Diet and nutrition, Chalandri
76

Health professionals for Diet and nutrition near Chalandri

About the specialist

Skoulidi Virna BSc, MSc is a Dietitian - Nutritionist with a private practice in Nea Ionia. She holds a degree in Nutrition and Dietetics from the Technological Educational Institute of Crete and has attended a clinical nutrition and dietetics seminar at the National and Kapodistrian University of Athens. Additionally, she possesses a master's degree in Nutrition, Public Health & Policies from the Agricultural University of Athens and in Nutritional Psychology from the CNP (Center for Nutritional Psychology). The specialist has worked as a Dietitian - Nutritionist at SALAS Catering Company and Fitpal Healthy Meals Company, as well as at the Elegance Aesthetic Center. Furthermore, she has worked in a Pulmonologist and Dietitian office, providing nutritional education to patients, body composition assessment, and designing individualized nutrition programs. Since 2016, she has been a contributor to magazines and websites related to wellness & fitness (Shape, Savoir Ville).

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Eleutheriou Venizelou 128, Nea Ionia, ΑΤΤΙΚΗ

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About the specialist

Dr. Kaza Maria, MD, MSc, PhD, is a Endocrinologist – Diabetologist | Metabolism Specialist and maintains a private practice in Gerakas. She is a contracted Lecturer at the Department of Pharmacy at the National and Kapodistrian University of Athens. She holds a doctorate with honors from the Medical School of the National and Kapodistrian University of Athens, with a doctoral thesis entitled "The effect of physical activity on the physical and mental well-being of children and adolescents with diabetes mellitus". She completed with Distinction her postgraduate studies in Endocrinology and Diabetes (MSc in Endocrinology and Diabetes) at the Medical School of Queen Mary University of London (Queen Mary University of London, Barts and the London School of Medicine and Dentistry UK) and is a graduate of the Medical School of the University of Patras. She has been trained in hospitals in Greece and the United Kingdom and possesses extensive clinical experience in a wide range of endocrinological disorders, such as type 1 and 2 diabetes mellitus, gestational diabetes, obesity, thyroid diseases, osteoporosis, and endocrine disorders of pregnancy, polycystic ovary syndrome, menstrual disorders, diseases of the adrenal glands and pituitary, and endocrine hypertension. Her research and academic activities further include publications in international medical journals, participation in Greek and international conferences, as well as teaching experience at the Dietetics and Sport Science departments of Metropolitan and Mediterranean College. She is a member of the Hellenic Endocrinological Society, the General Medical Council (GMC) of the United Kingdom, and the Athens Medical Association. Finally, she holds degrees in English and French languages. 

Θεσσαλονίκης 13 & Ηρώων Πολυτεχνείου 15, Gerakas, ΑΤΤΙΚΗ

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About the specialist

Zisiadis Dimitris MD, MSc, PhDc, is a General Surgeon and Director of the Surgical Clinic at the Medical Center of Athens - Psychiko, with private practices in Kifisia, Agios Dimitrios, Ilion, and Psychiko. He is a PhD candidate at the Medical School of the National and Kapodistrian University of Athens and holds a master's degree in Bioethics from the Medical School of Democritus University of Thrace. Additionally, it is worth mentioning his specialization in Laparoscopic Surgery from the University of Strasbourg in France, Minimally Invasive surgery for inguinal hernia repair at IRCAD, and training in robot-assisted laparoscopic surgery. He has participated in thousands of surgeries for critically ill patients during his surgical practice in the public sector, as well as numerous advanced surgical reconstructions abroad, with a strong commitment to implementing these techniques in Greece. He has served as a collaborating Surgeon in numerous private centers in Greece, Italy, and the UK (London), participating in a wide range of general, laparoscopic, and robotic surgical procedures. He employs the most modern equipment and state-of-the-art techniques worldwide. He has also been trained in the repair of inguinal hernia, hydrocele, and ventral hernia using double mesh and local anesthesia. Finally, he has actively participated in numerous surgical conferences in Greece and courses organized by the Hellenic Surgical Society.

