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SOBRE NOTICIAS EN ESPAÑOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad kamagra wholesale hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este contenido puede usarse kamagra wholesale de manera gratuita (detalles). Lone Tree, Colorado.- Darcy Velásquez, de 42 años, y su madre, Roberta Truax, caminaban recientemente por el centro comercial Park Meadows, 15 millas al sur del centro de Denver, buscando regalos de Navidad para los dos hijos de Velásquez, cuando vieron una tienda con un exhibición de máscaras faciales adornadas con diamantes de fantasía.Brillantes ideales para una nena de 9 años. La tienda se llama erectile dysfunction treatment Essentials kamagra wholesale. Y bien puede ser la primera cadena minorista del país dedicada exclusivamente a una enfermedad infecciosa.Con el cierre de muchas tiendas en los Estados Unidos durante la pandemia de erectile dysfunction, especialmente dentro de los centros comerciales, los propietarios de esta cadena han sacado provecho del espacio vacío, así como de la creciente aceptación de que usar máscaras es una realidad que puede durar hasta 2021, o más.Las máscaras faciales han evolucionado de ser un producto utilitario, cualquier cosa podía servir para taparte la boca, a una forma de expresar la personalidad, las inclinaciones políticas o el fanatismo deportivo.Y los propietarios de erectile dysfunction treatment Essentials están apostando a que los estadounidenses están dispuestos a poner dinero en sus bocas.

Los precios van desde $19,99 por una kamagra wholesale simple máscara para niños hasta $130 por una cubierta facial con un filtro N95 y un ventilador a batería.La cadena erectile dysfunction treatment Essentials reconoce que la máscara ya es algo más que un inconveniente temporal. Será la norma hasta 2021, y tal vez más allá. (Markian Hawryluk/KHN)Casi todas las tiendas kamagra wholesale en el centro comercial Park Meadows ahora venden máscaras. Pero erectile dysfunction treatment Essentials también ofrece otros accesorios para la pandemia, en un espacio exclusivo. su logo es una imagen estilizada de una partícula de erectile dysfunction.Ubicado junto a la tienda de remeras UNTUCKit y frente a una sala de exhibición de Tesla, no tiene el reconocimiento de marca ni kamagra wholesale el historial de un J.C.

Penney. Pero la longevidad no parece haber ayudado a que la cadena de ropa o muchas otras escaparan kamagra wholesale de la crisis por la pandemia. Según los analistas de S&P Global Market Intelligence, las quiebras minoristas de enero a mediados de agosto alcanzaron su punto más alto en 10 años.No es que los propietarios de erectile dysfunction treatment Essentials quieran que sus productos tengan demanda para siempre.“Estoy ansioso por cerrar el negocio eventualmente”, dijo Nadav Benimetzky, un minorista de Miami que fundó erectile dysfunction treatment Essentials, que ahora tiene ocho tiendas en todo el país.Nathan Chen, propietario de la tienda Lone Tree con Benimetzky, tenía un negocio diferente en el aeropuerto de Denver, pero a medida que disminuyeron los vuelos, una alternativa centrada en erectile dysfunction treatment se perfiló como una empresa mucho mejor.Las máscaras han pasado de ser un producto utilitario a algo personalizado, que identifica al que la usa con un partido político o un equipo de fútbol americano.(Markian Hawryluk/KHN)Benimetzky abrió la primera tienda erectile dysfunction treatment Essentials en el Aventura Mall en los suburbios de Miami después de ver la demanda de máscaras N95 al principio de la pandemia. €œSon feas kamagra wholesale e incómodas, y todo el mundo las odia”, dijo. €œSi vas a usar una máscara, también puede estar a la moda y ser bonita”.Eso podría significar una máscara de lentejuelas o satén para ocasiones más formales, o la sonrisa de una calavera para asuntos casuales.

Algunos cubrebocas tienen cremalleras para facilitar la alimentación, o un orificio para una pajita, con cierre de velcro.La cadena tiene tiendas en la ciudad de Nueva York, Nueva Jersey, Philadelphia y Las Vegas, y está buscando abrir otras en California, donde los incendios forestales han aumentado la demanda de máscaras.Inicialmente, los propietarios realmente no estaban seguros de que la idea kamagra wholesale funcionara. Abrieron la primera tienda justo cuando los centros comerciales volvían a abrir después de las cuarentenas.“Realmente no comprendimos qué tan grande sería”, dijo Benimetzky. €œNo lo analizamos kamagra wholesale con la idea de abrir muchas tiendas. Pero hemos estado ocupados desde el momento en que abrimos “.Un empleado de erectile dysfunction treatment Essentials decora una máscara con la palabra USA en piedras preciosas de fantasía.(Markian Hawryluk/KHN)Nancy Caeti, de 76 años, se detuvo en la tienda Lone Tree para comprar máscaras para sus nietos. Compró una transparente kamagra wholesale para su nieta, cuyo instructor de lenguaje de señas necesita ver sus labios moverse.

Le compró a su hija, profesora de música y fanática de los Denver Broncos, una máscara con el logo del equipo de fútbol americano.“Sobreviví a la epidemia de polio”, contó Caeti. Recordó cómo su madre los puso en fila a ella y a sus hermanos para recibir la vacuna contra la polio, y dijo que ella sería la primera en la fila para recibir la vacuna para kamagra wholesale erectile dysfunction treatment.Ese quizás sea el único “básico” que la tienda no vende. Pero tiene dispositivos similares a llaves para abrir puertas y presionar botones de ascensores sin tocarlos. Algunos tienen un kamagra wholesale abridor de botellas incorporado. Hay dispositivos de luz ultravioleta para desinfectar teléfonos y un desinfectante de manos exclusivo que los empleados rocían a los clientes como si fuera una muestra de perfume.Pero las máscaras son el mayor atractivo porque la tienda las puede personalizar.Al entrar, los clientes pueden verificar su temperatura con un escáner de frente digital con instrucciones audibles.

€œAcérquese. Acércate. Temperatura normal. Temperatura normal”.La tienda también ha agregado un fregadero cerca de la entrada para que los clientes puedan lavarse las manos antes de tocar los productos.Algunos pasan por la tienda desconcertados, deteniéndose para tomar fotos y publicarlas en las redes sociales. Una pareja mayor (blanca no hispana) con máscaras idénticas observó una máscara en el negocio con el lema “Black Lives Matter” y se alejó.El negocio no toma partido politico.

Hay tres diseños de máscaras del presidente Donald Trump, y dos para el candidato presidencial demócrata Joe Biden.erectile dysfunction treatment Essentials vende dispositivos parecidos a llaves que sirven para abrir puertas y tocar el botón de los elevadores "a distancia". (Markian Hawryluk/KHN)Daniel Gurule, de 31 años, pasó por el centro comercial a la hora del almuerzo para comprar un Apple Watch, pero se aventuró a entrar en la tienda por una nueva máscara. Dijo que normalmente usaba una máscara con ventilación, pero que no todos los lugares las permiten. (Protegen a los usuarios, pero no a las personas que los rodean). Compró una por $24,99 con el logo del equipo de baloncesto Denver Nuggets.“Nos quita un poco de nuestra personalidad cuando todo el mundo camina con máscaras desechables”, dijo Chen.

€œParece un hospital, como si todo el mundo estuviera enfermo”.La mayoría de las máscaras están cosidas específicamente para la cadena, incluidas muchas hechas a mano. Uno de sus proveedores es una familia de inmigrantes vietnamitas que cosen máscaras en su casa de Los Ángeles, dijo Benimetzky.Chen dijo que era difícil tener máscaras en stock y que todos los días hay un nuevo diseño que es éxito de ventas.Dorothy Lovett, de 80 años, se detuvo frente a la tienda, apoyada en un bastón con un diseño de estampado animal. €œTuve que retroceder y decir, ‘¿Qué diablos es esto?. €™â€, dijo. €œNunca antes había visto una tienda de máscaras”.Examinó la vitrina, notando que necesitaba encontrar una mejor opción que la versión de tela que estaba usando.“No puedo respirar con ésta”, dijo Lovett, antes de decidirse por su favorita.

€œMe gusta la máscara Black Lives Matter”. Markian Hawryluk. MarkianH@kff.org, @MarkianHawryluk Related Topics Noticias En Español Public Health States Colorado erectile dysfunction treatmentPETALUMA, Calif. €” Late on the night of Sept. 27, a bumper-to-bumper caravan of fleeing cars, horse trailers, RVs and overstuffed pickup trucks snaked east on Highway 12, the flames of the Glass Fire glowing orange in their rearview mirrors.With her cat, Bodhi, in his carrier in the back seat, 80-year-old Diana Dimas, who doesn’t see well at night, kept her eyes glued to the rear lights of her neighbor’s Toyota.

She and Magdalena Mulay had met a few years before at a bingo night in their sprawling retirement community on the outskirts of Santa Rosa. Both Libras, each with two marriages behind her, the two women soon became the sort of friends who finish each other’s sentences.Now, for the second time in three years, they heard the alarms and fled together as fire consumed the golden hills of Northern California’s wine country.“I thought, where on earth are we going to go?. € recalled Dimas. She remembered that when the catastrophic Tubbs Fire hit back in 2017, people had sought refuge outside well-lit supermarkets, which had water and bathrooms. Which is how Dimas and Mulay and dozens of other seniors ended up spending the night of the most recent evacuation in the parking lot of the Sonoma Safeway.

Email Sign-Up Subscribe to KHN’s free Morning Briefing. At midnight, Mulay was trying to get comfortable enough to catch a few winks in her driver’s seat when her phone began to chirp. A friend was calling to wish her a happy 74th birthday.The stories of that Sunday night — as a 20-acre fire started that morning merged with two other fires to become an 11,000-acre conflagration forcing tens of thousands from their homes in two counties — spotlight the challenges of evacuating elderly and infirm residents from the deadly wildfires that have become an annual occurrence in California. This year, the erectile dysfunction, which is especially dangerous to the elderly, has further complicated the problem.While the 2020 fire season will go down as the state’s biggest on record, rescuers have so far managed to avoid horrors on the scale of three years ago, when the firestorm that raced through California’s wine country killed 45 people. Almost all were over 65 — found in wheelchairs, trapped in their garages, isolated and hard of hearing, or simply too stubborn to leave.

The same grim pattern emerged from the Camp Fire, which leveled the Northern California town of Paradise in 2018.Assisted care homes in particular came under scrutiny after the 2017 fire, when ill-equipped and untrained workers at two Santa Rosa facilities abandoned two dozen frail, elderly residents as the flames closed in, according to state investigators. They concluded the seniors would have died in the flames had emergency workers and relatives not arrived at the last minute to rescue them.“The problem is we don’t value elders as a society,” said Debbie Toth, CEO of Choice in Aging, an advocacy group. €œIf children needed to be evacuated, we’d have a freaking Romper Room stood up overnight to entertain them so they wouldn’t be damaged by the experience.”The destructive effects of climate change in California have dovetailed with a rapidly graying population — which in a decade is projected to include 8.6 million senior citizens. That has fueled a growing demand for senior housing, from assisted care homes to swanky “active adult” facilities complete with golf courses and pools.Proximity to nature is a major selling point of Oakmont Village, Dimas and Mulay’s upscale community of nearly 5,000 over-55s, which has everything from bridge games to cannabis clubs. But the woodlands and vineyards surrounding this suburban sprawl have put thousands of elderly citizens in hazardous wildfire zones.“With seniors, there’s mobility issues, hearing issues — even the sense of smell is often gone in the later years,” said Marrianne McBride, who heads Sonoma County’s Council on Aging.

Getting out fast in an emergency is especially challenging for those who no longer drive. In Sunday’s evacuation, some residents who followed official advice to call ride services had to wait hours, until 3 or 4 a.m., for the overtaxed vans.Dimas and Mulay managed to scramble into their cars and get on the road shortly after 10 p.m., when a mandatory evacuation order went out for the thousands of seniors in Oakmont Village. But it was after midnight when residents of two Santa Rosa assisted care homes in the evacuation zone were shuffled onto city buses in their bathrobes, some with the aid of walkers. Off-duty drivers braved thick smoke and falling embers to ferry some of them to safety, only to spend hours being sent from one shelter to another as evacuation sites filled up fast because of social distancing rules designed to prevent the spread of erectile dysfunction treatment.Other precautions, including masks and temperature checks, were followed. But health officials nonetheless voiced concerns that vulnerable people in their 80s and 90s — especially residents of skilled nursing homes, the source of most of Sonoma County’s erectile dysfunction deaths so far — had been moved among multiple locations, upping their chance for exposure.In the following days, shelters were fielding frantic calls from out-of-town relatives searching for their loved ones.

