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How to cialis discount coupon cite visit this site right here this article:Singh OP. The need for routine psychiatric assessment of erectile dysfunction treatment survivors. Indian J Psychiatry 2020;62:457-8erectile dysfunction treatment cialis discount coupon cialis is expected to bring a Tsunami of mental health issues. Public health emergencies may affect the well-being, safety, and security of both individuals and communities, which lead to a range of emotional reactions, unhealthy behavior, and noncompliance, with public health directives (such as home confinement and vaccination) in people who contact the disease as well as in the general population.[1] Thus far, there has been an increased emphasis on psychosocial factors such as loneliness, effect of quarantine, uncertainty, vulnerability to erectile dysfunction treatment , economic factors, and career difficulties, which may lead to increased psychiatric morbidity.Time has now come to pay attention to the direct effect of the cialis on brain and psychiatric adverse symptoms, resulting from the treatment provided.

Viral s are known to be associated with psychiatric disorders such as cialis discount coupon depression, bipolar disorder, obsessive–compulsive disorder (OCD), or schizophrenia. There was an increased incidence of psychiatric disorders following the Influenza cialis. Karl Menninger described 100 cases of influenza presenting with psychiatric cialis discount coupon sequelae, which could mainly be categorized as dementia praecox, delirium, other psychoses, and unclassified subtypes. Dementia praecox constituted the largest number among all these cases.[2] Neuroinflammation is now known as the key factor in genesis and exacerbation of psychiatric disorders, particularly depression and bipolar disorders.Emerging evidence points toward the neurotropic properties of the erectile dysfunction cialis.

Loss of smell cialis discount coupon and taste as an initial symptom points toward early involvement of olfactory bulb. The rapid spread to brain has been demonstrated through retrograde axonal transport.[3] The cialis can enter the brain through endothelial cells lining the blood–brain barrier and also through other nerves such as the vagus nerve.[4] Cytokine storm, a serious immune reaction to the cialis, can activate brain glial cells, leading to delirium, depression, bipolar disorder, and OCD.Studies examining psychiatric disorders in acute patients suffering from erectile dysfunction treatment found almost 40% of such patients suffering from anxiety, depression, and posttraumatic stress disorder.[5] The data on long-term psychiatric sequelae in patients who have recovered from acute illness are limited. There are anecdotal reports of psychosis and mania occurring in patients of erectile dysfunction treatment following discharge from hospital. This may be either due to the direct effect of the cialis on the brain cialis discount coupon or due to the neuropsychiatric effects of drugs used to treat the or its complications.

For example, behavioral toxicity of high-dose corticosteroids which are frequently used during the treatment of severe cases to prevent and manage cytokine storm.The patients with erectile dysfunction treatment can present with many neuropsychiatric disorders, which may be caused by direct inflammation, central nervous system effects of cytokine storm, aberrant epigenetic modifications of stress-related genes, glial activation, or treatment emergent effects.[6] To assess and manage various neuropsychiatric complications of erectile dysfunction treatment, the psychiatric community at large should equip itself with appropriate assessment tools and management guidelines to effectively tackle this unprecedented wave of psychiatric ailments. References 1.Pfefferbaum B, North cialis discount coupon CS. Mental health and the erectile dysfunction treatment cialis. N Engl J cialis discount coupon Med 2020;383:510-2.

2.Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China cialis discount coupon. The mystery and the miracle. J Med Virol 2020;92:401-2.

3.Fodoulian L, Tuberosa J, Rossier D, Landis BN, cialis discount coupon Carleton A, Rodriguez I. erectile dysfunction receptor and entry genes are expressed by sustentacular cells in the human olfactory neuroepithelium. BioRxiv 2020.03.31.013268 cialis discount coupon. Doi.

Https://doi.org/10.1101/2020.03.31.013268. 4.Lochhead JJ, Thorne RG. Intranasal delivery of biologics to the central nervous system. Adv Drug Deliv Rev 2012;64:614-28.

5.Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe erectile dysfunction s. A systematic review and meta-analysis with comparison to the erectile dysfunction treatment cialis. Lancet Psychiatry 2020;7:611-27.

6.Steardo L Jr., Steardo L, Verkhratsky A. Psychiatric face of erectile dysfunction treatment. Transl Psychiatry 2020;10:261. Correspondence Address:Om Prakash SinghAA 304, Ashabari Apartments, O/31, Baishnabghata, Patuli Township, Kolkata - 700 094, West Bengal IndiaSource of Support.

None, Conflict of Interest. NoneDOI. 10.4103/indianjpsychiatry.indianjpsychiatry_1169_2Abstract The erectile dysfunction treatment cialis has emerged as a major stressor of a global scale, affecting all aspects of our lives, and is likely to contribute to a surge of mental ill health. Ancient Hindu scriptures, notably the Bhagavad Gita, have a wealth of insights that can help approaches to build psychological resilience for individuals at risk, those affected, as well as for caregivers.

The path of knowledge (Jnana yoga) promotes accurate awareness of nature of the self, and can help reframe our thinking from an “I” to a “we mode,” much needed for collectively mitigating the spread of the erectile dysfunction. The path of action (Karma yoga) teaches the art of selfless action, providing caregivers and frontline health-care providers a framework to continue efforts in the face of uncertain consequences. Finally, the path of meditation (Raja yoga) offers a multipronged approach to healthy lifestyle and mindful meditation, which may improve resilience to the illness and its severe consequences. While more work is needed to empirically examine the potential value of each of these approaches in modern psychotherapy, the principles herein may already help individuals facing and providing care for the erectile dysfunction treatment cialis.Keywords.

Bhagavad Gita, erectile dysfunction treatment, YogaHow to cite this article:Keshavan MS. Building resilience in the erectile dysfunction treatment era. Three paths in the Bhagavad Gita. Indian J Psychiatry 2020;62:459-61The erectile dysfunction treatment crisis has changed our world in just a matter of months, thrusting us into danger, uncertainty, fear, and of course social isolation.

At the time of this writing, over 11 million individuals have been affected worldwide (India is fourth among all countries, 674,515) and over half a million people have died. The erectile dysfunction treatment cialis has been an unprecedented global stressor, not only because of the disease burden and mortality but also because of economic upheaval. The very fabric of the society is disrupted, affecting housing, personal relationships, travel, and all aspects of lifestyle. The overwhelmed health-care system is among the most major stressors, leading to a heightened sense of vulnerability.

No definitive treatments or treatment is on the horizon yet. Psychiatry has to brace up to an expected mental health crisis resulting from this global stressor, not only with regard to treating neuropsychiatric consequences but also with regard to developing preventive approaches and building resilience.Thankfully, there is a wealth of wisdom to help us in our ancient scriptures such as the Bhagavad Gita[1] for building psychological resilience. The Bhagavad Gita is a dialog between the Pandava prince Arjuna and his charioteer Krishna in the epic Mahabharata, the great tale of the Bharata Dynasty, authored by Sage Vyasa (c. 4–5 B.C.E.).

The dialog occurs in the 6th chapter of the epic and has over 700 verses. In this epic story, Arjuna, the righteous Pandava hero was faced with the dilemma of waging a war against his cousins, the Kauravas, for territory. Arjuna is confused and has no will to initiate the war. In this context, Krishna, his charioteer and spiritual mentor, counsels him.

The key principles of this spiritual discourse in the Gita are embodied in the broad concept of yoga, which literally means “Yog” or “to unite.” Applying three tenets of yoga can greatly help developing resilience at individual, group, and societal levels. A fourth path, Bhakti yoga, is a spiritual approach in the Gita which emphasizes loving devotion toward a higher power or principle, which may or may not involve a personal god. In this editorial, I focus on three paths that have considerable relevance to modern approaches to reliance-focused psychotherapy that may be especially relevant in the erectile dysfunction treatment era. Path of Knowledge The first concept in the Gita is the path of knowledge (Jnana Yoga, chapter 2).

The fundamental goal of Jnana yoga is to liberate oneself from the limited view of the individual ego, and to develop the awareness of one's self as part of a larger, universal self. Hindu philosophers were among the earliest to ask the question of “who am I” and concluded that the self is not what it seems. The self as we all know is a collection of our physical, mental, and social attributes that we create for ourselves with input from our perceptions, and input by our families and society. Such a world view leads to a tendency to crave for the “I” and for what is mine, and not consider the “We.” As Krishna in the Bhagavad Gita points out, the person who sees oneself in others, and others in oneself, really “sees.” Such awareness, which guides action in service of self as well as others, is critically important in our goals of collectively preventing the spread of the erectile dysfunction.

A glaring example is the use of face masks, known to effectively slow the viral . Using the mask is as important to protecting oneself from the cialis as well as protecting others from oneself. Nations such as the USA (and their leaders), who have given mixed messages to the public about the need to wear masks, have been showing a strikingly high number of cases as well as mortality. Unfortunately, such reluctance to wear masks (and thus model protective hygiene for the population), as in the case of the US leader, has stemmed from ego or vanity-related issues (i.e., how he would appear to other leaders!.

). This factor may at least partly underlie the worse erectile dysfunction treatment outcome in the USA. The simple lesson here is that it is important to first flatten the ego if one wants to flatten the cialis curve!. Path of Action The second key concept is the path of action (Karma yoga, chapter 3).

Karma yoga is all about taking action without thinking, “what's in it for me.” As such, it seeks to mainly let go of one's ego. In the Bhagavad Gita, Arjuna is ambivalent about fighting because of the conflict regarding the outcome brought on by waging the war, i.e., having to kill some of his own kith and kin. Krishna reminds him that he should not hesitate, because it is his nature and duty (or Dharma), as a warrior, to protect the larger good, though it will have some downside consequences. The frontline health-care worker caring for severely ill patients with erectile dysfunction treatment is likely to have a similar emotional reaction as Arjuna, facing a lack of adequate treatments, high likelihood of mortality and of unpredictable negative outcomes, and risk to him/herself.

Compounding this, especially when resources such as ventilators are limited, the doctor may have to make tough decisions of whose life to save and whose not. Adding to this are personal emotions when facing with the death of patients, having to deliver bad news, and dealing with grieving relatives.[2] All these are likely to result in emotional anguish and guilt, leading to burnout and a war “neurosis.”So, what should the frontline health-care provider should do?. Krishna's counsel would be that the doctor should continue to perform his/her own dharma, but do so without desire or attachment, thereby performing action in the spirit of Karma yoga. Such action would be with detachment, without a desire for personal gain and being unperturbed by success or failure.

Such “Nishkaama Karma” (or selfless action) may help doctors working today in the erectile dysfunction treatment outbreak to carry forward their work with compassion, and accept the results of their actions with equanimity and without guilt. Krishna points out that training one's mind to engage in selfless action is not easy but requires practice (Abhyasa). Krishna is also emphatic about the need to protect oneself, in order to be able to effectively carry out one's duties. Path of Meditation The third core concept in the Gita is the path of meditation and self-reflection (Raja yoga, or Dhyana yoga, chapter 6).

It is considered the royal path (Raja means royal) for attaining self-realization, and often considered the 8-fold path of yoga (Ashtanga yoga) designed to discipline lifestyle, the body and mind toward realizing mindfulness and self-reflection. These techniques, which originated in India over two millennia ago, have evolved over recent decades and anticipate several approaches to contemplative psychotherapy, including dialectical behavior therapy, acceptance and commitment therapy, and mindfulness-based stress reduction.[3] These approaches are of particular relevance for stress reduction and resilience building in individuals faced by erectile dysfunction treatment-related emotional difficulties as well as health-care providers.[4]The majority of people affected by the erectile dysfunction treatment cialis recover, but about 20% have severe disease, and the mortality is around 5%. Older individuals, those with obesity and comorbid medical illnesses such as diabetes and lung disease, are particularly prone to developing severe disease. It is possible that a state of chronic low-grade inflammation which underlies each of these conditions may increase the risk of disproportionate host immune reactions (with excessive release of cytokines), characterizing severe disease in those with erectile dysfunction treatment.[4] With this in mind, it is important to note that exercise, some forms of meditation, anti-inflammatory and antioxidant diet (such as turmeric and melatonin), and yoga have known benefits in reducing inflammation.[5],[6],[7],[8],[9] Sleep loss also elevates inflammatory cytokines.

