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Current status where to buy kamagra. OpenOpened for input from May 10, 2021 to July 12, 2021.Drug-device combination products (DDCPs) are health products that combine one or more drug components with one or more medical device components into one single integrated product. Health Canada is updating where to buy kamagra its policy on DDCPs to provide more detail and clarity on the classification and regulation of these products. As the first step, an Issue Identification Paper has been drafted to capture the outstanding issues with the current version of the policy.Join in.

How to participateReview the issue identification where to buy kamagra paper:Drug-Device Combination Products (DDCPs) Issue Identification Paper Send us your input by email. Hc.policy.bureau.enquiries.sc@canada.caWho is the focus of this consultationHealth Canada aims to engage with. Manufacturers importers health system partnersKey questions for discussionThrough this consultation, Health Canada wants to make where to buy kamagra sure that key stakeholders. Are aware of this initiative to update the policy on drug-device combination productshave the opportunity to identify any concerns they have with the current version of the policyWe are seeking your input on the following themes.

Classifying drug-device combination products assigning an appropriate single regulatory pathwayestablishing suitable authorization requirementsThe information gathered from this process will help to create a shared understanding of the issues associated with the existing policy and where to buy kamagra will inform the policy work to support its update.Related information Contact usContact us by email. Hc.policy.bureau.enquiries.sc@canada.caDate published. May 7, 2021On this page Purpose and backgroundHealth Canada regulates the sale and import of medical devices, including commercial testing devices where to buy kamagra related to erectile dysfunction treatment.As noted elsewhere, Health Canada has made it a priority to review applications for erectile dysfunction treatment devices that meet an urgent public health need in Canada. These devices are needed immediately to protect or improve the health of Canadians, whether at the individual or community level.The purpose of this notice is to communicate the types of testing technologies that Health Canada considers are a priority for review.Only commercial testing devices that we have authorized can be advertised, imported or sold in Canada.

Unauthorized tests may where to buy kamagra not produce accurate results, leading to potential misdiagnosis. Authorized erectile dysfunction treatment tests are well supported by evidence that shows they will provide accurate and reliable results.Technologies that are a priorityWorking with our public health partners, we have identified the following testing technologies as being of the highest priority for evaluation at this time. Self-testing devices point-of-care antigen or molecular testing devices that use nasal swab or saliva samples for use in symptomatic and asymptomatic populations administered by trained operators (rather than health care professionals) asymptomatic populations are people who do not display erectile dysfunction treatment symptoms at the time of testing (see the guide on erectile dysfunction treatment signs, symptoms and severity of disease) to add to clinical trial populations, asymptomatic people may include those who have recently had contact with someone diagnosed with erectile dysfunction treatment (applicants are encouraged to contact us before designing a clinical trial to ensure appropriate populations are included and adequately characterized) We welcome new applications for these types of tests, as well as applications to amend authorized tests to include these new features.Applicants should provide direct evidence or scientific justification if appropriate. Scientific justification could include scientific articles on the performance of an applicant's device or highly similar device by trained operators, or in sample asymptomatic populations.Applicants are invited to consider strategies to strengthen the performance of their device where to buy kamagra for its claimed indications.

Strategies may include. Serial testing strategies paired testing strategies clarification of how the intended purpose of the testing device meets specific public health goalsThese where to buy kamagra strategies could likewise be supported by direct evidence or scientific justification, if appropriate.Other technologies that are a priority include. Point-of-care antigen tests that do not use only nasopharyngeal (NP) swab samples, or may be used in asymptomatic people or may be administered by trained operators point-of-care molecular tests that do not use only NP swab samples, or may be used in asymptomatic people or may be administered by trained operators tests designed to address emerging variants tests that offer new or unique advantages compared to other tests of the same type novel diagnostic technologies that may use alternative samples, such as breath, or a different analytical approachWe may review the types of applications or tests that we are prioritizing at any time to ensure our focus continues to reflects Canadian public health priorities.Technologies that are not prioritized for reviewTo ensure that the number and types of authorized testing technologies is aligned with the public health need, Health Canada has been prioritizing certain tests. Given the number of tests already authorized, as well as current public health needs, the following testing technologies are now considered to where to buy kamagra be of less priority.

Lab-based molecular tests that do not use saliva samples or otherwise offer new or unique advantages point-of-care antigen or molecular tests that use only NP swab samples lab-based and point-of-care serology testsThis means that these files will be advanced as quickly as can be enabled once the priority tests have been addressed. Identifying a file as being of lower priority may occur at any point after we where to buy kamagra receive an application. Often, when we "deprioritize" a file, it means that we will address such applications while we wait for information from an applicant for a priority test. Thus, it will take us longer to process applications for deprioritized tests than for priority tests.Access to testing devices for erectile dysfunction treatmentEarly diagnosis is critical to where to buy kamagra slowing and reducing the spread of erectile dysfunction treatment in Canada.

As part of the government's broad response to the kamagra, Health Canada introduced a number of agile regulatory measures to expedite the regulatory review of erectile dysfunction treatment health products. These measures do not compromise Canada's where to buy kamagra safety, efficacy and quality standards. We are committed to getting Canadians access to the tools they need to fight the spread of erectile dysfunction treatment in Canada.We have authorized a number of erectile dysfunction treatment tests and continue to expedite the review of testing device submissions. For more information on the authorization process for erectile dysfunction treatment testing devices, please consult testing devices for erectile dysfunction treatment..

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They will each bring a unique blend of expertise and experience which will prove invaluable at this pivotal moment for our profession. Serving on the IBMS’s governing body is a fantastic opportunity to drive change in IBMS policy, interact and kamagra fast reviews engage with colleagues across the country and gain new knowledge and skills. I look forward to working with you all as we look to serve the needs of our members and provide a voice for the profession.” Four New Council Members Dr Sarah Pitt – National 1. What does being an IBMS Council Member mean to you?. It kamagra fast reviews is a privilege to have been elected to the Council and to contribute to the work the IBMS.

