Podcasts about American Academy

Join Elevated GP: www.theelevatedgp.com Net32.com  Follow @dental_digest_podcast Instagram Follow @dr.melissa_seibert on Instagram His interdisciplinary approach to dentistry is founded in both empirical research and clinical experience. He attended the University of Washington for both his undergraduate and graduate studies where he received his D.D.S. degree in 1995 and an M.S.D. and certificate in Prosthodontics in 1998. For his entire career, Dr. Kinzer has been committed to furthering the art and science of dental education. His unique ability to impart complex clinical processes in a logical, systematic and clear methodology differentiates him from other Prosthodontists and makes him a highly regarded educator nationally and internationally. He is a full-time teaching faculty at Spear Education in Scottsdale, AZ. where he is also resides as the Faculty Chairman and Director of Curriculum and Campus Education. Dr. Kinzer is an Affiliate Assistant Professor in the Graduate Prosthodontics Department at the University of Washington School of Dentistry and an Adjunct Faculty at Arizona School of Dentistry and Oral Health. Dr. Kinzer is a member of many professional organizations including the American Academy of Restorative Dentistry and the American Academy of Esthetic Dentistry, of which he is currently the sitting President. He serves on the editorial review board for several recognized dental publications and has written numerous articles and chapters for dental publication. He has been honored with the American College of Prosthodontics Achievement Award and in 2018, he received the Saul Schluger Memorial Award for Excellence in Diagnosis and Treatment Planning from the Seattle Study Club. In 2022 he was inducted into the World's Top 100 Doctors as part of the Interdisciplinary Cohort. In his free time, Gregg cherishes spending time his wife Jill and their 6 children. He enjoys anything that he can do outside: golfing, hiking, running, skiing, and biking, in addition to a nice glass of wine.

This week on The Virtual Curbside, host Paul Wirkus, MD, FAAP, is joined by Megan Jensen, CEDS, MPH, RDN, CD, and Nicole Holland, RD Intern, for a thoughtful conversation on how to talk with children and families about eating disorders. Together, they discuss how pediatricians can recognize early warning signs, approach sensitive conversations with empathy, and connect families with the right resources. From disordered eating patterns to body image concerns, this episode provides valuable tools to support both prevention and treatment—while keeping relationships and trust at the center of care. Have a question? Email questions@vcurb.com. Your questions will be answered next week.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.

In this episode of ACM ByteCast, Rashmi Mohan hosts ACM Fellow and 2016 ACM Software System Award recipient Alfred Spector, Professor of Practice in the MIT EECS Department. He was previously CTO of Two Sigma Investments, and before that Vice President of Research and Special Initiatives at Google. Alfred played a key role in developing the Andrew File System (AFS), a breakthrough in distributed computing that later became a commercial venture. He is also known for coining the term “CS + X.” He is a Fellow of the American Academy of Arts and Sciences, Hertz Foundation, and National Academy of Engineering, and recipient of the IEEE Kanai Award for Distributed Computing. Alfred recounts how he initially pursued programming out of personal enjoyment in college. He talks about developing AFS at Carnegie Mellon University, the challenges of turning academic research into commercial products, and the transition from academia to entrepreneurship, sharing some of the lessons learned along the way. Alfred touches on his time at IBM, which acquired his startup Transarc, and the differences between startups and large corporations. He also talks about some of his most notable work as a technical leader at Google, such as Google Translate. Finally, he offers a unique perspective on the rapid evolution of AI and advocates for a more multidisciplinary approach for developing responsible technology. “Google's hybrid approach to research” paper “More Than Just Algorithms” (ACM Queue article)

When we think of the capacities that distinguish humans from other species, we generally turn to intelligence and its byproducts, including our technological prowess. But our intelligence is highly connected to our ability to use language, which is in turn closely related to our capacities as social creatures. Philosopher Philip Pettit would encourage us to think of those social capacities, as enabled by language, as the primary locus of what makes humans different, as discussed in his new book When Minds Converse: A Social Genealogy of the Human Soul. And that linguistic aptitude helps us understand the nature of agency, responsibility, and freedom.Blog post with transcript: https://www.preposterousuniverse.com/podcast/2025/07/21/322-philip-pettit-on-language-agency-politics-and-freedom/Support Mindscape on Patreon.Philip Pettit received his Ph.D. in philosophy from University College Belfast. He is currently Laurance S. Rockefeller University Professor of Human Values at Princeton University and Distinguished University Professor of Philosophy at Australian National University. He is a Fellow of the Academy of Social Sciences in Australia, the Australian Academy of the Humanities, the American Academy of Arts and Sciences, and the Guggenheim Foundation, among other honors.Princeton web pageGoogle Scholar publicationsWikipediaAmazon author pageSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Welcome to Season 5, Episode 29! Today we're joined by a true icon in the world of academia—Professor Gordon H. Chang. A celebrated historian, Professor Chang is both the Olive H. Palmer Professor in Humanities and a Professor of History at Stanford University. He's also a member of the American Academy of Arts and Sciences. We're honored to speak with him about his latest book War, Race, and Culture, published by Stanford University Press in May 2025. This anthology compiles some of his most powerful essays written over decades of impactful scholarship. The topics range from foreign relations and U.S. imperialism to race, Asian American identity, and the cultural contributions of Asian Americans. Our conversation covers everything from the role of propaganda in shaping views of Asians, the long history of harmful stereotypes, and the cultural erasure seen during Japanese internment—including how artists like Dr. Seuss and creators of Superman contributed to racist narratives. Professor Chang also reflects on the political engagement of Asian Americans and why “nurture vs. nature” plays a crucial role in debunking the myth of political apathy in the community. We also touch on a more personal subject: his interest in art history, including how his father's legacy inspired him to explore and uplift overlooked Asian American artists like Dong Kingman, whose brilliance was too often overshadowed by the racist caricatures found in mainstream media. This episode offers not only a look into Professor Chang's new book, but a deeper understanding of how history, race, and culture intersect in America—and why writing history is always personal. Links and Resources: Learn more about War, Race, and Culture from Stanford University Press Read more from Gordon H. Chang, including Ghosts of Gold Mountain, Fateful Ties, and Asian American Art: A History, 1850-1970 If you like what we do, please share, follow, and like us in your podcast directory of choice or on Instagram @AAHistory101. For previous episodes and resources, please visit our site at https://asianamericanhistory101.libsyn.com or our links at http://castpie.com/AAHistory101. If you have any questions, comments or suggestions, email us at info@aahistory101.com.  

This and all episodes at: https://aiandyou.net/ . It's more important than ever to define just what we mean by words like intelligence, consciousness, and thinking. Here to help us is Kate Hayles, Distinguished Research Professor at UCLA and the James B. Duke Professor Emerita from Duke University. Her research focuses on the relations of literature, science and technology, and her books include Postprint: Books and Becoming Computational, Unthought: The Power of the Cognitive Nonconscious, and How We Think: Digital Media and Contemporary Technogenesis. She has fellowships from the National Endowment for the Humanities, the Guggenheim, a Rockefeller Residential Fellowship at Bellagio, and two University of California Presidential Research Fellowships, and she is a member of the American Academy of Arts and Sciences. We are focusing on her new book, Bacteria to AI:  Human Futures with our Nonhuman Symbionts, where she lays out a new theory of mind—what she calls an integrated cognitive framework—that includes the meaning-making practices of lifeforms from bacteria to plants, animals, humans, and some forms of artificial intelligence. In part 2, we talk about where meaning resides, for instance in poetry and literature, and how students' attention span has changed and shortened as a result of multitasking or multiple information streams and how educational models need to change, how our cognitive symbiosis with AI might evolve, and markers of whether AI has consciousness, sentience, or deserves any individual rights. All this plus our usual look at today's AI headlines. Transcript and URLs referenced at HumanCusp Blog.        

Healing often begins with the courage to ask questions—and the right guide to walk you through the answers. Dr. Jill Jenkins shares how pediatric oral health connects to far more than teeth, influencing everything from nursing success to sleep, speech, and even a child's overall development. With warmth and wisdom, she explains how individualized care and a collaborative approach with other practitioners can empower parents to identify tongue ties and make confident decisions. Her passion is a reminder that small interventions early on can create ripple effects of wellness for a lifetime. Key Takeaways: Understanding tongue ties and their subtle symptoms can help parents advocate for their child's health. A multidisciplinary approach—including dentists, lactation consultants, and bodywork—leads to better outcomes. Early, individualized care builds a foundation for proper oral function and overall well-being. Parents' instincts are powerful; trusting your gut can lead to answers others might overlook. Restoring oral function can positively impact sleep, feeding, and emotional connection between parent and child.   About Dr. Jill Jenkins: With almost 20 years of experience as a pediatric dentist, Dr Jill Jenkins felt like there wasn't a child she couldn't help through her pediatric dental practice, Jenkins Dentistry for Kids. That was until 2 of her long term employees had infants with tongue tie restrictions, requiring frenectomy procedures. Without the proper training and equipment, Dr Jenkins had to refer her patients to another practitioner at a vulnerable time for the families who had come to trust her. So, after extensive coursework and in-person observation with one of the most renowned tongue tie pediatric dentists in the field, Dr Richard Baxter, Dr Jenkins is thrilled to now be able to provide frenectomy services to patients through the establishment of Midwest Tongue Tie Professionals. By utilizing the state of the art Lightscalpel CO2 laser and working closely with functional providers, Dr Jenkins is confident that patients receive exceptional care before, during and post-procedure to ensure not only a precise tongue tie release, but also the movement and functionality the release is designed to achieve. Dr Jill Jenkins attended dental school and her pediatric residency at the University of Missouri Kansas City School of Dentistry and Children's Mercy Hospital. After 15 years in her original partnership, Dr Jenkins pivoted to develop a practice based on her own patient and team centered philosophy to open Jenkins Dentistry for Kids with locations in Lenexa and Shawnee. She is also the owner and founder of Midwest Tongue Tie Professionals. Dr Jenkins has served organized dentistry in many volunteer roles throughout her career, most notably as President of the Fifth District Dental Society of Kansas, President of the State of Kansas Dental Association and currently as Chair of the KDA Membership committee, member of the ADA Council on Membership, and as a Delegate for the State of Kansas to the ADA. Dr Jenkins is a board certified pediatric dentist, and is involved with many professional organizations where she is a diplomate for the American Academy of Pediatric Dentistry, fellow of the Pierre Fauchard Academy, fellow of the American College of Dentists and fellow of the International College of Dentists. She also received the Women Who Mean Business Award from the Kansas City Business Journal in 2017, where she continues to stay active. She has also been awarded Dentist of the Year both locally and at the state level. Dr Jenkins has been married for over 25 years and is fortunate to have 3 amazing children. www.jenkinsdentistryforkids.com www.midwesttonguetieprofessionals.com https://www.facebook.com/JenkinsDentistryKids/ https://www.instagram.com/jenkinsdentistryforkids/    Connect with Dr. Michelle and Bayleigh at: https://smallchangesbigshifts.com hello@smallchangesbigshifts.com https://www.linkedin.com/company/smallchangesbigshifts https://www.facebook.com/SmallChangesBigShifts https://www.instagram.com/smallchangesbigshiftsco   Thanks 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 podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app. Leave us an Apple Podcasts review Ratings 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 have a minute, please leave an honest review on Apple Podcasts.  

Beyond the Digest are bonus episodes to the DermSurgery Digest that include reviews of interesting and relevant articles from Plastic and Reconstructive Surgery (ASPS), JAMA Dermatology and Journal of the American Academy of Dermatology (JAAD).Articles featured in this episode include: “Mohs micrographic surgery reduces the risk of reconstruction with positive margins, repeat surgeries, and time to definitive reconstruction compared to conventional excision of hand and foot melanomas: A retrospective cohort study” JAAD“Risk of metastasis at presentation and disease-specific death for desmoplastic and spindle cell melanoma: A SEER database analysis” JAAD“Nail unit melanoma treated with Mohs micrographic surgery: Technique, local recurrence rate, and surgical outcomes” JAAD“Limitations of the commercially available gene expression test in predicting cutaneous squamous cell carcinoma metastasis and clinical outcomes” JAAD“Mohs Surgery vs Wide Local Excision in Primary High-Stage Cutaneous Squamous Cell Carcinoma” JAMA “Improvement in Temple Hollowing with VYC-20L Hyaluronic Acid Filler: A Multicenter Randomized Controlled Trial of Safety and Effectiveness” ASPSBeyond the Digest Contributors include Naomi Lawrence, MD, Dermatologic Surgery Digital Content Editor; Yesul Kim, MD, Beyond the Digest Co-host; Kavita Darji, MD; Ami Greene, MD; Tara Jennings, MD; Sydney Proffer, MD; Kathryn Shahwan, MD; and Yssra Soliman, MD.Your feedback is encouraged. Please contact communicationstaff@asds.net. 

Dr. Steven Flanagan, a nationally renowned expert in the field of traumatic brain injury (TBI), has worked at the Rusk Rehabilitation Institute at NYU Langone Health since 2008. He serves as the Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at NYU Grossman School of Medicine. A former President of the American Academy of Physical Medicine & Rehabilitation (PM&R), he is certified by the American Board of PM&R (Brain Injury Medicine). A graduate of the University of Medicine & Dentistry of New Jersey, he completed his medical residency at Mt. Sinai Medical Center/Cabrini, Rehabilitation. Part 3 The discussion covered the following topics: social prescribing, artificial intelligence, reducing length of hospital stay, hospital readmission of patients, and implications of an obesity epidemic.

This week on Health Matters, we're joined by Dr. Brenna Farmer of NewYork-Presbyterian and Weill Cornell Medicine to talk through what you need to do to be prepared for emergencies. From the supplies you need in case of summer storms and power outages to the simple safety tips to prevent trips to the emergency room during summer fun, Dr. Farmer offers listeners the basics of emergency preparedness.___Brenna Farmer, MD is the chief of emergency medicine at NewYork-Presbyterian Brooklyn Methodist Hospital and vice chair for the Department of Emergency Medicine at Weill Cornell Medicine. She is also an associate professor of clinical emergency medicine at Weill Cornell Medicine. Dr. Farmer has previously served as an assistant residency program director for NewYork-Presbyterian Hospital's Emergency Medicine Residency program. Dr. Farmer is board certified in both emergency medicine and toxicology. She is active nationally in several organizations and is a fellow of the American College of Emergency Physicians, American Academy of Emergency Medicine, and the American College of Medical Toxicology. Her primary areas of focus are quality improvement, patient safety, and medication safety.___Health Matters is your weekly dose of health and wellness information, from the leading experts. Join host Courtney Allison to get news you can use in your own life. New episodes drop each Wednesday.If you are looking for practical health tips and trustworthy information from world-class doctors and medical experts you will enjoy listening to Health Matters. Health Matters was created to share stories of science, care, and wellness that are happening every day at NewYork-Presbyterian, one of the nation's most comprehensive, integrated academic healthcare systems. In keeping with NewYork-Presbyterian's long legacy of medical breakthroughs and innovation, Health Matters features the latest news, insights, and health tips from our trusted experts; inspiring first-hand accounts from patients and caregivers; and updates on the latest research and innovations in patient care, all in collaboration with our renowned medical schools, Columbia and Weill Cornell Medicine. To learn more visit: https://healthmatters.nyp.org

Marc Adee is the CEO of Crum & Forster, a leading specialty insurance carrier founded in 1822 and headquartered in Morristown, New Jersey. Marc joined Fairfax in 2000 and holds a B.A. from Northwestern University and an M.B.A. from the University of Chicago. He is a fellow of the Casualty Actuarial Society and a member of the American Academy of Actuaries. He serves on the boards of the American Property Casualty Insurance Association, the Maurice R. Greenberg School of Risk Management, Insurance and Actuarial Science, the Foundation for Morristown Medical Center, the Community Foundation of New Jersey, the Tri-County Scholarship Fund, and Fulcrum Digital. In this episode of In the Know, Chris Hampshire and Marc discuss his career path and work as an actuary, his book The Once and Future C & F, and his passion for getting the next generation fired up about being in insurance.   Key Takeaways Marc's career path and focus on preparing the next generation in the insurance industry.  Marc recalls his decision to research and write The Once and Future C & F as a busy CEO. The history of Crum, a great company that lost its way and got another chance. Luck versus strategic decision-making in redefining a company. The impact of culture on driving desired results. Marc's advice for crafting the career path you envision. Characteristics of key leadership individuals. Attracting high-quality talent in today's economy. Marc's blissful advice to his early career self.   In the Know podcast theme music written and performed by James Jones, CPCU, and Kole Shuda of the band If-Then.   To learn more about the CPCU Society, its membership, and educational offerings, tools, and programs, please visit CPCUSociety.org.   Follow the CPCU Society on social media: X (Twitter): @CPCUSociety Facebook: @CPCUSociety LinkedIn: @The Institutes CPCU Society Instagram: @the_cpcu_society   Quotes “Crum is a great company that lost its way and got another chance.” “Getting the right people in and getting them excited is a big part of a company's culture.” “You can have a rich career develop in one place, but it may require you to raise your hand for some of the crummy jobs.”  