Healthy sleep may reduce inflammation.[10] Clearly, a healthy lifestyle, including healthy sleep, exercise, and diet, may be protective against developing erectile dysfunction treatment-related severe complications. These principles of healthy living are beautifully summarized in the Bhagavad Gita.Yuktahara-viharasya yukta-cestasya karmasuYukta-svapnavabodhasya yogo bhavati duhkha-haHe who is temperate in his habits of eating, sleeping, working and recreation can mitigate all sorrows by practicing the yoga system.–Bhagavad Gita, Chapter 6, verse 17.The relevance of the Bhagavad Gita for modern psychotherapy has been widely reviewed.[11],[12] However, relatively little empirical literature exists on the effectiveness of versus spiritually integrated psychotherapy incorporating Hindu psychotherapeutic insights. Clearly, more work is needed, and erectile dysfunction treatment may provide an opportunity for conducting further empirical research.[13] In the meantime, using the principles outlined here may already be of benefit in helping those in need, and may be rapidly enabled in the emerging era of telehealth and digital health.[14]Financial support and sponsorshipNil.Conflicts of interestThere are no conflicts of interest. References 1.Pandurangi AK, Shenoy S, Keshavan MS.

Psychotherapy in the Bhagavad Gita, the Hindu scriptural text. Am J Psychiatry 2014;171:827-8. 2.Arango C. Lessons learned from the erectile dysfunction health crisis in Madrid, Spain.

How erectile dysfunction treatment has changed our lives in the last 2 weeks [published online ahead of print, 2020 Apr 8]. Biol Psychiatry 2020;26:S0006-3223 (20) 31493-1. [doi. 10.1016/j.biopsych.

2020.04.003]. 3.Keshavan MS, Gangadhar GN, Hinduism PA. In. Spirituality and Mental Health Across Cultures, Evidence-Based Implications for Clinical Practice.

Oxford, England. Oxford University Press. In Press. 4.Habersaat KB, Betsch C, Danchin M, Sunstein CR, Böhm R, Falk A, et al.

Ten considerations for effectively managing the erectile dysfunction treatment transition. Nat Hum Behav 2020;4:677-87. Doi. 10.1038/s41562-020-0906-x.

Epub 2020 Jun 24. 5.Kumar K. Building resilience to erectile dysfunction treatment disease severity. J Med Res Pract 2020;9:1-7.

6.Bushell W, Castle R, Williams MA, Brouwer KC, Tanzi RE, Chopra D, et al. Meditation and Yoga practices as potential adjunctive treatment of erectile dysfunction and erectile dysfunction treatment. A brief overview of key subjects [published online ahead of print, 2020 Jun 22]. J Altern Complement Med 2020;26:10.1089/acm.

7.Gupta H, Gupta M, Bhargava S. Potential use of turmeric in erectile dysfunction treatment [published online ahead of print, 2020 Jul 1]. Clin Exp Dermatol. 2020;10.1111/ced.14357.

Doi:10.1111/ced.14357. 8.Damiot A, Pinto AJ, Turner JE, Gualano B. Immunological implications of physical inactivity among older adults during the erectile dysfunction treatment cialis [published online ahead of print, 2020 Jun 25]. Gerontology 2020:26;1-8.

[doi. 10.1159/000509216]. 9.El-Missiry MA, El-Missiry ZM, Othman AI. Melatonin is a potential adjuvant to improve clinical outcomes in individuals with obesity and diabetes with coexistence of erectile dysfunction treatment [published online ahead of print, 2020 Jun 29].

Eur J Pharmacol 2020;882:173329. 10.Mullington JM, Simpson NS, Meier-Ewert HK, Haack M. Sleep loss and inflammation. Best Pract Res Clin Endocrinol Metab 2010;24:775-84.

11.Balodhi JP, Keshavan MS. Bhagavad Gita and psychotherapy. Asian J Psychiatr 2011;4:300-2. 12.Bhatia SC, Madabushi J, Kolli V, Bhatia SK, Madaan V.

The Bhagavad Gita and contemporary psychotherapies. Indian J Psychiatry 2013;55:S315-21. 13.Keshavan MS. cialiss and psychiatry.

Repositioning research in context of erectile dysfunction treatment [published online ahead of print, 2020 May 7]. Asian J Psychiatr 2020;51:102159. [doi. 10.1016/j.ajp.

2020.102159]. 14.Torous J, Keshavan M. erectile dysfunction treatment, mobile health and serious mental illness. Schizophr Res 2020;218:36-7.

Correspondence Address:Matcheri S KeshavanRoom 542, Massachusetts Mental Health Center, 75 Fenwood Road, Boston, MA 02115 USASource of Support. None, Conflict of Interest. NoneDOI. 10.4103/psychiatry.IndianJPsychiatry_829_20.

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Today, on behalf of the Honourable Patty Hajdu, Minister of Health, the Honourable Maryam Monsef, Minister for Women and Gender Equality and Rural Economic Development, announced more than $1.9 million in funding over the next three years to the Peterborough Police Service. Through this funding, people who use drugs and experience mental safe site to buy cialis online health issues will be connected to newly-created community-based outreach and support services. As part of this project, the Peterborough Police Service is working with local partners to create a community-based outreach team to increase the capacity for front-line community services to help people at risk who are referred by police.

With the help of this new team, people who use drugs or experience mental health issues will safe site to buy cialis online be redirected from the criminal justice system to harm reduction, peer support, health and social services. Additionally, this initiative will increase access to culturally appropriate services for Indigenous Peoples, LGBTQ2+ populations, youth, women, and those living with HIV through partnerships with other organizations such as Nogojiwanong Friendship Centre and Peterborough AIDS Research Network. The Government of Canada is committed to working with partners, peer workers, people with lived and living experience and other safe site to buy cialis online stakeholders to ensure Canadians receive the support they need to reduce the harms related to substance use.From.

Health Canada Media advisory Government of Canada to announce funding for community-based, multi-sector outreach and support services in Peterborough PETERBOROUGH, August 25, 2020 — On behalf of the Federal Minister of Health, Patty Hajdu, the Honourable Maryam Monsef, Minister for Women and Gender Equality and Rural Economic Development, will announce federal funding to help connect people at risk of experiencing opioid-related overdoses to community-based outreach and support services in Peterborough.There will be a media availability immediately following the announcement.DateWednesday, August 26, 2020Time10:00 AM (EDT)LocationThe media availability will be held on Zoom.Zoom link. Https://us02web.zoom.us/j/89698543218Meeting ID safe site to buy cialis online. 896 9854 3218 Contacts Media Inquiries:Cole DavidsonOffice of the Honourable Patty HajduMinister of Health613-957-0200Media RelationsHealth Canada613-957-2983hc.media.sc@canada.ca.

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Through this cialis discount coupon funding, people who use drugs and experience mental health issues will be connected to newly-created community-based outreach and support services. As part of this project, the Peterborough Police Service is working with local partners to create a community-based outreach team to increase the capacity for front-line community services to help people at risk who are referred by police. With the help of this new team, people who use drugs or experience mental cialis discount coupon health issues will be redirected from the criminal justice system to harm reduction, peer support, health and social services. Additionally, this initiative will increase access to culturally appropriate services for Indigenous Peoples, LGBTQ2+ populations, youth, women, and those living with HIV through partnerships with other organizations such as Nogojiwanong Friendship Centre and Peterborough AIDS Research Network.

The Government of Canada is committed to working with partners, peer workers, people with lived and living experience and other stakeholders to cialis discount coupon ensure Canadians receive the support they need to reduce the harms related to substance use.From. Health Canada Media advisory Government of Canada to announce funding for community-based, multi-sector outreach and support services in Peterborough PETERBOROUGH, August 25, 2020 — On behalf of the Federal Minister of Health, Patty Hajdu, the Honourable Maryam Monsef, Minister for Women and Gender Equality and Rural Economic Development, will announce federal funding to help connect people at risk of experiencing opioid-related overdoses to community-based outreach and support services in Peterborough.There will be a media availability immediately following the announcement.DateWednesday, August 26, 2020Time10:00 AM (EDT)LocationThe media availability will be held on Zoom.Zoom link. Https://us02web.zoom.us/j/89698543218Meeting ID cialis discount coupon. 896 9854 3218 Contacts Media Inquiries:Cole DavidsonOffice of the Honourable Patty HajduMinister of Health613-957-0200Media RelationsHealth Canada613-957-2983hc.media.sc@canada.ca.

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He was believed to have been hit by a car effects of cialis without ed and sustained a head injury. His story was covered by numerous media outlets in English and Spanish. The CHP and UC Davis social workers worked tirelessly for weeks to effects of cialis without ed sift through tips that flooded in from the community.After extensive searching and follow up, his identity was confirmed on Sept. 23.

The team also successfully identified his family in Mexico.“His family members are thrilled to be reunited with him,” said Joleen Lonigan, executive director effects of cialis without ed of Patient Care Services at UC Davis Medical Center. €œThank you to the community for their help in identifying him. It has changed this man and his family’s life.”.

(SACRAMENTO) Francisco cialis discount coupon had no ID and no memory of who he was, where he lived or whether he had any family when he was brought by an ambulance to the UC Davis emergency department on Aug http://2margraf.de/what-i-should-buy-with-viagra/. 24. Last Friday, he was discharged from UC Davis Medical cialis discount coupon Center after 88 days of hospitalization. He will be reunited with family back in Mexico.“God bless all of you and how much you help me,” Francisco told his primary nurse on Friday.Francisco had been found at the corner of Fulton and Marconi in Sacramento’s Arden-Arcade area. He was believed to have been hit by a car and sustained a head injury cialis discount coupon.

His story was covered by numerous media outlets in English and Spanish. The CHP and UC Davis social workers worked tirelessly for weeks cialis discount coupon to sift through tips that flooded in from the community.After extensive searching and follow up, his identity was confirmed on Sept. 23. The team also successfully identified his family in Mexico.“His family members are thrilled to be reunited with him,” said Joleen Lonigan, executive director of Patient Care Services at UC Davis cialis discount coupon Medical Center. €œThank you to the community for their help in identifying him.

It has changed this man and his family’s life.”.

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€œThere’s virtually no difference between white, Black, Hispanic, Asian American,” referring to vaccination rates among Where to get propecia pills Americans 65 and taking cialis up. President Joe Biden, May 3 During May 3 remarks on the American Families Plan, President Joe Biden boasted that there was not much disparity in the vaccination rates for white Americans and Americans of color who are at least 65. “And what’s happening now is all the talk about how people were not taking cialis going to get shots, they were not going to be involved — look at what that was — we were told that was most likely to be among people over 65 years of age,” said Biden. €œBut now people over 65 years of age, over 80%, have now been vaccinated, and 66% fully vaccinated.

And there’s virtually no difference between white, Black, Hispanic, Asian American.” This isn’t the only time that Biden has made that claim. He went even further on April 27 taking cialis during remarks on the erectile dysfunction treatment response. €œAnd, by the way, based on reported data, the proportion — the proportion of seniors who have been vaccinated is essentially equal between white and seniors of color. €¦ As a matter of a fact, if I’m not mistaken, there are more Latinos and African American seniors that have been vaccinated, as a percentage, than white seniors.” However, the national data that Biden keeps touting — vaccination statistics regarding both race and age — is not public.

We asked taking cialis the White House for the information underlying this claim, but officials did not provide specifics. So, we moved on to the Centers for Disease Control and Prevention. Spokesperson Chandra Zeikel told KHN-PolitiFact on May 6 that “unfortunately, we don’t have available a data breakdown of both racial demographics and age together.” Zeikel didn’t respond to a follow-up question asking when or if the CDC would be publishing this data, but current CDC vaccination data is broken down only by race/ethnicity and shows significant differences, with white Americans far outpacing the percentage of other groups getting a shot. It also shows that the rate of vaccinations among some groups, including Black and Latino Americans, does not match their share of the population, though new CDC data shows there has been some progress on this front in taking cialis the past two weeks.

That made us wonder about the premise of Biden’s statement. We turned to experts for their take taking cialis. €œAs far as I know, there is no comprehensive publicly available data on vaccination rates by race/ethnicity and age,” Samantha Artiga, vice president and director of the racial equity and health policy program at KFF, wrote in an email. €œAs such, we are not able to assess whether there are racial disparities in vaccinations among people over 65 years of age.” What about other state-level data or anecdotes that might support Biden’s claim?.

Let’s dive in and taking cialis see. A Small Number of States Report Both Age and Race Together At least seven states track vaccination based on a combination of age and race, according to Artiga. Michigan, South Carolina, West Virginia, Kansas, Minnesota, Washington and Vermont. (Vermont tracks only taking cialis two racial categories.

Non-Hispanic white and a combination of Black, Indigenous and people of color.) The results from some of these states show that racial disparities do exist in the older age groups. In Michigan, for instance, over 50% of non-Hispanic white people ages 65 to 74 had completed their vaccinations as of May 11. Other racial taking cialis groups — non-Hispanic Black people. Asian American and Pacific Islanders.

And Hispanics — all trailed by about 10 percentage points. The exception was the Native American and Alaska Natives category, taking cialis which was within 4 percentage points of white people. And as of May 11 in Kansas, the rate at which white people in that same age group were vaccinated was higher than the rates of Black people and Native Hawaiian/Pacific Islanders. In Vermont, for those 65 and up, about taking cialis 79% of people of color had received at least one dose of the treatment, compared with 85% of white people as of that date.