2. If you could only address one issue on behalf of the profession what would it be?. To encourage members to be thoughtful and kamagra fast reviews confident as professionals and for greater recognition of the contribution that our members make to healthcare and medical science. 3. Why do you think it is important to engage with the IBMS?.

The IBMS is run by and for its members kamagra fast reviews. Everyone has ideas and skills and talents to share. If you engage with the IBMS, you can help to influence its work. Tahmina Hussain – National 1 kamagra fast reviews. What does being an IBMS Council Member mean to you?.

Being an IBMS Council Member is the greatest achievement in my career journey so far. I’d like kamagra fast reviews to express my gratitude to all the members who voted for me. Being a council member is a valuable opportunity to contribute towards the representation of all communities and ensure diversity within our profession. Breaking down barriers will create opportunities, new approaches and ideas that are more inclusive of all backgrounds and bring new perspectives and experiences to the IBMS, which ultimately contribute towards successful recognition of the diversity within the profession and benefit our members. 2.

If you could only address one issue on behalf of who can buy kamagra the profession, what would it be? kamagra fast reviews. Helping graduates secure placements or trainee positions in order to gain work experience and achieve the Certificate of Competence to become HCPC registered I want to help the IBMS liaise more closely with universities to strengthen the current relationship with laboratories. Helping to incorporate practical learning into the syllabus and ensuring students put laboratory techniques into context with the theoretical knowledge. Ultimately, this will improve opportunities kamagra fast reviews and facilitate employability. 3.

Why do you think it is important to engage with the IBMS?. The IBMS provides the opportunity to develop a relationship kamagra fast reviews and network with members in the wider community. Being on IBMS Council is not only a fantastic opportunity to influence science policy, but also support the professional development of IBMS members and raise the profile of professionalism in science. Angela Jean-Francois – London 1. What does being an kamagra fast reviews IBMS Council Member mean to you?.

I have been involved in the IBMS since 2009 as a member of the Immunology Specialist Advisory panel serving in different roles over the years. As I have progressed in my career, it has been a natural progression to apply for IBMS Council. Representing the London kamagra fast reviews region. I will bring over 22 years of experience as a practicing Biomedical Scientist in an NHS Clinical Pathology service, and I want to provide as much support as possible to the IBMS and our members. 2.

If you could only address one issue on behalf of the profession, what kamagra fast reviews would it be?. Ensuring equality and diversity is at the forefront of the profession and to promote and develop our members to the best of their abilities, building upon the awareness developed through the kamagra to promote the fantastic work that we do. 3. Why do you think it is important to engage with the kamagra fast reviews IBMS?. As the professional body for biomedical science, it is really important that the IBMS hears the voice of its members.

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5 July 2021 The http://www.ec-erlenberg-bischwiller.ac-strasbourg.fr/wp/?p=2331 Queen has awarded the George Cross to the National Health Services of the UK, recognising all NHS staff in all four nations In a personal, handwritten message to award the George Cross to the National Health Service (NHS), the Queen said that NHS staff have carried out their work “with courage, compassion and dedication” for where to buy kamagra more than 70 years. In her message, the Queen also wrote. It is with great pleasure, on behalf of a grateful nation, that I award the George Cross to the National Health Services of the United Kingdom.

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The George Cross is the civilian equivalent where to buy kamagra of the Victoria Cross, the highest award for gallantry.Welcoming the honour, IBMS Chief Executive David Wells said. It is good to see the great work and huge sacrifices made to ensure that we emerge from the kamagra rewarded by the Queen. Testing numbers in the NHS have continued at the same volumes since the height of the last peak - meaning that many Biomedical and Clinical Scientists have been working at the same pace since March 2020.

The biomedical science profession where to buy kamagra has made a huge and vital part of the NHS effort for which the George Cross is recognition. This marks only the third occasion on which the George Cross, which may be awarded posthumously, has been awarded to a collective body, country or organisation, rather than an individual. In 1942, the George Cross was conferred on Malta by George VI, in recognition of the fortitude displayed by the island’s inhabitants during enemy bombardments in the Second World War.

And in 1999, the Queen awarded the George Cross to the Royal Ulster Constabulary in Northern Ireland, in recognition of the force’s bravery, including the families of those serving.Details of the presentation of the award will be confirmed at a later date.2 July 2021 At our Annual General Meeting (AGM) 2021, we announced the four new council members elected where to buy kamagra to council. Corporate Members recently voted in our Council elections and the results were announced at our Annual General Meeting last month. Dr Sarah Pitt and Tahmina Hussain were elected as national council members, while members chose Angela-Jean Francois as a London council member and Jennifer Collins for the North-East.

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Breaking down barriers will create opportunities, new approaches and ideas that are more inclusive of all backgrounds and bring new perspectives and experiences to the IBMS, which ultimately contribute towards successful recognition of the diversity within the profession and benefit our members. 2. If you could only address one issue on behalf of the profession, what would it be?.

Helping graduates secure placements or trainee positions in order to gain work experience and achieve the Certificate of Competence to become HCPC registered I want to help the IBMS liaise more closely with universities to strengthen the current relationship with laboratories. Helping to incorporate practical learning into the syllabus and ensuring students put laboratory techniques into context with the theoretical knowledge. Ultimately, this will improve opportunities and facilitate employability.

3. Why do you think it is important to engage with the IBMS?. The IBMS provides the opportunity to develop a relationship and network with members in the wider community.

Being on IBMS Council is not only a fantastic opportunity to influence science policy, but also support the professional development of IBMS members and raise the profile of professionalism in science. Angela Jean-Francois – London 1. What does being an IBMS Council Member mean to you?.

I have been involved in the IBMS since 2009 as a member of the Immunology Specialist Advisory panel serving in different roles over the years. As I have progressed in my career, it has been a natural progression to apply for IBMS Council.