Normal pressure hydrocephalus (NPH) is a pathologic condition whereby excess CSF is retained in and around the brain despite normal intracranial pressure. MRI-safe programmable shunt valves allow for fluid drainage adjustment based on patients' symptoms and radiographic images. Approximately 75% of patients with NPH improve after shunt surgery regardless of shunt type or location. In this episode, Aaron Berkowitz, MD, PhD, FAAN, speaks with Kaisorn L. Chaichana, MD, author of the article “Management of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology at the University of California San Francisco in the Department of Neurology in San Francisco, California. Dr. Chaichana is a professor of neurology in the department of neurological surgery at the Mayo Clinic in Jacksonville, Florida. Additional Resources Read the article: Management of Normal Pressure Hydrocephalus 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: @LyellJ Guest: @kchaichanamd Full episode transcript available here 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 Berkowitz: This is Dr Aaron Berkowitz, and today I'm interviewing Dr Kaisorn Chaichana about his article on management of normal pressure hydrocephalus, which he wrote with Dr Jeremy Cutsforth-Gregory. The article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr Chaichana: Yeah, thank you for having me. I'm Kaisorn Chaichana. I'm a neurosurgeon at Mayo Clinic in Jacksonville, Florida. Part of my practice is doing hydrocephalus care, which includes shunts for patients with normal pressure hydrocephalus. Dr Berkowitz: Fantastic. Well, before we get into shunt considerations and NPH specifically, which I know is the focus of your article, I thought it would be a great opportunity for a neurologist to pick a neurosurgeon's brain a bit about shunts. So, to start, can you lay out for us the different types of shunts and shunt procedures, the advantages, disadvantages of each type of shunt, how you think about which shunt procedure should be used for which patient, that type of thing? Dr Chaichana: Yeah. So, there are different types of shunts, and the most common one that is used is called a ventricular peritoneal shunt. So, it has a ventricular catheter, it has a catheter that tunnels underneath the skin and it goes into the peritoneum where the fluid goes from the ventricular system into the peritoneum. Typically, the shunts are in the ventricle because that is the largest fluid-filled space in the brain. Other terminal areas include the atrium, which is really the jugular vein, and those are called ventricular atrial shunts. You can also have ventricular pleural shunts, which end in the pleural space and drain flui into the pleural space. Those are pretty much the most common ventricular shunts. There's also a lumboperitoneal shunt that drains from the lumbar spine, similar to a lumbar drain into the peritoneum. For the lumbar shunts, we don't typically have a lumbar pleural or lumbar atrial shunt just because of the pressure dynamics, because the lumbar spine is below the lung and as well as the atrium. And so, the drainage pattern is very different than ventricular peritoneal which is top to bottom. The most common shunt, why we use the ventricular peritoneal shunt the most, is because it has the most control. So, the peritoneum is set at a standard pressure in the intraabdominal pressure, whereas the ventricular atrial shunt depends on your venous return or venous pressure and your ventricular pleural shunt varies with inspiration and expiration. So, the easiest way for us to control the fluid, the ventricular system is through the ventricular peritoneal shunt. And that's why that's our most common shunt that we use. Dr Berkowitz: Fantastic. So, as you mention in the article, neurologists may be reluctant to offer a shunt to patients with NPH because many patients may not improve, or they improve only transiently; and out of fear of shunt complications. So, of course, as neurologists, we often only hear about a patient's shunt when there is a problem. So, we have this sort of biased view of seeing a lot of shunt malfunction and shunt infection. Of course, we might not see the patient if their shunt is working just fine. How common are these complications in practice, and how do you as a neurosurgeon weigh the risks against the often uncertain or transient benefits of a shunt in a patient with NPH who may be older and multiple medical comorbidities? How do you think about that and talk about it with patients? Dr Chaichana: When you hear about shunt complications, most of the shunt complications you hear about are typically in patients with congenital hydrocephalus. Those patients often require several shunt revisions just from either growing or the shunt stays in for a long time or the ventricular caliber is a lot less than some with normal pressure hydrocephalus. So, we don't really see a lot of complications with normal pressure hydrocephalus. So that shunt placement in these patients is typically pretty safe. The procedure's a relatively short procedure, around 30 minutes to 45 minutes to place a shunt, and we can control the pressure within the shunt setting so that we don't overdrain---which means too much fluid drains from the ventricular system---which can cause things like a subdural, which is probably the most common complication associated with normal pressure hydrocephalus. So, to obviate those risks, what we do is typically insert the shunt and then keep the shunt setting at a high setting. The higher the setting, the less it drains, and then we bring it slowly down based on the patient's symptoms to try to minimize the risk of this over drainage in the subdural hematoma while at the same time benefiting the patient. So, there's a concern for shunt in patients with normal pressure hydrocephalus. The concern or the complication risks are very low. The problem with normal pressure hydrocephalus, though, is that over time these patients benefit less and less from drainage or their disease process takes over. So, I do recommend placing this shunt as soon as possible just so that we can maximize their quality of life for that period of time. Dr Berkowitz: So, if I'm understanding you, then the risk of complication is more sort of due to the mechanical factors in patients with congenital hydrocephalus or sort of outgrowing the shunt, their pressure dynamics may be changing over time. And in your experience, an older patient with NPH, although they may have more medical comorbidities, the procedure itself is relatively quick and low-risk. And the actual complications due to mechanical factors, my understanding, are just much less common because the patient is obviously fully grown and they're getting one sort of procedure at one point in time and tend to need less revision, have less complication. Is that right? Dr Chaichana: Yeah, that's correct. The complication risk for normal hydrocephalus is a lot less than other types of hydrocephalus. Dr Berkowitz: That's helpful to know. While we're talking about some of these complications, let's say we're following a patient in neurology with NPH who has a shunt. What are some of the symptoms and signs of shunt malfunction or shunt infection? And what are the best studies to order to evaluate for these if we're concerned about them? Dr Chaichana: Yeah. So basically, for shunt malfunction, it's basically broken down into two categories. It's either overdrainage or underdrainage. So, underdrainage is where the shunt doesn't function enough. And so basically, they return to their state before the shunt was placed. So that could be worsening gait function, memory function, urinary incontinence are the typical symptoms we look for in patients with normal pressure hydrocephalus and underdrainage, or the shunt is not working. For patients that are having overdrainage, which is draining too much, the classic sign is typically headaches when they stand up. And the reason behind that is when there's overdrainage, there's less cerebrospinal fluid in their ventricular system, which means less intracranial pressure. So that when they stand up, the pressure differential between their head and the ground is more than when they're lying down. And because of that pressure differential, they usually have worsening headaches when standing up or sitting up. The other thing are severe headaches, which would be a sign of a subdural hematoma or focality in their neurological symptoms that could point to a subdural hematoma, such as weakness, numbness, speaking problems, depending on the hemisphere. How we work this up is, regardless if you're concerned about overdrainage or underdrainage, we usually start with a CAT scan or an MRI scan. Typically, we prefer a CAT scan because it's quicker, but the CAT scan will show us if the ventricular caliber is the same and/or the placement of the proximal catheter. So, what we look for when we see that CAT scan or that MRI to see the location of the proximal catheter to make sure it hasn't changed from any previous settings. And then we see the caliber of the ventricles. If the caliber of the ventricles is smaller, that could be a sign of overdrainage. If the caliber of the ventricles are larger, it could be a sign of underdrainage. The other thing we look for are subdural fluid collections or hydromas or subdural hematomas, which would be another sign of lower endocranial pressure, which would be a sign of overdrainage. So those are the biggest signs we look for, for underdrainage and overdrainage. Other things we can look for if we're concerned of the shunt is fractured, we do a shunt X-ray and what a shunt x-ray is is x-rays of the skull, the neck and the abdomen to see the catheter to make sure it's not kinked or fractured. If you're really concerned, you can't tell from the x-ray, another scan to order is a CT of the chest and abdomen and pelvis to look at the location of the catheter to make sure there's no brakes in the catheter, there's no fluid collections on the distal portion of the catheter, which would be a sign of shunt malfunction as well. Other tests that you can do to really exclude shunt malfunction is a shunt patency test, and what that is a nuclear medicine test where radionucleotide is injected into the valve and then the radionucleotide is traced over time or imaged through time to make sure that it's draining appropriately from the valve into the distal catheter into the peritoneum or the distal site. If there's a shunt malfunction that's not drainage, that radioisotope would remain stagnant either in the valve or in the catheter. There's overdrainage, we can't really tell, but there will be a quick drainage of the radioisotope. For shunt infection, we start with an imaging just to make sure there's not a shunt malfunction, and that usually requires cerebrospinal fluid to test. The cerebrospinal fluid can come from the valve itself, or it can come from other areas like the lumbar spine. If the lumbar spine is showing signs of shunt infection, then that usually means the shunt is infected. If the valve is aspirated with- at the bedside with a butterfly needle into the valve and that shows signs of shunt infection, that also could be a sign of infection. Dr Berkowitz: That's very helpful. You mentioned CT and shunt series. One question that often comes up when obtaining neuroimaging in patients with a shunt, who have NPH or otherwise, is whether we need to call you when we're doing an MRI to reprogram the shunt before or after. Is there a way we can know as a neurologists at the bedside or as patients carry a card, like with some devices where we know whether we have to call and bother our neurosurgery colleagues to get this MRI? Or if the radiology techs ask us, is this safe? And is the patient's shunt going to get turned off? How do we go about determining this? Dr Chaichana: Yeah, so unfortunately, a lot of patients don't carry a card. We typically offer a card when we do the shunt, but that card, there's two problems with it. One is it tells the model, but the second thing is it has to be updated any time the shunt is changed to a different setting. Oftentimes patients don't know that shunt setting, and often times they don't know that company brand that they use. There are different types of shunts with different types of settings. If there's ever concern as to what type of shunt they have, an x-ray is usually the best bet to see with a shunt series, or a skull x-ray. A lateral skull x-ray usually looks at the valve, and the valve has certain radio-dense markers that indicate what type of shunt it is. And that way you can call neurosurgery and we can always tell you what the shunt setting is before the MRI is done. Problem with an MRI scan if you do it without a shunt x-ray before is that you don't know the setting before unless the patient really knows or it's in the patient chart, and the MRI can need to change the setting. It doesn't usually turn it off, but it would change the setting, which would change the fluid dynamics within their ventricular system, which could lead to overdrainage or underdrainage. So, any time a patient needs MRI imaging, whether it's even the brain MRI, a spine MRI, or even abdominal MRI, really a shunt x-ray should be done just to see the shunt setting so that it could be returned to that setting after the MRI is done. Dr Berkowitz: So, the only way to know sort of what type of shunt it would be short of the patient knowing or the patient getting care at the same hospital where the shunt was placed and looking it up in the operative reports would be a skull film. That would then tell us what type of shunt is there and then the marking of the setting. And then we would be able to call our colleagues in neurosurgery and say, this patient is getting an MRI this is the setting, this is the type of shunt. And do we need to call you afterwards to come by and reprogram it? Is that right? Dr Chaichana: That's correct, yeah. Dr Berkowitz: Is there anything we would be able to see on there, or it's best we just- best we just call you and clarify? Dr Chaichana: The easiest thing to do is, when you get the skull x-ray, you can Google different types of shunts or search for different shunts, and they'll have markers that show the type of shunt it is as well as the setting that it's at. And just match it up with the picture. Dr Berkowitz: And as long as it's not a programmable shunt, there's no concern about doing the MRI. Is that right? Dr Chaichana: Correct. So, if it's a programmable shunt, even if it's MRI-compatible, we still like to get the setting before and make sure the setting after the MRI is the same. Nonprogrammable shunts can't be changed with MRI scans, and those don't need neurosurgery after the MRI scan, but it should be confirmed before the scan is done. Dr Berkowitz: Very helpful. Okay, so let's turn to NPH specifically. As you know, there's a lot of debate in the literature, some arguing, even, NPH might not even exist, some saying it's underdiagnosed. I think. I don't know if it was last year at our American Academy of Neurology conference or certainly in recent years, there was a pro and con debate of “we are underdiagnosing NPH” versus “we are overdiagnosing NPH.” What's your perspective as a neurosurgeon? What's the perspective in neurosurgery? Is this something we're underdiagnosing, and the times you shunt these patients you see miraculous results? Is this something that we're overdiagnosing, you get a lot of patients sent to that you think maybe won't benefit from a shunt? Or is it just really hard to say and some patients have shunt-responsive noncommunicating hydrocephalus of unclear etiology and either concurrent Parkinson's disease, Alzheimer's, cervical lumbar stenosis, neuropathy, vestibular problems, and all these other issues that play into multifactorial gait to sort of display a certain amount of the percentage of problem in a given patient or take overtime? What's your perspective if you're open to sharing it, or what's the perspective of neurosurgery? Is this debated as it is in neurology or this is just a standard thing you see and patients respond to shunt to some degree in some proportion of the time? And what are the sort of predictors you see in your experience? Dr Chaichana: Yeah, so, for me, I'd say it's too complicated for a neurosurgeon to evaluate. We rely on neurology to tell us whether or not they need a shunt. But I think the problem is, obviously, a part of the workout for at least the ones that I like to do, is that I want them to have a high-volume lumbar puncture with pre- and postgait analysis to see if there's really an objective measure of them improving. If they have an objective measure of improvement---and what's even better is that they have a subjective measure of improvement on top of the objective measure of improvement---then they benefit from a shunt. The problem is, some patients do benefit even though they don't have objective performance increases after a high-volume shunt. And those are the ones that make me the most worrisome to do the shunt, just because I don't like to do a procedure where there's no benefit for the patient. I do see, according to the literature as well, that there's around a 30 to 40%, even 50%, increase in gait function, even in patients that don't have large improvements following the high-volume lumbar puncture. And those are the most challenging patients for us as neurosurgeons because we'll put the shunt in, they say we're no better in terms of their gait, no better in terms of their urinary incontinence. We try to lower their shunt down to a certain setting and we're kind of stuck after that point. The good thing about NPH, though, is that, from the neurosurgery side, the shunt, like I said, is a pretty benign, low-risk procedure. So, we're not putting the patient through a very severe procedure to see if there's any benefit. So, in cases where we try to improve their quality of life in patients that don't have a benefit from high-volume lumbar puncture, we give them the odds of whether or not it's improving and say it might not improve. But because the procedure's minimally invasive, I think it's a good way to see if we can benefit their quality of life. Dr Berkowitz: Yeah, it's a very helpful perspective. Yeah, those are the most challenging cases on our side as well, right. If the patient- we think they may have NPH, or their gait and/or urinary and/or cognitive problems are- at least have a component of NPH that could be reversible, we certainly want to do the large volume lumbar puncture and/or consider a lumbar drain trial, all discussed in other articles and interviews for this issue of Continuum, But the really tough ones, as you said, there is this literature on patients who don't respond to the large-volume lumbar puncture for some reason but still may be shunt responsive. And despite all the imaging predictors and all the other ways we try to think about this, it's hard to know who's going to benefit. I think that's really a helpful perspective from your end that, as you say in the very beginning of your article, right, maybe there's a little bit too much fear of shunting on the neurology side because when we hear about shunts, it's often in the setting of complication. And so, we're not sort of getting the full spectrum of all the patients you shunt and you see who are doing just fine. They might not improve---the question is related to NPH---but at least they're not harmed by the shunt, and we're maybe overbiased and/or seeing a overly representative sample of negative shunt outcomes when they're actually not that common in practice. Is that a fair summary of your perspective? Dr Chaichana: Yeah, that's correct. So, I mean, complications can occur---and anytime you do a surgery, there are risks of complications---but I think they're relatively low for the benefit that we can help their quality of life. And the procedure's pretty short. So, the risk, it mostly outweighs the benefits in cases with normal pressure hydrocephalus. Dr Berkowitz: Very helpful perspective. So, well, thanks so much again. Today I've been interviewing Dr Kaisorn Chaichana about his article on management of normal pressure hydrocephalus, which he wrote with Dr Jeremy Cutsforth-Gregory. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining us 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.

This week, host Paul Wirkus, MD, FAAP, sits down with experts Megan Jensen, CEDS, MPH, RDN, CD and Nicole Holland, Intern (RD) to explore how pediatricians can support healthy eating patterns in children and families. From addressing common nutritional pitfalls to offering practical guidance on balanced diets, the conversation covers what works—and how to talk about food in a way that empowers rather than shames. Whether it's food insecurity or building lifelong habits, this episode offers real-world insights for every pediatric practice.Have a question? Email questions@vcurb.com. Your questions will be answered in week four.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.