€œWith the exception of Vermont, which has the distinction of being the only state to target BIPOC [Black, Indigenous and people of color] populations by race explicitly, these are examples of states in which the numbers are not doing well in their equity efforts,” Dayna Bowen Matthew, dean of the George Washington University Law School and an expert in racial disparities in health care, wrote in an email. Minnesota is one of the few states in which people of color are actually being vaccinated at higher rates than white people — with 93% of Asian/Pacific Islanders and 87.5% of Black/African Americans age 65 and over having received at least one shot, compared with 81.5% of white people as of May 11. Some states are taking cialis vaccinating similar percentages of their population of Black or Hispanic people, Matthew said, however that data does not distinguish by age group. According to Bloomberg’s erectile dysfunction treatment Vaccination Racial Gap tracker, New Mexico, Idaho, Oregon and Utah have vaccinated approximately the same percentage of Black Americans as are represented in each state’s population.

Maine, Ohio, Alabama, Louisiana and Missouri have achieved similar population-based rates for the Hispanic population. KFF provides weekly updates on national and state race/ethnicity data of those who have received vaccinations, which have consistently shown that Black and Hispanic people are receiving smaller shares of vaccinations compared with their shares of the taking cialis total population, while white people are receiving a higher share. The May 5 weekly update, for instance, found that based on the 42 states that share race/ethnicity data, the percentage of white people who have received at least one erectile dysfunction treatment dose (39%) was roughly 1.5 times higher than the rates for Black (25%) and Hispanic people (27%). (KHN is an editorially independent program of KFF.) It’s also important to note that data on race and ethnicity information has not been gathered for many people who have been vaccinated.

As of taking cialis May 3, the CDC reported that race and ethnicity were known for only 55% of all people who had received at least one treatment dose. And three states, Montana, New Hampshire and Wyoming, don’t report race/ethnicity data at all. How to Approach treatment Equity, Experts Say Nneka Sederstrom, chief health equity officer at Hennepin Healthcare in Minneapolis, said that her state has done an “excellent job” vaccinating the 65-and-older population but that there’s still a lot of work to be done to reach communities of color. We “will need more direct tactics to reach” those who haven’t yet taking cialis been vaccinated, “and help address any issues of hesitancy due to lack of knowledge or systemic barriers,” Sederstrom wrote in an email.

Ensuring that treatments are available at primary care providers is also important, said Dr. Georges Benjamin, taking cialis executive director of the American Public Health Association. €œThe truth of the matter is, the more vaccinators that we can get that are placed where people are every day, where it becomes a routine part of your life, such as going … into your doctor’s office for a regular visit, that’s a winner,” said Benjamin. But, Dr.

Uché Blackstock, founder of Advancing Health Equity, an organization that advocates to taking cialis end bias and racism in health care, said she would set the bar for treatment equity success higher than just an equally proportionate share of a certain racial/ethnic population receiving their treatment doses. €œWhat success in treatment equity would look like would be if Black people or Hispanic people were overrepresented in terms of treatment received since they have been disproportionately impacted by the cialis,” said Blackstock. So even though Biden quotes these statistics that lack data behind them, if the evidence did support them, it would still not be enough, she said. In fact, taking cialis the CDC does describe treatment equity in those terms.

€œpreferential access and administration to those who have been most affected by erectile dysfunction treatment.” Our Ruling Biden has repeatedly claimed that vaccination rates among white people and people of color age 65 and older are virtually the same — or even higher among people of color. No public national data from the CDC or another database has been released to support this assertion. For the few taking cialis states that do report data on age and race/ethnicity combined, the numbers suggest that, for the most part, obvious disparities persist in the vaccination rates for white seniors and seniors of color. In several states, treatment administration rates are more proportional to the percentage of the Black and Hispanic populations, but the data covers all age groups.

National data for all age groups also shows that rates of vaccinations for Black and Hispanic people lag behind that of white people. Existing data paints one story on treatment equity, taking cialis while Biden’s words paint another. Without data to back it up, we rate Biden’s statement False. Sources:The Associated Press, “AP Fact check taking cialis.

Biden overstates how many Americans immunized,” May 3, 2021Bloomberg News, erectile dysfunction treatment Racial Gap Tracker, accessed May 5, 2021Centers for Disease Control and Prevention, “Demographic Characteristics of People Receiving erectile dysfunction treatment Vaccinations in the United States,” accessed May 10, 2021Centers for Disease Control and Prevention, “County-Level erectile dysfunction treatment Vaccination Coverage and Social Vulnerability — United States, December 14, 2020-March 1, 2021,” March 26, 2021Email exchange with Centers for Disease Control and Prevention spokesperson Chandra Zeikel, May 6, 2021Email exchange with White House administration official, May 6, 2021Email interview with Manuel Pastor, director of the University of Southern California Equity Research Institute, May 5, 2021Email interview with Nneka Sederstrom, chief health equity officer at Hennepin Healthcare in Minneapolis, May 5, 2021Email interview with Samantha Artiga, vice president and director of the racial equity and health policy program at KFF, May 5-6, 2021Kansas.gov, erectile dysfunction treatment Demographics, accessed May 10, 2021KFF, Latest Data on erectile dysfunction treatment Vaccinations Race/Ethnicity, May 5, 2021Michigan.gov, erectile dysfunction treatment dashboard, accessed May 10, 2021Minnesota.gov, “treatment Data,” accessed May 10, 2021NBC News, “Biden Hails Progress on treatment Equity, but Some Local Leaders Paint a Different Picture,” May 3, 2021Phone/email interview with Dayna Bowen Matthew, dean and Harold H. Greene Professor of Law at the George Washington University Law School, May 6-7, 2021Phone interview with Dr. Georges Benjamin, executive director of taking cialis the American Public Health Association, May 6, 2021Phone interview with Dr. Uché Blackstock, founder of Advancing Health Equity, May 6, 2021Vermont.gov, erectile dysfunction treatment Dashboard, accessed May 10, 2021White House, “Remarks by President Biden on the American Families Plan,” May 3, 2021White House, “Remarks by President Biden on the erectile dysfunction treatment Response,” April 27, 2021 Victoria Knight.

vknight@kff.org, @victoriaregisk Related Topics Contact Us Submit a Story TipEAST LOS ANGELES — For the past year, 13-year-old twins Ariel Jr. And Abraham Osorio have logged on to their online classes from their taking cialis parents’ flower shop. Ariel nestles in a corner among flowers, bows and stuffed animals. Abraham sets up on a small table in the back, where his dad used to work trimming flowers and keeping the books.

It’s not ideal for learning taking cialis. It’s loud. It’s cramped. It’s bustling with taking cialis people.

Still, when the twins’ mother, Graciela Osorio, recently had the chance to send her kids back to Brightwood Elementary in Monterey Park, California, she decided against it. €œAfter what we went through with their father, I’d rather taking cialis keep them at home where I know they are safe,” said Graciela, 51. €œThere’s only a month left. It doesn’t make sense that they return for such a short time.” The boys’ father, Ariel Osorio Sr., 51, died of erectile dysfunction treatment in January, four weeks after a trip to Mexico to visit his mother.

He fell ill quickly and wasn’t taking cialis able to say goodbye to his children. Graciela Osorio is mourning the loss of her husband, Ariel Osorio, who died of erectile dysfunction treatment in January. (Heidi de Marco/KHN) “I miss his presence,” Abraham said. €œI’m used to seeing him sit in his chair working, but not anymore.” Latinos have been hit taking cialis disproportionately hard by erectile dysfunction treatment, and many families are opting out of in-person learning.

In California, Latinos make up 39% of the state’s population but account for 47% of erectile dysfunction treatment deaths, according to the state Department of Public Health. Nationally, their risk of death from erectile dysfunction treatment is 2.3 times higher than that of whites. Latinos are vulnerable to the highly transmissible erectile dysfunction because they are more likely than non-Hispanic whites to work essential jobs that expose them to the public, said David Hayes-Bautista, a professor of public health and taking cialis medicine at UCLA and co-author of a January study on this topic. They are more likely to lack health insurance, which may make them less likely to seek medical care, he said.

And they are more likely to live in multigenerational households, which means the cialis can spread quickly and easily within families. €œMany of them are essential workers and the breadwinners for their families and don’t have the luxury of telework, of physical distancing and self-isolation,” said Alberto González, a senior health strategist at UnidosUS, a Latino advocacy group in Washington, D.C taking cialis. The Osorio family has lived in a multigenerational household since Ariel died, and Graciela had to keep other family members in mind when deciding whether to send her boys back into the classroom. In February, Graciela taking cialis and the twins moved in with her 74-year-old mother, Cleotilde Servin, in East Los Angeles.

Ten people now share the roughly 1,000-square-foot home, squeezing by one another in the kitchen every morning. Cleotilde Servin makes lunch for the family members who live with her, including two daughters, a son and several grandchildren. (Heidi de Marco/KHN) Graciela’s mother and the other adults in the home taking cialis have been vaccinated, but the children haven’t. Even though she instructs her sons to wear their masks and doesn’t allow them to visit friends, she’s terrified of what could happen if her kids caught the cialis at school and brought it home.

€œMy mother is active and takes vitamins, but it still worries me,” Graciela said. She got taking cialis erectile dysfunction treatment from her husband and gave it to her sister and niece. €œI don’t want anyone else to get sick,” she said. State and local education officials don’t have recent data on in-person attendance by race, but an EdSource analysis of California Public Health Department data from February shows that white students were more likely to attend school in person than other students.

The analysis showed that 12% of Latinos were attending taking cialis in-person classes at least some of the time, compared with 32% of whites and 18% of all students. The Los Angeles Unified School District, the second-largest in the country, serves more than 600,000 students and reopened for in-person learning in mid-April. Only some campuses are open, mostly elementary schools, and are running on hybrid schedules, combining on-campus classes with distance learning. €œWe’ve upgraded the air fiation systems in every classroom, reconfigured school facilities to keep all at a school appropriately distanced, doubled the custodial staff, and we’ll provide weekly erectile dysfunction treatment testing at school taking cialis for every student and staff member,” district superintendent Austin Beutner said in his weekly recorded video update on March 22.

In a statement released May 4, Beutner said 40% to 50% of elementary school students are now back in schools in “more affluent” communities compared with roughly 20% in low-income communities. €œWe see the greatest reluctance for children to be back in schools from families who live in some of the highest-needs communities we serve,” he said taking cialis. Brightwood Elementary is a K-8 school with 870 students, about half of whom are Asian American and 40% Latino, said principal Robby Jung. Just 15% of students are back on campus, he said, and, of those, about one-third are Latino.

Ariel Osorio taking cialis Jr. Works on his school homework at the back of the flower shop. (Heidi de Marco/KHN) Graciela Osorio owns Gracy’s Flower Shop in East Los Angeles, California, which she used to run with her husband. (Heidi de Marco/KHN) For the Osorio family, taking cialis the overriding reason the eighth grade twins are not back at Brightwood is fear.

Like so many other Latino families — roughly 28,000 Latinos have died of erectile dysfunction treatment in California — they are reeling from the grief and trauma that the disease has already wrought, and the fear of what it could do if it struck again. €œThe boys are seeing a therapist to deal with their dad’s death,” Graciela said. €œI know I should probably talk to someone, too.” With the memory of her husband’s death still so fresh that she can’t speak of him taking cialis without crying, Graciela is still adjusting to the emotional toll, and to the day-to-day realities of running a flower shop by herself. Originally from Guerrero, Mexico, she started Gracy’s Flower Shop with her husband in 1997.

Ariel took care of the finances at home and at the shop and was the better English speaker of the two. €œNow being alone taking cialis with the boys, it’s more difficult to keep up,” she said. After losing her husband to erectile dysfunction treatment, Graciela Osorio decided not to let her sons return to in-person learning out of fear they might contract the cialis at school. €œI tell them they have to stay focused taking cialis now that their dad isn’t around to push them,” she says.

(Heidi de Marco/KHN) During the erectile dysfunction treatment lockdowns, the boys joined the couple at the shop. Her husband sat next to their children while they attended school online, helping with their homework and acting as the main contact for the school. €œThey were always with us,” Graciela said taking cialis. €œThey grew up in the flower shop, so they didn’t have a problem setting up their school stations there.” Brightwood reopened its doors April 12, offering in-person learning two days a week for a few hours a day, with the rest of the sessions online.

Graciela said the limited schedule doesn’t work with her role as the family breadwinner. €œI would have to take them to school, pick them up for lunch and then taking cialis bring them back,” she said. €œI can’t do that. I have to work.” But mostly she’s keeping them off campus because she doesn’t want to lose another family member.