€œWe were getting phone calls from Michigan, other places across the country, saying, ‘I’m trying to find my mother!. €™â€ said Allison Keaney, CEO of the Sonoma-Marin Fairgrounds, which sheltered several hundred horses, chickens, goats and llamas as well as displaced people.Bart Pettijohn rests on his cot with his dog, Clumsy, in an evacuation center at the Petaluma Veterans Memorial Building on Sept. 30. Volunteer health care workers and a veterinarian were among those who checked up on dozens of seniors and pets forced out of their homes during the biggest wildfire season in California history. (Rachel Scheier for KHN)By Wednesday afternoon, a few dozen evacuees remained at the shelters, mostly seniors without relatives or friends nearby to take them in, like Dimas and Mulay.

The two women had left the Safeway lot and were sleeping on folding cots in a gym at the Veterans Memorial Building in Petaluma, an old poultry industry town dotted with upscale subdivisions.This was their first time out and around other people since March, when the two friends had been planning a big night out to see Il Volo, an Italian pop group. Seven months later, the new outfits they bought for the concert still hang unworn in their closets.“All we do since the shutdown is stay home and talk on the phone,” said Mulay, who spoke to a reporter while sitting next to her friend on a folding chair outside the shelter. €œNow, with all these crowds — it’s terrifying.”Dimas likened the kamagra followed by the fires to “a ball rolling downhill, getting bigger and bigger. And then there we were, with the flashing lights all around us and the cops shouting, ‘Go this way!. €™ ‘Keep moving!.

€™â€Listos California — an outreach program, for seniors and other vulnerable people, run out of the Governor’s Office of Emergency Services — allotted $50 million to engage dozens of nonprofits and community groups around the state to help warn and locate people during disasters. (Listos means “Ready” in Spanish.)In Sonoma and Napa counties, where the Glass Fire had destroyed at least 630 structures by late last week, the bolstered threat of wildfires in recent years has promoted new alert systems — including a weather radio that has strobe lights for the deaf or can shake the bed to awaken you.But while counties are legally responsible for alerting people and providing shelter for them once they’re out, no public agency is responsible for overseeing the evacuation. Practices differ widely from county to county, said Listos co-director Karen Baker.If Sonoma County has learned anything from the disasters of the past few years, it’s not to depend too much on any system in an emergency. €œYou’ve got to have a neighborhood network,” McBride said. €œAs community members, we have to rely on each other when these things happen.”Early last week, word filtered through the shelters that the fire had consumed a triplex and two single-family homes in the Oakmont neighborhood, but firefighters had battled the blaze through the night with hoses, shovels and chainsaws and miraculously managed to save the rest of the community.A week later, to their relief, Oakmont’s senior residents were allowed to return home.

By then, Mulay had developed severe back pain. Dimas missed her TV.Back in her apartment with Bodhi, Dimas noted with horror that the blaze had come close enough to her building to incinerate several juniper bushes and scorch a redwood just 2 feet away.“The whole thing feels surreal, like ‘Oh, my God, did that really happen, or did I dream it?. €™â€ she said. This KHN story first published on California Healthline, a service of the California Health Care Foundation. Rachel Scheier.

@rachelscheier Related Topics Aging Public Health erectile dysfunction treatment Natural DisastersLONE TREE, Colo. €” Darcy Velasquez, 42, and her mother, Roberta Truax, were walking recently in the Park Meadows mall about 15 miles south of downtown Denver, looking for Christmas gifts for Velasquez’s two children, when they spotted a store with a display of rhinestone-studded masks.It’s an immutable truth of fashion. Sparkles can go a long way with a 9-year-old.The store is called erectile dysfunction treatment Essentials. And it may well be the country’s first retail chain dedicated solely to an infectious disease.With many U.S. Stores closing during the erectile dysfunction kamagra, especially inside malls, the owners of this chain have seized on the empty space, as well as the world’s growing acceptance that wearing masks is a reality that may last well into 2021, if not longer.

Masks have evolved from a utilitarian, anything-you-can-find-that-works product into another way to express one’s personality, political leanings or sports fandom.And the owners of erectile dysfunction treatment Essentials are betting that Americans are willing to put their money where their mouth is. Prices range from $19.99 for a simple children’s mask to $130 for the top-of-the-line face covering, with an N95 filter and a battery-powered fan.The erectile dysfunction treatment Essentials chain recognizes that mask-wearing is more than a temporary inconvenience — it may become the norm well into 2021, or longer.(Markian Hawryluk/KHN)Almost all shops and many pop-up kiosks in the Park Meadows mall now sell masks. But erectile dysfunction treatment Essentials also carries other accessories for the kamagra, in a space that has a more established feel than a holiday pop-up store. Permanent signage above its glass doors includes a stylized image of a erectile dysfunction particle. Nestled beside the UNTUCKit shirt store and across from a Tesla showroom, it has neither the brand recognition nor the track record of a J.C.

Penney. But longevity doesn’t seem to have helped that clothing chain or many others escape industry upheaval during the kamagra. According to analysts at S&P Global Market Intelligence, retail bankruptcies from January to mid-August reached a 10-year-high.Not that the erectile dysfunction treatment Essentials owners want their products to be in demand forever.“I can’t wait to go out of business eventually,” said Nadav Benimetzky, a Miami retailer who founded erectile dysfunction treatment Essentials, which now has eight locations around the country.That seemed to be the attitude of most of the customers who walked into the store on a recent Friday afternoon. Most understood the need for masks — face coverings are required to even enter the mall — and thus they recognized the business case for a erectile dysfunction treatment store. Still, they hoped masks would soon go the way of bell-bottoms or leg warmers.

For the time being, they’re making the best of the situation. Email Sign-Up Subscribe to KHN’s free Morning Briefing. Nathan Chen, who owns the Lone Tree store with Benimetzky, previously ran a different store at the Denver airport, but as air travel declined, a erectile dysfunction treatment-focused business seemed a much better venture. The kamagra giveth and the kamagra taketh away.Benimetzky opened the first erectile dysfunction treatment Essentials store in the Aventura Mall in suburban Miami after seeing the demand for N95 masks early in the kamagra. €œThey’re ugly and uncomfortable, and everybody hates them,” he said.

€œI piggybacked off of that. If you’re going to wear a mask, you might as well make it fashionable and pretty.”Face masks have evolved from a utilitarian product into a customized accessory for personal expression.(Markian Hawryluk/KHN)That could mean a sequin or satin mask for more formal occasions, or the toothy grin of a skull mask for casual affairs. Some masks have zippers to make eating easier, or a hole for a straw, with a Velcro closure for when the cup is sucked dry.The chain has locations in New York City, New Jersey, Philadelphia and Las Vegas, and is looking to open stores in California, where wildfires have only added to the demand for masks.Initially, the owners really weren’t sure the idea would fly. They opened the first store just as malls were reopening following the lockdowns.“We really didn’t grasp how big it would get,” Benimetzky said. €œWe didn’t go into it with the idea of opening many stores.

But we got busy from the second we opened.”Nancy Caeti, 76, stopped in the Lone Tree store to buy masks for her grandchildren. She bought one with a clear panel for her granddaughter, whose sign language instructor needs to see her lips moving. She bought her daughter, a music teacher and Denver Broncos fan, a mask with the football team’s logo.“I lived through the polio epidemic,” Caeti said, as her latex-gloved hand inserted her credit card into the card reader. €œIt reminds me of that, but that I don’t think was as bad.” She recalled how her mother had lined her and her siblings up to get the polio treatment, and said she’d be first in line for a erectile dysfunction treatment shot.That perhaps is the one essential the store does not carry. It hawks keylike devices for opening doors and pressing elevator buttons without touching them.

Some have a built-in bottle opener. There are ultraviolet-light devices for disinfecting phones and upscale hand sanitizer that employees spray on customers as if it were a department store perfume sample.But the masks are the biggest draw. The store can personalize them with rhinestone letters or the kind of iron-on patches that teens once wore on their jeans.A erectile dysfunction treatment Essentials employee decorates a face mask with rhinestone letters, spelling U-S-A.(Markian Hawryluk/KHN)Upon entry, customers can check their temperature with a digital forehead scanner with audible directions. €œStep closer. Step closer.

Temperature normal. Temperature normal.”The store also has added a sink near the entrance so customers can wash their hands before handling the merchandise.Some mallgoers walk by the store in bewilderment, stopping to take photos to post to social media with a you’ve-got-to-be-kidding message. One older white couple in matching masks noticed a mask emblazoned with the slogan “Black Lives Matter” in the storefront display, and walked away in disgust.The store takes no political sides. There are three designs of President Donald Trump campaign masks, two for Democratic presidential candidate and former Vice President Joe Biden. One woman, who declined to give her name, came in wearing a mask below her nose and wondered whether a Trump mask would fit her smallish face.

The Trump masks are among the more popular sellers, Chen said, so he keeps them in a bigger cabinet to accommodate the extra stock. It’s not clear if that will forecast the election results, as some have posited with Halloween mask sales.Daniel Gurule, 31, stopped by the mall on his lunch hour to pick up an Apple Watch but ventured into the store for a new mask. He said that he normally wore a vented mask but that not all places allowed those. (They protect users but not the people around them.) He bought a $24.99 mask with the logo of the Denver Nuggets basketball team.“It takes away a little bit of our personalities when everybody is walking around in disposable masks,” Chen said. €œIt kind of looks like a hospital, like everybody is sick.”Most of the masks are sewn specifically for the chain, including many by hand.

One of their suppliers is a family of Vietnamese immigrants who sew masks at their Los Angeles home, Benimetzky said. Chen said that it was hard to keep masks in stock, and that every day it seemed some other design became their best seller.erectile dysfunction treatment Essentials sells keylike devices to open doors and press elevator buttons without touching them. Some even have built-in bottle openers.(Markian Hawryluk/KHN)Dorothy Lovett, 80, paused outside the store, leaning on a cane with an animal print design.“I had to back up and say, ‘What the heck is this?. €™â€ she said. €œI’ve never seen a mask store before.”She perused the display case, noting she needed to find a better option than the cloth version she was wearing.“I can’t breathe in this one,” said Lovett, who is white, before deciding on her favorite.

€œI like the Black Lives Matter mask.” Markian Hawryluk. MarkianH@kff.org, @MarkianHawryluk Related Topics Public Health States Colorado erectile dysfunction treatmentReferring to plans to combat erectile dysfunction treatment. €œThe reality is when you look at the Biden plan, it reads an awful lot like what President Trump and I and our task force have been doing every step of the way.”— Vice President Mike Pence on Oct. 7, 2020, during the vice presidential debate. During last week’s vice presidential debate, moderator Susan Page, USA Today’s Washington bureau chief, asked Vice President Mike Pence about the U.S.

erectile dysfunction treatment death toll. Pence replied by touting the Trump administration’s actions to combat the kamagra, such as restrictions on travel from China, steps to expand testing and efforts to accelerate the production of a treatment. This story was produced in partnership with PolitiFact. This story can be republished for free (details). Pence also took a jab at Democratic presidential nominee Joe Biden, a strong critic of the Trump kamagra response. €œThe reality is, when you look at the Biden plan, it reads an awful lot like what President Trump and I and our task force have been doing every step of the way,” said Pence.

€œAnd, quite frankly, when I look at their plan,” he added, “it looks a little bit like plagiarism, which is something Joe Biden knows a little bit about.”(Pence’s gibe about plagiarism is likely a reference to Biden copying phrases from a British politician’s speeches during his first run for president in 1987, an issue that caused him to drop out of the race. In 2019, the Biden campaign acknowledged it had inadvertently lifted language in its climate and education plans without attributing the sources.)Because erectile dysfunction treatment continues to spread throughout the United States, with nearly 8 million cases and upward of 215,000 deaths, we decided to examine both the Trump and Biden plans to curb the kamagra and investigate whether Pence was on target in his charge that the Biden plan is rooted in Trump’s ideas.We reached out to both presidential campaigns for their candidates’ erectile dysfunction treatment plans. The Trump campaign did not respond to our request, but we looked at a campaign website timeline of administration actions on erectile dysfunction treatment, as well as a erectile dysfunction fact sheet from the White House. The Biden campaign sent us a link to Biden’s erectile dysfunction treatment plan.At first glance, there are obvious similarities. Both declare goals like treatment development and expanding public availability of erectile dysfunction treatment tests.“Most kamagra response plans should be at their core fairly similar, if they’re well executed,” said Nicolette Louissaint, executive director of Healthcare Ready, a nonprofit organization focused on strengthening the U.S.

Health care supply chain.But public health experts also pointed to significant philosophical differences in how the plans are put into action.“You ought to think about it as two groups of people trying to make a car,” said Dr. Georges Benjamin, executive director of the American Public Health Association. €œThey have to have four wheels, probably have to have a bumper, have some doors,” he said. It is how you build the car from that point forward that determines what the end product looks like.What Trump Has DoneAs Pence pointed out, the Trump administration has focused its efforts to combat erectile dysfunction treatment along a couple of lines.The administration formed the White House erectile dysfunction task force in January and issued travel restrictions for some people traveling from China and other countries in February. Federal social distancing guidelines were issued in March and expired on April 30.

