Πιστοποιητικά υγείας για εργασία, Southern suburbs of Athens
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Doctors for Πιστοποιητικά υγείας για εργασία in the Southern suburbs of Athens

About the specialist

Tamvakos Ilias is an Ophthalmologist who maintains a private practice in the Glyfada area. He holds a degree from the Medical School of Turin, Italy, and received his specialty training at the Ophthalmology Clinic of the General Hospital of Piraeus "Tzaneio." Additionally, he completed further training in refractive surgery in Houston, United States of America. The practice in Glyfada is a patient-friendly and fully equipped facility. The doctor manages cases across the full spectrum of ophthalmology, providing high-level medical services such as refractive testing, fundoscopy, tonometry, macular assessment, and glaucoma evaluation. Moreover, patients receive comprehensive information on interventional methods for managing myopia, cataracts, glaucoma, and a well-documented treatment plan. Finally, the doctor actively participates in conferences throughout Greece and abroad, aiming for continuous professional development in his field, and is a member of the Hellenic Ophthalmological Society.

Lazaraki 25, Glyfada, ΑΤΤΙΚΗ

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About the specialist

Dr. Tzanis Georgios MD, PhD, FESC is an Interventional Cardiologist and the Director of the 4th Cardiology Clinic at Metropolitan General. He specializes in coronary artery disease and valvular heart diseases and maintains a private practice in Dafni. He holds a doctorate and graduated from the Medical School of the National and Kapodistrian University of Athens, where he also teaches in the postgraduate program "Exercise, Ergospirrometry, and Rehabilitation." He obtained his Cardiology specialty from the "Laiko" University Hospital of Athens. He specialized in interventional cardiology at the "San Raffaele" hospital in Milan, which is among the most renowned centers in Europe and one of the most distinguished worldwide in the field of interventional cardiology. Recently, he was honored with the prestigious title of Cardiologist Representative at the European Society of Cardiology (Interventional Cardiology sector - EAPCI Young Ambassador). He has been awarded major scholarships from highly respected scientific societies in Greece and Europe, including the Hellenic College of Cardiology for postdoctoral research in diabetes mellitus and coronary artery disease, and from the Hellenic Cardiological Society for further training in transcatheter aortic valve replacement. From the European Society of Cardiology (ESC), he received a scholarship in 2017 for specialization in the management of complex coronary artery disease at a world-renowned center. He has published more than 170 scientific papers in highly reputable international scientific journals and has presented at international conferences. Specifically, 70 of his scientific studies have been published in peer-reviewed international journals. Finally, he serves as a reviewer for international scientific journals and has participated as a speaker at numerous international and Greek conferences.

  • Certificates / Attestations
    • Certificates / Attestations
      Περιλαμβάνει κλινική εξέταση και ηλεκτροκαρδιογράφημα

Megalou Alexandrou 6, Dafni, ΑΤΤΙΚΗ

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About the specialist

Kouroumidis Aleksandros MD, MSc is a Ophthalmic Surgeon with extensive experience in the field of public health and primary care. He has served for many years in the National Health System (NHS) and is a consultant at the Keratsini Health Center, providing high-level ophthalmological care on a daily basis. He holds a postgraduate degree focused on "Quality of life and depression in patients with ophthalmic diseases" and places special emphasis on geriatric patient care, approaching the special needs of the elderly with sensitivity and scientific thoroughness. He has significant experience in the diagnosis and treatment of cataracts while also providing comprehensive ophthalmological care for all age groups, including children. The physician uses state-of-the-art equipment and applies the most advanced surgical techniques. Additionally, he is actively involved in social initiatives, participating in medical missions to island and remote areas of Greece, delivering ophthalmological services to populations with limited access to specialized care. He is the Ophthalmologist of the Flying Doctors Association, concretely supporting the work of social contribution through medicine. His philosophy is based on a trustful relationship with the patient, continuous scientific advancement, and the provision of personalized, humane care.

