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In this conversation, Keltie Maguire speaks with Professor of Pyschology, Dr. Jennifer Watling Neal about her research on childfree adults. They explore... The growing demographic of individuals who choose not to have children, including the unique needs of this population, and the societal perceptions surrounding childfree lifestyles. Stereotypes and myths surrounding childfree individuals, and the societal pressures that often accompany these choices. Insights from Jenna's research, including the life satisfaction levels of childfree people, and the various reasons individuals choose not to have children. As mentioned in the show: Find Jenna online at jennawneal.com and thechildfree.org Find Jenna on Bluesky: @jennawneal.bsky.social Instagram: @jennawneal Find information about pioneering researcher Amy Blackstone here: amyblackstonephd.com/childfreebychoice About Jennifer: Dr. Jennifer Watling Neal is a Professor of Psychology at Michigan State University. Her research uses large scale demographic data to understand the prevalence, characteristics, and experiences of childfree adults (adults who do not have and do not want kids) in the United States and other countries. She also researches social networks in educational contexts. She's authored 90 peer-reviewed papers, and her work is published in scholarly journals such as Scientific Reports, Developmental Psychology, and American Journal of Community Psychology. She has been a guest on several past podcasts including the American Psychological Association's Speaking of Psychology hosted by Kim Mills and The Overpopulation Podcast hosted by Nandita Bajaj and Alan Ware. ___ Want to explore how we can work together 1-on-1? Book a free discovery call here. Find my 1-on-1 coaching offers at kidsorchildfree.com/coaching Check out our free resources here, or at kidsorchildfree.com/free-resources And don't forget to subscribe, rate, and review The Kids or Childfree Podcast if you love what you're hearing! You can leave a rating and review on Apple Podcasts, or a rating on Spotify. Find us online at www.kidsorchildfree.com. Instagram: www.instagram.com/kidsorchildfree
Defense Secretary Hegseth Declares US Military No Longer A “Globalist” Institution
The ketogenic (keto) diet has surged in popularity, with many touting its weight loss and metabolic benefits. However, some individuals—particularly those following a low-carb, high-fat regimen—experience a significant rise in LDL cholesterol, a phenomenon now known as the Lean Mass Hyper-Responder (LMHR) phenotype. What does this mean for cardiovascular risk? In this episode, Chadi is joined by three of the lead investigators of the KETO-CTA study, recently published in The American Journal of Clinical Nutrition. They break down their findings on how the keto diet affects coronary plaque formation and what it could mean for LMHR individuals. This is Part 1 of a two-part series. Next week, Chadi brings in a contrasting perspective on the study's conclusions. A must-listen series for anyone interested in the intersection of diet, cholesterol, and cardiovascular health. View the KETO-CTA study. https://www.sciencedirect.com/science/article/pii/S2772963X25001036 Check out Chadi's website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on YouTube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA
We've been focusing on the dynamics of democratic backsliding in the United States and beyond. In this episode of Postscript: Conversations on Politics and Political Science, Susan talks the co-founder and co-director of the Democratic Erosion Consortium, Dr. Robert Blair about how the Consortium offers FREE resources to teachers, students, journalists, policy makers, and any interested person – including shared syllabus, readings, assignments, YouTube virtual roundtables, and policy briefs. Rob defines democratic erosion and offers critical insights on the importance of interdisciplinarity, calibrating outrage, and distinguishing between policy disputes and the erosion of democracy. He offers a clear-headed analysis of what is legal v. what breaks down democracy that is not to be missed. We conclude with thoughts on what everyone can do protect democracy. Dr. Robert Blair is Associate Professor of Political Science and International and Public Affairs at Brown University and co-founder and co-director of the Democratic Erosion