What if aging wasn't inevitable? Dr. Joy Kong—triple board-certified anti-aging physician and stem cell expert—says you can slow it down and even reverse it. As the founder of Chara Health and Chara Biologics, a global leader in regenerative medicine, she helps people transform their health using the body's natural intelligence. Dr. Kong founded the American Academy of Integrative Cell Therapy (AAICT) and has trained physicians around the world. She has been named Stem Cell Doctor of the Year and Stem Cell Doctor of the Decade. Her therapies have successfully helped people with degenerative disease, cognitive decline like Alzheimer's, fertility issues as well as age reversal. Tune into Women Road Warriors with Shelley Johnson and Kathy Tuccaro to discover how science, stem cells, and nature are changing the trajectory of aging.https://www.charahealth.com/www.charoomni.comhttps://joykongmd.com/https://womenroadwarriors.com/ https://womenspowernetwork.net#AntiAging #StemCellTherapy #DrJoyKong #JoyKongMD #CharaHealth #CharaBiologics #ShelleyMJohnson #ShelleyJohnson #KathyTuccaro #WomenRoadWarriors

Feeling adventurous but not sure how to travel with your psoriasis and psoriatic arthritis? Listen as certified physician assistant Rosemary Son offers tips to help make your care easier while traveling near or far.        Join hosts LB Herbert and Kaitlin Walden as they talk tips for making travel easier whether in the US or abroad with certified Physician Assistant Rosemary Son from UT Southwestern Medical Center. Listen in as they discuss what to pack, keeping medications including biologics cool, where to find help if needed, tips for navigating airline travel, vaccines for traveling abroad, managing travel stress, infection precautions, and more. This episode offers information to help you prepare in advance for that trip of a lifetime while maintaining management of your psoriasis and psoriatic arthritis so you can feel free to live your life to its fullest. Timestamps: ·       (0:00)  Intro to Psoriasis Uncovered & guest welcome certified Physician Assistant Rosemary Son. ·       (2:43)  Tips for keeping medications (including biologics) cool when traveling in hot weather.  ·       (5:37)  Types of skin and pain management products to pack. ·       (8:41)  Where to find help for psoriatic disease if needed in unfamiliar places. ·       (10:43) Preparing for airline travel including liquid limitations and developing a “psoriasis passport”. ·       (14:33) Travel to other countries and how to find over-the-counter medications if needed. ·       (16:43)  Vaccine recommendations for out of the country travel. ·       (19:02)  Cold weather protection recommendations. ·       (21:27)  Precautions for reducing risk of infection and should you purchase travel insurance. ·       (24:17)  Tips for managing stress as a disease trigger while traveling. ·       (28:56)  What to avoid when traveling. ·       (31:36)  Live life to the fullest with psoriatic disease and enjoy the adventure travel offers. 3 Key Takeaways: ·       Managing psoriasis and psoriatic arthritis while traveling near or far is possible with advance preparation and use of precautions to help avoid stress associated with travel in changing environments. ·       What and how you pack is key to reducing potential health issues that occur while traveling. ·       A “psoriasis passport” or letter from your physician and a list of generic names for your medications can make travel in and out of the country easier. Guest Bio: Rosemary Son, M.P.A.S., PA-C, RDN is a board-certified physician assistant in the Department of Dermatology at the University of Texas (UT) Southwestern Medical Center and Parkland Health and Hospital System. As a dual-certified Physician Assistant and Registered Dietitian with over a decade of experience in dermatology, Rosemary has a passion for treating complex inflammatory skin diseases such as psoriasis, atopic dermatitis, hidradenitis suppurativa, as well as, treating diseases that impact skin of color, and identifying social determinants of dermatologic health. She also has a personal passion for travel. Ms. Son is a Director at Large and member of the Society of Dermatology Physician Assistants and the American Academy of Physician Associates serving as a liaison to the American Academy of Dermatology. Resources: Ø  Taking Care of Your Skin in the Summer  Ø  Patient Navigation Center

Dr. Courtney Gillenwater is a US Navy veteran, global humanitarian, and pediatric specialist at Chara Health, Dr. Joy Kong's premier regenerative medicine clinic. With a background in traditional pediatrics and trauma medicine, Dr. Gillenwater transitioned into regenerative therapies after experiencing a rapid personal recovery using stem cells and exosomes. Now, she focuses on combining cutting-edge cellular treatments with comprehensive, integrative care to support children with autism, veterans with chronic injuries, and patients with complex inflammatory conditions.In this powerful episode, Dr. Joy Kong interviews Dr. Gillenwater about her unique path into regenerative medicine and the life-changing results she sees daily at Chara Health. From helping nonverbal children gain communication skills to aiding veterans with lung damage and patients on transplant lists, Dr. Gillenwater shares compelling case studies and clinical outcomes. The episode dives into how personalized stem cell protocols, micronutrient testing, and gut-brain optimization are transforming outcomes for children with autism spectrum disorders and adults facing serious health challenges.Visit My Clinic: Chara Health