She said she knows online classes taking cialis aren’t the same as in-person instruction “but they have been keeping their grades up,” she said. €œI thank God I have good boys. They listen. They understand why I kept them home.” Abraham Osorio and taking cialis Ariel Osorio Jr.

Outside their mother’s flower shop. (Heidi de Marco/KHN) The last day taking cialis of school is May 28. Ariel and Abraham said they’re looking forward to high school in the fall. Still dealing with their father’s death, the boys, who are shy and reserved by nature, are torn between returning to school in person or continuing their classes online.

€œWe might go back,” Abraham said taking cialis. €œFor now, we keep each other company.” This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. Heidi de Marco. heidid@kff.org, @Heidi_deMarco Related Topics Contact Us Submit a Story TipAn exclusive Montana taking cialis resort wants to turn sewage into snow so that its rich and famous members can ski its slopes in a winter season that’s shrinking because of climate change.

The Yellowstone Club — a ski and golf resort just north of Yellowstone National Park that counts Bill Gates, Justin Timberlake and Jessica Biel among its members — has asked the Montana Department of Environmental Quality for a permit to allow it to use wastewater for snowmaking operations on its ski slopes. About a dozen other ski areas across the U.S. Have used wastewater to make artificial snow before, but taking cialis the Yellowstone Club would be the first in Montana. The technique has also been used in Europe and Australia.

Officials at the club say the program would not only ensure the slopes can open on time, usually in late November and early December, but also replenish the area’s watershed and keep streams running longer into the season. And it would taking cialis allow the growing Big Sky resort area to handle its increasing wastewater volumes. €œIt’s an outside-the-box-idea,” said Rich Chandler, environmental manager for the club. €œBut it also checks a lot of boxes.” Is it taking cialis a safe plan for the rich and famous who will occasionally ingest it when they wipe out on the slopes?.

The short answer from state officials is yes. The method is safe for people and the environment as long as there is close monitoring to ensure contamination levels stay within standards, according to an environmental analysis. But, the state officials said, that analysis did not study potential pollutants for which there are no taking cialis environmental standards in wastewater, such as traces of prescription drugs. A similar effort to turn wastewater into snow was controversial at the Arizona Snowbowl ski resort near Flagstaff.

To combat snowless winters there, the resort in the early 2000s purchased wastewater from Flagstaff and pumped it from the treatment plant to the ski area, where it would be turned into snow and sprayed onto the San Francisco Peaks. That drew protests from the Hopi Tribe, which said the artificial snow posed risks to public health and the environment and taking cialis would desecrate a mountain it considers sacred. The tribe lost a legal challenge to prevent the Arizona ski area from moving ahead with the plan. In December 2012, the ski area fired up its snow guns and started making powder.

During the legal fight, environmental groups, including the Center for Biological Diversity, taking cialis raised specific concerns about how wastewater can reduce local aquatic populations and cause some male fish to take on female appearances and reproductive traits. Wastewater’s effect on human health also raises concerns. Although modern water treatment can eliminate many pollutants — and, in some instances, prepare that water for human consumption — some elements still escape the process, specifically pharmaceuticals. The research is in its infancy, but a 2017 study by the United Nations Educational, Scientific and Cultural Organization found that only half of the pharmaceutical compounds were removed taking cialis in the water treatment process.

It noted that evidence suggests some of the chemicals could affect human reproductive systems, too, just as studies have shown on aquatic life. “Modern wastewater treatment plants mostly reduce solids and bacteria by oxidizing taking cialis the water. They were not designed to deal with complex chemical compounds,” said Birguy Lamizana-Diallo, program management officer at the United Nations Environment Program and an expert on wastewater treatment. Officials in Montana are quick to point out differences between their plan and what happened in Arizona.

For one, the ski area near Flagstaff often makes all its snow from treated wastewater, whereas the Yellowstone Club will use it, at least initially, on only about 10% of the 2,700 taking cialis acres of skiable terrain and usually only in October and November to create a base layer for its ski runs. Come December, most of the snow people would be skiing and riding on would be natural. But perhaps the biggest difference between the two projects is the level of support the Yellowstone Club has for its plan, which is backed by environmental and conservation groups including the Gallatin River Task Force, the Association of Gallatin Agricultural Irrigators and Trout Unlimited. The idea to turn Big Sky’s wastewater into snow has been brewing for more than a decade and emerged from a collaboration between the Yellowstone Club and other local groups concerned about depleted snowpack due to climate change, which could starve area creeks and streams taking cialis of water later in the season.

Yellowstone already uses treated wastewater to hydrate its golf courses, and in 2011 it teamed up with the Montana DEQ and the Gallatin River Task Force to see if they could safely turn the same water into snow. Chandler, the club’s environmental manager, said they successfully turned a half-million gallons of wastewater into 2 acres of snow about 18 inches deep. Kristin Gardner, executive director of the Gallatin River Task Force, said the snowmaking process effectively re-treats the wastewater by blasting it out of a filtered snowmaking gun that atomizes the taking cialis water. €œIt’s an added layer of security for the human health side of things,” Chandler said.

Chandler said the information gathered taking cialis from the pilot study forms the core of the ski club’s application with the Montana DEQ. A draft permit tentatively approving the project has been issued by the state agency, and a final decision is expected later this year. Officials at DEQ said that the wastewater used to make snow will be treated to the highest standards possible and that they can issue permits only to projects that will not pollute state waters. But the effect of pharmaceuticals remains uncharted taking cialis territory.

Amy Steinmetz, public water supply bureau chief, said that neither the DEQ nor the U.S. Environmental Protection Agency has standards to specifically treat wastewater for pharmaceuticals. €œThe science is taking cialis still emerging on that,” she said. If the DEQ does issue its final permit this year, the Yellowstone Club will most likely begin turning wastewater into snow in late 2022.

It would then be required to post signage advising skiers not to consume the snow. Similar signage can be found taking cialis at Arizona Snowbowl. Chandler said that the Yellowstone Club is proud of the collaborative work and that, ultimately, the process will benefit the community and watershed. Making more snow and increasing the snowpack during the winter, Chandler estimates, will increase the summer runoff in area creeks by about 19 days, a big win in the increasingly arid West.

It’s also better taking cialis than the alternative, he said. Treating the wastewater and then just pushing it directly into the Gallatin River. €œIt’s not like the Earth is producing taking cialis more water, so we have to use what we have effectively,” he said. Related Topics Contact Us Submit a Story Tip[Editor’s note.

If you or someone you know is in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741. In Colorado, you can also contact Colorado Crisis Services at 1-844-493-TALK (8255) or text TALK to 38255.] taking cialis KIOWA, Colo. €” The yellow-and-green facade of Patty Ann’s Cafe stands out on the main street of this ranching community just 25 miles from the Denver suburbs. Before the cialis, the cafe was a place for ranchers to gather for meals and to swap stories.

“Some people would call it almost like a taking cialis conference room,” said Lance Wheeler, a local rancher and regular at the cafe. €œThere are some guys that, if you drive by Patty Ann’s at a certain time of day, their car or truck will always be there on certain days.” When erectile dysfunction treatment restrictions closed in-person dining across Colorado last year, Patty Ann’s opened a takeout window. Customers spread their food on the hoods of their trucks and ate there while sharing news and commiserating over the stresses of ranching during the cialis. Keeping that community hub operating has been taking cialis vital for the ranchers around Kiowa as the cialis takes its toll on mental health in agricultural communities where health providers are scarce and a “pull yourself up by your own bootstraps” mentality is prevalent.

Wheeler heads into Patty Ann’s Cafe for lunch. Ranchers often come to the Kiowa, Colorado, cafe for breakfast or lunch, which Wheeler said is a way to connect with others experiencing similar stresses. €œThat’s your support group, because you have commonality, a common experience, common taking cialis difficulty.” (Eli Imadali for KHN) Roberta Kusma (left) laughs with her old friend Betty Hood at Patty Ann’s Cafe. The two worked in the same building when it was a grocery store years ago.

(Eli Imadali for KHN) The cialis over the past year has been a surprising boon for many farms and ranches as higher consumer demand amid food shortages has taking cialis boosted business. But coupled with everyday worries about weather and commodity prices, the cialis also has led to mental health challenges, including serious stress, anxiety and depression among farmers and ranchers, health officials said. The American Farm Bureau Federation found that about 3 in 5 rural adults reported that the cialis has affected mental health in their communities, while two-thirds of farmers and farmworkers said the cialis has impacted their mental health. Treatment for mental health problems caused or worsened by taking cialis the stress and isolation of the cialis has obstacles particular to ranching and farming country.

The stigma of acknowledging the need for mental health care can prevent people from seeking it. For those who overcome that obstacle and look for help, they are likely to find underfunded, understaffed and underequipped health providers who often don’t have the bandwidth or expertise for sufficient mental health support. €œI guess my cows are my therapists,” taking cialis joked Wheeler. The 54-year-old rancher said he has felt the stress of the added responsibility of providing meat to customers in a time of food shortages, particularly at the beginning of the cialis.

But he feels lucky to have a family that supports him. Because drought has impeded hay production in Colorado, Wheeler has had to have bales shipped in from taking cialis South Dakota. Wheeler says the lack of rain has been his biggest stressor. (Eli Imadali for KHN) Similar to other Rocky Mountain states, Colorado has one of the highest suicide rates in the country.

The rates taking cialis are often worse in the state’s rural communities, a factor consistent with rural Americans’ risks nationwide. A Centers for Disease Control and Prevention report examining 2001-15 data found the suicide rate in rural counties was more than 17 per 100,000 people, compared with about 15 per 100,000 in small and medium-sized metro counties and about 12 per 100,000 in large metro counties. Kiowa is in Elbert County, whose 1,850 square miles of mostly dusty, flat plains start where the affluent bedroom communities of Denver end taking cialis. The county has no urgent care center or hospital like its suburban neighbors, just four clinics to serve a population of 27,000.

A health care center in Elizabeth, Colorado, offers counseling, among other services. The few physical and mental health resources available in Elbert County are concentrated taking cialis in the west, closer to Denver. (Eli Imadali for KHN) Dwayne Smith, Elbert County’s public health director, said that to help solve the problem residents need to talk with their health providers as candidly about their mental health challenges as about skin cancer or heart disease. €œIn a more conservative community, where historically mental health issues may not have been talked about as openly and as comfortably as in the [Denver] area, you have to work diligently to increase people’s comfort level,” Smith said.

€œEven saying the words ‘anxiety,’ ‘depression,’ ‘mental health’ — all those things that in prior generations were very much a taboo subject.” Elbert taking cialis County Public Health Director Dwayne Smith poses outside the Department of Health and Human Services, surrounded by prairie. (Eli Imadali for KHN) The public health crisis is just an added burden to the already high stress on people in the agricultural industry. €œFarmers and ranchers are absorbing a lot of the shocks to the system for us. Hailstorms, pest outbreaks, drought, markets — they’re adjusting for all that to keep food production moving,” said Colorado’s agriculture commissioner, taking cialis Kate Greenberg.

Unpredictable weather, a volatile commodity market and a 700-acre grass fire cost Laura Negley, a rancher in the southeastern town of Eads, a lot of income around 2012. Negley’s and her husband’s families have been in agriculture since the late 1600s and early 1700s, and they are now the third generation on the same Colorado land. But she taking cialis was devastated after those losses, followed by her youngest child’s departure for college. €œThat’s kind of when the wheels fell off for me.

And then taking cialis I kind of spiraled down,” Negley said. The cialis exacerbated Laura Negley’s anxiety, isolating her from extended family and causing worry about her elderly parents.(Eli Imadali for KHN) Negley, now 59, said she initially didn’t recognize she needed help even though she was deep into her “dark place” of depression and anxiety, but her brother encouraged her to see a counselor near him in Greeley. So, when the cattle were done grazing for the season, Negley spent six winter weeks getting counseling 200 miles north. Those visits taking cialis eventually transitioned to phone counseling and an anti-anxiety medication.

€œI do think you have to have a support group,” said Negley, who said her faith has helped her, too. Over the years, slashed budgets to local health departments have cut to the bone. In Elbert County, Smith is taking cialis one of just three full-time employees in his department. About 15 years ago, it had at least six nurses.

It now has none. It is trying to taking cialis hire one. €œWe have a lack of health providers” in rural America, Negley said. €œThe ones we do have are doing their best — but they’re trying to wear multiple hats.” Negley talks with son Jayce as he repairs a sweep plow on their family land in Eads, Colorado.

