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And we have so many people with Moderna and J&J treatments how to get prescribed viagra. There was, as you know, John, a MMWR that showed the J&J antibodies after just a matter of weeks from the treatment. And they were really quite low compared to the Moderna and Pfizer. So I would think we should have called out for the people who got the one and done to get the second how to get prescribed viagra shot, whether it's either Pfizer or Moderna.

We have these purists that want to wait for this data that we're not going to have for such a long time. The problem here is we're leaving people vulnerable. JOHN WHYTE how to get prescribed viagra. Right.

ERIC TOPOL. All of this was a third shot story from the how to get prescribed viagra beginning. The only question was, when would the third shot be necessary?. JOHN WHYTE.

Yeah. ERIC TOPOL. That I think it's becoming increasingly clear that all these treatments, whether it's five months, seven or eight months, a third shot is going to be part of the program to get the full treatment effectiveness. I think that's where we're head-- JOHN WHYTE.

Yeah, but is there going to be a fourth shot, a fifth shot, a sixth shot?. I mean, does it stop at three?. ERIC TOPOL. I hope not.

But I think the reality is that we're relying too much on neutralizing antibodies to carry us through, particularly this Delta period where it's so hyperinfectious. So it's a perfect storm. You have both the waning of time, then you have this hypertransmissible variant. Now once we get down to low circulating levels of viagra, which I hope we'll get in the near term, then this won't be as significant a problem.

Now, that also will have an influence on subsequent boosters. If we achieve containment, the utility of boosters, once a year let's say, will be of less significance. Plus, there's a possibility that we get a much better memory. That is because the spacing in the US was so limited.

That is, three weeks for Pfizer, four weeks for Moderna. It should have been at least six to eight weeks. So if we start the idea that we're going to get a far better memory of B and T-cells, that might help prevent the need for fourth and fifth shots subsequently. JOHN WHYTE.

All right. Well, let's talk about what other people are talking about. And what they're talking about is, I got Moderna, I got J&J, so can I get Pfizer in San Francisco?. Some other studies have allowed it.

Some experts are suggesting it actually might be a good idea if you got Moderna and J&J to actually get a different treatment. And as you point out, there are the purists out there saying, oh, no, we have to wait for the data. No mixing and matching. What's your advice to folks that are listening and that are worried?.

ERIC TOPOL. I wish we had more and better data. So we do have for AstraZeneca, which is a close cousin to the Johnson and Johnson. And there, if you had that treatment, the adenoviral vector, and then you've got an mRNA treatment, either Moderna or Pfizer, the immune response was the best we could get from any combinations of treatments, including two mRNA treatments or two AstraZeneca.

So if you extrapolate that, I do agree that if you had J&J, you really-- it would be wise to get a Pfizer or Moderna as your second shot. JOHN WHYTE. What about if you got Moderna?. ERIC TOPOL.

Yeah, if you got Moderna, I think, it doesn't probably matter. I mean, remember, you're well aware of the dose of the mRNA is triple in the Moderna as compared to Pfizer. JOHN WHYTE. Right.

ERIC TOPOL. Are actually a little bit more than that. So if you get Pfizer, except for that dose and the spacing, it's pretty close to interchangeable. I can't imagine getting the shot that doesn't follow the lane of Moderna or Pfizer makes that big a deal.

But the booster that Moderna has applied for when it formally is EU aid is for 50, half the dose of what it used-- JOHN WHYTE. A lower dose, right. ERIC TOPOL. Yeah.

So that may reduce the side effects, which initially, there was somewhat increased side effects with Moderna as compared to Pfizer. JOHN WHYTE. But here's where the confusion that I hope you can help clarify for folks. So we're saying folks need boosters, then we have the CDC director, say walk, not run, to get a booster, because you're protected from severe disease.

And some will argue that's what vaccinations really are supposed to do. So how important is it to get it at six months?. Can you wait nine months, a year?. I mean, it should it be on your priority list to-do this fall and winter.

ERIC TOPOL. If you're 60 and over, I would say it should be on your priority list to-do as you approach six months. Because the longer you wait, the more vulnerable. That is, if you're out and about, you're going to have some exposure.

The more exposures you have, ultimately it's cumulative in terms of the risk of the . The point here is that this is the ultimate, that is, prevention of hospitalizations. This is not just preventing symptomatic s, the severe illness. So that's where the older age group, it's really important short of age 60.

Then we're talking about s, symptomatic . The chance that you're going to really block hospitalizations, at least from the data we have right now, is not nearly as impressive. JOHN WHYTE. OK.

I want to move to kids 5 to 12. That's what everyone is talking about as well. And I'm not going to ask you when you think it's going to be authorized. What I want to talk about what we know so far and we don't have all the information.

But we know it's roughly 2,200 kids in that entire age range of 5 to 12. So not a lot of kids studied over two months. How concerned are you about do we have enough data in terms of looking at safety and efficacy for kids 5 through 11?. ERIC TOPOL.

Yeah, so we're talking about the trial of Pfizer which use a third of the dose as in adults and teens. So it's instead of 30 micrograms, it's 10 micrograms. Now, it was a 2 to 1 randomization, so 2/3 of the 2,200 or back in 1,500 children got the treatment. So what can you say about that?.

Well, there was a nice antibody response. So that's good. There were no significant safety problems that were encountered, that's good. You can't really talk about rare side effects.

So we saw in teens the myocarditis propped up in one in tens of thousands of kids. And we can't really say that much, because you only have 1,500 as a denominator. Most likely, though, because these doses are so low, already we started with a treatment that had much lower dose than Moderna. Now, we've taken one third of that.

So the chances of getting these rare side effects are low. But we'll know much more once that program gets going, because very quickly parents are very eager to get their kids vaccinated, so they don't have problems with school. And we'll within weeks if there's going to be some rare side effect if it's going to crop up. I doubt it, but it's possible.