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Tracking a person's change in cardiovascular risk over time modestly kamagra chewable tablets uk improved prediction of incident cardiovascular disease (CVD) and survival beyond a single risk estimate alone in primary prevention, a large study showed.Cardiovascular risk over nearly 20 years was better modeled when a repeat assessment at 5 years was added to earlier SCORE or ASCVD pooled cohort equations results:Harrell's find more information C index increased from 0.685 to 0.690 for SCORE. From 0.699 to 0.700 for ASCVDThe Akaike information criterion fell from 17,255 to 17,200 for SCORE kamagra chewable tablets uk. From 14,739 kamagra chewable tablets uk to 14,729 for ASCVDThe continuous net reclassification index was 0.353 for SCORE. 0.232 for ASCVD"These kamagra chewable tablets uk findings were not sensitive to competing risks, missing data, or inclusion of specific CVD outcomes, and the results were replicated in individuals who improved their SCORE and ASCVD risk scores without medication," reported Joni Lindbohm, MD, PhD, of University of Helsinki, Finland, and University College London, and colleagues.They took study results and developed an online calculator that estimates a person's CVD-free life-years as a function of two risk score measurements, the authors explained in the Lancet Digital Health.The analysis was based on the Whitehall II longitudinal cohort of several thousand government employees in London.Overall, the study supports the existing approach of tracking changes in cardiovascular risk over time based on known intervention effects."However, the approach has not been validated in intervention studies, does not aid in recommendation of a combination of lifestyle changes, and cannot be applied when no estimate of the effect of intervention exists as is the case when multiple lifestyle changes are combined. In these situations, measuring changes in risk scores could provide an alternative," the authors said.Their models showed that "commonly recommended lifestyle interventions might be insufficient to effectively prevent or delay the onset of cardiovascular events in most cases," as "clinically meaningful improvement in the risk scores would require substantial changes in lifestyle, such as quitting smoking, or a decrease in systolic blood pressure or total cholesterol similar to that achieved by low-intensity antihypertensive or statin therapy."Whitehall II participants included in the present analysis (n=7,574) underwent clinical examinations in 5-year intervals from 1991 to 2016, and were followed up for incident CVD until 2019.All had no history of CVD at baseline kamagra chewable tablets uk in 1991-1993, when they were ages 40-63.

Just under 70% were men.Over follow-up averaging 18.7 kamagra oral jelly canada price years, people tended kamagra chewable tablets uk to have SCORE and ASCVD risk scores rise over time.Ultimately, approximately one in five individuals developed CVD -- stroke, MI, coronary artery bypass grafting surgery, percutaneous coronary intervention, definite angina, heart failure, or peripheral artery disease -- according to linked electronic health records.Changing CVD risk scores were especially predictive of outcomes in younger people. For example, each 2-unit improvement in risk scores was associated with an additional 1.3 life-years free of CVD for SCORE and an additional 0.9 life-years for ASCVD -- but only an additional 0.4 life-years free of CVD for SCORE and 0.3 life-years for ASCVD, respectively, at age 65.Lindbohm's group acknowledged kamagra chewable tablets uk that Whitehall II is an occupational cohort of relatively healthy individuals compared with the general population. "This means that the incidence of disease and prevalence of risk factors are likely to kamagra chewable tablets uk be an underestimation of those in the general population," they stated.Another caveat of the study was its reliance on participants self-reporting variables (e.g., use of antihypertensive medications) on questionnaires. Nicole Lou is kamagra chewable tablets uk a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow Disclosures The Whitehall II study is funded by the Wellcome Trust, the UK Medical Research Council, the National Institute on Aging, and the British Heart Foundation.Lindbohm disclosed support from the kamagra chewable tablets uk Academy of Finland and NordForsk..

Tracking a person's change in cardiovascular risk over time modestly improved prediction of incident cardiovascular disease (CVD) and survival beyond a single risk estimate alone in primary prevention, a large study showed.Cardiovascular risk over where to buy kamagra nearly 20 years was better modeled when a repeat assessment at 5 years was added to earlier SCORE or ASCVD pooled cohort equations results:Harrell's C index increased from 0.685 to 0.690 for SCORE. From 0.699 to 0.700 for ASCVDThe Akaike information criterion fell from 17,255 to 17,200 where to buy kamagra for SCORE. From 14,739 where to buy kamagra to 14,729 for ASCVDThe continuous net reclassification index was 0.353 for SCORE. 0.232 for ASCVD"These findings were not sensitive to competing risks, missing data, or inclusion of specific CVD outcomes, and the results were replicated in individuals who improved their SCORE and ASCVD risk scores without medication," reported Joni Lindbohm, MD, PhD, of University of Helsinki, Finland, and University College London, and colleagues.They took study results and developed an online calculator that estimates a person's CVD-free life-years as a function of two risk score measurements, where to buy kamagra the authors explained in the Lancet Digital Health.The analysis was based on the Whitehall II longitudinal cohort of several thousand government employees in London.Overall, the study supports the existing approach of tracking changes in cardiovascular risk over time based on known intervention effects."However, the approach has not been validated in intervention studies, does not aid in recommendation of a combination of lifestyle changes, and cannot be applied when no estimate of the effect of intervention exists as is the case when multiple lifestyle changes are combined.

In these situations, measuring changes in risk scores could provide an alternative," the authors said.Their models showed that "commonly recommended lifestyle interventions might be insufficient to effectively prevent or delay the onset of cardiovascular events in most where to buy kamagra cases," as "clinically meaningful improvement in the risk scores would require substantial changes in lifestyle, such as quitting smoking, or a decrease in systolic blood pressure or total cholesterol similar to that achieved by low-intensity antihypertensive or statin therapy."Whitehall II participants included in the present analysis (n=7,574) underwent clinical examinations in 5-year intervals from 1991 to 2016, and were followed up for incident CVD until 2019.All had no history of CVD at baseline in 1991-1993, when they were ages 40-63. Just under 70% were men.Over where to buy kamagra follow-up averaging 18.7 years, people tended to have SCORE and ASCVD risk scores rise over time.Ultimately, approximately one in five individuals developed CVD -- stroke, MI, coronary artery bypass grafting surgery, percutaneous coronary intervention, definite angina, heart failure, or peripheral artery disease -- according to linked electronic health records.Changing CVD risk scores were especially predictive of outcomes in younger people. For example, each 2-unit improvement in risk scores was associated with an additional 1.3 life-years free of CVD for SCORE and an additional 0.9 life-years for ASCVD -- but only an additional 0.4 life-years free of CVD for SCORE where to buy kamagra and 0.3 life-years for ASCVD, respectively, at age 65.Lindbohm's group acknowledged that Whitehall II is an occupational cohort of relatively healthy individuals compared with the general population. "This means that the incidence of disease and prevalence of risk factors are likely to be an underestimation of those in the general population," they stated.Another caveat of the study was its reliance where to buy kamagra on participants self-reporting variables (e.g., use of antihypertensive medications) on questionnaires.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in where to buy kamagra medicine. Follow Disclosures The Whitehall II study is funded by the Wellcome Trust, the UK Medical Research Council, the National Institute on where to buy kamagra Aging, and the British Heart Foundation.Lindbohm disclosed support from the Academy of Finland and NordForsk..