(Eli Imadali for KHN) Negley’s and her husband’s families have been in agriculture since the late 1600s and early 1700s, and they taking cialis are now the third generation on the same Colorado land. (Eli Imadali for KHN) Stressors like severe drought and exhaustion from unrelenting hard work can lead to mental health struggles for farmers and ranchers. Negley will likely not have cattle this year because drought impeded grass growth.(Eli Imadali for KHN) Agencies in Colorado recognize the taking cialis need to improve mental health services offered to rural residents. Colorado Crisis Services has a hotline and text-messaging number to refer people to free, confidential support.

And the state is working on tailored messaging campaigns to help farmers and ranchers understand those numbers are free and confidential to contact. These services taking cialis can help. According to the CDC, for every adult death by suicide, about 230 people think seriously about suicide. A bill introduced in Colorado’s legislature would boost funding for rural rehabilitation specialists and help provide vouchers for rural Coloradans to get behavioral health services.

€œWe have to taking cialis be flexible. What works in Denver does not work in La Junta” or the rest of rural Colorado, said Robert Werthwein, director of the state’s Office of Behavioral Health. But in tightknit small towns, ranchers say, even if the resources are there the stigma remains. €œThese are taking cialis normal people with normal problems.

We’re just trying to, perhaps first and foremost, destigmatize mental health needs and resources,” Smith said. €œTimecards and schedules have had no meaning for the past year,” says Smith, one of three full-time employees in his department. €œIt’s just been never-ending.” (Eli Imadali for KHN) taking cialis Stigmas are something 26-year-old Jacob Walter and his family want to help tackle. As Walter was growing up, a friend’s father and another friend’s mother died by suicide.

Before Walter left the family’s ranch in southeastern Colorado to start his sophomore year in taking cialis college, he lost his own father, Rusty, to suicide in 2016. Walter said there were few local resources at the time to help people like his dad, and the nearest town was 45 minutes away. Rusty was involved in many community service organizations and gave a lot of his time to others, Walter said, but he suffered from depression. €œThe day before he committed suicide, we had been talking at the kitchen taking cialis table, and he was just talking about [his depression], and he said.

€˜You know, you can always get help and stuff.’” That’s the message agricultural leaders like Ray Atkinson, communications director at the American Farm Bureau Federation, say should be conveyed most. It’s OK to acknowledge when you need help. €œIf your tractor needed maintenance … taking cialis you would stop what you’re doing and you’d get it working right before you go try and go out in the field,” Atkinson said. €œYou are the most important piece of equipment on your farm.” Cattle eat hay on Rafter W Ranch near Simla, Colorado.

Drought hasn’t allowed grazing on grassy pastures. (Eli Imadali for KHN) [Editor’s taking cialis note. If you or someone you know is in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741. In Colorado, you can also contact Colorado Crisis Services at 1-844-493-TALK (8255) or text TALK to 38255.] Related Topics Contact Us Submit a Story TipKALISPELL, Mont.

€” The taking cialis erectile dysfunction treatment vaccination operation at the Flathead County fairgrounds can dole out 1,000 doses in seven hours. But demand has plummeted recently, down to fewer than 70 requests for the shots a day. So, at the start of May, the northwestern Montana county dropped taking cialis its mass vaccination offerings from three to two clinics a week. Though most of those eligible in the county haven’t yet gotten a dose, during the final Thursday clinic on April 29, few cars pulled up and nurses had time to chat between patients.

€œIt’s a trickle,” said Flathead City-County Health Officer Joe Russell. €œNot enough people will taking cialis get vaccinated to reach herd immunity, not in Flathead County and maybe not in Montana.” Daily erectile dysfunction treatment vaccination rates are falling nationwide. Gaps in treatment uptake are starting to show, especially in rural America. That leaves many communities grappling with an imperfect cialis endgame.

Flathead stands out as one of Montana’s most populated counties to fall behind taking cialis. There, 25% of people had been fully vaccinated by May 10. To compare, nearly 33% of Montanans were fully vaccinated, and that figure is closer to 35% nationwide. Flathead County is a medical destination for the top corner of the state, a gateway to Glacier National Park and neighbor to two taking cialis tribal nations.

It’s Montana’s fourth-largest county by population with more than 103,000 people, yet it’s rural — 18 people per square mile. It’s also conservative, with the majority of residents voting for former President Donald Trump last year. National polling has shown rural taking cialis Americans and Republicans to be among the most resistant to getting treatments. Russell said he hopes at least 40% of Flathead County residents eventually get the shots.

That’s well below the 70% to taking cialis 80% believed to be needed to create widespread protection from the pathogen that has stalled normal life. Public health experts worry about reservoirs of the cialis fueling outbreaks. That possibility further strains year-old tensions in places such as Flathead County, where strangers and family members alike can be split on whether the cialis is a threat and the decision to wear a mask marks where people stand. erectile dysfunction treatments are the latest phase of that taking cialis divide.

Cameron Gibbons, who lives outside Kalispell, has worried about how erectile dysfunction treatment could affect her 13-year-old son. He’s had coughs turn into lung s that landed him in the emergency room for trouble breathing, so the family has played it safe during the cialis. €œWe haven’t seen family in a long time because they haven’t chosen to be careful, which is OK, as long as when we taking cialis get back to normal we can all set our differences aside,” Gibbons said. €œNow there’s this judgment of ‘Oh, you got the treatment.’” Some of Montana’s most vaccinated places overlap with tribal nations.

Chelsea Kleinmeyer, the health director of the Confederated Salish and Kootenai Tribes, said the tribes’ members seemed to largely accept treatments after the cialis disproportionately sickened and killed Native Americans. But the reservation crosses four counties, including Flathead taking cialis. €œWe travel to those counties every single day,” Kleinmeyer said. €œIt goes back to.

Are we really protected against this cialis, these variants, if we taking cialis don’t achieve herd immunity?. € States are shifting from mass clinics to bringing shots to where people are, but that strategy, too, can be unpredictable. The same day of the county’s final Thursday clinic, the local health system hosted a walk-in clinic in the middle of taking cialis the Flathead Valley Community College campus in Kalispell. Most of the chairs for people to wait 15 minutes post-shot remained empty and, by early afternoon, the clinic had to send 200 doses to the county health department to avoid wastage.

Although organizers had hoped to vaccinate at least 100 people that day, Audra Saranto, a registered nurse who heads Kalispell Regional Healthcare’s vaccination team, said she counts the college event as a success — 50 people got treatments who might otherwise not have. As daily erectile dysfunction treatment vaccination rates slow across the nation, states are shifting from mass clinics to bringing shots more directly to taking cialis people. But results can be unpredictable. Organizers of a Flathead Valley Community College clinic on April 29 had hoped to vaccinate at least 100 people, but ended up giving out only half as many shots.

(Katheryn Houghton / KHN) The health system may taking cialis host similar clinics at major job sites, like for a lumber company. A mobile team will offer shots in busy places like farmers markets, even if it means risking people not following up for a second dose. It’s not surprising that erectile dysfunction treatment vaccinations aren’t universally accepted yet in this divided county. Flathead’s board of health deadlocked taking cialis over mask rules and crowd size limits amid the area’s worst erectile dysfunction treatment outbreaks.

Two top county health officials resigned in the past year. Thousands of people have signed dueling petitions to remove or keep one board of health member who had stirred doubt over erectile dysfunction treatment cases and opposed mask rules. And the city of Kalispell is home to state taking cialis Sen. Keith Regier, a Republican who repeated false claims on the Senate floor last month that erectile dysfunction treatments may contain microchips to track people.

Regier said in an interview he was “offering caution in how we progress with this taking cialis vaccination.” Meanwhile, Whitefish, roughly a 20-minute drive from Kalispell, has maintained a mask ordinance that has outlasted the statewide mandate. Banners downtown show local leaders asking people to mask up so people can pray together and keep schools open. Even so, the rule isn’t always followed there. At the county’s final Thursday clinic, John Calhoun, 67, undid his pearl snap shirt to get his second taking cialis shot and joked with the nurse, “I’m doing this so Joe Biden doesn’t throw me in jail.” Calhoun said he hopes being vaccinated will help him ease tensions the next time someone tells him to wear a mask.

He believes erectile dysfunction treatment is real but doesn’t think it’s as serious as health officials claim, even though he has diabetes, a risk factor for erectile dysfunction treatment complications. €œNothing seems to bother me all that bad,” Calhoun said. €œI had a horse fall on me, broke my hip, and once stabbed myself with taking cialis a hunting knife. All that caused me a bit of a problem, but other stuff just doesn’t bother me.” He decided to get the shot after an old high school friend with a degree in biochemistry told him it was important — an opinion Calhoun trusted over those of government-paid experts and liberal politicians who he said have used the cialis to grab more power.

John Calhoun doesn’t trust that erectile dysfunction treatment is as dangerous as national leaders have said, but a friend talked him into getting a shot. He hopes being vaccinated will ease tensions the next time someone tells him to wear a mask.(Katheryn Houghton / KHN) Calhoun said he’s still trying to talk his wife, taking cialis Lola, into getting vaccinated to play it safe. €œShe’s one of those ladies that you don’t talk her into much.” Lola Calhoun, 59, said she got her shingles treatment within the past year because she trusts the protection it offers. When it comes to erectile dysfunction treatment, she said she’d rather risk the cialis than be injected with treatments that feel too new, despite decades of research underpinning their unprecedented development.

€œThe erectile dysfunction treatment to me is experimental and we are the case studies,” she said taking cialis. €œMaybe a year from now, I’ll see what happens to these people who got the treatment.” On a recent evening, Ray Sederdahl, 63, sat on his girlfriend’s Kalispell porch while his grandkids picked dandelions. The Air Force veteran said even if he wasn’t skeptical of the treatments, he thinks of erectile dysfunction treatment as an illness that’s much like the flu. €œThe VA keeps trying to get me to schedule an appointment and I just say, ‘At this time, I’ll pass,’” Sederdahl said.

€œA lot of the older vets I talk to, they didn’t get it either, and they’re not gonna get it.” To Sederdahl, things feel normal enough. Businesses are open and he doesn’t have to wear a mask most places. Erica Lengacher, an intensive care unit nurse in Kalispell who has worked erectile dysfunction treatment units and treatment clinics, said she’s sad but not surprised that treatment rates are slowing. But, she said, the overall feeling at the county’s treatment clinics is hopefulness — people are still showing up, even if the crowds are smaller.

Lengacher said Flathead was hit so hard this winter, she hopes some natural immunity from those already infected, along with the growing vaccination levels, will be enough to hold off further outbreaks over the next few months. €œJust given our lifestyle — single-family homes, no public transportation, a few people per square mile — we may get away with it,” Lengacher said. €œBut there’s a big question mark of how variants show up here. There are just a lot of big question marks.” As of May 10, the county had 116 confirmed active cases of erectile dysfunction treatment, up from 71 on April 23.

Katheryn Houghton. khoughton@kff.org, @K_Hought Related Topics Contact Us Submit a Story Tip.

€œThere’s virtually no difference between white, Black, Hispanic, Asian American,” referring to vaccination cialis discount coupon rates my review here among Americans 65 and up. President Joe Biden, May 3 During May 3 remarks on the American Families Plan, President Joe Biden boasted that there was not much disparity in the vaccination rates for white Americans and Americans of color who are at least 65. “And what’s happening cialis discount coupon now is all the talk about how people were not going to get shots, they were not going to be involved — look at what that was — we were told that was most likely to be among people over 65 years of age,” said Biden. €œBut now people over 65 years of age, over 80%, have now been vaccinated, and 66% fully vaccinated.

And there’s virtually no difference between white, Black, Hispanic, Asian American.” This isn’t the only time that Biden has made that claim. He went even further on April 27 during cialis discount coupon remarks on the erectile dysfunction treatment response. €œAnd, by the way, based on reported data, the proportion — the proportion of seniors who have been vaccinated is essentially equal between white and seniors of color. €¦ As a matter of a fact, if I’m not mistaken, there are more Latinos and African American seniors that have been vaccinated, as a percentage, than white seniors.” However, the national data that Biden keeps touting — vaccination statistics regarding both race and age — is not public.

We asked the White House for the information underlying this claim, but officials cialis discount coupon did not provide specifics. So, we moved on to the Centers for Disease Control and Prevention. Spokesperson Chandra Zeikel told KHN-PolitiFact on May 6 that “unfortunately, we don’t have available a data breakdown of both racial demographics and age together.” Zeikel didn’t respond to a follow-up question asking when or if the CDC would be publishing this data, but current CDC vaccination data is broken down only by race/ethnicity and shows significant differences, with white Americans far outpacing the percentage of other groups getting a shot. It also shows that the rate of vaccinations among some groups, including Black and Latino Americans, does not match their share of cialis discount coupon the population, though new CDC data shows there has been some progress on this front in the past two weeks.

