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NCHS Data http://sw.keimfarben.de/cheap-viagra-online/ Brief viagra online in canada No. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic conditions such as cardiovascular disease (1) and diabetes (2) viagra online in canada. Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition.

Menopause is “the permanent cessation of menstruation that viagra online in canada occurs after the loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% of women are viagra online in canada premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal.

Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on viagra online in canada average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 viagra online in canada. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend viagra online in canada by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had viagra online in canada a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for viagra online in canada Figure 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble falling asleep four times viagra online in canada or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 viagra online in canada. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant viagra online in canada linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less viagra online in canada. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 2pdf viagra online in canada icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage viagra online in canada of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 viagra online in canada. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, viagra online in canada 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their viagra online in canada last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure viagra online in canada 3pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age viagra online in canada group who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 viagra online in canada. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5).

Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status. A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?.

€. 2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less.

Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?. €Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?.

€Trouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS.

For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States. The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS.

Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No.

141. Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N. Perimenopause.

From research to practice. J Women’s Health (Larchmt) 25(4):332–9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult.

A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software].

2012. Suggested citationVahratian A. Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286.

Hyattsville, MD. National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J. Blumberg, Ph.D., Associate Director for Science.

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This aims to improve the pan-European capacity to terazosin viagra analyse, predict and respond to changing communicable disease patterns. Healthcare IT News spoke to Prof. Jan Semenza to learn more about the challenges climate change poses to public health.HITN. In what terazosin viagra way does climate change aggravate risk for future health crises?. Semenza.

Numerous theories have been developed in recent years to explain the relationship between climate change and infectious diseases. They include higher proliferation rates at higher temperatures, extended transmission season, changes in ecological balances, and climate-related migration of terazosin viagra vectors, reservoir hosts, or human populations.Most importantly, the potential population health impacts of environmental changes extend far into the future, if environmental conditions deteriorate further. Change can be abrupt and unexpected but they can also be protracted and gradual and thus pose considerable challenges to public health.HITN. Which diseases does global warming increase the risk for?. Semenza.

The impact on public health from climate change may be far-reaching and include deaths and hospitalisations due to heat waves. In fact, I investigated the 1995 heat wave in Chicago that killed over 700 people, which was a precursor of what was to come in other parts of the world. Other impacts include injuries and death from flooding. And potential shifts in the transmission ranges of vector-borne diseases such as hantaviagra, West Nile viagra, tick-borne encephalitis, lyme disease, malaria and dengue. Meanwhile, food-borne diseases like salmonellosis have been observed to be highly temperature sensitive, meaning that increased annual average temperatures could have important effects on food safety.

Climate change may influence water quality and availability while also leading to increased risks of flooding in some regions. Thus water-borne diseases, such as those caused by the parasite Cryptosporidium in drinking water and vibrio bacteria in bathing water, have been associated with climate change - which I’ll discuss in my talk during the HIMSS &. Health 2.0 European Digital Event. HITN. What role does digital health play in monitoring or responding to disease caused by climate change?.

Semenza. ECDC is exploring the development of the European Environment and Epidemiology Network (E3) that could link climatic/environmental and infectious disease data to strengthen the European capacity in forecasting, monitoring and responding to the threats posed by new and emerging diseases.For example, ECDC has developed the Vibrio map viewer, which monitors sea surface temperature and salinity with satellites and produces forecasts when the environmental suitability for vibrio s in the Baltic Sea is high. Wound s with vibrio are potentially life-threatening, so this early warning system provides alerts during the summer months about which beaches in the Baltic should be avoided.Through integrating and synthesising these data sets, disease surveillance systems are able to incorporate and analyse environmental precursors to diseases, thus preparing public health to meet the challenges of our time.Learn more from Prof.

Healthcare IT viagra online in canada News spoke to Prof. Jan Semenza to learn more about the challenges climate change poses to public health.HITN. In what way does climate change aggravate risk for future health crises?.

Semenza. Numerous theories have been developed in recent years to explain the relationship between climate change and infectious diseases. They include higher proliferation rates at higher temperatures, extended transmission season, changes in ecological balances, and climate-related migration of vectors, reservoir hosts, or human populations.Most importantly, the potential population health impacts of environmental changes extend far into the future, if environmental conditions deteriorate further.

Change can be abrupt and unexpected but they can also be protracted and gradual and thus pose considerable challenges to public health.HITN. Which diseases does global warming increase the risk for?. Semenza.

The impact on public health from climate change may be far-reaching and include deaths and hospitalisations due to heat waves. In fact, I investigated the 1995 heat wave in Chicago that killed over 700 people, which was a precursor of what was to come in other parts of the world. Other impacts include injuries and death from flooding.

And potential shifts in the transmission ranges of vector-borne diseases such as hantaviagra, West Nile viagra, tick-borne encephalitis, lyme disease, malaria and dengue. Meanwhile, food-borne diseases like salmonellosis have been observed to be highly temperature sensitive, meaning that increased annual average temperatures could have important effects on food safety. Climate change may influence water quality and availability while also leading to increased risks of flooding in some regions.

Thus water-borne diseases, such as those caused by the parasite Cryptosporidium in drinking water and vibrio bacteria in bathing water, have been associated with climate change - which I’ll discuss in my talk during the HIMSS &. Health 2.0 European Digital Event. HITN.

What role does digital health play in monitoring or responding to disease caused by climate change?. Semenza. ECDC is exploring the development of the European Environment and Epidemiology Network (E3) that could link climatic/environmental and infectious disease data to strengthen the European capacity in forecasting, monitoring and responding to the threats posed by new and emerging diseases.For example, ECDC has developed the Vibrio map viewer, which monitors sea surface temperature and salinity with satellites and produces forecasts when the environmental suitability for vibrio s in the Baltic Sea is high.

Wound s with vibrio are potentially life-threatening, so this early warning system provides alerts during the summer months about which beaches in the Baltic should be avoided.Through integrating and synthesising these data sets, disease surveillance systems are able to incorporate and analyse environmental precursors to diseases, thus preparing public health to meet the challenges of our time.Learn more from Prof. Jan Semenza about the challenges climate change poses to public health at the HIMSS &.