The administration launched Operation Warp Speed in April, with the goal of producing and delivering 300 million doses of a erectile dysfunction treatment beginning in January 2021. A more detailed logistics plan to distribute a treatment was issued later. Trump activated the Defense Production Act for certain protective equipment and ventilators. His administration also has talked about efforts to expand erectile dysfunction treatment testing in partnership with the private sector, as well as initiatives to help cover costs for erectile dysfunction treatments and make tests free of charge.Importantly, the administration also shifted significant decision-making responsibility to states, leaving the development of testing plans, procurement of personal protective equipment and decrees on stay-at-home orders and mask mandates to the discretion of the governor or local governments. Despite that, Trump still urged states to reopen beginning in May, though in many areas cases of erectile dysfunction treatment remained high.

Don't Miss A Story Subscribe to KHN’s free Weekly Edition newsletter. What Biden Proposes to DoBiden’s plan would set out strong national standards for testing, contact tracing and social distancing — words that echo the Trump plan. It proposes working with states on mask mandates, establishing a “supply commander” in charge of shoring up PPE, aggressively using the Defense Production Act and accelerating treatment development.It also outlines plans to extend more fiscal relief, provide enhanced health insurance coverage, eliminate cost sharing for erectile dysfunction treatments, reestablish a team on the National Security Council to address kamagra response and to maintain membership inthe World Health Organization. Trump announced earlier this summer that the U.S. Would begin procedures to withdraw from the WHO, effective as of July 6, 2021.Biden has said he would follow scientific advice if indicators pointed to a need to dial up social distancing guidelines in light of another wave of erectile dysfunction treatment cases.What’s the Same, What’s Different Sources: The Boston Globe, “On the Campaign Trail, Trump and Biden Operate in Different Circles on erectile dysfunction treatment,” Oct.

6, 2020Department of Health and Human Services, “From the Factory to the Frontlines — The Operation Warp Speed Strategy for Distributing a erectile dysfunction treatment,” accessed Oct. 12, 2020Department of Health and Human Services, “Trump Administration Will Deploy 150 Million Rapid Tests in 2020,” Aug. 27, 2020DonaldJTrump.com, “Trump Campaign Announces President Trump’s 2nd Term Agenda. Fighting for You!. € accessed Oct.

8, 2020DonaldJTrump.com, “Timeline. The Trump Administration’s Decisive Actions to Combat the erectile dysfunction,” accessed Oct. 9, 2020Email exchange with Joe Biden for President campaign staffer, Oct. 7, 2020Email interview with Dr. Rachel Vreeman, director of the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, Oct.

8, 2020JoeBiden.com, “The Biden Plan to Combat erectile dysfunction (erectile dysfunction treatment) and Prepare for Future Global Health Threats,” accessed Oct. 8, 2020KFF, “Comparing Trump and Biden on erectile dysfunction treatment,” Sept. 11, 2020Phone interview with Brooke Nichols, assistant professor of global health at Boston University, Oct. 9, 2020Phone interview with Josh Michaud, associate director for global health policy at KFF (Kaiser Family Foundation), Oct. 8, 2020Phone interview with Joseph Antos, Wilson H.

Taylor resident scholar in health care and retirement policy at the American Enterprise Institute, Oct. 8, 2020Phone interview with Dr. Georges Benjamin, executive director of the American Public Health Association, Oct. 8, 2020Phone interview with Dr. Leana Wen, public health professor at George Washington University, Oct.

8, 2020Phone interview with Nicolette Louissaint, executive director and president of Healthcare Ready, Oct. 9, 2020Rev.com, “Kamala Harris &. Mike Pence 2020 Vice Presidential Debate Transcript,” Oct. 7, 2020Tableau, “erectile dysfunction treatment at the White House — Public Reports,” accessed Oct. 12, 2020Tradeoffs Podcast, “Season 1.

Episode 71, Biden and erectile dysfunction treatment,” Sept. 24, 2020Tradeoffs Podcast, “All the President’s … Health Policies. Where Do the Candidates Stand on Health Policy?. € Sept. 24, 2020The White House, “President Trump’s Historic erectile dysfunction Response,” Aug.

10, 2020The White House, “erectile dysfunction Guidelines,” March 16, 2020The Washington Post, “Echoes of Biden’s 1987 Plagiarism Scandal Continue to Reverberate,” June 5, 2019The Washington Post, “Joe Biden’s Campaign Acknowledges Lifting Language From Other Groups for Its Policy Plans,” June 4, 2019 Dr. Rachel Vreeman, director of the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, noted in an email that a key likeness is that the two plans “sometimes used similar words, such as testing, PPE and treatments.”But “the overall philosophy from the start, from the White House and from Trump, has been to let states and local governments deal with this problem,” said Josh Michaud, associate director for global health policy at KFF. €œBiden would have a much more forceful role for the federal government in setting strategy and guidelines in regards to the public health response.” (KHN is an editorially independent program of KFF.)Even Pence pointed out this philosophical difference during the debate, saying that Democrats want to exert government control while Trump and Republicans left health choices up to individual Americans.Vreeman and others pointed to another contrast — that the Trump administration has yet to issue a comprehensive erectile dysfunction treatment response plan.“What plan?. I would really love it if someone could show me a plan. A press release is not a plan,” said Dr.

Leana Wen, a public health professor at George Washington University.Wen is right that the Trump administration has not issued a detailed plan, such as Biden’s document. The Trump administration has, however, offered a road map for how treatments would be distributed.Behavior Matters, TooAnother major distinction emerged in the way the candidates have communicated the threat of the erectile dysfunction to the public and reacted to public health guidelines, such as those issued by the Centers for Disease Control and Prevention.During most public outings and campaign rallies, Trump has chosen not to wear a mask — even after he tested positive and was treated for erectile dysfunction treatment. He has been known to mock others, including reporters and Biden, for wearing masks. And, Trump and members of his administration have not adhered to social distancing guidelines at official events. The White House indoor reception and outdoor Rose Garden event held to mark the nomination of Amy Coney Barrett to the Supreme Court – at each one, few attendees followed these precautions – have been associated with the transmission of at least 11 cases of erectile dysfunction, according to a website tracking the cases from public reports.

There are also multiple reported cases among White House and Trump campaign staff members.Throughout the kamagra, Trump has downplayed the threat of erectile dysfunction treatment, touted unproven treatments for the disease such as bleach, hydroxychloroquine or UV light, questioned the effectiveness of face masks and criticized or contradicted public health officials’ statements about the kamagra.In comparison, Biden has worn masks during his public campaign events and has encouraged Americans to do so as well. His events strictly adhere to public health guidelines, including wearing masks, social distancing and limiting the number of attendees.The two candidates’ approaches to listening to scientists are also different.“Biden has said he is going to look at science and value the best scientists,” said Benjamin. €œThe Trump administration has not walked the talk. They have said one thing and done something else. If you go on the Trump administration website, you see guidelines that they didn’t follow themselves.”In the end, the Biden campaign has the distinction of being able to learn from the Trump administration’s early missteps, said the experts.There’s also a reality check.

If Biden wins and attempts to implement his erectile dysfunction treatment plan, it’s important to consider that no matter how well thought out it looks on paper, he may not be able to accomplish everything.“There’s a lot of words in this plan,” said Joseph Antos, a resident scholar in health care policy at the American Enterprise Institute. €œBut until you’re in the job, a lot of this doesn’t really matter.”Our RulingPence claimed the Biden plan to address erectile dysfunction treatment was similar to the Trump administration’s plan “every step of the way.”A cursory, side-by-side look at the Trump administration’s erectile dysfunction treatment actions — no actual comprehensive plan has been released — and the Biden plan indicates some big picture overlap on securing a treatment and ramping up testing. But that’s where the similarities end.Biden’s plan includes proposed actions the Trump administration has not pursued. It also is focused on federal rather than state authority, a significant distinction Pence himself pointed out during the debate.Additionally, the candidates’ behaviors toward erectile dysfunction treatment and views on science have been diametrically opposed, with Trump eschewing the use of face masks and social distancing, and Biden closely adhering to both.Pence’s statement ignores critical facts and realities, making it inaccurate and ridiculous.We rate it Pants On Fire. Victoria Knight.

vknight@kff.org, @victoriaregisk Related Topics Elections Health Industry Public Health erectile dysfunction treatment KHN &. PolitiFact HealthCheck Trump AdministrationJournalists from KHN and the Guardian have identified 1,290 workers who reportedly died of complications from erectile dysfunction treatment they contracted on the job. Reporters are working to confirm the cause of death and workplace conditions in each case. They are also writing about the people behind the statistics — their personalities, passions and quirks — and telling the story of every life lost.Explore the new interactive tool tracking those health worker deaths. More From This Series.

Related Topics Health Industry erectile dysfunction treatment Doctors Investigation Lost On The Frontline Nursing Homes.

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Federal health officials are cautioning that the new Delta erectile dysfunction treatment variant is likely to become the new dominant strain of the kamagra in the US, prompting new calls for Americans to get vaccinated.Rochelle Walensky, the director for the where to buy kamagra pills Centers for Disease Control and Prevention http://www.venditebagni.com/zithromax-500mg-for-sale/ (CDC), said on Friday, June 18 that the more transmissible Delta variant, known as B.1.617.2 has already become the dominant strain in the UK and is likely to follow suit in the US.“As worrisome as this Delta strain is with regard to its hyper transmissibility, our treatments work," Walensky said. "Right now, they are working where to buy kamagra pills and they require actually two doses to be fully vaccinated, to work well. €¨â€œSo I would encourage all Americans, get your first shot, and when you're due for your second, get your second shot and you'll be protected against this Delta variant.”Officials have cautioned that the Delta variant is highly contagious, more deadly, and could potentially be more resistant to treatments, which still remain the best defense, they cautioned.“treatments are our only way out of this," treatment expert Dr. Paul Offit told CNN's where to buy kamagra pills Wolf Blitzer. "Unless we vaccinate a significant percentage of the population before winter hits, you're going to see more spread and the creation of more variants, which will only make this task more difficult.”Infectious disease expert Dr.

Anthony Fauci said that variants should not be a concern to those who are vaccinated, and that the emergence of the Delta strain and other variants provide extra incentive to get the treatment.“The combination of more transmissibility and greater severity of disease, appropriately, prompted the CDC to elevate it to a variant of concern,” he said this week where to buy kamagra pills. €œI'm not concerned about the people who are vaccinated. Because the good news about all this, among the seriousness where to buy kamagra pills of the situation with regards to the variant, is that the treatments work really quite well.”People who are vaccinated are protected, he noted, "which is another very good reason to encourage people strongly to get vaccinated because if you are not vaccinated, you are at risk of getting infected with a kamagra that now spreads more rapidly and gives more serious disease," Click here to sign up for Daily Voice's free daily emails and news alerts.Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!. GET STARTED Log In | Learn More What is it?. STAT+ is STAT's premium subscription service for in-depth biotech, where to buy kamagra pills pharma, policy, and life science coverage and analysis.

Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What's included?. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr..

Federal health officials are cautioning that the new Delta erectile dysfunction treatment variant is likely to become the new dominant strain of the kamagra in the US, prompting new calls for Americans to get vaccinated.Rochelle Walensky, the director for the Centers for Disease Control and Prevention (CDC), said on Friday, June 18 that the more transmissible Delta variant, known as B.1.617.2 has already become the dominant strain in the UK and is likely to follow suit in the US.“As worrisome as this Delta strain kamagra wholesale is with regard to its hyper transmissibility, our treatments work," Walensky said. "Right now, they are working and they require kamagra wholesale actually two doses to be fully vaccinated, to work well. €¨â€œSo I would encourage all Americans, get your first shot, and when you're due for your second, get your second shot and you'll be protected against this Delta variant.”Officials have cautioned that the Delta variant is highly contagious, more deadly, and could potentially be more resistant to treatments, which still remain the best defense, they cautioned.“treatments are our only way out of this," treatment expert Dr. Paul Offit told CNN's kamagra wholesale Wolf Blitzer.

"Unless we vaccinate a significant percentage of the population before winter hits, you're going to see more spread and the creation of more variants, which will only make this task more difficult.”Infectious disease expert Dr. Anthony Fauci said that variants should not be a concern to those who are vaccinated, and that the emergence of the Delta strain and other variants provide extra incentive to get the treatment.“The combination of more transmissibility and greater kamagra wholesale severity of disease, appropriately, prompted the CDC to elevate it to a variant of concern,” he said this week. €œI'm not concerned about the people who are vaccinated. Because the good news about all this, among the seriousness of the situation with regards to the variant, is that the treatments work really quite well.”People who are vaccinated are protected, he noted, "which is another very good reason to encourage people strongly to get vaccinated because if you kamagra wholesale are not vaccinated, you are at risk of getting infected with a kamagra that now spreads more rapidly and gives more serious disease," Click here to sign up for Daily Voice's free daily emails and news alerts.Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!.

GET STARTED Log In | Learn More What is it?. STAT+ is STAT's premium subscription service for in-depth kamagra wholesale biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What's kamagra wholesale included?.

Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr..