Interview Summary So, you two, along with a number of other people in the field, wrote a chapter for a recently published book called The Handbook of Children and Screens. We discussed that book in an earlier podcast with its editors, Dmitri Christakis and Kris Perry, the executive director of the Children and Screens organization. And I'd like to emphasize to our listeners that the book can be downloaded at no cost. I'd like to read a quote if I may, from the chapter that the two of you wrote. 'Screen time continues to evolve with the advent of continuous and immersive video reels, voice activated assistance, social media influencers, augmented and virtual reality targeted advertising. Immersive worlds where children can virtually shop for food and beverages, cook or work in a fast-food outlet from a smartphone, a tablet, a computer, or an internet connected tv and more.' So as much as I follow the field, I still read that and I say, holy you know what. I mean that's just an absolutely alarming set of things that are coming at our children. And it really sounds like a tidal wave of digital sophistication that one could have never imagined even a short time ago. Amanda, let's start with you. Can you tell us a little bit more about these methods and how quickly they evolve and how much exposure children have? I think you're right, Kelly, that the world is changing fast. I've been looking at screen media for about 20 years now as a researcher. And in the earlier years, and Tom can attest to this as well, it was all about TV viewing. And you could ask parents how much time does your child spend watching TV? And they could say, well, they watch a couple shows every night and maybe a movie or two on the weekend, and they could come up with a pretty good estimate, 1, 2, 3 hours a day. Now, when we ask parents how much time their children spend with media, they have to stop and think, 'well, they're watching YouTube clips throughout the day. They're on their smartphone, their tablet, they're on social media, texting and playing all these different games.' It really becomes challenging to even get a grasp of the quantity of screen time let alone what kids are doing when they're using those screens. I will say for this book chapter, we found a really great review that summarized over 130 studies and found that kids are spending about three and a half or four hours a day using screens. Yet some of these studies are showing as high as seven or eight hours. I think it's probably under-reported because parents have a hard time really grasping how much time kids spend on screens. I've got a one-year-old and a five-year-old, and I've got some nieces and nephews and I'm constantly looking over their shoulder trying to figure out what games are they playing and where are they going online and what are they doing. Because this is changing really rapidly and we're trying to keep up with it and trying to make sure that screen time is a safe and perhaps healthy place to be. And that's really where a lot of our research is focused. I can only imagine how challenging it must be to work through that landscape. And because the technology advances way more quickly than the policies and legal landscape to control it, it really is pretty much whatever anybody wants to do, they do it and very little can be done about it. It's a really interesting picture, I know. We'll come back later and talk about what might be done about it. Tom, if you will help us understand the impact of all this. What are the effects on the diets of children and adolescents? I'm thinking particularly when Amanda was mentioning how many hours a day children are on it that three to four hours could be an underestimate of how much time they're spending. What did kids used to do with that time? I mean, if I think about when you and I were growing up, we did a lot of different things with that time. But what's it look like now? Well, that's one of the important questions that we don't really know a lot about because even experimental studies that I can talk about that look at reducing screen time have not been very good at being able to measure what else is going on or what substitutes for it. And so, a lot of the day we don't really know exactly what it's displacing and what happens when you reduce screen time. What replaces it? The assumption is that it's something that's more active than screen time. But, you know, it could be reading or homework or other sedentary behaviors that are more productive. But we really don't know. However, we do know that really the general consensus across all these studies that look at the relationship between screen time and nutrition is that the more time children spend using screens in general, the more calories they consume, the lower the nutritional quality of their diets and the greater their risk for obesity. A lot of these studies, as Amanda mentioned, were dominated by studies of television viewing, or looking at television viewing as a form of screen use. And there's much less and much more mixed results linking nutrition and obesity with other screens such as video games, computers, tablets, and smartphones. That doesn't mean those relationships don't exist. Only that the data are too limited at this point. And there's several reasons for that. One is that there just haven't been enough studies that single out one type of screen time versus another. Another is what Amanda brought up around the self-report issue, is that most of these studies depend on asking children or the parents how much time they spend using screens. And we know that children and adults have a very hard time accurately reporting how much time they're using screens. And, in fact when we measure this objectively, we find that they both underestimate and overestimate at times. It's not all in one direction, although our assumption is that they underestimate most of the time, we find it goes in both directions. That means that in addition to sort of not having that answer about exactly what the amount of screen time is, really makes it much tougher to be able to detect relationships because it adds a lot of error into our studies. Now there have been studies, as I mentioned, that have tried to avoid these limitations by doing randomized controlled trials. Including some that we conducted, in which we randomized children, families or schools in some cases to programs that help them reduce their screen time and then measure changes that occur in nutrition, physical activity, and measures of obesity compared to kids who are randomized to not receive those programs. And the randomized trials are really useful because they allow us to make a conclusion about cause-and-effect relationships. Some of these programs also targeted video games and computers as well as television. In fact, many of them do, although almost all of them were done before tablets and smartphones became very common in children. We still don't have a lot of information on those, although things are starting to come out. Most of these studies demonstrated that these interventions to reduce screen use can result in improved nutrition and less weight gain. And the differences seen between the treatment and control groups were sometimes even larger than those commonly observed from programs to improve nutrition and increased physical activity directly. Really, it's the strongest evidence we have of cause-and-effect relationships between screen use and poor nutrition and risk for obesity. Of course, we need a lot more of these studies, particularly more randomized controlled studies. And especially those including smartphones because that's where a lot of kids, especially starting in the preteen age and above, are starting to spend their time. But from what we know about the amount of apparent addictiveness that we see in the sophisticated marketing methods that are being used in today's media, I would predict that the relationships are even larger today than what we're seeing in all these other studies that we reviewed. It's really pretty stunning when one adds up all that science and it looks pretty conclusive that there's some bad things happening, and if you reduce screen time, some good things happen. So, Amanda, if you know the numbers off the top of your head, how many exposures are kids getting to advertisements for unhealthy foods? If I think about my own childhood, you know, we saw ads for sugar cereals during Saturday morning cartoon televisions. And there might have been a smattering if kids watch things that weren't necessarily just directed at kids like baseball games and stuff like that. But, and I'm just making this number up, my exposure to those ads for unhealthy foods might have been 20 a week, 30 a week, something like that. What does it look like now? That is a good question. Kelly. I'm not sure if anyone can give you a totally accurate answer, but I'll try. If you look at YouTube ads that are targeting children, a study found that over half of those ads were promoting foods and beverages, and the majority of those were considered unhealthy, low nutritional value, high calorie. It's hard to answer that question. What we used to do is we'd take, look at all the Saturday morning cartoons, and we'd actually record them and document them and count the number of food ads versus non-food ads. And it was just a much simpler time in a way, in terms of screen exposure. And we found in that case, throughout the '90s and early 2000s, a lot of food ads, a lot of instances of these food ads. And then you can look at food placement too, right? It's not an actual commercial, but these companies are paying to get their food products in the TV show or in the program. And it's just become much more complicated. I think it's hard to capture unless you have a study where you're putting a camera on a child, which some people are doing, to try to really capture everything they see throughout their day. It's really hard to answer, but I think it's very prolific and common and becoming more sophisticated. Okay, thanks. That is very helpful context. Whatever the number is, it's way more than it used to be. Definitely. And it also sounds as if and it's almost all for unhealthy foods, but it sounds like it's changed in other ways. I mean, at some point as I was growing up, I started to realize that these things are advertising and somebody's trying to sell me something. But that's a lot harder to discern now, isn't it with influencers and stuff built in the product placements and all that kind of stuff. So, to the extent we had any safeguards or guardrails in the beginning, it sounds like those are going to be much harder to have these days. That's right. It really takes until a child is 6, 7, 8 years old for them to even identify that this is a commercial. That this is a company that's trying to sell me something, trying to persuade. And then even older children are having to really understand those companies are trying to make money off the products that they sell, right? A lot of kids, they just look at things as face value. They don't discriminate against the commercial versus the non-commercial. And then like you're suggesting with social influencers, that they're getting paid to promote specific products. Or athletes. But to the child that is a character or a person that they've learned to love and trust and don't realize, and as adults, I think we forget sometimes too. That's very true. Amanda, let me ask about one thing that you and Tom had in your chapter. You had a diagram that I thought was very informative and it showed the mechanisms through which social media affects the diet and physical activity of children. Can you describe what you think some of the main pathways of influence might be? That figure was pretty fun to put together because we had a wonderful wealth of knowledge and expertise as authors on this chapter. And people provided different insight from the scientific evidence. I will say the main path we were trying to figure out how does this exposure to screen really explain changes in what children are eating, their risk for obesity, the inactivity and sedentary behavior they're engaging in? In terms of food, really what is I believe the strongest relationship is the exposure to food advertisement and the eating while engaging in screen time. You're getting direct consumption while you're watching screens, but also the taste preferences, the brand loyalty that's being built over time by constantly seeing these different food products consistently emerge as one of the strongest relationships. But we identified some other interesting potential mechanisms too. While kids are watching screens or engaging in screens, there's some evidence to indicate that they're not able to read their body as well. Their feelings of hunger, their feelings of satiety or fullness. That they're getting distracted for long periods of time. Also, this idea of instant gratification, just like the reward process of instant gratification with using the screen. They're so interactive. You can go online and get what you want and reach what you want. And the same thing is happening with food. It becomes habitual as well. Children get off of school and they go home, and they grab a snack, and they watch tv or they watch their YouTube clips or play their games. And it becomes an eating occasion that may not have otherwise existed. But they're just associating screen time with eating. There's some evidence even on screen time impacting inhibition and controlling impulse and memory. And that's more emerging, but it's interesting to just consider how this prolonged screen time where you're not interacting with someone in person, your eyes are focused on the screen, might actually be having other cognitive impacts that we may not even be aware of yet. If we ask the question why Is screen time having a bad impact on children and their diets? It's almost let us count the ways. There are a lot of possible things going on there. And speaking of that, there's one question in particular I'd like to ask you, Tom. Certainly marketing might affect what kids prefer. Like it might make them want to have a cereal or a beverage A or snack food B or whatever it happens to be. But could it also affect hunger? How much kids want to eat? I mean, you think, well, hunger is biological, and the body sends out signals that it's time to eat. How does that all figure in? The research suggests it can. Advertising in particular but even non-advertising references or images of food can trigger hunger and eating whether or not you felt hungry before you saw them. And I'm guessing almost everyone's experienced that themselves, where they see an image of food, and all of a sudden, they're craving it. It can be as simple as Pavlov's dogs, you know, salivating in response to cues about food. In addition, I think one of the mechanisms that Amanda brought up is this idea that when you're distracted with a screen, it actually overruns or overwhelms your normal feelings of fullness or satiety during eating. When distracted, people are less aware of how much they're eating. And when you're eating while using a screen, people tend to eat until they've finished the plate or the bag or the box, you know? And until that's empty, till they get to the bottom, instead of stopping when they start to get full. Well, there's sort of a double biological whammy going on there, isn't there? It is affecting your likelihood of eating in the first place, and how hungry you feel. But then it also is affecting when you stop and your satiety happening. And you put those two together there's a lot going on, isn't there? Exactly. And it's really one of the reasons why a lot of our programs to reduce weight gain and improve nutrition really put a lot of emphasis on not eating in front of screens. Because our studies have shown it accounts for a large proportion of the calories consumed during the day. Oh, that's so interesting. Amanda, you mentioned influencers. Tell us a little bit more about how this works in the food space. These social influencers are everywhere, particularly Instagram, TikTok, et cetera. Kids are seeing these all the time and as I mentioned earlier, you often build this trusting relationship with the influencer. And that becomes who you look to for fads and trends and what you should and shouldn't do. A lot of times these influencers are eating food or cooking or at restaurants, even the ones that are reaching kids. As you analyze that, oftentimes it's the poor nutrition, high calorie foods. And they're often being paid for the ads too, which as we discussed earlier, kids don't always realize. There's also a lot of misinformation about diet and dieting, which is of concern. Misinformation that could be harmful for kids as they're growing and trying to grow in a healthy way and eat healthy foods. But kids who may look to overly restrict their foods, for example, rather than eating in a healthier manner. So that's definitely a problem. And then also, oftentimes these social influencers really have these unattainable beauty standards. Maybe they're using a filter or maybe they are models or whatnot. They're projecting these ideal body images that are very difficult and sometimes inappropriate for children to try to attain. Now, we've seen this in other forms, right? We've seen this in magazines going back. We've seen this on websites. But now as soon as a kid turns on their smartphone or their tablet and they're online, it's in front of them all the time. And, and they're interacting, they're liking it, they're commenting and posting. I think the social influencers have just really become quite pervasive in children's lives. Somebody who's an influencer might be recording something that then goes out to lots and lots of people. They're eating some food or there's some food sitting in the background or something like that. And they're getting paid for it, but not saying they're getting paid for it. Probably very few people realize that money is changing hands in all of that, I'm suspecting, is that right? Yes, I do believe they're supposed to do hashtag ad and there are different indicators, but I'm not sure the accountability behind that. And I'm also not sure that kids are looking for that and really understand what that means or really care what that means. Okay. Because they're looking to sense what's popular. But there's an opportunity to perhaps further regulate, or at least to educate parents and kids in that regard that I think would be helpful. Tom, while we're on this issue of conflicts of interest, there was recent press coverage, and then there were reports by reporters at the Washington Post and The Examination showing that the food industry was paying dieticians to be influencers who then posted things favorable to industry without disclosing their funding. How big of a problem do you think this is sort of overall with professionals being paid and not disclosing the payments or being paid even if they disclose things. What kind of a negative impact that's having? Yes, I find it very concerning as you would guess, knowing me. And I believe one of the investigations found that about half of influencers who were being paid to promote foods, drinks, or supplements, didn't disclose that they were paid. It was quite a large magnitude. It goes throughout all types of health professionals who are supposed to be sources of quality information and professional organizations themselves which take advertising or take sponsorships and then don't necessarily disclose it. And you know in this day when we're already seeing drops in the public's trust in science and in research, I think this type of information, or this type of deception just makes it a lot worse. As you know, Kelly, there's quite a bit of research that suggests that being paid by a company actually changes the way you talk about their products and even conduct research in a way that's more favorable to those products. Whether you think it does or not, whether you're trying to be biased or not. Tom, just to insert one thing in my experience. If you ask people in the field, does taking money from industry affect the way scientists do their work and they'll almost always say yes. But if you say, does it influence your work, they'll almost always say no. There's this unbelievable blind spot. And one might conclude from what you were telling us is that disclosure is going to be the remedy to this. Like for the half of people who didn't disclose it, it would be okay if they took the money as long as they disclosed it. But you're saying that's obviously not the case. That there's still all kinds of bias going on and people who are hearing some disclosure don't necessarily discount what they're hearing because of it. And it's still a pretty bad kettle of fish, even if disclosure occurs. It's especially pernicious when it doesn't, but it seems even when disclosure happens, it's not much of a remedy to anything. But you may not agree. No, I definitely agree with that. And that's only, you know, part of it too because there's the other side of the audience that Amanda brought up as well. And in particular what kids, but also adults, how they react to disclosures. And, while it's been possible to teach people to recognize potential bias, you know, when there's a disclosure. And to make people aware, which is a good thing, we want disclosure, I guess, so people are aware to be more vigilant in terms of thinking about what biases may be in the messages. There's not much evidence that teaching people that or making them aware of that changes their behavior. They still believe the advertising. Right. They still act in the same way. It's still just as persuasive to them. One more little editorial insertion. The thing that has always puzzled me about disclosure is that it implies that there's something bad going on or else, why would you have to disclose it? And the solution seems not to disclose it, but not to do the bad thing. And it's like, I could come up and kick you in the leg, but it's okay if I disclose that I kick you in the leg. I mean, it just makes no sense to me. But let me move on to something different. Amanda, I'd like to ask you this. I assume the food industry gets a lot more impact and reach per dollar they spend from when the only option was to run ads on national television and now, they're doing things at much less expense, I think, that can have, you know, orders of magnitude more impact and things. But is my perception correct? And how do you think through that? I think of it like the Tupperware model, right? You're building these trusted local or national celebrities, spokespeople for kids. Oftentimes these young adults or teenagers who are doing funny things and they're engaging, and so you're building this trust like you did with the Tupperware. Where you go and train people to go out to people's homes and their neighbors and their friends and their church and sell the product. It's really similar just in an online space. I think you're right; the cost is likely much less. And yet the reach and even the way these influencers are paid is all about the interaction, the likes, the comments, that sort of thing. The reposts. It's become quite sophisticated, and clearly, it's effective because companies are doing this. And one other thing to mention we haven't talked about yet is the food companies themselves have hired young people who use humor as a way to create a following for the different brands or products. It's not a person now, it's either the branded character or the actual company itself. And I think that has great influence of building some loyalty to the brand early in life. So that child is growing up and not only persuading their parents to purchase these products, but as they have more disposable income, they're going to continue purchasing the product. I wonder if Edward Tupper or I don't know if I remember his first name right, but I wonder if you could have ever imagined the how his plastic invention would permeate more of society than he ever thought? Tom, what about the argument that it's up to parents to decide and to monitor what their children are exposed to and the government needs to back off. Oh, it would be so nice if they were that easy, wouldn't it? If we could depend on parents. And I think every parent would love to be able to do that. But we're talking about individual parents and their kids who are being asked to stand up against billions, literally billions and billions of dollars spent every year to get them to stay on their screens as long as possible. To pay attention to their marketing, as Amanda was talking about the techniques they use. And to really want their products even more. If you could think of a parent with endless knowledge and time and resources, even they are really unable to stand up to such powerful forces working against them. Unfortunately, and this is not unique to the issues of screens in children's health, but really many of the issues around health, that in the absence of government regulation and really lack of any oversight, this really difficult job is dumped on parents. You know, not their choice, but it's sort of in their lap. We still try and help them to be better at this. While we're waiting for our elected representatives to stand up to lobbyists and do their jobs, we still in a lot of our interventions we develop, we still try and help parents as well as schools, afterschool programs, teachers, health professionals, develop the skills to really help families resist this pool of media and marketing. But that shouldn't be the way it is. You know, most parents are really already doing the best they can. But it's drastically unfair. It's really an unfair playing field. That all makes good sense. We've been talking thus far about the negative impacts of media, but Amanda, you've done some work on putting this technology to good use. Tell us about that if you will. I do enjoy trying to flip the script because technology is meant to help us, not harm us. It's meant to make our lives more efficient, to provide entertainment. Now with video chatting, to provide some social connection. A lot of my work over the past 20 years has been looking at what's commercially available, what kids are using, and then seeing let's test these products or these programs and can we flip them around to promote healthier eating? To promote physical activity? Can we integrate them for kids who are in a weight management program? Can we integrate the technology to really help them be successful? It doesn't always work, and we certainly aren't looking to increase screen time, but we also need to recognize that achieving zero hours of screen time is really unattainable pretty much universally. Let's try to evaluate the screen time that is being used and see if we can make it healthier. A few examples of that include when the Nintendo Wii came out about 18 years ago now. I was part of a group that was one of the first to test that video game console system because up until that point, most of the games you sat down to play, you held a remote in your hand. There were Dance Dance Revolution games and arcade halls so you could do a little bit of movement with games. But pretty much they were sedentary. Nintendo Wii came out and really changed a lot because now you had to get up off the couch, move your body, move your arms and legs to control the game. And we found it cut across all demographics. Men, women, boys, girls, different age groups. There was content available for a lot of different groups. These types of games became really popular. And I did some of the earlier studies to show that at least in a structured program that kids can engage in what we call moderate levels of physical activity. They're actually moving their bodies when they play these games. And over time, I and others have integrated these games into programs as a way to be an in with kids who may not be involved in sports, may not go outside to play, but they're willing to put on a video game and move in their living room at home. Building from that, we've developed and tested various apps. Some of these apps directly reach the parents, for example, teaching the parents. These are strategies to get your child to eat healthier. Prepare healthier meals, grocery shop, be more physically active as a family. We've looked at different wearables, wristwatches that can help kids and parents. Maybe they'll compete against each other to try to get the most steps of a day and that sort of thing. And then some of my recent work is now integrating chatbots and artificial intelligence as ways to provide some tailored feedback and support to kids and families who are looking to be more physically active, eat healthier. And then one study I'm really excited about uses mixed reality. This is virtual reality where you're putting on a headset. And for that study we are integrating children's homework that they would otherwise do on their Chromebook. And we're removing the keyboard and computer mouse so that they now have to use their body to click and point and drag and move the screen. And these are just a few examples. I do not think this is the magical solution. I think as Tom alluded to, there are different levels of government regulation, educating parents, working with schools. There's working with the food industry. There's a lot that we need to do to make this a healthier media space for kids. But I think this is something we should be open to, is figuring out if people are going to spend a lot of time using screens, what can we do to try to make those screens healthier? You make me smile when I'm hearing that because all these things sound really exciting and like there's plenty of potential. And you're right, I mean, if they're going to be on there anyway, maybe there can be some positive way to harness that time. And those all sound really important and really good. And let's hope that they spread enough to really touch lots and lots of children and their families. Tom, you and I keep caught up. We see each other at professional meetings or we just have periodic phone calls where we tell each other what we're up to. And you've been telling me over the past couple years about this really amazing project you're heading up tracking screen usage. Could you tell us a little bit about that? I'd love to. Really it addresses the problem that came up before, which is really how we measure what people are doing and seeing on their screens. Basically all the studies of media effects for the past a hundred plus years that the field has been studying media, has been dependent on people telling us what they do and what they saw. When in fact, we know that's not particularly accurate. So now we have technology that allows us to track exactly what people are doing and seeing on their screens. We call this screenomics, like genomics, except instead of studying how genes affect us, it's studying how screens affect us and how the screens we experience in our lives really are a reflection of our lives. The way we are doing this is we put software on your phone or your laptop, and it can be on other screens as well, and it runs in the background and takes a screenshot every five seconds. And it covers everything on the screen because it's just taking a picture of the screen. All the words, all the images. Then we use AI to help us decipher [00:34:00] what was on those screens. And so far, we've collected over 350 million screenshots from several hundred adults and teenagers who've participated in our studies for periods of six months to a year. Some of our most interesting findings, I think, is how much idiosyncrasy there is in people's screen use. And this has a huge impact on how we do research on the effects of screens, I believe. Because no two people really have the same screenomes, which is what we call the sequence of screenshots that people experience. And even for the same person, no two hours or days or weeks are the same. We're looking at both how different people differ in their screen use, and how that's related to their mental health, for example. But also how changes over time in a single person's screenome is related to their mental health, for example. Comparing your screen use this afternoon to your screen use this morning or yesterday, or last week or last month. And how that changes your health or is at least associated with changes in your health at this point. Eventually, we hope to move this into very precise interventions that would be able to monitor what your screen experience is and give you an appropriate either change in your screen or help you change your behavior appropriate to what you're feeling. One of our current studies is to learn really the details of what, when, how, why, and where foods and beverages appear in adolescent screenomes. And how these factors relate to foods and beverages they consume and their health. In fact, we're currently recruiting 13- to 17-year-olds all over the US who can participate in this study for six months of screenome collection and weekly surveys we do with them. Including detailed surveys of what they're eating. But this sort of goes back to an issue that came up before that you had asked us about how much is advertising? I can tell you that at least some of our preliminary data, looking at a small number of kids, suggests that food, it varies greatly across kids and what they're experiencing, especially on their phones. And, we found, for example, one young girl who 37% of all her screens had food on them. About a third, or more than a third of her entire screenome, had food in it. And it wasn't just through advertising and it wasn't just through social media or influencers. It was everywhere. It was pictures she was taking of food. It was influencers she was following who had food. It was games she was playing that were around food. There are games, they're all about running a restaurant or making food and serving and kitchen work. And then there were also videos that people watched that are actually fairly popular among where you watch other people eat. Apparently it's a phenomenon that came out of Korea first. And it's grown to be quite popular here over the last several years in which people just put on their camera and show themselves eating. I mean, nothing special, nothing staged, just people eating. There's all kinds of food exists everywhere throughout the screenome, not just in one place or another, and not just in advertising. Tom, a study with a hundred data points can be a lot. You've got 350 million, so I wish you the best of luck in sorting all that out. And boy, whatever you find is going to be really informative and important. Thanks for telling us about this. I'd like to end with kind of a basic question to each of you, and that is, is there any reason for hope. Amanda, let's, let's start with you. Do you see any reason to be optimistic about all this? We must be optimistic. No matter how we're facing. We have no choice. I think there's greater awareness. I think parents, policy makers, civic leaders are really recognizing this pervasive effective screen use on mental health, eating, obesity risk, even just the ability to have social interactions and talk to people face to face. And I think that's a good sign. I've seen even in my own state legislature in Louisiana, bills going through about appropriately restricting screens from schools and offering guidance to pediatricians on counseling related to screen use. The American Academy of Pediatrics changed their guidelines a number of years ago. Instead of just saying, no screens for the really little ones, and then limit to fewer than two hours a day for the older ones. They recognized and tried to be more practical and pragmatic with family. Sit down as a family, create some rules, create some boundaries. Make sure you're being healthy with your screen use. Put the screens away during mealtime. Get the screens out of the bedroom. And I think going towards those more practical strategies that families can actually do and sustain is really positive. I'd like to remain optimistic and let's just keep our eyes wide open and talk to the kids too. And ask the kids what they're doing and get them part of this because it's so hard to stay up to date on the technology. Thanks. I appreciate that positive note. Tom, what do you think? Yeah, I agree with Amanda. I can be positive about several things. First of all, I think last year, there were two bills, one to protect child privacy and the other to regulate technology aimed at children. COPPA 2.0 (Children's Online Private Protection Act) and KOSA (Kid's Online Safety Act). And they passed the Senate overwhelmingly. I mean, almost unanimously, or as close as you can get in our current senate. Unfortunately, they were never acted upon by the house, but in the absence of federal legislature regulation, we've had, as Amanda mentioned, a lot of states and also communities where they have actually started to pass bills or regulate social media. Things like prohibiting use under a certain age. For example, social media warning labels is another one. Limiting smartphone use in schools has become popular. However, a lot of these are being challenged in the courts by tech and media industries. And sadly, you know, that's a strategy they've borrowed, as you know well, Kelly, from tobacco and food industry. There also have been attempts that I think we need to fight against. For the federal legislature or the federal government, congress, to pass legislation to preempt state and local efforts, that would not allow states and local communities to make their own laws in this area. I think that's an important thing. But it's positive in that we're hearing advocacy against that, and people are getting involved. I'm also glad to hear people talking about efforts to promote alternative business models for media. I believe that technology itself is not inherently good or bad, as Amanda mentioned, but the advertising business models that are linked to this powerful technology has inevitably led to a lot of these problems we're seeing. Not just in nutrition and health, but many problems. Finally, I see a lot more parent advocacy to protect children and teens, especially around tech in schools and around the potential harms of social media. And more recently around AI even. As more people start to understand what the implications of AI are. I get the feeling these efforts are really starting to make a difference. Organizations, like Fair Play, for example, are doing a lot of organizing and advocacy with parents. And, we're starting to see advocacy in organizing among teens themselves. I think that's all really super positive that the public awareness is there, and people are starting to act. And hopefully, we'll start to see some more action to help children and families. Bios Developmental psychologist Dr. Amanda Staiano is an associate professor and Director of the Pediatric Obesity & Health Behavior Laboratory at Pennington Biomedical Research Center at Louisiana State University. She also holds an adjunct appointment in LSU's Department of Psychology. Dr. Staiano earned her PhD in developmental psychology and Master of Public Policy at Georgetown University, followed by a Master of Science in clinical research at Tulane University. Her primary interest is developing and testing family-based healthy lifestyle interventions that utilize innovative technology to decrease pediatric obesity and its comorbidities. Her research has involved over 2500 children and adolescents, including randomized controlled trials and prospective cohorts, to examine the influence of physical activity and sedentary behavior on body composition and cardiometabolic risk factors. Thomas N. Robinson, MD, MPH is the Irving Schulman, MD Endowed Professor in Child Health, Professor of Pediatrics and of Medicine, in the Division of General Pediatrics and the Stanford Prevention Research Center at Stanford University School of Medicine, and Director of the Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford. Dr. Robinson focuses on "solution-oriented" research, developing and evaluating health promotion and disease prevention interventions for children, adolescents and their families to directly inform medical and public health practice and policy. His research is largely experimental in design, conducting school-, family- and community-based randomized controlled trials to test the efficacy and/or effectiveness of theory-driven behavioral, social and environmental interventions to prevent and reduce obesity, improve nutrition, increase physical activity and decrease inactivity, reduce smoking, reduce children's television and media use, and demonstrate causal relationships between hypothesized risk factors and health outcomes. Robinson's research is grounded in social cognitive models of human behavior, uses rigorous methods, and is performed in generalizable settings with diverse populations, making the results of his research more relevant for clinical and public health practice and policy.

