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Insomnia affects neurologic health, quality of life, and daily functioning, but effective treatments are available. In this episode, Dr. Brandon Peters-Mathews discusses a practical approach to evaluating chronic insomnia, highlights the importance of identifying contributing conditions such as sleep apnea and mood disorders, and reviews cognitive behavioral therapy for insomnia (CBT-I), the recommended first-line treatment. Learn how addressing sleep can improve outcomes across a wide range of neurologic disorders. In this episode, Katie Grouse, MD, FAAN, speaks with Brandon R. Peters-Mathews, MD, FAAN, FAASM, author of the article "Insomnia" in the Continuum® August 2026 Sleep Neurology issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Peters-Mathews is the Section Head of Sleep Medicine at Virginia Mason Franciscan Health in Seattle, Washington. Additional Resources Read the article: Insomnia Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @BrandonPetersMD Full episode transcript available here Dr Grouse: Insomnia may be one of the most common medical issues experienced by patients, yet our knowledge about how to manage it remains limited. Today, I have the opportunity to speak with one of the world's leading experts on sleep disorders, Dr. Brandon Peters-Mathews, about the latest issue of Continuum on Neurology of Sleep.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Dr. Brandon Peters-Mathews about his article on insomnia. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Welcome to the podcast, and please introduce yourself to our audience.  Dr Peters-Mathews: It's my pleasure to join you, and I'm happy to talk about this article. I think it's an interesting one for most folks. I am a board-certified sleep neurologist. I practice at Virginia Mason Franciscan Health in Seattle. I did my neurology training back at the University of Minnesota and my sleep training at Stanford University. I've been in practice for more than thirteen years at this point. It's hard to believe, but it's exciting to be able to speak with you today.  Dr Grouse: This is definitely an important topic for everybody. Certainly, sleep and the lack of it affects all of our patients, and I can't imagine there's a single clinical neurologist who doesn't have to answer questions and help evaluate patients with this problem, so very high-yield topic for everyone. Now, having read your article, I'm curious if you had to choose one key point that you want the readers of your article to take away after reading it, what would it be?  Dr Peters-Mathews: Emphasize for my patients that insomnia is a condition that we can work through and resolve, that if we really can understand the underlying contributing causes and resolve those issues, we can typically improve sleep. It's a process. It takes time. It takes some attention and, and sometimes even testing to figure out what's going on. But if we can dial into these root causes, we can typically help somebody to sleep much better. As part of that, we often employ a therapy called CBT-I, which we'll talk about here a little bit later. But that also helps us to identify some of these contributing factors that are leading to the poor sleep.  Dr Grouse: And I definitely want to talk more about CBT, it's such an important topic. But even before we get into that, I'd love it if you could just walk us through a hypothetical case of a patient with insomnia. I think the type of patient that I think we've all seen in our clinical practice and somebody who says, "You know, I've had poor sleep. I've had insomnia for many years. I've tried all of the things you're supposed to try. You know, I've tried sleep hygiene. I've tried this. I've tried that. I've tried medications. Nothing seems to work." Could you walk us through how you would evaluate a patient like this and start to consider what to recommend? Dr Peters-Mathews: So, some simple information that we can gather, would be information about when they're trying to go to bed, how long it's taking them to fall asleep initially. If they wake in the night and have trouble getting back to sleep, how often they wake in the night. If they're experiencing early morning awakenings, their final wake time, and when they actually get out of bed in the morning. That gives me a sense of the structure of their sleep pattern and whether or not they might be spending an excessive amount of time in bed for their own sleep need at their current age. The other factors that we might consider are sleep disorders, and typically, I would assess for other symptoms that would point me towards sleep apnea or restless legs and occasionally other disorders of sleep. We wanna make sure we're not missing comorbid conditions that might be affecting that person. These often include mood disorders. Sleep and mood walk hand in hand, and so anxiety and depression are important to identify and treat if present. We also want to make sure someone's not suffering from chronic pain or other conditions that might be impacting their sleep. So, I take a broad approach. I ask the same questions to each patient that comes to see me. I wanna make sure I'm not missing some of these details. And then some of these folks will require testing to further understand their sleep. Others may move on to a different therapy, and long-term may require even other interventions, including medications, to fully resolve their condition.  Dr Grouse: You mentioned in your article circadian rhythm sleep disorders. How often are these really a factor in patients with chronic insomnia? And do you think that's something that we as kind of first-line clinicians should be screening for as well?  Dr Peters-Mathews: So delayed sleep phase syndrome is the most common circadian disorder, and these are folks who are night owls by nature. They often develop their sleep patterns, as teenagers, if not before, and they may fade away in the working years but come back in retirement age. I would say that's a very common condition. It may affect as many as one in ten people. The other circadian disorders are pretty uncommon, so advanced sleep phase syndrome, where somebody is sleepy early and waking too early, that may only affect one in three hundred people. There are other conditions that affect specific populations, like non-twenty-four circadian pattern affects blind people. Typically, half of blind people have that condition. There are conditions that affect the regularity of sleep, so an irregular sleep-wake pattern that might occur more in folks with maybe an advanced dementia. So, there are populations where these conditions can be fairly common, but among the general population, that night owl tendency is by far the most common.  Dr Grouse: That's really helpful. And just taking a step back, why is insomnia bad for us? So, we worry about this in our patients. We know it can make neurologic issues worse. But in general, like, what are the reasons that having poor sleep can affect our health? Dr Peters-Mathews: Yeah, and it's not enough hours, certainly quantity, but also quality of sleep that matters. And I tell people that sleep is a pillar of health, just like nutrition and exercise. It's the other main contributor to our health and well-being. And so, it has its fingers in almost every aspect of our health. Insomnia on its own is a risk factor for other psychiatric conditions, including depression, anxiety, even disorders like bipolar and schizophrenia. Folks with insomnia are more likely to have alcohol or drug abuse issues and are at higher risk for things like chronic pain, suicide and, and social and occupational dysfunction. So, it's a disorder that has a really profound effect on how someone functions during the day, and again, may take a toll on their health over time.  Dr Grouse: That makes sense, and I would assume that there are certain populations within our neurology practices where we should really be attuned to the risk of insomnia. Are there specific populations you'd recommend really make it a habit of screening for insomnia?  Dr Peters-Mathews: I was joking with someone recently that anyone with a neurological nervous system can have issues, impacted by poor sleep. There are certain groups, so chronic headache patients are perhaps one that might warrant a further evaluation and management. Folks with multiple sclerosis or Parkinson's may have physical conditions that lead to more discomfort in sleep, fewer movements of their body in sleep, issues around nocturia that would disturb their sleep. Certainly, those with dementia, Alzheimer's disease and other dementias. Parkinson's and Lewy body dementia overlap a lot, as does multiple system atrophy. That can point us towards other conditions like REM sleep behavior disorder, but also insomnia can be an important feature of those disorders as well. And then folks with stroke often have disturbance to their sleep and may develop insomnia after experiencing a stroke. So those are specific populations where I think the yield is high to be looking for insomnia and other sleep disorders.  Dr Grouse: Yeah, that makes sense. I think a lot of us think of insomnia as almost like, make sure we're not missing this as sort of a mimic of the problem, when in fact it's probably just more part and parcel of the problem and something we need to be thinking about treating as part of their disorder. So helpful to think about it in that light, at least in my own mind. Now, I want to get a little bit back to some of the therapies you've recommended, and I think first just stopping again at sleep hygiene. Your article has a really great list, I think, of sort of like a checklist of actions that people should be taking to make sure that they are managing their sleep hygiene well. And I definitely recommend our listeners look to that. How often do you think that focusing on sleep hygiene helps when you get a patient who says, "Hey, I have got terrible sleep. You know, what do I do?"  Dr Peters-Mathews: It's pretty common for people to have access to this information through their own reading online, and most folks have worked through this by the time they've come to see me, and often a primary care provider or specialist may have given some of this guidance as well. It's pretty rare for them to not recognize something as obvious as having caffeine too late in the day by the time they're coming to my attention. The sleep hygiene generally is used as a control when we do research to look at how something like medication is working or CBT-I might be working. It's the comparative control. It's almost like the null intervention. So, it's not highly effective, and if folks are not finding it helpful, they've made those adjustments to their sleep environment or their habits, and they're continuing to have issues, there's typically more that needs to be done, and that's where CBT-I really comes in as a strong intervention for those people.  Dr Grouse: And then getting on the topic of CBT-I, so helpful. I'm really glad that your article spent a lot of time talking about it as really a truly high-yield, great intervention for insomnia. And I really felt that the question shouldn't be: When is cognitive behavior therapy for insomnia helpful? But like, when isn't it helpful? What are your thoughts about that?  Dr Peters-Mathews: Yeah. I always point out that the American College of Physicians has recommended CBT-I for adult patients as the initial treatment for chronic insomnia even before the use of a medication for nearly ten years. That recommendation came out in July of 2016. So, there are folks who may not be good candidates for it, who may be screened out because of other conditions that they have, and there certainly are folks who don't do as well with CBT-I. And adherence is important. Somebody needs to be able to follow the instructions and apply that to their lives. And certainly, there are a number of things that could interfere with that compliance. I would say untreated anxiety and pain are two things that often trip people up. It's like running a race with a broken leg. Despite their best efforts, if those are not addressed, they will continue to have issues around insomnia. And then one thing that often is unrecognized and may be missed is untreated sleep apnea. That is a common contributor to a chronic insomnia, especially in older folks, women beyond the age of menopause and men even starting in middle age, thirties and forties. We don't want to miss sleep apnea. Even insomnia that's, "I can't fall asleep at the beginning of night," that could still be sleep apnea, so that's something I really emphasize with my patients.  Dr Grouse: Really great reminder about sleep apnea for sure. Something that always is beneficial to make sure we are not missing. Oftentimes I'll bring up a CBT for insomnia, and what is that? Like, what would we actually do, and what is a high-level overview of what happens with CBT-I?  Dr Peters-Mathews: Yeah. So, I generally tell my patients that this is a six-week program. It's a structured program, almost like a boot camp for sleep, in which we are addressing underlying causes, recognizing what those are and, and working through those underlying causes. There is often tracking using a sleep log or sometimes wearable data.To guide decisions that are made in the program. It's very goal-directed, science-based therapy. We often introduce concepts around sleep drive, circadian rhythm dealing with a busy mind at night. There's concepts of mindfulness and relaxation training that are introduced. People often are able to taper or stop using sleeping pills as part of this therapy. And the nice thing is they walk away with a set of skills that they can apply the rest of their lives to sleep more normally. And so, there's good research that suggests even years after someone's completed a CBT-I course, they continue to sleep more normally. They have the tools that they need to sleep better even years beyond that education.  Dr Grouse: You know, this just sounds so great. It almost sounds like why wouldn't someone benefit from this? But of course, like I would imagine many institutions experience, I've definitely run into difficulties with access for my patients for CBT-I, and we have long wait lists. And I imagine there's many places where there just aren't even any specialists that patients can get to, to help with this. What are the resources that our listeners can take advantage of for their patients to get access to these types of therapies?  Dr Peters-Mathews: So, one thing I tried to really emphasize in the article is that there are resources that can be drawn in. I'll give you some examples. So, at our institution, we have three sleep specialists, full-time sleep specialists, who trained at Stanford to become CBT-I specialists, and so we have more resources than probably most institutions would have. We do shared medical appointment workshops so that we can manage the number of patients that we have to see. And, and unfortunately, not everybody has that opportunity. You might plug into resources in your community, and one of the resources I point to in the article is the International Directory that's managed by the University of Pennsylvania that has eight hundred and seventy-five CBT-I specialists listed with contact information, et cetera. And I think that's an amazing opportunity to access this therapy. Unfortunately, there are countries and certainly states that do not have a specialist, that there's no one in the state that provides this therapy. And then we need to extend other resources, and that could be online treatment programs that can be done independently, bibliotherapy, so accessing books that could guide people through the therapy, even accessing other apps and maybe even wearables that pair with an app that could provide some of this guidance. The Veterans Administration worked with Stanford and worked with the National Center for PTSD and developed an app called CBT-I Coach that is free and can be downloaded and, and gives, I think, good education, good guidance. So, there are resources that exist. It's somewhat finding what might work for your individual patient, how they're preferring to access this or their learning preferences. Do they want to read a book or not? And getting them into the right pathway.  Dr Grouse: And I think that gets me into a whole other Pandora's box of the fact that they're already out there in the world are tons of different apps, wearable devices, all sorts of things that promise that they can help us with sleep, some that may have more, I think, data and evidence behind them than others. Do any of these apps or wearables in your mind show promise in our patients helping our patients track and diagnose and manage their insomnia?  Dr Peters-Mathews: Yeah, there's a lot out there, and unfortunately, some of these devices actually can make sleep worse. People can develop a condition called orthosomnia or straight sleep, where they're trying to perfect their sleep and their sleep numbers, their metrics, and the wearables feeding them data that they continue to try to improve upon. And that fixation on those metrics can actually make their sleep quite a bit worse. A lot of these wearables and apps and other resources have not been well-studied. There's not research trials showing outcomes comparing to other standards of care. I would say the basic guidance of CBT-I, which many of these programs are based on, I think will be helpful to the majority of folks who are able to engage and complete that education. A lot of these are not dependent on that sort of framework or structure so that we may not actually be using the standards of CBT-I to try to improve sleep. They may be connecting you with other resources, like listen to this sleep story or this relaxation file or do some meditation, et cetera, which again, may be of some benefit, but it is not the same as a structured CBT-I experience. So, I think there are a few good resources that we highlight within the article, and I think there are probably others coming that may give individuals a more individualized, directed approach to managing their sleep issues. But it's almost like going to the App Store and there's thousands of apps. It's hard to know which one might be most based on science or the most beneficial to that individual.  Dr Grouse: Well, I really appreciate in your article that you did have a great list of apps and things along those lines to try, so I do encourage our listeners to check that out as well. Some really, really great resources there in the article in many different areas. Now, I wanted to turn the conversation to a slightly different thing, which is medications for insomnia. Now, when are medications appropriate for treating insomnia? When should we be thinking about turning to these for our patients?  Dr Peters-Mathews: So again, we would suggest that CBT-I would be first, and that failing improvement with CBT-I, that medications would be extended to a person affected by insomnia. And over-the-counter options as well as prescription medications might be used. Unfortunately, that's not how things unfold in the real world. Many people are jumping to medications first, whether that be an over-the-counter supplement or other medication, or they're seeing primary care and other specialists who's providing them a prescription for sleep aid. So there's data from the CDC going back to twenty twenty that suggests that about six point three percent of adults were taking a sleeping medication every day in the months prior to the survey. And women who were older than sixty five, white women, were more likely to be using a sleeping medication every day. That number was 13.5 percent of those surveyed. So, lots of folks are on medications, and certainly melatonin is widely used. Unfortunately, it's not regulated by the FDA in a sense that we don't have exact concentrations controlled. So, people can take melatonin that has no melatonin in it. They might take melatonin that's forty or more times the dose. There's variance within lots from the same manufacturer. There's a lot of trouble knowing exactly what you're getting when you try to take something like melatonin over the counter. Other sleep aids that we might reach to over the counter, like variants of diphenhydramine or doxylamine, and these are often the PM drugs that we think about. They have risks associated with population-based studies which suggest risk of dementia, risk of falling, risk of mortality with these drugs, especially in older populations. So again, that would give us potentially pause. The prescription medications that we go to, there are some that the American Academy of Sleep Medicine would recommend as more beneficial than harmful, and some are good for both initiating and maintaining sleep. Some have such a short half-life that they're really best as initiation drugs. And then others are better for maintenance of sleep, so reducing awakenings and wakefulness in the night. My own individual take, often people are coming to me on medications, typically over the counter, but often prescriptions, and have even tried and failed many of those medications before they finally come to see a specialist. And so, I don't often reach to medications until I've exhausted CBT-I, until we've completed a sleep test to make sure we're not missing something like sleep apnea, until we've ruled out some other potential contributing causes. But there are patients I have who really will not sleep without medication support and sometimes even multiple medications that work in complementary ways to try to normalize their sleep. And so, in some cases it is necessary, but it is not meant to be a first line for anyone.  Dr Grouse: Yeah, and I think all of our listeners can relate to the fact that we often see patients who've been on sleep medicines for many, many years and take them every night. It's good to know that there is sort of a procedure here to consider and perhaps again, back to the plug to CBT-I as being the right starting point to see if there's some that we can help get off of these meds, although, as you mentioned, maybe not always going to be successful. Well, I really appreciate our conversation about this. It's been really great to read this article about insomnia. Again, I encourage our listeners to check it out. Some really great resources for many different therapies, thinking about other alternative diagnoses and different medical conditions where insomnia really needs to be considered. And I really appreciate you writing this article. It's been a pleasure to talk with you today.  Dr Peters-Mathews: It's my pleasure to share this information with folks, and I hope that you find it useful in your clinical practice or even your personal life as the need arises.  Dr Grouse: Again today, I've been interviewing Dr. Brandon Peters-Mathews about his article on insomnia. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audiocme. Thank you for listening to Continuum Audio. 

In this special episode, we share a recording of a UCLA event titled Why History Matters: Immigration, sponsored by the UCLA Meyer and Renee Luskin Department of History as well as the John D. and Catherine T. MacArthur Foundation. Moderated by Dean of the UCLA Division of Social Sciences, Abel Valenzuela, this event features a discussion between UCLA professors Kelly Lytle- Hernández, Ahilan Arulanantham, and Rubén Hernández-León. Our experts consider the fraught and often racist history of immigration policy in the U.S. as well as the immigration pathways and policy today. Kelly Lytle- Hernández is Professor and Thomas E. Lifka Endowed Chair of History, with appointments in History, African American Studies, and Urban Planning at UCLA. As one of the nation's leading experts on race, immigration, and mass incarceration, she was named a MacArthur Genius Fellow in 2019. She is also an elected member of the Society of American Historians, the American Academy of Arts and Sciences, and she sits on the Pulitzer Prize Board.  She is the author of multiple award-winning books, including Bad Mexicans: Race, Empire, and Revolution in the Borderlands (W. W. Norton, 2022). Her newest book, Racist by Design: Two Centuries of U.S. Immigration Control,  will be published by W. W. Norton in late 2026.Ahilan Arulanantham is Professor from Practice and co-director of Miñana Family Center for Immigration Law and Policy at the UCLA School of Law. In addition to his teaching, Ahilan maintains an active litigation practice. Prior to joining UCLA, Ahilan was senior counsel at the ACLU in Los Angeles, where he worked for two decades. In 2016, Ahilan was named a MacArthur Foundation Genius Fellow. Rubén Hernández-León is Professor of Sociology at UCLA, Director of the UCLA Latin American Institute, and Co-Chair of the Master of Arts in Latin American Studies program at UCLA. He previously directed the UCLA Center for Mexican Studies (2009-2021). His most recent book, Skills of the “Unskilled”: Work and Mobility among Mexican Migrants (UC Press, 2015), co-authored with Jacqueline Hagan and Jean-Luc Demonsant, received the best book award (co-winner) from the Section on Inequality, Poverty, and Mobility of the American Sociological Association in 2016. His research focuses on new developments in Mexico-U.S. migration and the role of the migration industry in international migration.