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Last spring, New Jersey emergency room nurse Maritza Beniquez saw “wave after wave” of sick patients, each look at more info wearing a look of fear that kamagra shop review grew increasingly familiar as the weeks wore on. Soon, it was her colleagues at Newark’s University Hospital — the nurses, techs and doctors with whom she had been working side by side — who turned up in the ER, themselves struggling to breathe. €œSo many of our own co-workers got sick, kamagra shop review especially toward the beginning.

It literally decimated our staff,” she said. By the end of June, 11 of Beniquez’s colleagues were dead. Like the patients they had been treating, most were kamagra shop review Black and Latino.

€œWe were disproportionately affected because of the way that Blacks and Latinos in this country have been disproportionately affected across every [part of] our lives — from schools to jobs to homes,” she said. Now Beniquez feels like a vanguard of another kind. On Dec kamagra shop review.

14, she became the first person in New Jersey to receive the erectile dysfunction treatment — and was one of many medical workers of color featured prominently next to headlines heralding the treatment’s arrival at U.S. Hospitals. It was a joyous occasion, one that kindled the possibility of again seeing her parents and her 96-year-old grandmother, who live in kamagra shop review Puerto Rico.

But those nationally broadcast images were also a reminder of those for whom the treatment came too late. erectile dysfunction treatment has taken an outsize toll on Black and Hispanic Americans. And those disparities extend to the medical workers who have intubated them, cleaned their bedsheets and held their hands in their final days, a kamagra shop review KHN/Guardian investigation has found.

People of color account for about 65% of fatalities in cases in which there is race and ethnicity data. One recent study found health care workers of color were more than twice as likely as their white counterparts to test positive for the kamagra. They were kamagra shop review more likely to treat patients diagnosed with erectile dysfunction treatment, more likely to work in nursing homes — major erectile dysfunction hotbeds — and more likely to cite an inadequate supply of personal protective equipment, according to the report.

In a national sample of 100 cases gathered by KHN/The Guardian in which a health care worker expressed concerns over insufficient PPE before they died of erectile dysfunction treatment, three-quarters of the victims were identified as Black, Hispanic, Native American or Asian. €œBlack health care workers are more likely to want to go into public-sector care where they know that they will disproportionately treat communities of color,” said Adia Wingfield, a sociologist at Washington University in St. Louis who has studied racial inequality kamagra shop review in the health care industry.

€œBut they also are more likely to be attuned to the particular needs and challenges that communities of color may have,” she said. Not only do many Black health care staffers work in lower-resourced health centers, she said, they are also more likely to suffer from many of the same co-morbidities found in the general Black population, a legacy of systemic inequities. And they may fall victim kamagra shop review to lower standards of care.

Dr. Susan Moore, a 52-year-old Black pediatrician in Indiana, was hospitalized with erectile dysfunction treatment in November and, according to a video posted to her Facebook account, had to ask repeatedly for tests, remdesivir and pain medication. She said her white kamagra shop review doctor dismissed her complaints of pain and she was discharged, only to be admitted to another hospital 12 hours later.

Numerous studies have found Black Americans often receive worse medical care than their white counterparts. In March, a Boston biotech firm published an analysis showing physicians were less likely to refer symptomatic Black patients for erectile dysfunction tests than symptomatic whites. Doctors are also less likely kamagra shop review to prescribe painkillers to Black patients.

€œIf I was white, I wouldn’t have to go through that,” Moore said in the video posted from her hospital bed. €œThis is how Black people get killed, when you send them home, and they don’t know how to fight for themselves.” She died on Dec. 20 of erectile dysfunction treatment complications, her son Henry Muhammad told news kamagra shop review outlets.

Along with people of color, immigrant health workers have suffered disproportionate losses to erectile dysfunction treatment. More than one-third of health care workers to die of erectile dysfunction treatment in the U.S. Were born abroad, from the Philippines to Haiti, Nigeria and Mexico, according to a KHN/Guardian analysis of cases for kamagra shop review which there is data.

They account for 20% of health care workers in the U.S. Overall. Dr.

Ramon Tallaj, a physician and chairman of Somos, a nonprofit network of health care providers in New York, said immigrant doctors and nurses often see patients from their own communities — and many working-class, immigrant communities have been devastated by erectile dysfunction treatment. €œOur community is essential workers. They had to go to work at the beginning of the kamagra, and when they got sick, they would come and see the doctor in the community,” he said.

Twelve doctors and nurses in the Somos network have died of erectile dysfunction treatment, he said. Dr. Eriberto Lozada was an 83-year-old family physician in Long Island, New York.

He was still seeing patients out of his practice when cases began to climb last spring. Originally from the Philippines, a country with a history of sending skilled medical workers to the United States, he was proud to be a doctor and “proud to have been an immigrant who made good,” his son James Lozada said. Lozada’s family members remember him as strict and strong-willed — they affectionately called him “the king.” He instilled in his children the importance of a good education.

He died in April. Two of his four sons, John and James Lozada, are doctors. Both were vaccinated last month.

