in place for their workers. Screening for mental health issues and treatment, including counselling, should be made available. In addition, nurses and other healthcare staff should be encouraged to reflect on their experiences and consider how to implement self-care kamagra liquid strategies that will enhance their well-being. This includes staying informed of the current data and information and being aware of the risks to themselves and others while caring for patients with the kamagra.

By monitoring and enacting strategies to reduce stress and develop support systems, staff can minimise longer-term impacts.4Whether organisational support and self-care monitoring have achieved better mental health outcomes for healthcare workers is, as yet, unknown. Research across the globe is underway not only related kamagra liquid to the kamagra itself but also to the mental health consequences of the kamagra. We do not yet know the extent of the issues or how best to support healthcare providers. In order to better understand the issues and to support nurses at this time, kamagra liquid evidence-based nursing will focus our social media to mental health issues during the month of October.

We will highlight and share relevant resources and information and encourage discussion of the key challenges facing healthcare workers.During October, we will showcase the experiences of four key groupsâpatients, nurses, students and informal carers and families. Be sure to kamagra liquid log into evidence-based nursing each week for the following blogs:October 4. Impact of erectile dysfunction treatment on patient mental health.October 11. Impact of erectile dysfunction treatment on nursesâ mental health and.Twitter Chat on Wednesday October 14 at 20:00 UK kamagra liquid time.Oct.

18. Impact of erectile dysfunction treatment on student nursing.Oct. 25. Impact of erectile dysfunction treatment on informal carers and families.A PhD is a globally recognised postgraduate degree and typically the highest degree programme awarded by a University, with students usually required to expand the boundaries of knowledge by undertaking original research.

The purpose of PhD programmes of study is to nurture, support and facilitate doctoral students to undertake independent research to expected academic and research standards, culminating in a substantial thesis and examined by viva voce. In this paperâthe first of two linked Research Made Simple articlesâwe explore what the foundations of a high-quality PhD are, and how a Doctoral candidate can develop a study which is successful, original and impactful.Foundations of a âgoodâ PhD studySupervision and supportCentral to the development and completion of a good PhD is the supervisory relationship between the student and supervisor. The supervisor guides the student by directing them to resources and training to ensure continuous learning, provides opportunity to engage with experts in the field, and facilitates the development of critical thinking through questioning and providing constructive criticism.1The support needs of students will be different, so a flexible yet quality assured approach to PhD research training is required. A good supervisory team (usually includes at least two postdoctoral academics) provide experienced guidance and mentorship and will offer students academic support, with regular meetings and timely feedback on written submissions, will assist the student to develop a peer network and help them access research communities relative to their field.

Effective supervision has beneficial outcomes for students, including encouraging a positive work ethic and influencing engagement in a stimulating environment, allowing students to pursue their own ideas with educated encouragement. The quality of the supervisory relationship can impact greatly on the PhD experience and ultimately sets the student on the road to producing excellent Doctoral work.1An environment that promotes personal and professional development is further aided by positive peer interactions. If students feel part of a community and have contact with others also working on doctoral studies, there is the scope for peer compassion and understanding during both challenging and rewarding periods. Students who access personal and professional support and guidance through mentoring models during their studies are more likely to succeed.

These models include one-to-one peer mentoring or activities for example journal discussion or methods learning groups. Often, groups of students naturally come together and give each other support and advice about research process expectations and challenges, and offer friendship, and guidance.2 Given the usefulness of different types of mentoring models, all can create a supportive and collaborative environment within a PhD programme of study, to minimise working in isolation and enable students to achieve their greatest potential.Characteristics of a good study. Originality and theoretical underpinningA PhD should make an original contribution to knowledge. Originality can be achieved through the study design, the nature or outcomes of the knowledge synthesis, or the implications for research and/or practice.3 Disciplinary variation, however, influences the assessment of originality.