JOHN WHYTE. But what do you do for an 11 and 1/2-year-old, right?. So the 12-year-old is getting the full dose that every adult got as part of the Pfizer. Yet, they're getting a third of the dose, in theory, depending upon what happens with authorization or approval, of someone six months older than they are?.

ERIC TOPOL. Yeah, well, good question. I mean, you go with the plan. The plan is that you get a good immune response, and it's probably good enough.

I think, we always learn more. You made a very astute qualifier about the two months. That is, these data are two months, just like the initial treatments for adults. And that we'll only learn about whether that dose is short for the 11 and 1/2-year-old as we look at data six months and a year from now.

So it's hard to know. JOHN WHYTE. But the trial for adults was around 40,000 people around the world and multiple trials were done. We're talking about 2,200 kids.

We were talking before we came on about MMWR, Morbidity and Mortality Weekly Report, that the CDC puts out-- and we'll show it on screen-- where it talks about hospitalizations in kids and adolescents throughout the viagra. It's been in the news, especially about the increase in the number of hospitalizations for kids through the past couple of months. But the reality is, when we look at the graph, for 5 to 11-year-olds they're the group that have the lowest hospitalization rate, including compared to kids younger than five. So the assessment has been by some people.

I want to hear your thoughts on it that, hey, Dr. Topol, this isn't a true public health emergency in where emergency use authorization powers are appropriate. Sure, we don't want kids to be hospitalized. We don't want kids to die of a disease that could be preventable.

But are we moving too fast as we talk about vaccination in kids?. ERIC TOPOL. Well, there's different ways to look at this. To say that the reason to have a broad vaccination program in young kids is to block hospitalizations is probably not the primary motive, but rather, to break the chain of transmission.

So if you're trying to break the chain of transmission, you want to get 85%, 90% of the population vaccinated. And so, kids are a part of it, they're a vector in this whole process. I mean, there's certainly a conduit of getting transmission to other kids and adults, family members, and household contacts, et cetera. So this is an issue.

Now, we do know, as you've seen from the Children's Hospitals Association and American Academy of Ped, we just have coming down from the highest children-infected and hospitalized in the whole viagra because of Delta. And this is the problem, we're not talking about waning of immunity. We're talking about because it had a really hypertransmissible variant. Now, if, let's say, we get Delta contained really well, which doesn't look particularly sanguine, but let's say it does, in the weeks ahead.

Well then, the urgency is different. But if we are still looking at 90,000 cases a day, high children involvement, and then all of these hospitalizations, did not help to break this chain and to protect kids, because some of them do get hospitalized. And you saw the pediatric hospitals in the Southeast, the ICUs were full. The worst situation we've had in the entire epidemic, and when there's vaccinations galore.

So my sense is that this urgency is where we are now. If we are able to achieve very low levels of cases, it's a different story. It's a circulating viagra, not just in the country but in a particular location, is a very important determinant of this decision. The other thing is, if you're a reluctant parent, you're worried about side effects, you could just wait a few weeks to see what's going on out there.

We'll know-- JOHN WHYTE. Well, everyone can't wait a few weeks, though. To be fair. If we all as parents say, we're going to wait a few weeks, so-- ERIC TOPOL.

There are so many eager parents, you don't have to worry. You don't have to worry. But actually, I think, it's perfectly reasonable to go ahead. But John, I think we could be looking at-- this is going to be probably late October or early November at the best to get the go ahead.

We could be looking at a much, hopefully, I mean, I'm the optimist as you know, a more favorable situation where it's not such an urgent issue. JOHN WHYTE. Yeah. Well, one metrics that makes us a little discouraged, Dr.

Topol, is the rate of vaccinations over the last couple of months. We have slowed down dramatically, and we know there is a lot of hesitancy. Where are we on antivirals?. Where are we on really good treatments in the form of a pill?.

I mean, we have injections, subcutaneous infusions, in terms of monoclonal antibodies, we have some benefit of Remdesivir, but we really don't have a simple pill. But there's some encouraging news about that. What's your perspective on the availability soon of some type of antiviral to treat most cases of erectile dysfunction treatment?. ERIC TOPOL.

Right. Though, this is really important, because it goes back to the earlier things you were bringing up. It's about how are we going to need fourth boosters, fifth shots, and whatnot?. If we had really good antivirals that you could have in your medicine cabinet or carry it around with you when you travel, and an exposure or at the earliest symptoms possible symptoms, it was perfectly safe.

This would be all we need. But there hasn't been a nearly enough emphasis on the drugs side effects. Now, Remdesivir is very weak, and the studies are mixed. But there are better direct antivirals.

Remember Remdesivir was a repurposed drug. Now, there are drugs that have very high viral erectile dysfunction neutralization that are in clinical trials. So maybe we'll see a pill. But also, we have inhalation interferon preparations that could just take a puff of that and that would be at the earliest possible time.

There are going to be some more drugs down the-- JOHN WHYTE. But when?. People want to know when. ERIC TOPOL.

Yeah. Well, you know what?. I'll tell you, it would happen a lot sooner if we'd given it as much attention. Ultimately, it's not going to be just a treatment story.

It's going to involve medications and rapid test, and that's how we'll eventually live with this viagra for the years to come. And it won't really interfere with our lives as it is right now. JOHN WHYTE. As folks know, you've been one of the leading voices throughout this viagra.

Your Twitter handle-- and we'll show it on screen-- is a must-read for anyone that wants to know the latest going on on erectile dysfunction treatment. I have no idea how you have time to make all these graphs and descriptions and summaries. But I want to ask you, Dr. Topol, since you've been involved in this throughout, what's the one thing you might have changed in the communication strategy on the rollout of these treatments?.