Considering all they had been through, John said, it was a “bittersweet” occasion. But he thought it was important for another reason — to set an example for his patients. The inequities in erectile dysfunction treatment s and deaths risk fueling distrust in the treatment.

In a recent Pew study, around 42% of Black respondents said they would “definitely or probably” get the treatment compared with 60% of the general population. This makes sense to Patricia Gardner, a Black, Jamaican-born nursing manager at Hackensack University Medical Center in New Jersey who has been infected with the erectile dysfunction along with family members and colleagues. €œA lot of what I hear is, ‘How is it that we weren’t the first to get the care, but now we’re the first to get vaccinated?.

€™â€ she said. Like Beniquez, the nurse in Newark, she was vaccinated on Dec. 14.

€œFor me to step up to say, ‘I want to be in the first group’ — I’m hoping that sends a message,” she said. Beniquez said she felt the weight of that responsibility when she signed on to be the first person in her state to receive the treatment. Many of her patients have expressed skepticism over the treatment, fueled, she said, by a health system that has failed them for years.

€œWe remember the Tuskegee trials. We remember the ‘appendectomies’” — reports that women were forcibly sterilized in a U.S. Immigration and Customs Enforcement detention center in Georgia.

€œThese are things that have happened to this community to the Black and Latino communities over the last century. As a health care worker, I have to recognize that their fears are legitimate and explain ‘This is not that,’” she said. Beniquez said her joy and relief over receiving the treatment are tempered by the reality of rising cases in the ER.

The adrenaline she and her colleagues felt last spring is gone, replaced by fatigue and wariness of the months ahead. Her hospital placed 11 trees in the lobby, one for each employee who has died of erectile dysfunction treatment. They have been adorned with remembrances and gifts from their colleagues.

There is one for Kim King-Smith, 53, the friendly EKG technician, who visited friends of friends or family whenever they ended up in the hospital. One for Danilo Bolima, 54, the nurse from the Philippines who became a professor and was the head of patient care services. One for Obinna Chibueze Eke, 42, the Nigerian nursing assistant, who asked friends and family to pray for him when he was hospitalized with erectile dysfunction treatment.

€œEach day, we remember our fallen colleagues and friends as the heroes who helped buy cheap kamagra oral jelly keep us going throughout this kamagra and beyond,” hospital president and CEO Dr. Shereef Elnahal said in a statement. €œWe can never forget their contributions and their collective passion for this community, and each other.” Just outside the building, stands a 12th tree.

€œIt’s going to be for whoever else we lose in this battle,” Beniquez said. This story is part of “Lost on the Frontline,” an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S. Who die from erectile dysfunction treatment, and to investigate why so many are victims of the disease.

If you have a colleague or loved one we should include, please share their story. Related Topics Contact Us Submit a Story TipAs I prepared to get my shot in mid-December as part of a erectile dysfunction treatment trial run by Janssen Pharmaceuticals, I considered the escape routes. Bailing out of the trial was a very real consideration since two other treatments, made by Moderna and Pfizer-BioNTech, had been deemed safe and effective for emergency approval.

Leaving the trial would be a perfectly sane decision for me or anyone who had volunteered for an ongoing erectile dysfunction treatment experiment. Why risk getting erectile dysfunction treatment if I was given a placebo, a shot with no treatment in it?. The way tests are designed, I might not be told whether I received the treatment until the clinical trial is over, months from now.

Dropping the placebo arm could also be ethically sound from the company’s point of view. Researchers frequently halt trials when they have a product that works — or manifestly doesn’t. And the two approved treatments are 95% effective.

That very real choice for thousands of people offering to join or remain in the ongoing treatment tests creates a conundrum for science and for society. If trials can’t go forward, that could very well have an impact on the world’s supply of erectile dysfunction treatments and eventually on treatment prices, especially if booster shots are needed in years to come. In markets where there are only two competing drugs, prices can shoot sky-high.

If there are four or five on the market, competition usually kicks in to control costs. In short, the welcome arrival of two erectile dysfunction treatments deemed safe has uncovered a series of ethical and logistical challenges. And it has governments, companies and scientists scrambling for solutions.

€œThe world’s treatment experts are saying the longer we can carry out a placebo-controlled trial the better,” Matthew Hepburn, who runs the treatment development arm of Operation Warp Speed, the multibillion-dollar federal program to fight erectile dysfunction treatment, told me. €œBut as a volunteer in the Janssen trial, you can always drop out.” As for the best way to resolve broader problems, “it’s a debate in real time,” he said. Generally, there are two aspects to the debate.

First, what should be done with placebo recipients of the Moderna and Pfizer trials now that it’s clear both shots prevent the disease and appear safe?. Second, how can the scores of companies in the United States and overseas that are still testing erectile dysfunction treatments adapt when there are apparently reliable products already on the market?. The FDA’s advisory committee debated the first question during two meetings in December.

They heard Stanford University statistician Steven Goodman argue in favor of a “double-blind crossover” modification of the Pfizer and Moderna trials. Everyone who got placebo shots in the trials would now get two doses of the real treatment, and vice versa. That way everyone would be protected but still “blind” as to when they were properly vaccinated.

Such a rejigger of the current trial would provide more data on the treatment’s safety and durability of protection, although the longer-term comparison of treatment versus placebo would be lost. It’s a marvelous idea in principle, the panelists agreed, but pretty hard to carry out. Neither Moderna nor Pfizer has agreed to it.

Pfizer wants to “unblind” placebo recipients of its treatment — to reveal they got the saline solution and give them the real thing — once their risk group gets its turn in line for the treatment. It has already started vaccinating health care workers who got the placebo. Moderna, which has thousands of soon-to-expire leftover doses from its trial, said it intends to unblind its trial and vaccinate all the placebo recipients.

In doing so, it would be recognizing the altruistic service the test subjects made to science and society by joining the trial. Another proposal would split the placebo recipients in the trial into two groups. In one group, everyone would get a single dose of the treatment.