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erectile dysfunction treatment has viagra for sale online evolved viagra cialis levitra rapidly into a viagra with global impacts. However, as the viagra has viagra cialis levitra developed, it has become increasingly evident that the risks of erectile dysfunction treatment, both in terms of rates and particularly of severe complications, are not equal across all members of society. While general risk factors for hospital admission with erectile dysfunction treatment include age, male sex and specific comorbidities (eg, cardiovascular disease, hypertension and diabetes), there is increasing evidence that people identifying with Black, Asian and Minority Ethnic (BAME) groupsi have disproportionately higher risks of being adversely affected by erectile dysfunction treatment in the UK and the USA. The ethnic disparities include overall numbers of cases, as well as the relative numbers of critical care admissions and deaths.1In the area of mental health, for people from BAME groups, even before the current viagra there were already significant mental health inequalities.2 These viagra cialis levitra inequalities have been increased by the viagra in several ways. The constraints of quarantine have made access to traditional face-to-face support from mental health services more difficult in general.

This difficulty will increase pre-existing inequalities where there are challenges to engaging people in care and viagra cialis levitra in providing early access to services. The restrictions may also reduce the flexibility of care offers, given the need for social isolation, limiting non-essential travel and closure of routine clinics. The service impacts are compounded by constraints on the use of non-traditional or alternative routes to care and support.In addition, there is growing evidence of specific mental health consequences from significant erectile dysfunction treatment , with increased rates of not only post-traumatic stress disorder, anxiety and depression, but also specific neuropsychiatric symptoms.3 viagra cialis levitra Given the higher risks of mental illnesses and complex care needs among ethnic minorities and also in deprived inner city areas, erectile dysfunction treatment seems to deliver a double blow. Physical and mental health vulnerabilities are inextricably linked, especially as a significant proportion of healthcare workers (including in mental health services) in the UK are from BAME groups.Focusing on mental health, there is very little erectile dysfunction treatment-specific guidance on the needs of patients in the BAME group. The risk to staff in general healthcare (including mental healthcare) is a particular concern, and in response, the Royal College of Psychiatrists and NHS England have produced a report on the impact of erectile dysfunction treatment on BAME staff in mental healthcare settings, with guidance on assessment and management of risk using an associated risk assessment tool for staff.4 5However, there viagra cialis levitra is little formal guidance for the busy clinician in balancing different risks for individual mental health patients and treating appropriately.

Thus, for example, an inpatient clinician may want to know whether a patient who is older, has additional comorbidities and is from an ethnic background, should be started on one antipsychotic medication or another, or whether treatments such as vitamin D prophylaxis or treatment and venous thromboembolism prevention should be started earlier in the context of the erectile dysfunction treatment viagra. While syntheses of the existing guidelines are available about erectile dysfunction treatment and mental health,6 7 there is nothing specific about the healthcare needs of patients from ethnic minorities during the viagra.To fill this gap, we propose three core actions that may help:Ensure good information and psychoeducation packages are made available to viagra cialis levitra those with English as a second http://ilovepte.com/why-pte/ language, and ensure health beliefs and knowledge are based on the best evidence available. Address culturally grounded explanatory models and illness perceptions to allay fears and worry, and ensure timely access to testing and care if needed.Maintain levels of service, flexibility in care packages, and personal relationships with patients and carers from ethnic minority backgrounds in order to continue existing care and to identify changes needed to respond to worsening of mental health.Consider modifications to existing interventions such as psychological therapies and viagra cialis levitra pharmacotherapy. Have a high index of suspicion to take into account emerging physical health problems and the greater risk of serious consequences of erectile dysfunction treatment in ethnic minority people with pre-existing chronic conditions and vulnerability factors.These actions are based on clinical common sense, but guidance in this area should be provided on the basis of good evidence. There has already been a call for urgent viagra cialis levitra research in the area of erectile dysfunction treatment and mental health8 and also a clear need for specific research focusing on the post-erectile dysfunction treatment mental health needs of people from the BAME group.

Research also needs to recognise the diverse range of different people, with different needs and vulnerabilities, who are grouped under the multidimensional term BAME, including people from different generations, first-time migrants, people from Africa, India, the Caribbean and, more recently, migrants from Eastern Europe. Application of a race equality impact assessment to all research viagra cialis levitra questions and methodology has recently been proposed as a first step in this process.2 At this early stage, the guidance for assessing risks of erectile dysfunction treatment for health professionals is also useful for patients, until more refined decision support and prediction tools are developed. A recent Public Health England report on ethnic minorities and erectile dysfunction treatment9 recommends better recording of ethnicity data in health and social care, and goes further to suggest this should also apply to death certificates. Furthermore, the report recommends more participatory and experience-based research to understand causes and consequences of pre-existing multimorbidity and erectile dysfunction treatment , integrated care systems that work well for susceptible and marginalised groups, culturally competent health promotion, prevention and occupational risk viagra cialis levitra assessments, and recovery strategies to mitigate the risks of widening inequalities as we come out of restrictions.Primary data collection will need to cover not only hospital admissions but also data from primary care, linking information on mental health, erectile dysfunction treatment and ethnicity. We already have research and specific guidance emerging on other risk factors, such as age and gender.

Now we viagra cialis levitra also need to focus on an equally important aspect of vulnerability. As clinicians, we need to balance the relative risks for each of our patients, so that we can act promptly and proactively in response to their individual needs.10 For this, we need evidence-based guidance to ensure we are balancing every risk appropriately and without bias.Footnotei While we have used the term ‘people identifying with BAME groups’, we recognise that this is a multidimensional group and includes vast differences in culture, identity, heritage and histories contained within this abbreviated term..

erectile dysfunction treatment has viagra online in canada evolved rapidly into a viagra with global impacts. However, as the viagra has developed, it has become increasingly evident that the risks of erectile dysfunction treatment, both in terms viagra online in canada of rates and particularly of severe complications, are not equal across all members of society. While general risk factors for hospital admission with erectile dysfunction treatment include age, male sex and specific comorbidities (eg, cardiovascular disease, hypertension and diabetes), there is increasing evidence that people identifying with Black, Asian and Minority Ethnic (BAME) groupsi have disproportionately higher risks of being adversely affected by erectile dysfunction treatment in the UK and the USA.