For example, originality in science, technology, engineering and mathematics subjects is often inferred if the work is published/publishable, in comparison to intellectual originality in the social sciences.4 Although PhD originality assumes different nuances in different contexts, there is a general acceptance across disciplines that there should be evidence of the following within the thesis:An interplay between old and newâany claims of originality are developed from existing knowledge and practices.There are degrees of originality, relating to more than one aspect of the thesis.Any claims for originality are accompanied by clear articulation of significance.A good PhD should be also underpinned by theoretical and/or conceptual frameworks (that include philosophical and methodological models) that give clarity to the approach, structure and vision of the study.5 These theoretical and conceptual frameworks can explain why the study is pertinent and how the research addresses gaps in the literature.6 Table 1 provides a distinction of what construes theoretical and conceptual frameworks.View this table:Table 1 Characteristics of theoretical and conceptual frameworks7Theoretical/conceptual frameworks must align with the research question/aims, and the student must be able to articulate how conceptual/theoretical framework were chosen. Key points for consideration include:Are the research questions/aim and objectives well defined?. What theory/theories/concepts are being operationalised?. How are the theories/concepts related?.

Are the ontological and epistemological perspectives clearly conveyed and how do they relate to theories and concepts outlined?. What are the potential benefits and limitations of the theories and concepts outlined?. Are the ways the theories/concepts are outlined and being used original?. A PhD thesis (and demonstrable in viva) must be able to offer cohesion between the choice of research methods that stems from the conceptual/theoretical framework, the related ontological and epistemological decisions, the theoretical perspective and the chosen methodology (table 2).

PhD students must be able to articulate the methodological decisions made and be critical of methods employed to answer their research questions.View this table:Table 2 Relationship between research paradigms, perspectives, methodologies and methods.8 9ConclusionIn summary, we offer considerations of what the foundations of a good PhD should be. We have considered some of the key ingredients of quality PhD supervision, support and research processes and explored how these will contribute to the development of a study that leads to student success and which makes a valuable contribution to the evidence base. In the next paper, we will look in more detail at the assessment of the PhD through the submission of a thesis and an oral viva..

October is Mental Health buy generic kamagra online Awareness Month and World Mental Health Day takes place on 10 October 2020. This year, the erectile dysfunction treatment kamagra has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of peopleâs experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the kamagra.1â3 Job losses, financial and housing insecurity, buy generic kamagra online the challenges of working from home, home schooling, restricted access to health and social care services and social isolation coupled with reduced support and contact with family and friends have all impacted peopleâs well-being. There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care.

These factors have significant potential for negative repercussions on the mental health and well-being of healthcare staff.4 5 There have been buy generic kamagra online reports of high levels of stress, depression and even suicides,6 and long-term effects include a higher risk for post-traumatic stress disorder or moral injury.5Healthcare organisations need to plan for the inevitable consequence of this kamagra and ensure that resources are in place for their workers. Screening for mental health issues and treatment, including counselling, should be made available. In addition, nurses and other healthcare staff should be encouraged to reflect on their experiences and consider how to implement self-care buy generic kamagra online strategies that will enhance their well-being. This includes staying informed of the current data and information and being aware of the risks to themselves and others while caring for patients with the kamagra.

By monitoring and enacting strategies to reduce stress and develop support systems, staff can minimise longer-term impacts.4Whether organisational support and self-care monitoring have achieved better mental health outcomes for healthcare workers is, as yet, unknown. Research across the globe is underway not only related to the kamagra itself but also to buy generic kamagra online the mental health consequences of the kamagra. We do not yet know the extent of the issues or how best to support healthcare providers. In order to better understand the issues and to support nurses at this time, evidence-based nursing will focus our social media to mental health issues during the buy generic kamagra online month of October.

We will highlight and share relevant resources and information and encourage discussion of the key challenges facing healthcare workers.During October, we will showcase the experiences of four key groupsâpatients, nurses, students and informal carers and families. Be sure to log into evidence-based nursing each week for the following blogs:October 4 buy generic kamagra online. Impact of erectile dysfunction treatment on patient mental health.October 11. Impact of erectile dysfunction treatment on nursesâ mental health and.Twitter Chat on Wednesday October 14 at buy generic kamagra online 20:00 UK time.Oct.