This month we turn to psychiatric topics, beginning with an important clinical question: when a child or adolescent presents with unusual thoughts, perceptions, or behaviors, how do we distinguish psychosis from other psychiatric or medical conditions?In this episode, our host Paul Wirkus, MD and guest Kristi Kleinschmit, MD discuss psychotic experiences and how they can occur in conditions including major depression, bipolar disorder, and OCD, as well as with substance use and trauma or PTSD. We explore how to think about experiences such as imaginary friends and vivid imagination, and when symptoms such as catatonia should prompt a closer evaluation.The conversation also emphasizes the importance of looking beyond a psychiatric diagnosis. Infection, other medical illnesses, and genetic syndromes can all play a role in changes in behavior or perception, making a thoughtful history and appropriate medical evaluation essential. The episode offers pediatricians a framework for recognizing concerning symptoms, considering the broader differential diagnosis, and determining when additional evaluation or referral is needed.Have a question for our hosts or guests? Email questions@vcurb.com. For more information, additional episodes, and available CME/MOC credit, visit vcurb.com.The Virtual Curbside is a podcast of the American Academy of Pediatrics, Utah Chapter (UTAAP), connecting pediatricians and subspecialists through practical, accessible pediatric education. Learn more about UTAAP at aaputah.org.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This member-driven podcast is a benefit of membership of the Arizona Chapter of the American Academy of Pediatrics (AzAAP) and is intended for AzAAP pediatric healthcare members. No information or content in this podcast is intended to substitute or replace a consultation with a healthcare provider or specialist. All non-healthcare providers should reach out to their child's pediatrician for guidance. Music: Wallpaper by Kevin MacLeodLink: https://incompetech.filmmusic.io/song/4604-wallpaperLicense: http://creativecommons.org/licenses/by/4.0/ 

My guest today on the Online for Authors podcast is Sean Pauzauskie, author of the book Stage of Fools. Sean Pauzauskie, M.D., is a hospital neurologist in the University of Colorado system, where he conducts clinical research employing neurotechnology, primarily for the optimization of epilepsy management. He is an active member of the American Academy of Neurology and The American Medical Association, and his research experience includes time at The National Institute of Mental Health, The Energy and Commerce Committee of the U.S. House of Representatives, and the Kaufmann Foundation for entrepreneurship. He is also a member of the American Academy of Neurology's Palatucci Advocacy Leadership Forum, a highly competitive program that selects 30 out of 40,000 members to develop and implement action plans on advocacy issues related to neuroscience. He is president-elect of the Colorado Medical Society.   As a clinician who works daily with comatose patients, Sean brings scientific authenticity to his literary exploration of cognitive-motor dissociation—a condition where patients remain mentally aware while physically unresponsive.   In my book review, I stated Stage of Fools is a literary fiction by Sean Pauzauskie. We quickly meet Thomas Mariner, a billionaire who appears to have it all - until an unfortunate fishing accident leaves him in a coma in a San Francisco ICU.   The entire story is in the mind of Thomas while he is in a coma and flashbacks to his childhood and early adulthood. Despite his fortune and fame, Thomas has demons, and these demons have created problems in his family. His hope? To figure things out, make the needed changes, and save them from what he set in motion due to jealousy, his ego, and rash actions.   I think what is most interesting is that the author is a neurologist. He offers a lot of information to help us understand what it might be like inside a brain during a coma. And for Thomas, his obsession with the play, King Lear, shows up throughout.   I found the novel interesting and thought-provoking with an ending I didn't expect.     Subscribe to Online for Authors to learn about more great books! https://www.youtube.com/@onlineforauthors?sub_confirmation=1   You can follow Author Sean Pauzauskie Website: https://seanpauzauskie.com/ Social media: IG: @seanpauzauskie LinkedIn: @sean-pauzauskie FB: @sean.pauzauskie   Purchase Stage of Fools on Amazon: Paperback: Hardback: https://amzn.to/4pcLB3A Ebook: https://amzn.to/44WBcQe   Teri M Brown, Author and Podcast Host: https://www.terimbrown.com FB: @TeriMBrownAuthor IG: @terimbrown_author X: @terimbrown1   Want to be a guest on Online for Authors? Send Teri M Brown a message on PodMatch, here: https://www.podmatch.com/member/onlineforauthors   #seanpauzauskie #stageoffools #literaryfiction #terimbrownauthor #authorpodcast #onlineforauthors #characterdriven #researchjunkie #awardwinningauthor #podcasthost #podcast #readerpodcast #bookpodcast #writerpodcast #author #books #goodreads #bookclub #fiction #writer #bookreview *As an Amazon Associate I earn from qualifying purchases.

Tongue tie is a process not just a procedure.  We say this all the time but not all providers actually mean they practice interdisciplinary care.  Dr Jaju at Smile Wonders in Virginia is a big advocate for collaborating with other providers.  Katie and Dr Jaju discuss the trends causing babies to not be treated young, all about interdisciplinary care and communication and aftercare.  As we said it's a whole process not just a procedure.  Listen here for the episode Podcast Guest: Dr. Rishita Jaju, is a Board Certified Pediatric Dentist, and founder of Smile Wonders in Reston, VA. She is a Harvard trained mommy dentist, a TEDx speaker, author and a published expert in Pediatric Laser Dentistry. Dr. Rishita's expertise in laser dentistry and passion for infant oral health have come from her experience in providing care for thousands of infants, toddlers and children with feeding difficulties over the last 15+ years. She is one of the few pediatric dentists in the country who has achieved Advanced Laser Proficiency Certification and Mastership Status from the Academy of Laser Dentistry as well as Breastfeeding Specialist Certification from Lactation Educational Resources. Her service as the chief resident and visiting faculty at Children's National Medical center,  the Council of Clinical Affairs for American Academy of Pediatric Dentistry and as a part of the Examination Committee of the American Board of Pediatric Dentistry, has given her a unique opportunity to have a positive influence on her profession. When it comes to research and publications her work can be found in peer reviewed journals on topics of pediatric dental care for patients with special healthcare needs, behavior guidance, esthetic dentistry, pain management and lasers in dentistry. Her numerous live and virtual training to  introduce the benefits of laser applications have been well received by her colleagues in general dentistry, pediatricians, lactation consultants, speech pathologists and other allied healthcare professionals. Each year she participates in Give Kids a Smile initiative to provide pro bono care for  children of Northern Virginia in an effort to give back to her community. Dr. Rishita and her husband are both proud UGA bulldogs who adore their son and their 2 Maltese doggies named Kaju and Kulfi. They have traveled together all over the world and have visited every continent (except Antarctica).Podcast Host: Katie Oshita, RN, BSN, IBCLC has over 25 years of experience working in Maternal-Infant Medicine.  While Katie sees clients locally in western WA, Katie is also a telehealth lactation consultant believing that clients anywhere in the world deserve the best care possible for their needs.  Being an expert on TOTs, Katie helps families everywhere navigate breastfeeding struggles, especially when related to tongue tie or low supply.  Katie is also passionate about finding the root cause of symptoms, using Functional Medicine practices to help client not just survive, but truly thrive. Email katie@cuddlesandmilk.com or www.cuddlesandmilk.comSupport the show

Detailed Show Notes Episode Overview In part one of this two-part series on Dental Digest, host Dr. Melissa Seibert sits down with dual-boarded periodontist and prosthodontist Dr. Ashley Hoders to examine the latest consensus literature on peri-implant soft tissue deficiencies, biologic bone preservation, and the biomechanics of skeletal expansion . They unpack why soft tissue recession is fundamentally a bone problem, how thin tissue starved of blood supply triggers crestal loss, and why treating skeletal arch deficiencies with dental compensation compromises cortical bone . Guest Information Guest: Dr. Ashley Hoders, DDS, MS Credentials & Affiliations: Dual board-certified diplomat and fellow of the American Board of Periodontology and the American Board of Prosthodontics; MS from UT Health Science Center at San Antonio . Clinical researcher with the McGuire Institute, co-creator of Spear Hygiene, visiting faculty at the University of Washington Graduate Periodontics Department, and active member of the American Academy of Restorative Dentistry (AARD) . Key Clinical Takeaways 1. The Reality of Peri-Implant Soft Tissue Deficiencies Recent joint consensus papers (AO/AAP) reveal that non-diseased peri-implant soft tissue deficiencies have an overall prevalence of 46.2% . These deficiencies worsen over time: 33% at 1 year and 64.5% at 5 years . Clinicians should exercise caution when planning implants in the aesthetic zone and consider alternative modalities (such as resin-bonded bridges) when appropriate . 2. Mid-Facial Margins vs. Interproximal Papilla Interproximal papilla height is dictated primarily by the bone levels on adjacent natural teeth . Mid-facial mucosal margin stability is driven by facial bone thickness (which is frequently $

Send us Fan Mail In this episode of Your Child Is Normal, Dr. Jessica Hochman talks with pediatric sleep specialist Dr. Bhattacharjee, who leads the sleep program at Rady Children's Hospital, about why sleep is so important for children's physical health, mood, learning, attention, and athletic performance.They discuss why teenagers naturally want to stay up later, how early school schedules work against adolescent biology, and what parents can realistically do to help. Dr. Bhattacharjee shares practical advice about screens, phones in the bedroom, caffeine, weekend sleep schedules, bedtime routines, and figuring out how much sleep your individual child actually needs.They also discuss the connection between sleep deprivation and ADHD-like symptoms, whether sleep helps children grow, melatonin and other sleep aids, when excessive sleepiness deserves medical attention, and why consistency may be one of the most underrated sleep strategies.Learn more about Dr. Bhattacharjee: Dr. Bhattacharjee practices at UC San Diego and Rady Children's Hospital in San Diego and is an active member of the American Academy of Sleep Medicine. Make sure and Follow Your Child Is Normal  podcast for practical, evidence-based conversations designed to help parents learn more and worry less.Your Child is Normal is the trusted podcast for parents, pediatricians, and child health experts who want smart, nuanced conversations about raising healthy, resilient kids. Hosted by Dr. Jessica Hochman — a board-certified practicing pediatrician — the show combines evidence-based medicine, expert interviews, and real-world parenting advice to help listeners navigate everything from sleep struggles to mental health, nutrition, screen time, and more. Follow Dr Jessica Hochman:Instagram: @AskDrJessica and Tiktok @askdrjessicaYouTube: Ask Dr JessicaShop my favorite products for kids on Amazon hereIf you are interested in placing an ad on Your Child Is Normal click here or fill out our interest form.To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA The information presented in Ask Dr Jessica is for general educational purposes only.  She does not diagnose medical conditions or formulate treatment plans for specific individuals.  If you have a concern about your child's health, be sure to call your child's health care provider.

Helen Simpson reads her story “Lub Dub Lub Dub Lub Dub,” from the September 7, 2026, issue of the magazine. A winner of the American Academy of Arts and Letters's E. M. Forster Award, Simpson is the author of seven short-story collections, including “Four Bare Legs in a Bed,” which won the Somerset Maugham Award in 1990, and “Cockfosters,” which was published in 2025.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Today on the program, a trip into the archive and a return to Episode 149, my conversation with Terry Tempest Williams. We were talking about her book When Women Were Birds: Fifty-Four Variations on Voice, available from Picador. Air date: February 17, 2013. Terry Tempest Williams is the award-winning author of over twenty books of creative nonfiction, including the environmental classic, Refuge: An Unnatural History of Family and Place. Among her other books are Leap; Red; The Open Space of Democracy; Finding Beauty in a Broken World;  The Hour of Land; and Erosion: Essays of Undoing. Her work has been translated and anthologized worldwide. A recipient of a Guggenheim Fellowship and a Lannan Literary Award, she is a member of the American Academy of Arts & Letters and is currently writer-in-residence at the Harvard Divinity School. She divides her time between Cambridge, Massachusetts and Southeastern Utah. *** ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Otherppl with Brad Listi⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ is a weekly podcast featuring in-depth interviews with today's leading writers. Available where podcasts are available: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, etc. Get ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠How to Write a Novel,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ the debut audio course from DeepDive. 50+ hours of never-before-heard insight, inspiration, and instruction from dozens of today's most celebrated contemporary authors. Subscribe to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Brad's email newsletter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Support the show on Patreon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Merch⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TikTok⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Bluesky⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email the show: letters [at] otherppl [dot] com The podcast is a ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠proud affiliate partner of Bookshop⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, working to support local, independent bookstores. Learn more about your ad choices. Visit megaphone.fm/adchoices

“Hitler had to abolish democracy to take over Berlin.” — Wendy Lesser “Ich bin ein Berliner” (I Am a Berliner), JFK famously said in West Berlin on June 26, 1963, in the face of Soviet imperial tyranny. Today, Wendy Lesser is offering the same defiance in her new book Berlin Before and After. Only Lesser offers a cautionary mirror for our times of not just post-Soviet Putin but also wannabe-tyrants like Trump. Lesser's loving portrait of Berlin is of a free city. She reminds us that even in Germany's darkest hour, Berlin never actually went Nazi. The city voted left up to and including 1933, so Hitler had to abolish democracy to take it over. Nor, Lesser argues, was Nazism a reaction to Weimar Berlin's Cabaret-style nightlife, any more than Trump is a reaction to wokeness. Economic forces, not cultural ones, she insists, enable dictators. Today's Berlin, as a city that memorializes its own crimes, offers America an urban lesson in acknowledging historical guilt. That's what makes Berlin such a defiant beacon of freedom in our authoritarian age. There are more urbane cities than Berlin, but none quite as dedicated to freedom. Go there and/or read Berlin Before and After. Today we should all be Berliners. Five Takeaways •       Our Own 1929 — or 1932? The book began as a love letter to the Berlin Lesser adopted in 2003 — the everywhere writer of Berkeley, New York, and Berlin, against Lampedusa the ultimate somewhere, who never left Sicily and carried Shakespeare through the coffee houses of Palermo. But as she wrote, America's condition worsened: “We were not only in our own 1929, but perhaps in 1930, '31, or even '32 — verging on our own descent into frightening dictatorship.” Hence the subtitle's cautionary mirror — though history, she insists, never exactly repeats itself, and the American analogies came unforced, surfacing every thirty or forty pages without hammering. Being an everywhere, she says, doesn't make you write better — Lampedusa proves that — “but it improves your life,” and it gave her the subjects her native California never could.•       Berlin Never Went Nazi. The episode's revelation: the city of Weimar flamboyance never gave the Nazis a majority — Berlin voted left up to and including 1933, and “Hitler had to abolish democracy to take over Berlin.” From which follows her sharpest argument: Nazism was not a backlash against Berlin's sexual and artistic freedoms, “just as I do not see the election of Trump as a reaction to so-called wokeness or trans rights. Cultural manifestations do not cause such government changes. Economic forces do” — wealth gaps, regional deprivation, the east feeling second-class, then and now (the AfD's heartland). The direct equivalences are rhetorical: America's poisoned-blood language on immigrants comes “straight from the Goebbels playbook,” and the rights that flowered in twenties Germany were “instantly squished” in the thirties. As for today: the AfD polls high before Berlin's September city elections, but the firewall holds — and the party is formally flagged by German intelligence as constitutionally dangerous. Andrew's question stands: any vaccines for this thing?•       1929: The Year Everything Premiered. Why that year: Grosz, Sander, and Otto Dix at their peak; Brecht and Piscator both premiering; All Quiet on the Western Front, the underrated Grand Hotel, and Berlin Alexanderplatz in the bookshops — plus Thomas Mann's Mario and the Magician, the novella that predicted fascism; Billy Wilder still a weekly-paper journalist shooting his first film; and Christopher Isherwood arriving on the first visit that became Goodbye to Berlin and, via Broadway, Cabaret. “Only in retrospect do we see these things as major.” The culture flourished beside economic and political chaos — “having a terrible government is not inconsistent with producing good culture. Look at nineteenth-century Russia” — and when the chaos won, the exiles washed up in the German ghetto of Los Angeles: Brecht (on the beach, per this week's Baerwald episode), Döblin, Mann. Many went back — Brecht in 1949, Piscator after — because in Hollywood and New York they “couldn't live on the thin slice of culture,” a homesickness Lesser saw again in Berkeley's own Czesław Miłosz, watching Americans like children playing in a sandbox.•       After Means 1989. The title's twist: the After is not the Nazis' arrival but the Wall's fall. The dark half-century — twelve years of Reich, then “with barely a pause to take a breath” the divided city — is deliberately skipped: “the city is going to tell you what happened,” through what its monuments confess, like Bebelplatz's memorial to the burned books of May 1933. Berlin now wears its freedom knowingly: graffiti flourishes precisely because speech was twice policed; May Day's bottle-throwing is tolerated and swept up; Freiheit arrives like the choral finale of Beethoven's Ninth — Andrew's analogy, which she embraced with irony, since “nobody is totally free these days.” The Wall's hothouse island remains separate from Germany half a century on. And the city stays cinematic to the point of unreality — Wings of Desire's angels in the actual Staatsbibliothek (“I thought it was just a set”), Babylon Berlin's set-choosers clearing away the present — with a thriller shelf to match: Deighton's Berlin Game (freshly reread on his death), le Carré's Spy Who Came in from the Cold, Herron, McEwan, Schneider's Wall Jumper.•       A Mirror That Might Become Useful. Berlin's deepest lesson is for after the fall: it is the city that acknowledges its bad deeds — monuments and plaques saying this is where we did it — while America “likes to brush it all aside and act like we're always the heroes.” Andrew's pushback landed: Montgomery, Bryan Stevenson's lynching memorial, the African American Museum — “You're right. I'm not being fair.” But the qualification sharpens rather than sinks the thesis: “we do not have a history yet like Holocaust Germany or even Berlin Wall Germany… It's a mirror that might become useful if the worst comes about.” Meanwhile Berlin models the livable city: rent control the voters wanted to push all the way to expropriation, transit worth “ecstasies,” and a constitutional welfare clause promising a dignified existence — economic rights our Bill of Rights never mentions. The book ends aboard the M29 bus, top deck, regular fare, from the Maybachufer's twice-weekly market (running since before 1929) across the old West to Grunewald. “Maybe you're going to be made into a Berlin angel.” “A great fate.” About the Guest Wendy Lesser is the founding editor of The Threepenny Review, the celebrated Berkeley literary quarterly, and the author of a novel and twelve works of nonfiction, including You Say to Brick: The Life of Louis Kahn (winner of the Marfield Prize), Why I Read, and Scandinavian Noir. A fellow of the American Academy of Arts & Sciences, she has held fellowships from the Guggenheim Foundation, the NEH, the Cullman Center — and the American Academy in Berlin, where her love affair with the city deepened. Berlin Before and After: A Cautionary Mirror for Our Times (Harper, September 2026) is her portrait of the city in 1929 and now. She divides her time between B...

