Are you happy with your penis size? Many men are not. Men with small penises are often the butt of jokes and may even fear rejection from women. If you’ve decided to do something about your penis size instead of just suffering with it, good for you. However, you need to know that there are NO LAZY WAYS to enlarge your penis! Surgery, penis weight hanging, penis pumps, and penis enlargement pills DO NOT WORK! Avoid these four penis enlargement methods at all costs! Find out why. Read more
יום שלישי, 1 בנובמבר 2011
4 Penis Enlargement Methods to Avoid at All Costs!
Men interested in viagra cialis online pharmacy pharmacy enlargement need to read Svetlana Ivanova's article at her blog Sex Secrets about the four penis enlargement methods you should avoid at all costs. These methods are not only expensive and potentially unsafe, but also ineffective.
יום שבת, 29 באוקטובר 2011
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יום שלישי, 24 במאי 2011
President Obama and the Red Pill Blue Pill Discussion: The Real World Doesn't Work So Simply
In its health insurance days, the Disease Management Care Blog learned an important rule: never ever let anyone upstairs in the 'C' suites get involved in the cumbersome details of pharmaceutical coverage. That included the formulary, comparative effectiveness, pricing or making a medical necessity call on an individual patient. It wasn’t their fault, but they often messed things up with over-simplifications, lack of scientific knowledge or poor communication.Case in point? All were amply demonstrated in last night’s President Obama’s red pill-blue pill explanation:
“If there’s a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that’s going to make you well?”
This was a rare lapse for a President with such impressive communication skills and a staff that’s been helping to keep him on message. What’s more, the euphemism blew right past our bored (‘may cause drowsiness,’ ‘lackluster,’ ‘paying defense’ and ‘small’) press corps into Americans’ living rooms, where the damage to our body politic was done. It reinforced a hopeless expectation that can never be achieved in the real world.
“If there’s a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that’s going to make you well?”
This was a rare lapse for a President with such impressive communication skills and a staff that’s been helping to keep him on message. What’s more, the euphemism blew right past our bored (‘may cause drowsiness,’ ‘lackluster,’ ‘paying defense’ and ‘small’) press corps into Americans’ living rooms, where the damage to our body politic was done. It reinforced a hopeless expectation that can never be achieved in the real world.
In the real world, the blue pill never works ‘just as well’ as the red pill.
Different viagra have different molecular structures that impart different properties in how quickly they are absorbed, digested, reacted to, metabolized and cleared. In the laboratory, in individuals and in populations, there are, and sometimes there aren’t, real differences in risks, benefits and side effects.
Red pill-blue thinking is often applied to stomach acid, cholesterol lowering and anti-depressant medications. Some examples of how complicated this can become:
Esomeprazole (Nexium) is the active stereoisomer of the active ingredient omeprazole (Prilosec). According to this paper, it reduces stomach acid for a longer period of time. Many well meaning lay persons and some physicians could scientifically conclude Nexium is a better drug. That doesn’t mean there will be necessarily improved clinical outcomes. Should Nexium be the red or the blue pill?
It is well known that cholesterol drugs differ in ‘potency.’ Many well meaning lay persons and physicians could conclude that a high dose of a potent statin is a better strategy. This observational and real world study, however, found that a change involving atrovastin (Pfizer’s potent Lipitor) did not lead to a significant decline in the study population’s cholesterol levels. If a doctor is convinced that the potency is important for the patient, should Lipitor be the red or the blue pill?
The success of antidepressant medications are known to vary, depending on the symptoms, concurrent medications, side effects, medication response history, tolerance and patient preferences. Yet, there is consensus is that there is an ‘equivalence of therapeutic effect,’ which is shared by primary care physician leaders. Which symptoms, concurrent medications, side effects etc. should be used to decide which should be the antidepressant red cialis and which should be the blue ones?
Which brings up a deeper problem in the President’s words. Reconciling red versus blue pills is what doctors do. Unfortunately, they don’t necessarily do a good job. Saying that we’re going to insist on blue pills while simultaneously respecting the independence of the doctor-patient relationship is an exercise in cognitive dissonance.
If pressed about covering medications, health insurance C-suite execs and Presidents should stick to saying they are doing their best to make sure that the right drug reaches the right patient for the right reasons. They should also admit that that process for making this happen is imperfect and that we have ways to make it less cumbersome and more precise.
Last but not least, the DMCB wonders if the red pill –blue pill discussion may be more than a Presidential misstep. If it is representative of sophistication of the policy-making going on inside the White House, maybe it’s not such a bad idea that things slow down.
יום שלישי, 3 במאי 2011
SSWAHS = SWSLHN + SLHN: Will it be different for the people of the Southern Highlands?
SSWAHS = SWSLHN + SLHN: Will it be different for the people of the Southern Highlands?
Well, apart from two rural LHNs, the Premier and Health Minister have decided upon who will be the Chief Executives of the other 16 Local Health/Hospital Networks.
At this time it is still unclear to the community members as to what will happen to the old SSWAHS Clinical Divisions and, more importantly, whether the people of the Southern Highlands will have the same access to the specialist inpatient beds which they had in the past. Or will the old Central Sydney AHS now re-branded as the Sydney Local order cialis Network (SLHN), manage to set up the barricades again?