Αγίας Μαρίνης 9 , Piraeus, ΑΤΤΙΚΗ

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About the specialist

Dr. Sykoutris Euaggelos is a Gynecologist - Obstetrician who maintains a private practice in Alimos, while also serving as a collaborator at the Obstetrics Clinic "Gaia." He is a graduate of the Medical School of the National and Kapodistrian University of Athens, specialized in Obstetrics and Gynecology at the General Hospital of Athens "Alexandra," and received advanced ultrasound training in the United Kingdom. The clinic offers a wide range of medical services including Pap tests, colposcopy, transvaginal ultrasound of the uterus and ovaries, 3D-4D imaging of obstetric and gynecological ultrasounds, monitoring of high-risk pregnancies, monitoring of multiple pregnancies, monitoring of pregnancies with fetal growth restriction, management of amenorrhea, oligomenorrhea, and polycystic ovary syndrome, monitoring of menopausal women, management of metrorrhagia, sperm inseminations, diagnosis and monitoring of women with HPV infections, and therapeutic intervention with LOOP laser for CIN I, II, and III lesions.

  • Πιστοποιητικά\Βεβαιώσεις

THoukydidou 53 - 55, Alimos, ΑΤΤΙΚΗ

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About the specialist

Dara Euthymia MD, MSc is a Gynecologist - Obstetrician with private practices in Agios Dimitrios, Attica, and Livadeia. She graduated in Medicine from the National and Kapodistrian University of Athens and holds a postgraduate diploma in Disaster Medicine - Health Crisis Management. She specialized at Konstantopouleio Hospital "Agia Olga" and at Nikaia General State Hospital "Agios Panteleimon". She holds official certification in colposcopy and in performing and using obstetric and gynecological ultrasounds, as well as specialized training in the management and treatment of obstetric emergencies. She has 20 years of experience in Obstetrics, Clinical and Surgical Gynecology.

  • Πιστοποιητικά\Βεβαιώσεις

Ethnikis Antistaseos 118, Agios Dimitrios, ΑΤΤΙΚΗ

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About the specialist

Konstantinidou Kyriaki is a General Practitioner with many years of presence and experience in the Primary Health Care sector, maintaining a private practice in Alimos. Simultaneously, she is actively engaged as a Director in the National Health System. Since 2004, she has served as a General Practitioner at the 5 Primary Care Clinics of Avlida, additionally performing on-call duties at the Psachna Health Center, undertaking home visits in the villages of the area and managing emergency cases. In the past, she has served as an auxiliary physician at the National Center for Emergency Care (EKAB) as well as in rural clinics such as those in Nea Karia, Kapandriti Health Center, and Skyros Primary Care. She also has experience as a physician at sports events and children’s camps. She is a graduate of the Carol Davila University of Medicine and Pharmacy and has completed postgraduate studies in Public Health (MSc) at the National School of Public Health. She has specialized in Emergency Prehospital Medicine through a training program of EKAB and in prehospital trauma care (Prehospital Trauma Life Support – PHTLS) by the Hellenic Chapter of the American College of Surgeons. Additionally, she has attended for three years educational programs in trainer education, psychosocial skills, and mental health promotion at the Psychiatric Clinic of the National and Kapodistrian University of Athens (EKPA), highlighting the holistic and person-centered nature of her medical approach. With professionalism, continuous training, and a patient-centered philosophy, Dr. Konstantinidou Kyriaki provides reliable medical care, covering a broad spectrum of the modern patient’s needs.

Λεωφόρος Ιωνίας 35, Alimos, ΑΤΤΙΚΗ

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About the specialist

Maria Maili MD, MSc, PhDc is a Neurologist and the Scientific Director of the neurology department at the CENTRAL MEDICAL PARK polyclinic in Kallithea, where she maintains a private practice.

She holds a postgraduate diploma in "Clinical Neurophysiology" from the Medical School of the National and Kapodistrian University of Athens as well as the ATLS (Advanced Trauma Life Support) certification.

She is a PhD candidate at the Medical School of the National and Kapodistrian University of Athens.

She completed her specialty in Neurology at the General Hospital of Athens "Evangelismos," in Psychiatry at the Psychiatric Hospital of Leros, and in Pathology at the General Hospital of Rhodes "Andreas Papandreou."

Currently, she collaborates scientifically with Metropolitan Hospital (Stroke Intensive Care Unit - Emergency Department) and the 2nd Neurology Clinic of the General University Hospital "Attikon."

Previously, she worked in the emergency department and the internal medicine sector at the General Clinic of Dodecanese "Euromedica."

She participates with scientific papers in international and Greek medical conferences and systematically follows scientific developments in the field of Neurology, both in Greece and abroad.

She is a member of the Hellenic Neurological Society.