In the other, each would get two doses. This would be a way of testing evidence that emerged during the Pfizer and Moderna trials that a single dose might provide sufficient protection. If that were true, vaccination of the country could happen nearly twice as fast, because there would be twice as many doses of treatment to go around.

No one knows to what extent the Food and Drug Administration could force the hands of the two companies, which still expect to get full licensure for their treatments this year. Moderna is considered more amenable to the suggestion since, unlike Pfizer, it got nearly $1 billion in federal funding to develop its treatment. Other treatment developers — including Operation Warp Speed participants Janssen (owned by Johnson &.

Johnson), AstraZeneca, Novavax, Sanofi and Merck &. Co. €” are closely watching to see which path is taken.

They are in a race against time — a race that may not end well for those running late in getting their treatment out. And halting those efforts could hurt billions of people elsewhere in the world whose lives and livelihoods will depend on the arrival of plentiful, cheap treatments. One problem is finding willing test subjects.

As increasing numbers of Americans are vaccinated, and the kamagra recedes from our shores, “the fewer the number of people eligible to participate in trials,” said Susan Ellenberg, professor of biostatistics at the University of Pennsylvania. For now, AstraZeneca and Janssen appear well situated. Both have closed enrollment in their U.S.

Trials and are likely to file within a few months for emergency use authorizations, like those that have allowed Moderna and Pfizer to start vaccinating the public. Novavax officials last week started their late-stage trial in the U.S. And predict they can get full enrollment before the majority of the U.S.

Population is vaccinated. Sanofi and Merck, whose timetables are more drawn out, are more likely to conduct most of their trials overseas. In theory, drug companies could overcome these hurdles by testing multiple treatments against one another and against approved treatments.

Dr. Steven Joffe, a University of Pennsylvania bioethicist, proposed in a recent JAMA article that Operation Warp Speed pay for such a trial. Scientists and policymakers batted around the idea of a single U.S.

Trial, with multiple treatment candidates competing against one another and a single placebo arm, during initial discussions last spring about the creation of Operation Warp Speed. The idea went nowhere in the United States. It was taken up by World Health Organization officials and major biomedical research groups, which have tried to create such a treatment trial in the rest of the world — with little success thus far.

So, for now, future treatment trials are somewhat up in the air. €œThere’s this tension created by getting the first treatments out there so quickly,” said David Wendler, a senior researcher in bioethics at the National Institutes of Health’s Clinical Center. €œFor public health it’s good, but it has the potential to undermine our ability to keep going on the research side and really knock out the kamagra.” Companies, governments and outside funders need to quickly develop consensus on appropriate trial designs and regulatory processes for additional erectile dysfunction treatments, added Mark Feinberg, president and CEO of the International AIDS treatment Initiative.

As for me, I decided I would stay in the Janssen trial. However, the day before I was scheduled to get my injection — real or fake — the research organization running the inoculations called to say I failed to make the cut. J&J had stopped its trial enrollment.

So, I’ll buy some new masks and get in line for my treatment with everyone else. Arthur Allen. aallen@kff.org, @ArthurAllen202 Related Topics Contact Us Submit a Story Tip.

Last spring, New Jersey emergency room nurse Maritza Beniquez saw “wave where to buy kamagra after wave” of sick patients, each wearing a look of fear that grew increasingly familiar as the weeks wore on. Soon, it was her colleagues at Newark’s University Hospital — the nurses, techs and doctors with whom she had been working side by side — who turned up in the ER, themselves struggling to breathe. €œSo many of our own co-workers got where to buy kamagra sick, especially toward the beginning. It literally decimated our staff,” she said. By the end of June, 11 of Beniquez’s colleagues were dead.

Like the patients they had where to buy kamagra been treating, most were Black and Latino. €œWe were disproportionately affected because of the way that Blacks and Latinos in this country have been disproportionately affected across every [part of] our lives — from schools to jobs to homes,” she said. Now Beniquez feels like a vanguard of another kind. On Dec where to buy kamagra. 14, she became the first person in New Jersey to receive the erectile dysfunction treatment — and was one of many medical workers of color featured prominently next to headlines heralding the treatment’s arrival at U.S.

Hospitals. It was a joyous occasion, one that kindled the possibility of again seeing her parents and her 96-year-old where to buy kamagra grandmother, who live in Puerto Rico. But those nationally broadcast images were also a reminder of those for whom the treatment came too late. erectile dysfunction treatment has taken an outsize toll on Black and Hispanic Americans. And those disparities extend to the medical workers who where to buy kamagra have intubated them, cleaned their bedsheets and held their hands in their final days, a KHN/Guardian investigation has found.

People of color account for about 65% of fatalities in cases in which there is race and ethnicity data. One recent study found health care workers of color were more than twice as likely as their white counterparts to test positive for the kamagra. They were more likely to treat patients diagnosed with erectile dysfunction treatment, more likely to work in nursing homes — where to buy kamagra major erectile dysfunction hotbeds — and more likely to cite an inadequate supply of personal protective equipment, according to the report. In a national sample of 100 cases gathered by KHN/The Guardian in which a health care worker expressed concerns over insufficient PPE before they died of erectile dysfunction treatment, three-quarters of the victims were identified as Black, Hispanic, Native American or Asian. €œBlack health care workers are more likely to want to go into public-sector care where they know that they will disproportionately treat communities of color,” said Adia Wingfield, a sociologist at Washington University in St.

Louis who where to buy kamagra has studied racial inequality in the health care industry. €œBut they also are more likely to be attuned to the particular needs and challenges that communities of color may have,” she said. Not only do many Black health care staffers work in lower-resourced health centers, she said, they are also more likely to suffer from many of the same co-morbidities found in the general Black population, a legacy of systemic inequities. And they may fall victim to lower standards where to buy kamagra of care. Dr.

Susan Moore, a 52-year-old Black pediatrician in Indiana, was hospitalized with erectile dysfunction treatment in November and, according to a video posted to her Facebook account, had to ask repeatedly for tests, remdesivir and pain medication. She said her white doctor dismissed her complaints of pain and she was discharged, where to buy kamagra only to be admitted to another hospital 12 hours later. Numerous studies have found Black Americans often receive worse medical care than their white counterparts. In March, a Boston biotech firm published an analysis showing physicians were less likely to refer symptomatic Black patients for erectile dysfunction tests than symptomatic whites. Doctors are also less likely to prescribe painkillers to Black where to buy kamagra patients.