Paid Subscribers are invited to tonight's weekly SUPD hangout at 8pmEST! I will send the link at 7EST Subscribe and Watch Interviews LIVE : On YOUTUBE.com/StandUpWithPete ON SubstackStandUpWithPete Stand Up is a daily podcast. I book,host,edit, post and promote new episodes with brilliant guests every day. This show is Ad free and fully supported by listeners like you! Please subscribe now for as little as 5$ and gain access to a community of over 750 awesome, curious, kind, funny, brilliant, generous souls Subscribe now Dr. Michael E. Mann is Presidential Distinguished Professor in the Department of Earth and Environmental Science at the University of Pennsylvania, with a secondary appointment in the Annenberg School for Communication. He served as Penn's inaugural Vice Provost for Climate Science, Policy, and Action, and currently serves as Director of the Penn Center for Science, Sustainability, and the Media (PCSSM). Dr. Mann received his undergraduate degrees in Physics and Applied Math from the University of California at Berkeley, an M.S. degree in Physics from Yale University, and a Ph.D. in Geology & Geophysics from Yale University. His research interests include the study of Earth's climate system and the science, impacts and policy implications of human-caused climate change. Dr. Mann was a Lead Author on the Observed Climate Variability and Change chapter of the Intergovernmental Panel on Climate Change (IPCC) Third Scientific Assessment Report in 2001 and was organizing committee chair for the National Academy of Sciences Frontiers of Science in 2003. He has received a number of honors and awards including NOAA's outstanding publication award in 2002 and selection by Scientific American as one of the fifty leading visionaries in science and technology in 2002. He contributed, with other IPCC authors, to the award of the 2007 Nobel Peace Prize. He was awarded the Hans Oeschger Medal of the European Geosciences Union in 2012 and was awarded the National Conservation Achievement Award for science by the National Wildlife Federation in 2013. He made Bloomberg News' list of fifty most influential people in 2013. In 2014, he was named Highly Cited Researcher by the Institute for Scientific Information (ISI) and received the Friend of the Planet Award from the National Center for Science Education. He received the Stephen H. Schneider Award for Outstanding Climate Science Communication from Climate One in 2017, the Award for Public Engagement with Science from the American Association for the Advancement of Science in 2018 and the Climate Communication Prize from the American Geophysical Union in 2018. In 2019 he received the Tyler Prize for Environmental Achievement and in 2020 he received the World Sustainability Award of the MDPI Sustainability Foundation. He was elected to the U.S. National Academy of Sciences in 2020. He received the Leo Szilard Award of the American Physical Society in 2021 and was named Humanist of the Year by the American Humanist Association in 2023. He was elected a Foreign Member of the Royal Society in 2024 and was elected to the American Academy of Arts & Sciences in 2026. He is a Fellow of the American Geophysical Union, the American Meteorological Society, the Geological Society of America, the American Association for the Advancement of Science, and the Committee for Skeptical Inquiry. He is also a co-founder of the award-winning science website RealClimate.org. Listen rate and review on Apple Podcasts Listen rate and review on Spotify Pete On Instagram Pete on Blue Sky Pete on Threads Pete on Tik Tok Pete on Twitter Pete Personal FB page Stand Up with Pete FB page All things Jon Carroll Gift a Subscription https://www.patreon.com/PeteDominick/gift Send Pete $ Directly on Venmo May I be safe and protected from harm. May I be happy in the midst of how things are. May I be healthy, strong, and whole. May I live with ease of well-being

View This Week's Show NotesJuliet and I are officially empty nesters. Both girls are launched, the bathroom is clean every morning, and we're figuring out what the next phase looks like. It rhymes with dusk bike rides, protein shakes for dinner, and a cereal bar in Marin we somehow didn't know existed until now.We also revisited one of our longest-running household debates: women's pain tolerance. An Instagram infographic claiming childbirth equals breaking 20 bones made the rounds and reignited everything. We cover what the McGill pain scale actually says, why medical research has failed women on pain, and the full story of my eardrum, which ends with blood in the ER and a pain scale I have never quite recovered from.From there we got into our book Outplay and the data shaping every youth sports conversation right now. The number everyone cites is that 70% of kids drop out of sport by age 13. A researcher on LinkedIn tried to find the primary source and came up empty. So did researchers at the Aspen Institute. So did everyone else. We unpack what the CDC data actually shows and why citation drift doesn't mean youth sports is fine.The biggest chunk of this episode is something I wanted to make sure we gave real time to: what two years of running the Starrett System has actually taught us. Most people coming into the program weren't working a coherent physical practice at all. They might have been doing some weight training or riding a Peloton, but nobody was hitting all three legs of the longevity triangle: strength, conditioning, and mobility. Nobody was sprinting. And a lot of people believed that the moment they felt discomfort, they should stop.Watching that shift has been one of the most rewarding things we've done. Member Lily gained 5.4 pounds of lean mass in eight months. Cole said he's craving training every day for the first time. The fall cohort starts September 8th. Early bird: $200 off at starrettsystem.com.What You'll Learn in This EpisodeWhy the "70% of kids drop out of sports by age 13" statistic cited by the American Academy of Pediatrics and major sports governing bodies may have no verifiable primary source, and what the CDC and Aspen Institute data actually showsWhy the claim that childbirth equals breaking 20 bones is a myth, and what the McGill pain scale says is actually more painfulWhy medical research has historically underserved women on pain, and how self-reporting skews the pictureWhat two years of running the Starrett System revealed about what most people were actually missing in their physical practiceWhy having a strength practice, a conditioning practice, and mobility work are three separate things, and why most people were only doing one of themWhat the "longevity triangle" is and why most wellness and longevity conferences have almost no conversation about itHow teaching people to train around injuries and physical limitations, rather than stop, has been one of the biggest shifts for Starrett System membersWhy the program's nutrition approach centers on abundance and eliminating nothing, and what happens when people who have been chronically underfueling start eating enoughKey Highlights(00:00) Welcome to RECESS / Kelly and Juliet go officially empty nest(00:31) The bathroom story and Byron Katie's towel wisdom via Gabby Reese(03:19) Life as empty nesters: bike rides at dusk, protein shakes, cereal for dessert(04:43) Listener ask: send your best recipes for two(05:18) Women vs. men pain tolerance: the debate renewed(06:44) Kelly's eardrum story(08:57) McGill pain scale and Juliet's finger(11:11) Outplay: preparing families for youth sports(13:32) Pay-to-play, private equity, and the Norwegian youth sports model(16:26) The 70% dropout stat and its missing primary source(19:12) Starrett System: origin story from the YPO conference(26:48) Starrett System: member results and the September 8th fall cohort(30:41) Cereal bar in Marin and the great Raisin Bran debate(34:07) Wrap and early bird CTA

You Can't Pizza Party Your Way Out of Burnout: Moral Injury, Compassion Fatigue, and Treating Healthcare Workers - An Interview with Kimberly Johnson, PhD, LMHCD, and Lucy Li, MD Kimberly Johnson, PhD, and Lucy Li, MD, of the Emotional PPE Project on healthcare worker mental health and moral injury. Curt and Katie talk with Kimberly Johnson, PhD, LMHCD, a counselor educator at Touro University with more than thirty years of clinical experience in trauma, crisis, and disaster mental health, and Lucy Li, MD, a pediatric anesthesiologist at the Children's Hospital of Philadelphia. Both serve on the board of the Emotional PPE Project, a volunteer-run nonprofit reducing the barriers that keep healthcare workers from accessing mental health care. Healthcare workers rarely arrive in therapy looking the way the distress would suggest. They mask, they overcompensate, and they spend session time explaining the job before they get to what the job has done to them. Kimberly describes the trifecta therapists often flatten into ordinary workplace burnout: burnout, compassion fatigue and complex trauma, and moral injury braided together, frequently presenting subclinically. Lucy describes the same terrain from inside medicine, including what shifted for her after her friend and co-resident died by suicide during residency. They also walk through the Emotional PPE Project's directory of volunteer therapists and its ePPE 101 training for mental health professionals who want to work with healthcare workers well. In this episode, we discuss: - Why healthcare workers are a heterogeneous population, not a single clinical profile - How burnout, complex trauma, and moral injury show up together and subclinically - The intake questions that surface occupational risk factors early - Why moral injury sits where occupational, vocational, and personal identity stop aligning - What stigma costs healthcare workers, their patients, and the workforce - How the Emotional PPE Project connects healthcare workers to free, confidential care - Why the same barriers show up for therapists as healthcare providers Timestamps: - 02:38 - What therapists get wrong with healthcare workers - 07:11 - Professional humility and the questions worth asking early - 09:24 - Burnout, trauma, and moral injury as a trifecta - 15:30 - Where moral injury actually lives - 17:43 - Stigma and the fear of seeking care - 22:00 - The second victim effect and being sent home - 25:10 - Beyond pizza parties: what structural support looks like - 33:27 - Inside the Emotional PPE Project and ePPE 101 Guest Bios: Kimberly Johnson, PhD, LMHCD is Director of Special Projects and Assistant Professor in Clinical Mental Health Counseling at Touro University, a licensed therapist in New York, a certified Compassion Fatigue Therapist and Educator and Field Traumatologist, and a Diplomate with the American Academy of Experts in Traumatic Stress. Lucy Li, MD is an attending anesthesiologist in Pediatric Anesthesiology at the Children's Hospital of Philadelphia and a board member of the Emotional PPE Project. She completed her anesthesiology residency at Massachusetts General Hospital, where she was chief resident, and focuses on physician mental health and wellness. Learn more at emotionalppe.org Full show notes and transcript: mtsgpodcast.com Join the Modern Therapist Community Patreon: https://www.patreon.com/c/mtsgpodcast Facebook Group: https://www.facebook.com/groups/therapyreimagined Modern Therapist's Survival Guide Creative Credits Voice Over by DW McCann: https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano: https://groomsymusic.com/

In this special bonus episode of the Science of Skin Podcast, Dr. Patti Farris sits down with Dr. Sandra (Sandy) Johnson — private practice dermatologist in Fort Smith, Arkansas, and member of the American Academy of Dermatology's Board of Directors — for an urgent conversation on the CMS reimbursement cuts threatening the future of dermatology.Dr. Johnson breaks down the three major proposals from CMS that could devastate dermatology practices nationwide: a proposed cut to the 25-modifier that would penalize combined evaluation-and-procedure visits, a potential overhaul of indirect practice expense calculations that could hit dermatology harder than most specialties, and an effort to remove the AMA's RUC representation — stripping physicians of their voice in how reimbursement values are set.Beyond the policy breakdown, Dr. Johnson shares what the AAD is doing to fight back and exactly what members can do right now: submitting the 30-second advocacy letter through Voter Voice, rallying staff and patients to do the same, donating to SkinPAC, and attending this year's Legislative Conference in Washington, DC before the mid-September deadline.This is a call to action for the entire dermatology community — because a united voice is the specialty's best defense.Topics covered:The proposed 9–25% CMS reimbursement cutsThe 25-modifier and what it means for combined visitsIndirect practice expenses and why dermatology may be hit hardestEfforts to remove the AMA from the RUCHow to take action: Voter Voice, SkinPAC, and the AAD Legislative Conference

Cori Uccello, FSA, MAAA, FCA, MPP joins host Ankit Nanda, FSA, MAAA, FCA for a tour of the U.S. health insurance coverage landscape, including Medicare, Medicaid, and the ACA marketplaces. Drawing on a career as the senior health fellow at the American Academy of Actuaries, MedPAC commissioner, and Congressional Budget Office panel of health advisers member, she discusses how actuarial analysis enters policy debates, where it carries weight, and what actuaries should understand about the programs shaping the market they price in.

The 2026 NAIC Summer National Meeting brought a wide range of actuarial and regulatory issues into focus, from mortality and expense assumptions to long-term care, artificial intelligence, catastrophe risk, insurance affordability and more. In this episode of the Research Insights Podcast, Dale Hall, Managing Director of Research at the Society of Actuaries Research Institute, is joined by Geralyn Trujillo, Senior Director of Public Policy at the American Academy of Actuaries, for a recap of the meeting in Columbus, Ohio. Together, they explore key developments across the life, health and property and casualty practice areas and discuss what these evolving issues could mean for actuaries, regulators, consumers and the broader insurance system. The conversation examines SOA Research Institute experience studies and emerging research, the Generally Recognized Expense Table (GRET), long-term care and combination products, the growing use and regulation of artificial intelligence in insurance, catastrophe risk, affordability, resilience and the increasingly interdisciplinary role of actuaries. Listen to hear which developments from the NAIC Summer National Meeting may have the most momentum through the remainder of 2026—and what actuaries should keep on their radar.