Robert Macfarlane is a British writer internationally known for his writing on nature, people, and place.  His best-selling books include Underland, Landmarks, The Old Ways, The Wild Places and Mountains of the Mind.  They have been translated into more than 30 languages and won many prizes around the world and have been adapted for film, music, theatre, radio, and dance.  He has also written operas, plays and films including river and mountain.  In 2017 the American Academy of Arts and Letters awarded him the EM Forester Prize for literature.  Macfarlane lives in Cambridge England where he is a fellow at Emmanual College, Cambridge. Learn more about your ad choices. Visit megaphone.fm/adchoices

Sleep isn't just rest—it's the foundation of your fertility, hormones, and long-term health. In this episode, we dive deep into how inadequate sleep, circadian rhythm disruption, and conditions like sleep apnea are contributing to the fertility crisis—especially in men.In this episode, I sit down with Dr Bijoy John! a board-certified physician and practicing sleep specialist currently in private practice with over 25 years of experience in Pulmonary/Critical Care and Sleep Medicine. Based in Nashville, TN, he treats both children and adults with various sleep disorders. Dr. John is the founder and medical director of Sleep Wellness Clinics of America which offers in-person and online consultation, education, modern diagnostic modalities, home testing, and comprehensive treatment for a full spectrum of sleep disorders. He also is the founder of Sleep Fix Academy which offers online courses, podcasts, and other resources to improve sleep quality, and serves as an Affiliate Assistant Professor at the University of Tennessee Health Science Center College of Medicine.Dr. John is a member of the American Academy of Chest Physicians, American Medical Association, and American Academy of Sleep Medicine. He was recognized as one of the Top 100 Physicians in Nashville for 2022 by My Nashville magazine. Additionally, he received the Top Sleep Specialist award consecutively from 2015–2020 from Nashville Lifestyle magazine, as voted by his peers and patients. He is also mentioned in Marquis Who's Who as one of the Top Sleep Physicians for 2023-24.Dr. John has been happily married to Dotty for 30 years and is the proud father of two grown children. He enjoys maintaining his coral reef aquarium, playing ping pong, tennis, golf, and loves to travel.Discover:Why testosterone levels are dropping in young menHow poor sleep affects egg quality, sperm health & libidoSigns of hidden sleep disorders (yes, even snoring!)Non-CPAP solutions to sleep apneaWhy "just one more scroll" before bed might sabotage your fertilitySimple strategies from the “7 Proven Sleep Steps” to balance hormones naturally

Celý rozhovor najdete na našem Patreonu nebo HeroHeroPředvolební preference a náladu voličů jsme probrali s nejpovolanější dvojící na průzkumy v Česku, Michalem Kormaňákem z IPSOS a Martinem Buchtíkem ze STEM. Proč nedošlo k propadu preferencí SPOLU po vypuknutí BTC kauzy, můžou uspět strany jednoho muže a jedné ženy (Filip Turek/Kateřina Konečná)? A jaké šance dávají koalici na obhajobu vládních postů? Vyhlídky jsou při nejlepší 15 %, vše závisí na úspěchu či neúspěchu Pirátů, Stačilo a Motoristů. Jak správně seskládat koaliční kandidáty, aby nikdo nebyl znevýhodněn kroužkováním? Udělá někdo stejnou chybu jako Piráti 4 roky zpět?Partnerem podcastu je advokátní kancelář ROWAN LEGAL, provozovatel zdravotnických zařízení PENTA HOSPITALS a American Academy.

Send us a textThis is an episode from the People of Animal Health Podcast, hosted by Stacy Pursell, Founder and CEO of the VET Recruiter. Stacy interviews the host of Vet Life Reimagined. Dr. Megan Sprinkle, a board certified veterinary nutritionist, entrepreneur, podcast host, and self-proclaimed odd veterinarian. From caring for orphaned elephants in Zambia to leading scientific communication for pet nutrition brands, Dr. Sprinkle has built an unconventional career outside of the traditional clinic. She's the founder of the Vet Life Reimagined Podcast, president of the American Academy of Veterinary Nutrition and co-founder of Rise 3D Printing. Passionate about innovation, storytelling and reimagining veterinary possibilities. Dr. Sprinkle brings curiosity, creativity, and compassion to everything she does. Let's dive into her incredible journey. Resources:Episode on The People of Animal Health podcastThe VET Recruiter websiteReady, Vet, Go is a 7-month cohort veterinarian mentorship program with live mentorship, community, and real-world skills to help you grow your confidence. It's perfect for early-career vets and anyone transitioning into small animal practice, but anyone is welcome to join. New cohorts start in July and October. Enroll at https://readyvetgo.co/ Use code SPRINKLE for a 10% discount on enrollment!Support the showMore Vet Life Reimagined?

This and all episodes at: https://aiandyou.net/ . It's more important than ever to define just what we mean by words like intelligence, consciousness, and thinking. Here to help us is Kate Hayles, Distinguished Research Professor at the University of California at Los Angeles. Her research focuses on the relations of literature, science and technology, and a new theory of mind—what she calls an integrated cognitive framework (ICF)—that includes the meaning-making practices of lifeforms from bacteria to plants, animals, humans, and some forms of artificial intelligence. That's the topic of her new book, Bacteria to AI:  Human Futures with our Nonhuman Symbionts. A symbiont is an organism living in symbiosis with another, with a closely-coupled mutual relationship between them. Kate's other books include Postprint: Books and Becoming Computational, Unthought: The Power of the Cognitive Nonconscious, and How We Think: Digital Media and Contemporary Technogenesis. She has many fellowships, including two University of California Presidential Research Fellowships, and is a member of the American Academy of Arts and Sciences. We talk about the relationship between cognition and consciousness, and between cognition and computation; our dependency and codependency on technology; concepts like anthropocentrism and technosymbiosis, which Kate unpacks in the service of laying out a really novel way of thinking about thinking; and whether AI is thinking, or feeling. All this plus our usual look at today's AI headlines. Transcript and URLs referenced at HumanCusp Blog.        

Welcome or welcome back to Authentically ADHD, the podcast where we embrace the chaos and magic of the ADHD brain. Im carmen and today we're diving into a topic that's as complex as my filing system (which is to say, very): ADHD and its common co-occurring mood and learning disorders. Fasten your seatbelts (and if you're like me, try not to get distracted by the shiny window view) – we're talking anxiety, depression, OCD, dyslexia, dyscalculia, and bipolar disorder, all hanging out with ADHD.Why cover this? Because ADHD rarely rides solo. In fact, research compiled by Dr. Russell Barkley finds that over 80% of children and adults with ADHD have at least one other psychiatric disorder, and more than half have two or more coexisting conditions. Two-thirds of folks with ADHD have at least one coexisting condition, and often the classic ADHD symptoms (you know, fidgeting, daydreaming, “Did I leave the stove on?” moments) can overshadow those other disorders. It's like ADHD is the friend who talks so loud at the party that you don't notice the quieter buddies (like anxiety or dyslexia) tagging along in the background.But we're going to notice them today. With a blend of humor, sass, and solid neuroscience (yes, we can be funny and scientific – ask me how I know!), we'll explore how each of these conditions shows up alongside ADHD. We'll talk about how they can be misdiagnosed or missed entirely, and—most importantly—we'll dish out strategies to tell them apart and tackle both. Knowledge is power and self-awareness is the key, especially when it comes to untangling ADHD's web of quirks and comrades in chaos. So, let's get into it!ADHD and Anxiety: Double Trouble in OverdriveLet's start with anxiety, ADHD's frequent (and frantic) companion. Ever had your brain ping-pong between “I can't focus on this work” and “I'm so worried I'll mess it up”? That's ADHD and anxiety playing tango in your head. It's a double whammy: ADHD makes it hard to concentrate, and anxiety cranks up the worry about consequences. As one study notes, about 2 in 5 children with ADHD have significant problems with anxiety, and over half of adults with ADHD do as well. In other words, if you have ADHD and feel like a nervous wreck half the time, you're not alone – you're in very good (and jittery) company.ADHD and anxiety can look a lot alike on the surface. Both can make you restless, unfocused, and irritable. I mean, is it ADHD distractibility or am I just too busy worrying about everything to pay attention? (Hint: it can be both.) Especially for women, ADHD is often overlooked and mislabeled as anxiety. Picture a girl who can't concentrate in class: if she's constantly daydreaming and fidgety, one teacher calls it ADHD. Another sees a quiet, overwhelmed student and calls it anxiety. Same behavior, different labels. Women in particular have had their ADHD misdiagnosed as anxiety or mood issues for years, partly because anxious females tend to internalize symptoms (less hyperactive, more “worrier”), and that masks the ADHD beneath.So how do we tell ADHD and anxiety apart? One clue is where the distraction comes from. ADHD is like having 100 TV channels in your brain and someone else is holding the remote – your attention just flips on its own. Anxiety, on the other hand, is like one channel stuck on a horror movie; you can't focus on other things because a worry (or ten) is running on repeat. An adult with ADHD might forget a work deadline because, well, ADHD. An adult with anxiety might miss the deadline because they were paralyzed worrying about being perfect. Both end up missing the deadline (relatable – ask me how I know), but for different reasons.Neuroscience is starting to unravel this knot. There's evidence of a genetic link between ADHD and anxiety – the two often run in the family together. In brain studies, both conditions involve irregularities in the prefrontal cortex (the brain's command center for focus and planning) and the limbic system (emotion center). Essentially, if your brain were a car, ADHD means the brakes (inhibition) are a bit loose, and anxiety means the alarm system is hyper-sensitive. Combine loose brakes with a blaring alarm and you get… well, us. Fun times, right?Here's an interesting tidbit: Females with ADHD are more likely to report anxiety than males. Some experts think this is partly due to underdiagnosed ADHD – many girls grew up being told they were just “worrywarts” when in fact ADHD was lurking underneath, making everyday life more overwhelming and thus feeding anxiety. As Dr. Thomas Brown (a top ADHD expert) points out, emotional regulation difficulties (like chronic stress or worry) are characteristic of ADHD, even though they're not in the official DSM checklist. Our ADHD brains can amplify emotions – so a normal worry for someone else becomes a five-alarm fire for us.Now, action time: How do we manage this dynamic duo? The first step is getting the right diagnosis. A clinician should untangle whether symptoms like trouble concentrating are from anxiety, ADHD, or both. They might ask: Have you always had concentration issues (pointing to ADHD), or did they start when your anxiety kicked into high gear? Also, consider context – ADHD symptoms occur in most settings (school, work, home), while pure anxiety might spike in specific situations (say, social anxiety in crowds, or panic attacks only under stress).Treatment has to tackle both. Therapy – especially Cognitive Behavioral Therapy (CBT) – is a rockstar here. CBT can teach you skills to manage worry (hello, deep breathing and logical rebuttals to “what if” thoughts) and also help with ADHD organization hacks (like breaking tasks down, creating routines). Many find that medication is needed for one or both conditions. Stimulant meds (like methylphenidate or amphetamines) treat ADHD, but in someone with severe anxiety, a stimulant alone can sometimes ramp up the jitters. In fact, children (and adults) with ADHD + anxiety often don't respond as well to ADHD meds unless the anxiety is also addressed. Doctors might add an SSRI or other anti-anxiety medication to the mix, or choose a non-stimulant ADHD med if stimulants prove too anxiety-provoking.Let me share a quick personal strategy (with a dash of humor): I have ADHD and anxiety, so my brain is basically an internet browser with 50 tabs open – and 10 of them are frozen on a spinning “wheel of doom” (those are the anxieties). One practical tip that helps me distinguish the two is to write down my racing thoughts. If I see worries like “I'll probably get fired for sending that email typo” dominating the page, I know anxiety is flaring. If the page is blank because I got distracted after one sentence... well, hello ADHD! This silly little exercise helps me decide: do I need to do some calming techniques, or do I need to buckle down and use an ADHD strategy like the Pomodoro method? Try it out: Knowledge is power, and self-awareness is the key.Quick Tips – ADHD vs Anxiety: When in doubt, ask what's driving the chaos.* Content of Thoughts: Racing mind full of specific worries (anxiety) vs. racing mind full of everything except what you want to focus on (ADHD).* Physical Symptoms: Anxiety often brings friends like sweaty palms, racing heart, and tummy trouble. ADHD's restlessness isn't usually accompanied by fear, just boredom or impulsivity.* Treatment Approaches: For co-occurring cases, consider therapy and possibly a combo of medications. Experts often treat the most impairing symptom first – if panic attacks keep you homebound, address that alongside ADHD. Conversely, untreated ADHD can actually fuel anxiety (ever notice how missing deadlines and forgetfulness make you more anxious? Ask me how I know!). A balanced plan might be, say, stimulant medication + talk therapy for anxiety, or an SSRI combined with ADHD coaching. Work closely with a professional to fine-tune this.Alright, take a breath (seriously, if you've been holding it – breathing is good!). We've tackled anxiety; now let's talk about the dark cloud that can sometimes follow ADHD: depression.ADHD and Depression: When the Chaos Brings a CloudADHD is often associated with being energetic, spontaneous, even optimistic (“Sure, I can start a new project at 2 AM!”). So why do so many of us also struggle with depression? The reality is, living with unmanaged ADHD can be tough. Imagine years of what Dr. Russell Barkley calls “developmental delay” in executive function – always feeling one step behind in managing life, despite trying so hard. It's no surprise that about 1 in 5 kids with ADHD also has a diagnosable depression, and studies show anywhere from 8% to 55% of adults with ADHD have experienced a depressive disorder in their lifetime. (Yes, that range is huge – it depends how you define “depression” – but even on the low end it's a lot.) Dr. Barkley himself notes that roughly 25% of people with ADHD will develop significant depression by adulthood. In short, ADHD can come with a case of the blues (not the fun rhythm-and-blues kind, unfortunately).So what does ADHD + depression look like? Picture this: You've got a pile of unfinished projects, bills, laundry – the ADHD “trail of crumbs.” Initially, you shrug it off or maybe crack a joke (“organizational skills, who's she?”). But over time, the failures and frustrations can chip away at your self-esteem. You start feeling helpless or hopeless: “Why bother trying if I'm just going to screw it up or forget again?” That right there is the voice of depression sneaking in. ADHD's impulsivity might also lead to regrettable decisions or conflicts that you later brood over, another pathway to depressed mood.In fact, the Attention Deficit Disorder Association points out that ADHD's impact on our lives – trouble with self-esteem, work or school difficulties, and strained relationships – can contribute to depression. It's like a one-two punch: ADHD creates problems; those problems make you sad or defeated, which then makes it even harder to deal with ADHD. Fun cycle, huh?Now, depression itself can mask as ADHD in some cases, especially in adults. Poor concentration, low motivation, fatigue, social withdrawal – these can appear in major depression and look a lot like ADHD symptoms. If an adult walks into a doctor's office saying “I can't focus and I'm procrastinating a ton,” a cursory eval might yield an ADHD diagnosis. But if that focus problem started only after they, say, lost a loved one or fell into a deep funk, and they also feel worthless or have big sleep/appetite changes, depression may be the primary culprit. On the flip side, a person with lifelong ADHD might be misdiagnosed as just depressed, because they seem down or overwhelmed. As always, timeline is key: ADHD usually starts early (childhood), whereas depression often has a more defined onset. Also, ask: Is the inability to focus present even when life's going okay? If yes, ADHD is likely in the mix. If the focus issues wax and wane with mood, depression might be the driver.There's also a nuance: ADHD mood issues vs. clinical depression. People with ADHD can have intense emotions and feel demoralized after a bad day, but often these feelings can lift if something positive happens (say, an exciting new interest appears – suddenly we have energy!). Clinical depression is more persistent – even good news might not cheer you up much. As Dr. Thomas Brown emphasizes, ADHD includes difficulty regulating emotion; an ADHD-er might feel sudden anger or sadness that's intense but then dissipates . By contrast, depression is a consistent low mood or loss of pleasure in things over weeks or months. Knowing this difference can be huge in sorting out what's going on.Now, how do we deal with this combo? The good news: many treatments for depression also help ADHD and vice versa. Therapy is a prime example. Cognitive Behavioral Therapy and related approaches can address negative thought patterns (“I'm just a failure”) and also help with practical skills for ADHD (like scheduling, or as I call it, tricking my brain into doing stuff on time). There are even specialized therapies for adults with ADHD that blend mood and attention strategies. On the medication front, sometimes a single med can pull double duty. One interesting option is bupropion (Wellbutrin) – an antidepressant that affects dopamine and norepinephrine, which can improve both depression and ADHD symptoms in some people. There's also evidence that stimulant medications plus an antidepressant can be a powerful combo: stimulants to improve concentration and energy, antidepressant to lift mood. Psychiatrists will tailor this to the individual – for instance, if someone is severely depressed (can't get out of bed), treating depression first may be priority. If the depression seems secondary to ADHD struggles, improving the ADHD could automatically boost mood. Often, it's a balancing act of treating both concurrently – maybe starting an antidepressant and an ADHD med around the same time, or ensuring therapy covers both bases.Let's not forget lifestyle: exercise, sleep, nutrition – these affect both ADHD and mood. Regular exercise, for example, can increase BDNF (a brain growth factor) and neurotransmitters that help both attention and mood. Personally, I found that when I (finally) started a simple exercise routine, my mood swings evened out a bit and my brain felt a tad less foggy. (Of course, starting that routine required overcoming my ADHD inertia – ask me how I know that took a few tries... or twenty.)Quick Tips – ADHD vs Depression:* Check Your Joy Meter: With ADHD alone, you can still feel happy/excited when something engaging happens (ADHD folks light up for interesting tasks!). With depression, even things you normally love barely register. If your favorite hobbies no longer spark any joy, that's a red flag for depression.* All in Your Head? ADHD negative thoughts sound like “Ugh, I forgot again, I need a better system.” Depression thoughts sound like “I forgot again because I'm useless and nothing will ever change.” Listen to that self-talk; depression is a sneaky bully.* Professional Help: A thorough evaluation can include psychological tests or questionnaires to measure attention and mood separately. For treatment, consider a combined approach: therapy (like CBT or coaching) plus meds as needed. According to research, a mix of stimulant medication and therapy (especially CBT) can help treat both conditions. And remember, addressing one can often relieve the other: improve your ADHD coping skills, and you might start seeing hope instead of disappointment (boosting mood); treat your depression, and suddenly you have the energy to tackle that ADHD to-do list.Before we move on, one more important note: if you ever have thoughts of self-harm or suicide, please reach out to a professional immediately. Depression is serious, and when compounded with ADHD impulsivity, it can be dangerous. There is help, and you're not alone – so many of us have been in that dark place, and it can get better with the right support. Knowledge is power and self-awareness is the key, yes, but sometimes you also need a good therapist, maybe a support group, and possibly medication to truly turn things around. There's no shame in that game.Alright, deep breath. It's getting a bit heavy in here, so let's pivot to something different: a condition that seems like the opposite of ADHD in some ways, yet can co-occur – OCD. And don't worry, we'll crank the sass back up a notch.ADHD and OCD: The Odd Couple of AttentionWhen you think of Obsessive-Compulsive Disorder (OCD), you might picture someone extremely organized, checking the stove 10 times, everything neat and controlled. When you think ADHD… well, “organized” isn't the first word that comes to mind, right?