ERIC TOPOL. Well, that's a tough one. Thanks, John, by the way. That's very kind of you.

I think, there's just so many. It's hard to just pick one. But I think, the problem we had is we didn't take on the anti-science vigorously before even the treatments started to go out. It is nuke it, you know?.

That you're going to hear this or that, or this or that, in fact, we couldn't even imagine what people were going to make up. That you'll become infertile, that you would be impotent-- JOHN WHYTE. Magnetized. ERIC TOPOL.

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Daily cries from parents, pediatricians, the press, and the public to reopen linked here schools where to buy generic viagra in the fall are certainly well-intentioned, but they are overlooking a critical opportunity to advance adolescent physical and mental health long after the erectile dysfunction treatment viagra is over. Delaying school start times for teens by an hour, or even two, could optimize a teen's sleep and their ability to learn throughout the day.Sleep Is Critical for Teen Health and LearningAdequate sleep is critically related to adolescent mental health, wellness, learning, and even safety. During a period of unprecedented challenges for teens, one benefit to the new virtual school where to buy generic viagra experience has been the later start times.

Teens who started their school day by logging onto class closer to 9 a.m. Experienced first-hand where to buy generic viagra what research has long suggested. Later school start times help teens thrive.

Gone was the morning rush for families to draw drowsy teens out of bed, often skipping breakfast to get out the door in time for early morning lessons, followed by long, over-scheduled days.If we can overcome bureaucratic obstacles to rapidly and successfully launch telehealth services and virtual learning, why where to buy generic viagra can't we use the same drive and resources to implement evidence-based recommendations to delay school start times?. One of the few silver linings of the viagra was the positive impact that later school-start times had on many teens and families. We have heard from families in our practices where to buy generic viagra how this experience with later remote school start times increased their sleep during weeknights, decreased Saturday sleep-ins needed to recoup lost sleep, allowed for family breakfasts, and cut out risky drowsy-driving commutes.

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Before 11 p.m.) to obtain sufficient sleep, given the early school start times in most school districts. Their bodies are just not ready for bedtime.Research has shown that later school start times lead to more sleep, with many adolescents able to get at least 8 where to buy generic viagra hours of sleep per night. Academics, attendance, mood, and graduation rates all improve.

Decreases in where to buy generic viagra caffeine use, depression, drowsy driving and car accidents, and sports-related injuries are also reported. As a result, many professional organizations including the American Academy of Pediatrics and American Academy of Sleep Medicine, and even the CDC have strongly recommended a school start time of no earlier than 8:30 a.m. For adolescents.Most Middle and High Schools Start Before 8:30 a.m.Despite the abundant research, most schools have rejected where to buy generic viagra the recommendation, citing parents' work schedules or childcare issues, logistical issues such as bus schedules, and after-school conflicts like athletics that go into the early evening.

Every school district is different and has varying challenges and needs. Creativity is key and working together to be flexible (sometimes across districts) with busing, athletics (including investing in flood lighting where feasible), and after-school programs is paramount.Some argue it would be problematic for younger children to shift to earlier school start times -- which could happen where to buy generic viagra if teens started later due to bussing schedules flipping -- but a recent study following children and teens through a start time change found that this is not true. While it is extremely tough for teens to force sleep earlier, it is easier for elementary-age children to go to bed earlier because they have not yet had the shift in the circadian rhythm.Despite these findings, before the viagra up to 93% of high schools and 87% of middle schools rang their morning bells before the recommended start time of 8:30 a.m.What Is a Clinician To Do?.

Talk to where to buy generic viagra your families and teen patients, and advocate for later school start times in your communities. Youth voices are powerful, so embrace your teen patients as advocates for this change. Now is the right time to ask families to write to their superintendent and principals to inquire about fall schedules.Clinicians can also write to local politicians for legislature change and provide their expert opinions to schools and education where to buy generic viagra boards.

Coalitions of health professionals such as Start School Later have online resources and advocacy tools for families and professionals, as well as details of how some states, like California in 2019, have successfully made the switch. Don't underestimate the value of lending your physician voice to an informational flyer, Facebook post, or local media outreach.The erectile dysfunction treatment viagra has where to buy generic viagra accelerated needed change in many realms, and in the case of later school start times, many families and teens experienced the real benefits a later start time can bring. The viagra has not produced many positive long-term effects yet, but pediatricians, caregivers, educators, and mental health experts can seize this opportunity to make lasting and impactful change for adolescents.Hina Talib, MD, is an adolescent medicine specialist and associate professor of pediatrics at the Children's Hospital at Montefiore/Albert Einstein College of Medicine in New York City.

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Teens who started their school day by logging onto class closer to 9 a.m. Experienced first-hand how to get prescribed viagra what research has long suggested. Later school start times help teens thrive.

Gone was the morning rush for families to draw drowsy teens out of bed, often skipping breakfast to get out the door in time for how to get prescribed viagra early morning lessons, followed by long, over-scheduled days.If we can overcome bureaucratic obstacles to rapidly and successfully launch telehealth services and virtual learning, why can't we use the same drive and resources to implement evidence-based recommendations to delay school start times?. One of the few silver linings of the viagra was the positive impact that later school-start times had on many teens and families. We have heard from families in our practices how this experience with later remote school start times increased their sleep during weeknights, how to get prescribed viagra decreased Saturday sleep-ins needed to recoup lost sleep, allowed for family breakfasts, and cut out risky drowsy-driving commutes.

Many families have now seen the significant benefit that later lessons can afford. Teens feel physically and mentally how to get prescribed viagra better, have more energy, and are able to focus better during lessons. They also report not dreading mornings as much -- isn't this something we wish for everyone?.