Consortium. He studies the consolidation of state authority after civil war, with an emphasis on rule of law and security institutions, as well as the causes and consequences of democratic backsliding. His book, Peacekeeping, Policing, and the Rule of Law after Civil War, was published in 2020 with Cambridge University Press and his articles appear in political science outlets such as American Political Science Review, American Journal of Political Science, Journal of Politics, Comparative Political Studies, and International Organization but also science journals such as Science, Nature Human Behaviour, or Current Opinion in Psychology. Mentioned: Inside Higher Ed piece on grants terminated by the Trump administration, including one that funded the Democratic Erosion Consortium “An Events-Based Approach to Understanding Democratic Erosion,” P/S Political Science & Politics by Rob, Hannah Baron, Jessica Gottlieb, and Laura Paler summarizes their data collection efforts on democratic backsliding A special issue of P/S Political Science & Politics on the study of democratic backsliding An academic article on combatting misinformation from Current Opinion in Psychology by Rob, Jessica Gottlieb, Brendan Nyhan, Laura Paler, Pablo Argote, and Charlene J. Stainfield Democratic Erosion Project website and data set Chris Geidner, Law Dork: Supreme Court, Law, Politics, and More Substack Center for Systemic Peace's Polity Project coding authority characteristics of states in the world system University of Notre Dame's V-Dem Project measuring democracy Rob mentioned Brazil as a fruitful comparison for the US. He is particularly focused on how the courts can defend democratic institutions and processes – and how hard it can be to know where to draw the line between courts protecting vs. assailing democracy, and to know when the line has been crossed. Two gift articles from The New York Times here and here. Contact info for Rob: robert_blair@brown.edu Follow Rob and Democratic Erosion Consortium on social media: @robert_a_blair on X, @DemErosionDEC on X, @robertblair.bsky.social on BlueSky, @demerosiondec.bsky.social on BlueSky Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network
In this episode, we dive into a study from the American Journal of Veterinary Research exploring how dogs adapt their gait after pelvic limb amputation. Discover how changes in limb loading, joint motion, and spinal movement help amputee dogs maintain stability and efficiency. Bookmark the Vet Rehab Summit: https://vetrehabsummit.com/ Learn more about Paw Prosper's special offer: https://pawprosper.com/OPH Learn more about Paw Prosper: https://pawprosper.com/ To learn about Onlinepethealth, watch a free webinar, or join any of our Facebook groups, click here: https://onlinepethealth.com/podcast
ÄR DU NYTER LILLE VÄN? Vi tar ett nappatag med en trevlig lyssnarfråga innan vi återigen dunkar huvudet i ekträ. Roger Melander, master distiller på High Coast är vår ek-ciceron och läser årsringarna av oss så löven rasslar. Men dagens tips är en attack on the whiskyskåp. Pigg och nyter – nyter är glad minsann! Kolla här bara: https://www.saob.se/artikel/?seek=nyter Hur hålla provningar, hur många flaskor? Tack för bra fråga Simon. Attack on the whiskyskåp som koncept anbefalles! High Coasts master distiller Roger Melander fortsätter jiddra om ek… Vi kör på samma gamla länkar när det gäller ek: Conner, John, ”Maturation”, i Russell, Stewart & Kellershohn, red., Whisky and other spirits: Technology, production and marketing, 3 uppl. (London: Academic Press, 2022), s. 291–311. Conner, John, Alistair Paterson & John R. Piggott, ”Analysis of lignin from oak casks used for the maturation of Scotch whisky”, Journal of the Science of Food and Agriculture 60 (1992), s. 349–353. Derbidge, Andrew, ”The complete guide to oak, casks, & whisky maturation”, 7/1 2022, https://www.whiskyandwisdom.com/complete-guide-to-oak-casks-and-whisky-maturation/ Gollihue, Jarrad, Victoria G. Pook & Seth DeBolt, ”Sources of variation in bourbon whiskey barrels: a review”, Journal of the Institute of Brewing 127 (2021), s. 210–223: https://onlinelibrary.wiley.com/doi/full/10.1002/jib.660 [Lüning, Horst], ”Maturation in Casks”, odaterad text, https://www.whisky.com/information/knowledge/production/details/maturation-in-casks.html Reazin, George H., ”Chemical mechanisms of whiskey maturation”, American Journal of Enology and Viticulture 32 (1981), s. 282–289. Strengell, Teemu, ”Oak species”, 30/1 2011, http://whiskyscience.blogspot.se/2011/01/oak-species_30.html Strengell, ”Oaky flavours”, 15/2 2011, http://whiskyscience.blogspot.se/2011/02/oaky-flavours.html OCH NEJ ALL WHISKY ÄR FAN I MIG INTE DUBBELDESTILLERAD MATHIAS Här når du oss: En trea whisky på Facebook (https://www.facebook.com/entreawhisky) Maila till oss på hej@entreawhisky.se Davids blogg tjederswhisky.se (https://www.tjederswhisky.se) Följ oss på Instagram: https://www.instagram.com/entreawhisky Bli medlem! https://entreawhisky.memberful.com/checkout?plan=74960