Generalizations about ADHD haven't done girls any favors. ADHD often manifests very differently in girls than in boys. What causes parents, educators, and even doctors, to view the symptoms of ADHD differently with girls? We know that masking, and even variations in environments, often cause symptoms to be missed. How is that happening? We're revisiting the subject and chat with Stephen Hinshaw, a Distinguished Professor of Psychology at UC Berkeley and Professor of Psychiatry and Behavioral Sciences at UC San Francisco. Find out more about building neurodiversity-affirming schools, and about the courses we'll be offering soon, here. Stephen P. Hinshaw is Distinguished Professor of Psychology at UC Berkeley and Professor of Psychiatry and Behavioral Sciences at UC San Francisco. His focus is on developmental psychopathology, child and adolescent mental health (particularly ADHD), and the use of clinical trials to understand underlying mechanisms. He also actively investigates mental illness stigmatization and attempts to reduce such stigma. Hinshaw has authored over 400 articles, chapters, and commentaries, plus 12 books. He has won numerous national and international research awards, including the James McKeen Cattell Fellow Award from the Association for Psychological Science, the Distinguished Scientific Contributions Award from the American Psychological Association, and the Sarnat International Prize in Mental Health from the National Academy of Medicine. He was inducted into the American Academy of Arts and Sciences in 2021. His extensive media coverage includes the New York Times, Washington Post, Wall Street Journal, Today Show, CBS Evening News, ABC World News Tonight, and many more. BACKGROUND READING Berkeley, research, website, Straight Talk about ADHD in Girls: How to Help Your Daughter Thrive The Neurodiversity Podcast is on Facebook, Instagram, BlueSky, and you're invited to join our Facebook Group.

What if the best diet for you isn't in a book or trending on social media—but instead, hidden in your own biology? In this episode, I sit down with functional medicine expert Dr. Anju Mathur to explore the world of personalized nutrition—a science-backed approach that tailors food and lifestyle choices to your unique body, genes, gut health, and more. We discuss: Why “one-size-fits-all” diets often fail How food sensitivities and nutrient imbalances affect autoimmune health The role of gut testing, genetic markers, and lab work in creating a personalized plan How to start listening to your body and create a nutrition strategy that actually works for you Whether you're struggling with autoimmune symptoms, chronic fatigue, or simply want to optimize your wellness, this conversation will empower you to take control of your health in a more personal way.

In this powerful episode of The Red Light Report, I'm joined by the brilliant Dr. Joy Kong — stem cell specialist, anti-aging physician, and founder of Chara Health and the American Academy of Integrative Cell Therapy.   We dive deep into: The science and clinical use of stem cell therapy Why umbilical cord-derived stem cells are safer and more potent than adult sources The truth about exosomes, cytokine storms, and foreign DNA fears How stem cells can transfer mitochondria, reverse tissue damage, and modulate immunity The importance of prepping your terrain with nutraceuticals, detox, and nitric oxide The role of red, green, and yellow light in stem cell activation and targeting Synergy between red light therapy and BioLight's enhanced methylene blue (BioBlue)   Whether you're exploring stem cells for longevity, healing, or neuroregeneration, this episode will reshape your understanding of what's truly possible.  

Edwin Howard Armstrong isn’t exactly a well-known inventor, but his work in radio literally changed communications around the globe. But his most famous invention – FM radio – became a source of constant frustration after he developed it. Research: Armstrong, Edwin H. “Frequency Modulation and Its Future Uses.” The Annals of the American Academy of Political and Social Science, vol. 213, 1941, pp. 153–61. JSTOR, http://www.jstor.org/stable/1024069 Armstrong, Edwin H. “Personalities in Science.” Scientific American, vol. 154, no. 1, 1936, pp. 3–3. JSTOR, http://www.jstor.org/stable/26144367 “First public radio broadcast.” Guinness World Records. https://www.guinnessworldrecords.com/world-records/381969-first-public-radio-broadcast “FM Inventor Dies in Fall.” The Patriot News. Feb. 2, 1954. https://www.newspapers.com/image/1094174282/?match=1&terms=%22Edwin%20Howard%20Armstrong%22 Lessing, Lawrence P.. "Edwin H. Armstrong". Encyclopedia Britannica, 14 Dec. 2024, https://www.britannica.com/biography/Edwin-H-Armstrong Lessing, Lawrence P. “Man of High Fidelity: Edwin Howard Armstrong.” Bantam. 1969. Lessing, Lawrence P. “The Late Edwin H. Armstrong.” Scientific American, vol. 190, no. 4, 1954, pp. 64–69. JSTOR, http://www.jstor.org/stable/24944524 “Proceedings of the Institute of Radio Engineers, Volume 5.” Institute of Radio Engineers. 1917. Accessed online: https://books.google.com/books?id=YEASAAAAIAAJ&source=gbs_navlinks_s “Radio Broadcast.” Garden City, N.Y.: Doubleday, Page & Co., 1922-1930. https://babel.hathitrust.org/cgi/pt?id=iau.31858044013914&view=1up&seq=277 “Telephoning Without Wires.” The Fort Wayne Journal Gazette. Oct. 20, 1907. https://www.newspapers.com/image/29125618/?match=1&terms=audion%20%22de%20Forest%22 Tsividis, Yannis. “Edwin Armstrong: Pioneer of the Airwaves.” Columbia Magazine. April 1, 2002. https://magazine.columbia.edu/article/edwin-armstrong-pioneer-airwaves Turner, H. M. “Dr. Edwin H. Armstrong, Edison Medalist.” The Scientific Monthly, vol. 56, no. 2, 1943, pp. 185–87. JSTOR, http://www.jstor.org/stable/17796 “What’s the Difference Between AM and FM Radio?” National Inventors Hall of Fame. Aug, 16, 2023. https://www.invent.org/blog/trends-stem/difference-between-am-fm See omnystudio.com/listener for privacy information.

In just a few short months on the job, Health And Human Services Secretary Robert F. Kennedy Jr. has managed to upend the American public health system, successfully inserting his decades of vaccine skepticism into national policy. Late last month, he fired every member of the Centers for Disease Control and Prevention's vaccine advisory panel, replacing them mostly with people who've voiced skepticism about vaccines. In May, he announced the CDC would stop recommending COVID vaccines for pregnant people and babies. The American Academy of Pediatrics and other health groups are now suing him and HHS over the latter decision. Dr. Fiona Havers, a former senior advisor on vaccine policy at the CDC, resigned from the agency over Kennedy's changes to federal vaccine policy. She joins us to talk about what everyday people should do to keep themselves and their family safe.And in headlines: President Donald Trump abruptly reversed course on sending defense weapons to Ukraine, Agriculture Secretary Brooke Rollins doubles down on “no amnesty” for undocumented farmworkers, and someone out there is using AI to impersonate Secretary of State/National Security Advisor/Acting Archivist Marco Rubio. Show Notes:Subscribe to the What A Day Newsletter – https://tinyurl.com/3kk4nyz8What A Day – YouTube – https://www.youtube.com/@whatadaypodcastFollow us on Instagram – https://www.instagram.com/crookedmedia/For a transcript of this episode, please visit crooked.com/whataday

Host Mikalyn DeFoor, MD Guest interviewee Nicholas A. Apseloff, MD, discussing his review article, “Primary Anterior Cruciate Ligament Injury: Extrinsic and Intrinsic Risk Factors” from the July 1, 2025 issue Article summarized from the July 1, 2025 issue Review article ““FATAL Graft”: A Diagnostic Algorithm for the Workup of Anterior Cruciate Ligament Reconstruction Graft Failure” Articles summarized from the July 15, 2025 issue Two-part series: Review article “Shoulder Arthroplasty: Current Evidence and Techniques on Infection Diagnosis and Treatment” Review article “Shoulder Arthroplasty: Current Evidence and Techniques on Infection Prevention” Follow this link to download these and other articles from the July 1, 2025 issue of JAAOS and the July 15, 2025 issue of JAAOS. The JAAOS Unplugged podcast series is brought to you by the Journal of the American Academy of Orthopaedic Surgeons and the AAOS Resident Assembly.

It's fun to be outside in the sun, but it also means you're at greater risk for sun burns, bug bites, and other skin issues. This week, dermatologist Dr. Victoria Perez of NewYork-Presbyterian and Columbia offers an expert guide to how to protect your skin this summer and all year round. She discusses the best sunscreen to use, how to manage bug bites and heat rashes, and when it's time to see a doctor for your skin ailment.NewYork-Presbyterian experts will be sharing simple tips all month long on how to stay healthy and safe this summer.___Dr. Victoria Perez earned her medical degree from Columbia University Vagelos College of Physicians and Surgeons and completed her dermatology residency at NewYork-Presbyterian/Columbia University Irving Medical Center, where she served as chief resident in her final year. Dr. Perez is an active member of the American Academy of Dermatology, the Women's Dermatologic Society, and the Skin of Color Society, where she serves on the Center for Leadership Learning Collaborative. She has authored numerous publications and presented research at both national and local conferences. She is committed to delivering compassionate, evidence-based care to all patients.Dr. Perez will provide dermatology services at NewYork-Presbyterian The One, a state-of-the-art center for advanced care with doctors from Columbia in Westchester. NewYork-Presbyterian The One is now accepting appointments and opens in September 2025. The facility will offer adult and pediatric care spanning more than 90 specialties and subspecialties, so patients can find the care they and their families need in one convenient location.___Health Matters is your weekly dose of health and wellness information, from the leading experts. Join host Courtney Allison to get news you can use in your own life. New episodes drop each Wednesday.If you are looking for practical health tips and trustworthy information from world-class doctors and medical experts you will enjoy listening to Health Matters. Health Matters was created to share stories of science, care, and wellness that are happening every day at NewYork-Presbyterian, one of the nation's most comprehensive, integrated academic healthcare systems. In keeping with NewYork-Presbyterian's long legacy of medical breakthroughs and innovation, Health Matters features the latest news, insights, and health tips from our trusted experts; inspiring first-hand accounts from patients and caregivers; and updates on the latest research and innovations in patient care, all in collaboration with our renowned medical schools, Columbia and Weill Cornell Medicine.To learn more visit: https://healthmatters.nyp.org

Dr. Madan is the immediate Past President for BC Doctors of Optometry and the Chair of the Government and Professional Affairs Committee. She completed a residency in ocular disease at the Eye Center of Texas in Houston and is a fellow of the American Academy of Optometry. In addition to all of this, Dr. Madan currently practices in an MD/OD setting, where she provides advanced services such as treating glaucoma and offering PRP eye drops to dry eye patients. All of this makes her the perfect guest to continue our series on scope optimization.In the first episode in this series of short interviews, we spoke with Dr. Cedrick Mah to understand how his experience with advanced procedures in Oklahoma can help us understand why scope advancement is important in Canada.In this episode we continue our conversation on scope with Dr. Madan by asking what the future of optometry looks like. What should primary care optometrist expect their job to look like? Why should we be asking for scope modernization?Keep the conversation about scope optimization going by sharing these interviews with our colleagues. Send in your thoughts and comments to help us improve these discussions so we can continue to elevate our profession.Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

When you're parenting autistic children or kids with high support needs, it's easy to wonder how it all impacts their siblings. Do they feel forgotten? Overwhelmed? Lost in the shuffle? In this heartfelt episode of The Autism Dad Podcast, I sit down with autism mom Amy Kelly and her adult son Danny for a raw, emotional, and hopeful look at the sibling experience—and why it matters more than we often realize. Amy is a powerhouse in the autism community. She's the National Director of Family Engagement at Devereux and a longtime advocate for autism support for families. But this episode isn't about professional titles—it's about her lived experience as a mom raising profoundly autistic Annie, while trying to meet the needs of her neurotypical sons, including today's guest, Danny. Danny brings a sibling's perspective that every parent needs to hear. He opens up about what it was like growing up with a sister who needed constant care, the unspoken pressures siblings carry, and how he's now leading a national effort to support siblings like him. Whether you're parenting autistic children or raising neurodivergent kids of any kind, this episode offers valuable insight, encouragement, and a reminder that every child in your home deserves to feel seen. What You'll Learn in This Episode: What it's really like growing up with a sibling who has autism or profound disabilities Why siblings may feel isolated, unseen, or forgotten—even in loving homes How parents can better balance attention between neurodivergent and neurotypical kids The lifelong bond between siblings, and how it evolves into adulthood Danny's work creating resources and community through Devereux's sibling initiative Practical ways siblings can stay connected and prepare for future caregiving roles How autism reshaped (not ruined) their family in powerful ways Why redefining success and independence is key for autistic individuals Subscribe, Support, and Connect: If you found this episode helpful, please consider subscribing to The Autism Dad Podcast on your favorite platform and leave a review to help more families find this content. You can visit theautismdad.com for articles, resources, and updates—or if you're interested in sponsoring an episode, get in touch. This episode is sponsored by: Mama Bird – Brain-focused kids' multivitamins designed by a neurologist mom. Get 20% off your first order at lovemamabird.com/theautismdad. Mightier – Help your child build emotional regulation skills through biofeedback video games. Learn more at mightier.com and use the code "theautismdad22" to save 10%. About Rob Gorski (Host): Rob Gorski is a single dad to three autistic sons and the creator of The Autism Dad blog and podcast. He shares real-life stories, insights, and support for parents raising neurodivergent kids. Rob's work has been featured by CNN, ABC, BBC, and The Tamron Hall Show. Contact: rob@theautismdad.com About Amy Kelly: Amy Kelly, MBA, MNM, is the National Director of Family Engagement at Devereux Advanced Behavioral Health and mom to three kids, including her daughter Annie, who has profound autism. Amy is a national advocate for disability support, working with organizations like the Autism Care Network and the American Academy of Pediatrics. Contact: amy.kelly@devereux.org About Danny Kelly: Danny Kelly is the older brother of Annie, who has profound autism. He co-chairs Devereux's Sibling Engagement Committee and serves on the National Family Advisory Board. Danny uses his lived experience to advocate for siblings and inclusive support across the disability community.