The ethnic disparities include overall numbers of cases, as well as the relative numbers of critical care admissions and deaths.1In the area of mental health, for people from BAME groups, even before the current viagra there were already significant mental health inequalities.2 These inequalities have been increased by viagra online in canada the viagra in several ways. The constraints of quarantine have made access to traditional face-to-face support from mental health services more difficult in general. This difficulty will increase pre-existing inequalities where there are challenges to engaging people in care and in providing early access viagra online in canada to services.

The restrictions may also reduce the flexibility of care offers, given the need for social isolation, limiting non-essential travel and closure of routine clinics. The service impacts are compounded by constraints on the use of non-traditional or alternative routes to care and support.In addition, there is growing evidence of specific mental health consequences from significant erectile dysfunction treatment , with increased rates of not only post-traumatic stress disorder, anxiety and depression, but also specific neuropsychiatric symptoms.3 Given the higher risks of mental illnesses and complex care needs among ethnic minorities and also in deprived inner city areas, erectile dysfunction treatment seems to viagra online in canada deliver a double blow. Physical and mental health vulnerabilities are inextricably linked, especially as a significant proportion of healthcare workers (including in mental health services) in the UK are from BAME groups.Focusing on mental health, there is very little erectile dysfunction treatment-specific guidance on the needs of patients in the BAME group.

The risk to staff in general healthcare (including mental healthcare) is a particular concern, and in response, the Royal College of Psychiatrists and NHS England have produced a report on the impact of viagra online in canada erectile dysfunction treatment on BAME staff in mental healthcare settings, with guidance on assessment and management of risk using an associated risk assessment tool for staff.4 5However, there is little formal guidance for the busy clinician in balancing different risks for individual mental health patients and treating appropriately. Thus, for example, an inpatient clinician may want to know whether a patient who is older, has additional comorbidities and is from an ethnic background, should be started on one antipsychotic medication or another, or whether treatments such as vitamin D prophylaxis or treatment and venous thromboembolism prevention should be started earlier in the context of the erectile dysfunction treatment viagra. While syntheses of the existing guidelines are available about erectile dysfunction treatment and mental health,6 7 there is nothing specific about the healthcare needs of patients from viagra online in canada ethnic minorities during the viagra.To fill this gap, we propose three core actions that may help:Ensure good information and psychoeducation packages are made available to those with English as a second language, and ensure health beliefs and knowledge are based on the best evidence available.

Address culturally viagra online in canada grounded explanatory models and illness perceptions to allay fears and worry, and ensure timely access to testing and care if needed.Maintain levels of service, flexibility in care packages, and personal relationships with patients and carers from ethnic minority backgrounds in order to continue existing care and to identify changes needed to respond to worsening of mental health.Consider modifications to existing interventions such as psychological therapies and pharmacotherapy. Have a high index of suspicion to take into account emerging physical health problems and the greater risk of serious consequences of erectile dysfunction treatment in ethnic minority people with pre-existing chronic conditions and vulnerability factors.These actions are based on clinical common sense, but guidance in this area should be provided on the basis of good evidence. There has already been a call for urgent research in the area of erectile dysfunction treatment and mental health8 and also a clear need viagra online in canada for specific research focusing on the post-erectile dysfunction treatment mental health needs of people from the BAME group.

Research also needs to recognise the diverse range of different people, with different needs and vulnerabilities, who are grouped under the multidimensional term BAME, including people from different generations, first-time migrants, people from Africa, India, the Caribbean and, more recently, migrants from Eastern Europe. Application of a race equality impact assessment to all research questions and methodology has recently been proposed as a first step in this process.2 At this early stage, the guidance viagra online in canada for assessing risks of erectile dysfunction treatment for health professionals is also useful for patients, until more refined decision support and prediction tools are developed. A recent Public Health England report on ethnic minorities and erectile dysfunction treatment9 recommends better recording of ethnicity data in health and social care, and goes further to suggest this should also apply to death certificates.

Furthermore, the viagra online in canada report recommends more participatory and experience-based research to understand causes and consequences of pre-existing multimorbidity and erectile dysfunction treatment , integrated care systems that work well for susceptible and marginalised groups, culturally competent health promotion, prevention and occupational risk assessments, and recovery strategies to mitigate the risks of widening inequalities as we come out of restrictions.Primary data collection will need to cover not only hospital admissions but also data from primary care, linking information on mental health, erectile dysfunction treatment and ethnicity. We already have research and specific guidance emerging on other risk factors, such as age and gender. Now we also need to focus on an equally important aspect of vulnerability viagra online in canada.

As clinicians, we need to balance the relative risks for each of our patients, so that we can act promptly and proactively in response to their individual needs.10 For this, we need evidence-based guidance to ensure we are balancing every risk appropriately and without bias.Footnotei While we have used the term ‘people identifying with BAME groups’, we recognise that this is a multidimensional group and includes vast differences in culture, identity, heritage and histories contained within this abbreviated term..

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A new study in mice helps explain why gut microbiomes of breastfed infants can differ greatly from those of formula-fed infants.The study, "Dietary Sphinganine Is Selectively Assimilated by Members of the Mammalian Gut Microbiome," was published in July in the Journal of Lipid african viagra Research.Sphinganine from milk Johnson Lab/Provided A new technique allows researchers to track specific nutrients as they are taken http://www.ceessnoek.info/index.php/abbey-loves-multimedia/ up by gut microbes in a mouse's digestive tract. The image shows certain microbes (red) taking in a african viagra nutrient common in human milk called sphinganine. Blue microbes have not taken it in.The paper describes an innovative technique developed at Cornell to track the fate of metabolites -- nutrients formed in or necessary for metabolism -- through a mouse's digestive tract and identify how they interact with specific gut microbes."We think the methods are expandable to many different microbiome systems," said senior author Elizabeth Johnson, assistant professor of nutritional sciences in the College of Agriculture and Life Sciences. She noted that african viagra researchers investigating effects of a high-fat vs. Low-fat diet, or a keto diet, might use the technique to track metabolites.The methodology could reveal how specific metabolites promote specific bacteria.