Biden's Cancer Diagnosis Announced Just As GOP Launches Autopen Investigation & Embarrassing Special Counsel Hur Audio Released
We've been focusing on the dynamics of democratic backsliding in the United States and beyond. In this episode of Postscript: Conversations on Politics and Political Science, Susan talks the co-founder and co-director of the Democratic Erosion Consortium, Dr. Robert Blair about how the Consortium offers FREE resources to teachers, students, journalists, policy makers, and any interested person – including shared syllabus, readings, assignments, YouTube virtual roundtables, and policy briefs. Rob defines democratic erosion and offers critical insights on the importance of interdisciplinarity, calibrating outrage, and distinguishing between policy disputes and the erosion of democracy. He offers a clear-headed analysis of what is legal v. what breaks down democracy that is not to be missed. We conclude with thoughts on what everyone can do protect democracy. Dr. Robert Blair is Associate Professor of Political Science and International and Public Affairs at Brown University and co-founder and co-director of the Democratic Erosion Consortium. He studies the consolidation of state authority after civil war, with an emphasis on rule of law and security institutions, as well as the causes and consequences of democratic backsliding. His book, Peacekeeping, Policing, and the Rule of Law after Civil War, was published in 2020 with Cambridge University Press and his articles appear in political science outlets such as American Political Science Review, American Journal of Political Science, Journal of Politics, Comparative Political Studies, and International Organization but also science journals such as Science, Nature Human Behaviour, or Current Opinion in Psychology. Mentioned: Inside Higher Ed piece on grants terminated by the Trump administration, including one that funded the Democratic Erosion Consortium “An Events-Based Approach to Understanding Democratic Erosion,” P/S Political Science & Politics by Rob, Hannah Baron, Jessica Gottlieb, and Laura Paler summarizes their data collection efforts on democratic backsliding A special issue of P/S Political Science & Politics on the study of democratic backsliding An academic article on combatting misinformation from Current Opinion in Psychology by Rob, Jessica Gottlieb, Brendan Nyhan, Laura Paler, Pablo Argote, and Charlene J. Stainfield Democratic Erosion Project website and data set Chris Geidner, Law Dork: Supreme Court, Law, Politics, and More Substack Center for Systemic Peace's Polity Project coding authority characteristics of states in the world system University of Notre Dame's V-Dem Project measuring democracy Rob mentioned Brazil as a fruitful comparison for the US. He is particularly focused on how the courts can defend democratic institutions and processes – and how hard it can be to know where to draw the line between courts protecting vs. assailing democracy, and to know when the line has been crossed. Two gift articles from The New York Times here and here. Contact info for Rob: robert_blair@brown.edu Follow Rob and Democratic Erosion Consortium on social media: @robert_a_blair on X, @DemErosionDEC on X, @robertblair.bsky.social on BlueSky, @demerosiondec.bsky.social on BlueSky Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/political-science
Deep State Kingpin James Comey Walks Back “8647” Threat Directed At President Trump After MASSIVE Backlash
Iran Ready For Nuclear Deal, Buckles To Trump By Offering Concessions If Tariffs & Sanctions Dropped
Trump Bans Reuters, AP & Bloomberg From Air Force One To Limit Deep State Intel Agency Spying
Trump Arrives In Saudi Arabia To Secure MAJOR Investments, May Personally Attend Ukraine-Russia Peace Talks In Turkey Thursday