  • Πιστοποιητικά/Βεβαιώσεις

Epameinonda 42 & Klytaimnistras 3 (Central Medical Park), Kallithea, ΑΤΤΙΚΗ

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About the specialist

Dr. Karampatos Theodoros MD is an Ophthalmic Surgeon with a private practice in Piraeus. He is a PhD candidate at the Medical School of the National and Kapodistrian University of Athens and specializes in glaucoma and cataract surgery, while also possessing extensive experience in the correction of myopia and hypermetropia. Dr. Karampatos is a Scientific Associate at the Ophthalmology Clinic of the General Hospital of Athens "Evangelismos". At his private practice, he offers a wide range of services, always respecting the individual needs of each patient.

Kleisovis 26, Piraeus, ΑΤΤΙΚΗ

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About the specialist

Gkouvas Nikolaos is a Psychiatrist with a private practice in Ilioupoli. Concurrently, he serves as Chief Psychiatrist at the Athens Medical Center, responsible for the Psychiko, Faliro, and Peristeri Clinics. Additionally, he is the Chief Psychiatrist at the "Kardiologia" Medical Center in Ilioupoli, as well as an External Collaborator - Clinical Psychiatrist at the "Sinouri" Neuropsychiatric Clinic in Kifissia. He specialized in Psychiatry at the General Hospital of Athens "Evangelismos" of the University of Athens and has expertise in mood disorders, sleep-related issues, anxiety somatization, and phobias. Finally, he is a member of the Athens Medical Association as well as the British Medical Association.

Sofokli Venizelou 100 & Marinou Antupa (Polyiatreio "Kardiologia"), Ilioupoli, ΑΤΤΙΚΗ

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About the specialist

Ο Νικόλαος Κ. Οικονόμου είναι Ιατρός Ωτορινολαρυγγολόγος – Χειρουργός και Ειδικός Αισθητικής Προσώπου, με πολυετή κλινική εμπειρία στη διάγνωση και αντιμετώπιση παθήσεων του ωτός, της ρινός, των παραρρινίων κόλπων, του λάρυγγα και της κεφαλής και τραχήλου. Αποφοίτησε από την Ιατρική Σχολή του Δημοκριτείου Πανεπιστημίου Θράκης και ολοκλήρωσε την ειδίκευσή του στη Γενική Χειρουργική και στη συνέχεια στην Ωτορινολαρυγγολογία στο Γενικό Νοσοκομείο Ασκληπιείο Βούλας.

Έχει εργαστεί τόσο σε νοσοκομειακό όσο και σε ιδιωτικό περιβάλλον, αποκτώντας σφαιρική κλινική εμπειρία, ενώ από το 2016 διατηρεί ιδιωτικό ιατρείο, προσφέροντας ολοκληρωμένες υπηρεσίες πρόληψης, διάγνωσης και θεραπείας σε ενήλικες και παιδιά. Το ιατρικό του ενδιαφέρον καλύπτει όλο το φάσμα της σύγχρονης ΩΡΛ, με ιδιαίτερη έμφαση στις παθήσεις της ρινός και των παραρρινίων κόλπων, τις διαταραχές ακοής και ισορροπίας, τον ίλιγγο, την αλλεργική ρινίτιδα, την υπνική άπνοια και τις παθήσεις της φωνής.

Παράλληλα, έχει αναπτύξει σημαντική εξειδίκευση στη λειτουργική και αισθητική ρινοπλαστική, καθώς και στις σύγχρονες μη επεμβατικές και ελάχιστα επεμβατικές αισθητικές θεραπείες προσώπου, όπως η χρήση υαλουρονικού οξέος, βοτουλινικής τοξίνης και άλλων σύγχρονων τεχνικών αναζωογόνησης. Έχει εκπαιδευθεί σε εξειδικευμένα χειρουργικά κέντρα και συμμετέχει ενεργά σε ελληνικά και διεθνή συνέδρια, workshops και σεμινάρια, παραμένοντας σε διαρκή επαφή με τις τελευταίες εξελίξεις στον τομέα της ΩΡΛ και της Facial Plastic Surgery.

Διαθέτει πλούσιο επιστημονικό έργο, με πολυάριθμες ανακοινώσεις σε ελληνικά και διεθνή συνέδρια, καθώς και δημοσιεύσεις σε έγκριτα ελληνικά και διεθνή ιατρικά περιοδικά. Έχει επίσης συμμετάσχει ως ομιλητής σε επιστημονικές εκδηλώσεις, συμβάλλοντας ενεργά στη συνεχιζόμενη ιατρική εκπαίδευση.