Zisiadis Adersen 1, Psychiko, ΑΤΤΙΚΗ

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About the specialist

Ο Πλούταρχος Τζούλης, Ενδοκρινολόγος – Διαβητολόγος, είναι επίτιμος Αναπληρωτής Καθηγητής Ενδοκρινολογίας στην Ιατρική Σχολή του UCL (University College London). Έλαβε τον ιδιαιτέρως τιμητικό τίτλο του FRCP (Lon) από το Βασιλικό Κολλέγιο των Παθολόγων το 2022 σε αναγνώριση της 18ετούς συμβολής του στην πρόοδο της ιατρικής επιστήμης μέσω της κλινικής και ερευνητικής του δραστηριότητας στη Μεγάλη Βρετανία. Επιπλέον του ερευνητικού και διδακτικού του έργου στnν Ιατρική Σχολή του UCL, που συγκαταλέγεται στις 10 κορυφαίες ιατρικές σχολές παγκοσμίως, συνεχίζει το κλινικό του έργο τόσο στη Μεγάλη Βρετανία, εκτελώντας καθήκοντα Διευθυντή στην Ενδοκρινολογική και Παθολογική Κλινική του Νοσοκομείου Whittington του Λονδίνου, όσο και στην Ελλάδα, στη Γενική και Μαιευτική Κλινική ΙΑΣΩ.  

Μετά την εισαγωγή του με πανελλήνιες εξετάσεις και αποφοίτησή του από την Ιατρική Σχολή του Εθνικού και Καποδιστριακού Πανεπιστημίου Αθηνών, μετέβη το 2004 στη Μεγάλη Βρετανία, όπου και εργάστηκε σε κορυφαία Πανεπιστημιακά Νοσοκομεία μέχρι το 2018. Το 2007 έγινε, μετά από εξετάσεις, τακτικό μέλος του Βασιλικού Κολεγίου των Παθολόγων (Member of the Royal College of Physicians, UK). Μετά την ολοκλήρωση της ειδικότητάς του στην Ενδοκρινολογία και Διαβητολογία στη Μεγάλη Βρετανία (CCT in Endocrinology & Diabetes, UK) και συγκεκριμένα στα Πανεπιστημιακά Νοσοκομεία Royal Free Hospital, University College London Hospital και Whittington Hospital του UCL, τον Φεβρουάριο 2015 ανέλαβε θέση Διευθυντή στην Ενδοκρινολογική - Διαβητολογική Κλινική και Παθολογική Κλινική του Νοσοκομείου Whittington του Λονδίνου. Έλαβε  μεταπτυχιακό τίτλο MSc (Hons) στην Κλινική Ενδοκρινολογία από το Barts & the London School of Medicine, Queen Mary University of London. Aκολούθως, έγινε διδάκτορας (PhD, Doctor of Philosophy) στην Ιατρική Σχολή του UCL μετά την ολοκλήρωση σειράς κλινικών μελετών και της διδακτορικής διατριβής του με θέμα τη διερεύνηση και θεραπεία της υπονατριαιμίας.

Συνεχίζει το ερευνητικό του έργο με βάση το UCL και πλήθος διεθνών συνεργασιών με περισσότερες από 55 δημοσιεύσεις σε έγκριτα διεθνή περιοδικά και περισσότερες από 50 παρουσιάσεις εργασιών και ομιλίες σε βρετανικά, ευρωπαϊκά και αμερικάνικα ιατρικά συνέδρια. Έχει μεγάλη εμπειρία στη διάγνωση και αντιμετώπιση όλου του φάσματος των ενδοκρινολογικών παθήσεων και διαβήτη και το πρωταρχικό του μέλημα είναι η προσφορά υψηλού επιπέδου εξατομικευμένων υπηρεσιών υγείας με βασικό γνώμονα την Ιατρική με βάση την πιο επικαιροποιημένη επιστημονική γνώση (Evidence - Based Medicine).

Papaflessa 5, Marousi, ΑΤΤΙΚΗ

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About the specialist

Restart Coaching & Psychological Solutions was founded by Katia Petrocheilou and Evangelia Bakola and is based in Agia Paraskevi. The life issues they address concern common problems or crises that occur in ordinary people living ordinary lives. The creation of healthy and functional relationships, child-rearing, self-care and self-esteem, and career development are such life matters. To these are added less common life challenges, such as managing a chronic medical condition, handling a psychiatric diagnosis, or coping with a disability, which result in a complete and radical disruption of daily life. The scientific team at Restart is committed to providing the tools and techniques you need to successfully address both common and uncommon problems at every stage of life. Utilizing many contemporary as well as traditional proven methods (coaching, psychotherapy, EMDR, etc.), they offer you over 30 years of experience and a holistic approach that combines coaching, psychotherapy, EMDR, nutrition, and physical fitness improvement, ensuring that no issue remains unsolvable.