That made us wonder about the premise of Biden’s statement. We turned cialis discount coupon to experts for their take. €œAs far as I know, there is no comprehensive publicly available data on vaccination rates by race/ethnicity and age,” Samantha Artiga, vice president and director of the racial equity and health policy program at KFF, wrote in an email. €œAs such, we are not able to assess whether there are racial disparities in vaccinations among people over 65 years of age.” What about other state-level data or anecdotes that might support Biden’s claim?.

Let’s dive in cialis discount coupon and see. A Small Number of States Report Both Age and Race Together At least seven states track vaccination based on a combination of age and race, according to Artiga. Michigan, South Carolina, West Virginia, Kansas, Minnesota, Washington and Vermont. (Vermont tracks only two racial cialis discount coupon categories.

Non-Hispanic white and a combination of Black, Indigenous and people of color.) The results from some of these states show that racial disparities do exist in the older age groups. In Michigan, for instance, over 50% of non-Hispanic white people ages 65 to 74 had completed their vaccinations as of May 11. Other racial groups — non-Hispanic Black cialis discount coupon people. Asian American and Pacific Islanders.

And Hispanics — all trailed by about 10 percentage points. The exception was the Native American and Alaska Natives category, which was cialis discount coupon within 4 percentage points of white people. And as of May 11 in Kansas, the rate at which white people in that same age group were vaccinated was higher than the rates of Black people and Native Hawaiian/Pacific Islanders. In Vermont, for those 65 and up, about 79% of people of color had received at least one dose of the treatment, cialis discount coupon compared with 85% of white people as of that date.

€œWith the exception of Vermont, which has the distinction of being the only state to target BIPOC [Black, Indigenous and people of color] populations by race explicitly, these are examples of states in which the numbers are not doing well in their equity efforts,” Dayna Bowen Matthew, dean of the George Washington University Law School and an expert in racial disparities in health care, wrote in an email. Minnesota is one of the few states in which people of color are actually being vaccinated at higher rates than white people — with 93% of Asian/Pacific Islanders and 87.5% of Black/African Americans age 65 and over having received at least one shot, compared with 81.5% of white people as of May 11. Some states are vaccinating similar percentages of their population of Black or Hispanic people, Matthew cialis discount coupon said, however that data does not distinguish by age group. According to Bloomberg’s erectile dysfunction treatment Vaccination Racial Gap tracker, New Mexico, Idaho, Oregon and Utah have vaccinated approximately the same percentage of Black Americans as are represented in each state’s population.

Maine, Ohio, Alabama, Louisiana and Missouri have achieved similar population-based rates for the Hispanic population. KFF provides weekly updates on national and state race/ethnicity data of cialis discount coupon those who have received vaccinations, which have consistently shown that Black and Hispanic people are receiving smaller shares of vaccinations compared with their shares of the total population, while white people are receiving a higher share. The May 5 weekly update, for instance, found that based on the 42 states that share race/ethnicity data, the percentage of white people who have received at least one erectile dysfunction treatment dose (39%) was roughly 1.5 times higher than the rates for Black (25%) and Hispanic people (27%). (KHN is an editorially independent program of KFF.) It’s also important to note that data on race and ethnicity information has not been gathered for many people who have been vaccinated.

As of May 3, the CDC reported that race and ethnicity were known for only 55% of all people who had received at cialis discount coupon least one treatment dose. And three states, Montana, New Hampshire and Wyoming, don’t report race/ethnicity data at all. How to Approach treatment Equity, Experts Say Nneka Sederstrom, chief health equity officer at Hennepin Healthcare in Minneapolis, said that her state has done an “excellent job” vaccinating the 65-and-older population but that there’s still a lot of work to be done to reach communities of color. We “will need more direct tactics to reach” those who haven’t yet been vaccinated, “and help address any issues of hesitancy due to lack of knowledge or systemic barriers,” Sederstrom wrote in cialis discount coupon an email.

Ensuring that treatments are available at primary care providers is also important, said Dr. Georges Benjamin, executive director of the American Public cialis discount coupon Health Association. €œThe truth of the matter is, the more vaccinators that we can get that are placed where people are every day, where it becomes a routine part of your life, such as going … into your doctor’s office for a regular visit, that’s a winner,” said Benjamin. But, Dr.

Uché Blackstock, cialis discount coupon founder of Advancing Health Equity, an organization that advocates to end bias and racism in health care, said she would set the bar for treatment equity success higher than just an equally proportionate share of a certain racial/ethnic population receiving their treatment doses. €œWhat success in treatment equity would look like would be if Black people or Hispanic people were overrepresented in terms of treatment received since they have been disproportionately impacted by the cialis,” said Blackstock. So even though Biden quotes these statistics that lack data behind them, if the evidence did support them, it would still not be enough, she said. In fact, the CDC does describe cialis discount coupon treatment equity in those terms.

€œpreferential access and administration to those who have been most affected by erectile dysfunction treatment.” Our Ruling Biden has repeatedly claimed that vaccination rates among white people and people of color age 65 and older are virtually the same — or even higher among people of color. No public national data from the CDC or another database has been released to support this assertion. For the few states that do report data on age and race/ethnicity combined, the numbers suggest that, for the most part, obvious disparities persist in the vaccination rates for white seniors and cialis discount coupon seniors of color. In several states, treatment administration rates are more proportional to the percentage of the Black and Hispanic populations, but the data covers all age groups.

National data for all age groups also shows that rates of vaccinations for Black and Hispanic people lag behind that of white people. Existing data paints one story on cialis discount coupon treatment equity, while Biden’s words paint another. Without data to back it up, we rate Biden’s statement False. Sources:The Associated Press, “AP Fact cialis discount coupon check.

Biden overstates how many Americans immunized,” May 3, 2021Bloomberg News, erectile dysfunction treatment Racial Gap Tracker, accessed May 5, 2021Centers for Disease Control and Prevention, “Demographic Characteristics of People Receiving erectile dysfunction treatment Vaccinations in the United States,” accessed May 10, 2021Centers for Disease Control and Prevention, “County-Level erectile dysfunction treatment Vaccination Coverage and Social Vulnerability — United States, December 14, 2020-March 1, 2021,” March 26, 2021Email exchange with Centers for Disease Control and Prevention spokesperson Chandra Zeikel, May 6, 2021Email exchange with White House administration official, May 6, 2021Email interview with Manuel Pastor, director of the University of Southern California Equity Research Institute, May 5, 2021Email interview with Nneka Sederstrom, chief health equity officer at Hennepin Healthcare in Minneapolis, May 5, 2021Email interview with Samantha Artiga, vice president and director of the racial equity and health policy program at KFF, May 5-6, 2021Kansas.gov, erectile dysfunction treatment Demographics, accessed May 10, 2021KFF, Latest Data on erectile dysfunction treatment Vaccinations Race/Ethnicity, May 5, 2021Michigan.gov, erectile dysfunction treatment dashboard, accessed May 10, 2021Minnesota.gov, “treatment Data,” accessed May 10, 2021NBC News, “Biden Hails Progress on treatment Equity, but Some Local Leaders Paint a Different Picture,” May 3, 2021Phone/email interview with Dayna Bowen Matthew, dean and Harold H. Greene Professor of Law at the George Washington University Law School, May 6-7, 2021Phone interview with Dr. Georges Benjamin, executive director of the American Public Health cialis discount coupon Association, May 6, 2021Phone interview with Dr. Uché Blackstock, founder of Advancing Health Equity, May 6, 2021Vermont.gov, erectile dysfunction treatment Dashboard, accessed May 10, 2021White House, “Remarks by President Biden on the American Families Plan,” May 3, 2021White House, “Remarks by President Biden on the erectile dysfunction treatment Response,” April 27, 2021 Victoria Knight.

vknight@kff.org, @victoriaregisk Related Topics Contact Us Submit a Story TipEAST LOS ANGELES — For the past year, 13-year-old twins Ariel Jr. And Abraham Osorio have logged on to their online classes from their parents’ cialis discount coupon flower shop. Ariel nestles in a corner among flowers, bows and stuffed animals. Abraham sets up on a small table in the back, where his dad used to work trimming flowers and keeping the books.

It’s not ideal for learning cialis discount coupon. It’s loud. It’s cramped. It’s bustling cialis discount coupon with people.

Still, when the twins’ mother, Graciela Osorio, recently had the chance to send her kids back to Brightwood Elementary in Monterey Park, California, she decided against it. €œAfter what we went through with their father, I’d rather keep them at home where I cialis discount coupon know they are safe,” said Graciela, 51. €œThere’s only a month left. It doesn’t make sense that they return for such a short time.” The boys’ father, Ariel Osorio Sr., 51, died of erectile dysfunction treatment in January, four weeks after a trip to Mexico to visit his mother.

He fell ill quickly and wasn’t able to say goodbye to his cialis discount coupon children. Graciela Osorio is mourning the loss of her husband, Ariel Osorio, who died of erectile dysfunction treatment in January. (Heidi de Marco/KHN) “I miss his presence,” Abraham said. €œI’m used to seeing him sit in his chair working, but not anymore.” Latinos have been hit disproportionately hard by erectile dysfunction treatment, and cialis discount coupon many families are opting out of in-person learning.

In California, Latinos make up 39% of the state’s population but account for 47% of erectile dysfunction treatment deaths, according to the state Department of Public Health. Nationally, their risk of death from erectile dysfunction treatment is 2.3 times higher than that of whites. Latinos are vulnerable to the highly transmissible erectile dysfunction because they are more cialis discount coupon likely than non-Hispanic whites to work essential jobs that expose them to the public, said David Hayes-Bautista, a professor of public health and medicine at UCLA and co-author of a January study on this topic. They are more likely to lack health insurance, which may make them less likely to seek medical care, he said.

And they are more likely to live in multigenerational households, which means the cialis can spread quickly and easily within families. €œMany of them are essential workers and the breadwinners for their families and don’t have the luxury of telework, of physical distancing and cialis discount coupon self-isolation,” said Alberto González, a senior health strategist at UnidosUS, a Latino advocacy group in Washington, D.C. The Osorio family has lived in a multigenerational household since Ariel died, and Graciela had to keep other family members in mind when deciding whether to send her boys back into the classroom. In February, Graciela and the twins moved in with her 74-year-old mother, Cleotilde Servin, in East Los cialis discount coupon Angeles.

Ten people now share the roughly 1,000-square-foot home, squeezing by one another in the kitchen every morning. Cleotilde Servin makes lunch for the family members who live with her, including two daughters, a son and several grandchildren. (Heidi de Marco/KHN) Graciela’s mother and the other adults in the home have been vaccinated, but the children cialis discount coupon haven’t. Even though she instructs her sons to wear their masks and doesn’t allow them to visit friends, she’s terrified of what could happen if her kids caught the cialis at school and brought it home.

€œMy mother is active and takes vitamins, but it still worries me,” Graciela said. She got erectile dysfunction treatment from her husband and gave it to her sister and niece cialis discount coupon. €œI don’t want anyone else to get sick,” she said. State and local education officials don’t have recent data on in-person attendance by race, but an EdSource analysis of California Public Health Department data from February shows that white students were more likely to attend school in person than other students.

The analysis showed that 12% of Latinos were attending in-person classes at least some of the time, compared cialis discount coupon with 32% of whites and 18% of all students. The Los Angeles Unified School District, the second-largest in the country, serves more than 600,000 students and reopened for in-person learning in mid-April. Only some campuses are open, mostly elementary schools, and are running on hybrid schedules, combining on-campus classes with distance learning. €œWe’ve upgraded the air fiation systems in every classroom, reconfigured school facilities to keep all at a school appropriately distanced, doubled the custodial staff, and cialis discount coupon we’ll provide weekly erectile dysfunction treatment testing at school for every student and staff member,” district superintendent Austin Beutner said in his weekly recorded video update on March 22.

In a statement released May 4, Beutner said 40% to 50% of elementary school students are now back in schools in “more affluent” communities compared with roughly 20% in low-income communities. €œWe see the greatest reluctance cialis discount coupon for children to be back in schools from families who live in some of the highest-needs communities we serve,” he said. Brightwood Elementary is a K-8 school with 870 students, about half of whom are Asian American and 40% Latino, said principal Robby Jung. Just 15% of students are back on campus, he said, and, of those, about one-third are Latino.

Ariel Osorio cialis discount coupon Jr. Works on his school homework at the back of the flower shop. (Heidi de Marco/KHN) Graciela Osorio owns Gracy’s Flower Shop in East Los Angeles, California, which she used to run with her husband. (Heidi de Marco/KHN) For the Osorio family, the overriding reason the eighth grade twins are not back at Brightwood is cialis discount coupon fear.