Central sleep apnea is a complex and often underrecognized sleep-related breathing disorder that differs from obstructive sleep apnea by involving reduced respiratory drive rather than upper airway obstruction. In this episode, Dr. Ran Liu reviews the underlying mechanisms of central sleep apnea, including the role of ventilatory control instability, discusses its association with neurologic conditions such as stroke, multiple sclerosis, ALS, and myasthenic disorders, and highlights key considerations for diagnosis and management. Learn how emerging technologies, personalized treatment strategies, and advances in sleep medicine are improving outcomes for patients with this heterogeneous group of disorders. In this episode, Teshamae Monteith, MD, FAAN, speaks with Ran R. Liu, MD, FRCPC, MSc, author of the article "Central Sleep Apnea" in the Continuum® August 2026 Sleep Neurology issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Liu is an Adjunct Clinical Assistant Professor at McMaster University in Hamilton, Canada, and an Adjunct Lecturer at the University of Toronto in Toronto, Canada. Additional Resources Read the article: Central Sleep Apnea Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @SleepyNeuroDoc  Full episode transcript available here Dr Monteith: You may be familiar with obstructive sleep apnea, but central sleep apnea is often less understood and frequently underdiagnosed. In this podcast, we break down the key clinical pearls to sharpen your diagnostic reasoning, discuss why central sleep apnea matters, and to explore some of the fascinating advances transforming the field. Dr Jones: This is Dr. Lyell Jones, editor-in-chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Monteith: This is Dr. Teshamae Monteith. Today, I'm interviewing Dr. Richard Liu about his article on central sleep apnea. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Welcome to our podcast. How are you?  Dr Liu: Good. Thank you, Dr. Monteith, for having me today.  Dr Monteith: Please introduce yourself to our audience.  Dr Liu: Hello, everybody. My name is Richard Liu. I am a sleep neurologist. I am working out of Toronto at both Sunnybrook Health Science Center and MedSleep. I did my residency at Queen's for neurology and my sleep medicine fellowship at Harvard University.  Dr Monteith: Great. And what got you interested in sleep?  Dr Liu: Thank you very much for asking. For me, sleep medicine is a field where essentially everything is connected. Certainly, impaired sleep can affect many other conditions, including many neurological conditions. And even within sleep medicine, when somebody has a sleep disorder, often the entire system is connected. So as an example, if you have insomnia and fragmented sleep and periodic limb movements of sleep, certainly these conditions can impact sleep apnea. And certainly, for today's topic of central sleep apnea, this is an extremely complicated disorder where it's a very in-depth integration between neurological and respiratory physiology, among other systems as well.  Dr Monteith: So, I guess you're kind of like the cornerstone, sleep being the cornerstone of neurology. Everyone has to sleep. That's for sure. Great. So why don't we talk about what central sleep apnea is, and how prevalent is it as a collective group of disorders compared to obstructive sleep apnea?  Dr Liu: So, one way to think about central sleep apnea is that this is a heterogeneous group of etiology. But the primary concept here for central sleep apnea is that there's a reduction in respiratory drive. This is in contrast to obstructive sleep apnea, where essentially this is some form of airway obstruction in the presence of relatively intact respiratory drive. And of course, there's mixed apneas where they may contain features of both. But of course, now we know that even obstructive sleep apnea, there's a certain degree of drive dependence somewhat blurring these distinctions. The overall prevalence of central sleep apnea is about five to ten percent of all patients with sleep- disorder breathing. And certainly, it could be higher in some neurological conditions, such as things like stroke, multiple sclerosis, and multisystem atrophy.  Dr Monteith: Great. So certainly, it's out there. Why don't you tell us about the objectives of your article?  Dr Liu: Absolutely. Thank you for asking. I think the main objective of this article is really to highlight that central sleep apnea is a complex syndrome resulting from a large group of heterogeneous etiologies. And of course, again, it could be associated with many neurological conditions. And really here, I want to highlight advancements, both medicine and technology, on both the side of diagnosis of central sleep apnea, as well as the multimodal targeted treatment.  Dr Monteith: And what do you want our listeners to take away from this talk and certainly your article? What are the key essential points?  Dr Liu: Thank you very much for asking. I think that one way of looking at central sleep apnea to etiologically divide this into both hypocapnic and hypercapnic central sleep apnea. And of course, loop gain being a major driver for a hypocapnic central sleep apnea, and that one can actually think about hypocapnic central sleep apnea beyond a phenotypic spectrum with obstructive sleep apnea, with many patients having overlapping features of both obstruction and central component. On the other hand, hypercapnic central sleep apnea, often also known as hyperventilation syndrome, can span etiology from chemoreflex dysfunction to a broad range of neuroanatomical localization, such as central nervous system, peripheral nervous system, neuromuscular junction, and muscle disorders.  Dr Monteith: And what are some of the symptoms of central sleep apnea? Do any of them differ from obstructive sleep apnea?  Dr Liu: Thank you for asking, that's an excellent question. So certainly, central sleep apnea symptoms can overlap with obstructive sleep apnea symptoms. And of course, given the large range of underlying etiology, often the CSA symptoms depend on the underlying etiology. There may be less snoring compared to obstructive sleep apnea patients, especially the hypocapnic CSA patients. Of course, these patients, like OSA, may have frequent awakenings, gasping and choking their sleep, and nocturia, and so on.These patients may have daytime sleepiness, insomnia-like symptoms, or they could be asymptomatic. Interestingly, the hypocarbnic central sleep apnea patients, they're a bit more prone to have the insomnia-like symptoms, whereas the hypercarbnic central sleep apnea patients, they tend to have a bit more of the daytime sleepiness and morning headaches.  Dr Monteith: You spoke about some of the neurological disorders that might be associated with central sleep apnea, like stroke and multiple sclerosis. What about some of the more traditional risk factors associated with obstructive sleep apnea or conditions associated with it, like obesity and hypertension? Or does that just mix the picture?  Dr Liu: There is many overlap between risk factors between obstructive sleep apnea and central sleep apnea, and certainly one of the things that I highlight in this article is really that often it's not just black and white, that this could be a spectrum with overlapping disease between both conditions. So certainly, in our neurological world, stroke is the most common thing that may be associated with central sleep apnea. But overall, cardiovascular issues such as heart failure, atrial fibrillation, these things can also be associated with central sleep apnea. And again, from the neurological perspective, if we were to divide from hypocarbnic versus hypercarbnic central sleep apnea, by thinking about the hypercarbic central sleep apnea, again, this is where we're thinking about hypoventilation syndromes. You know, anything that can cause neuromuscular weakness, this is something that we should have a high alarm for, that potentially there may be a hypoventilation component. So, things like any myasthenic syndromes and ALS.  Dr Monteith: Great. Why don't we also talk about the classification? When was the last time central sleep apnea's classification was updated, and what should we know about the classification?  Dr Liu: The most recent classification for central sleep apnea is written in the International Classification of Sleep Disorders, third edition. In this edition, it's classified with six central sleep apnea syndromes. So, these are the CSA with Cheyne-Stoke breathing, CSA due to high altitude periodic breathing, primary CSA, CSA due to medication or substance, CSA due to medical disorder without Cheyne-Stoke breathing, and treatment-emergent central sleep apnea. These classifications more so describe the circumstance of when CSA occurs. A more etiological classification that we can consider would be classifying them by the underlying pathophysiology, which is dividing this from hypercarbnic central sleep apnea versus a hypocarbnic central sleep apnea. Certainly, both set of classification are discussed in this article.  Dr Monteith: Yeah. You discussed at length, the major physiological factors that our audience is just going to have to read. I don't want them to hear this too much while they're driving or on the treadmill, cause its super high level. But why don't we just start with some very basic factors that we need to know about this circuitry?  Dr Liu: Perhaps I can start with this concept of loop gain, which is the most important concept under hypocarbnic central sleep apnea. For any one of my colleagues who's listening to this, they're probably laughing right now cause they think that loop gain is my favorite word. So, loop gain is an engineering term referring to the sensitivity of a feedback loop. So, in the context of sleep medicine, this is an overly sensitive respiratory control to carbon dioxide and oxygen fluctuation. There are three components. The main one is controller gain. This is a chemosensitivity predominant to CO2. The second is plant gain, which is the lung's effectiveness for carbon dioxide excretion. And the last is what's called the mixing gain. This is circuitry delay from the time the signal travels from the pulmonary artery to the peripheral and central chemoreceptors. So conceptually, one may think, let's say something decreases your ventilation, so for example, apnea or hypopnea. With this, as you can imagine, when you stop breathing, your CO2 builds up, and this builds up according to the curve of the plant gain. And of course, this build of CO2 signal takes time to go from your lung to your chemoreceptor. That's your mixing gain. And of course, here it meets the overly sensitive chemoreceptors. This is your controller gain. As a result, this results in amplification of your ventilation to the initial respiratory disturbance. So, you have a overshoot of ventilation. All of a sudden, you're blowing out too much carbon dioxide, then you become hypocarbnic. At one point, if you blow out way too much carbon dioxide, your CO2 goes below what's called a PCO2 apneic threshold. After this, if your CO2's below, you essentially stop breathing. And of course, after that, you can imagine your CO2s are building up again. So, when this loop goes over and over, you generate what's called a chemoreflex-driven respiratory oscillation, where you create a crescendo, decrescendo-like flow pattern, which is underneath what we see in periodic breathing in central sleep apnea.  Dr Monteith: So, without going into too much detail, what is the key way to target restoration of equilibrium? Are there anatomical targets, physiologic targets that we're trying to manipulate here? Dr Liu: Again, thank you very much for that wonderful question. There's certainly many approaches that we could do to improve the stability of the system. Certainly, there are treatments for ventilation, either CPAP or in the case of hypocarbon central sleep apnea, things like adaptive servo ventilation. There is also medications that we can certainly discuss later that can double down the entire system for loop gain. Positional therapy can help for many of these patients. For the appropriate patient, improving their arousal threshold can actually reduce arousal-induced amplification of loop gain. Many of these patients, again, if appropriate, certainly weight loss may be helpful, and these are among many things that we can potentially do to improve the ventilatory stability of these patients.  Dr Monteith: Okay, great. But let's also talk about the general overall approach to diagnosing, and much of it is by history, as you mentioned. There's also sometimes a need, as you say, to differentiate out how much is obstructive. So, what is the thinking process there when you're approaching a patient?  Dr Liu: So perhaps I can start with in terms of the diagnostic modalities that we could use for this. So, the gold standard for diagnosis of central sleep apnea is still our polysonogram. The home sleep apnea test sometimes may be harder to distinguish between obstructive and central events. In addition, on a PSG, you have EEG. This allows you to assess for sleep quality and arousals, as well as the EMGs, which can help you pick up periodic limb movements of sleep. And of course, all of these things themselves can affect the central sleep apnea and can be a potential treatment factor.  Dr Monteith: Before we get into treatment, can you just give us, like, the top five or six drugs or drug classes we need to look for so that, you know, we can discontinue or try something else for our patients that might be complicating their presentation?  Dr Liu: Certainly medications, in some cases, can help central sleep apnea, but other cases can certainly be a precipitant of central sleep apnea. So, one thing to consider would be opioid medication. They can certainly cause very complicated central sleep apnea, something called ataxic breathing, where you have irregularity to the tidal volume and the rate of breathing. Other medications such as Oxybate, baclofen, valproic acid, gabapentin, all of which can certainly contribute to central sleep apnea. And of course, in the stroke world, something that we should always think about is that Tetagelor can also contribute to central sleep apnea. And outside of this, things like muscle relaxants, anesthetic agents can also be a contributor.  Dr Monteith: Great. Now let's get into some of the treatment.  Dr Liu: I like to divide treatment into targeting a hypercarbnic central sleep apnea and a hypocarbonic central sleep apnea. For hypocarbonic central sleep apnea, the first line is CPAP treatment. But for many patients, CPAP therapy is insufficient. There's also adaptive servo ventilation, which is an advanced device designed for hypocarbonic central sleep apnea. For hypercarbic central sleep apnea, again, first line is CPAP treatment, with more advanced devices being a bilevel therapy as well as volume-assured pressure support ventilation. There are also medications that can reduce loop gain, with the most researched one being acetazolamide. We can also reduce arousal thresholds, which could be appropriate for certain patients. And for certain patients, improving arousal threshold can be helpful as, especially in hypocarbic central sleep apnea, that arousals can amplify loop gain. Weight loss can be helpful for both hyper- and hypocarbonic central sleep apnea, and we have great new medication on the market for this. Other therapy can include supplemental oxygen that can be added to PAP devices, as well as phrenic nerve stimulation, positional therapy, as well as carbon dioxide modulation.  Dr Monteith: Excellent. So, it sounds like there's a lot of opportunity to help patients. Now, what are you most excited about in terms of latest development for detection as well as for intervention?  Dr Liu: Thank you very much. I'm actually excited about many things in sleep medicine. Perhaps the thing that I'm most excited about in detection in sleep medicine would be the wearable technologies. So, these technologies may use photoplethysmography to detect peripheral artertonometry. This is where we're measuring the pulsatile arterial volume signals as a surrogate of cardiac and respiratory function. And when paired, that was often desaturation. With these technologies, we can actually detect the staging, autonomic arousals, and HI. So of course, these technologies do not have flow, and they do not have EEG. But they're very powerful technology that allows us to do multi-night testing from home. And of course, understanding both the potential limitation of these technology in the context of patients can be very useful. In terms of treatment-wise, we're learning so much about the underlying contributing drivers of different forms of central sleep apnea. So again, this is highlighted in my article that many of these patients needs multimodal targeted treatment, both between either a PAP device in addition to other things such as medication, oxygen, positional therapy, and so on.  Dr Monteith: Great. So, I mean, I think there's so much to this field. Your article is very extensive. Thank you very much for writing this. I know it may have taken a bit of time, and I appreciate you being on our podcast.  Dr Liu: Thank you very much.  Dr Monteith: Again today, I've been interviewing Dr. Richard Liu about his article on central sleep apnea. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio. 

​Today we're talking about the complex and often misunderstood sleep challenges that show up in neurodivergent kids with Dr. Melisa Moore, a clinical psychologist who is board-certified in behavioral sleep medicine and has spent years supporting children, teens, and young adults with sleep and mood concerns. We'll talk about some of the concepts in Melisa's new book, The Good Sleep Guide for Neurodivergent Kids, including why sleep issues are so common in neurodivergent children, the role of underlying conditions like obstructive sleep apnea, how to recognize when something more than “typical” sleep struggles might be going on, and what kinds of support can actually make a difference. Melisa also shares practical strategies for improving sleep routines and helping kids—and their families—get the rest they need. About Melisa Moore, PhD  Melisa Moore, PhD, is a clinical psychologist board-certified in behavioral sleep medicine. Dr. Moore currently practices in the Los Angeles area and virtually across the country, supporting children, teens, and young adults for a variety of sleep and mood issues. She also works for the Sleep Center at Rady Children's Health, San Diego. Dr. Moore continues to supervise medical and psychology trainees and teaches courses on pediatric sleep around the world. She previously worked at the Children's Hospital of Philadelphia (CHOP) for 17 years, serving as the Psychosocial Director of the Sleep Center and as faculty of the University of Pennsylvania. Inspired by her work with families in combination with her experience as a mom, Dr. Moore's book The Good Sleep Guide for Neurodivergent Kids is a compassionate, comprehensive, science-backed guide to improving sleep in neurodiverse children and teens, released by New World Library on March 4, 2026. Things you'll learn from this episode  How biology, genetics, and circadian rhythms shape sleep patterns in neurodivergent children Why sleep challenges are so common in kids with ADHD and autism, and what's driving them How to recognize signs of obstructive sleep apnea and other underlying sleep disorders Why co-occurring conditions like allergies or hypermobility can further disrupt sleep How consistent routines and supportive sleep associations can improve bedtime success When to seek professional support and what options are available for addressing complex sleep issues Resources mentioned Dr. Melisa Moore's website The Good Sleep Guide for Neurodivergent Kids: Science-Backed Strategies for Children and Teens with ADHD, Autism, and Other Neurodiversities by Melisa Moore, PhD Alex Mortlock Explains Circadian Rhythm Syndromes & Complex Sleep Challenges (Tilt Parenting podcast) Dr. Mel Houser on Navigating the Healthcare System as a Neurodivergent Person (Tilt Parenting podcast) Dr. Zachary Rubin on What Every Parent Should Understand About Allergies (Tilt Parenting podcast) Dr. Roberto Olivardia on ADHD and Sleep Challenges (Tilt Parenting podcast) American Academy of Sleep Medicine (AASM) Pediatric Sleep Council National Sleep Foundation (NSF)   Learn more about your ad choices. Visit podcastchoices.com/adchoices

When your child gets sick, it's easy to spiral—Googling symptoms at 2am, worrying about fevers, and wondering if you're missing something serious. In this reassuring and eye-opening episode, Dr. Diane Arnaout—board-certified pediatrician, mom of two, and Fellow of the American Academy of Pediatrics—breaks down what's actually going on in your child's body, and what parents truly need to know. From fevers and antibiotics to vaccines and “weird but normal” baby symptoms, this conversation will help you replace fear with understanding—and respond with more calm and confidence when your child is sick. Dr. Diane shares what pediatricians wish parents would stop worrying about, the subtle signs that really do matter, and how to avoid the late-night Google spiral that only fuels anxiety. If you've ever wondered “Is this normal?”—this episode is for you. What You'll Learn Why fevers are not dangerous—and how they actually help your child heal The difference between “normal kid stuff” and signs that need medical attention When antibiotics help—and when they can do more harm than good What pediatricians wish parents would stop worrying about Subtle symptoms you should never ignore (like breathing changes or limping) How to stay calm when your child is sick The truth about vaccines—and what they protect against What's actually in vaccines and why those ingredients are there Why spreading out vaccines may not be safer How to make informed health decisions without fear  ABOUT HUNTER CLARKE-FIELDS: Hunter Clarke-Fields is the host Mindful Parenting Podcast (Top 0.5% podcast ), global speaker, number 1 bestselling author of “Raising Good Humans” and “Raising Good Humans Every Day,” Mindfulness Meditation teacher and creator of the Mindful Parenting Course and Teacher Training. Find more podcasts, Hunter's books, blog posts, free resources, and more at ⁠⁠⁠⁠⁠⁠⁠⁠⁠MindfulMamaMentor.com⁠⁠⁠⁠⁠⁠⁠⁠⁠.   Discover your Unique-To-You Podcast Playlist at ⁠⁠⁠⁠⁠⁠⁠⁠⁠mindfulmamamentor.com/quiz/⁠⁠⁠⁠⁠⁠⁠⁠⁠   We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on our website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠/mindfulmamamentor.com/mindful-mama-podcast-sponsors/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Join Elevated GP: www.theelevatedgp.com Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram Connect with Melissa on Linkedin   Dr. Vince Kokich Jr. is a highly esteemed orthodontist, educator, and thought leader in the field of orthodontics and interdisciplinary dentistry. Following in the footsteps of his father, Dr. Vince Kokich Sr., a globally recognized pioneer in orthodontics, Dr. Kokich Jr. has built his own legacy by advancing innovative approaches to patient care, education, and the integration of specialties within dentistry. Educational Background Dr. Kokich Jr. earned his Doctor of Dental Surgery (DDS) degree with high honors from the University of Washington School of Dentistry, a program known for its rigorous clinical training and commitment to evidence-based care. He went on to complete his orthodontic residency at the same institution, where he honed his skills in diagnosing and treating complex malocclusions, facial growth discrepancies, and interdisciplinary cases. Throughout his education, Dr. Kokich was recognized for his academic excellence and dedication to improving patient outcomes. His passion for teaching began early in his career and has remained a cornerstone of his professional life. Professional Career Dr. Kokich Jr. has practiced orthodontics for over two decades, specializing in comprehensive treatment plans that address both functional and esthetic concerns. He is particularly renowned for his expertise in: Interdisciplinary Treatment: Collaborating with restorative dentists, periodontists, and oral surgeons to achieve optimal outcomes for complex cases. Aesthetic Orthodontics: Enhancing smiles through precision orthodontic treatment tailored to each patient's unique facial structure and goals. Education and Mentorship: Sharing his knowledge and clinical experience with the next generation of orthodontists. As an orthodontist, Dr. Kokich is committed to providing patient-centered care. His approach focuses on creating harmonious outcomes that not only align teeth but also improve facial aesthetics and long-term dental health. Educator and Speaker Dr. Kokich Jr. is a sought-after speaker at national and international dental conferences, where he shares his expertise on topics such as: Advanced interdisciplinary treatment planning. Managing complex dental esthetic cases. Incorporating emerging technologies into orthodontic practice. He has been invited to lecture for prestigious organizations and institutions, including the American Association of Orthodontists, the American Academy of Esthetic Dentistry, and various study clubs and universities worldwide. His dynamic and engaging teaching style makes him a favorite among both clinicians and students. Innovator and Founder Dr. Kokich Jr. is the creator of Kokich Education, an educational platform dedicated to elevating the knowledge and skills of dental professionals. Kokich Education offers a range of resources, from webinars and case studies to in-depth courses, empowering clinicians to tackle even the most challenging cases with confidence. The platform reflects Dr. Kokich's philosophy of interdisciplinary collaboration and lifelong learning. To learn more about Kokich Education, visit kokicheducation.com. Publications and Research Dr. Kokich Jr. has contributed to several peer-reviewed articles and textbook chapters that focus on the integration of orthodontics with other dental specialties. His work has been instrumental in advancing the understanding of how orthodontics can complement restorative and prosthetic dentistry to achieve superior outcomes. Professional Affiliations Dr. Kokich Jr. is an active member of several professional organizations, including: The American Association of Orthodontists (AAO). The American Dental Association (ADA). The Pacific Coast Society of Orthodontists (PCSO). Legacy and Vision Dr. Vince Kokich Jr. continues to honor the legacy of his father while forging his own path in orthodontics. His dedication to innovation, education, and patient care has made him a leader in the field. Through his practice, lectures, and Kokich Education, Dr. Kokich inspires clinicians worldwide to achieve excellence in their work and deliver transformative care to their patients.