Megalou Spilaiou 7, Agia Paraskevi, ΑΤΤΙΚΗ

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About the specialist

Dr Kapitsimadis Fragkiskos is a General Practitioner and operates two private clinics located at Kifisias Avenue 119 and Solomou Dionysiou Street 22 in Marousi. He holds a PhD from the Medical School of the National and Kapodistrian University of Athens, with a dissertation titled "The effects of atmospheric pollution on the respiratory system of postal workers: A study in the Attica basin." He specialized in General Medicine at the General State Hospital of Athens and holds a degree from the Medical School of the National and Kapodistrian University of Athens, as well as a degree in Physiotherapy from the Technological Educational Institute of Athens. Additionally, Dr Kapitsimadis was awarded the Environmental Sensitivity Award in the category of "scientific study" during the Oikopolis 2010 event.

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Khfisias 119 kai Grammoy 72, Marousi, ΑΤΤΙΚΗ

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Miliordou Kristi MBA, MSc, MBPsS is a Psychologist, Psychotherapist - Sports Psychologist - Psychotherapy for Adolescents and Adults and maintains a private practice in Marousi. She is a Psychology graduate of the National and Kapodistrian University of Athens with further training in Cognitive-Behavioral Psychotherapy at Aiginiteio Hospital and in Health Psychology, holds a Certificate in Psychology for High Performance Sports, and a Professional Diploma in Neurobiology and Psychology in Team Sports from Barca Innovation Hub, Universitas. Additionally, she has specialized in Health Unit Management, Sports Management, and Marketing. Currently, she works as an independent professional psychologist at her office in Marousi, as a Sports Psychologist at the Olympiacos BC Academy, and as an external collaborator-psychologist for employees through the company Hellas EAP. Furthermore, she participates in conferences related to Mental Health and has created the asynchronous seminar "Small Movements - Big Changes, The Beginning of a New Life," focusing on integrating exercise and movement into daily life.

Together with her colleagues at the office, they operate as a Team with continuous collaboration and supervision, offering scientifically substantiated and high-quality care.

Eleutheriu Venizelu 1, Marousi, ΑΤΤΙΚΗ

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About the specialist

Pathologist Dr. Syneifakoulis Theoxaris is the third generation of physicians in his family. He graduated with "Excellent" from the Medical School of the University of Pécs, Hungary, and was awarded his Doctorate from the Medical School of the National and Kapodistrian University of Athens, having completed his dissertation on skin melanoma. Additionally, he is a member of the RCPSG (Royal College of Physicians and Surgeons of Glasgow) and collaborates with the private hospitals "Hygeia" and "Euroclinic".

Dr. Syneifakoulis Theoxaris's further specialization and sequential years of training, including postgraduate studies in Mountain Medicine at the University of Leicester, U.K., as well as his certifications as an instructor for the American Heart Association ("AHA"), the European Resuscitation Council ("ERC"), Prehospital Trauma Life Support ("PHTLS") by the National Association of Emergency Medical Technicians ("NAEMT"), and Advanced Trauma Life Support ("ATLS") from the American College of Surgeons ("ACS"), have inspired him to continue the family tradition and broaden his professional horizons. These qualifications have provided him with the motivation and tools to engage not only in Internal Medicine but also in Travel and Mountain Medicine, as well as emergency Prehospital Medicine, both as an instructor and as a healthcare professional.

Περικλέους 5, Neo Psychiko, ΑΤΤΙΚΗ

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About the specialist

Pappa Lina is an Acupuncturist who operates a private clinic specializing in Acupuncture and Aesthetic Medicine in Agia Paraskevi. She holds a medical degree from the G. D'Annunzio Medical School in Chieti, Italy, with postgraduate training at the International Council of Medical Acupuncture and Related Techniques (ICMART) and at the European Cosmetic Academy of Chinese Acupuncture (Dr. Radha Thambirajah). The physician has extensive experience in pain management and aesthetic medicine and has also obtained relevant certification from the Italian School of Mesotherapy. Additionally, she is a member of the Athens Medical Association, the Hellenic Medical Acupuncture Society, and a founding member of the Hellenic Medical Mesotherapy Society.