This could allow nutritionists to prescribe that patients eat foods containing specific metabolites to intentionally change african viagra the composition of their microbiomes, Johnson said. advertisement Human milk and many other foods contain a class of lipid metabolites called sphingolipids. Previous research suggested that these metabolites help shape an infant's microbiome, but it was not known if they actually interact with african viagra the microbiome.The study identified two types of gut microbes, Bacteroides and Bifidobacterium, that use sphingolipids for their own metabolism.While very little is known about the specific roles of gut microbes in human health, Bacteroides have been implicated in both beneficial and not-so-beneficial effects, depending on context. They are generally associated with microbiomes of healthy breastfed infants. Bifidobacterium, shown for the first time in this study to process dietary sphingolipids, are considered the quintessential beneficial bacteria, comprising up to 95% of breastfed infants microbiome.They're also a highly popular over-the-counter probiotic."Our lab is very interested in how the diet interacts with the microbiome in order to really understand how you can best modulate it to have african viagra positive effects on health," Johnson said.

"In this study, we were able to see that yes, these dietary lipids that are a big part of [breastfed] infants diets, are interacting quite robustly with the gut microbiome."Sphingolipids originate from three main sources. Diet. Bacteria that can produce them. And most host tissues. advertisement Johnson, along with first author Min-Ting Lee, a doctoral student, and Henry Le, a postdoctoral researcher, both in Johnson's lab, created a technique to specifically track dietary sphingolipids as they passed through the mouse gut."We custom synthesized the sphingolipid we added to the diet," Johnson said.

"It is almost identical to ones derived from breast milk but with a small chemical tag so we could trace the location of the sphingolipid once it was ingested by the mice."Lee then used a fluorescent label that attached to cells or microbes that absorbed the tagged lipid, such that any bacteria that had taken up sphingolipids lit up red. Microbes from the mice's microbiomes were then isolated and analyzed. Populations with red microbes were separated from the others, and these were then genetically sequenced to identify the species of bacteria.With further investigation, Le was able to identify the metabolites that Bacteroides and Bifidobacterium produce when exposed to dietary sphingolipids. Further investigations are underway to determine whether these microbially-produced metabolites are beneficial for infant health.Johnson recently received a five-year, $1.9 million Maximizing Investigators' Research Award from the National Institutes of Health (NIH) to expand on this work, to better understand how lipid-dependent host-microbe interactions affect human health..The study was supported by seed funds from the Genomics Facility of the Biotechnology Resource Center at Cornell's Institute of Biotechnology. Story Source.

Materials provided by Cornell University. Original written by Krishna Ramanujan. Note. Content may be edited for style and length.SOBRE NOTICIAS EN ESPAÑOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles).

“¿Qué actividades se pueden hacer la próxima semana?. €, pregunta un usuario de Facebook.“¡Quedarse en casa!. €, responde otro usuario. El grupo de Facebook llamado “¿Qué está pasando en St. Thomas?.

€ se ha visto inundado de comentarios mordaces que instan a los viajeros a mantenerse alejados. Es un cambio fuerte. Antes de la pandemia, los intercambios entre turistas y residentes de la isla significaban promesas de diversión. Ahora, los operadores turísticos del continente que administran la página de Facebook intentan eliminar rápido cualquier expresión de enojo.En la cercana Puerto Rico, la fricción se ha extendido a la vida real. Informes de medios de comunicación han detallado varios episodios en los que los turistas, escapando de las restricciones pandémicas en sus países de origen, se volvieron violentos y destruyeron mercadería cuando se les pidió que usaran máscara dentro de tiendas.La pandemia de erectile dysfunction treatment ha enfrentado los intereses económicos con las guías de salud pública en todo Estados Unidos.

Puerto Rico y las Islas Vírgenes de los Estados Unidos sienten esta tensión de manera aguda, ya que ambos territorios estadounidenses dependen del turismo para generar ingresos y proporcionar empleos.Cada vez más, los lugareños han comenzado a preguntarse si vale la pena arriesgarse a dar la bienvenida a los turistas.El turismo representa más de la mitad del producto interno bruto de las Islas Vírgenes. En Puerto Rico, la industria representa 80,000 empleos y aproximadamente el 6.5% de la economía total de la isla.Pero los isleños no sólo son vulnerables a los trastornos económicos de erectile dysfunction treatment. A los residentes tanto de Puerto Rico como de las Islas Vírgenes se les diagnostica condiciones de salud crónicas como diabetes y enfermedades cardiovasculares en tasas más altas que en la mayoría de los estados continentales, lo que los pone en mayor riesgo de desarrollar complicaciones si contraen el viagra.En resumen, la misma industria que representa un salvavidas económico para los isleños amenaza su capacidad de proteger su salud.Un paso adelanteCuando erectile dysfunction treatment impactó a fines del invierno, Puerto Rico y las Islas Vírgenes adoptaron sólidas estrategias de prevención, incluso antes que la mayoría de los estados continentales.En Puerto Rico, la gobernadora Wanda Vázquez emitió una orden ejecutiva el 15 de marzo, que literalmente cerró la isla al imponer un toque de queda, una orden de quedarse en casa y cierres de negocios. Los primeros casos de erectile dysfunction se reportaron allí el 13 de marzo.De igual manera, el gobernador de las Islas Vírgenes, Albert Bryan Jr., emitió órdenes ejecutivas que prohibieron que hoteles, villas y otros alojamientos aceptaran huéspedes por placer entre el 25 de marzo y el 1 de junio.El área permaneció abierta a viajeros de negocios, tripulaciones de vuelos, funcionarios de salud, personal de emergencia, residentes e invitados del gobierno. Según una actualización del 20 de marzo del Departamento de Salud, el territorio tenía, en ese momento, seis casos confirmados de erectile dysfunction treatment y 43 resultados de pruebas pendientes.Sin embargo, ninguno de los territorios pudo cerrar sus aeropuertos.