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Over 300 representatives from countries, partners and civil society kamagra oral jelly fake came together virtually at the Global Meeting of the Working Group Meeting on Public-Private http://appol.pl/venti_products/sok-nfc-jablkowy/ Mix (PPM) on TB prevention and care on 23 and 25 November. The Meeting was convened by the World Health Organization (WHO) and the Stop TB Partnership with support from the US Agency for International Development (USAID) and the Global Fund. The meeting was opened by Dr Tereza Kasaeva, Director of WHO’s Global TB Programme and Dr Madhukar Pai, Chair of the Stop TB PPM Working Group and Associate Director of kamagra oral jelly fake the McGill International TB Centre. Nigerian TB survivor and advocate Funke Dosumu shared her personal struggle against TB and made a passionate plea for stronger public-private collaboration to ensure access to quality care for those ill with TB without added financial burden. The meeting placed a spotlight on the impact of the erectile dysfunction treatment kamagra on the TB response, which has been especially severe on private sector care delivery.

A special kamagra oral jelly fake talk was delivered by award-winning journalist Barkha Dutt. She issued a strong wake-up call on the tragic impact of erectile dysfunction treatment on the poor and vulnerable, especially those struggling with TB and other infectious diseases in accessing affordable care.“The erectile dysfunction treatment kamagra has widened gaps in access to TB prevention and care services in both the public and private sector, as evidenced from the experiences and rich discussions shared at the PPM Working Group Meeting,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. €œWe need to urgently unite forces and strengthen multisectoral action, including through the engagement of all care providers, to get back-on-track towards universal health coverage, to ensure those ill with TB and other infectious diseases are not left behind”.The meeting resulted in a set of comprehensive priority actions to bolster PPM efforts in the face of the kamagra oral jelly fake erectile dysfunction treatment kamagra. An updated landscape analysis on private sector engagement with the latest data and PPM models was also pre-launched at the meeting to facilitate improved engagement of private providers to end TB. Global progress, challenges and opportunities to expand PPM to reach End TB targets– notably those committed to in the UN political declaration on TB, were extensively discussed at the meeting.“erectile dysfunction treatment and TB pose a deadly, dual threat - a syndemic”, said Dr Madhukar Pai, Chair of the Stop TB PPM Working Group.” Tremendous catch-up work, advocacy, and funding is needed, to get back on track.

We need all hands on the deck, including the private health sector, kamagra oral jelly fake to battle an existing as well as a new killer disease. I am glad the PPM Working Group annual meeting included critical content on how we might accomplish this goal.”The meeting was held in an interactive format. The first day featured interventions from a TB kamagra oral jelly fake survivor, WHO and key partners including USAID, The Global Fund, Stop TB Partnership and the Bill and Melinda Gates Foundation. A special country roundtable focused on progress and challenges being faced by countries in scaling up PPM, including around outsourcing of PPM services for greater efficiency. A comprehensive overview of progress made over one year since the launch of the TB PPM Learning Network was presented including a rapid growth in membership &.

Knowledge sharing kamagra oral jelly fake. This was followed by a spotlight on PPM and drug resistant TB, through a visual patient story and intervention from Viet Nam to mark World Antimicrobial Awareness Week. The 2020 update of the PPM Landscape Analysis on private sector engagement to end TB was pre-launched at the meeting.The kamagra oral jelly fake second day focused on the impact of the erectile dysfunction treatment kamagra on PPM scale-up efforts. Private practitioners and national TB programme managers shared candid feedback on the grim situation in maintaining private TB care provision during the erectile dysfunction treatment crisis but also shared how digital innovations are proving a game changer to ensure access to care. The meeting closed with group discussions on top priority actions to get PPM back-on-track to reach End TB targets, given the erectile dysfunction treatment context.

Harnessing digital innovations including telemedicine, improved monitoring and strengthening multisectoral accountability were among the key actions identified.At the close of the meeting, representatives from national TB programmes, partners and kamagra oral jelly fake civil society commended the work of the PPM Working Group and WHO and pledged to work with WHO and partners in restoring and strengthening PPM efforts during the erectile dysfunction treatment kamagra.WATCH THE RECORDINGS:Day 1. 23 November 2020Day 2. 25 November 2020.

Over 300 representatives from countries, partners and civil society came kamagra wholesale together virtually at the Global Meeting of the Working Group Meeting on Public-Private Mix (PPM) on TB prevention and care on 23 and 25 November. The Meeting was convened by the World Health Organization (WHO) and the Stop TB Partnership with support from the US Agency for International Development (USAID) and the Global Fund. The meeting was opened by Dr Tereza Kasaeva, Director of WHO’s Global TB Programme and Dr Madhukar Pai, Chair of the Stop TB PPM Working Group and Associate Director of the McGill International TB Centre kamagra wholesale. Nigerian TB survivor and advocate Funke Dosumu shared her personal struggle against TB and made a passionate plea for stronger public-private collaboration to ensure access to quality care for those ill with TB without added financial burden. The meeting placed a spotlight on the impact of the erectile dysfunction treatment kamagra on the TB response, which has been especially severe on private sector care delivery.

A special kamagra wholesale talk was delivered by award-winning journalist Barkha Dutt. She issued a strong wake-up call on the tragic impact of erectile dysfunction treatment on the poor and vulnerable, especially those struggling with TB and other infectious diseases in accessing affordable care.“The erectile dysfunction treatment kamagra has widened gaps in access to TB prevention and care services in both the public and private sector, as evidenced from the experiences and rich discussions shared at the PPM Working Group Meeting,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. €œWe need to urgently unite forces and strengthen multisectoral action, including through the engagement of all care providers, to kamagra wholesale get back-on-track towards universal health coverage, to ensure those ill with TB and other infectious diseases are not left behind”.The meeting resulted in a set of comprehensive priority actions to bolster PPM efforts in the face of the erectile dysfunction treatment kamagra. An updated landscape analysis on private sector engagement with the latest data and PPM models was also pre-launched at the meeting to facilitate improved engagement of private providers to end TB. Global progress, challenges and opportunities to expand PPM to reach End TB targets– notably those committed to in the UN political declaration on TB, were extensively discussed at the meeting.“erectile dysfunction treatment and TB pose a deadly, dual threat - a syndemic”, said Dr Madhukar Pai, Chair of the Stop TB PPM Working Group.” Tremendous catch-up work, advocacy, and funding is needed, to get back on track.

We need all hands on the deck, including the private health sector, to battle an existing as well as a new killer disease kamagra wholesale. I am glad the PPM Working Group annual meeting included critical content on how we might accomplish this goal.”The meeting was held in an interactive format. The first day featured interventions from a TB survivor, WHO and key partners including USAID, The Global Fund, Stop TB Partnership and the Bill and Melinda Gates Foundation kamagra wholesale. A special country roundtable focused on progress and challenges being faced by countries in scaling up PPM, including around outsourcing of PPM services for greater efficiency. A comprehensive overview of progress made over one year since the launch of the TB PPM Learning Network was presented including a rapid growth in membership &.

Knowledge sharing kamagra wholesale. This was followed by a spotlight on PPM and drug resistant TB, through a visual patient story and intervention from Viet Nam to mark World Antimicrobial Awareness Week. The 2020 update of the PPM Landscape Analysis on kamagra wholesale private sector engagement to end TB was pre-launched at the meeting.The second day focused on the impact of the erectile dysfunction treatment kamagra on PPM scale-up efforts. Private practitioners and national TB programme managers shared candid feedback on the grim situation in maintaining private TB care provision during the erectile dysfunction treatment crisis but also shared how digital innovations are proving a game changer to ensure access to care. The meeting closed with group discussions on top priority actions to get PPM back-on-track to reach End TB targets, given the erectile dysfunction treatment context.

Harnessing digital innovations including telemedicine, improved monitoring and strengthening multisectoral accountability were among the key actions identified.At the close kamagra wholesale of the meeting, representatives from national TB programmes, partners and civil society commended the work of the PPM Working Group and WHO and pledged to work with WHO and partners in restoring and strengthening PPM efforts during the erectile dysfunction treatment kamagra.WATCH THE RECORDINGS:Day 1. 23 November 2020Day 2. 25 November 2020.

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The Office of National Drug Control Policy (ONDCP) recently awarded two New Hampshire drug prevention coalitions $250,000 in Drug Free Communities (DFC) grants.Grants were awarded to the All Together in the Upper Valley region and the Keene YMCA Community Coalition on Youth Substance Use for their youth substance abuse prevention efforts.DFC coalitions have contributed to a decline in prescription drug misuse among http://bryant-heating.com/buy-levitra-australia/ participants and have led innovative opioid prevention initiatives.U.S kamagra uk next day. Sens. Jeanne Shaheen (D-NH) and Maggie Hassan (D-NH) and U.S. Rep.

Annie Kuster (D-NH) announced the awards.“Youth drug prevention coalitions do lifesaving work to protect children from substance misuse in our effort to stop another generation from succumbing to this epidemic. As the erectile dysfunction treatment kamagra exacerbates the substance use disorder crisis, we need to ensure these programs have the resources they need to maintain existing programs and reach more people,” Shaheen said.The Substance Abuse and Mental Health Services Administration supports the program.Shaheen is a senior member of the Senate Appropriations Subcommittee that funds the Department of Justice. The department oversees many programs intended to combat substance use disorder.Shaheen also has hosted Drug Free Communities roundtable discussions in Milford and Woodsville with youth advocates, community leaders, school administrators, and students.A successful program in Sullivan County, Tenn., that works with people who have had an overdose to get them treatment and prevent future overdoses has received nearly $900,000 in new federal funding, according to the Tennessee Department of Mental Health and Substance Abuse Services.The U.S. Department of Justice Bureau of Justice Assistance recently awarded the funds to the Sullivan County Overdose Response Team (SCORT) to allow it to continue its work over three years.

SCORT will use the funding to expand its outreach and self-referral capacity. The team also will expand its followup period with clients to two years.Since launching in 2018 as a pilot program, 77 percent of clients enrolled in substance use treatment and more than 93 percent avoided another overdose.“It has been extremely beneficial and has had a huge impact in our county working with the Sullivan County Overdose Response Team,” Sullivan County Sheriff Jeff Cassidy said. €œWith the collaboration of Sullivan County Anti-Drug Coalition and law enforcement, we have been able to connect individuals that have overdosed with treatment and resources of rehabilitation to prevent future overdoses. As we continue to expand our resources, I believe we can break the cycle of addiction and set these individuals up for success in their lives.”SCORT is a collaboration between law enforcement, community behavioral health providers, area agencies, and the Sullivan County Anti-Drug Coalition.Pear Therapeutics, a leader in prescription digital therapeutics (PDT), announced the publication of real-world data on the use of its reset-O cognitive behavioral therapy applications.The data, published in the Journal of Current Medical Research and Opinion, looked at more than 3,000 patients using reSET-O, the first FDA-approved Prescription Digital Therapeutic intended to increase retention of patients with opioid use disorder (OUD) in outpatient treatment by providing cognitive behavioral therapy as an adjunct of outpatient treatment and contingency management.“We are excited to share these data as we believe this is an important confirmation of the potential for reSET-O to improve clinical outcomes at scale and address the unmet needs of OUD treatment,” said Yuri Maricich, M.D., Chief Medical Officer at Pear Therapeutics and lead author of the paper.

€œThis cohort of patients represents one of the largest datasets of community OUD treatment analyzed to date and robustly demonstrates the real-world impact of a PDT integrated into standard of care for patients with OUD.”The company said the analysis of patient engagement and use of reset-O and OUD outcomes, and found that the prescription digital therapeutic is potentially a valuable tool to use for patients getting medication-assisted treatment for OUD.Prescription digital therapeutics use software to treat diseases. Like traditional medicines, the software has to be tested in randomized controlled trials and evaluated by the FDA. But unlike traditional medicines, PDTs are designed to collect real-world data for use that can be used by clinicians and others.The study looked at 3,144 patients with OUD in a 12-week treatment program from 30 different states between the ages of 19 and over 60. The study found that 80 percent of the patients completed at least 25 percent of the core behavioral treatment modules, while 66 percent completed at least half of the behavioral modules, and 49 percent completed all of the modules.

Research indicated that 70 percent of patients stuck with the treatment and continued the PDT during the last four weeks of the treatment. And of those using four or more PDT modules per week for the first four weeks, 88.1 percent remained abstinent for the last four weeks.Shutterstock U.S. Rep. Frank Lucas (R-OK) applauded a $125,000 grant from the Drug-Free Communities (DFC) Support Program for Oklahoma’s Creek County Substance Abuse Prevention Partnership on Thursday.The grant from the Office of National Drug Control Policy would allow the partnership, in cooperation with Oklahoma State University, to use evidence-based strategies to reduce underage drinking and prescription drug misuse in young people under the age of 18 in Creek County.“Strengthening community partnerships is critical in battling and preventing youth substance abuse.