Mesogeion 387, Agia Paraskevi, ΑΤΤΙΚΗ

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Η Εύα Τορνάρη είναι πτυχιούχος Ψυχολογίας, Ψυχοθεραπεύτρια και Σεξολόγος συνθετικής προσέγγισης

THemidos 4 (Plision Stathmou ISAP), Marousi, ΑΤΤΙΚΗ

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Η Γεωργία Δουλάμη είναι Γενική Χειρουργός με εξειδίκευση Ελάχιστα Επεμβατική Χειρουργική Πεπτικού.

Λεωφ. Κηφισίας 37-39, 5ος όροφος, Marousi, ΑΤΤΙΚΗ

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About the specialist

Dr. Kaza Maria, MD, MSc, PhD, is a Endocrinologist – Diabetologist | Metabolism Specialist and maintains a private practice in Gerakas. She is a contracted Lecturer at the Department of Pharmacy of the National and Kapodistrian University of Athens. She is a distinguished PhD graduate of the Medical School of the National and Kapodistrian University of Athens, with a doctoral thesis entitled "Effect of physical activity on the physical and mental well-being of children and adolescents with diabetes mellitus". She completed with Distinction her postgraduate studies in Endocrinology and Diabetes (MSc in Endocrinology and Diabetes) at the Medical School of Queen Mary University of London (Barts and the London School of Medicine and Dentistry, UK) and is a graduate of the Medical School of the University of Patras. She has trained in hospitals in Greece and the United Kingdom and possesses extensive clinical experience in a wide range of endocrinological disorders, including type 1 and type 2 diabetes mellitus, gestational diabetes, obesity, thyroid diseases, osteoporosis and endocrine disorders of pregnancy, polycystic ovary syndrome, menstrual disorders, adrenal and pituitary diseases, and endocrine hypertension. Her research and academic activities further include publications in international medical journals, participation in Greek and international conferences, as well as teaching experience in the Departments of Dietetics and Sport Science at Metropolitan and Mediterranean College. She is a member of the Hellenic Endocrine Society, the General Medical Council (GMC) of the UK, and the Medical Association of Athens. Finally, she holds certificates in English and French languages. 

Θεσσαλονίκης 13 & Ηρώων Πολυτεχνείου 15, Gerakas, ΑΤΤΙΚΗ

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Oikonomou Nansy is a Specialist Pathologist and maintains private practices in Peristeri and Neo Psychiko, where she provides high-quality medical care. She has many years of experience and specialization in the field of pathology. She completed her specialty at the General Hospital of Attica "Sismanoglio," has served as a collaborator in the Oncology Clinic at the private clinic 'Iaso,' as well as in the Oncology Clinic of 'Hygeia' Hospital, managing a wide range of medical issues such as the nutrition of oncology patients. Additionally, she has served as a scientific collaborator in the Psychiatric Clinic "Panagia I Grigorousa," handling the management of pathological problems of psychiatric patients. Committed to the quality of healthcare, she is a reliable choice for those seeking meticulous medical care, including home care services, as she also undertakes home hospitalization cases upon request.

Γεωργίου Βλάχου 49, Neo Psychiko, ΑΤΤΙΚΗ

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Έμπειρος Γενικός Χειρουργός με εξειδίκευση στην Προηγμένη Λαπαροσκοπική και Ρομποτική Χειρουργική

Leoforos Mesogeion 264, Cholargos, ΑΤΤΙΚΗ

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Sofias Aleksandros - Premedicare is an Endocrinologist, a graduate of the Medical School of the National and Kapodistrian University of Athens. Following two years of training in the Internal Medicine Department of the 7th IKA Hospital and four years of work at the Aspropyrgos refinery clinic as an on-call physician, he specialized in the Endocrinology Department of the General Hospital of Athens "Evangelismos". There, he actively participated in the Endocrinology Laboratory - Dynamic Testing Unit, the endocrinology clinic, outpatient clinics, and specialized clinics for Type 1 Diabetes Mellitus, pituitary disorders, diabetic nephropathy, and osteoporosis. He gained significant experience in adrenal gland diseases, pituitary disorders, and thyroid cancer. Additionally, he has taken part in numerous weekly interdisciplinary clinical case discussions and literature updates of the department, coordinated by Director Dr. Stylianos Tsagkarakis. Since then, he has participated in numerous conferences and has served as a reviewing physician for MedNet Greece SA, while continuing to provide high-quality services to his patients.