Los funcionarios locales no tienen la autoridad para hacerlo porque el gobierno federal regula la aviación.“Parte del desafío de ser una colonia de los Estados Unidos es que, ya sabes, my site no tenemos control sobre nuestras fronteras”, dijo Hadiya Sewer, presidenta y cofundadora de St. JanCo. The St John Heritage Collective , una organización de preservación del patrimonio cultural y derechos territoriales en la pequeña isla de St. John, parte de las Islas Vírgenes.Aún así, las medidas agresivas, aunque efectivas, se cobraron un precio para residentes como Melina Aguilar.Antes del cierre, la emprendedora de 31 años trabajaba como guía turística para Isla Caribe, una empresa que fundó y que ofrece recorridos históricos a pie por Ponce, Puerto Rico. La orden de quedarse en casa en marzo cerró el negocio de Aguilar durante tres meses.Aguilar dijo que el sacrificio habría valido la pena si la isla hubiera podido mantener el control de la propagación al cerrar la frontera y hacer cumplir la cuarentena de 14 días para los viajeros.

Pero no funcionó de esa manera. Según datos de The New York Times, el promedio de casos al 1 de mayo, mientras Puerto Rico todavía estaba cerrado, fue de 42 por día. El 1 de julio, 102 casos. Para el 15 de julio, 233.Reabriendo las puertasPara el verano, ambos territorios estaban ansiosos por reabrir negocios. Con muchos destinos de vacaciones en el extranjero prohibiendo la entrada de los viajeros estadounidenses, parecía que el continente cercano estaría lleno de bañistas que, después de vivir bajo órdenes de quedarse en casa durante meses, estarían listos para viajar, sin necesidad de pasaporte, a disfrutar del sol y la arena.Las Islas Vírgenes de los Estados Unidos recibieron formalmente a los turistas de regreso a sus costas el 1 de junio, con salvedades.

Los viajeros de los “zonas rojas” del erectile dysfunction debían enviar la información de la prueba erectile dysfunction treatment a través de un portal en línea para recibir un “código de certificación” de resultado negativo.Aquéllos que no lo hicieron tuvieron que ponerse en cuarentena durante 14 días o hasta que tuvieran documentación de un resultado negativo de la prueba.Pero tanto los lugareños como los turistas dijeron que las medidas de aplicación de erectile dysfunction treatment no han sido consistentes. El capitán Matthias Bitterwolf, propietario de Antillean Yacht Charters en St. Thomas, dijo que entregó un bote a Puerto Rico y no se le permitió salir del barco hasta que la policía local pudiera verificar su documentación de erectile dysfunction treatment. Su estatus para erectile dysfunction treatment no fue verificado al regresar a St. Thomas.Los recuentos de casos de las Islas Vírgenes pronto comenzaron a aumentar.

Entre junio y mediados de julio, aumentó en más de 3,500%, según un informe de NBC.El gobernador Bryan respondió emitiendo otras órdenes ejecutivas para recuperar el control del brote, incluida la prohibición de las visitas a la playa después de las 4 pm y no permitir que los clientes se paren o coman en los bares de los restaurantes. Al 24 de agosto, las Islas Vírgenes tenían un total de 984 casos positivos de erectile dysfunction treatment y 11 muertes.Puerto Rico dio la bienvenida formalmente a los turistas el 15 de julio sin dejar de imponer algunas restricciones relacionadas con erectile dysfunction treatment. Al igual que en las Islas Vírgenes, los funcionarios exigieron a los viajeros que presentaran documentación de un resultado negativo de la prueba para erectile dysfunction treatment a su llegada.El doctor Víctor Ramos, presidente de la asociación médica de la isla que está involucrado con el grupo de trabajo médico de Puerto Rico, dijo que estas decisiones expusieron de alguna manera las diferencias “entre el grupo de trabajo médico que favorece el cierre y el grupo de trabajo económico que quiere dejar todo abierto”.En julio, la economía local estaba en ruinas. El Departamento de Trabajo informó que más del 21% de la fuerza laboral de la isla estaba recibiendo asistencia por desempleo relacionada con la pandemia en la semana que terminó el 1 de agosto.Pero el creciente número de casos atribuidos a los viajeros llevó a los funcionarios locales a alentar que sólo se permitieran los viajes esenciales. Hasta el 24 de agosto, la isla había registrado más de 30,700 casos de erectile dysfunction treatment y al menos 395 muertes, según la base de datos de The New York Times.Sin embargo, los datos del gobierno indicaron que el aumento de casos en Puerto Rico no había sido causado por turistas.

Ellos no son los culpables, insistió Leah Chandler, directora de marketing de Discover Puerto Rico, el sitio oficial de turismo de la isla en internet. Más bien, la propagación se relacionó con los residentes de la isla que regresaban a casa después de visitar puntos calientes de erectile dysfunction treatment como Texas y Florida.A pesar de la pandemia mundial y las restricciones, ambos territorios no han experimentado escasez de veraneantes. €œHabríamos esperado que éste fuera un momento lento en términos de turismo”, dijo Sewer. €œPero estamos muy ocupado”.Aún así, los recuentos de casos de erectile dysfunction treatment no se movían en la dirección correcta en ninguno de los territorios, por lo que no fue una sorpresa cuando Puerto Rico cerró días después de la reapertura y las Islas Vírgenes hicieron lo mismo el 19 de agosto.Los problemas socioeconómicos y de salud subyacentes ponen a los residentes en ambos lugares en alto riesgo. No se trata solo de la prevalencia de enfermedades crónicas como la diabetes y las enfermedades cardiovasculares.