Like so many other Latino families — roughly 28,000 Latinos have died of erectile dysfunction treatment in California — they are reeling from the grief and trauma that the disease has already wrought, and the fear of what it could do if it struck again. €œThe boys are seeing a therapist to deal with their dad’s death,” Graciela said. €œI know I should probably talk cialis discount coupon to someone, too.” With the memory of her husband’s death still so fresh that she can’t speak of him without crying, Graciela is still adjusting to the emotional toll, and to the day-to-day realities of running a flower shop by herself. Originally from Guerrero, Mexico, she started Gracy’s Flower Shop with her husband in 1997.

Ariel took care of the finances at home and at the shop and was the better English speaker of the two. €œNow being alone with the boys, it’s more difficult to keep up,” she cialis discount coupon said. After losing her husband to erectile dysfunction treatment, Graciela Osorio decided not to let her sons return to in-person learning out of fear they might contract the cialis at school. €œI tell them they have to stay focused now that their dad isn’t cialis discount coupon around to push them,” she says.

(Heidi de Marco/KHN) During the erectile dysfunction treatment lockdowns, the boys joined the couple at the shop. Her husband sat next to their children while they attended school online, helping with their homework and acting as the main contact for the school. €œThey were cialis discount coupon always with us,” Graciela said. €œThey grew up in the flower shop, so they didn’t have a problem setting up their school stations there.” Brightwood reopened its doors April 12, offering in-person learning two days a week for a few hours a day, with the rest of the sessions online.

Graciela said the limited schedule doesn’t work with her role as the family breadwinner. €œI would have to take them to school, pick cialis discount coupon them up for lunch and then bring them back,” she said. €œI can’t do that. I have to work.” But mostly she’s keeping them off campus because she doesn’t want to lose another family member.

She said cialis discount coupon she knows online classes aren’t the same as in-person instruction “but they have been keeping their grades up,” she said. €œI thank God I have good boys. They listen. They understand why I kept them home.” Abraham Osorio cialis discount coupon and Ariel Osorio Jr.

Outside their mother’s flower shop. (Heidi de Marco/KHN) The cialis discount coupon last day of school is May 28. Ariel and Abraham said they’re looking forward to high school in the fall. Still dealing with their father’s death, the boys, who are shy and reserved by nature, are torn between returning to school in person or continuing their classes online.

€œWe might go cialis discount coupon back,” Abraham said. €œFor now, we keep each other company.” This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. Heidi de Marco. heidid@kff.org, @Heidi_deMarco Related Topics Contact Us Submit a Story TipAn exclusive Montana resort wants cialis discount coupon to turn sewage into snow so that its rich and famous members can ski its slopes in a winter season that’s shrinking because of climate change.

The Yellowstone Club — a ski and golf resort just north of Yellowstone National Park that counts Bill Gates, Justin Timberlake and Jessica Biel among its members — has asked the Montana Department of Environmental Quality for a permit to allow it to use wastewater for snowmaking operations on its ski slopes. About a dozen other ski areas across the U.S. Have used wastewater to make artificial snow before, but the Yellowstone Club would be the first cialis discount coupon in Montana. The technique has also been used in Europe and Australia.

Officials at the club say the program would not only ensure the slopes can open on time, usually in late November and early December, but also replenish the area’s watershed and keep streams running longer into the season. And it would allow the cialis discount coupon growing Big Sky resort area to handle its increasing wastewater volumes. €œIt’s an outside-the-box-idea,” said Rich Chandler, environmental manager for the club. €œBut it also checks a lot of boxes.” Is it a safe plan cialis discount coupon for the rich and famous who will occasionally ingest it when they wipe out on the slopes?.

The short answer from state officials is yes. The method is safe for people and the environment as long as there is close monitoring to ensure contamination levels stay within standards, according to an environmental analysis. But, the state cialis discount coupon officials said, that analysis did not study potential pollutants for which there are no environmental standards in wastewater, such as traces of prescription drugs. A similar effort to turn wastewater into snow was controversial at the Arizona Snowbowl ski resort near Flagstaff.

To combat snowless winters there, the resort in the early 2000s purchased wastewater from Flagstaff and pumped it from the treatment plant to the ski area, where it would be turned into snow and sprayed onto the San Francisco Peaks. That drew protests from the Hopi Tribe, which said the artificial snow posed risks to public health and the environment and would desecrate a mountain it cialis discount coupon considers sacred. The tribe lost a legal challenge to prevent the Arizona ski area from moving ahead with the plan. In December 2012, the ski area fired up its snow guns and started making powder.

During the legal fight, environmental groups, including the Center for Biological Diversity, cialis discount coupon raised specific concerns about how wastewater can reduce local aquatic populations and cause some male fish to take on female appearances and reproductive traits. Wastewater’s effect on human health also raises concerns. Although modern water treatment can eliminate many pollutants — and, in some instances, prepare that water for human consumption — some elements still escape the process, specifically pharmaceuticals. The research is in its infancy, but a 2017 study by the United Nations Educational, Scientific and Cultural Organization found that only half of the pharmaceutical compounds were cialis discount coupon removed in the water treatment process.

It noted that evidence suggests some of the chemicals could affect human reproductive systems, too, just as studies have shown on aquatic life. “Modern cialis discount coupon wastewater treatment plants mostly reduce solids and bacteria by oxidizing the water. They were not designed to deal with complex chemical compounds,” said Birguy Lamizana-Diallo, program management officer at the United Nations Environment Program and an expert on wastewater treatment. Officials in Montana are quick to point out differences between their plan and what happened in Arizona.

For one, the ski area near Flagstaff often makes all its snow from treated wastewater, whereas the Yellowstone Club will use it, at least initially, on only about 10% of the 2,700 acres of skiable terrain and usually only in October and November to create a cialis discount coupon base layer for its ski runs. Come December, most of the snow people would be skiing and riding on would be natural. But perhaps the biggest difference between the two projects is the level of support the Yellowstone Club has for its plan, which is backed by environmental and conservation groups including the Gallatin River Task Force, the Association of Gallatin Agricultural Irrigators and Trout Unlimited. The idea to turn Big Sky’s wastewater into snow has been brewing for more than a decade and emerged from a collaboration between the Yellowstone Club and other local groups concerned about depleted snowpack due to climate change, cialis discount coupon which could starve area creeks and streams of water later in the season.

Yellowstone already uses treated wastewater to hydrate its golf courses, and in 2011 it teamed up with the Montana DEQ and the Gallatin River Task Force to see if they could safely turn the same water into snow. Chandler, the club’s environmental manager, said they successfully turned a half-million gallons of wastewater into 2 acres of snow about 18 inches deep. Kristin Gardner, executive cialis discount coupon director of the Gallatin River Task Force, said the snowmaking process effectively re-treats the wastewater by blasting it out of a filtered snowmaking gun that atomizes the water. €œIt’s an added layer of security for the human health side of things,” Chandler said.

Chandler said the information gathered from the pilot study forms the core of the ski club’s application cialis discount coupon with the Montana DEQ. A draft permit tentatively approving the project has been issued by the state agency, and a final decision is expected later this year. Officials at DEQ said that the wastewater used to make snow will be treated to the highest standards possible and that they can issue permits only to projects that will not pollute state waters. But the effect of cialis discount coupon pharmaceuticals remains uncharted territory.

Amy Steinmetz, public water supply bureau chief, said that neither the DEQ nor the U.S. Environmental Protection Agency has standards to specifically treat wastewater for pharmaceuticals. €œThe science is still emerging cialis discount coupon on that,” she said. If the DEQ does issue its final permit this year, the Yellowstone Club will most likely begin turning wastewater into snow in late 2022.

It would then be required to post signage advising skiers not to consume the snow. Similar signage can be found at Arizona Snowbowl cialis discount coupon. Chandler said that the Yellowstone Club is proud of the collaborative work and that, ultimately, the process will benefit the community and watershed. Making more snow and increasing the snowpack during the winter, Chandler estimates, will increase the summer runoff in area creeks by about 19 days, a big win in the increasingly arid West.

It’s also better than the cialis discount coupon alternative, he said. Treating the wastewater and then just pushing it directly into the Gallatin River. €œIt’s not like the Earth is producing more water, so we have to use cialis discount coupon what we have effectively,” he said. Related Topics Contact Us Submit a Story Tip[Editor’s note.

If you or someone you know is in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741. In Colorado, you can also contact Colorado Crisis Services at 1-844-493-TALK (8255) or text TALK to 38255.] KIOWA, Colo cialis discount coupon. €” The yellow-and-green facade of Patty Ann’s Cafe stands out on the main street of this ranching community just 25 miles from the Denver suburbs. Before the cialis, the cafe was a place for ranchers to gather for meals and to swap stories.

“Some people would call it almost like a conference cialis discount coupon room,” said Lance Wheeler, a local rancher and regular at the cafe. €œThere are some guys that, if you drive by Patty Ann’s at a certain time of day, their car or truck will always be there on certain days.” When erectile dysfunction treatment restrictions closed in-person dining across Colorado last year, Patty Ann’s opened a takeout window. Customers spread their food on the hoods of their trucks and ate there while sharing news and commiserating over the stresses of ranching during the cialis. Keeping that community hub operating has been vital for the ranchers around Kiowa as the cialis takes its toll on mental health in agricultural communities where health providers are scarce and a “pull yourself up by your cialis discount coupon own bootstraps” mentality is prevalent.

Wheeler heads into Patty Ann’s Cafe for lunch. Ranchers often come to the Kiowa, Colorado, cafe for breakfast or lunch, which Wheeler said is a way to connect with others experiencing similar stresses. €œThat’s your support group, because you have commonality, a common experience, common difficulty.” (Eli Imadali for KHN) Roberta Kusma (left) laughs with her old friend Betty Hood at cialis discount coupon Patty Ann’s Cafe. The two worked in the same building when it was a grocery store years ago.

(Eli Imadali for KHN) The cialis over the past year has been a surprising boon for many cialis discount coupon farms and ranches as higher consumer demand amid food shortages has boosted business. But coupled with everyday worries about weather and commodity prices, the cialis also has led to mental health challenges, including serious stress, anxiety and depression among farmers and ranchers, health officials said. The American Farm Bureau Federation found that about 3 in 5 rural adults reported that the cialis has affected mental health in their communities, while two-thirds of farmers and farmworkers said the cialis has impacted their mental health. Treatment for mental health problems caused or worsened by the stress and isolation of the cialis has obstacles cialis discount coupon particular to ranching and farming country.

The stigma of acknowledging the need for mental health care can prevent people from seeking it. For those who overcome that obstacle and look for help, they are likely to find underfunded, understaffed and underequipped health providers who often don’t have the bandwidth or expertise for sufficient mental health support. €œI guess my cows are my cialis discount coupon therapists,” joked Wheeler. The 54-year-old rancher said he has felt the stress of the added responsibility of providing meat to customers in a time of food shortages, particularly at the beginning of the cialis.

But he feels lucky to have a family that supports him. Because drought has impeded hay production in Colorado, Wheeler has had to have bales cialis discount coupon shipped in from South Dakota. Wheeler says the lack of rain has been his biggest stressor. (Eli Imadali for KHN) Similar to other Rocky Mountain states, Colorado has one of the highest suicide rates in the country.

The rates are often cialis discount coupon worse in the state’s rural communities, a factor consistent with rural Americans’ risks nationwide. A Centers for Disease Control and Prevention report examining 2001-15 data found the suicide rate in rural counties was more than 17 per 100,000 people, compared with about 15 per 100,000 in small and medium-sized metro counties and about 12 per 100,000 in large metro counties. Kiowa is in Elbert County, whose 1,850 square miles of mostly dusty, flat plains cialis discount coupon start where the affluent bedroom communities of Denver end. The county has no urgent care center or hospital like its suburban neighbors, just four clinics to serve a population of 27,000.

A health care center in Elizabeth, Colorado, offers counseling, among other services. The few physical and mental health resources available cialis discount coupon in Elbert County are concentrated in the west, closer to Denver. (Eli Imadali for KHN) Dwayne Smith, Elbert County’s public health director, said that to help solve the problem residents need to talk with their health providers as candidly about their mental health challenges as about skin cancer or heart disease. €œIn a more conservative community, where historically mental health issues may not have been talked about as openly and as comfortably as in the [Denver] area, you have to work diligently to increase people’s comfort level,” Smith said.

€œEven saying the words ‘anxiety,’ ‘depression,’ ‘mental health’ — all those things that in prior generations were very much a taboo cialis discount coupon subject.” Elbert County Public Health Director Dwayne Smith poses outside the Department of Health and Human Services, surrounded by prairie. (Eli Imadali for KHN) The public health crisis is just an added burden to the already high stress on people in the agricultural industry. €œFarmers and ranchers are absorbing a lot of the shocks to the system for us. Hailstorms, pest cialis discount coupon outbreaks, drought, markets — they’re adjusting for all that to keep food production moving,” said Colorado’s agriculture commissioner, Kate Greenberg.