This week we wrap up our series on supporting children's social, emotional, and relational health with a conversation focused on what pediatricians and other clinicians can take from the series and put into practice. Our host Paul Wirkus, MD and guests Neal Davis, MD and Quang-Tuyen "Q" Nguyen join us to reflect on the key messages from the previous episodes and explore how clinicians can incorporate relational health into everyday pediatric care, particularly when working with families facing additional challenges.The discussion emphasizes that supporting children's mental and relational health doesn't always require a lengthy intervention. Sometimes, it happens in the small encounters - a pediatrician showing genuine care, listening to a family, noticing what they need, and helping parents feel supported. We also consider how clinical care can be strengthened when the policies and systems surrounding families are designed to work for them rather than create additional barriers.Q shares practical insights into advancing relational health in pediatric practice and supporting vulnerable populations, while Neal offers a broader vision for the future of early childhood health care. The episode closes by looking at the role pediatricians, health systems, and communities can play in creating a healthier future for Utah's children and families.Book Club: Amazing GenerationHave a question? Email questions@vcurb.com.For more information about available credit, visit vCurb.com, or for information about the UTAAP, visit aaputah.org.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Cocaine action involves preventing the reuptake of the norepinephrine (NE) transporter, increasing NE and heightening nervous system stimulation.  NE also signals through E. coli receptors to regulate its virulence, but is there a connection between E. coli and cocaine addiction? Dr. Vanessa Sperandio is Professor and Chair of the Department of Medical Microbiology and Immunology at the University of Wisconsin, whose laboratory studies pathogenic E. coli and their interaction with the human host.   Dr. Sperandio describes how E. coli metabolism of glycine in the gut increases addiction to cocaine, how her lab discovered that NE signals through E. coli quorum sensing receptors, how peer review rejection can indicate a novel discovery, how the plasticity of the E. coli pan-genome can lead to rapid and dangerous outbreaks, how treatment of E. coli infections with antibiotics is problematic, how she misses TexMex food, how Wisconsin is a great place to study microbiology, and her vision for the American Academy of Microbiology.  Dr. Marvin Whiteley, editor-in-chief of mBio, joined microTalk on this episode, which was supported by Cholera IV Rehydration Therapy. Participants: Karl Klose, Ph.D. (UTSA) Janakiram Seshu, Ph.D. (UTSA) Vanessa Sperandio, Ph.D. (University of Wisconsin) Marvin Whiteley, Ph.D. (Georgia Institute of Technology)

What exactly is on-treatment remission in psoriasis? Listen as rheumatologist Dr. Jeffrey Stark discusses this question with dermatologist Dr. April Armstrong and patient advocate Elizabeth Park. On-treatment remission is a relatively new term being applied to the management of psoriasis. What does this mean for treatment goals and why is it important to address that last 10% of residual skin involvement? is it truly possible to attain skin clearance? Listen as rheumatologist Dr. Jeffrey Stark, head of medical immunology at UCB asks such questions and more with internationally recognized dermatologist and researcher Dr. April Armstrong, Chief of Dermatology at UCLA and patient advocate Elizabeth Park offering her perspective of living with plaque psoriasis since age 11. The intent of this episode is to identify what on-treatment remission is and why it is important to achieve in the management of psoriasis.  This episode is sponsored by UCB.  Timestamps: 0:00 Intro to Psoriasis Uncovered and guest welcome to dermatologist Dr. April Armstrong, Professor and Chief of Dermatology, University of California Los Angeles (UCLA) and patient advocate Elizabeth Park who shares her perspective on living with psoriasis.  1:05 The evolution of psoriasis management over the last 15 years from a better understanding of the disease and treatment to attain clear skin.    3:30 Elizabeth's early days of diagnosis and management of her psoriasis at a young age.  7:20 How talking to my doctor and advocating for myself changed my psoriasis management.  8:47 Why clearing even residual psoriasis plaques is important to reducing the inflammatory storm and subsequent risks associated with psoriasis. 11:43 Psoriasis is more than what's visible on the skin.                                                                                                                                                         12:08 How Elizabeth stays vigilant about changes and chooses to live her life.  13:00 The concept of on-treatment remission vs a cure, and how it relates to psoriasis and guidelines in use for other diseases. 16:14 The official definition of on-treatment remission in psoriasis. 19:35 The mental load of having psoriasis and what clearance or remission means to Elizabeth. 21:56 Nuances of on-treatment remission vs tight disease control. 23:56 As a chronic disease, ongoing treatment is necessary. 26:15 We are living in an exciting time where through use of advanced therapies, clearance is possible for many people. Key Takeaways: ·       Introduced in June 2025 through a consensus statement from the Medical Board of the National Psoriasis Foundation, on-treatment remission is a new view of managing psoriasis made possible through a greater understanding of the disease and the evolution of systemic treatments.    ·       Attaining complete clearance and remission of psoriasis is possible with current and ongoing treatment.  ·       Intervening early in psoriasis management to control the cytokine storm and attain remission may help prevent progression of related           comorbidities like cardiovascular disease or psoriatic arthritis. Guest Bios:   April Armstrong, M.D., M.P.H. is an internationally renowned dermatologist and clinical researcher who is a Professor and Chief of Dermatology at the University of California Los Angeles (UCLA) where she specializes in inflammatory skin diseases such as psoriasis, atopic dermatitis, and hidradenitis suppurativa (HS). Dr. Armstrong is also the Co-Director for Network Resources at the UCLA Clinical and Translational Research Institute. She has conducted over 150 clinical trials and published over 600 articles in scientific journals.                        Dr.  Armstrong holds multiple leadership positions including Past Chair of the National Psoriasis Foundation Medical Board, Co-President of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), councilor for the International Psoriasis Council, and board member for the International Dermatology Outcome Measures, and the American Academy of Dermatology. Elizabeth Park is a patient advocate and volunteer for the National Psoriasis Foundation. She developed plaque psoriasis in 2008 after being misdiagnosed with seborrheic dermatitis. For most of her adolescence she managed her scalp psoriasis with topicals and phototherapy. In college her psoriasis became worse and she sought other treatment options which included oral systemic treatments and biologics. She is vigilant about changes to her skin and does what she can to live a healthy life to stay on top of her disease management. Resources: "Redefining Remission: A new definition for patients, providers and payers" Advance Online. S. Schlosser. July 2025. April W. Armstrong, MD, MPH; Geroge C. Gondo, MA; Joseph F. Merola, MD, MMSc; et al "Defining On- Treatment Remission in Plaque Psoriasis" A Consensus Statement from the National Psoriasis Foundation Medical Board. JAMA Dermatology, June 2025.

Do you believe a Pennsylvania could send out thousands of mail-in ballots that were received, filled out, returned and PROCESSED on the exact same day? Of course you don't, any more than you believe Joe Biden got 81 million votes. Arizona's "questionable ballots" from 2020 are 5 times the margin of Biden's mulleged "victory." Childrens' Health Defense is suing the American Academy of Pediatrics for knowingly pushing dozens of shots on America's children without ever safety testing a single one. Hillary is reportedly planning Bill's funeral. Bless her heart.

President Trump signed an executive order earlier this month to limit the vaccine schedule to 11 immunizations. Trump directed officials to review the timing and sequencing of vaccinations. The American Academy of Pediatrics (AAP), heavily criticized the decision, warning that it lacks scientific backing, creates unnecessary hurdles for parents, and leaves children vulnerable to preventable diseases.

Beowulf Sheehan is the author of The Father of the Man: The Last Author Portrait Sitting with Cormac McCarthy (Autofocus Books). Sheehan is a photographer of figures in the arts and humanities. To date, he's photographed better than 1,000 writers from more than 60 countries. His work has been published in the likes of Elle, Esquire, L'Uomo Vogue, The New Yorker, People, Time, Vanity Fair, and Vogue and has been exhibited at institutions such as the American Academy of Arts and Letters, Dostoevsky Museum, International Center of Photography, Museum of the City of New York, Museum of Fine Arts Houston, Smithsonian National Museum of African American History and Culture, and The Witliff Colelctions. Author: The Portraits of Beowulf Sheehan, a collection of portraits of 200 writers from 35 countries with a foreword by Salman Rushdie, was published in 2018. The Father of the Man: The Last Author Portrait Sitting with Cormac McCarthy is Sheehan's second monograph. Beowulf Sheehan is the proud son of an immigrant and translator, grandson of a poet and photographer, grandson of a copy editor, first cousin once removed from an editor, and cousin, first cousin once removed, and great-great-nephew of authors. Raised in Fort Lauderdale, Florida, he lives in New York City. *** Today's episode is brought to you by Rula. Thousands of people are already using Rula to get affordable, high-quality therapy that's actually covered by insurance. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.rula.com/otherppl⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to get started. *** ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Otherppl with Brad Listi⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ is a weekly podcast featuring in-depth interviews with today's leading writers. Available where podcasts are available: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, etc. Get ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠How to Write a Novel,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ the debut audio course from DeepDive. 50+ hours of never-before-heard insight, inspiration, and instruction from dozens of today's most celebrated contemporary authors. Subscribe to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Brad's email newsletter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Support the show on Patreon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Merch⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TikTok⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Bluesky⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email the show: letters [at] otherppl [dot] com The podcast is a ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠proud affiliate partner of Bookshop⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, working to support local, independent bookstores. Learn more about your ad choices. Visit megaphone.fm/adchoices

Three Tenses (Random House, 2026) by Ed Park is not quite a memoir, not quite fiction, not quite poetry and not quite prose—and yet it transcends the sum of all its not-quite parts as a resonant portrait of its young artist. Written when he was 28, Park's “transmission from the nineties” displays his more earnest, more vulnerable version: a writer toiling away in upstart obscurity, working thankless New York jobs, who has yet to reach the triumph of publishing his first book. Three Tenses would not be that book. Instead, Park stashed it away in a manilla folder. Fast forward to the dog days of the pandemic, 2020, when Park rediscovered his old manuscript, tinkering with it while he worked on other projects, including his novel Same Bed, Different Dreams, which went on to be a Pulitzer Prize finalist after its 2023 publication. Fascinated and charmed by its lack of convention, I knew that I wanted to speak to Park about Three Tenses, and he was kind enough to join me for a chat about the process of confronting—and publishing—his younger self.  Ed Park is the author of the novels Same Bed, Different Dreams, a finalist for the Pulitzer Prize and the winner of the Los Angeles Times Book Prize, and Personal Days, a finalist for the PEN/Hemingway Award, as well as the story collection An Oral History of Atlantis. He is a founding editor of The Believer, and his writing appears in The New Yorker, the New York Review of Books, Harper's, The Atlantic, and other publications. In 2025, he received the Arts and Letters Award from the American Academy of Arts and Letters and the Deborah Pease Prize from A Public Space Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/biography

What if the key to leading change isn't having all the answers, but knowing how to listen? In this episode, Sue Hassmiller, a nationally recognized nurse leader, leadership coach, and health care strategist, talks about the human side of leading teams through change and what it takes to build trust, psychological safety, and true ownership. She explains why deep listening and genuine relationships are more effective than simply telling people what to do. She also explores the difference between compliance and ownership, and how leaders can help teams take greater responsibility for improvement by connecting change to their values and giving them a voice. Finally, Sue shares how coaching, curiosity, and self-awareness can help leaders overcome judgment and better understand why teams may feel stuck, resistant, or exhausted. Tune in to learn how leaders can listen differently, build stronger connections, and create the conditions for meaningful, lasting change in health care! IHI Spotlight - Jesse McCall: In this IHI Spotlight, Jesse McCall, Senior Director at IHI, explains that sustainable healthcare improvement depends as much on people and culture as it does on technical methods. He emphasizes connecting frontline staff to a shared purpose, creating psychologically safe environments where people can speak up and test new ideas, and ensuring leaders close feedback loops so employees become partners in change rather than recipients of it. About Sue Hassmiller: Sue Hassmiller, PhD, RN, FAAN, is an executive and leadership coach for nurse executives and health care leaders. Across a distinguished career spanning frontline public health, nursing academia, high-level government policy, and 25 years leading national initiatives at the Robert Wood Johnson Foundation, she has dedicated her life to transforming health care systems from the inside out. An elected member of the National Academy of Medicine, recipient of the Florence Nightingale Medal, and recognized as a Living Legend by the American Academy of Nursing, Sue combines multi-sector expertise with certified coaching to help health care leaders navigate complex relationships, drive health equity, and champion compassionate care. She is also the author of Resetting: An Unplanned Journey of Love, Loss, and Living Again, which explores healing and the vital human element in modern health care. Things You'll Learn: Deep listening is essential for understanding how people experience and respond to change. Leaders build ownership by listening to their teams, acknowledging their perspectives, and connecting change to shared values. Psychological safety enables teams to contribute ideas, innovate, and perform at their best. Effective behavior change requires leaders to change their own behaviors by becoming more curious, self-aware, and less judgmental. Leaders can better support stuck or exhausted teams by asking questions and seeking to understand the underlying causes instead of making assumptions. Resources: Connect with and follow Sue Hassmiller on LinkedIn.

Three Tenses (Random House, 2026) by Ed Park is not quite a memoir, not quite fiction, not quite poetry and not quite prose—and yet it transcends the sum of all its not-quite parts as a resonant portrait of its young artist. Written when he was 28, Park's “transmission from the nineties” displays his more earnest, more vulnerable version: a writer toiling away in upstart obscurity, working thankless New York jobs, who has yet to reach the triumph of publishing his first book. Three Tenses would not be that book. Instead, Park stashed it away in a manilla folder. Fast forward to the dog days of the pandemic, 2020, when Park rediscovered his old manuscript, tinkering with it while he worked on other projects, including his novel Same Bed, Different Dreams, which went on to be a Pulitzer Prize finalist after its 2023 publication. Fascinated and charmed by its lack of convention, I knew that I wanted to speak to Park about Three Tenses, and he was kind enough to join me for a chat about the process of confronting—and publishing—his younger self.  Ed Park is the author of the novels Same Bed, Different Dreams, a finalist for the Pulitzer Prize and the winner of the Los Angeles Times Book Prize, and Personal Days, a finalist for the PEN/Hemingway Award, as well as the story collection An Oral History of Atlantis. He is a founding editor of The Believer, and his writing appears in The New Yorker, the New York Review of Books, Harper's, The Atlantic, and other publications. In 2025, he received the Arts and Letters Award from the American Academy of Arts and Letters and the Deborah Pease Prize from A Public Space Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

Three Tenses (Random House, 2026) by Ed Park is not quite a memoir, not quite fiction, not quite poetry and not quite prose—and yet it transcends the sum of all its not-quite parts as a resonant portrait of its young artist. Written when he was 28, Park's “transmission from the nineties” displays his more earnest, more vulnerable version: a writer toiling away in upstart obscurity, working thankless New York jobs, who has yet to reach the triumph of publishing his first book. Three Tenses would not be that book. Instead, Park stashed it away in a manilla folder. Fast forward to the dog days of the pandemic, 2020, when Park rediscovered his old manuscript, tinkering with it while he worked on other projects, including his novel Same Bed, Different Dreams, which went on to be a Pulitzer Prize finalist after its 2023 publication. Fascinated and charmed by its lack of convention, I knew that I wanted to speak to Park about Three Tenses, and he was kind enough to join me for a chat about the process of confronting—and publishing—his younger self.  Ed Park is the author of the novels Same Bed, Different Dreams, a finalist for the Pulitzer Prize and the winner of the Los Angeles Times Book Prize, and Personal Days, a finalist for the PEN/Hemingway Award, as well as the story collection An Oral History of Atlantis. He is a founding editor of The Believer, and his writing appears in The New Yorker, the New York Review of Books, Harper's, The Atlantic, and other publications. In 2025, he received the Arts and Letters Award from the American Academy of Arts and Letters and the Deborah Pease Prize from A Public Space Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/literature

GLP-1 receptor agonists have transformed weight loss and metabolic health—but what are we overlooking? In this episode of New Frontiers in Functional Medicine, Dr. Kara Fitzgerald is joined by Dr. Sanjay Bhojraj and Dr. Alexis Gonzales to explore the clinical tradeoffs of GLP-1 therapy, including lean muscle preservation, nutrient status, weight regain, and long-term metabolic health. The conversation also examines SiPore, an engineered silica-based intervention that works locally in the GI tract to slow the breakdown and absorption of carbohydrates and fats. Dr. Fitzgerald and her guests discuss findings from the randomized, double-blind, placebo-controlled SHINE trial, including outcomes related to A1c, visceral fat, waist circumference, cholesterol, and lean mass. They also explore how CGMs can reveal post-meal glucose patterns, why muscle preservation matters during weight loss, and how clinicians can support patients transitioning off GLP-1 medications—including those preparing for pregnancy, IVF, or surgery. Full show notes + references: https://www.drkarafitzgerald.com/fxmed-podcast/ GUEST DETAILS Sanjay Bhojraj, MD, FACC is an interventional cardiologist and Fellow of the American Academy of Anti-Aging Medicine specializing in cardiometabolic health, longevity medicine, and precision cardiovascular prevention. He's the founder of the Laguna Institute of Functional Medicine. His programs focus on reversing metabolic dysfunction, improving resilience, and reducing cardiovascular risk through lifestyle optimization and advanced diagnostic testing. Dr. Alexis Gonzales ("Dr. G") is OvationLab's Senior Clinical Implementation and AI Specialist, translating breakthrough research into practical clinical workflows, and holds advanced degrees in biochemistry (Saint Mary's), biotechnology (Johns Hopkins), and naturopathic medicine (Bastyr). She provides concierge functional-medicine care at her private practice in California—focusing on endometriosis, fertility, PCOS, and menopause—while distilling emerging research into practical frameworks at conferences to make integrative solutions accessible. http://sigridpro.com/DRKF THANK YOU TO OUR SPONSOR SIGRID http://sigridpro.com/DRKF *CONNECT with DrKF* Want more? Join our newsletter here: https://www.drkarafitzgerald.com/newsletter/ Or take our pop quiz and test your BioAge! https://www.drkarafitzgerald.com/bioagequiz YouTube: https://tinyurl.com/hjpc8daz Instagram: https://www.instagram.com/drkarafitzgerald/ Facebook: https://www.facebook.com/DrKaraFitzgerald/ DrKF Clinic: Patient consults with DrKF physicians including Younger You Concierge: https://tinyurl.com/yx4fjhkb Younger You Practitioner Training Program: https://www.drkarafitzgerald.com/trainingyyi/ Younger You book: https://tinyurl.com/mr4d9tym Better Broths and Healing Tonics book: https://tinyurl.com/3644mrfw Younger You book: https://tinyurl.com/mr4d9tym Better Broths and Healing Tonics book: https://tinyurl.com/3644mrfw

What if a decades-old infection-control rule isn't actually making eye care safer and is instead damaging equipment, generating unnecessary plastic waste, and costing the health care system millions?  In this episode, we are joined by Mayo Clinic glaucoma specialist, Dr. Cheryl Khanna, to discuss a potentially practice-changing position statement from the American Glaucoma Society and American Academy of Ophthalmology on tonometer disinfection. The group explores why longstanding high-level disinfection requirements may deserve reconsideration, including the lack of confirmed infections transmitted through tonometry, potential damage to Goldmann tonometer tips from high-level disinfection, and the unique antimicrobial properties of the ocular surface.  Tune in to hear evidence supporting physical cleaning and low-level disinfection for appropriately selected patients.  Finally, the conversation tackles the financial and environmental consequences of disposable devices in ophthalmology and what still needs to happen before these recommendations translate into widespread changes in clinical practice.   Subscribe to the podcast:  https://MayoClinicOphthalmology.podbean.com  Follow and reach out to us on X and IG: @mayocliniceye