El elevado número de hogares multigeneracionales en ambas áreas complica la capacidad de una familia para distanciarse socialmente de sus miembros más vulnerables.Aproximadamente una cuarta parte de la población de Puerto Rico y las Islas Vírgenes tiene 65 años o más, y la pobreza es generalizada.Además, ambos territorios tienen una infraestructura de atención médica limitada, lo que dificulta imaginar que puedan cuidar a sus propias poblaciones en una emergencia, y mucho menos a los visitantes que podrían enfermarse e ir a la isla si el viagra aumentara.Actualmente, las Islas Vírgenes de los Estados Unidos tiene dos hospitales principales, uno en St. Thomas y otro en St. Croix, y una clínica de salud en St. John. El territorio cuenta con 20 camas de unidades de cuidados intensivos y alrededor de 100 ventiladores individuales para sus 106,235 residentes, dijo Justa Encarnación, comisionada de salud de las Islas Vírgenes.

Cada isla tiene alrededor de 30 ventiladores de capacidad total.En Puerto Rico, alrededor del 60% de los ventiladores de la isla para adultos estaban disponibles el 24 de agosto. Sin embargo, las camas de terapias intensiva son más difíciles de conseguir, dijo Ramos. Están llenas de pacientes con erectile dysfunction treatment y de aquéllos cuyas condiciones empeoraron después de evitar la atención por temor a contraer el viagra, dijo.La serie de problemas que han asolado a estas islas magnifica los efectos de la pandemia. Eso incluye crisis de deuda y daños a la infraestructura por huracanes y terremotos. Los residentes también temen la posibilidad de luchar contra un huracán y un brote de erectile dysfunction al mismo tiempo.Los investigadores de huracanes de la Universidad Estatal de Colorado predicen una temporada de huracanes en el Atlántico 2020 “extremadamente activa”.“En este punto, literalmente tenemos desastres superpuestos”, expresó Sewer, de St.

John’s Collective.Aún así, Joseph Boschulte, comisionado de turismo de las Islas Vírgenes, es cautelosamente optimista sobre encontrar un equilibrio entre los intereses económicos y de salud.“Apreciamos las preocupaciones de nuestros socios turísticos y partes interesadas”, dijo. Pero con el aumento en los casos, dijo, “debemos hacer un balance, salvaguardar la vida humana y prepararnos para reiniciar nuestra economía turística más adelante”. Chaseedaw Giles. cgiles@kff.org, @cgonsocial Carmen Heredia Rodriguez. CarmenH@kff.org, @ByCHRodriguez Related Topics Noticias En Español Public Health States erectile dysfunction treatment Latinos Natural Disasters Puerto Rico.

A new mail order viagra study in mice helps explain why gut microbiomes of breastfed infants can differ greatly from those of formula-fed infants.The study, "Dietary Sphinganine Is Selectively Assimilated by Members of the Mammalian Gut Microbiome," was published in July in the viagra online in canada Journal of Lipid Research.Sphinganine from milk Johnson Lab/Provided A new technique allows researchers to track specific nutrients as they are taken up by gut microbes in a mouse's digestive tract. The image shows certain microbes (red) taking in viagra online in canada a nutrient common in human milk called sphinganine. Blue microbes have not taken it in.The paper describes an innovative technique developed at Cornell to track the fate of metabolites -- nutrients formed in or necessary for metabolism -- through a mouse's digestive tract and identify how they interact with specific gut microbes."We think the methods are expandable to many different microbiome systems," said senior author Elizabeth Johnson, assistant professor of nutritional sciences in the College of Agriculture and Life Sciences.

She noted that researchers investigating effects of viagra online in canada a high-fat vs. Low-fat diet, or a keto diet, might use the technique to track metabolites.The methodology could reveal how specific metabolites promote specific bacteria. This could allow nutritionists to prescribe that patients eat foods containing specific metabolites to intentionally change viagra online in canada the composition of their microbiomes, Johnson said.

advertisement Human milk and many other foods contain a class of lipid metabolites called sphingolipids. Previous research suggested that these metabolites help shape an infant's microbiome, but it was not known if they actually interact with the microbiome.The study identified two types of gut microbes, Bacteroides and Bifidobacterium, that viagra online in canada use sphingolipids for their own metabolism.While very little is known about the specific roles of gut microbes in human health, Bacteroides have been implicated in both beneficial and not-so-beneficial effects, depending on context. They are generally associated with microbiomes of healthy breastfed infants.

Bifidobacterium, shown for the first time in this study to process dietary sphingolipids, are considered the quintessential beneficial bacteria, comprising up to 95% of breastfed infants microbiome.They're also a highly popular over-the-counter probiotic."Our lab is very interested viagra online in canada in how the diet interacts with the microbiome in order to really understand how you can best modulate it to have positive effects on health," Johnson said. "In this study, we were able to see that yes, these dietary lipids that are a big part of [breastfed] infants diets, are interacting quite robustly with the gut microbiome."Sphingolipids originate from three main sources. Diet.

Bacteria that can produce them. And most host tissues. advertisement Johnson, along with first author Min-Ting Lee, a doctoral student, and Henry Le, a postdoctoral researcher, both in Johnson's lab, created a technique to specifically track dietary sphingolipids as they passed through the mouse gut."We custom synthesized the sphingolipid we added to the diet," Johnson said.

"It is almost identical to ones derived from breast milk but with a small chemical tag so we could trace the location of the sphingolipid once it was ingested by the mice."Lee then used a fluorescent label that attached to cells or microbes that absorbed the tagged lipid, such that any bacteria that had taken up sphingolipids lit up red. Microbes from the mice's microbiomes were then isolated and analyzed. Populations with red microbes were separated from the others, and these were then genetically sequenced to identify the species of bacteria.With further investigation, Le was able to identify the metabolites that Bacteroides and Bifidobacterium produce when exposed to dietary sphingolipids.