As clinicians caring for teens and advocating for their health and wellness throughout this viagra, and as parents ourselves, we have seen adolescents experience loneliness, depression, anxiety, restrictive eating, how to get prescribed viagra learning loss, and school difficulties this past year. A common thread in these clinical encounters is the role of sleep, and most often the role of inadequate sleep. We share teen-centered "sleep hygiene" tips with families and adolescents on auto-pilot, but we cannot continue an unfair fight against teenagers' biology.Teens' Biological Clock Bedtime Is Closer to 11 p.m.Adolescents have a biological need of approximately 9 hours of sleep how to get prescribed viagra per night.

However, studies have routinely shown that upwards of 75% of American teens obtain on average 7 hours or less. For pre-teens, some as young as 11 years old, there is a natural biological shift in the circadian rhythm by one to 2 hours, meaning that there is a natural delay in the brain's secretion of melatonin, leading to later bed and wake times. As a result, the biological shift in the circadian rhythm makes it very difficult how to get prescribed viagra for teens to fall asleep early enough (read.

Before 11 p.m.) to obtain sufficient sleep, given the early school start times in most school districts. Their bodies are just how to get prescribed viagra not ready for bedtime.Research has shown that later school start times lead to more sleep, with many adolescents able to get at least 8 hours of sleep per night. Academics, attendance, mood, and graduation rates all improve.

Decreases in caffeine use, depression, how to get prescribed viagra drowsy driving and car accidents, and sports-related injuries are also reported. As a result, many professional organizations including the American Academy of Pediatrics and American Academy of Sleep Medicine, and even the CDC have strongly recommended a school start time of no earlier than 8:30 a.m. For adolescents.Most Middle and High Schools how to get prescribed viagra Start Before 8:30 a.m.Despite the abundant research, most schools have rejected the recommendation, citing parents' work schedules or childcare issues, logistical issues such as bus schedules, and after-school conflicts like athletics that go into the early evening.

Every school district is different and has varying challenges and needs. Creativity is key and working together to be flexible (sometimes across districts) with busing, athletics (including investing in flood lighting where feasible), and after-school programs is paramount.Some argue it would be problematic for younger children to shift to earlier school start times -- which could happen if how to get prescribed viagra teens started later due to bussing schedules flipping -- but a recent study following children and teens through a start time change found that this is not true. While it is extremely tough for teens to force sleep earlier, it is easier for elementary-age children to go to bed earlier because they have not yet had the shift in the circadian rhythm.Despite these findings, before the viagra up to 93% of high schools and 87% of middle schools rang their morning bells before the recommended start time of 8:30 a.m.What Is a Clinician To Do?.

Talk to how to get prescribed viagra your families and teen patients, and advocate for later school start times in your communities. Youth voices are powerful, so embrace your teen patients as advocates for this change. Now is the right time to ask families to write to their superintendent and principals to inquire about fall schedules.Clinicians can also write to local politicians for legislature change and provide their expert opinions to schools how to get prescribed viagra and education boards.

Coalitions of health professionals such as Start School Later have online resources and advocacy tools for families and professionals, as well as details of how some states, like California in 2019, have successfully made the switch. Don't underestimate the value of lending your physician voice to an informational flyer, Facebook post, or local media outreach.The erectile dysfunction treatment viagra has accelerated needed change in many realms, and in the case of later school start how to get prescribed viagra times, many families and teens experienced the real benefits a later start time can bring. The viagra has not produced many positive long-term effects yet, but pediatricians, caregivers, educators, and mental health experts can seize this opportunity to make lasting and impactful change for adolescents.Hina Talib, MD, is an adolescent medicine specialist and associate professor of pediatrics at the Children's Hospital at Montefiore/Albert Einstein College of Medicine in New York City.

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First-of-its-kind study, based on a mouse model, finds living in a polluted environment could be comparable to eating a high-fat diet, leading how long does it take for viagra to kick in to a pre-diabetic state CLEVELANDâAir pollution is the worldâs leading environmental risk factor, and causes more than nine million deaths per year. New research published in the Journal of Clinical Investigation shows air pollution may play a role in the development of cardiometabolic diseases, such as diabetes. Importantly, the effects were reversible with cessation how long does it take for viagra to kick in of exposure. Researchers found that air pollution was a ârisk factor for a risk factorâ that contributed to the common soil of other fatal problems like heart attack and stroke. Similar to how an unhealthy diet and lack of exercise can lead to disease, exposure to air pollution could be added to this risk factor list as well.

âIn this study, we created an environment that mimicked a polluted day in New Delhi or Beijing,â said Sanjay Rajagopalan, MD, first author on the study, Chief of Cardiovascular Medicine at University Hospitals Harrington Heart and Vascular how long does it take for viagra to kick in Institute, and Director of the Case Western Reserve University Cardiovascular Research Institute. ÂWe concentrated fine particles of air pollution, called PM2.5 (particulate matter component <. 2.5 microns) how long does it take for viagra to kick in. Concentrated particles like this develop from human impact on the environment, such as automobile exhaust, power generation and other fossil fuels.â These particles have been strongly connected to risk factors for disease. For example, cardiovascular effects of air pollution can lead to heart attack and stroke.

The research team has shown exposure to air pollution can increase the likelihood of the same how long does it take for viagra to kick in risk factors that lead to heart disease, such as insulin resistance and type 2 diabetes. In the mouse model study, three groups were observed. A control group receiving clean filtered air, a group exposed to polluted air for 24 weeks, and a group fed a high-fat diet. Interestingly, the researchers found that being exposed to air how long does it take for viagra to kick in pollution was comparable to eating a high-fat diet. Both the air pollution and high-fat diet groups showed insulin resistance and abnormal metabolism â just like one would see in a pre-diabetic state.