€œIf I was white, I wouldn’t have to go through that,” Moore said in the video posted from her hospital bed. €œThis is how Black people get killed, when you send them home, and they don’t know how to fight for themselves.” She died on Dec. 20 of where to buy kamagra erectile dysfunction treatment complications, her son Henry Muhammad told news outlets. Along with people of color, immigrant health workers have suffered disproportionate losses to erectile dysfunction treatment. More than one-third of health care workers to die of erectile dysfunction treatment in the U.S.

Were born abroad, from the Philippines to Haiti, Nigeria and Mexico, according to a KHN/Guardian analysis of cases for which there is where to buy kamagra data. They account for 20% of health care workers in the U.S. Overall. Dr. Ramon Tallaj, a physician and chairman of Somos, a nonprofit network of health care providers in New York, said immigrant doctors and nurses often see patients from their own communities — and many working-class, immigrant communities have been devastated by erectile dysfunction treatment.

€œOur community is essential workers. They had to go to work at the beginning of the kamagra, and when they got sick, they would come and see the doctor in the community,” he said. Twelve doctors and nurses in the Somos network have died of erectile dysfunction treatment, he said. Dr. Eriberto Lozada was an 83-year-old family physician in Long Island, New York.

He was still seeing patients out of his practice when cases began to climb last spring. Originally from the Philippines, a country with a history of sending skilled medical workers to the United States, he was proud to be a doctor and “proud to have been an immigrant who made good,” his son James Lozada said. Lozada’s family members remember him as strict and strong-willed — they affectionately called him “the king.” He instilled in his children the importance of a good education. He died in April. Two of his four sons, John and James Lozada, are doctors.

Both were vaccinated last month. Considering all they had been through, John said, it was a “bittersweet” occasion. But he thought it was important for another reason — to set an example for his patients. The inequities in erectile dysfunction treatment s and deaths risk fueling distrust in the treatment. In a recent Pew study, around 42% of Black respondents said they would “definitely or probably” get the treatment compared with 60% of the general population.

This makes sense to Patricia Gardner, a Black, Jamaican-born nursing manager at Hackensack University Medical Center in New Jersey who has been infected with the erectile dysfunction along with family members and colleagues. €œA lot of what I hear is, ‘How is it that we weren’t the first to get the care, but now we’re the first to get vaccinated?. €™â€ she said. Like Beniquez, the nurse in Newark, she was vaccinated on Dec. 14.

€œFor me to step up to say, ‘I want to be in the first group’ — I’m hoping that sends a message,” she said. Beniquez said she felt the weight of that responsibility when she signed on to be the first person in her state to receive the treatment. Many of her patients have expressed skepticism over the treatment, fueled, she said, by a health system that has failed them for years. €œWe remember the Tuskegee trials. We remember the ‘appendectomies’” — reports that women were forcibly sterilized in a U.S.

Immigration and Customs Enforcement detention center in Georgia. €œThese are things that have happened to this community to the Black and Latino communities over the last century. As a health care worker, I have to recognize that their fears are legitimate and explain ‘This is not that,’” she said. Beniquez said her joy and relief over receiving the treatment are tempered by the reality of rising cases in the ER. The adrenaline she and her colleagues felt last spring is gone, replaced by fatigue and wariness of the months ahead.

Her hospital placed 11 trees in the lobby, one for each employee who has died of erectile dysfunction treatment. They have been adorned with remembrances and gifts from their colleagues. There is one for Kim King-Smith, 53, the friendly EKG technician, who visited friends of friends or family whenever they ended up in the hospital. One for Danilo Bolima, 54, the nurse from the Philippines who became a professor and was the head of patient care services. One for Obinna Chibueze Eke, 42, the Nigerian nursing assistant, who asked friends and family to pray for him when he was hospitalized with erectile dysfunction treatment.

€œEach day, we remember our fallen colleagues and friends as the heroes who helped keep us going throughout this kamagra and beyond,” hospital president and CEO Dr. Shereef Elnahal said in a statement. €œWe can never forget their contributions and their collective passion for this community, and each other.” Just outside the building, stands a 12th tree. €œIt’s going to be for whoever else we lose in this battle,” Beniquez said. This story is part of “Lost on the Frontline,” an ongoing project from The Guardian and Kaiser Health News that aims to document the lives of health care workers in the U.S.

Who die from erectile dysfunction treatment, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please share their story. Related Topics Contact Us Submit a Story TipAs I prepared to get my shot in mid-December as part of a erectile dysfunction treatment trial run by Janssen Pharmaceuticals, I considered the escape routes. Bailing out of the trial was a very real consideration since two other treatments, made by Moderna and Pfizer-BioNTech, had been deemed safe and effective for emergency approval. Leaving the trial would be a perfectly sane decision for me or anyone who had volunteered for an ongoing erectile dysfunction treatment experiment.

Why risk getting erectile dysfunction treatment if I was given a placebo, a shot with no treatment in it?. The way tests are designed, I might not be told whether I received the treatment until the clinical trial is over, months from now. Dropping the placebo arm could also be ethically sound from the company’s point of view. Researchers frequently halt trials when they have a product that works — or manifestly doesn’t. And the two approved treatments are 95% effective.

That very real choice for thousands of people offering to join or remain in the ongoing treatment tests creates a conundrum for science and for society. If trials can’t go forward, that could very well have an impact on the world’s supply of erectile dysfunction treatments and eventually on treatment prices, especially if booster shots are needed in years to come. In markets where there are only two competing drugs, prices can shoot sky-high. If there are four or five on the market, competition usually kicks in to control costs. In short, the welcome arrival of two erectile dysfunction treatments deemed safe has uncovered a series of ethical and logistical challenges.