Advances in sleep technology are transforming how neurologists identify and manage obstructive sleep apnea, a condition that affects up to 70% of patients with certain neurologic disorders and can negatively impact cognitive and neurologic outcomes if left untreated. In this episode, Dr. Joyce Lee-Iannotti discusses the growing role of wearable and nearable sleep-monitoring devices, when home sleep studies are appropriate, and how emerging technologies are expanding access to diagnosis and treatment. Learn practical strategies for screening patients, interpreting sleep data, and partnering with sleep specialists to improve long-term neurologic health through better sleep. In this episode, Casey S. Albin, MD, FAAN, speaks with Joyce K. Lee-Iannotti, MD, FAAN, FAASM, author of the article "Sleep Diagnostics and Monitoring Technology in Obstructive Sleep Apnea" in the Continuum® August 2026 Sleep Neurology issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Lee-Iannotti is a Professor of Neurology at the Barrow Neurological Institute, University of Arizona College of Medicine, and Creighton School of Medicine in Phoenix, Arizona. Additional Resources Read the article: Sleep Diagnostics and Monitoring Technology in Obstructive Sleep Apnea Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Guest: @jleeiannotti Full episode transcript available here Dr Albin: Through the neurology of sleep issue, I think we have all been convinced that we all need better sleep, both for ourselves and for our patients. And fortunately, there is an abundance of new technology that can enable us to diagnose sleep problems, and then also make sure that our patients are getting the rest that's going to give them the best chance at a good cognitive recovery, and improve their cognitive function even if they are not currently suffering from a neurologic condition. Today, I am so excited to dive deeper into this topic.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Albin: Hello, this is Dr. Casey Albin. Today I'm interviewing Dr. Joyce Lee-Iannotti about her article on sleep diagnostics and monitoring technology in obstructive sleep apnea. This article appears in the August 2026 Continuum issue on neurology of sleep. Welcome to the podcast, I'd love to just start by having you introduce yourself to our audience.  Dr Lee-Iannotti: Sure. Thank you so much for having me, Dr. Albin. I'm Joyce Lee-Iannotti. I'm a professor of neurology at Barrow Neurological Institute. I am boarded in general neurology, stroke, and sleep, but I spend most of my time in the sleep world, so I jokingly say that I get more sleep doing sleep than I certainly did in stroke.  Dr Albin: Absolutely. I mean, wow, what a fascinating career, and I suspect that we're actually gonna get to some of how all of those pathophysiologies might overlap in the world of sleep. But you had the really exciting task of trying to distill this exciting, rapidly evolving field of sleep diagnostics, and I suspect it's relevant to many of the patients who end up in the neurology clinic, and I suspect that it's actually pretty relevant to many of our listeners who themselves might actually be wearing sleep tracking devices. And all of us probably wonder, well, how can we use that data to improve our own cognitive function and certainly make our patient's life even better? Before we even get into some of the meat and potatoes of this, I thought it would be really helpful for us to define some terms that come up in your article, one of which is wearables. We might figure that out, but the other is nearable. Walk us through what's a wearable, what's a nearable, how are they different?  Dr Lee-Iannotti: I'm happy to do that. First of all, the article is entitled Sleep Diagnostics and Monitoring Technology, and this was a super fun article for me to write because it's very practical, and it's generalizable to everybody. So, I'm going to start with a wearable, and a wearable is really a device that is simply worn on the body. And we're all familiar with wearables like smart watches, they're rings, they're patches, they're headbands, and the most validated form of a wearable that you've probably heard about is actigraphy, which we use in the sleep clinic.  Dr Albin: Tell us a little bit more. So, what is actigraphy? I've heard the word before, but don't actually know what it means.  Dr Lee-Iannotti: Actigraphy has been a tool that we've used in the sleep clinic for a really long time. Traditionally, we used it to monitor circadian rhythm patterns in people who are night owls or morning larks. And then more currently, we actually use it to track sleep patterns in people with suspected narcolepsy. So, before they come in for a sleep study, we actually have them wear an actigraphy for about a week just to get a sense of their sleep duration and their circadian pattern.  Dr Albin: Got it. And what is it monitoring? Our movement or the patterns that we may or may not make?  Dr Lee-Iannotti: It's really based on movement. You're exactly right.  Dr Albin: Cool. Okay, so most of this is based on gold standard monitoring with actigraphy. What other things can be incorporated into these wearable devices?  Dr Lee-Iannotti: Yeah, the technology is really advanced, and every day it changes, which is super exciting. So, on top of movement, these wearables can look at temperature. They can look at even EEG, like limited EEG, heart rate variability, and a really big word that we like to use in sleep technology, which is PPG, or photoplethysmography data, and that's really looking at heart rate variability and oxygenation, saturations, and following those levels as well.  Dr Albin: Wow, so you basically can get most of the data that you might have historically needed to go to a sleep lab to get.  Dr Lee-Iannotti: Most of them. They're still a surrogate. You'll hear me emphasize in the article as well that the gold standard remains the in-lab polysomnogram, but these are good surrogate markers that patients can wear long term to look at trends and patterns.  Dr Albin: Absolutely. And we're gonna unpack a little bit about who specifically those are best for and, really what it gives you in the clinic. But before we jump into that, what's a nearable, and how is that different?  Dr Lee-Iannotti: Yeah. Nearables are really exciting too. So, these are devices that monitor sleep but don't require direct contact on the body. So, these are devices that our patients will use, but it'll be at the bedside table. They're devices that actually go underneath the mattress, or they can be in, like, the ambient environment to detect sleep patterns.  Dr Albin: Oh my gosh. How is it doing that if it's not actually something you're wearing? Dr Lee-Iannotti: I know. It seems a little Big Brother-ish, doesn't it?  Dr Albin: Yes.  Dr Lee-Iannotti: So, they use a technology called radio frequency signals, sometimes radar, sometimes sonar, pressure sensors, even microphones, and they're picking up things like respiration, movement, snoring, and that's how they can decipher sleep patterns.  Dr Albin: Crazy. I mean, I guess the benefit of that is that it's less disruptive to the user 'cause it's not actually on them and having contact with them, and I suspect there's probably some downsides in terms of just it's a more limited data set you're getting.  Dr Lee-Iannotti: Absolutely. Yeah, you're exactly right. It's more convenient because it's not touching them, so, in theory, they're gonna sleep more comfortably. But I would like to think that the most validated forms of devices that we use to track sleep have to have some form of contact with the body, and this technology is new and probably needs a few layers of more sophistication to be as accurate as the wearables.  Dr Albin: Absolutely. I feel like we're going to have this conversation in five, maybe even less than that, years, and this data will have become like, oh, we all have something in our room that's monitoring everything. The world is crazy. All right. One of the places where your article really stood out to me is that sleep diagnostics have really taken off, particularly when we're thinking about obstructive sleep apnea. And I think we all might sort of scratch our heads and be like, "This is a neurology podcast. Why should I, as a neurologist, care about obstructive sleep apnea?" But I think you laid out a very convincing argument in the article. Walk us through why we should care about this.  Dr Lee-Iannotti: Absolutely. So, for neurologists, sleep matters, and I hope that my article translates that. Obstructive sleep apnea, which I'm gonna call OSA, is incredibly common in all of our neurologic patients, whether you see epilepsy, Parkinson's, stroke, Alzheimer's, neuromuscular, or even chronic headache patients. The prevalence of sleep apnea is as high as 70% in these patients.  Dr Albin: Wow. That's incredible. That is an incredibly high number.  Dr Lee-Iannotti: And if I can add, Dr. Albin, there's growing literature in multiple studies across the literature that show that untreated sleep apnea negatively impacts neurologic outcomes in our patients. So, it is really important to ask the question about sleep, and if the red flags pop up, to then screen for sleep apnea in particular.  Dr Albin: I think that that's a great point for us to drill down on, and obviously you're a sleep neurologist. You're very used to screening people in the clinic. But say someone comes in, and I'm gonna have you put your former stroke hat on, and say someone comes into the stroke clinic, and you're just making sure that they're optimized on their aspirin or dual antiplatelet therapy, and you're doing secondary risk modification. How would screening for OSA fit into that?  Dr Lee-Iannotti: It would be a part of that screening process to look at preventative ways to prevent strokes, whether it be primary or secondary prevention. So, we did a survey a while back, and it actually showed that 17% of stroke neurologists are screening for sleep apnea. It has quadrupled, fortunately, in the last few years due to public awareness and a lot of education that the AAN has done, in fact. So, at this point, I would say not asking about sleep apnea to a stroke patient is similar to not asking about diabetes.  Dr Albin: So, we really have to be cognizant and conscious about saying, you know, "Do you snore at night? Do you have episodes of apnea, or does someone witness you stop?" Are there things that you ask that maybe I wouldn't be aware and thinking of?  Dr Lee-Iannotti: Those are the right questions, and then very practically, very easy questionnaires to implement that literally take a minute that your nurses or medical assistants can administer to the patient, and the most commonly one that is used in stroke patients is called the STOP BANG, S-T-O-P B-A-N-G, which is a validated questionnaire to screen for symptoms.  Dr Albin: Absolutely. So okay, so this is easy to do. We should all be doing this. If you're not, now's the time. And I suspect if they screen positive, next steps, it can be hard to get into a sleep lab, and we're gonna talk about some workarounds, but I think some of our listeners may never have spent time in the actual sleep lab. So, let's say you refer a patient and you actually can get them in for a gold standard in-lab sleep study. What's gonna happen in that sleep study?  Dr Lee-Iannotti: Yeah. And I just want to preface this by saying that my article hopefully highlights that we've come a long way where we understand that there are many neurologic populations then that can undergo home ambulatory sleep studies with just as much accuracy as an in-lab polysomnogram. But with that, I wanna say an in-lab polysomnogram is actually a highly sophisticated physiologic recording overnight, typically, unless somebody is a day sleeper. So, if I could take a minute to kinda describe the data that we're monitoring throughout the night. There is a limited EEG. We concentrate on frontal, central, occipital leads to look at sleep staging. We have eye leads. We have EMG leads on the chin and the leg. We look at EKG, flow monitors, belt, and then we also do pulse oximetry, snoring mics, and even body position sensors. So, a lot is going on.  Dr Albin: This is incredible. Yeah, it truly is. I mean, this is like... I'm a neurointensivist, and so I think that you have just really outdone what I consider multimodal monitoring in your sleep study patients. I'm not even sure our neuro ICU patients accumulate that much data. All right, so tell me, they go through, and they can get this. But like you said, there's actually a lot of data that you've presented that, you know, not everyone needs to go to the in-lab sleep study. So how do you decide who actually needs to be in a sleep lab versus who can do this at home? And then how do you set them up with getting this done at home?  Dr Lee-Iannotti: Yeah. The home sleep studies are really more accessible ways for us to assess for sleep apnea in our neurologic patients, especially patients who live in very rural areas and don't have access or have very long wait times for an in-lab polysomnogram. With that being said, though, Dr. Albin, I will say that there are a subset of patients who have to go into the lab, and those are patients where you suspect a sleep disorder other than obstructive sleep apnea, so like parasomnias or central sleep apnea, patients with severe cognitive or physical debilitation, like our stroke patients who are hemiplegic and won't be able to apply the home sleep study. But for the most part, I do feel like a home sleep study is a good beginner study to screen the patient. And if there are red flags, then you can always get the in-lab afterwards.  Dr Albin: That's super helpful. And just from a pragmatic standpoint, will insurance cover the home sleep study?  Dr Lee-Iannotti: They will, yes, and it's all about documenting. So, if I could get really practical, for neurologists, it really just requires documenting snoring, for one, whether it's noted by the patient or by their bed partner, and then any form of hypersomnia, which is daytime sleepiness or even a sense of fatigue, having low energy or napping during the day.  Dr Albin: I suspect so many of our patients meet those criterias. That seems, like, wildly simple to do.  Dr Lee-Iannotti: Yes. And if you wanna be the favorite referral person to your sleep neurologist or your sleep specialist, then take another step and do that STOP-Bang. And if you record a score greater than three, that automatically gets them at least a home sleep study.  Dr Albin: It's amazing. And then when you get this data, again, this is really practical, pragmatic stuff, how do you get the report? Does it integrate in your electronic medical record? Does the patient bring it in? How do you get that data back?  Dr Lee-Iannotti: Yeah, so this is where technology is amazing, Dr. Albin. Now we have disposable devices. Sometimes they sync to the WatchPat, or the greater Wi-Fi. So we can get them all through password-protected internet forums that transmits the data, so sometimes the patients don't even have to come back to give us the data. And then we have different forms where we can actually relay the results as well, either through the electronic medical record or through systems themselves to relay those results directly to the patient.  Dr Albin: Yeah, and your article really laid out in beautiful tables, like, all the different devices that are available to patients, and it's honestly mind-blowing how many of these companies and devices exist. So, seems like the world is your oyster in terms of picking from them.  Dr Lee-Iannotti: Absolutely. I think there's... The last time I counted, there was over 20 different home sleep study devices for obstructive sleep apnea. And it's a great thing to have, but sometimes too many choices can be a little bit confusing. So that's where I do say partner with your sleep specialist close by, and they will find the right type of home sleep study device for your particular patient.  Dr Albin: Drilling down a little further, let's say your patient does get diagnosed with OSA. One of the things that really stuck out to me is that there's a whole range of now devices that are new that make this treatment easy so that we can actually prevent and treat neurological conditions by just improving patient sleep. So, walk us through a little bit about how that landscape has changed.  Dr Lee-Iannotti: Sure. And I'll start with the gold standard of treatment, which is still CPAP, which is continuous positive airway pressure. Not only can we monitor the pressure, look at adherence, change the humidification for the patient all remotely through, again, password-protected internet forums, but we can even change the pressure with patients 300-plus miles away.  Dr Albin: Wow.  Dr Lee-Iannotti: It's really cool, right? It prevents patients, especially with significant neurologic debilitation, from having to come into the office for adjustments. The other thing I wanted to mention, Dr. Albin, is for patients, a lot of patients like positive feedback on a daily basis. And a lot of these companies, if you are on CPAP, have come up with a smartphone app that you can look at how many hours you used your CPAP device. They give you a score, and they even tell you how many times you had stoppage of breathing that night.  Dr Albin: I think that this is what's really exciting about where we are in neurology and, like, neurologic care, is we have gotten so much better at getting patients their own data and allowing people to really see that data, integrate lifestyle changes, and see how it impacts them. And that positive feedback loop, I think, is a really powerful tool for our patients to say, "Look, this makes me better," or, "Oh, this makes me worse." I'm just really excited by how much data we can give directly to our patients.  Dr Lee-Iannotti: I agree. It's so empowering. You know, as a CPAP user myself, you want that positive affirmation that all of your efforts at night and cleaning your mask and your machine paid off, and everybody likes to see an A+ on their report card.  Dr Albin: I love that. Now I'm going to ask you on the flip side, I imagine, and I myself am a sleep tracker, like I have my little device and I look at, you know, the score in the morning and I kind of perseverate on like what makes it better, what makes it worse, and I can imagine that sometimes in sleep clinic, people are coming in to you and they have just pages and pages and, you know, they're flipping through all their data from the last year. And I imagine that's pretty overwhelming when you have just the insane amount of data that these devices can generate. So, from another pragmatic, practical standpoint, how are you integrating all that data when someone comes in for a sleep visit?  Dr Lee-Iannotti: I love that question. So first of all, I will say myself, and I think a lot of my sleep colleagues, we love objective data, right? Because it's something that we can see. We can see whether it matches their subject's symptoms. Sometimes it can be a lot of reassurance that, "Look, you actually got more sleep than you thought you did." But sometimes patients will bring in like a month's worth, and that's really hard to analyze, you know, in a 30 or 60-minute visit. So oftentimes what I do is I look at like the last week or last two weeks, and I look at trends. And I think a lot of the apps for whatever device you decide to use have done a really good job in terms of visual graphics to show how much sleep on average you're getting, how much deep sleep or REM sleep or wake-up times that you have. So, I, again, I feel like the technology has really helped us consolidate a lot of data, but also be efficient with the messaging that we relay to our patients.  Dr Albin: Absolutely. And I know personally, at least for the sleep tracker I wear, it also allows you to diary. So, you can say like, "Oh, last night I had a glass of wine," or, "Yesterday I had a really hard workout," or, "I stayed out late with friends," or, "I was on call." Turns out call is really, really bad for my sleep. But it does allow you to sort of track what behaviors, and I wonder how much of that informs what you're counseling patients to do in terms of trying to notice the things that either improve their sleep performance or their subjective feeling of restlessness or restfulness, and how all of that plays into what you're doing in the clinic.  Dr Lee-Iannotti: I love all of those comments. It is validation for the patient. Again, it's empowering for them to look at, what did I do last night to get more REM sleep than the night prior? I want to mention that the best people who do this so well are professional athletes, and they look at, how am I going to cater my day to make sure that I'm sleeping well, that I reduce my risk of injury and concussion and increase my reaction time? And I feel like all of us should do that. That's such a great philosophy, to analyze how we can do things better.  Dr Albin: I love that. This whole issue, but this article in particular, really emphasized to me that sleep, again, it's not a passive time that we're taking a nap. It's a really active form of sort of neurologic healing. There's important removal of toxins through the lymphatics. And like there's a lot happening in sleep, and there are so many more tools that allow us to unpack that sort of peak performance of sleep, which again, sort of is that athletic mentality of like, how can I make this better? Not just to treat a neurologic condition, but also really importantly, to prevent one.  Dr Lee-Iannotti: I often refer to sleep as icing on the cake. With our patients, when you're doing everything right, for example, a multiple sclerosis patient, they're on the right medications, they are exercising, they're participating in rehab, their mood is good, but they're just not getting to the quality-of-life metric that they want to be, it usually is sleep. And if you can add that as a neurologist to your piece of the algorithm to help your patient, it really does improve their quality of life and ultimately their neurologic outcome. I'm a true believer of that.  Dr Albin: I was a true believer. I've been made even more of a true believer through your article and getting to talk to you. I always like to close by asking the person I'm interviewing, what's one really exciting thing in this field? What are you kind of most looking forward to as you think about sleep medicine and its impact in neurology in the next five or 10 years?  Dr Lee-Iannotti: Oh, I love that question, too. So, the thing I'm most excited about in the field of sleep, and specifically sleep neurology, is the power of preventative care. When I did a lot of stroke, I would see young people, older people, healthy people, people with a lot of genetic risk factors come in, and one minute they were totally normal. The second minute, they're paralyzed and can't speak. And for a lot of these patients, I would ask, "Why am I seeing you now? Why couldn't I have seen you 10 years earlier, worked on risk factors, and prevented this outcome?" And I truly believe that is exactly where sleep lies. If you work on sleep, whether you're an adolescent, 20 year old, 30, et cetera, you are ultimately going to prevent horrible cardiovascular, cerebrovascular, neurologic diseases in the long run.  Dr Albin: So important. I really want to direct our listeners back to your article because all of the articles are really practical, but this one in particular looks at how do you do this? What are your options? How do you get this to patients? It really is sort of a step-by-step guidebook on like, A, why this is important, how you should screen, what you should do if someone screens positive for needing to have a sleep study.There's so much more technology that allows really anyone anywhere to have access to the testing that they need to get the right diagnosis, to improve their sleep, to improve their cognitive outcomes, to improve their neurologic health. It's pretty amazing.  Dr Lee-Iannotti: It is amazing. And in the article, I do allude to certain devices and then websites that are very helpful. If I can announce, Dr. Albin, I'm super excited about this. Through work with the American Academy of Sleep Medicine, endorsement with the AAN, we are coming out with a new clinical guideline specifically on home sleep study devices and looking at the validation studies. So, I think that's going to be very helpful. But I hope that everybody after listening to this picks up the phone, call your friendly sleep specialist, and align with them and partner with them. And this will ultimately help your patients, I guarantee it.  Dr Albin: Again, today I've been interviewing Dr. Joyce Lee-Iannotti about her article on sleep diagnostics and monitoring technology in obstructive sleep apnea. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners, and thank you, Dr. Lee-Iannotti, for joining us today. Dr Lee-Iannotti: Thank you.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audiocme. Thank you for listening to Continuum Audio. 