Premedicare Medical clinic

Σάκη Καράγιωργα 17, Agia Paraskevi, ΑΤΤΙΚΗ

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Garzonis Spyros is an Internist - Diabetologist and maintains a private practice in Cholargos. He graduated from the Medical School of the National and Kapodistrian University of Athens and specialized in Internal Medicine at the General Hospital for Chest Diseases of Athens "Sotiria". Additionally, he received further training in Diabetes Mellitus and Diabetic Foot at the Diabetology Center of the General Hospital of Athens "Laiko," where he remained as a collaborator for over 10 years. He holds official specialization in Diabetes Mellitus. He has a particular interest and involvement in diabetes technology and insulin pumps. He has participated as a volunteer physician in a Doctors Without Borders - Greece mission in Zambia and in programs within Greece. Finally, he is a member of the Hellenic Diabetological Association, the European Association for the Study of Diabetes, the Hellenic Society for the Study of Diabetic Foot Disorders, the Hellenic Society of Internal Medicine, and Doctors Without Borders - Greece.

Faneromenis 5, Cholargos, ΑΤΤΙΚΗ

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Kalatzopoulou Garyfalia Liana MD, MSc is a Specialist in Internal Medicine and maintains a private practice in Neo Psychiko. She is a graduate of the Athens College and holds a medical degree from the Medical School of the National and Kapodistrian University of Athens. She completed a postgraduate program in Immunology and Infectious Diseases at the University of Birmingham in the United Kingdom, specialized in Internal Medicine at the General Hospital of Athens "G. Gennimatas," and has extensive experience in the management of obesity, having handled hundreds of cases to date. Dr. Kalatzopoulou is an external associate of Metropolitan General Hospital and serves as the attending Internist at the Outpatient Clinics of the same hospital.

Adrianeiou 42, Neo Psychiko, ΑΤΤΙΚΗ

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Aggoules Antonios MD, PhD is an Orthopedic Surgeon and Acupuncturist, maintaining a private practice in Neo Psychiko. He holds a doctoral degree from the Medical School of the National and Kapodistrian University of Athens, as well as a medical degree from the same institution. He completed his specialty training in Orthopedics at the "Asklepieio" Voula Hospital, the "P. & A. Kyriakou" Children’s Hospital, and "Agios Savvas" Hospital, followed by further training at the Academic Unit of Orthopaedic and Trauma Surgery at Leeds General Infirmary, supported by a scholarship from the Hellenic Society of Orthopaedic Surgery and Traumatology. The doctor has extensive experience in sports injuries, traumatology, knee surgery, low back pain, neck pain, and medical acupuncture, holding certification in Traditional Chinese Medicine and Medical Acupuncture from the AcuScience International Postgraduate Center on Acupuncture. He collaborates with reputable private healthcare institutions and concurrently teaches in higher education. His scientific contributions include publications in international and recognized Greek medical journals, as well as numerous presentations at medical conferences concerning orthopedic-traumatologic and rehabilitation topics. Finally, he is a member of the Athens Medical Association, former Chair of its Alternative Medicine Committee, and a member of the Hellenic Medical Society of Acupuncture.

Karatheodori 45, Neo Psychiko, ΑΤΤΙΚΗ

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Kalliampakos Dimitris is a Military Doctor – Specialist in Internal Medicine and maintains a private practice in Agia Paraskevi. Simultaneously, he serves as the Deputy Director at the 4th Internal Medicine Clinic of "HYGEIA" (building 2). He is a graduate of the Medical School of Aristotle University of Thessaloniki and specialized in Internal Medicine at the University Clinic of the General Hospital of Athens "Laiko." Subsequently, he served for several years as an attending physician at the 1st Internal Medicine Clinic of the 401 Military Hospital of Athens while also working for 8 years at the emergency outpatient medical company "SOS IATROI." Additionally, he received further training in Diabetes Mellitus at the Diabetology Center of the General Hospital of Athens "Hippokration" and is a regular member of the Hellenic Diabetology Society. He has extensive experience in managing infections, diabetes mellitus, hyperlipidemia, hypertension, rheumatic diseases, chronic systemic diseases, geriatric patients, as well as home-based emergency outpatient care. Finally, preventive medicine is thoroughly practiced in the private clinic, where rapid tests, electronic prescription, electrocardiogram, and spirometry are performed.