In order for our communities to remain healthy, we must connect with and educate our children on these dangers,” Lucas said. €œMoving forward, we all have a role to play in preventing substance abuse, and I will continue to support our communities and fight to prevent the use of these harmful drugs in Oklahoma’s youth.”The DFC Support program works in conjunction with the Centers for Disease Control and Prevention (CDC) to fund community coalitions that work to reduce local youth substance use. The program recognizes that local problems need local solutions and provides the funding for local coalitions to engage their communities on several levels.“CDC is committed to strengthening local capacity to develop innovative, community-based programs that save lives,” said Centers for Disease Control and Prevention Director Robert R. Redfield.

€œOur partnership with the ONDCP and with community coalitions is critical to our Nation’s efforts to prevent substance use among youth.”Creek County Substance Abuse Partnership Project said it will address the issue through social and retail access, tackling issues like social host liability laws, alcohol compliance checks, responsible beverage service and sales training, and the safe use, storage, and disposal of prescriptions drugs.The White House Office of National Drug Control Policy (ONDCP) recently awarded $500,000 to four Kentucky organizations for their substance-abuse prevention efforts, according to U.S. Senate Majority Leader Mitch McConnell (R-KY).Funding will be made through the Drug-Free Communities Program.The recipients are the Casey County School District in Liberty, Oldham County Health Department in La Grange, Seven Counties Services in Louisville, and Mental Health America of Northern Kentucky and Southwest Ohio in Edgewood. Each organization received $125,000 for their efforts to prevent addiction.“Last year, through collaboration with this community and youth groups, we provided critical drug prevention activities to more than 7,000 Graymoor-Devondale residents,” Abby Drane, Seven Counties Services president and CEO for Bellewood and Brooklawn, said. “The erectile dysfunction treatment kamagra is creating an unprecedented need for services to youth in many of the communities we serve.

We look forward to helping more young people reduce their risk of substance abuse in the upcoming year. €Earlier this year, Seven Counties Services also received $4 million from the erectile dysfunction Aid, Relief, and Economic Security Act in order to provide long-term recovery during the kamagra.Funding will help the Coalition for a Healthy Oldham County build on its success in reducing the number of young people using drugs, alcohol, and tobacco, the organization said.ONDCP has awarded $1.75 million to Kentucky substance abuse prevention programs.Sen. McConnell said he has prioritized the fight against the opioid and substance abuse epidemic by working to increase federal funding for the response.“Each of us has a responsibility to protect Kentucky’s young people from the dangers of drugs, and I’m proud to support these organizations leading the effort,” McConnell said. €œThe kamagra hasn’t shaken our focus on combating the scourge of abuse that tears Kentucky families apart, and we will continue working together to save lives from addiction.”.

The Office of National Drug Control Policy (ONDCP) recently awarded two New Hampshire drug prevention coalitions $250,000 in Drug Free Communities kamagra wholesale (DFC) grants.Grants were awarded to the All Together in the Upper Valley region and the Keene YMCA Community Coalition on Youth Substance Use for their youth substance you could try these out abuse prevention efforts.DFC coalitions have contributed to a decline in prescription drug misuse among participants and have led innovative opioid prevention initiatives.U.S. Sens. Jeanne Shaheen (D-NH) and Maggie Hassan (D-NH) and U.S. Rep.

Annie Kuster (D-NH) announced the awards.“Youth drug prevention coalitions do lifesaving work to protect children from substance misuse in our effort to stop another generation from succumbing to this epidemic. As the erectile dysfunction treatment kamagra exacerbates the substance use disorder crisis, we need to ensure these programs have the resources they need to maintain existing programs and reach more people,” Shaheen said.The Substance Abuse and Mental Health Services Administration supports the program.Shaheen is a senior member of the Senate Appropriations Subcommittee that funds the Department of Justice. The department oversees many programs intended to combat substance use disorder.Shaheen also has hosted Drug Free Communities roundtable discussions in Milford and Woodsville with youth advocates, community leaders, school administrators, and students.A successful program in Sullivan County, Tenn., that works with people who have had an overdose to get them treatment and prevent future overdoses has received nearly $900,000 in new federal funding, according to the Tennessee Department of Mental Health and Substance Abuse Services.The U.S. Department of Justice Bureau of Justice Assistance recently awarded the funds to the Sullivan County Overdose Response Team (SCORT) to allow it to continue its work over three years.

SCORT will use the funding to expand its outreach and self-referral capacity. The team also will expand its followup period with clients to two years.Since launching in 2018 as a pilot program, 77 percent of clients enrolled in substance use treatment and more than 93 percent avoided another overdose.“It has been extremely beneficial and has had a huge impact in our county working with the Sullivan County Overdose Response Team,” Sullivan County Sheriff Jeff Cassidy said. €œWith the collaboration of Sullivan County Anti-Drug Coalition and law enforcement, we have been able to connect individuals that have overdosed with treatment and resources of rehabilitation to prevent future overdoses. As we continue to expand our resources, I believe we can break the cycle of addiction and set these individuals up for success in their lives.”SCORT is a collaboration between law enforcement, community behavioral health providers, area agencies, and the Sullivan County Anti-Drug Coalition.Pear Therapeutics, a leader in prescription digital therapeutics (PDT), announced the publication of real-world data on the use of its reset-O cognitive behavioral therapy applications.The data, published in the Journal of Current Medical Research and Opinion, looked at more than 3,000 patients using reSET-O, the first FDA-approved Prescription Digital Therapeutic intended to increase retention of patients with opioid use disorder (OUD) in outpatient treatment by providing cognitive behavioral therapy as an adjunct of outpatient treatment and contingency management.“We are excited to share these data as we believe this is an important confirmation of the potential for reSET-O to improve clinical outcomes at scale and address the unmet needs of OUD treatment,” said Yuri Maricich, M.D., Chief Medical Officer at Pear Therapeutics and lead author of the paper.

€œThis cohort of patients represents one of the largest datasets of community OUD treatment analyzed to date and robustly demonstrates the real-world impact of a PDT integrated into standard of care for patients with OUD.”The company said the analysis of patient engagement and use of reset-O and OUD outcomes, and found that the prescription digital therapeutic is potentially a valuable tool to use for patients getting medication-assisted treatment for OUD.Prescription digital therapeutics use software to treat diseases. Like traditional medicines, the software has to be tested in randomized controlled trials and evaluated by the FDA. But unlike traditional medicines, PDTs are designed to collect real-world data for use that can be used by clinicians and others.The study looked at 3,144 patients with OUD in a 12-week treatment program from 30 different states between the ages of 19 and over 60. The study found that 80 percent of the patients completed at least 25 percent of the core behavioral treatment modules, while 66 percent completed at least half of the behavioral modules, and 49 percent completed all of the modules.

Research indicated that 70 percent of patients stuck with the treatment and continued the PDT during the last four weeks of the treatment. And of those using four or more PDT modules per week for the first four weeks, 88.1 percent remained abstinent for the last four weeks.Shutterstock U.S. Rep. Frank Lucas (R-OK) applauded a $125,000 grant from the Drug-Free Communities (DFC) Support Program for Oklahoma’s Creek County Substance Abuse Prevention Partnership on Thursday.The grant from the Office of National Drug Control Policy would allow the partnership, in cooperation with Oklahoma State University, to use evidence-based strategies to reduce underage drinking and prescription drug misuse in young people under the age of 18 in Creek County.“Strengthening community partnerships is critical in battling and preventing youth substance abuse.

In order for our communities to remain healthy, we must connect with and educate our children on these dangers,” Lucas said. €œMoving forward, we all have a role to play in preventing substance abuse, and I will continue to support our communities and fight to prevent the use of these harmful drugs in Oklahoma’s youth.”The DFC Support program works in conjunction with the Centers for Disease Control and Prevention (CDC) to fund community coalitions that work to reduce local youth substance use. The program recognizes that local problems need local solutions and provides the funding for local coalitions to engage their communities on several levels.“CDC is committed to strengthening local capacity to develop innovative, community-based programs that save lives,” said Centers for Disease Control and Prevention Director Robert R. Redfield.

€œOur partnership with the ONDCP and with community coalitions is critical to our Nation’s efforts to prevent substance use among youth.”Creek County Substance Abuse Partnership Project said it will address the issue through social and retail access, tackling issues like social host liability laws, alcohol compliance checks, responsible beverage service and sales training, and the safe use, storage, and disposal of prescriptions drugs.The White House Office of National Drug Control Policy (ONDCP) recently awarded $500,000 to four Kentucky organizations for their substance-abuse prevention efforts, according to U.S. Senate Majority Leader Mitch McConnell (R-KY).Funding will be made through the Drug-Free Communities Program.The recipients are the Casey County School District in Liberty, Oldham County Health Department in La Grange, Seven Counties Services in Louisville, and Mental Health America of Northern Kentucky and Southwest Ohio in Edgewood. Each organization received $125,000 for their efforts to prevent addiction.“Last year, through collaboration with this community and youth groups, we provided critical drug prevention activities to more than 7,000 Graymoor-Devondale residents,” Abby Drane, Seven Counties Services president and CEO for Bellewood and Brooklawn, said. “The erectile dysfunction treatment kamagra is creating an unprecedented need for services to youth in many of the communities we serve.

We look forward to helping more young people reduce their risk of substance abuse in the upcoming year. €Earlier this year, Seven Counties Services also received $4 million from the erectile dysfunction Aid, Relief, and Economic Security Act in order to provide long-term recovery during the kamagra.Funding will help the Coalition for a Healthy Oldham County build on its success in reducing the number of young people using drugs, alcohol, and tobacco, the organization said.ONDCP has awarded $1.75 million to Kentucky substance abuse prevention programs.Sen. McConnell said he has prioritized the fight against the opioid and substance abuse epidemic by working to increase federal funding for the response.“Each of us has a responsibility to protect Kentucky’s young people from the dangers of drugs, and I’m proud to support these organizations leading the effort,” McConnell said. €œThe kamagra hasn’t shaken our focus on combating the scourge of abuse that tears Kentucky families apart, and we will continue working together to save lives from addiction.”.

Kamagra gold

When you have untreated hearing loss, hearing aids can make all the difference in your quality of life, reducing kamagra gold your isolation and improving communication with loved ones. And, as research shows, wearing hearing aids is also good for your physical health.Yet, hearing aids continue to be underused. Millions of Americans who could benefit from hearing aids never receive them, or wait for a very long time before finally buying them, statistics show. Cost, access, and stigma are common reasons people kamagra gold do not wear hearing aids. Hearing aid use is increasing That's why, in a broad sense, it's good news that hearing aids usage has gone up among older Americans, according to new data.

Specifically, between 2011 and 2018, hearing aid use increased from 15% to 18.5%, according to a nationally representative sample of adults older than 70. The data was published December 2020 in kamagra gold the medical journal JAMA. Internal Medicine. Hearing loss not only makes conversationsharder, it can affect your physical health, too.​ This translate to a lot more older Americans reducing their isolation, improving their communication with loved ones and lowering the risk of health conditions linked to untreated hearing loss. Hearing aid use not equal among socioeconomic kamagra gold groups But there was a concerning trend when the researchers dug in to the data.

Far fewer Black Americans reported an increase in owning and using hearing aids (a +.8% change in 7 years) compared with White Americans (a +4.3% change). And when looking at income levels, hearing aid ownership actually dropped in the past few years—from 12.4% to 10.8%—among older adults living at less than 100% of the federal poverty level. In other words, if you're white or of kamagra gold higher income, you're more likely to use hearing aids. The study did not specifically examine hearing aid use among Hispanic older Americans, but separate studies have found a similar disparity when it comes to hearing care. Why the treatment gap in hearing care?.

This is a known treatment gap, but the new kamagra gold data set affirms this problem is persisting rather than improving, particularly among the poorest Americans. Systemic problems in U.S. Healthcare mean minorities and lower-income Americans have less access to a range of services, even if they have Medicare or Medicaid. (Hearing care kamagra gold is only partly covered by Medicare. Medicaid hearing care coverage tends to be better, but depends on your state's laws.) What it mostly comes down to, some experts say.

The price of hearing aids puts them out of reach for many older Americans on a fixed budget. "Too often, preventive care is limited or nonexistent, hearing loss is underdiagnosed, and access to treatment is delayed or out of reach," said the authors of an editorial that kamagra gold accompanied a study examining hearing loss, dementia and heart disease among Hispanics. A bright spot?. A federal law passed in 2017 (that may go into effect in 2021) will mean that hearing aids will be available over-the-counter. This may kamagra gold help bring down costs and improve access for everyone.

Efforts to expand hearing aid use Untreated hearing loss is linked to physical and mental health impacts, most notably dementia. And rates of dementia are expected to increase disproportionately among minorities in the U.S. In the next few decades kamagra gold. Closing the gap in hearing care could be a pivotal way to stem this tide, particularly when caught early and addressed in mid-life, research indicates. Oyendo Bien How to do so?.