Η φιλοσοφία του βασίζεται στον συνδυασμό της ιατρικής ακρίβειας με την αισθητική αντίληψη και τον σεβασμό στη μοναδικότητα κάθε ανθρώπου. Στόχος του είναι η ουσιαστική βελτίωση της υγείας, της λειτουργικότητας και της ποιότητας ζωής των ασθενών του, καθώς και η επίτευξη φυσικών και αρμονικών αισθητικών αποτελεσμάτων. Ιδιαίτερη έμφαση δίνεται στην ασφάλεια, στη σωστή ενημέρωση και στη δημιουργία σχέσης εμπιστοσύνης με τον ασθενή.

ΓΡΗΓΟΡΙΟΥ ΛΑΜΠΡΑΚΗ 19, Glyfada, ΑΤΤΙΚΗ

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About the specialist

Ο Νικόλαος Ζακυνθινάκης-Κυριακού είναι Ειδικός Παθολόγος και διατηρεί ιδιωτικό ιατρείο στη Νέα Σμύρνη. Μετά την ολοκλήρωση της ειδικότητας Παθολογίας στα Ιωάννινα εργάστηκε σε νοσοκομεία του Ηνωμένου Βασιλείου για 10 έτη αποκτώντας σημαντική εμπειρία στην αντιμετώπιση οξέων και χρόνιων παθολογικών νοσημάτων. Το ιδιαίτερο επιστημονικό του ενδιαφέρον εστιάζει στη μεταβολική ιατρική, τον σακχαρώδη διαβήτη, την παχυσαρκία, τη δυσλιπιδαιμία, την πρόληψη καρδιαγγειακών νοσημάτων, την ιατρική της άσκησης και την εξατομικευμένη βελτίωση της υγείας μέσω αλλαγών στον τρόπο ζωής. Στο ιατρείο του παρέχει ολοκληρωμένη παθολογική φροντίδα, μεταβολικό έλεγχο, αξιολόγηση σωματικής σύστασης και καθοδήγηση βασισμένη στις αρχές της προληπτικής ιατρικής και της ιατρικής του τρόπου ζωής (lifestyle medicine).Έχει ολοκληρώσει μεταπτυχιακές σπουδές  στο University of Leicester-UK, με εκπαίδευση στη σύγχρονη διαχείριση του σακχαρώδη διαβήτη, τις ενέσιμες θεραπείες, την παχυσαρκία, τις επιπλοκές του διαβήτη, τη φροντίδα ηλικιωμένων ασθενών και την εφαρμοσμένη κλινική έρευνα. Παράλληλα έχει παρακολουθήσει μεταπτυχιακές ενότητες στο αντικείμενο της Ιατρικής της Άσκησης και του Αθλητισμού και της Διατροφής (Sports & Exercise Medicine and Nutrition) στο University of Kent-UK, Διαθέτει επιπλέον εκπαίδευση στην Ορεινή Ιατρική και τη Νόσο Υψομέτρου (Diploma in Mountain Medicine) στο Nepal και συνεχίζει την ακαδημαϊκή του ενασχόληση με μεταπτυχιακές σπουδές στην Άσκηση, την Εργοσπιρομετρία και την Αποκατάσταση. Είναι μέλος της νέας γενιάς παθολόγων που συνδυάζουν την κλασική εσωτερική παθολογία με τις σύγχρονες επιστήμες της μεταβολικής υγείας, της άσκησης και της πρόληψης, με στόχο τη μακροχρόνια βελτίωση της υγείας και της ποιότητας ζωής των ασθενών.

Eleftheriou Venizelou 60, Nea Smirni, ΑΤΤΙΚΗ

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About the specialist

Dragazis Ioannis is a Cardiologist with a private practice in Ilioupoli. He completed his Doctoral Thesis in the Thorax Research Program as Head of the Experimental Surgery Unit at the University Intensive Care Clinical Unit of the General Hospital of Athens "Evangelismos." He holds a Medical Degree from the National and Kapodistrian University of Athens and specialized in Internal Medicine at the 1st Internal Medicine Clinic of the Regional Oncology Hospital "Agioi Anargyroi" and in Cardiology at the 1st Cardiology Clinic of the General Hospital of Athens "Evangelismos." He is a Scientific Collaborator in the Cardiology Department of the "Central Medical Park" Polyclinic and a Consultant in the Intensive Care Unit of the General Clinic of Kallithea - "Iasio Therapeutirion." Additionally, he has served as a Cardiologist in the Cardiology Department of the "Lifecheck" Polyclinic and has covered shifts in the Emergency Department of the Psychiko Medical Center. Finally, the doctor is a member of the European Society of Cardiology and the Hellenic Cardiological Society.