These changes were associated with changes in the epigenome, a layer how long does it take for viagra to kick in of control that can masterfully turn on and turn off thousands of genes, representing a critical buffer in response to environmental factors. This study is the first-of-its-kind to compare genome-wide epigenetic changes in response to air pollution, compare and contrast these changes with that of eating an unhealthy diet, and examine the impact of air pollution cessation on these changes.âThe good news is that these effects were reversible, at least in our experimentsâ added Dr. Rajagopalan. ÂOnce the air how long does it take for viagra to kick in pollution was removed from the environment, the mice appeared healthier and the pre-diabetic state seemed to reverse.â Dr. Rajagopalan explains that if you live in a densely polluted environment, taking actions such as wearing an N95 mask, using portable indoor air cleaners, utilizing air conditioning, closing car windows while commuting, and changing car air filters frequently could all be helpful in staying healthy and limiting air pollution exposure.Next steps in this research involve meeting with a panel of experts, as well as the National Institutes of Health, to discuss conducting clinical trials that compare heart health and the level of air pollution in the environment.

For example, if someone has a heart attack, should they be wearing an N95 mask or using a portable air filter at home during recovery?. Dr how long does it take for viagra to kick in. Rajagopalan and his team believe that it is important to address the environment as a population health risk factor and continue to diligently research these issues. The authors also note that these findings should encourage policymakers to enact measures aimed at reducing air pollution.Shyam Biswal, PhD, Professor in the Department of Environmental Health and Engineering at Johns Hopkins University School of Public Health, is the joint senior author on how long does it take for viagra to kick in the study. Drs.

Rajagopalan and Biswal are co-PIs on the NIH grant that supported this work.###Rajagopalan, S., Biswal, S., et al. ÂMetabolic effects of air pollution how long does it take for viagra to kick in exposure and reversibility.â Journal of Clinical Investigation. DOI. 10.1172/JCI137315. This work was supported by the National Institute of Environmental Health Sciences TaRGET II Consortium grant U01ES026721, as well as grants R01ES015146 and R01ES019616.About one in five women experience some form of depression during pregnancy, with poorly understood effects on the fetus.

Prenatal depression is linked to behavioural and developmental issues in children as well as an increased risk for depression as young adults. But how prenatal depression leads to these changes remains unclear. UCalgary researcher Dr. Catherine Lebel, PhD, is helping understand what may be happening in the developing brains of these children. The research team has shown that young children whose mothers experienced more numerous symptoms of depression in pregnancy have weakened connectivity in brain pathways involved in emotion.

These structural changes can be related to increased hyperactivity and aggression in boys. The research is based on diffusion magnetic resonance imaging, an imaging technique that probes the strength of structural connections between brain regions. The findings are published in The Journal of Neuroscience. Catherine Lebel, senior author and investigator. Riley Brandt, University of Calgary âThe results help us understand how depression can have multigenerational impacts, and speaks to the importance of helping mothers who may be experiencing depression during pregnancy,â says Lebel, an associate professor at the Cumming School of Medicine, and researcher in the Alberta Childrenâs Hospital Research Institute.

She holds the Canada Research Chair in Paediatric Neuroimaging. Lebel and her team studied 54 Calgary mothers and their children. They were enrolled from the ongoing, prospective study called the Alberta Pregnancy Outcomes and Nutrition study. Mothers answered a survey about their depression symptoms at several points during their pregnancy. Their children were followed after birth and undertook an MRI scan at the Alberta Childrenâs Hospital at around age four.

As well, the childrenâs behaviour was assessed within six months of their MRI scan. The team found a significant reduction in structural brain connectivity between the amygdala, a structure essential for emotional processing, and the frontal cortex. Weakened connectivity between the amygdala and frontal cortex is associated with disruptive behaviours and vulnerability to depression. The first author on the study, Dr. Rebecca Hay, MD, stresses the importance of recognition of depression and intervention in prenatal health.

ÂThese results suggest complex associations between the prenatal environment and childrenâs brain development, and may help us to understand why children of depressed mothers are more vulnerable to depression themselves,â says Hay, a resident physician in paediatrics and recent Cumming School of Medicine graduate. The main clinical takeaway from this is to emphasize the importance of recognizing, treating prenatal depression and supporting mothers, both for better maternal outcomes and to help future child development. Rebecca Hay, the study's first author. Courtesy Rebecca Hay Current study looks at stress during viagra Lebel and her research team are currently trying to understand how stress and mental health are affecting pregnant women during the erectile dysfunction treatment viagra. She is examining how factors such as social supports might mitigate stress, and how this may influence pregnancy and birth outcomes.

If you are interested, you can get involved here in the Pregnancy During the erectile dysfunction treatment viagra study at the University of Calgary. So far, approximately 7,500 women from across Canada are enrolled and supplying information through questionnaires. ÂIt is critical to appropriately recognize and treat prenatal maternal mental health problems, both for the mothers and to improve child outcomes,â says Lebel. ÂNow more than ever, with increased stress, anxiety and depression during the erectile dysfunction treatment viagra, we should do more to support mothers to positively impact the health of their children.â Lebel is an associate professor in the Department of Radiology at the Cumming School of Medicine, adjunct associate professor in the Werklund School of Education and a member of The Mathison Centre for Mental Health Research &. Education, Owerko Centre at ACHRI, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute.

The study was funded by the Canadian Institute of Health Research, Alberta Innovates - Health Solutions, the Alberta Children's Hospital Foundation, the National Institute of Environmental Health Sciences, the Mach-Gaensslen Foundation, and an Eyes High University of Calgary Postdoctoral Scholar. Led by the Hotchkiss Brain Institute, Brain and Mental Health is one of six research strategies guiding the University of Calgary toward its Eyes High goals. The strategy provides a unifying direction for brain and mental health research at the university..