YOUR BIRTH, GOD’S WAY - Christian Pregnancy, Natural Birth, Postpartum, Breastfeeding Help
SHOW NOTES: Many women who want to labor naturally want to know if waterbirth is a safe option for them. I thought I had dealt with this topic in the past, but apparently I hadn't so today I'm doing that while covering this systemic review from the American Journal of Obstetrics and Gynecology. In this episode you will learn: Is water birth safe? What is water birth? Who is a good candidate to have a waterbirth? Who is not a good candidate to have a waterbirth?? Link to article - https://www.ajog.org/article/S0002-9378(23)00604-X/fulltext Helpful Links: — BIBLE STUDY - FREE Bible Study Course - How To Be Sure Of Your Salvation - https://the-ruffled-mango-school.teachable.com/p/how-to-be-sure-of-your-salvation -- COACHING - If you're tired of shallow, cheap, meaningless connections in pregnancy that leave you feeling passed over and confused, The REAL DEAL Transformative Coaching might be for you. If you're ready to invest in coaching that will bring REAL results and REAL change, not only now but for the future of your family and your children's families, let's talk about how this 1-on-1 coaching might be just what you've been looking for! Go here to learn more - https://go.yourbirthgodsway.com/coachinginterest — CHRISTIAN CHILDBIRTH EDUCATION - Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course! This is a COMPLETE childbirth education course with a God-led foundation taught by a certified nurse-midwife with over 20 years of experience in all sides of the maternity world! - https://go.yourbirthgodsway.com/cec — HOME BIRTH PREP - Having a home birth and need help getting prepared? Sign up HERE for the Home Birth Prep Course. — homebirthprep.com — GET HEALTHY - Sign up here to be the first to know about the new Women's Wellness Program coming from Lori SOON! https://go.yourbirthgodsway.com/yourhealth — MERCH - Get Christian pregnancy and birth merch HERE - https://go.yourbirthgodsway.com/store — RESOURCES & LINKS - All of Lori's Recommended Resources HERE - https://go.yourbirthgodsway.com/resources Sign up for email updates Here Be heard! Take My Quick SURVEY to give input on future episodes you want to hear -- https://bit.ly/yourbirthsurvey Got questions? Email lori@yourbirthgodsway.com Social Media Links: Follow Your Birth, God's Way on Instagram! @yourbirth_godsway Follow the Your Birth, God's Way Facebook Page! facebook.com/lorimorriscnm Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway Learn more about Lori and the podcast at go.yourbirthgodsway.com! DISCLAIMER: Remember that though I am a midwife, I am not YOUR midwife. Nothing in this podcast shall; be construed as medical advice. Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate. You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care. Talk with your own care provider before putting any information here into practice. Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed. I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices. Some links may be affiliate links which provide me a small commission when you purchase through them. This does not cost you anything at all and it allows me to continue providing you with the content you love.
On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Larragem Raines, MS, director of research at the Center for Innovation & Value Research, about her organization's open-source value model for major depressive disorder (MDD). She also defines dynamic pricing and explains how it is incorporated into the MDD value model, topics she expands upon in a recent contributor article. Looking ahead, Raines discusses the potential of artificial intelligence (AI) to improve diagnosis, treatment, and access in the MDD space.
New Trump EO Reduces Drug Prices By 30% To 80%, Americans Will Pay Same Price As Countries That Pay Lowest Price! Plus, Russia, Ukraine Exchange Large-Scale Drone Fire Despite Plan For Istanbul Peace Talks
In this episode, we are speaking with Professor Scott Duxbury about his work on group politics and the sociology of punishment. Scott W. Duxbury is an Associate Professor of sociology at the University of North Carolina at Chapel Hill. His research examines social networks, criminal law, mass incarceration, racism, public opinion, drug markets, and computational methods. His work has appeared in American Sociological Review, American Journal of Sociology, and Social Forces, among other outlets.