 Normal pressure hydrocephalus (NPH) is a clinical syndrome of gait abnormality, cognitive impairment, and urinary incontinence. Evaluation of CSF dynamics, patterns of fludeoxyglucose (FDG) uptake, and patterns of brain stiffness may aid in the evaluation of challenging cases that lack typical clinical and structural radiographic features. In this episode, Katie Grouse, MD, FAAN, speaks with Aaron Switzer, MD, MSc, author of the article “Radiographic Evaluation of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics 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. Switzer is a clinical assistant professor of neurology in the department of clinical neurosciences at the University of Calgary in Calgary, Alberta, Canada. Additional Resources Read the article: Radiographic Evaluation of Normal Pressure Hydrocephalus 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 Full episode transcript available here 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 Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr. Switzer: Thanks so much for having me, Katie. I'm a neurologist that's working up in Calgary, Alberta, Canada, and I have a special interest in normal pressure hydrocephalus. So, I'm very happy to be here today to talk about the radiographic evaluation of NPH. Dr Grouse: I'm so excited to have you here today. It was really wonderful to read your article. I learned a lot on a topic that is not something that I frequently evaluate in my clinic. So, it's really just a pleasure to have you here to talk about this topic. So, I'd love to start by asking, what is the key message that you hope for neurologists who read your article to take away from it? Dr. Switzer: The diagnosis of NPH can be very difficult, just given the clinical heterogeneity in terms of how people present and what their images look like. And so, I'd like readers to know that detailed review of the patient's imaging can be very helpful to identify those that will clinically improve with shunt surgery. Dr Grouse: There's another really great article in this edition of Continuum that does a really great job delving into the clinical history and exam findings of NPH. So, I don't want to get into that topic necessarily today. However, I'd love to hear how you approach a case of a hypothetical patient, say, where you're suspicious of NPH based on the history and exam. I'd love to talk over how you approach the imaging findings when you obtain an MRI of the brain, as well as any follow-up imaging or testing that you generally recommend. Dr. Switzer: So, I break my approach down into three parts. First, I want to try to identify ventriculomegaly and any signs that would support that, and specifically those that are found in NPH. Secondly, I want to look for any alternative pathology or evidence of alternative pathology to explain the patient's symptoms. And then also evaluate any contraindications for shunt surgery. For the first one, usually I start with measuring Evans index to make sure that it's elevated, but then I want to measure one of the other four measurements that are described in the article, such as posterior colossal angle zed-Evans index---or z-Evans index for the American listeners---to see if there's any other features that can support normal pressure hydrocephalus. It's very important to identify whether there are features of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, which can help identify patients who may respond to shunt surgery. And then if it's really a cloudy clinical picture, it's complicated, it's difficult to know, I would usually go through the full evaluation of the iNPH radscale to calculate a score in order to determine the likelihood that this patient has NPH. So, the second part of my evaluation is to rule out evidence of any alternative pathology to suggest another cause for the patient's symptoms, such as neurodegeneration or cerebrovascular disease. And then the third part of my evaluation is to look for any potential contraindications for shunt surgery, the main one being cerebral microbleed count, as a very high count has been associated with the hemorrhagic complications following shunt surgery. Dr Grouse: You mentioned about your use of the various scales to calculate for NPH, and your article does a great job laying them out and where they can be helpful. Are there any of these scales that can be reasonably relied on to predict the presence of NPH and responsiveness to shunt placement? Dr. Switzer: I think the first thing to acknowledge is that predicting shunt response is still a big problem that is not fully solved in NPH. So, there is not one single imaging feature, or even combination of imaging features, that can reliably predict shunt response. But in my view and in my practice, it's identifying DESH, I think, is really important---so, the disproportionately enlarged subarachnoid space hydrocephalus---as well as measuring the posterior colossal angle. I find those two features to be the most specific. Dr Grouse: Now you mentioned the concept of the NPH subtypes, and while this may be something that many of our listeners are familiar with, I suspect that, like myself when I was reading this article, there are many who maybe have not been keeping up to date on these various subtypes. Could you briefly tell us more about these NPH subtypes? Dr. Switzer: Sure. The Japanese guidelines for NPH have subdivided NPH into three different main categories. So that would be idiopathic, delayed onset congenital, and secondary normal pressure hydrocephalus. And so, I think the first to talk about would be the secondary NPH. We're probably all more familiar with that. That's any sort of pathology that could lead to disruption in CSF dynamics. These are things like, you know, a slow-growing tumor that is obstructing CSF flow or a widespread meningeal process that's reducing absorption of CSF, for instance. So, identifying these can be important because it may offer an alternative treatment for what you're seeing in the patient. The second important one is delayed onset congenital. And when you see an image of one of these subtypes, it's going to be pretty different than the NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. Clinically, you may see that the patients have a higher head circumference. So, the second subtype to know about would be the delayed onset congenital normal pressure hydrocephalus. And when you see an image of one of these subtypes, it's going to be a little different than the imaging of NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. And there are two specific subtypes that I'd like you to know about. The first would be long-standing overt ventriculomegaly of adulthood, or LOVA. And the second would be panventriculomegaly with a wide foramen of magendie and large discernomagna, which is quite a mouthful, so we just call it PAVUM. The importance of identifying these subtypes is that they may be amenable to different types of treatment. For instance, LOVA can be associated with aqueductal stenosis. So, these patients can get better when you treat them with an endoscopic third ventriculostomy, and then you don't need to move ahead with a shunt surgery. And then finally with idiopathic, that's mainly what we're talking about in this article with all of the imaging features. I think the important part about this is that you can have the features of DESH, or you can not have the features of DESH. The way to really define that would be how the patient would respond to a large-volume tap or a lumbar drain in order to define whether they have this idiopathic NPH. Dr Grouse: That's really helpful. And for those of our listeners who are so inclined, there is a wonderful diagram that lays out all these subtypes that you can take a look at. I encourage you to familiarize yourself with these different subtypes. Now it was really interesting to read in your article about some of the older techniques that we used quite some time ago for diagnosing normal pressure hydrocephalus that thankfully we're no longer using, including isotope encephalography and radionuclide cisternography. It certainly made me grateful for how we've come in our diagnostic tools for NPH. What do you think the biggest breakthrough in diagnostic tools that are now clinically available are? Dr. Switzer: You know, definitely the advent of structural imaging was very important for the evaluation of NPH, and specifically the identification of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, in the late nineties has been very helpful for increasing the specificity of diagnosis in NPH. But some of the newer technologies that have become available would be phase-contrast MRI to measure the CSF flow rate through the aqueduct has been very helpful, as well as high spatial resolution T2 imaging to actually image the ventricular system and look for any evidence of expansion of the ventricles or obstruction of CSF flow. Dr Grouse: Regarding the scales that you had referenced earlier, do you think that we can look forward to more of these scales being automatically calculated and reported by various software techniques and radiographic interpretation techniques that are available or going to be available? Dr. Switzer: Definitely yes. And some of these techniques are already in development and used in research settings, and most of them are directed towards automatically detecting the features of DESH. So, that's the high convexity tight sulci, the focally enlarged sulci, and the enlarged Sylvian fissures. And separating the CSF from the brain tissue can help you determine where CSF flow is abnormal throughout the brain and give you a more accurate picture of CSF dynamics. And this, of course, is all automated. So, I do think that's something to keep an eye out for in the future. Dr Grouse: I wanted to ask a little more about the CSF flow dynamics, which I think may be new to a lot of our listeners, or certainly something that we've only more recently become familiar with. Can you tell us more about these advances and how we can apply this information to our evaluations for NPH? Dr. Switzer: So currently, only the two-dimensional phase contrast MRI technique is available on a clinical basis in most centers. This will measure the actual flow rate through the cerebral aqueduct. And so, in NPH, this can be elevated. So that can be a good supporting marker for NPH. In the future, we can look forward to other techniques that will actually look at three-dimensional or volume changes over time and this could give us a more accurate picture of aberrations and CSF dynamics. Dr Grouse: Well, definitely something to look forward to. And on the topic of other sort of more cutting-edge or, I think, less commonly-used technologies, you also mentioned some other imaging modalities, including diffusion imaging, intrathecal gadolinium imaging, nuclear medicine studies, MR elastography, for example. Are any of these modalities particularly promising for NPH evaluations, in your opinion? Do you think any of these will become more popularly used? Dr. Switzer: Yes, I think that diffusion tract imaging and MR elastography are probably the ones to keep your eye out for. They're a little more widely applicable because you just need an MR scanner to acquire the images. It's not invasive like the other techniques mentioned. So, I think it's going to be a lot easier to implement into clinical practice on a wide scale. So, those would be the ones that I would look out for in the future. Dr Grouse: Well, that's really exciting to hear about some of these techniques that are coming that may help us even more with our evaluation. Now on that note, I want to talk a little bit more about how we approach the evaluation and, in your opinion, some of the biggest pitfalls in the evaluation of NPH that you've found in your career. Dr. Switzer: I think there are three of note that I'd like to mention. The first would be overinterpreting the Evans index. So, just because an image shows that there's an elevated Evans index does not necessarily mean that NPH is present. So that's where looking for other corroborating evidence and looking for the clinical features is really important in the evaluation. Second would be misidentifying the focally enlarged sulci as atrophy because when you're looking at a brain with these blebs of CSF space in different parts of the brain, you may want to associate that to neurodegeneration, but that's not necessarily the case. And there are ways to distinguish between the two, and I think that's another common pitfall. And then third would be in regards to the CSF flow rate through the aqueduct. And so, an elevated CSF flow is suggestive of NPH, but the absence of that does not necessarily rule NPH out. So that's another one to be mindful of. Dr Grouse: That's really helpful. And then on the flip side, any tips or tricks or clinical pearls you can share with us that you found to be really helpful for the evaluation of NPH? Dr. Switzer: One thing that I found really helpful is to look for previous imaging, to look if there were features of NPH at that time, and if so, have they evolved over time; because we know that in idiopathic normal pressure hydrocephalus, especially in the dash phenotype, the ventricles can become larger and the effacement of the sulci at the convexity can become more striking over time. And this could be a helpful tool to identify how long that's been there and if it fits with the clinical history. So that's something that I find very helpful. Dr Grouse: Absolutely. When I read that point in your article, I thought that was really helpful and, in fact, I'm guessing something that a lot of us probably aren't doing. And yet many of our patients for one reason or other, probably have had imaging five, ten years prior to their time of evaluation that could be really helpful to look back at to see that evolution. Dr. Switzer: Yes, absolutely. Dr Grouse: It's been such a pleasure to read your article and talk with you about this today. Certainly a very important and helpful topic for, I'm sure, many of our listeners. Dr. Switzer: Thank you so much for having me. Dr Grouse: Again, today I've been interviewing Dr Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. 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's West Coast Cookbook & Speakeasy Podcast for our especially special Daily Special, Smothered Benedict Wednesday is now available on the Spreaker Player!Starting off in the Bistro Cafe, the American public knows Donald Trump is lying about tariffs and they've figured it out without any help from the White House press corps who continue to accept his lies as answers.Then, on the rest of the menu, RFK Jr.'s vaccine policy sparks a lawsuit from the American Academy of Pediatrics; Trump appointees have ties to companies that stand to benefit from privatizing weather forecasts; and, Trump blocked a ‘click-to-cancel' rule, intended to make cancelling subscriptions easier, just before it was to go in effect.After the break, we move to the Chef's Table where a Turkish court ordered a ban on Elon Musk's AI chatbot Grok for offensive content; and, French police raided the far-right National Rally headquarters in a new finance probe.All that and more, on West Coast Cookbook & Speakeasy with Chef de Cuisine Justice Putnam.The Netroots Radio Live Player​Keep Your Resistance Radio Beaming 24/7/365!“It may be safely averred that good cookery is the best and truest economy, turning to full account every wholesome article of food, and converting into palatable meals what the ignorant either render uneatable or throw away in disdain.” - Eliza Acton ‘Modern Cookery for Private Families' (1845)Bon Appétit!Become a supporter of this podcast: https://www.spreaker.com/podcast/west-coast-cookbook-speakeasy--2802999/support.

Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world.Medical societies, including the American Academy of Pediatrics, have filed a lawsuit against RFK Jr. over changes to COVID-19 vaccine policies. They argue that his directive to remove COVID-19 from vaccination guidelines for healthy pregnant women and children puts them at risk of serious illness. Concentra has acquired struggling biotech company Cargo Therapeutics in a $200 million buyout. President Trump's tax law has restored orphan drug exemptions, cut Medicaid funding, and threatened the 340B program, while giving pharmacy benefit managers a pass. The ALS community has petitioned the FDA to reconsider Brainstorm's cell therapy Nurown, citing recent survival data. Drug developers are exploring new digitization strategies to optimize processes and embrace technology in drug development. Overall, the text discusses legal action against RFK Jr. over vaccine policy changes, recent acquisitions in the biotech industry, implications of Trump's tax law on healthcare programs, petitions regarding ALS therapies, digitization strategies in drug development.

This month, host Dr. Paul Wirkus is joined by experts Megan Jensen, CEDS, MPH, RDN, CD and Nicole Holland, Intern (RD) to discuss how pediatric providers can better recognize the early signs and symptoms of eating disorders. They'll cover red flags to watch for in clinical settings, subtle behavioral cues, and how early identification can lead to timely, life-saving intervention.Tune in for a practical, evidence-based conversation to help you spot disordered eating early and support adolescent patients with compassion and confidence.Have a question? Email questions@vcurb.com. Your questions will be answered in week four.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.

Dr. Ravi D. Goel, MD is a board-certified ophthalmologist and cataract surgeon at Regional Eye Associates in Cherry Hill, NJ. He serves as Senior Secretary for Ophthalmic Practice and Trustee of the American Academy of Ophthalmology. A passionate advocate for patient education, he creates ophthalmology and cataract surgery education content at ProtectingSight.com. Dr. Goel is also Chair of the AMA Ophthalmology Section Council and an Instructor at Wills Eye Hospital. His expertise spans ophthalmic innovation and practice management.https://www.seniorcareauthority.com/resources/boomers-today/

The first days, weeks, and months after a baby is born are filled with so many emotions—joy, exhaustion, love, and sometimes, even uncertainty. I've been right there, too, and felt all of them. But in those early moments, something incredibly powerful is happening beneath the surface: your baby is learning how to trust the world through you. It's pretty incredible when you think about it. So we had to learn more about this and the significance of developing a strong bond with our babies. In this episode of Chick Chat, I had the privilege of speaking with Dr. Joanna Parga-Belinkie, a neonatologist, pediatrician, and AAP spokesperson, all about the science and soul of bonding with your baby and why it's critical for our babies' development. Who is Dr. Joanna Parga-Belinkie? Dr. Joanna Parga-Belinkie is an associate professor of pediatrics and a practicing clinical neonatologist at the Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania. She's a trusted voice for parents as a spokesperson for the American Academy of Pediatrics and co-host of their flagship podcast, "Pediatrics On Call." With three kids of her own and years of expertise in newborn medicine, Dr. Joanna bridges the worlds of evidence-based research and real-life parenting in a way that's truly empowering. What Did We Discuss? In this episode, Dr. Joanna and I cover: Dr. Joanna's background and how she became passionate about the emotional bond between parent and baby What bonding really means and why it matters so much What happens when bonding is delayed or doesn't come easily How birth choices (like C-sections, skin-to-skin, or delayed cord clamping) affect bonding Practical ways to build an emotional connection even if it doesn't feel instant Small steps parents can take every day to strengthen attachment Common mistakes that unknowingly interfere with bonding How routines like feeding, sleeping, and responding to cries shape emotional security What the latest science tells us about attachment and long-term child development Sleep training, co-sleeping, and how to decide what works for your family Dr. Joanna's biggest takeaway for new and expecting parents Final Thoughts Whether bonding feels natural or takes more time, the good news that we heard from Dr. Joanna is that attachment isn't a one-time moment. It's a relationship that grows with daily care, presence, and love. Dr. Joanna reminds us that small acts of responsiveness and warmth go a long way in shaping your baby's sense of safety and confidence. It's also reassuring hearing from an experienced baby doctor that you don't have to be perfect as a parent; you just have to keep showing up. We're so grateful to Dr. Joanna for joining us and sharing her expertise and heart with our listeners. You can follow her work through the American Academy of Pediatrics, tune in to her podcast, Pediatrics On Call, and get her book The Baby Bonding Book to learn more. Until next time, remember—your presence and love matter more than anything. You are exactly what your baby needs. Dr. Joanna's Resources Website: JPBelinkieMD.com Instagram: @jopargalinkiemd LinkedIn: @joannaparga Podcast: Pediatrics On Call Book: The Baby Bonding Book: Connecting With Your Newborn Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of The Dr. Joy Kong Podcast, Dr. Joy speaks with Dr. Mike Jamshidi, a naturopathic doctor at Chara Health, about natural, hands-on approaches to pain relief beyond pills and surgery. Dr. Mike shares his journey from healing his own chronic health issues to helping patients address root causes of pain through bodywork, acupuncture, nutrition, and lifestyle changes.They also discuss advanced regenerative treatments like stem cells and exosomes, and Dr. Mike shares powerful stories of patients finding relief from severe conditions. This conversation highlights the power of working with the body's innate healing abilities for deeper, long-lasting recovery.--Additional Resources:Visit My Clinic: Chara Health