  • Certificates / Attestations
    • Certificates / Attestations
      Βεβαίωση άθλησης και κάρτα υγείας αθλητή. Περιλαμβάνει τον πλήρη καρδιολογικό έλεγχο (λήψη ιστορικού, κλινική εξέταση, καρδιογράφημα, Triplex καρδιάς και θωρακικής αορτής, συνταγογράφηση εξετάσεων και εκτίμησή τους). Προσφορά για νέους έως 35 ετών στα 35 ευρώ.

Plateia Anexartisias 1, Ilioupoli, ΑΤΤΙΚΗ

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Cognitive Analytic Therapy (CAT)
About the specialist

The "Vima Koino" Center is a model Mental Health Services Center located in Agios Dimitrios. It represents an innovative initiative in the field of mental health as it incorporates the principles and the most contemporary data of social psychiatry within a purely private enterprise. Utilizing the capabilities of its interdisciplinary team, it offers a comprehensive range of diagnostic and therapeutic services on-site, responding holistically and individually to mental health needs. This approach enables the Center to receive a request, conduct a thorough evaluation, and propose the most appropriate therapeutic intervention. Our medical team consists of four psychiatrists who possess high theoretical training and clinical experience covering the full spectrum of mental disorders. With a shared goal of excellent diagnostic assessment and provision of comprehensive therapeutic care, they collaborate both among themselves and with the Center’s interdisciplinary team. By choosing a psychiatrist from the "Vima Koino" team, you select a specialist with expertise and extensive experience, as well as a team of mental health professionals who will work together towards the best possible solution for the patient.

Leof. Vouliagmenis 315 & Aishulou, Agios Dimitrios, ΑΤΤΙΚΗ

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About the specialist
Respiratory Medicine and Tuberculosis Specialist Intensive Care Unit Specialist MD,Msc,Phd

Επαμεινώνδα 42, Kallithea, ΑΤΤΙΚΗ

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About the specialist

Margaritis Athanasios is a Specialist in Pathology - Intensive Care Medicine and maintains a private practice in Argyroupoli. He is a graduate and PhD holder from the Medical School of the National and Kapodistrian University of Athens. He possesses significant clinical experience and serves as Consultant in the First Pathology Clinic of the Errikos Dynan Hospital Center.

Λ.Αλεξιουπόλεως 29, Argyroupoli, ΑΤΤΙΚΗ

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About the specialist

Tyros George is dermatologist - Venereologist in private practice in New Smyrna. He has a medical degree from the University of Padua in Italy. Still, the doctor is preparing his doctoral thesis at the University of Athens in Psychodermatology issue in Section Sexually Transmitted Diseases Hospital "Andreas Syngros". In private practice provided several services such as laser hair removal, peeling, acne treatments and warts, cryotherapy and hyaluronic acid / Fillers and can be treated many diseases, such as hair loss, cellulite, melanoma and herpes. Finally, the great love and knowledge of the physician for skin translates to more targeted treatments for patients.

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About the specialist

Tzenaki Maria is an Ophthalmologist with a private practice in Paleo Faliro. She holds a degree from the Medical School of the National and Kapodistrian University of Athens and is a specialized ophthalmic surgeon. During her studies, she has worked at the Athens Polyclinic and the University Ophthalmology Clinic of the General State Hospital of Athens "G. Gennimatas." As a private practitioner, she has collaborated with "Hygeia" Hospital, the Athens Medical Center, Paleo Faliro Clinic, the Athenian Clinic, and Eyedayclinic. She has been a private ophthalmologist since 1990 in Paleo Faliro. Her areas of practice in her private clinic include general clinical ophthalmology, refractive assessment, fundus diseases, glaucoma, neuro-ophthalmological conditions, thyroid-related eye disorders, pediatric ophthalmological examinations, anterior segment surgery, refractive surgeries (correction of myopia, hyperopia, presbyopia), and contact lens application.

Ahilleos 86, Palaio Faliro, 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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