Injection moulding is meant to save you time. Too often it hands you a mouthful of flash and a cleanup that swallows the chair time you thought you were saving.Dr Sandra Hulac is a Clinical Instructor at the Kois Center in Seattle and an Accredited Fellow of the American Academy of Cosmetic Dentistry. She uses full-mouth injection moulding to road-test occlusions and stabilise breaking-down dentitions, and she teaches the technique hands-on.In this episode she works through where the mess actually comes from, and how design, matrix strategy, careful PTFE and a simple cleanup protocol keep a case clean from the first injection.This episode comes with an infographic: the whole no-mess workflow on one visual guide to keep beside you during design and cleanup. Download it at protrusive.co.uk/nomess. It is the fastest way to turn this episode into something you actually use at the chair.What You'll Take From This EpisodeMost injection-moulding mess is prevented at the design stage, through thickness targets and clear lab communication, long before any cleanup.The alternating matrix technique, injecting every other tooth, is the biggest single cleanup saver and cuts the PTFE you need.Matrices cured in a pressure pot, with a spacer protocol, give even thickness and far fewer bubbles.Thin, careful PTFE prevents distortion; bunching it interproximally creates the very excess you are trying to avoid.An S-shaped motion with a Ceri-saw and several 12-plate blades clears resin while protecting the contact.Good pre-treatment hygiene, using diluted hypochlorite or povidone-iodine rather than chlorhexidine, cuts bleeding and contamination.Highlights of this episode:00:00 Teaser00:54 Introduction02:17 Dental Pearl: Free Injection Moulding Infographic03:17 Main Interview with Dr. Sandra Hulac4:49 Innovations in Dental Education07:26 The Mess Problem in Injection Moulding15:38 Alternating Matrix Technique18:18 Every-Other-Tooth Technique27:54 Cleanup Instruments and Techniques31:35 Handling Teflon and PTFE36:41 Patient Oral Hygiene Tips37:27 Dilution protocol:39:24 Key Principles for Minimizing Mess40:42 Matrix Fabrication and Spacer Protocol43:55 Course Information and Conclusion46:19 OutroFrom the GuestMaster Full Mouth Injection Moulding in this exclusive two-day hands-on course!

Peter J. Katsufrakis, MD, MBA, is president and CEO of NBME. Dr. Katsufrakis previously served as senior vice president of Assessment Programs at the National Board of Medical Examiners and is recognized nationally in the medical education and assessment community, both for his work at the NBME and in past roles advancing professionalism, HIV education, clinical training, and medical education administration. Prior to joining the NBME, Dr. Katsufrakis's positions included associate dean for student affairs and associate professor of clinical family medicine at the Keck School of Medicine at the University of Southern California, where he received several teaching and outstanding service awards for his work. He has also served as a clinical associate professor of family and community medicine, at Sidney Kimmel Medical College at Thomas Jefferson University. Dr. Katsufrakis is licensed to practice medicine in Pennsylvania and is a diplomate of the American Board of Family Medicine. He is a member of the American Academy of Family Physicians and has served many organizations as a member, including the International AIDS Society, the American Academy of HIV Medicine, and the Association of American Medical Colleges Group on Student Affairs in many roles on committees and task forces.

This week, we turn to one of the most common parenting questions in pediatric practice: screen time and digital wellness. Our host Paul Wirkus, MD, FAAP and guest Mark Witt, MD, discuss the unique role pediatricians have in helping families navigate technology use, while recognizing the challenge of addressing an increasingly complex topic within the limited time of a well-child visit.Rather than focusing only on a specific number of screen-time hours, the conversation emphasizes an age-specific approach and encourages pediatricians to consider what screen use may be displacing. We explore how increased screen time can affect physical activity, family time, sleep, and even where children use screens within the home. The discussion also highlights the value of establishing screen-free spaces and creating healthy boundaries around technology.Throughout the episode, our guest offers practical ways pediatricians can begin conversations about digital wellness and help families develop healthy, sustainable habits around screens.AAP Statement on Screen Time Book Club: Amazing GenerationHave a question? Email questions@vcurb.com. For more information about available credit, visit vCurb.com, or for information about the UTAAP, visit aaputah.org.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

What happens when work rooted in service slowly disconnects you from the very values that called you to it?For leaders working inside humanitarian crises, nonprofits, healthcare, education, business, and other demanding systems, exhaustion can become more than physical. Margie Buchanan-Smith calls it “soul weary,” the feeling of dragging yourself from one demand to the next while losing contact with purpose.Amy, Margie, and Dr. Margaret Benefiel, explore what it takes to stay human when need is immense, resources are shrinking, and systems increasingly reward compliance, metrics, and upward accountability. Margie brings the reality of decades in humanitarian leadership. Margaret brings a spiritual lens to organizational life, asking how leaders can draw on inner resources when systemic dysfunction cannot simply be worked around.Replenishment emerges not as escape from responsibility, but as part of how responsibility is sustained. So do values alignment, contemplative practice, community, and the willingness to take thoughtful risks.The work does not become less urgent when a leader pauses. Sometimes the pause restores the ability to see clearly. A breath, five quiet minutes, or an honest question about whose rules we are following can reconnect leadership with the people, purpose, and inner knowing that made the work matter in the first place.Moments That Create Momentum:When Compliance Pulls Leaders Away From Purpose – Explore how an intense focus on reporting, accountability, and organizational requirements can disconnect leaders from the people they serve and the values that brought them to the work.What It Means to Become Soul Weary – Understand how sustained pressure in purpose-driven work can slowly deplete a leader's inner resources, and why burnout can become a signal that something deeper needs attention.Leading From the Inside Out – Discover why creating even a few minutes of space for reflection can help leaders reconnect with their values, balance soul and ego, and respond from a more grounded place.When Success Measures Lose the Human Being – See how an overreliance on metrics, bureaucracy, and traditional definitions of success can obscure the well-being of both leaders and the people their organizations exist to serve.The Difference Between Thoughtful Risk and Recklessness – Hear why trying to eliminate uncertainty can keep leaders trapped in old ways of working, while carefully judged risks create space for new possibilities to emerge.Learn about The Soul of Leadership experience here: https://www.executivesoul.com/soulofleadership.htmlAbout the Guests:Margaret Benefiel, Ph.D., founder and CEO of Executive Soul, directs the Soul of Leadership program, which has been offered on four continents over the past 14 years. Over 3,000 executives, managers, and other leaders have participated in her seminars and programs. She has served as Chair of the Academy of Management's Management, Spirituality, and Religion Group, and is currently Vice President of the Society for the Study of Christian Spirituality. She served as Executive Director of the Shalem Institute for over 10 years, has served as Co-chair of the Christian Spirituality Program Unit of the American Academy of Religion, and has held various leadership roles in Spiritual Directors International. Author of Soul at Work, The Soul of a Leader, and Crisis Leadership, and co-editor of The Soul of Supervision, The Soul of Higher Education, Soul Food, and Hidden in Plain Sight, Dr. Benefiel has also written for The Leadership Quarterly, Management Communication Quarterly, Managerial Finance, Journal of Organizational Change Management, Organization, Personal Excellence, Psychology of Religion and Spirituality, America, Presence, The Way, Studies in Spirituality, Radical Grace, and Faith at Work. She lives with her husband in Greenbelt, MD. and enjoys hiking, cycling, reading novels, and scuba diving in her free time.https://www.facebook.com/people/Executive-Soul/100057597423603/#https://x.com/executivesoulhttps://executivesoulblog.wordpress.com/https://www.pinterest.com/executivesoul/Margie Buchanan-Smith has been working in a range of different leadership roles in the humanitarian aid sector for over 30 years, with a current focus on the crisis in Sudan. She has conducted and published research on models of excellence in value-driven humanitarian leadership across the globe. She co-facilitates the Soul of Leadership programme in the UK with Margaret Benefiel. Margie works as an independent consultant, facilitator and coach. As a well-published policy researcher, she is a Senior Research Associate with ODI Global, a Visiting Fellow at the Feinstein Center of Tufts University, and a Fellow of the Rift Valley Institute.https://www.linkedin.com/in/margie-buchanan-smith-2905a01/About Amy:Amy Lynn Durham, known by her clients as the Corporate Mystic, is the founder of the Executive Coaching Firm, Create Magic At Work®, where they help leaders build workplaces rooted in creativity, collaboration, and fulfillment. A former corporate executive turned Executive Coach, Amy blends practical leadership strategies with spiritual intelligence to unlock human potential at work.She's a certified Executive Coach through UC Berkeley & the International Coaching Federation (ICF) In addition, Amy holds coaching certifications in Spiritual Intelligence (SQ21), the Edgewalker Profile, and the Archetypes of Change . In addition to being the host of the Create Magic At Work® podcast, Amy is the author of Create Magic At Work®, Creating Career Magic: A Daily Prompt Journal and the founder of Magic Thread Media™. Through her work, she inspires intentional leadership for thriving workplaces and lives where “magic” becomes reality.Connect with Amy:https://createmagicatwork.net/https://www.linkedin.com/company/create-magic-at-workhttps://www.facebook.com/112951637095427https://www.instagram.com/createmagicatworkhttps://www.youtube.com/channel/UCnEm4h3fUgaq8qgvZpz6dGgThanks for listening!Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page.Do you have some feedback or questions about this episode? Leave a comment in the section below!Subscribe to the podcastIf you would like to get automatic updates of new podcast episodes, you can follow the podcast on Apple Podcasts or your favorite podcast app.Leave us an Apple Podcasts reviewRatings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you are enjoying the show, please leave us a review on Apple Podcasts.Mentioned in this episode:This show was brought to you in part by the Magic Thread Media Network. To learn more visit: https://magicthreadmedia.com/

Aspirin or biologics? How do you choose the right treatment for AERD? On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash interviews Dr. Andrew White, Director of the AERD Clinic at Scripps Clinic, to discuss the diagnosis and management of this often underrecognized condition. They cover practical strategies for identifying AERD, the importance of a detailed NSAID history, and how treatment decisions are shaped by patient goals and disease severity. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:08 - What Is AERD and Prevalence 06:32 - History Taking and Mechanism 11:10 - Typical Symptom Progression and Alcohol Intolerance 16:41 - When to Do Aspirin Challenge 19:00 - Challenge Protocol And Upper Airway Reactions24:53 - Aspirin Desensitization vs Challenge27:58 - Aspirin therapy after desensitization and Risk of GI Bleeds31:17 - Biologics Change AERD33:42 - Choosing Aspirin Desensitization vs Biologics 35:52 - Patient Counseling and Motivational Interviewing 41:26 - Convenience and Cost of Therapy 44:10 - ENT Allergy Collaboration47:22 - Rapid Fire Pearls51:13 - Future Research & Management Direction54:05 - Final Takeaways --- More about this episode Dr. White explains that AERD affects about 8 to 10 percent of asthmatics, with even higher rates in those with severe asthma or nasal polyps. He reviews typical adult-onset progression, alcohol-related respiratory symptoms, and the underlying pathophysiology, including imbalances in arachidonic acid mediators and leukotriene surges after NSAID exposure.The conversation includes practical questions to ask when taking an NSAID history, such as reactions to common pain relievers or alcohol, and when to consider aspirin challenge. Dr. White also details long-term treatment strategies, including the role of biologics like dupilumab and aspirin therapy after desensitization, with considerations for dosing and gastrointestinal risk. He explains how factors like asthma severity, recurrent polyp disease, sense of smell, cost, and convenience all influence therapy choice. The episode concludes with a discussion of multidisciplinary collaboration, patient counseling, and Dr. White's insights on future research directions in AERD management. --- Resources Aspirin sensitivity and severity of asthma: evidence for irreversible airway obstruction in patients with severe or difficult-to-treat asthmahttps://pubmed.ncbi.nlm.nih.gov/16275362/ Polyphenolic Activation of Basophils Explains Alcohol Hypersensitivity in AERDhttps://pubmed.ncbi.nlm.nih.gov/41065188/ New insights into the mechanisms of aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/39641750/ The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunologyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC7980229/ Safety and outcomes of aspirin desensitization for aspirin-exacerbated respiratory disease: A single-center studyhttps://pubmed.ncbi.nlm.nih.gov/28550988/ Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/17208597/ Factors influencing aspirin therapy after desensitization (ATAD) tolerance in aspirin-exacerbated respiratory disease (AERD) patientshttps://pubmed.ncbi.nlm.nih.gov/41022281/ Feed the Good Wolf: Motivational Interviewing, Cognitive Behavioral Therapy, and Mindsethttps://pubmed.ncbi.nlm.nih.gov/42103433/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

You're exhausted but can't sleep. Your brain feels foggy. Your mood has changed, stubborn belly fat seems to appear from nowhere, painful periods derail your life, or recurring UTIs keep coming back. If you're in your 40s, 50s, or beyond, these symptoms aren't something you should automatically dismiss as “just getting older.”In this episode of V.I.B.E. Living Podcast, Lynnis Woods-Mullins sits down with osteopathic physician Dr. Jeffrey Brown, who specializes in hormone imbalance and chronic pelvic pain, to uncover what may really be happening when hormones begin to shift during perimenopause and menopause.We explore hormone imbalance, bioidentical hormone replacement therapy (BHRT), estrogen dominance, cortisol, chronic stress, gut health, sleep disruption, brain fog, weight changes, and recurrent urinary symptoms—and how these seemingly separate issues may be more connected than many women realize.Dr. Brown explains what hormone therapy actually means, how BHRT approaches hormonal symptoms, and why the conversation about hormones extends far beyond hot flashes. We discuss the role hormones can play in sleep, bone health, cardiovascular health, cognitive function, mood, energy, and overall quality of life.We also take a closer look at one of the biggest disruptors of hormonal health: chronic stress and cortisol. Why can you feel completely exhausted all day and suddenly wide awake at night? What does “wired but tired” really mean? And how can long-term stress make navigating menopause and perimenopause even harder?The conversation goes deeper into estrogen dominance and gut health, including the estrobolome and the role the gut plays in estrogen metabolism. Dr. Brown also discusses when more comprehensive hormone testing may be useful and how everyday exposure to potential endocrine disruptors—including certain plastics, fragrances, cosmetics, and other environmental exposures—may affect hormonal health.Most importantly, this episode is about helping women become better advocates for themselves.If you've been told your symptoms are simply part of aging—or you know something has changed in your body but haven't been able to connect the dots—this conversation can help you understand what questions to ask and what options to explore with your healthcare provider.In this episode, you'll learn about:Perimenopause and menopause symptoms women often overlookSigns that may be associated with hormone imbalanceCortisol, chronic stress, and the “wired but tired” cycleBHRT and hormone therapyEstrogen dominanceMenopause belly fat and metabolic changesBrain fog, mood changes, and disrupted sleepGut health, estrogen metabolism, and the estrobolomeHormone testingEndocrine disruptors in everyday lifeHow to have a more productive conversation with your healthcare providerIf this conversation reminds you of yourself—or another woman in your life—share this episode with her. And subscribe to V.I.B.E. Living for more conversations about menopause, hormone health, stress, nutrition, healthy aging, and holistic wellness for women 40+.BioUndergraduate at Cornell University. New York College of Osteopathic Medicine.  Family Medicine Residency Mt. Sinai School of Medicine at Jamaica Hospital Medical Center.  Got frustrated with conventional medicine's focus on symptom care and later became board certified by the American Academy of Anti-Aging & Regenerative Medicine (A4m).  Has been practicing functional medicine with a focus on women's health for over 15 yearsWebsitehormonehealthwithdrbrown.comPlease Patronize Our Sponsors  Healthy aging starts from the inside out. Great Lakes Wellness Collagen is made with clean, grass-fed collagen peptides that are iGen Non-GMO tested, dissolve effortlessly in hot or cold liquids, and fit seamlessly into your daily routine. I personally use it to support healthy skin, stronger hair, joint comfort, and gut health. If you're looking for a simple way to nourish your body after 40, this is one of my favorite daily wellness essentials. Learn more by clicking here. Special Discount Code: VIBEWELLNESSWOMAN

A single executive order can spark a thousand headlines, but it can't conjure new evidence into existence. We dig into the recent move to change childhood vaccine recommendations in the United States and why the American Academy of Pediatrics is pushing back with the same blunt message: the science hasn't changed. If you're a parent hearing “maybe the schedule isn't safe,” we unpack what that claim would require scientifically and why politics is not a substitute for data.We also slow down on the parts that feel personal. Yes, it can look like “a lot of shots” when you're staring at a baby's thigh. But the number of syringes is not a measurement of immune overload. We talk through how the childhood immunization schedule is designed, what safety monitoring actually looks like, and why spacing vaccines out is not automatically safer. Delays create longer windows of vulnerability to measles, pertussis, and meningitis, and they add real burdens: more appointments, more missed work, more transportation stress, and more chances to fall behind.Then we address the question that never seems to die: vaccines and autism. We explain what happened, why researchers investigated it so intensely, and what the large studies across millions of children consistently show. From there, we land on the bigger takeaway: skepticism has two responsibilities, questioning what we think we know and accepting the answer when the evidence becomes overwhelming.If you want clear, evidence-based context from a family doctor and a nurse, hit play. Subscribe, share this with a parent who's getting mixed messages, and leave a review so more people can find the show.Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply.Support the showProduction and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RNArtwork Rebrand and Avatars:Vantage Design Works (Vanessa Jones) Website: https://www.vantagedesignworks.com/Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qrOriginal Artwork Concept: Olivia Pawlowski

The American Academy of Pediatrics is blaming the Trump administration for lower vaccination rates of children in the U.S. AP correspondent Donna Warder reports.