First-of-its-kind study, based on a mouse model, finds living in a polluted environment could be comparable to eating a high-fat diet, leading to a pre-diabetic state CLEVELANDâAir pollution how to get prescribed viagra is the worldâs leading environmental risk factor, and causes more than nine million deaths per year. New research published in the Journal of Clinical Investigation shows air pollution may play a role in the development of cardiometabolic diseases, such as diabetes. Importantly, the effects were reversible with cessation of how to get prescribed viagra exposure. Researchers found that air pollution was a ârisk factor for a risk factorâ that contributed to the common soil of other fatal problems like heart attack and stroke.

Similar to how an unhealthy diet and lack of exercise can lead to disease, exposure to air pollution could be added to this risk factor list as well. âIn this study, we created an environment that mimicked a polluted day in New Delhi or Beijing,â said Sanjay Rajagopalan, MD, first author on the study, Chief of Cardiovascular Medicine at University Hospitals Harrington Heart and Vascular Institute, and Director of the Case Western how to get prescribed viagra Reserve University Cardiovascular Research Institute. ÂWe concentrated fine particles of air pollution, called PM2.5 (particulate matter component <. 2.5 microns) how to get prescribed viagra.

Concentrated particles like this develop from human impact on the environment, such as automobile exhaust, power generation and other fossil fuels.â These particles have been strongly connected to risk factors for disease. For example, cardiovascular effects of air pollution can lead to heart attack and stroke. The research team has shown exposure to air pollution can how to get prescribed viagra increase the likelihood of the same risk factors that lead to heart disease, such as insulin resistance and type 2 diabetes. In the mouse model study, three groups were observed.

A control group receiving clean filtered air, a group exposed to polluted air for 24 weeks, and a group fed a high-fat diet. Interestingly, the researchers found that being exposed to air pollution was comparable to eating a high-fat diet how to get prescribed viagra. Both the air pollution and high-fat diet groups showed insulin resistance and abnormal metabolism â just like one would see in a pre-diabetic state. These changes were associated with changes in the epigenome, a layer of control that can masterfully turn on and turn off thousands of genes, representing a critical buffer in response to environmental factors how to get prescribed viagra.

This study is the first-of-its-kind to compare genome-wide epigenetic changes in response to air pollution, compare and contrast these changes with that of eating an unhealthy diet, and examine the impact of air pollution cessation on these changes.âThe good news is that these effects were reversible, at least in our experimentsâ added Dr. Rajagopalan. ÂOnce the air pollution was removed from the environment, the mice appeared healthier and the pre-diabetic state seemed to reverse.â how to get prescribed viagra Dr. Rajagopalan explains that if you live in a densely polluted environment, taking actions such as wearing an N95 mask, using portable indoor air cleaners, utilizing air conditioning, closing car windows while commuting, and changing car air filters frequently could all be helpful in staying healthy and limiting air pollution exposure.Next steps in this research involve meeting with a panel of experts, as well as the National Institutes of Health, to discuss conducting clinical trials that compare heart health and the level of air pollution in the environment.

For example, if someone has a heart attack, should they be wearing an N95 mask or using a portable air filter at home during recovery?. Dr how to get prescribed viagra. Rajagopalan and his team believe that it is important to address the environment as a population health risk factor and continue to diligently research these issues. The authors also note that these findings should encourage policymakers to enact measures how to get prescribed viagra aimed at reducing air pollution.Shyam Biswal, PhD, Professor in the Department of Environmental Health and Engineering at Johns Hopkins University School of Public Health, is the joint senior author on the study.

Drs. Rajagopalan and Biswal are co-PIs on the NIH grant that supported this work.###Rajagopalan, S., Biswal, S., et al. ÂMetabolic effects of air pollution exposure and reversibility.â how to get prescribed viagra Journal of Clinical Investigation. DOI.

10.1172/JCI137315. This work was supported by the National Institute of Environmental Health Sciences TaRGET II Consortium grant U01ES026721, as well as grants R01ES015146 and R01ES019616.About one in five women experience some form of depression during pregnancy, with poorly understood effects on the fetus. Prenatal depression is linked to behavioural and developmental issues in children as well as an increased risk for depression as young adults. But how prenatal depression leads to these changes remains unclear.

UCalgary researcher Dr. Catherine Lebel, PhD, is helping understand what may be happening in the developing brains of these children. The research team has shown that young children whose mothers experienced more numerous symptoms of depression in pregnancy have weakened connectivity in brain pathways involved in emotion. These structural changes can be related to increased hyperactivity and aggression in boys.

The research is based on diffusion magnetic resonance imaging, an imaging technique that probes the strength of structural connections between brain regions. The findings are published in The Journal of Neuroscience. Catherine Lebel, senior author and investigator. Riley Brandt, University of Calgary âThe results help us understand how depression can have multigenerational impacts, and speaks to the importance of helping mothers who may be experiencing depression during pregnancy,â says Lebel, an associate professor at the Cumming School of Medicine, and researcher in the Alberta Childrenâs Hospital Research Institute.

Their children were followed after birth and undertook an MRI scan at the Alberta Childrenâs Hospital at around age four. As well, the childrenâs behaviour was assessed within six months of their MRI scan. The team found a significant reduction in structural brain connectivity between the amygdala, a structure essential for emotional processing, and the frontal cortex. Weakened connectivity between the amygdala and frontal cortex is associated with disruptive behaviours and vulnerability to depression.

The first author on the study, Dr. Rebecca Hay, MD, stresses the importance of recognition of depression and intervention in prenatal health. ÂThese results suggest complex associations between the prenatal environment and childrenâs brain development, and may help us to understand why children of depressed mothers are more vulnerable to depression themselves,â says Hay, a resident physician in paediatrics and recent Cumming School of Medicine graduate. The main clinical takeaway from this is to emphasize the importance of recognizing, treating prenatal depression and supporting mothers, both for better maternal outcomes and to help future child development.