Hello Interactors,This week, I've been reflecting on the themes of my last few essays — along with a pile of research that's been oddly in sync. Transit planning. Neuroscience. Happiness studies. Complexity theory. Strange mix, but it keeps pointing to the same thing: cities aren't just struggling with transportation or housing. They're struggling with connection. With meaning. With the simple question: what kind of happiness should a city make possible? And why don't we ask that more often?STRANGERS SHUNNED, SYSTEMS SIMULATEDThe urban century was supposed to bring us together. Denser cities, faster mobility, more connected lives — these were the promises of global urbanization. Yet in the shadow of those promises, a different kind of city has emerged in America with growing undertones elsewhere: one that increasingly seeks to eliminate the stranger, bypass friction, and privatize interaction.Whether through algorithmically optimized ride-sharing, private tunnels built to evade street life, or digital maps simulating place without presence for autonomous vehicles, a growing set of design logics work to render other people — especially unknown others — invisible, irrelevant, or avoidable.I admit, I too can get seduced by this comfort, technology, and efficiency. But cities aren't just systems of movement — they're systems of meaning. Space is never neutral; it's shaped by power and shapes behavior in return. This isn't new. Ancient cities like Teotihuacan (tay-oh-tee-wah-KAHN) in central Mexico, once one of the largest cities in the world, aligned their streets and pyramids with the stars. Chang'an (chahng-AHN), the capital of Tang Dynasty China, used strict cardinal grids and walled compounds to reflect Confucian ideals of order and hierarchy. And Uruk (OO-rook), in ancient Mesopotamia, organized civic life around temple complexes that stood at the spiritual and administrative heart of the city.These weren't just settlements — they were spatial arguments about how people should live together, and who should lead. Even Middle Eastern souks and hammams were more than markets or baths; they were civic infrastructure. Whether through temples or bus stops, the question is the same: What kind of social behavior is this space asking of us?Neuroscience points to answers. As Shane O'Mara argues, walking is not just transport — it's neurocognitive infrastructure. The hippocampus, which governs memory, orientation, and mood, activates when we move through physical space. Walking among others, perceiving spontaneous interactions, and attending to environmental cues strengthens our cognitive maps and emotional regulation.This makes city oriented around ‘stranger danger' not just unjust — but indeed dangerous. Because to eliminate friction is to undermine emergence — not only in the social sense, but in the economic and cultural ones too. Cities thrive on weak ties, on happenstance, on proximity without intention. Mark Granovetter's landmark paper, The Strength of Weak Ties, showed that it's those looser, peripheral relationships — not our inner circles — that drive opportunity, creativity, and mobility. Karl Polanyi called it embeddedness: the idea that markets don't float in space, they're grounded in the social fabric around them.You see it too in scale theory — in the work of Geoffrey West and Luís Bettencourt — where the productive and innovative energy of cities scales with density, interaction, and diversity. When you flatten all that into private tunnels and algorithmic efficiency, you don't just lose the texture — you lose the conditions for invention.As David Roberts, a climate and policy journalist known for his systems thinking and sharp urban critiques, puts it: this is “the anti-social dream of elite urbanism” — a vision where you never have to share space with anyone not like you. In conversation with him, Jarrett Walker, a transit planner and theorist who's spent decades helping cities design equitable bus networks, also pushes back against this logic. He warns that when cities build transit around avoidance — individualized rides, privatized tunnels, algorithmic sorting — they aren't just solving inefficiencies. They're hollowing out the very thing that makes transit (and cities) valuable and also public: the shared experience of strangers moving together.The question isn't just whether cities are efficient — but what kind of social beings they help us become. If we build cities to avoid each other, we shouldn't be surprised when they crumble as we all forget how to live together.COVERAGE, CARE, AND CIVIC CALMIf you follow urban and transit planning debates long enough, you'll hear the same argument come up again and again: Should we focus on ridership or coverage? High-frequency