A lot kamagra gold more work is needed, but pilot projects offer glimpses of hope. One example being Oyendo Bien ("Hearing Well"), a program in Arizona that partnered with local community members to help increase culturally relevant communication about hearing loss. "The program’s 5 weekly group education sessions were facilitated by community health workers, who are culturally representative of the populations they serve and assist with navigating structural barriers in access to care," explained University of Arizona associate professor Nicole Marrone, PhD, CCC-A, in the editorial mentioned above. The project was successful and has received funding for expansion, leading to the newly created Hispanic Hearing Healthcare Access kamagra gold Coalition. "Clinicians, scientists, scholars, and leaders must practice cultural humility to be responsive to community needs," she added.

What can you do?. If kamagra gold you or a loved one has untreated hearing loss, the first step is to contact a hearing care provider in your area. They can walk you through the process, and if needed, recommend a hearing aid within your budget. They'll likely want to start with a hearing test, which is often covered by Medicare or Medicaid. Learn more about insurance and financial assistance for hearing aids.Very often, people aren’t aware of hearing loss, because it occurs slowly over a kamagra gold matter of years.

The signs may be subtle—you keep having to turn the TV up, or you struggle to hear your grandkids. Even after diagnosis, people wait an average of 10 years to actually get the hearing aids that’ll help them hear better. That’s a mistake that’s best avoided, since failing to treat kamagra gold hearing impairment can result in auditory deprivation—and over time, the parts of your brain responsible for hearing can shrink or atrophy from lack of use. Yes, you read that right. Brain shrinkage can occur if you don't treat your hearing loss.

What is kamagra gold auditory deprivation?. Auditory deprivation occurs when your brain is deprived of sound, such as from untreated hearing loss. Over time, your brain loses the ability to process sound. If left kamagra gold untreated, the parts of the brain normally responsible for hearing get "reassigned" to other tasks. Those parts also tend to shrink or atrophy.

It can affect anyone with hearing loss, not just severe cases. “Auditory deprivation is when the brain has difficulty understanding and processing information due to the lack of stimulation,” kamagra gold said audiologist Jenilee P. Pulido, AuD, of HearCare Audiology Center in Sarasota, Fla. Brain atrophy from untreated hearing loss Remember. Hearing is a kamagra gold brain activity (sometimes referred to as "brain hearing").

Your ears deliver sound as electrical impulses via the auditory nerve, but it’s within your brain that these electrical impulses are translated into what we recognize as sound. When fewer sounds make their way to the brain, the brain reacts by shifting how it operates. Even with only minor hearing loss, the parts of your brain that handle auditory processing can switch to visual processing kamagra gold instead, per a 2014 study. Other negative changes in your brain may happen as well, and as a result, even after getting hearing aids, processing sounds may be challenging. If you let hearing loss go untreated for too long, the auditory parts of your brain may be "reassigned" to other functions.

This can make it harder to treat kamagra gold hearing loss with standard treatments like hearing aids. Audiologists call this phenomenon "use it or lose it." Use it or lose it. Hearing loss and brain function Talk to audiologists about hearing, and there’s one phrase that you’ll hear time and again. Use it or lose kamagra gold it. “The longer you wait to seek treatment, the [more the] brain has trouble understanding and processing information,” says Pulido, who is a fellow with the American Academy of Audiology.

That is, you may “hear” the sounds of someone talking, but your brain will struggle to understand the actual words being used. Some people may feel like they kamagra gold have cognitive decline when it's really just hearing loss. Is auditory deprivation permanent?. It’s unclear if the cerebral atrophy is permanent or not, and it likely varies from person to person. Overall, though, the "brain is very [flexible] and it can make a lot of changes—once it’s being stimulated, new connections can form so that it can understand more information,” kamagra gold Pulido says.

A small study found that wearing hearing aids “may reverse compensatory changes in cortical resource allocation”—in other words, negative changes in your brain may improve with consistent hearing aid use. Brain shrinkage may slow or stop, and your brain my begin to pick up on sound signals once more. Causes of auditory deprivation One common way people develop auditory deprivation is by kamagra gold avoiding hearing loss treatment. For example, if hearing aids remain in their case (and not in your ears), then auditory deprivation can result. “This mostly comes about when someone has a diagnosed hearing loss and they don’t treat that hearing loss,” Pulido says.

€œOver the time of not getting that auditory stimulation that connection between the ears and the brain gets weak." The auditory nerve begins to atrophy and weaken, she kamagra gold says. Another reason it may occur is when people have hearing loss in both ears, but only wear a hearing aid in one ear, she says. Why two hearing aids are important People may opt for a single hearing aid because they think it’s less conspicuous or find it more comfortable. But often, Pulido says, it’s due to the kamagra gold price of hearing aids. Regardless of the reason, using one hearing aid—when both ears have hearing loss—will have a negative impact.

“The one side that wears the hearing device will stay nice and strong, but the other side that isn’t treated with a hearing device can get weak and start to atrophy more than the other side that’s getting help,” Pulido says. More kamagra gold. Why two hearing aids are better than one Auditory deprivation can also be caused by hearing aids that don’t fit well or aren’t programmed properly—that’s one of the reasons it’s key to follow-up with your audiologist or hearing instrument specialist if you hate your hearing aids. Keep in mind that hearing aids are customized to your unique hearing loss and are far more complex than eyeglasses. You may need more than one office visit to figure kamagra gold out how to use them correctly.

Also, your hearing will change over time, so make sure to keep up with your hearing care appointments. Hearing aid adjustment may take a while Some patience is required with hearing aids. Unlike glasses, where you’ll be good to go from nearly the moment you slip kamagra gold them on, getting used to the restoration of sound can be a more gradual process, Pulido says. It’s also different for everyone—some people acclimate in days or weeks, while others take longer. Putting on hearing devices can take some adjustment, especially if it’s been awhile since your hearing was at full force.

“The most common kamagra gold type of hearing loss is slow and gradual—so you get used to it, and think it’s normal to hear like that,” Pulido points out. Your brain gets used to it, too. With the hearing aids on, sounds in your environment (like the hum of the dishwasher or fridge) can seem loud, as can the sound of your own voice, Pulido says. Here’s the good news. With time, you’ll adjust.

“Over time, if you wear the devices consistently, the brain gets used to the sound and acclimates,” Pulido says. But some patience is required—unlike glasses, where you’ll be good to go from nearly the moment you slip them on, getting used to the restoration of sound can be a more gradual process, Pulido says. It’s also different for everyone—some people acclimate in days or weeks, while others take longer. Once you've adjusted, try to avoid taking any "hearing aid holidays." Wear your hearing aids all day, even if you're home alone. This keeps your hearing—and your brain—sharp.

Prevent auditory deprivation before it starts Of course, the best way to avoid auditory deprivation from occurring is to be proactive when it comes to your hearing. The American Speech-Language-Hearing Association (ASHA) recommends that adults get a hearing screening every 10 years up until age 50, and after that, once every three years. “We recommend that everyone over age 50 get a hearing screening or a diagnosis evaluation, whether they have hearing issues or not,” Pulido says. Even mild hearing loss has been shown to affect understanding and processing, and is linked to a decline in cognition, Pulido notes. Moderate to severe hearing loss is linked to dementia.

“It’s so important to get a hearing test early,” she says..

When you have untreated hearing loss, hearing my blog aids can make all kamagra wholesale the difference in your quality of life, reducing your isolation and improving communication with loved ones. And, as research shows, wearing hearing aids is also good for your physical health.Yet, hearing aids continue to be underused. Millions of Americans who could benefit from hearing aids never receive them, or wait for a very long time before finally buying them, statistics show. Cost, access, and stigma are common reasons people do not wear hearing kamagra wholesale aids.

Hearing aid use is increasing That's why, in a broad sense, it's good news that hearing aids usage has gone up among older Americans, according to new data. Specifically, between 2011 and 2018, hearing aid use increased from 15% to 18.5%, according to a nationally representative sample of adults older than 70. The data was published December 2020 kamagra wholesale in the medical journal JAMA. Internal Medicine.

Hearing loss not only makes conversationsharder, it can affect your physical health, too.​ This translate to a lot more older Americans reducing their isolation, improving their communication with loved ones and lowering the risk of health conditions linked to untreated hearing loss. Hearing aid use not kamagra wholesale equal among socioeconomic groups But there was a concerning trend when the researchers dug in to the data. Far fewer Black Americans reported an increase in owning and using hearing aids (a +.8% change in 7 years) compared with White Americans (a +4.3% change). And when looking at income levels, hearing aid ownership actually dropped in the past few years—from 12.4% to 10.8%—among older adults living at less than 100% of the federal poverty level.

In other words, if you're white or of kamagra wholesale higher income, you're more likely to use hearing aids. The study did not specifically examine hearing aid use among Hispanic older Americans, but separate studies have found a similar disparity when it comes to hearing care. Why the treatment gap in hearing care?. This is a known treatment gap, but the new data set affirms this problem is persisting rather than kamagra wholesale improving, particularly among the poorest Americans.

Systemic problems in U.S. Healthcare mean minorities and lower-income Americans have less access to a range of services, even if they have Medicare or Medicaid. (Hearing care is only partly kamagra wholesale covered by Medicare. Medicaid hearing care coverage tends to be better, but depends on your state's laws.) What it mostly comes down to, some experts say.

The price of hearing aids puts them out of reach for many older Americans on a fixed budget. "Too often, preventive care kamagra wholesale is limited or nonexistent, hearing loss is underdiagnosed, and access to treatment is delayed or out of reach," said the authors of an editorial that accompanied a study examining hearing loss, dementia and heart disease among Hispanics. A bright spot?. A federal law passed in 2017 (that may go into effect in 2021) will mean that hearing aids will be available over-the-counter.

This may help bring down costs and improve access for kamagra wholesale everyone. Efforts to expand hearing aid use Untreated hearing loss is linked to physical and mental health impacts, most notably dementia. And rates of dementia are expected to increase disproportionately among minorities in the U.S. In the kamagra wholesale next few decades.

Closing the gap in hearing care could be a pivotal way to stem this tide, particularly when caught early and addressed in mid-life, research indicates. Oyendo Bien How to do so?. A lot more work is needed, but pilot projects kamagra wholesale offer glimpses of hope. One example being Oyendo Bien ("Hearing Well"), a program in Arizona that partnered with local community members to help increase culturally relevant communication about hearing loss.

"The program’s 5 weekly group education sessions were facilitated by community health workers, who are culturally representative of the populations they serve and assist with navigating structural barriers in access to care," explained University of Arizona associate professor Nicole Marrone, PhD, CCC-A, in the editorial mentioned above. The project kamagra wholesale was successful and has received funding for expansion, leading to the newly created Hispanic Hearing Healthcare Access Coalition. "Clinicians, scientists, scholars, and leaders must practice cultural humility to be responsive to community needs," she added. What can you do?.

If kamagra wholesale you or a loved one has untreated hearing loss, the first step is to contact a hearing care provider in your area. They can walk you through the process, and if needed, recommend a hearing aid within your budget. They'll likely want to start with a hearing test, which is often covered by Medicare or Medicaid. Learn more about insurance and financial assistance for hearing aids.Very often, people aren’t aware of hearing loss, because it occurs slowly over a matter of kamagra wholesale years.

The signs may be subtle—you keep having to turn the TV up, or you struggle to hear your grandkids. Even after diagnosis, people wait an average of 10 years to actually get the hearing aids that’ll help them hear better. That’s a mistake that’s best avoided, since failing to treat hearing impairment can result in auditory deprivation—and over time, the parts of your brain responsible for hearing can shrink or kamagra wholesale atrophy from lack of use. Yes, you read that right.

Brain shrinkage can occur if you don't treat your hearing loss. What is kamagra wholesale auditory deprivation?. Auditory deprivation occurs when your brain is deprived of sound, such as from untreated hearing loss. Over time, your brain loses the ability to process sound.

If left kamagra wholesale untreated, the parts of the brain normally responsible for hearing get "reassigned" to other tasks. Those parts also tend to shrink or atrophy. It can affect anyone with hearing loss, not just severe cases. “Auditory deprivation is when the brain has difficulty understanding and kamagra wholesale processing information due to the lack of stimulation,” said audiologist Jenilee P.

Pulido, AuD, of HearCare Audiology Center in Sarasota, Fla. Brain atrophy from untreated hearing loss Remember. Hearing is a brain kamagra wholesale activity (sometimes referred to as "brain hearing"). Your ears deliver sound as electrical impulses via the auditory nerve, but it’s within your brain that these electrical impulses are translated into what we recognize as sound.

When fewer sounds make their way to the brain, the brain reacts by shifting how it operates. Even with kamagra wholesale only minor hearing loss, the parts of your brain that handle auditory processing can switch to visual processing instead, per a 2014 study. Other negative changes in your brain may happen as well, and as a result, even after getting hearing aids, processing sounds may be challenging. If you let hearing loss go untreated for too long, the auditory parts of your brain may be "reassigned" to other functions.

This can make it harder to treat hearing loss with standard treatments like kamagra wholesale hearing aids. Audiologists call this phenomenon "use it or lose it." Use it or lose it. Hearing loss and brain function Talk to audiologists about hearing, and there’s one phrase that you’ll hear time and again. Use it kamagra wholesale or lose it.