Rebecca Hay, the study's first author. Courtesy Rebecca Hay Current study looks at stress during viagra Lebel and her research team are currently trying to understand how stress and mental health are affecting pregnant women during the erectile dysfunction treatment viagra. She is examining how factors such as social supports might mitigate stress, and how this may influence pregnancy and birth outcomes. If you are interested, you can get involved here in the Pregnancy During the erectile dysfunction treatment viagra study at the University of Calgary.

So far, approximately 7,500 women from across Canada are enrolled and supplying information through questionnaires. ÂIt is critical to appropriately recognize and treat prenatal maternal mental health problems, both for the mothers and to improve child outcomes,â says Lebel. ÂNow more than ever, with increased stress, anxiety and depression during the erectile dysfunction treatment viagra, we should do more to support mothers to positively impact the health of their children.â Lebel is an associate professor in the Department of Radiology at the Cumming School of Medicine, adjunct associate professor in the Werklund School of Education and a member of The Mathison Centre for Mental Health Research &. Education, Owerko Centre at ACHRI, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute.

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Olympic athletes train generic viagra sildenafil to be thebest in the world at their respective sports. They are determined, talented,capable, and display a level of grit and determination qualifying them for thehighest stage of competition. They spend generic viagra sildenafil years working toward a few simpleultimate goals. Giving their best performance, honoring their country and leavingthe court, mat, field or track with a medal in their hand. When gymnast Simone Biles recentlywithdrew from the Olympic Games, it came to many as a surprise.

What may havecome as even more of a surprise to some is generic viagra sildenafil the reason she withdrew. Her mentalhealth. This latest example of thecourage of an athlete to stand up and let the world know that mental health ishealth has brought incredible awareness to the importance of mental health inall people, even Olympians. If youâre an athlete, or if youhave kids who play generic viagra sildenafil sports, you might be worried and wondering what you can doto address potential mental health struggles related to sports. Consider thesesuggestions when it comes to sports and mental health.

Talk, talk, talk generic viagra sildenafil. Ifyou find yourself experiencing stress, anxiety or depression related to asport, consider finding a qualified counselor/therapist to discuss these issues.If youâve got a child who plays sports, keep an open dialogue with them. Haveregular, open and honest conversations about how theyâre feeling, both mentallyand physically. Watch for generic viagra sildenafil warning signs. Thisis especially important if you have a child or adolescent in sports.

Keep aneye out for things like mood, sleep, or behavior changes that seem concerning. Find balance generic viagra sildenafil. Itâsokay to admit that you need help or that you need to take a break frompracticing or competing. If you feel overwhelmed consider meditation, generic viagra sildenafil tryingnew things or giving your body a rest.Ask for help. Thereis no shame in seeking out help, whether it be with a therapist, psychiatristor other medical health professional.

Treating a mental illness is just asimportant as treating a physical one. Protecting and prioritizing youroverall health generic viagra sildenafil is essential for all levels of athletes. Itâs not rare to havean athlete pull out of a race, game or event due to a physical injury. Seeingan athlete withdraw for mental health reasons is much less common, however, itsrecognition is just as important. The hope going forward is that we assistathletes generic viagra sildenafil in all aspects of performance and recognize that mental health is health.

Thomas Bills, M.D., is a psychiatrist with a special interestin sports psychiatry. Dr. Bills is welcoming athletes to his office in theTowsley Building, located on the campus of MidMichigan Medical Center âMidland. Those who would like to make an appointment may call the office at(989) 839-3385.The history of mental health treatment is a long story. The first private hospitals, known as almshouses, for those with severe symptoms of mental illnesses and the infirmed elderly, were created in the early 18th century.

In the early 19th century, a new idea about care for the mentally ill called âmoral treatmentâ emerged, which focused on the belief that kindness and quietness in treatment would help with recovery. In the 1840âs, Thomas Kirkbride developed the âKirkbride Planâ for moral treatment that included sunshine, fresh air, privacy and comfort. Throughout the 1850s and â60s Dorothea Dix traveled throughout the country promoting this approach. By the 1870s virtually all states had such asylums. By the 1890s, private almhouses were sending people to the asylums.

This influx overwhelmed both space and resources of the asylums and threatened their attempts at humane treatment. The Great Depression in the 1930s drastically cut state appropriations and World War II created acute shortages of personnel. A move began to reduce costs. The large psychiatric hospitals began to be reduced to units within general hospitals. Some psychiatrists turned to the new Mental Hygiene movement and created outpatient clinics that focused on preventing psychiatric hospitalizations.

Others focused on the brain pathology and experimented with electric shock therapies, psychosurgery and different kinds of medications. By the 1950s, with the rise of nursing homes for the elderly, the asylum period came to an end. In Michigan, it was University of Michigan Professor William Herdman that set the wheels in motion to build a psychopathic hospital, which opened its doors in 1906, one of the first in the nation. The hospital has lead in cutting-edge research on brain function and the genetic underpinnings of mental illness symptoms ever since, including the development of the biopsychosocial model that is the foundation of psychiatry today. It is out of this same reductionist approach that Partial Hospitalization was born.

Doctors in the 1950s recognized that not all people being treated for mental illness needed overnight stays, even if they needed something more than a weekly appointment in an outpatient clinic. In the early 1960s a group of clinicians involved in the relatively new treatment approach of âday hospitalâ began to discuss the challenges of this approach. By the end of that decade they had organized the American Association for Partial Hospitalization (AAPH). In 1988, Congress approved a major benefit change for Medicare by including reimbursement for PHP that met a strict definition â treatment five days a week, six hours a day. By the early 1990s, the group had grown to more than 1,200 members and published standards and guidelines for this mode of treatment.