Παθολογικό Ιατρείο Paparrigopoulou 53, Agia Paraskevi, ΑΤΤΙΚΗ

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Cognitive Behavioral Therapy (CBT)
mental health

What it is

Cognitive Behavioural Therapy (CBT) is a form of psychotherapy applied to problems such as depression, anxiety disorders, abuse, relationship and marriage problems, eating disorders and serious mental illness.The therapist emphasizes what is happening in the current life rather than the past and what led to the difficulties.

Approach

Identifying the distortions in a person's thinking that are causing problems and then examining these in the light of reality. Understanding the behaviour and motivations of others and using problem-solving skills to deal with difficult situations. Dealing with fears rather than avoiding them. Role-playing to better prepare for potentially problematic interactions with others. You become your own self-therapist.

How it could benefit you

Helps the individual to change dysfunctional thought patterns and behaviors. Improves your functioning and quality of life by helping to change patterns and behaviours. Teaches you to be your own self-therapist.

Dialectical Behavioural Therapy (DBT)
mental health

What it is

It is a form of psychotherapy that teaches a person to identify negative thought patterns and change them. DBT reinforces the acceptance that all your thoughts are valid, as they are part of your life experiences and who you are. The person acts by doing the best they can for the moment. It is used for people with suicidal behavior, post-traumatic stress disorder, substance use disorder, bipolar disorder, eating disorders, ADHD, depression, anxiety.

Approach

DBT focuses on acceptance and change. It helps the person to get to know themselves better, to think about why they do what they do, without judgment. Replacing a negative behavior or habit with ones that can improve the quality of life. Dialectic is the idea that two different things can be true at the same time. At the same time as accepting yourself exactly as you are, comes the recognition of your effort to change.

How it could benefit you

It helps you make positive changes in the way you act. It identifies your negative thought patterns and changes them, helping to make positive changes in the way you act. Teaches you ways to manage intense emotions and stressful thoughts when they occur.

Humanistic psychotherapy
mental health

What it is

Humanistic therapy is a form of psychotherapy in which self-awareness and self-acceptance are considered the keys to personal growth. It emphasizes creativity, collaboration and interaction between the individual and the therapist, using techniques such as role-play.

Approach

Each person is a combination of mind, emotions, body and soul with unique experiences and events. No single life event, personality trait or psychological diagnosis defines you.

How it could benefit you

It improves self-awareness and self-confidence, helps you understand how your past affects your present, how to deal effectively with stressful situations, improves human relationships and helps you better manage your emotions.

Psychodynamic psychotherapy
mental health

What it is

Psychodynamic psychotherapy is talk therapy that aims to understand current thoughts and feelings through the behaviours shaped by past experiences and the past. Understanding the past can help you avoid repeating unhelpful patterns that have existed in it and facilitate your quality of life alongside relief from distressing symptoms. It is used in depression, anxiety, interpersonal problems, addictions, trauma, eating disorders, personality disorder.

Approach

Psychodynamic psychotherapy provides a space to explore and understand how unhelpful patterns from the past may be influencing our current difficulties. Defence mechanisms are explored and how our feelings and behaviours in the present are shaped by our past experiences.

How it could benefit you

It helps people to live a healthier life. There may be things in a person's unconscious that they are not aware of that cause them pain or keep them stuck in the past. Identifying these and understanding them can lead you to move forward.

Systemic psychotherapy
mental health

What it is

Systemic psychotherapy is an approach about how the individual acts as part of a wider group or broader system of relationships: family, partner relationship, work, friendships, and social environment. This approach connects communication and interaction patterns with a problem or a difficulty that the individual may be experiencing.

Approach

Systemic psychotherapy identifies behavioral patterns within a persons’ relationships and in the way someone connects with others. It helps the individual understand themselves more effectively, along with their roles and communication style and supports them in developing more functional ways of thinking and communicating within their system.

How it could benefit you

It helps improve understanding of relationship and family dynamics. It can change dysfunctional communication and behavior patterns within the system, strengthen empathy, support the development of stronger relationships and help with managing conflicts and difficulties.

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