Further investigations are underway to determine whether these microbially-produced metabolites are beneficial for infant health.Johnson recently received a five-year, $1.9 million Maximizing Investigators' Research Award from the National Institutes of Health (NIH) to expand on this work, to better understand how lipid-dependent host-microbe interactions affect human health..The study was supported by seed funds from the Genomics Facility of the Biotechnology Resource Center at Cornell's Institute of Biotechnology. Story Source. Materials provided by Cornell University.

Original written by Krishna Ramanujan. Note. Content may be edited for style and length.SOBRE NOTICIAS EN ESPAÑOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos.

Use Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles). “¿Qué actividades se pueden hacer la próxima semana?. €, pregunta un usuario de Facebook.“¡Quedarse en casa!.

€, responde otro usuario. El grupo de Facebook llamado “¿Qué está pasando en St. Thomas?.

€ se ha visto inundado de comentarios mordaces que instan a los viajeros a mantenerse alejados. Es un cambio fuerte. Antes de la pandemia, los intercambios entre turistas y residentes de la isla significaban promesas de diversión.

Ahora, los operadores turísticos del continente que administran la página de Facebook intentan eliminar rápido cualquier expresión de enojo.En la cercana Puerto Rico, la fricción se ha extendido a la vida real. Informes de medios de comunicación han detallado varios episodios en los que los turistas, escapando de las restricciones pandémicas en sus países de origen, se volvieron violentos y destruyeron mercadería cuando se les pidió que usaran máscara dentro de tiendas.La pandemia de erectile dysfunction treatment ha enfrentado los intereses económicos con las guías de salud pública en todo Estados Unidos. Puerto Rico y las Islas Vírgenes de los Estados Unidos sienten esta tensión de manera aguda, ya que ambos territorios estadounidenses dependen del turismo para generar ingresos y proporcionar empleos.Cada vez más, los lugareños han comenzado a preguntarse si vale la pena arriesgarse a dar la bienvenida a los turistas.El turismo representa más de la mitad del producto interno bruto de las Islas Vírgenes.

En Puerto Rico, la industria representa 80,000 empleos y aproximadamente el 6.5% de la economía total de la isla.Pero los isleños no sólo son vulnerables a los trastornos económicos de erectile dysfunction treatment. A los residentes tanto de Puerto Rico como de las Islas Vírgenes se les diagnostica condiciones de salud crónicas como diabetes y enfermedades cardiovasculares en tasas más altas que en la mayoría de los estados continentales, lo que los pone en mayor riesgo de desarrollar complicaciones si contraen el viagra.En resumen, la misma industria que representa un salvavidas económico para los isleños amenaza su capacidad de proteger su salud.Un paso adelanteCuando erectile dysfunction treatment impactó a fines del invierno, Puerto Rico y las Islas Vírgenes adoptaron sólidas estrategias de prevención, incluso antes que la mayoría de los estados continentales.En Puerto Rico, la gobernadora Wanda Vázquez emitió una orden ejecutiva el 15 de marzo, que literalmente cerró la isla al imponer un toque de queda, una orden de quedarse en casa y cierres de negocios. Los primeros casos de erectile dysfunction se reportaron allí el 13 de marzo.De igual manera, el gobernador de las Islas Vírgenes, Albert Bryan Jr., emitió órdenes ejecutivas que prohibieron que hoteles, villas y otros alojamientos aceptaran huéspedes por placer entre el 25 de marzo y el 1 de junio.El área permaneció abierta a viajeros de negocios, tripulaciones de vuelos, funcionarios de salud, personal de emergencia, residentes e invitados del gobierno.

Según una actualización del 20 de marzo del Departamento de Salud, el territorio tenía, en ese momento, seis casos confirmados de erectile dysfunction treatment y 43 resultados de pruebas pendientes.Sin embargo, ninguno de los territorios pudo cerrar sus aeropuertos. Los funcionarios locales no tienen la autoridad para hacerlo porque el gobierno federal regula la aviación.“Parte del desafío de ser una colonia de los Estados Unidos es que, ya sabes, no tenemos control sobre nuestras fronteras”, dijo Hadiya Sewer, presidenta y cofundadora de St. JanCo.

The St John Heritage Collective , una organización de preservación del patrimonio cultural y derechos territoriales en la pequeña isla de St. John, parte de las Islas Vírgenes.Aún así, las medidas agresivas, aunque efectivas, se cobraron un precio para residentes como Melina Aguilar.Antes del cierre, la emprendedora de 31 años trabajaba como guía turística para Isla Caribe, una empresa que fundó y que ofrece recorridos históricos a pie por Ponce, Puerto Rico. La orden de quedarse en casa en marzo cerró el negocio de Aguilar durante tres meses.Aguilar dijo que el sacrificio habría valido la pena si la isla hubiera podido mantener el control de la propagación al cerrar la frontera y hacer cumplir la cuarentena de 14 días para los viajeros.

Pero no funcionó de esa manera. Según datos de The New York Times, el promedio de casos al 1 de mayo, mientras Puerto Rico todavía estaba cerrado, fue de 42 por día. El 1 de julio, 102 casos.

Para el 15 de julio, 233.Reabriendo las puertasPara el verano, ambos territorios estaban ansiosos por reabrir negocios. Con muchos destinos de vacaciones en el extranjero prohibiendo la entrada de los viajeros estadounidenses, parecía que el continente cercano estaría lleno de bañistas que, después de vivir bajo órdenes de quedarse en casa durante meses, estarían listos para viajar, sin necesidad de pasaporte, a disfrutar del sol y la arena.Las Islas Vírgenes de los Estados Unidos recibieron formalmente a los turistas de regreso a sus costas el 1 de junio, con salvedades. Los viajeros de los “zonas rojas” del erectile dysfunction debían enviar la información de la prueba erectile dysfunction treatment a través de un portal en línea para recibir un “código de certificación” de resultado negativo.Aquéllos que no lo hicieron tuvieron que ponerse en cuarentena durante 14 días o hasta que tuvieran documentación de un resultado negativo de la prueba.Pero tanto los lugareños como los turistas dijeron que las medidas de aplicación de erectile dysfunction treatment no han sido consistentes.