In the mid-1990s, the organization became the Association for Ambulatory Behavioral Healthcare (AABH) and now represents hundreds of providers and professionals in the United States, and is the leading advocate for Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) nationally. PHP is often used as a step down from an inpatient stay, or as a way to prevent an inpatient stay. Partial is appropriate for people who are experiencing psychiatric symptoms that interfere with their daily functioning, but are not of imminent danger to themselves or others. The development of the IOP has followed a different route, one steered by the treatment of addictions. Addiction treatment began in an organized way between 1750 and 1850 through âmutual aid societies.â The asylum model was followed with the opening of âinebriate homesâ throughout the 19th century.

Outpatient treatment for addiction began with the opening of the Charles B. Towns Hospital in 1901 in New York. In 1906, a church-based therapy program began at Bostonâs Emmanuel Clinic, which laid the foundations for the Alcoholics Anonymous movement, which began in earnest 25 years later. Outpatient addiction treatment options grew from 1920s through the 1950s. In the 1960s, insurances began to reimburse for treatments, which lead to continued growth in options.

The famous Betty Ford Clinic was founded in 1982. With the recognition that addictions often have co-occurring mental illness symptoms, by the 1990s addiction programs were expanding to include treatment for mental illness symptoms also, either as dual diagnosis with addictions or stand-alone diagnoses. Now there are IOP programs that specialize in addictions and those that treat specific mental illnesses, such as eating disorders, bipolar, PTSD, as well as general mental illness. There are also IOPs that serve specific age-related populations such as geriatrics, adolescents and children, as well as general adult programs. IOP may be anywhere from three to five days a week, from three to five hours a day, depending on the program.

Michigan has 25 Partial Programs. MidMichigan Medical Center â Gratiotâs PHP began in 1995. It is one of only three such programs in Michigan north of Lansing. The Gratiot program is an adult program and operates Monday through Friday, 9 a.m. Â 3 p.m.

The average length of stay is seven days. Insurance coverage is the same as other hospitalization coverage. MidMichigan also has an IOP program for seniors in Gladwin called Senior Life Solutions, which operates three days a week. Depression and anxiety are the most common mental health conditions in the U.S. And the most common conditions treated in Gratiotâs PHP.

According to the Anxiety and Depression Association of America, depression affects about 7.1 percent of the U.S adult population, while anxiety affects about 18 percent of U.S. Population. Adults with depression have a 64 percent greater risk of coronary artery disease. Depression often co-occurs with medical conditions. 25 percent of cancer patients experience depression, 10 to 27 percent of post-stroke patients, 30 percent of heart attack survivors, 50 percent of patients with Parkinsonâs disease, 30 percent of diabetes patients, and 40 to 70 percent of adult caregivers of the elderly struggle with depression.

Women are twice as likely as men to have depression. Research shows that people with anxiety are three to five times more likely to go to the doctor. In fiscal year 2021, depression was the most common diagnosis seen at Gratiotâs PHP with nearly 83 percent of patients having this diagnosis. Thirty percent of those with depression had a secondary diagnosis of anxiety, with an addition 5 percent of patients having a primary anxiety diagnosis. Over 100 years of moderntreatment of depression and anxiety has made it clear that these commonconditions are very treatable.

In the 25 years of treating them in a daytreatment setting the process has been clarified and refined and is now quitesuccessful. For those who arestruggling with depression or anxiety, the Psychiatric Partial HospitalizationProgram at MidMichigan Medical Center â Gratiot may be reached at (989)466-3253. Senior Life Solutions can be reached at (989) 246-6339. Thoseinterested in more information on MidMichiganâs comprehensive behavioral healthprograms may visit www.midmichigan.org/mentalhealth..

Olympic athletes train to be thebest in the world how to get prescribed viagra at their respective sports. They are determined, talented,capable, and display a level of grit and determination qualifying them for thehighest stage of competition. They spend how to get prescribed viagra years working toward a few simpleultimate goals. Giving their best performance, honoring their country and leavingthe court, mat, field or track with a medal in their hand. When gymnast Simone Biles recentlywithdrew from the Olympic Games, it came to many as a surprise.

What may havecome how to get prescribed viagra as even more of a surprise to some is the reason she withdrew. Her mentalhealth. This latest example of thecourage of an athlete to stand up and let the world know that mental health ishealth has brought incredible awareness to the importance of mental health inall people, even Olympians. If youâre an athlete, or if youhave kids who play how to get prescribed viagra sports, you might be worried and wondering what you can doto address potential mental health struggles related to sports. Consider thesesuggestions when it comes to sports and mental health.

Talk, talk, how to get prescribed viagra talk. Ifyou find yourself experiencing stress, anxiety or depression related to asport, consider finding a qualified counselor/therapist to discuss these issues.If youâve got a child who plays sports, keep an open dialogue with them. Haveregular, open and honest conversations about how theyâre feeling, both mentallyand physically. Watch for how to get prescribed viagra warning signs. Thisis especially important if you have a child or adolescent in sports.

Keep aneye out for things like mood, sleep, or behavior changes that seem concerning. Find balance how to get prescribed viagra. Itâsokay to admit that you need help or that you need to take a break frompracticing or competing. If you feel overwhelmed how to get prescribed viagra consider meditation, tryingnew things or giving your body a rest.Ask for help. Thereis no shame in seeking out help, whether it be with a therapist, psychiatristor other medical health professional.

Treating a mental illness is just asimportant as treating a physical one. Protecting and prioritizing youroverall health is essential how to get prescribed viagra for all levels of athletes. Itâs not rare to havean athlete pull out of a race, game or event due to a physical injury. Seeingan athlete withdraw for mental health reasons is much less common, however, itsrecognition is just as important. The hope going forward how to get prescribed viagra is that we assistathletes in all aspects of performance and recognize that mental health is health.