“The longer you wait to seek treatment, the [more the] brain has trouble understanding and processing information,” says Pulido, who is a fellow with the American Academy of Audiology. That is, you may “hear” the sounds of someone talking, but your brain will struggle to understand the actual words being used. Some people may feel like they have kamagra wholesale cognitive decline when it's really just hearing loss. Is auditory deprivation permanent?.

It’s unclear if the cerebral atrophy is permanent or not, and it likely varies from person to person. Overall, though, the "brain is very [flexible] and it can make a lot of changes—once it’s being stimulated, new connections can form so that kamagra wholesale it can understand more information,” Pulido says. A small study found that wearing hearing aids “may reverse compensatory changes in cortical resource allocation”—in other words, negative changes in your brain may improve with consistent hearing aid use. Brain shrinkage may slow or stop, and your brain my begin to pick up on sound signals once more.

Causes of auditory deprivation One common way people develop auditory kamagra wholesale deprivation is by avoiding hearing loss treatment. For example, if hearing aids remain in their case (and not in your ears), then auditory deprivation can result. “This mostly comes about when someone has a diagnosed hearing loss and they don’t treat that hearing loss,” Pulido says. €œOver the time of not getting that auditory stimulation that connection between the ears and the brain gets weak." The auditory nerve begins to kamagra wholesale atrophy and weaken, she says.

Another reason it may occur is when people have hearing loss in both ears, but only wear a hearing aid in one ear, she says. Why two hearing aids are important People may opt for a single hearing aid because they think it’s less conspicuous or find it more comfortable. But often, Pulido kamagra wholesale says, it’s due to the price of hearing aids. Regardless of the reason, using one hearing aid—when both ears have hearing loss—will have a negative impact.

“The one side that wears the hearing device will stay nice and strong, but the other side that isn’t treated with a hearing device can get weak and start to atrophy more than the other side that’s getting help,” Pulido says. More kamagra wholesale. Why two hearing aids are better than one Auditory deprivation can also be caused by hearing aids that don’t fit well or aren’t programmed properly—that’s one of the reasons it’s key to follow-up with your audiologist or hearing instrument specialist if you hate your hearing aids. Keep in mind that hearing aids are customized to your unique hearing loss and are far more complex than eyeglasses.

You may need kamagra wholesale more than one office visit to figure out how to use them correctly. Also, your hearing will change over time, so make sure to keep up with your hearing care appointments. Hearing aid adjustment may take a while Some patience is required with hearing aids. Unlike glasses, where you’ll be good to go kamagra wholesale from nearly the moment you slip them on, getting used to the restoration of sound can be a more gradual process, Pulido says.

It’s also different for everyone—some people acclimate in days or weeks, while others take longer. Putting on hearing devices can take some adjustment, especially if it’s been awhile since your hearing was at full force. “The most common type of hearing loss is slow and gradual—so you get used to it, and think it’s normal to hear kamagra wholesale like that,” Pulido points out. Your brain gets used to it, too.

With the hearing aids on, sounds in your environment (like the hum of the dishwasher or fridge) can seem loud, as can the sound of your own voice, Pulido says. Here’s kamagra wholesale the good news. With time, you’ll adjust. “Over time, if you wear the devices consistently, the brain gets used to the sound and acclimates,” Pulido says.

But some patience is required—unlike glasses, where you’ll be kamagra wholesale good to go from nearly the moment you slip them on, getting used to the restoration of sound can be a more gradual process, Pulido says. It’s also different for everyone—some people acclimate in days or weeks, while others take longer. Once you've adjusted, try to avoid taking any "hearing aid holidays." Wear your hearing aids all day, even if you're home alone. This keeps your hearing—and your brain—sharp.

Prevent auditory deprivation before it starts Of course, the best way to avoid auditory deprivation from occurring is to be proactive when it comes to your hearing. The American Speech-Language-Hearing Association (ASHA) recommends that adults get a hearing screening every 10 years up until age 50, and after that, once every three years. “We recommend that everyone over age 50 get a hearing screening or a diagnosis evaluation, whether they have hearing issues or not,” Pulido says. Even mild hearing loss has been shown to affect understanding and processing, and is linked to a decline in cognition, Pulido notes.

Moderate to severe hearing loss is linked to dementia. “It’s so important to get a hearing test early,” she says..

Kamagra jelly for sale

Indian context kamagra jelly for sale official site. Indian J Psychiatry 2021;63:211Grief is a normal response to loss and bereavement. Human beings are aware of the concept of death and permanence of loss leading to grief and bereavement. It may be kamagra jelly for sale seen in some other species also.

While there has been a neurobiological mechanism explaining grief, it primarily remains a sociocultural phenomenon affecting the brain and the body. The perception of death followed by the gradual “sinking in” of its consequences leads to psychobiological reaction. Grief which is unmanaged can lead to serious health reactions like increased kamagra jelly for sale cardiovascular mortality (broken heart) and psychiatric disorders like depression and suicide.erectile dysfunction treatment as an epidemic has brought grief and bereavement to the doorstep of each and every person. Constantly hearing, seeing about death, and losing friends and family has brought enormous strain to people's lives.

Death rituals have a therapeutic function wherein they allow a family and a group to mourn in a ritualistic way. This allows people to share grief and keep the deceased as focus of attention for a fixed time and then to move on with life kamagra jelly for sale. Sometimes, this process is hampered by what Kenneth Doka called “disenfranchised grief” in 1989 and defined it “as a process in which loss is felt as not being openly acknowledged, socially validated or publicly mourned.”[1] Externally imposed disenfranchised grief leads to grief remaining unresolved and unaddressed, and the person feels that his right to grieve has been denied.erectile dysfunction treatment has unexpectedly disturbed the process of death rituals as it leads to:Unexpected or sudden lossDepletion of emotional and coping resourcesLimitation in visiting and end of care supportNot able to perform last ritualsLack of social support due to erectile dysfunction treatment restrictions.[2]The mechanical and impersonal process has led to severe psychological trauma in the survivors, particularly in the early phase of the disease when the knowledge was less and health-care workers were burdened and under cover of personal protective equipment, communication was difficult. Realizing this, the Indian Council of Medical Research has come out with guidelines for health-care workers to deal with death and guide family members.

However, persistence of grief reaction remains a problem, and due to lack of kamagra jelly for sale social support due to erectile dysfunction treatment, people are increasingly relying on professionals to take care of their grief reactions.In India, the sharing of grief is very important. People try to reach the grieving family. So, what should be the model of care for these people?. We should try to increase the sharing of grief and the handling of the person should be allowed to take placeThe physical support and the economical support have to be arranged, particularly where both parents have diedThere are some common modes like “condolence meetings” or “smaran sabha” which should be attended by both family members and colleagues.erectile dysfunction treatment has brought an unprecedented amount of grief, and it is our duty to manage kamagra jelly for sale grief with innovative solutions to prevent the emergence of prolonged grief reaction, depression, and suicide.

References 1.Doka KJ, editor. Disenfranchised Grief. New Directions, kamagra jelly for sale Challenges, and Strategies for Practice. Champaign, IL.

Research Press. 2002. 2.Albuquerque S, Teixeira AM, Rocha JC. erectile dysfunction treatment and Disenfranchised Grief.

Front Psychiatry 2021;12:638874. Correspondence Address:Om Prakash SinghDepartment of Psychiatry, WBMES, Kolkata, West Bengal. AMRI Hospitals, Kolkata, West Bengal IndiaSource of Support. None, Conflict of Interest.

NoneDOI. 10.4103/indianjpsychiatry.indianjpsychiatry_489_21How to cite this article:Parthasarathy R, Channaveerachari NK, Manjunatha N, Sadh K, Kalaivanan RC, Gowda GS, Basvaraju V, Harihara SN, Rao GN, Math SB, Thirthalli J. Mental health care in Karnataka. Moving beyond the Bellary model of District Mental Health Program.

Indian J Psychiatry 2021;63:212-4How to cite this URL:Parthasarathy R, Channaveerachari NK, Manjunatha N, Sadh K, Kalaivanan RC, Gowda GS, Basvaraju V, Harihara SN, Rao GN, Math SB, Thirthalli J. Mental health care in Karnataka. Moving beyond the Bellary model of District Mental Health Program. Indian J Psychiatry [serial online] 2021 [cited 2021 Jun 29];63:212-4.

Available from. Https://www.indianjpsychiatry.org/text.asp?. 2021/63/3/212/318719Karnataka state has taken many strides forward with regard to the District Mental Health Program (DMHP) and is one of the few states to have dedicated DMHP psychiatrists as team leaders in all the districts. Moreover, some of the recent developments have moved beyond the Bellary model and augur well for the nation.

This article attempts to provide a summary of such developments in the state and discusses the future directions. Core Services DMHP in Karnataka offers (a) clinical services, including the outreach services (on a rotation basis), covering the primary health centers (PHCs), community health centers, and taluk hospitals. (b) training of all the medical officers and other health professionals such as nurses and pharmacists of the district. (c) information, education, and communication (IEC) activities – posters, wall paintings in PHCs, IEC activities for schools, colleges, police personnel, judicial departments, elected representatives, faith healers, bus branding, radio talks, etc., In addition, sensitization of Anganwadi workers, accredited social health activists, auxiliary nurse midwives, police/prison staff, agriculture department/horticulture department/primary land development bank staff, village rehabilitation workers, staff of noncommunicable disease/revised National Tuberculosis Control Program, etc..

And (d) targeted interventions are being focused on life skills education and counseling in schools, college counseling services, workplace stress management, and suicide prevention services. These initiatives have led to a phenomenal increase in patient footfalls to clinics [Figure 1] and >100,000 stakeholders are trained in various aspects of mental health (in the past 3 years).Figure 1. Chart showing the phenomenal increase in the number of footfalls covered over the past 3 yearsClick here to view Seamless Medication Availability The procurement has been streamlined. The state-level purchase is done by the Karnataka Drugs and Logistics Society, based on the indents collated from each of the districts, and then, sent to their respective district warehouses.

Individual indenters (taluk hospitals, community health centers, and primary health centers) then need to procure them from the district warehouses. The amount spent for the purpose has gone up drastically to INR 3 crores (30 million rupees) in the past financial year (2017–2018). However, further streamlining is possible in the sense that the delays can be further curtailed. The Collaboration with the Karnataka State Wakf Board The WAKF board of Karnataka runs a “Darga” in south interior Karnataka.

Thousands of persons with mental illnesses do come over here for religious cure. On a day of every week, the attendance crosses 10,000 footfalls. Recently, the authorities have agreed to come up with an allopathic PHC inside the campus of the Darga. The idea is to have integrated and comprehensive care for patients without hurting their religious sentiments.

Although such collaborative initiatives are spread across the country, this one is occurring at a larger scale with involvement of governmental agencies [Table 1].Table 1. Details of the key developments and innovations in mental health care in IndiaClick here to view Research Initiatives Although excellent evidence-based studies have come out in community settings, actual involvement of government machinery in these kinds of initiatives is few and far. Their involvement is imperative for the evidence to become pragmatic and generalizable. Of course, by doing so, the methodological rigor compromises a bit.

NIMHANS and Government of Karnataka have been collaborating for such service-driven research initiatives for over a decade and a half. Community-based interventions are going on in three taluks – Thirthahalli, Turuvekere, and Jagaluru, wherein cohorts of severe mental disorders are being cared for. In addition, several research questions (of public health significance) are being answered.[6],[7] Exciting new initiatives are also underway. Examining the magnitude of reduction of treatment gap by these community interventions, impact of care at doorsteps (CAD) services from the DMHP machinery, impact of technology-based mentoring program for DMHP staff, evaluation of the impact of tele-OCT, etc.

Discussion and Future Directions All the above-mentioned activities in Karnataka take it beyond the Bellary model of DMHP. For example, the Memorandum of understanding (MOU) between NIMHANS and the state gives the flexibility and easy maneuverability for active collaboration. Odisha is another state which has taken this path of MOU. This collaborative activity can be expanded pan India as there are several Centers of Excellence spread throughout India.

Another aspect of the Karnataka story is collaborative research activity. As described above, many activities going on across the state have the potential to inform public health policies. Karnataka has also been able to counter long-standing and well-known criticisms of DMHP/NMHP. For example, issues related to human resources, availability of medications, funding, mentoring and monitoring, and sustenance, etc., at least to an extent.

Of course, the state needs to do much more for mental health care. For example, compliance with Mental Health Care Act-2017. Handling unequal distribution of mental health human resources. Rigorous involvement of local administration to tackle micro-level issues.

Refining DMHP to suit special populations such as geriatric, children, and adolescents. And perinatal and upscaling urban DMHP, in areas such as Bengaluru Metropolitan City. Another area for improvement is that the DMHP evaluation strategies should move beyond head counting and consider meaningful patient-related outcomes, including cost-effective analysis. Digital technology should further be exploited.