El capitán Matthias Bitterwolf, propietario de Antillean Yacht Charters en St. Thomas, dijo que entregó un bote a Puerto Rico y no se le permitió salir del barco hasta que la policía local pudiera verificar su documentación de erectile dysfunction treatment. Su estatus para erectile dysfunction treatment no fue verificado al regresar a St.

Thomas.Los recuentos de casos de las Islas Vírgenes pronto comenzaron a aumentar. Entre junio y mediados de julio, aumentó en más de 3,500%, según un informe de NBC.El gobernador Bryan respondió emitiendo otras órdenes ejecutivas para recuperar el control del brote, incluida la prohibición de las visitas a la playa después de las 4 pm y no permitir que los clientes se paren o coman en los bares de los restaurantes. Al 24 de agosto, las Islas Vírgenes tenían un total de 984 casos positivos de erectile dysfunction treatment y 11 muertes.Puerto Rico dio la bienvenida formalmente a los turistas el 15 de julio sin dejar de imponer algunas restricciones relacionadas con erectile dysfunction treatment.

Al igual que en las Islas Vírgenes, los funcionarios exigieron a los viajeros que presentaran documentación de un resultado negativo de la prueba para erectile dysfunction treatment a su llegada.El doctor Víctor Ramos, presidente de la asociación médica de la isla que está involucrado con el grupo de trabajo médico de Puerto Rico, dijo que estas decisiones expusieron de alguna manera las diferencias “entre el grupo de trabajo médico que favorece el cierre y el grupo de trabajo económico que quiere dejar todo abierto”.En julio, la economía local estaba en ruinas. El Departamento de Trabajo informó que más del 21% de la fuerza laboral de la isla estaba recibiendo asistencia por desempleo relacionada con la pandemia en la semana que terminó el 1 de agosto.Pero el creciente número de casos atribuidos a los viajeros llevó a los funcionarios locales a alentar que sólo se permitieran los viajes esenciales. Hasta el 24 de agosto, la isla había registrado más de 30,700 casos de erectile dysfunction treatment y al menos 395 muertes, según la base de datos de The New York Times.Sin embargo, los datos del gobierno indicaron que el aumento de casos en Puerto Rico no había sido causado por turistas.

Ellos no son los culpables, insistió Leah Chandler, directora de marketing de Discover Puerto Rico, el sitio oficial de turismo de la isla en internet. Más bien, la propagación se relacionó con los residentes de la isla que regresaban a casa después de visitar puntos calientes de erectile dysfunction treatment como Texas y Florida.A pesar de la pandemia mundial y las restricciones, ambos territorios no han experimentado escasez de veraneantes. €œHabríamos esperado que éste fuera un momento lento en términos de turismo”, dijo Sewer.

€œPero estamos muy ocupado”.Aún así, los recuentos de casos de erectile dysfunction treatment no se movían en la dirección correcta en ninguno de los territorios, por lo que no fue una sorpresa cuando Puerto Rico cerró días después de la reapertura y las Islas Vírgenes hicieron lo mismo el 19 de agosto.Los problemas socioeconómicos y de salud subyacentes ponen a los residentes en ambos lugares en alto riesgo. No se trata solo de la prevalencia de enfermedades crónicas como la diabetes y las enfermedades cardiovasculares. El elevado número de hogares multigeneracionales en ambas áreas complica la capacidad de una familia para distanciarse socialmente de sus miembros más vulnerables.Aproximadamente una cuarta parte de la población de Puerto Rico y las Islas Vírgenes tiene 65 años o más, y la pobreza es generalizada.Además, ambos territorios tienen una infraestructura de atención médica limitada, lo que dificulta imaginar que puedan cuidar a sus propias poblaciones en una emergencia, y mucho menos a los visitantes que podrían enfermarse e ir a la isla si el viagra aumentara.Actualmente, las Islas Vírgenes de los Estados Unidos tiene dos hospitales principales, uno en St.

Thomas y otro en St. Croix, y una clínica de salud en St. John.

El territorio cuenta con 20 camas de unidades de cuidados intensivos y alrededor de 100 ventiladores individuales para sus 106,235 residentes, dijo Justa Encarnación, comisionada de salud de las Islas Vírgenes. Cada isla tiene alrededor de 30 ventiladores de capacidad total.En Puerto Rico, alrededor del 60% de los ventiladores de la isla para adultos estaban disponibles el 24 de agosto. Sin embargo, las camas de terapias intensiva son más difíciles de conseguir, dijo Ramos.

Están llenas de pacientes con erectile dysfunction treatment y de aquéllos cuyas condiciones empeoraron después de evitar la atención por temor a contraer el viagra, dijo.La serie de problemas que han asolado a estas islas magnifica los efectos de la pandemia. Eso incluye crisis de deuda y daños a la infraestructura por huracanes y terremotos. Los residentes también temen la posibilidad de luchar contra un huracán y un brote de erectile dysfunction al mismo tiempo.Los investigadores de huracanes de la Universidad Estatal de Colorado predicen una temporada de huracanes en el Atlántico 2020 “extremadamente activa”.“En este punto, literalmente tenemos desastres superpuestos”, expresó Sewer, de St.

John’s Collective.Aún así, Joseph Boschulte, comisionado de turismo de las Islas Vírgenes, es cautelosamente optimista sobre encontrar un equilibrio entre los intereses económicos y de salud.“Apreciamos las preocupaciones de nuestros socios turísticos y partes interesadas”, dijo. Pero con el aumento en los casos, dijo, “debemos hacer un balance, salvaguardar la vida humana y prepararnos para reiniciar nuestra economía turística más adelante”. Chaseedaw Giles.

cgiles@kff.org, @cgonsocial Carmen Heredia Rodriguez. CarmenH@kff.org, @ByCHRodriguez Related Topics Noticias En Español Public Health States erectile dysfunction treatment Latinos Natural Disasters Puerto Rico.