This Day in Legal History: Vermont Abolishes Slavery for MenOn July 8, 1777, the Vermont Republic adopted a constitution that became the first in what would eventually become the United States to formally abolish slavery. At the time, Vermont was not yet a state—it was an independent republic formed after declaring independence from both New York and British colonial rule. The new constitution, influenced by Enlightenment principles and revolutionary ideals, declared that “no male person born in this country, or brought from over sea, ought to be held by law, to serve any person, as a servant, slave or apprentice” after the age of 21.This clause effectively outlawed slavery for adult men and set the groundwork for emancipation, although enforcement was inconsistent. Vermont's action was revolutionary, especially considering that slavery remained deeply entrenched in both the southern and northern American colonies. While other Northern states like Pennsylvania and Massachusetts would later take steps toward abolition, Vermont's constitutional ban was a bold and early legal rebuke of human bondage.Despite its symbolic significance, the legal impact was somewhat limited. Vermont did not join the Union until 1791, and historical records indicate that some slavery-like practices may have persisted unofficially. Nevertheless, the 1777 constitution established an early legal precedent for anti-slavery sentiment, showing how legal documents could be used to challenge institutional oppression. The language also hinted at the contradictions between American ideals of liberty and the reality of enslavement.Several major U.S. medical organizations filed a lawsuit on July 7 against Health and Human Services Secretary Robert F. Kennedy Jr. and the HHS, challenging recent changes to federal COVID-19 vaccine policy. The plaintiffs—including the American Academy of Pediatrics and the American College of Physicians—are seeking to overturn Kennedy's directive removing COVID-19 vaccines from the CDC's immunization schedules for children and pregnant women. They argue that the move poses an immediate threat to public health and undermines evidence-based medical policy.The complaint accuses Kennedy of dismantling the federally established vaccine framework that has historically saved millions of lives. Kennedy, a longtime vaccine skeptic, took control of HHS earlier this year and has taken steps to reshape vaccine policy. In addition to altering the immunization schedules, he also dismissed all 17 members of the CDC's independent vaccine advisory committee and replaced them with seven individuals, some of whom have publicly opposed vaccination.Medical groups contend that these actions are not grounded in science and place vulnerable populations at significant risk of preventable diseases. HHS has not yet commented on the lawsuit.Medical groups sue HHS, Kennedy over vaccine policy | ReutersThe Biden administration had extended Temporary Protected Status (TPS) for Hondurans and Nicaraguans in 2023, citing lingering effects of Hurricane Mitch, political instability, and economic hardship. But on July 7, the Department of Homeland Security under President Donald Trump announced it will end those protections effective September 6, 2025, impacting roughly 72,000 Hondurans and 4,000 Nicaraguans. TPS offers deportation relief and work permits to migrants from countries experiencing crisis, but Trump officials argue the program has been overused.Homeland Security Secretary Kristi Noem said both countries have recovered significantly, referencing tourism, real estate, and energy developments. Critics, including Democrats and migrant advocates, say ending TPS will uproot people who have legally lived and worked in the U.S. for decades and may force them to return to dangerous or unstable conditions. The Honduran deputy foreign minister acknowledged the decision wasn't country-specific, but part of a broader rollback of TPS protections.Trump's administration has already targeted TPS designations for migrants from Venezuela, Haiti, Afghanistan, and Cameroon. Legal battles continue over the policy's rollback: while the Supreme Court recently upheld ending TPS for Venezuelans, a federal judge blocked the termination for Haitians just last week.Trump to end deportation protections for thousands of Hondurans and Nicaraguans | ReutersMy column for Bloomberg this week focuses on Maryland's new 3% digital services tax, which took effect on July 1. I argue that while the state's goal of modernizing its tax base is understandable, the execution creates more problems than it solves. Rather than taxing consumption—the standard, more efficient route—Maryland is taxing business inputs like data hosting and web services. This approach violates basic tax principles, potentially stifling investment and driving up operational costs for firms doing business in the state.The administrative burden is uniquely complex. Vendors must determine how much of each service is used in Maryland, secure pre-approval for calculation methods, and issue separate certificates per transaction. No other state requires this, which leaves businesses with a costly choice: build a Maryland-specific tax compliance system, risk penalties, or exit the market entirely. The true burden, then, is not just the 3% rate, but the compliance infrastructure that must be created from scratch.Ultimately, the tax may hurt the very businesses Maryland is counting on for economic growth. Consumers may face higher prices, companies may route around the state, and the tax may collapse under its own administrative weight. I argue that the smarter path forward lies in multistate coordination, where shared definitions and harmonized rules could make enforcement more efficient and less distortionary. Without collaboration, Maryland risks substituting short-term revenue for long-term competitiveness. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.minimumcomp.com/subscribe

Join Kayla Hicks, MD, and Harry DeCabo, AAO-HNS Director for Advocacy, for an essential discussion on advocacy in otolaryngology, exploring why physician and resident engagement in healthcare policy has never been more critical. This episode breaks down the key legislative priorities affecting otolaryngologists and their patients, with a special emphasis on why residents must be active participants in shaping their professional future. Whether you're a resident feeling unsure about advocacy or an established physician wanting to make a difference, this episode demonstrates how otolaryngologists can effectively bridge clinical expertise with legislative decision-making to ensure policies truly serve patients and physicians alike. Resources: ENT Advocacy Network: https://www.entnet.org/the-ent-advocacy-network/  Project 535: https://www.entnet.org/project535  State Tracker Program: https://www.entnet.org/state-trackers  ENT PAC: https://www.entpac.org  More Ways to Listen: Spotify: https://open.spotify.com/show/3UeVLtFdLHDnWnULUPoiin Apple Podcasts: https://podcasts.apple.com/us/podcast/voice-of-otolaryngology/id1506655333   Connect the AAO-HNS: Instagram: https://www.instagram.com/aaohns  X (Twitter): https://x.com/AAOHNS  Facebook: https://www.facebook.com/AAOHNS  LinkedIn: https://www.linkedin.com/company/american-academy-of-otolaryngology/  Website: https://www.entnet.org  Shop AAO-HNS Merchandise: https://www.otostore.org  Help Us Improve Future Episodes: Share your feedback and topic suggestions at https://forms.office.com/r/0XpA83XNBQ  Subscribe to Voices of Otolaryngology for more insights from leading voices in ENT. New episodes released every Tuesday. Note: Contributions to ENT PAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of the American Academy of Otolaryngology–Head and Neck Surgery have the right to refuse to contribution without reprisal. Federal law prohibits ENT PAC from accepting contributions from foreign nationals. By law, if your contributions are made using a personal check or credit card, ENT PAC may use your contribution only to support candidates in federal elections. All corporate contributions to ENT PAC will be used for educational and administrative fees of ENT PAC, and other activities permissible under federal law. Federal law requires ENT PAC use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. ENT PAC is a program of the AAO-HNS which is exempt from federal income tax under section 501 (c) (6) of the Internal Revenue Code.

According to the American Academy of Sleep Medicine (AACM) and the American College of Physicians (ACP), Chronic insomnia occurs when you have trouble falling asleep or staying asleep. In this episode, I discuss Cognitive Behavioral Therapy-Insomnia (CBT-I) and medicines used to treat insomnia. Connect --> https://drmatmonharrell.bio.link/Music provided by PodcastleReferencesCooper, M., & Nelson, L.A. (2025). Better night equals better days: Strategies for effective treatment in chronic insomnia disorder. Pharmcon The Rx Consultant, 34(1). Hosted on Acast. See acast.com/privacy for more information.

Celý díl najdete na našem Patreonu.Letního klidu jsme se rozhodli využít pro nadčasový díl o prezidentství, tak jak ho definovali Václavové Havel & Klaus. Pozvání přijali mluvčí a poradce Václava Havla, Michael Žantovský a prezidentský kancléř Václava Klause, Jiří Weigl. Moderátorskou židli Michala Půra velmi výjimečně obsadil Vladimír Mlynář.Skrze historii jsme se dostali i k velmi aktuálním až ústavním otázkám, zda prezident může odmítnout jmenovat ministry, co má dělat, když má odlišný názor než 90 % společnosti. Probrali jsme i jak technicky funguje chod kanceláře.Dejte nám do komentářů vědět, jak vás díl bavil. Ihned po nahrávání nás napadlo pokračování, které by šlo více v osobní rovině a reflektovalo by zlomové okamžiky vztahu VH a VK. Než se do toho pustíme, zajímá nás, zda o to stojíte.Partnerem podcastu je advokátní kancelář ROWAN LEGAL a provozovatel zdravotnických zařízení PENTA HOSPITALS, American Academy a ARETE Transition Fund pro kvalifikované investory.

Geoff Dyer is the author of the memoir Homework, available from Farrar, Straus, & Giroux.  Dyer's other books include The Last Days of Roger Federer, Out of Sheer Rage, Yoga for People Who Can't Be Bothered to Do It, Zona,See/Saw, and the essay collection Otherwise Known as the Human Condition (winner of a National Book Critics Circle Award for criticism). A fellow of the Royal Society of Literature and a member of the American Academy of Arts and Sciences, Dyer lives in Los Angeles, where he is a writer in residence at the University of Southern California. His books have been translated into twenty-four languages. *** 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. Subscribe to ⁠⁠⁠⁠⁠⁠⁠⁠Brad Listi's email newsletter⁠⁠⁠⁠⁠⁠⁠⁠. ⁠⁠⁠⁠⁠⁠⁠⁠Support the show on Patreon⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Merch⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠  ⁠⁠⁠⁠⁠⁠⁠⁠Bluesky⁠⁠⁠⁠⁠⁠⁠⁠ Email the show: letters [at] otherppl [dot] com The podcast is an ⁠⁠⁠⁠⁠⁠⁠⁠affiliate partner of Bookshop⁠⁠⁠⁠⁠⁠⁠⁠, working to support local, independent bookstores. Learn more about your ad choices. Visit megaphone.fm/adchoices

This Flashback Friday and 10th show is from episode 340, published last Sep 25, 2013. Renowned author, physiologist, evolutionary biologist and bio geographer, Dr. Jared Diamond, joins Jason Hartman for a discussion of his newest book, The World Until Yesterday. Dr. Diamond's unique background has shaped his integrated version of human history. He posits that success – and failure – depends on how well societies adapt to their changing environment. Dr. Diamond is also a medical researcher and professor of physiology at the UCLA School of Medicine. His book "Guns, Germs and Steel" won a Pulitzer Prize and "The Third Chimpanzee" was a best-selling award winner. Elected to the American Academy of Arts and Sciences, the National Academy of Sciences and the American Philosophical Society, Professor Diamond is a MacArthur Fellow who has published over 200 articles in Discover, Natural History, Nature and Geo magazines. In his books Guns, Germs and Steel and Collapse (and the popular PBS and National Geographic documentaries they inspired), big-picture scholar Jared Diamond explores civilizations and why they all seem to fall. Now in his latest book, The World Until Yesterday, Diamond examines the traditional societies of New Guinea -- and discovers that modern civilization is only our latest solution to survival.     Follow Jason on TWITTER, INSTAGRAM & LINKEDIN Twitter.com/JasonHartmanROI Instagram.com/jasonhartman1/ Linkedin.com/in/jasonhartmaninvestor/ Call our Investment Counselors at: 1-800-HARTMAN (US) or visit: https://www.jasonhartman.com/ Free Class:  Easily get up to $250,000 in funding for real estate, business or anything else: http://JasonHartman.com/Fund CYA Protect Your Assets, Save Taxes & Estate Planning: http://JasonHartman.com/Protect Get wholesale real estate deals for investment or build a great business – Free Course: https://www.jasonhartman.com/deals Special Offer from Ron LeGrand: https://JasonHartman.com/Ron Free Mini-Book on Pandemic Investing: https://www.PandemicInvesting.com  

Dr. Thomas A. Tweed, who did his graduate study at Harvard and Stanford, is the Harold and Martha Welch Professor of American Studies and Professor of History at Notre Dame University. Dr. Tweed served as president of the American Academy of Religion in 2015, the largest learned society for the study of religion. He is the author of many books, including his more recent: Religion in the Lands That Became America: A New History (Yale University Press) Learn more about your ad choices. Visit megaphone.fm/adchoices

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 700 awesome, curious, kind, funny, brilliant, generous souls Karen Elliott House is a senior fellow at Harvard Kennedy School's Belfer Center for Science and International Affairs. Elliott House retired in 2006 as publisher of The Wall Street Journal, senior vice president of Dow Jones & Company, and a member of the company's executive committee.  She is a broadly experienced business executive with particular expertise and experience in international affairs stemming from a distinguished career as a Pulitzer Prize winning reporter and editor. She is author of On Saudi Arabia: Its People, Past, Religion, Fault Lines—and Future, published in September 2012 by Knopf. During a 32-year career with Dow Jones and The Wall Street Journal, Elliott House also served as foreign editor, diplomatic correspondent, and energy correspondent based in Washington D.C.  Her journalism awards include a Pulitzer Prize for international reporting for coverage of the Middle East (1984), two Overseas Press Club awards for coverage of the Middle East and of Islam and the Edwin M. Hood award for Excellence in Diplomatic Reporting for a series on Saudi Arabia (1982). In both her news and business roles, she traveled widely over many years and interviewed world leaders including Saddam Hussein, Lee Kwan Yew,  Zhu Rongji, Vladimir Putin, Shimon Peres, Benjamin Natanyahu, Saudi King Abdullah, Hosni Mubarak, Margaret Thatcher, Richard Nixon, Helmut Kohl, George H.W. Bush, the late King Hussein and Yasser Arafat. She  has appeared frequently on television over the past three decades as an executive of the Wall Street Journal and as an expert on international relations. Elliott House has served and continues to serve on multiple non-profit boards including the Rand Corp., where she is chairman of the board, the Trilateral Commission, the Council on Foreign Relations, the Asia Society, the German-American Council, and Boston University.  She also is a member of the advisory board of the College of Communication at the University of Texas. She is a graduate of the University of Texas at Austin where in 1996 she was the recipient of the University's “Distinguished Alumnus” award.  She studied and taught at Harvard University's Institute of Politics and she holds honorary degrees from Pepperdine University (2013), Boston University (2003) and Lafayette College (1992).  She also is a fellow of the American Academy of Arts and Sciences.

Today, we're continuing our exploration of the fascinating intersection between positive psychology and travel and I couldn't be more excited to have one of the leading minds in the field with us.  Shige Oishi is a Professor of Psychology at the University of Chicago, an elected member of the American Academy of Arts and Sciences, and one of the most cited psychologists in the world. With over 200 journal articles and books to his name — including his latest book, Life in Three Dimensions — Shige has spent decades researching happiness, meaning, and cultural influences on well-being. In today's episode, we unpack what psychological richness really means, how it differs from happiness and meaning, and how travel is one of the very best ways tap into this powerful dimension of life.  If you've ever felt that travel enriches your life in unexpected ways, this episode is for you. So sit back, relax, and get ready to dive into the world of curiosity and perspective shifts with one of the foremost experts on the subject.  Let's dive in!  Learn more at www.luxtravelinsider.com   Connect with me on Social: Instagram LinkedIn  

Dr. Steven Flanagan, a nationally renowned expert in the field of traumatic brain injury (TBI), has worked at the Rusk Rehabilitation Institute at NYU Langone Health since 2008. He serves as the Howard A. Rusk Professor of Rehabilitation Medicine and Chairperson of the Department of Rehabilitation Medicine at NYU Grossman School of Medicine. A former President of the American Academy of Physical Medicine & Rehabilitation (PM&R), he is certified by the American Board of PM&R (Brain Injury Medicine). A graduate of the University of Medicine & Dentistry of New Jersey, he completed his medical residency at Mt. Sinai Medical Center/Cabrini, Rehabilitation. Part 2 The discussion covered the following topics: Rusk's interprofessional approach to patient care, future hiring needs, health promotion efforts to enhance health of staff, preparing Rusk residents for the future in health care, and putting patients first.  

In this episode, I'm talking with pediatrician and author Ken Ginsburg about his new book Lighthouse Parenting. Ken shares his powerful framework for showing up as a steady, loving guide for our kids—offering both support and boundaries as they grow. We get into what it means to really know and prepare our kids, how to be their safe harbor in tough times, and why our own self-care matters just as much as theirs, especially in today's world of social media and constant pressure. About Dr. Ken Ginsburg Dr. Ken Ginsburg practices Adolescent Medicine at The Children's Hospital of Philadelphia and is a Professor of Pediatrics at the University of Pennsylvania School of Medicine. Dr. Ginsburg practices social adolescent medicine – service with special attention to prevention and the recognition that social context and stressors affect both physical and emotional health. His research over the last 35 years has focused on facilitating youth to develop their own solutions to social problems and to teach adults how to better serve them. He is the Founding Director of The Center for Parent and Teen Communications which works to empower parents with the skill-sets to strengthen their family connections and position them to guide their teens to become their best selves. It works to shift the cultural narrative about adolescence from being a time to survive to one in which development is to be optimized. His books include, Building Resilience in Children and Teens: Giving Kids Roots and Wings; Congrats- You're Having a Teen!: Strengthen Your Family and Raise a Good Person; and Lighthouse Parenting:Raising your Child with Loving Guidance for an Enduring Bond. All of these works are published by The American Academy of Pediatrics. He currently works with Covenant House International's 35 sites to solidify and magnify their practice model rooted in the healing power of loving and respectful adult connections with youth. Things you'll learn from this episode What “lighthouse parenting” is and how it offers a research-backed framework for guiding kids to grow up as resilient, thriving adults What it means to be a “secure base” for our kids and the power of stability in fostering resilience in all children Why preparing kids for life's challenges starts with feeling unconditionally loved and truly known Why self-care, authentic modeling, and genuine repair are essential for strong parent-child relationships What it means to “actively see the best in our child” and why it matters  Resources mentioned About Dr. Ken Ginsburg Center for Parent and Teen Communication Fostering Resilience Lighthouse Parenting: Raising your Child with Loving Guidance for an Enduring Bond by Dr. Ken Ginsburg Congrats—You're Having a Teen! Strengthen Your Family and Raise a Good Person by Dr. Ken Ginsburg Building Resilience in Children and Teens: Giving Kids Roots and Wings by Dr. Ken Ginsburg Dr. Devorah Heitner on Helping Kids Thrive in a Digital World (Tilt Parenting Podcast) Dr. Devorah Heitner on Parenting Kids Growing Up in Public (Tilt Parenting Podcast) Learn more about your ad choices. Visit podcastchoices.com/adchoices