Dr Victor Storm must be rubbing his hands with glee that he is back in his old stamping ground with control of his new, beaut "asylum" (you know, the one he said we should do without) the Concord Centre for Mental Health. I wonder if his vision of mental health (and treatment of the mentally ill) still extends southwards to Bowral cheap cialis and the Southern Highlands.
It's yet too early to get the information as to "who's who in the zoo" when it comes to the lesser mortals in the new 18 Local Hospital/Health Networks. One of the other persons mentioned in this blog, notably for her prolonged silences, appears to have slipped off the radar when it comes to the top jobs. Surprisingly, Jan Whalan appears to have also slipped off the Christmas card list for the Premier and the Minister as she did not get one of the Chief Executive positions published by NSW Health to date. I guess she could still manage to swing into one of the two remaining rural LHNs - if she hasn't trodden on too many toes! Perhaps, (hopefully) Ms Jan Whalan is making a return to running a pharmacy somewhere!
One bright spot in the shuffle of chairs is that the new Chief Executive for the SWSLHN which, according to the blurb, runs from "Fairfield to Bowral" is none other than Ms Amanda Larkin.
Amanda Larkin started her rise up the ranks by being the General Manager of Bowral Hospital for a number of years. She was then asked to manage the Campbelltown/Camden Hospitals when there was a shake-up in the system there a few years ago. She presided over the Macarthur-Wingecarribee health services until the recruitment of the General Manager for Macarthur Health Service took place and then took up the permanent position of General Manager of the Macarthur Health Service, thereby allowing the hardworking Denis Thomas to be appointed to the Bowral Hospital as General Manager. Even though she may be relocating to the Liverpool Hospital campus in her new position as Chief Executive of the SWSLHN I'm happy to report that, unlike her predecessors, Amanda Larkin does know where Bowral is and where the rest of the health services in Southern Highlands happen to be.
Nevertheless, as residents of the Southern Highlands we cannot become complacent about the state of the health services being offered in the Highlands. There are still issues of a more appropriate use of the operating theatres at Bowral Hospital to reduce the waiting list for elective surgery. And while Bowral Hospital is given a tick for renal dialysis does it really happen as much as it should?
Let's keep vigilant about our health service and remember - the NSW State election is only about 43 days away!
Well, apart from two rural LHNs, the Premier and Health Minister have decided upon who will be the Chief Executives of the other 16 Local Health/Hospital Networks.
At this time it is still unclear to the community members as to what will happen to the old SSWAHS Clinical Divisions and, more importantly, whether the people of the Southern Highlands will have the same access to the specialist inpatient beds which they had in the past. Or will the old Central Sydney AHS now re-branded as the Sydney Local order cialis Network (SLHN), manage to set up the barricades again?
Dr Victor Storm must be rubbing his hands with glee that he is back in his old stamping ground with control of his new, beaut "asylum" (you know, the one he said we should do without) the Concord Centre for Mental Health. I wonder if his vision of mental health (and treatment of the mentally ill) still extends southwards to Bowral cheap cialis and the Southern Highlands.
It's yet too early to get the information as to "who's who in the zoo" when it comes to the lesser mortals in the new 18 Local Hospital/Health Networks. One of the other persons mentioned in this blog, notably for her prolonged silences, appears to have slipped off the radar when it comes to the top jobs. Surprisingly, Jan Whalan appears to have also slipped off the Christmas card list for the Premier and the Minister as she did not get one of the Chief Executive positions published by NSW Health to date. I guess she could still manage to swing into one of the two remaining rural LHNs - if she hasn't trodden on too many toes! Perhaps, (hopefully) Ms Jan Whalan is making a return to running a pharmacy somewhere!
One bright spot in the shuffle of chairs is that the new Chief Executive for the SWSLHN which, according to the blurb, runs from "Fairfield to Bowral" is none other than Ms Amanda Larkin.
Amanda Larkin started her rise up the ranks by being the General Manager of Bowral Hospital for a number of years. She was then asked to manage the Campbelltown/Camden Hospitals when there was a shake-up in the system there a few years ago. She presided over the Macarthur-Wingecarribee health services until the recruitment of the General Manager for Macarthur Health Service took place and then took up the permanent position of General Manager of the Macarthur Health Service, thereby allowing the hardworking Denis Thomas to be appointed to the Bowral Hospital as General Manager. Even though she may be relocating to the Liverpool Hospital campus in her new position as Chief Executive of the SWSLHN I'm happy to report that, unlike her predecessors, Amanda Larkin does know where Bowral is and where the rest of the health services in Southern Highlands happen to be.
Nevertheless, as residents of the Southern Highlands we cannot become complacent about the state of the health services being offered in the Highlands. There are still issues of a more appropriate use of the operating theatres at Bowral Hospital to reduce the waiting list for elective surgery. And while Bowral Hospital is given a tick for renal dialysis does it really happen as much as it should?
Let's keep vigilant about our health service and remember - the NSW State election is only about 43 days away!
Bicycles - viagra 4 the urban landscape
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Bicycles are sexy!! - a "multivitamin order cialis pill 4 the urban landscape"
Notice that the models can actually ride the bicycles - cool!!
Bicycles are sexy!! - a "multivitamin order cialis pill 4 the urban landscape"
Notice that the models can actually ride the bicycles - cool!!
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