N. Gray Sutanto offers a fresh reading of Herman Bavinck's theological epistemology and argues that his Trinitarian and organic worldview utilizes an extensive range of sources. Sutanto unfolds Bavinck's understanding of what he considered to be the two most important aspects of epistemology: the character of the sciences and the correspondence between subjects and objects. Writing at the heels of the European debates in the 19th and 20th centuries concerning theology's place in the academy, and rooted in historic Christian teachings, Sutanto demonstrates how Bavinck's argument remains fresh and provocative. God and Knowledge: Herman Bavinck's Theological Epistemology (T&T Clark, 2021) explores archival material and peripheral works translated for the first time in English. The author re-reads several key concepts, ranging from Organicism to the Absolute, and relates Bavinck's work to Thomas Aquinas, Eduard von Hartmann, and other thinkers. Sutanto applies this reading to current debates on the relationship between theology and philosophy, nature and grace, and the nature of knowing; and in doing so provides students and scholars with fresh methods of considering Orthodox and modern forms of thought, and their connection with each other. Dr. Sutanto serves as the Associate Professor of Systematic Theology at Reformed Theological Seminary, Washington D.C. and an associate editor of the Journal of Reformed Theology. He has received visiting fellowships at the Theological University of Kampen-Utrecht and Princeton Theological Seminary. He is a member of the Evangelical Theological Society and is on the steering committee for the Reformed Theology and History Unit of the American Academy of Religion. Along with the theologian Herman Bavinck, Dr. Sutanto's research interests are broad, ranging from modern Protestant theology, prolegomena, humanity and sin, the relationship between philosophy and theology, analytic theology, and Christianity and culture. For previous NBN conversations on similar topics, see these interviews on Herman Bavinck's Christology and academic addresses or an introduction on Neo-Calvinism or the T&T Clark handbook on the global movement. For the NBN conversation on a Bavinck biography. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

N. Gray Sutanto offers a fresh reading of Herman Bavinck's theological epistemology and argues that his Trinitarian and organic worldview utilizes an extensive range of sources. Sutanto unfolds Bavinck's understanding of what he considered to be the two most important aspects of epistemology: the character of the sciences and the correspondence between subjects and objects. Writing at the heels of the European debates in the 19th and 20th centuries concerning theology's place in the academy, and rooted in historic Christian teachings, Sutanto demonstrates how Bavinck's argument remains fresh and provocative. God and Knowledge: Herman Bavinck's Theological Epistemology (T&T Clark, 2021) explores archival material and peripheral works translated for the first time in English. The author re-reads several key concepts, ranging from Organicism to the Absolute, and relates Bavinck's work to Thomas Aquinas, Eduard von Hartmann, and other thinkers. Sutanto applies this reading to current debates on the relationship between theology and philosophy, nature and grace, and the nature of knowing; and in doing so provides students and scholars with fresh methods of considering Orthodox and modern forms of thought, and their connection with each other. Dr. Sutanto serves as the Associate Professor of Systematic Theology at Reformed Theological Seminary, Washington D.C. and an associate editor of the Journal of Reformed Theology. He has received visiting fellowships at the Theological University of Kampen-Utrecht and Princeton Theological Seminary. He is a member of the Evangelical Theological Society and is on the steering committee for the Reformed Theology and History Unit of the American Academy of Religion. Along with the theologian Herman Bavinck, Dr. Sutanto's research interests are broad, ranging from modern Protestant theology, prolegomena, humanity and sin, the relationship between philosophy and theology, analytic theology, and Christianity and culture. For previous NBN conversations on similar topics, see these interviews on Herman Bavinck's Christology and academic addresses or an introduction on Neo-Calvinism or the T&T Clark handbook on the global movement. For the NBN conversation on a Bavinck biography. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/critical-theory

In part two of our deep dive into China (and part four of our socialist organization series), we break down how Mao attempted to dialectically sublate a national front and a united front. We explore the structural inclusion of the "patriotic national bourgeoisie" into the block of four classes (symbolized by the stars on the Chinese flag) and contrast it with classical Soviet developmental theory and orthodox Marxism.We also dive into:- The historical debate between Chen Duxiu, Li Dazhao, Lenin, and Trotsky.- Why modern "Hoxhaists" and Left Communists consider New Democracy to be revisionist.- The evolution of class structures under Deng Xiaoping and Jiang Zemin's "Three Represents" doctrine (allowing billionaires into the Party).- The reality of modern China's development: Is it a transitioning socialist project, or an hyper-competent form of state capitalism and developmental liberalism?Don't forget to like, subscribe, and hit the notification bell for Episode 5, where we pivot to National Frontism and National Bolshevism.Journal ArticlesDirlik, A. (1970). The ideological foundations of the Chinese Revolution. Journal of Contemporary History, 5(3), 39–54.Dittmer, L. (1977). Line struggle: Notes on its organizational context and theoretical development. Modern China, 3(3), 303–312.Fogel, J. A. (1980). Ai Siqi, establishment intellectual by Joshua A. Fogel. Modern China, 6(1), 23–47.Hammond, E. R. (1978). Marxism and the mass line [Doctoral dissertation, University of California, Berkeley]. ProQuest Dissertations and Theses Global.Korolev, A. (2017). De-ideologized mass line, regime responsiveness, and state-society relations. China Review, 17(2), 7–36.Lyman, S. V. (1970). The Chinese Communist Party in the United Front, 1937–1945 [Doctoral dissertation, University of California, Berkeley]. ProQuest Dissertations and Theses Global.Mazur, M. G. (1995). The United Front of the 1940s: A social and cultural perspective. Modern China, 21(4), 431–456.Selden, M. (1971). The Yenan Way in revolutionary China. The China Quarterly, (45), 263–294.Steiner, H. A. (1951). Current mass line tactics in Communist China. The Annals of the American Academy of Political and Social Science, 277(1), 422–436.Teiwes, F. C. (1978). The origins of rectification: Inner-party purgation in the 1930s. The China Quarterly, (74), 181–201.Tokuda, N. (1971). The mass line during the Yenan period. The China Quarterly, (47), 1–18.Townsend, J. R. (1967). Political participation in Communist China. University of California Press.Womack, B. (1980). The phase of de-Maoization in China. China Report, 16(1), 7–21.Womack, B. (1991). Mao Zedong and the sinification of Marxism. The China Quarterly, (126), 1–15.Young, G. (1980). On New Democracy and the transition to socialism. Modern China, 6(1), 3–22.Books & Primary SourcesCoble, P. M. (2023). The collapse of Nationalist China: How Chiang Kai-shek lost China's civil war. Cambridge University Press.Elbaum, M. (2018). Revolution in the air: Sixties radicals turn to Lenin, Mao and Che. Verso Books.Hirata, K. (2024). Making Mao's steelworks: Industrial Manchuria and the transnational origins of Chinese socialism. Cambridge University Press.Karl, R. E. (2010). Mao Zedong and China in the twentieth-century world: A concise history. Duke University Press.Li, H. (2024). Fighting on the cultural front: U.S.-China relations in the Cold War. Columbia University Press.Lin, C. (2019). Mass line. In C. Sorace, I. Franceschini, & N. Loubere (Eds.), Afterlives of Chinese Communism: Political concepts from Mao to Xi (p. 122). ANU Press.Lovell, J. (2019). Maoism: A global history. Knopf Doubleday Publishing Group.Lowe, D. M. (1966). The function of "China" in Marx, Lenin, and Mao. University of California Press.Mao, Z. (1940). On New Democracy. Marxists Internet Archive.Mao, Z. (1977). A critique of Soviet economics. Monthly Review Press.Moufawad-Paul, J. (2016). Continuity and rupture: Philosophy in the Maoist terrain. Zero Books.Schram, S. R. (Ed.). (2005). Mao's road to power: Revolutionary writings 1912–1949: Vol. VII. New Democracy, 1939–1941. M.E. Sharpe.Zheng, Q. (Ed.). (2020). An ideological history of the Communist Party of China (Vol. 2) (L. Sun & S. Bryant, Trans.). Royal Collins Publishing Group.Send us Fan Mail Musis by Bitterlake, Used with Permission, all rights to BitterlakeSupport the showCrew:Host: C. Derick VarnIntro and Outro Music by Bitter Lake.Intro Video Design: Jason MylesArt Design: Corn and C. Derick VarnLinks and Social Media:twitter: @varnvlogblue sky: @varnvlog.bsky.socialYou can find the additional streams on YoutubeCurrent Patreon at the Sponsor Tier: Jordan Sheldon, Mark J. Matthews, Lindsay Kimbrough, RedWolf, DRV, Kenneth McKee, JY Chan, Matthew Monahan, Parzival, Adriel Mixon, Buddy Roark, Daniel Petrovic,Julian, Drea, Free Beer 

In this Wellness Tech installment, Jonathan Mendoza, DC, APRN, NP-C — Nurse Doza — explains why red light panels have become a daily fixture in his clinic and his home. He covers how red and near-infrared wavelengths reach the mitochondria to support healthy ATP production, why panels deliver solar-style input without UV exposure, how he personally uses violet light to wind down at night, and what the emerging 40Hz gamma-frequency research does and does not yet show in humans. FEATURED PARTNER LightpathLED builds veteran-owned red and near-infrared light therapy panels. Nurse Doza uses one daily and highlights this brand specifically because it offers more than a single red setting — it includes violet-spectrum output and adjustable frequency, including a 40Hz option he notes he hasn't found on other consumer panels. Shop: https://lightpathled.com Code: NURSEDOZA (discount applied at checkout) Current promo:Select Diesel Gen3 panels ship with a free stand — verify at checkout, promos change Join the School of Doza The School of Doza is a paid health-education community with live group consults every **Wednesday at 1 PM Central**, plus courses, protocols, and direct access to Nurse Doza. Start your free trial: https://www.schoolofdoza.com --- 5 Key Takeaways 1. Red and near-infrared light interact with your mitochondria, not just your skin.These wavelengths are absorbed by cytochrome c oxidase in the electron transport chain, which supports healthy ATP production — the mechanism researchers call photobiomodulation. 2. A panel delivers solar-style light input without the UV load.Most people spend the majority of daylight hours indoors under light their cells don't recognize. Red light panels are one way to add that input without the burn risk that comes with UV exposure. 3. Panels are low-friction to use. No undressing required — Nurse Doza sits in front of his and lets it hit his forehead. He uses sessions in the two-to-five-minute range as his own personal routine, not a prescribed protocol. 4. Violet light sits at the opposite end of the visible spectrum from red. Nurse Doza reports using violet output in the evening as part of his wind-down. This is his subjective experience — violet-specific calming effects are not yet well established in the peer-reviewed literature. 5. The 40Hz frequency setting is an area of active research, not settled science. Gamma-frequency entrainment at 40Hz has been studied for its effects on brain activity, but the most-cited amyloid findings are from animal models and have published author corrections. Interesting, worth following — not a treatment. Citations: 1. de Freitas LF, Hamblin MR. **Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy.** *IEEE Journal of Selected Topics in Quantum Electronics.* 2016. PMID: 28070154 — https://pubmed.ncbi.nlm.nih.gov/28070154/ 2. Hamblin MR. **Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation.** *Photochemistry and Photobiology.* 2018. PMID: 29164625 — https://pubmed.ncbi.nlm.nih.gov/29164625/ 3. Maghfour J, Ozog DM, Mineroff J, Jagdeo J, Kohli I, Lim HW. **Photobiomodulation CME Part I: Overview and Mechanism of Action.** *Journal of the American Academy of Dermatology.* 2024. PMID: 38309304 — https://pubmed.ncbi.nlm.nih.gov/38309304/ 4. Nairuz T, Cho S, Lee JH. **Photobiomodulation Therapy on Brain: Pioneering an Innovative Approach to Revolutionize Cognitive Dynamics.** *Cells.* 2024. PMID: 38891098 — https://pubmed.ncbi.nlm.nih.gov/38891098/ 5. Iaccarino HF, Singer AC, Martorell AJ, et al. **Gamma frequency entrainment attenuates amyloid load and modifies microglia.** *Nature.* 2016;540:230–235. PMID: 27929004 · PMCID: PMC5656389 — https://pmc.ncbi.nlm.nih.gov/articles/PMC5656389/    *Note: animal-model study. Two author corrections have since been published (2018, 2024).* Bonus — sleep and LED light therapy: Liao YH, Tai CJ, Ming JL, Lin LH, Chien LY. **The Effectiveness of Low-Level LED Light Therapy for Sleep Problems, Psychological Symptoms, and Heart Rate Variability in Shift-Work Nurses: A Randomized Controlled Trial.** *Journal of Nursing Management.* 2025. PMID: 40557249 — https://pubmed.ncbi.nlm.nih.gov/40557249/

Stem Cell Therapy Explained: What Stem Cells & Peptides Actually Do - Dr. Joy Kong What does stem cell therapy actually do? Dr. Joy Kong explains stem cells, regenerative medicine, peptides, brain health, joint repair, inflammation, and the science behind cellular regeneration. In this conversation, we explore stem cell therapy, peptide therapy, functional medicine, longevity, and why regenerative medicine is becoming a major area of medical research. We explore stem cells explained simply, uncover exactly what are peptides, and reveal how stem cell therapy targets the root cause of aging and disease. It is time to reclaim your longevity and stop outsourcing your health. In this episode, you will learn: ✅ What are stem cells and peptides explained simply for longevity and health. ✅ How stem cell therapy applications work to signal existing cells to regenerate ✅ How Dr. Joy Kong integrates Chinese medicine and modern stem cell science to root causes of illness.  ✅ Why holistic health approaches and calming inflammation are essential for stem cell therapy anti aging benefits.  ✅ The truth why mainstream medical system stigmatizes regenerative medicine and holistic health. ✅ The realities of stem cell research including navigating treatments like stem cell therapy Mexico. ✅ What to consider when seeking peptides and evidence-based regenerative medicine. Our Guest Dr. Joy Kong, M.D. is a UCLA-trained, triple board-certified physician and global leader in regenerative medicine. As the founder of Chara Health and president of the American Academy of Integrative Cell Therapy, she specializes in advanced stem cell therapy and clinical peptide protocols to combat chronic disease and maximize longevity.   Our Mission Eyes Wide Open is a space for honest communication. Our goal is to remove the stigmas around mental health, holistic lifestyles, culture, and free speech so you can show up as your authentic self with your eyes wide open. By having real conversations about difficult truths, we move toward collective healing.   Chapters:  0:00 - The Journey of Medicine East Meets West  13:32 - Holistic Approaches to Mental Health  16:29 - Nutrition and Lifestyle for Brain Health  19:16 - Stem Cells Explained Nature's Repair Mechanism  22:07 - The Legal Landscape of Stem Cell Therapy  24:54 - Integrating Chinese Medicine and Modern Science  38:10 - Dr Joy Kong on the Awakening to Stem Cell Therapy  41:27 - Why Mainstream Medicine Lacks Intellectual Curiosity  43:45 - Empowering Patients Against the Medical System  45:14 - The Evolution of Regenerative Medicine  46:22 - Top Use Cases for Stem Cell Therapy  49:09 - The Promise of Stem Cell Therapy Anti-Aging  51:50 - What Are Peptides Explained Simply   Find Dr. Joy Kong here: Website: https://joykongmd.com/  Instagram: https://www.instagram.com/dr_joy_kong/ Facebook: https://www.facebook.com/stemcelldrjoy LinkedIn: https://www.linkedin.com/in/joy-kong-md-4b8627123/ YouTube: https://www.youtube.com/@JoyKongMD  Find Nick Thompson here: Nick Instagram: https://www.instagram.com/nthompson513/    UCAN Instagram: https://www.instagram.com/the_ucan_foundation/       YouTube: https://www.youtube.com/@EyesWideOpenContent       LinkedIn: https://www.linkedin.com/in/nickthompson13/        UCAN Foundation: https://theucanfoundation.org/      Website: https://www.engagewithnick.com   

... and other autism/ADHD research! So pleased to have Dr. Jenessa Seymour back - this time with a variety of studies in the Autism and ADHD realms. Jurek, L., Duchier, A., Gauld, C., Henault, L., Giroudon, C., Fourneret, P., … Nourredine, M. (2025). Sensory processing in individuals with Attention-Deficit/Hyperactivity Disorder compared with control populations: A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 64, 1132-1147. Le Cunff, A., Russell, C. & Dommett, E.J. (2026). Hyperactive–impulsive ADHD traits predict Higher curiosity in adults: evidence from a cross-sectional study. BMC Psychology, 14, 1-11. White, R.C. & Remington, A. (2018). Object personification in Autism: This paper will be very sad if you don't read it. Autism, 23, 1042-1045. Botha, M. & Cage, E. (2022). “Autism research is in crisis”: A mixed method study of researcher's constructions of autistic people and autism research. Frontiers in Psychology, 13, 1-22. Devlin, H. (July 5, 2026). Pioneer of ‘extreme male brain' theory of autism now says phrase unhelpful. The Guardian. Are you an expert in something and want to be on the show? Apply here! Please support the show on Patreon! You get ad-free episodes, early episodes, and other bonus content! https://www.patreon.com/seriouspod

In Episode 2 of our quality improvement series on parenting advice in pediatric practice, we focus on the role pediatricians can play in supporting emotional resilience for both children and their parents. Host Paul Wirkus, MD, FAAP and guest Ryan Gottfredson, DO begin by discussing why quality improvement matters in clinical practice and how small, intentional changes can help pediatricians incorporate meaningful parenting guidance into routine care.The conversation explores modern parenting challenges, including stress, toxic levels of stress, and strategies for building resilience. We discuss how parents can teach resilience by modeling healthy behaviors, while maintaining balanced boundaries that provide children with both structure and support. Additional topics include helping children navigate failure, fostering independence, and finding the balance between parental authority and recognizing the humanity of both parents and children.Finally, we address a practical challenge familiar to every pediatrician: how to make space for these important conversations during a well-child visit when time is limited. The episode offers ideas for integrating parenting guidance into everyday clinical encounters without adding an unrealistic burden to already busy practices.Have a question? Email questions@vcurb.com.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Strong leaders know that facts alone rarely change minds. In this episode, Dean Newlund and Danny Bobrow explore why authentic connection comes before persuasion and how leaders can communicate in ways that earn trust, strengthen relationships, and inspire action.   In this episode, Dean Newlund and Danny Bobrow discuss: Lessons from endurance sports and teamwork The Persuasion Blueprint framework Persuasion in digital and AI-assisted communication Building stronger relationships through emotional awareness Leadership communication during difficult conversations   Key Takeaways: Begin difficult conversations by helping people feel understood before trying to convince them. Care and emotional attunement create the foundation for collaboration. Let enthusiasm grow by discovering what already motivates the other person instead of overwhelming them with your own excitement. In digital communication, take time to write thoughtful, respectful messages that provide context and show consideration. Before debating emotional issues, understand where someone is coming from instead of leading with facts alone. Use AI to support your thinking, but preserve authentic judgment and relationships where trust depends on your own words.   "What people are really craving is to be understood, not to be impressed.” — Danny Bobrow   About Danny Bobrow: Daniel A. “Danny” Bobrow is the creator of The Art of First Impressions™ and The Persuasion Blueprint™, communication mastery programs that help businesses build trust and drive ethical conversion. He is President of AIM Dental Marketing, which has helped grow dental practices since 1989, and serves as Executive Director of Climb for a Cause™ and The Smile Tree™. Danny is the Founding Executive Committee Chair of the American Academy for Oral Systemic Health and holds two MBAs from the University of Chicago and K.U.L. Belgium. A Distinguished Toastmaster, mediator, mountaineer, and endurance athlete,  Danny champions patient persistence and respectful resilience.   Connect with Danny Bobrow:   Website: https://www.dannybobrow.com/ LinkedIn: https://www.linkedin.com/in/dannybobrow Facebook: https://www.facebook.com/DanielABobrow/ Instagram: https://www.instagram.com/danielabobrow       See Dean's TedTalk “Why Business Needs Intuition” here: https://www.youtube.com/watch?v=EEq9IYvgV7I Connect with Dean:YouTube: https://www.youtube.com/channel/UCgqRK8GC8jBIFYPmECUCMkwWebsite: https://www.mfileadership.com/The Mission Statement E-Newsletter: https://www.mfileadership.com/blog/LinkedIn: https://www.linkedin.com/in/deannewlund/X (Twitter): https://twitter.com/deannewlundFacebook: https://www.facebook.com/MissionFacilitators/Email: dean.newlund@mfileadership.comPhone: 1-800-926-7370 Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.