The upcoming Karnataka Mental Healthcare Management System is a step in the right direction.[8] Finally, the DMHP should involve health and wellness centers to cater to the mental health needs, particularly for follow-up services, case detection, providing basic counseling, stress management, advocating lifestyle changes, relapse prevention strategies, and other preventive and promotive strategies. References 1.Manjunatha N, Kumar CN, Chander KR, Sadh K, Gowda GS, Vinay B, et al. Taluk Mental Health Program. The new kid on the block?.

Indian J Psychiatry 2019;61:635-9. [PUBMED] [Full text] 2.Manjunatha N, Kumar CN, Math SB, Thirthalli J. Designing and implementing an innovative digitally driven primary care psychiatry program in India. Indian J Psychiatry 2018;60:236-44.

[PUBMED] [Full text] 3.Pahuja E, Santhosh KT, Fareeduzzafar, Manjunatha N, Kumar CK, Gupta R, et al. An impact of digitally-driven Primary Care Psychiatry Pr. Indian J Psychiatry 2020;62 Suppl 1:S17. 4.Manjunatha N, Singh G.

Manochaitanya. Integrating mental health into primary health care. Lancet 2016;387:647-8. 5.Manjunatha N, Singh G, Chaturvedi SK.

Manochaitanya programme for better utilization of primary health centres. Indian J Med Res 2017;145:163-5. [PUBMED] [Full text] 6.Agarwal PP, Manjunatha N, Parthasarathy R, Kumar CN, Kelkar R, Math SB, et al. A performance audit of first 30 months of Manochaitanya programme at secondary care level of Karnataka, India.

Indian J Community Med 2019;44:222-4. [PUBMED] [Full text] 7.Kumar CN, Thirthalli J, Suresha KK, Arunachala U, Gangadhar BN. Alcohol use disorders in patients with schizophrenia. Comparative study with general population controls.

Addict Behav 2015;45:22-5. 8. Correspondence Address:Naveen Kumar ChannaveerachariDepartment of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka IndiaSource of Support. None, Conflict of Interest.

NoneDOI. 10.4103/psychiatry.IndianJPsychiatry_345_19 Figures [Figure 1] Tables [Table 1].

Indian context kamagra wholesale http://www.em-cygnes-weyersheim.ac-strasbourg.fr/?p=345. Indian J Psychiatry 2021;63:211Grief is a normal response to loss and bereavement. Human beings are aware of the concept of death and permanence of loss leading to grief and bereavement. It may be seen in some kamagra wholesale other species also.

While there has been a neurobiological mechanism explaining grief, it primarily remains a sociocultural phenomenon affecting the brain and the body. The perception of death followed by the gradual “sinking in” of its consequences leads to psychobiological reaction. Grief which is unmanaged can lead to serious health reactions like increased cardiovascular mortality (broken heart) and psychiatric disorders like depression and suicide.erectile dysfunction treatment as kamagra wholesale an epidemic has brought grief and bereavement to the doorstep of each and every person. Constantly hearing, seeing about death, and losing friends and family has brought enormous strain to people's lives.

Death rituals have a therapeutic function wherein they allow a family and a group to mourn in a ritualistic way. This allows people to share grief and keep the deceased as focus of attention for a fixed time and then to move kamagra wholesale on with life. Sometimes, this process is hampered by what Kenneth Doka called “disenfranchised grief” in 1989 and defined it “as a process in which loss is felt as not being openly acknowledged, socially validated or publicly mourned.”[1] Externally imposed disenfranchised grief leads to grief remaining unresolved and unaddressed, and the person feels that his right to grieve has been denied.erectile dysfunction treatment has unexpectedly disturbed the process of death rituals as it leads to:Unexpected or sudden lossDepletion of emotional and coping resourcesLimitation in visiting and end of care supportNot able to perform last ritualsLack of social support due to erectile dysfunction treatment restrictions.[2]The mechanical and impersonal process has led to severe psychological trauma in the survivors, particularly in the early phase of the disease when the knowledge was less and health-care workers were burdened and under cover of personal protective equipment, communication was difficult. Realizing this, the Indian Council of Medical Research has come out with guidelines for health-care workers to deal with death and guide family members.

However, persistence of grief reaction remains a problem, and due to lack of social support due to erectile dysfunction treatment, people are increasingly relying on professionals to take care of their grief reactions.In India, the sharing of grief is very kamagra wholesale important. People try to reach the grieving family. So, what should be the model of care for these people?. We should try to increase the kamagra wholesale sharing of grief and the handling of the person should be allowed to take placeThe physical support and the economical support have to be arranged, particularly where both parents have diedThere are some common modes like “condolence meetings” or “smaran sabha” which should be attended by both family members and colleagues.erectile dysfunction treatment has brought an unprecedented amount of grief, and it is our duty to manage grief with innovative solutions to prevent the emergence of prolonged grief reaction, depression, and suicide.

References 1.Doka KJ, editor. Disenfranchised Grief. New Directions, Challenges, and kamagra wholesale Strategies for Practice. Champaign, IL.

Research Press. 2002. 2.Albuquerque S, Teixeira AM, Rocha JC. erectile dysfunction treatment and Disenfranchised Grief.

Front Psychiatry 2021;12:638874. Correspondence Address:Om Prakash SinghDepartment of Psychiatry, WBMES, Kolkata, West Bengal. AMRI Hospitals, Kolkata, West Bengal IndiaSource of Support. None, Conflict of Interest.

NoneDOI. 10.4103/indianjpsychiatry.indianjpsychiatry_489_21How to cite this article:Parthasarathy R, Channaveerachari NK, Manjunatha N, Sadh K, Kalaivanan RC, Gowda GS, Basvaraju V, Harihara SN, Rao GN, Math SB, Thirthalli J. Mental health care in Karnataka. Moving beyond the Bellary model of District Mental Health Program.

Indian J Psychiatry 2021;63:212-4How to cite this URL:Parthasarathy R, Channaveerachari NK, Manjunatha N, Sadh K, Kalaivanan RC, Gowda GS, Basvaraju V, Harihara SN, Rao GN, Math SB, Thirthalli J. Mental health care in Karnataka. Moving beyond the Bellary model of District Mental Health Program. Indian J Psychiatry [serial online] 2021 [cited 2021 Jun 29];63:212-4.

Available from. Https://www.indianjpsychiatry.org/text.asp?. 2021/63/3/212/318719Karnataka state has taken many strides forward with regard to the District Mental Health Program (DMHP) and is one of the few states to have dedicated DMHP psychiatrists as team leaders in all the districts. Moreover, some of the recent developments have moved beyond the Bellary model and augur well for the nation.

This article attempts to provide a summary of such developments in the state and discusses the future directions. Core Services DMHP in Karnataka offers (a) clinical services, including the outreach services (on a rotation basis), covering the primary health centers (PHCs), community health centers, and taluk hospitals. (b) training of all the medical officers and other health professionals such as nurses and pharmacists of the district. (c) information, education, and communication (IEC) activities – posters, wall paintings in PHCs, IEC activities for schools, colleges, police personnel, judicial departments, elected representatives, faith healers, bus branding, radio talks, etc., In addition, sensitization of Anganwadi workers, accredited social health activists, auxiliary nurse midwives, police/prison staff, agriculture department/horticulture department/primary land development bank staff, village rehabilitation workers, staff of noncommunicable disease/revised National Tuberculosis Control Program, etc..

And (d) targeted interventions are being focused on life skills education and counseling in schools, college counseling services, workplace stress management, and suicide prevention services. These initiatives have led to a phenomenal increase in patient footfalls to clinics [Figure 1] and >100,000 stakeholders are trained in various aspects of mental health (in the past 3 years).Figure 1. Chart showing the phenomenal increase in the number of footfalls covered over the past 3 yearsClick here to view Seamless Medication Availability The procurement has been streamlined. The state-level purchase is done by the Karnataka Drugs and Logistics Society, based on the indents collated from each of the districts, and then, sent to their respective district warehouses.

Individual indenters (taluk hospitals, community health centers, and primary health centers) then need to procure them from the district warehouses. The amount spent for the purpose has gone up drastically to INR 3 crores (30 million rupees) in the past financial year (2017–2018). However, further streamlining is possible in the sense that the delays can be further curtailed. The Collaboration with the Karnataka State Wakf Board The WAKF board of Karnataka runs a “Darga” in south interior Karnataka.

Thousands of persons with mental illnesses do come over here for religious cure. On a day of every week, the attendance crosses 10,000 footfalls. Recently, the authorities have agreed to come up with an allopathic PHC inside the campus of the Darga. The idea is to have integrated and comprehensive care for kamagra online canada patients without hurting their religious sentiments.

Although such collaborative initiatives are spread across the country, this one is occurring at a larger scale with involvement of governmental agencies [Table 1].Table 1. Details of the key developments and innovations in mental health care in IndiaClick here to view Research Initiatives Although excellent evidence-based studies have come out in community settings, actual involvement of government machinery in these kinds of initiatives is few and far. Their involvement is imperative for the evidence to become pragmatic and generalizable. Of course, by doing so, the methodological rigor compromises a bit.

NIMHANS and Government of Karnataka have been collaborating for such service-driven research initiatives for over a decade and a half. Community-based interventions are going on in three taluks – Thirthahalli, Turuvekere, and Jagaluru, wherein cohorts of severe mental disorders are being cared for. In addition, several research questions (of public health significance) are being answered.[6],[7] Exciting new initiatives are also underway. Examining the magnitude of reduction of treatment gap by these community interventions, impact of care at doorsteps (CAD) services from the DMHP machinery, impact of technology-based mentoring program for DMHP staff, evaluation of the impact of tele-OCT, etc.

Discussion and Future Directions All the above-mentioned activities in Karnataka take it beyond the Bellary model of DMHP. For example, the Memorandum of understanding (MOU) between NIMHANS and the state gives the flexibility and easy maneuverability for active collaboration. Odisha is another state which has taken this path of MOU. This collaborative activity can be expanded pan India as there are several Centers of Excellence spread throughout India.

Another aspect of the Karnataka story is collaborative research activity. As described above, many activities going on across the state have the potential to inform public health policies. Karnataka has also been able to counter long-standing and well-known criticisms of DMHP/NMHP. For example, issues related to human resources, availability of medications, funding, mentoring and monitoring, and sustenance, etc., at least to an extent.

Of course, the state needs to do much more for mental health care. For example, compliance with Mental Health Care Act-2017. Handling unequal distribution of mental health human resources. Rigorous involvement of local administration to tackle micro-level issues.

Refining DMHP to suit special populations such as geriatric, children, and adolescents. And perinatal and upscaling urban DMHP, in areas such as Bengaluru Metropolitan City. Another area for improvement is that the DMHP evaluation strategies should move beyond head counting and consider meaningful patient-related outcomes, including cost-effective analysis. Digital technology should further be exploited.

The upcoming Karnataka Mental Healthcare Management System is a step in the right direction.[8] Finally, the DMHP should involve health and wellness centers to cater to the mental health needs, particularly for follow-up services, case detection, providing basic counseling, stress management, advocating lifestyle changes, relapse prevention strategies, and other preventive and promotive strategies. References 1.Manjunatha N, Kumar CN, Chander KR, Sadh K, Gowda GS, Vinay B, et al. Taluk Mental Health Program. The new kid on the block?.

Indian J Psychiatry 2019;61:635-9. [PUBMED] [Full text] 2.Manjunatha N, Kumar CN, Math SB, Thirthalli J. Designing and implementing an innovative digitally driven primary care psychiatry program in India. Indian J Psychiatry 2018;60:236-44.

[PUBMED] [Full text] 3.Pahuja E, Santhosh KT, Fareeduzzafar, Manjunatha N, Kumar CK, Gupta R, et al. An impact of digitally-driven Primary Care Psychiatry Pr. Indian J Psychiatry 2020;62 Suppl 1:S17. 4.Manjunatha N, Singh G.

Manochaitanya. Integrating mental health into primary health care. Lancet 2016;387:647-8. 5.Manjunatha N, Singh G, Chaturvedi SK.

Manochaitanya programme for better utilization of primary health centres. Indian J Med Res 2017;145:163-5. [PUBMED] [Full text] 6.Agarwal PP, Manjunatha N, Parthasarathy R, Kumar CN, Kelkar R, Math SB, et al. A performance audit of first 30 months of Manochaitanya programme at secondary care level of Karnataka, India.

Indian J Community Med 2019;44:222-4. [PUBMED] [Full text] 7.Kumar CN, Thirthalli J, Suresha KK, Arunachala U, Gangadhar BN. Alcohol use disorders in patients with schizophrenia. Comparative study with general population controls.

Addict Behav 2015;45:22-5. 8. Correspondence Address:Naveen Kumar ChannaveerachariDepartment of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka IndiaSource of Support. None, Conflict of Interest.

NoneDOI. 10.4103/psychiatry.IndianJPsychiatry_345_19 Figures [Figure 1] Tables [Table 1].