routes where lots of people travel, or wide access for people who live farther out — even if fewer use the service? For transit nerds, it's a policy question. For everyone else, it's about dignity.As Walker puts it, coverage isn't about efficiency — it's about “a sense of fairness.” It's about living in a place where your city hasn't written you off because you're not profitable to serve. Walker's point is that coverage isn't charity. It's a public good, one that tells people: You belong here.That same logic shows up in more surprising places — like the World Happiness Report. Year after year, Finland lands at the top. But as writer Molly Young found during her visit to Helsinki, Finnish “happiness” isn't about joy or euphoria. It's about something steadier: trust, safety, and institutional calm. What the report measures is evaluative happiness — how satisfied people are with their lives over time — not affective happiness, which is more about momentary joy or emotional highs.There's a Finnish word that captures this. It the feeling you get after a sauna: saunanjälkeinen raukeus (SOW-nahn-yell-kay-nen ROW-keh-oos) — the softened, slowed state of the body and mind. That's what cities like Helsinki seem to deliver: not bliss, but a stable, low-friction kind of contentment. And while that may lack sparkle, it makes people feel held.And infrastructure plays a big role. In Helsinki, the signs in the library don't say “Be Quiet.” They say, “Please let others work in peace.” It's a small thing, but it speaks volumes — less about control, more about shared responsibility. There are saunas in government buildings. Parents leave their babies sleeping in strollers outside cafés. Transit is clean, quiet, and frequent. As Young puts it, these aren't luxuries — they're part of a “bone-deep sense of trust” the city builds and reinforces. Not enforced from above, but sustained by expectation, habit, and care.My family once joined an organized walking tour of Copenhagen. The guide, who was from Spain, pointed to a clock in a town square and said, almost in passing, “The government has always made sure this clock runs on time — even during war.” It wasn't just about punctuality. It was about trust. About the quiet promise that the public realm would still hold, even when everything else felt uncertain. This, our guide noted from his Spanish perspective, is what what make Scandinavians so-called ‘happy'. They feel held.Studies show that most of what boosts long-term happiness isn't about dopamine hits — it's about relational trust. Feeling safe. Feeling seen. Knowing you won't be stranded if you don't have a car or a credit card. Knowing the city works, even if you don't make it work for you.In this way, transit frequency and subtle signs in Helsinki are doing the same thing. They're shaping behavior and reinforcing social norms. They're saying: we share space here. Don't be loud. Don't cut in line. Don't treat public space like it's only for you.That kind of city can't be built on metrics alone. It needs moral imagination — the kind that sees coverage, access, and slowness as features, not bugs. That's not some socialist's idea of utopia. It's just thoughtful. Built into the culture, yes, but also the design.But sometimes we're just stuck with whatever design is already in place. Even if it's not so thoughtful. Economists and social theorists have long used the concept of path dependence to explain why some systems — cities, institutions, even technologies — get stuck. The idea dates back to work in economics and political science in the 1980s, where it was used to show how early decisions, even small ones, can lock in patterns that are hard to reverse.Once you've laid train tracks, built freeways, zoned for single-family homes — you've shaped what comes next. Changing course isn't impossible, but it's costly, slow, and politically messy. The QWERTY keyboard is a textbook example: not the most efficient layout, but one that stuck because switching systems later would be harder than just adapting to what we've got.Urban scholars Michael Storper and Allen Scott brought this thinking into city studies. They've shown how economic geography and institutional inertia shape urban outcomes — how past planning decisions, labor markets, and infrastructure investments limit the options cities have today. If your city bet on car-centric growth decades ago, you're probably still paying for that decision, even if pivoting is palatable to the public.CONNECTIONS, COMPLEXITY, CITIES THAT CAREThere's a quote often attributed to Stephen Hawking that's made the rounds in complexity science circles: “The 21st century will be the century of complexity.” No one's entirely sure where he said it — it