Unpredictable weather, a volatile commodity market and a 700-acre grass fire cost Laura Negley, a rancher in the southeastern town of Eads, a lot of income around 2012. Negley’s and her husband’s families have been in agriculture since the late 1600s and early 1700s, and they are now the third generation on the same Colorado land. But she was devastated after those losses, followed by her youngest child’s departure cialis discount coupon for college. €œThat’s kind of when the wheels fell off for me.

And then I kind cialis discount coupon of spiraled down,” Negley said. The cialis exacerbated Laura Negley’s anxiety, isolating her from extended family and causing worry about her elderly parents.(Eli Imadali for KHN) Negley, now 59, said she initially didn’t recognize she needed help even though she was deep into her “dark place” of depression and anxiety, but her brother encouraged her to see a counselor near him in Greeley. So, when the cattle were done grazing for the season, Negley spent six winter weeks getting counseling 200 miles north. Those visits eventually transitioned cialis discount coupon to phone counseling and an anti-anxiety medication.

€œI do think you have to have a support group,” said Negley, who said her faith has helped her, too. Over the years, slashed budgets to local health departments have cut to the bone. In Elbert County, Smith cialis discount coupon is one of just three full-time employees in his department. About 15 years ago, it had at least six nurses.

It now has none. It is trying cialis discount coupon to hire one. €œWe have a lack of health providers” in rural America, Negley said. €œThe ones we do have are doing their best — but they’re trying to wear multiple hats.” Negley talks with son Jayce as he repairs a sweep plow on their family land in Eads, Colorado.

(Eli Imadali for KHN) Negley’s and her husband’s families have been in agriculture since the cialis discount coupon late 1600s and early 1700s, and they are now the third generation on the same Colorado land. (Eli Imadali for KHN) Stressors like severe drought and exhaustion from unrelenting hard work can lead to mental health struggles for farmers and ranchers. Negley will likely not have cattle this year cialis discount coupon because drought impeded grass growth.(Eli Imadali for KHN) Agencies in Colorado recognize the need to improve mental health services offered to rural residents. Colorado Crisis Services has a hotline and text-messaging number to refer people to free, confidential support.

And the state is working on tailored messaging campaigns to help farmers and ranchers understand those numbers are free and confidential to contact. These services cialis discount coupon can help. According to the CDC, for every adult death by suicide, about 230 people think seriously about suicide. A bill introduced in Colorado’s legislature would boost funding for rural rehabilitation specialists and help provide vouchers for rural Coloradans to get behavioral health services.

€œWe have to cialis discount coupon be flexible. What works in Denver does not work in La Junta” or the rest of rural Colorado, said Robert Werthwein, director of the state’s Office of Behavioral Health. But in tightknit small towns, ranchers say, even if the resources are there the stigma remains. €œThese are normal people with normal problems cialis discount coupon.

We’re just trying to, perhaps first and foremost, destigmatize mental health needs and resources,” Smith said. €œTimecards and schedules have had no meaning for the past year,” says Smith, one of three full-time employees in his department. €œIt’s just been never-ending.” (Eli Imadali for KHN) Stigmas are cialis discount coupon something 26-year-old Jacob Walter and his family want to help tackle. As Walter was growing up, a friend’s father and another friend’s mother died by suicide.

Before Walter left the family’s ranch cialis discount coupon in southeastern Colorado to start his sophomore year in college, he lost his own father, Rusty, to suicide in 2016. Walter said there were few local resources at the time to help people like his dad, and the nearest town was 45 minutes away. Rusty was involved in many community service organizations and gave a lot of his time to others, Walter said, but he suffered from depression. €œThe day before he committed suicide, we had been talking cialis discount coupon at the kitchen table, and he was just talking about [his depression], and he said.

€˜You know, you can always get help and stuff.’” That’s the message agricultural leaders like Ray Atkinson, communications director at the American Farm Bureau Federation, say should be conveyed most. It’s OK to acknowledge when you need help. €œIf your cialis discount coupon tractor needed maintenance … you would stop what you’re doing and you’d get it working right before you go try and go out in the field,” Atkinson said. €œYou are the most important piece of equipment on your farm.” Cattle eat hay on Rafter W Ranch near Simla, Colorado.

Drought hasn’t allowed grazing on grassy pastures. (Eli Imadali cialis discount coupon for KHN) [Editor’s note. If you or someone you know is in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741. In Colorado, you can also contact Colorado Crisis Services at 1-844-493-TALK (8255) or text TALK to 38255.] Related Topics Contact Us Submit a Story TipKALISPELL, Mont.

€” The erectile dysfunction treatment vaccination operation at the Flathead County fairgrounds can dole out 1,000 doses in seven hours cialis discount coupon. But demand has plummeted recently, down to fewer than 70 requests for the shots a day. So, at the start of May, the northwestern Montana county dropped its mass vaccination offerings cialis discount coupon from three to two clinics a week. Though most of those eligible in the county haven’t yet gotten a dose, during the final Thursday clinic on April 29, few cars pulled up and nurses had time to chat between patients.

€œIt’s a trickle,” said Flathead City-County Health Officer Joe Russell. €œNot enough people will cialis discount coupon get vaccinated to reach herd immunity, not in Flathead County and maybe not in Montana.” Daily erectile dysfunction treatment vaccination rates are falling nationwide. Gaps in treatment uptake are starting to show, especially in rural America. That leaves many communities grappling with an imperfect cialis endgame.

Flathead stands out as one of cialis discount coupon Montana’s most populated counties to fall behind. There, 25% of people had been fully vaccinated by May 10. To compare, nearly 33% of Montanans were fully vaccinated, and that figure is closer to 35% nationwide. Flathead County is a medical destination for the top corner of the state, a gateway cialis discount coupon to Glacier National Park and neighbor to two tribal nations.

It’s Montana’s fourth-largest county by population with more than 103,000 people, yet it’s rural — 18 people per square mile. It’s also conservative, with the majority of residents voting for former President Donald Trump last year. National polling cialis discount coupon has shown rural Americans and Republicans to be among the most resistant to getting treatments. Russell said he hopes at least 40% of Flathead County residents eventually get the shots.

That’s well cialis discount coupon below the 70% to 80% believed to be needed to create widespread protection from the pathogen that has stalled normal life. Public health experts worry about reservoirs of the cialis fueling outbreaks. That possibility further strains year-old tensions in places such as Flathead County, where strangers and family members alike can be split on whether the cialis is a threat and the decision to wear a mask marks where people stand. erectile dysfunction treatments are cialis discount coupon the latest phase of that divide.

Cameron Gibbons, who lives outside Kalispell, has worried about how erectile dysfunction treatment could affect her 13-year-old son. He’s had coughs turn into lung s that landed him in the emergency room for trouble breathing, so the family has played it safe during the cialis. €œWe haven’t seen family in a long time because they haven’t chosen to be careful, which is OK, as long as when we cialis discount coupon get back to normal we can all set our differences aside,” Gibbons said. €œNow there’s this judgment of ‘Oh, you got the treatment.’” Some of Montana’s most vaccinated places overlap with tribal nations.

Chelsea Kleinmeyer, the health director of the Confederated Salish and Kootenai Tribes, said the tribes’ members seemed to largely accept treatments after the cialis disproportionately sickened and killed Native Americans. But the reservation crosses four counties, cialis discount coupon including Flathead. €œWe travel to those counties every single day,” Kleinmeyer said. €œIt goes back to.

Are we really protected against this cialis, these cialis discount coupon variants, if we don’t achieve herd immunity?. € States are shifting from mass clinics to bringing shots to where people are, but that strategy, too, can be unpredictable. The same day of the county’s final cialis discount coupon Thursday clinic, the local health system hosted a walk-in clinic in the middle of the Flathead Valley Community College campus in Kalispell. Most of the chairs for people to wait 15 minutes post-shot remained empty and, by early afternoon, the clinic had to send 200 doses to the county health department to avoid wastage.

Although organizers had hoped to vaccinate at least 100 people that day, Audra Saranto, a registered nurse who heads Kalispell Regional Healthcare’s vaccination team, said she counts the college event as a success — 50 people got treatments who might otherwise not have. As daily erectile dysfunction treatment cialis discount coupon vaccination rates slow across the nation, states are shifting from mass clinics to bringing shots more directly to people. But results can be unpredictable. Organizers of a Flathead Valley Community College clinic on April 29 had hoped to vaccinate at least 100 people, but ended up giving out only half as many shots.

(Katheryn Houghton / KHN) The health system may host similar clinics at major job sites, like for a lumber company cialis discount coupon. A mobile team will offer shots in busy places like farmers markets, even if it means risking people not following up for a second dose. It’s not surprising that erectile dysfunction treatment vaccinations aren’t universally accepted yet in this divided county. Flathead’s board of health deadlocked cialis discount coupon over mask rules and crowd size limits amid the area’s worst erectile dysfunction treatment outbreaks.

Two top county health officials resigned in the past year. Thousands of people have signed dueling petitions to remove or keep one board of health member who had stirred doubt over erectile dysfunction treatment cases and opposed mask rules. And the city of Kalispell is home to state Sen cialis discount coupon. Keith Regier, a Republican who repeated false claims on the Senate floor last month that erectile dysfunction treatments may contain microchips to track people.

Regier said in an interview he was “offering caution in how we progress cialis discount coupon with this vaccination.” Meanwhile, Whitefish, roughly a 20-minute drive from Kalispell, has maintained a mask ordinance that has outlasted the statewide mandate. Banners downtown show local leaders asking people to mask up so people can pray together and keep schools open. Even so, the rule isn’t always followed there. At the county’s final Thursday clinic, John Calhoun, 67, undid his pearl snap shirt to get his second shot and joked with the nurse, “I’m doing this so Joe Biden doesn’t cialis discount coupon throw me in jail.” Calhoun said he hopes being vaccinated will help him ease tensions the next time someone tells him to wear a mask.

He believes erectile dysfunction treatment is real but doesn’t think it’s as serious as health officials claim, even though he has diabetes, a risk factor for erectile dysfunction treatment complications. €œNothing seems to bother me all that bad,” Calhoun said. €œI had a cialis discount coupon horse fall on me, broke my hip, and once stabbed myself with a hunting knife. All that caused me a bit of a problem, but other stuff just doesn’t bother me.” He decided to get the shot after an old high school friend with a degree in biochemistry told him it was important — an opinion Calhoun trusted over those of government-paid experts and liberal politicians who he said have used the cialis to grab more power.

John Calhoun doesn’t trust that erectile dysfunction treatment is as dangerous as national leaders have said, but a friend talked him into getting a shot. He hopes being vaccinated will ease tensions the next time someone tells him to wear a mask.(Katheryn Houghton / KHN) Calhoun said he’s still trying to talk his wife, Lola, cialis discount coupon into getting vaccinated to play it safe. €œShe’s one of those ladies that you don’t talk her into much.” Lola Calhoun, 59, said she got her shingles treatment within the past year because she trusts the protection it offers. When it comes to erectile dysfunction treatment, she said she’d rather risk the cialis than be injected with treatments that feel too new, despite decades of research underpinning their unprecedented development.

€œThe erectile dysfunction treatment to me is experimental and we are the case studies,” she said. €œMaybe a year from now, I’ll see what happens to these people who got the treatment.” On a recent evening, Ray Sederdahl, 63, sat on his girlfriend’s Kalispell porch while his grandkids picked dandelions. The Air Force veteran said even if he wasn’t skeptical of the treatments, he thinks of erectile dysfunction treatment as an illness that’s much like the flu. €œThe VA keeps trying to get me to schedule an appointment and I just say, ‘At this time, I’ll pass,’” Sederdahl said.

€œA lot of the older vets I talk to, they didn’t get it either, and they’re not gonna get it.” To Sederdahl, things feel normal enough. Businesses are open and he doesn’t have to wear a mask most places. Erica Lengacher, an intensive care unit nurse in Kalispell who has worked erectile dysfunction treatment units and treatment clinics, said she’s sad but not surprised that treatment rates are slowing. But, she said, the overall feeling at the county’s treatment clinics is hopefulness — people are still showing up, even if the crowds are smaller.

Lengacher said Flathead was hit so hard this winter, she hopes some natural immunity from those already infected, along with the growing vaccination levels, will be enough to hold off further outbreaks over the next few months. €œJust given our lifestyle — single-family homes, no public transportation, a few people per square mile — we may get away with it,” Lengacher said. €œBut there’s a big question mark of how variants show up here. There are just a lot of big question marks.” As of May 10, the county had 116 confirmed active cases of erectile dysfunction treatment, up from 71 on April 23.

Katheryn Houghton. khoughton@kff.org, @K_Hought Related Topics Contact Us Submit a Story Tip.