And it has governments, companies and scientists scrambling for solutions. €œThe world’s treatment experts are saying the longer we can carry out a placebo-controlled trial the better,” Matthew Hepburn, who runs the treatment development arm of Operation Warp Speed, the multibillion-dollar federal program to fight erectile dysfunction treatment, told me. €œBut as a volunteer in the Janssen trial, you can always drop out.” As for the best way to resolve broader problems, “it’s a debate in real time,” he said. Generally, there are two aspects to the debate. First, what should be done with placebo recipients of the Moderna and Pfizer trials now that it’s clear both shots prevent the disease and appear safe?.

Second, how can the scores of companies in the United States and overseas that are still testing erectile dysfunction treatments adapt when there are apparently reliable products already on the market?. The FDA’s advisory committee debated the first question during two meetings in December. They heard Stanford University statistician Steven Goodman argue in favor of a “double-blind crossover” modification of the Pfizer and Moderna trials. Everyone who got placebo shots in the trials would now get two doses of the real treatment, and vice versa. That way everyone would be protected but still “blind” as to when they were properly vaccinated.

Such a rejigger of the current trial would provide more data on the treatment’s safety and durability of protection, although the longer-term comparison of treatment versus placebo would be lost. It’s a marvelous idea in principle, the panelists agreed, but pretty hard to carry out. Neither Moderna nor Pfizer has agreed to it. Pfizer wants to “unblind” placebo recipients of its treatment — to reveal they got the saline solution and give them the real thing — once their risk group gets its turn in line for the treatment. It has already started vaccinating health care workers who got the placebo.

Moderna, which has thousands of soon-to-expire leftover doses from its trial, said it intends to unblind its trial and vaccinate all the placebo recipients. In doing so, it would be recognizing the altruistic service the test subjects made to science and society by joining the trial. Another proposal would split the placebo recipients in the trial into two groups. In one group, everyone would get a single dose of the treatment. In the other, each would get two doses.

This would be a way of testing evidence that emerged during the Pfizer and Moderna trials that a single dose might provide sufficient protection. If that were true, vaccination of the country could happen nearly twice as fast, because there would be twice as many doses of treatment to go around. No one knows to what extent the Food and Drug Administration could force the hands of the two companies, which still expect to get full licensure for their treatments this year. Moderna is considered more amenable to the suggestion since, unlike Pfizer, it got nearly $1 billion in federal funding to develop its treatment. Other treatment developers — including Operation Warp Speed participants Janssen (owned by Johnson &.

Johnson), AstraZeneca, Novavax, Sanofi and Merck &. Co. €” are closely watching to see which path is taken. They are in a race against time — a race that may not end well for those running late in getting their treatment out. And halting those efforts could hurt billions of people elsewhere in the world whose lives and livelihoods will depend on the arrival of plentiful, cheap treatments.

One problem is finding willing test subjects. As increasing numbers of Americans are vaccinated, and the kamagra recedes from our shores, “the fewer the number of people eligible to participate in trials,” said Susan Ellenberg, professor of biostatistics at the University of Pennsylvania. For now, AstraZeneca and Janssen appear well situated. Both have closed enrollment in their U.S. Trials and are likely to file within a few months for emergency use authorizations, like those that have allowed Moderna and Pfizer to start vaccinating the public.

Novavax officials last week started their late-stage trial in the U.S. And predict they can get full enrollment before the majority of the U.S. Population is vaccinated. Sanofi and Merck, whose timetables are more drawn out, are more likely to conduct most of their trials overseas. In theory, drug companies could overcome these hurdles by testing multiple treatments against one another and against approved treatments.

Dr. Steven Joffe, a University of Pennsylvania bioethicist, proposed in a recent JAMA article that Operation Warp Speed pay for such a trial. Scientists and policymakers batted around the idea of a single U.S. Trial, with multiple treatment candidates competing against one another and a single placebo arm, during initial discussions last spring about the creation of Operation Warp Speed. The idea went nowhere in the United States.

It was taken up by World Health Organization officials and major biomedical research groups, which have tried to create such a treatment trial in the rest of the world — with little success thus far. So, for now, future treatment trials are somewhat up in the air. €œThere’s this tension created by getting the first treatments out there so quickly,” said David Wendler, a senior researcher in bioethics at the National Institutes of Health’s Clinical Center. €œFor public health it’s good, but it has the potential to undermine our ability to keep going on the research side and really knock out the kamagra.” Companies, governments and outside funders need to quickly develop consensus on appropriate trial designs and regulatory processes for additional erectile dysfunction treatments, added Mark Feinberg, president and CEO of the International AIDS treatment Initiative. As for me, I decided I would stay in the Janssen trial.

However, the day before I was scheduled to get my injection — real or fake — the research organization running the inoculations called to say I failed to make the cut. J&J had stopped its trial enrollment. So, I’ll buy some new masks and get in line for my treatment with everyone else. Arthur Allen. aallen@kff.org, @ArthurAllen202 Related Topics Contact Us Submit a Story Tip.

Buy kamagra oral jelly in canada

October is Mental Health Awareness Month and World Mental Health Day buy kamagra oral jelly in canada takes place http://dynamicsolutionstoday.com/order-levitra/ on 10 October 2020. This year, the erectile dysfunction treatment kamagra has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of people’s experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the kamagra.1–3 Job losses, buy kamagra oral jelly in canada financial and housing insecurity, the challenges of working from home, home schooling, restricted access to health and social care services and social isolation coupled with reduced support and contact with family and friends have all impacted people’s well-being. There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care.

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

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

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

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

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

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

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

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

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

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

October is Mental Health Awareness Month and World Mental Health Day takes place where to buy kamagra on 10 October 2020. This year, the erectile dysfunction treatment kamagra has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of people’s where to buy kamagra experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the kamagra.1–3 Job losses, financial and housing insecurity, the challenges of working from home, home schooling, restricted access to health and social care services and social isolation coupled with reduced support and contact with family and friends have all impacted people’s well-being. There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care.

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

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

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

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

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

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

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

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

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

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