shows up in systems theory blogs, talks, and books — but it sticks. Probably because it feels true.If the last century was about physics — closed systems, force, motion, precision — then this one is about what happens when the pieces won't stay still. When the rules change mid-game. When causes ripple back as consequences. In other words: cities.Planners have tried to tame that complexity in all kinds of ways. Grids. Zoning codes. Dashboards. There's long been a kind of “physics envy” in both planning and economics — a belief that if we just had the right model, the right inputs, we could predict and control the city like a closed system. As a result, for much of the 20th century, cities were designed like machines — optimized for flow, separation, and predictability.But even the pushback followed a logic of control — cul-de-sacs and suburban pastoralism — wasn't a turn toward organic life or spontaneity. It was just a softer kind of order: winding roads and whispered rules meant to keep things calm, clean, and contained…and mostly white and moderately wealthy.If you think of cities like machines, it makes sense to want control. More data, tighter optimization, fewer surprises. That's how you'd tune an engine or write software. But cities aren't machines. They're messy, layered, and full of people doing unpredictable things. They're more like ecosystems — or weather patterns — than they are a carburetor. And that's where complexity science becomes useful.People like Paul Cilliers and Brian Castellani have argued for a more critical kind of complexity science — one that sees cities not just as networks or algorithms, but as places shaped by values, power, and conflict. Cilliers emphasized that complex systems, like cities, are open and dynamic: they don't have fixed boundaries, they adapt constantly, and they respond to feedback in ways no planner can fully predict. Castellani extends this by insisting that complexity isn't just technical — it's ethical. It demands we ask: Who benefits from a system's design? Who has room to adapt, and who gets constrained? In this view, small interventions — a zoning tweak, a route change — can set off ripple effects that reshape how people move, connect, and belong. A new path dependence.This is why certainty is dangerous in urban design. It breeds overconfidence. Humility is a better place to start. As Jarrett Walker puts it, “there are all kinds of ways to fake your way through this.” Agencies often adopt feel-good mission statements like “compete with the automobile by providing access for all” — which, he notes, is like “telling your taxi driver to turn left and right at the same time.” You can't do both. Not on a fixed budget.Walker pushes agencies to be honest: if you want to prioritize ridership, say so. If you want to prioritize broad geographic coverage, that's also valid — but know it will mean lower ridership. The key is not pretending you can have both at full strength. He says, “What I want is for board members… to make this decision consciously and not be surprised by the consequences”.These decisions matter. A budget cut can push riders off buses, which then leads to reduced service, which leads to more riders leaving — a feedback loop. On the flip side, small improvements — like better lighting, a public bench, a frequent bus — can set off positive loops too. Change emerges, often sideways.That means thinking about transit not just as a system of movement, but as a relational space. Same with libraries, parks, and sidewalks. These aren't neutral containers. They're environments that either support or suppress human connection. If you design a city to eliminate friction, you eliminate chance encounters — the stuff social trust is made of.I'm an introvert. I like quiet. I recharge alone. But I also live in a city — and I've learned that even for people like me, being around others still matters. Not in the chatty, get-to-know-your-neighbors way. But in the background hum of life around you. Sitting on a bus. Browsing in a bookstore. Walking down a street full of strangers, knowing you don't have to engage — but you're not invisible either.There's a name for this. Psychologists call it public solitude or sometimes energized privacy — the comfort of being alone among others. Not isolated, not exposed. Just held, lightly, in the weave of the crowd. And the research backs it up: introverts often seek out public spaces like cafés, libraries, or parks not to interact, but to feel present — connected without pressure.In the longest-running happiness study ever done, 80 years, Harvard psychologist Robert Waldinger found that strong relationships — not income, not status — were the best predictor of long-term well-being. More recently, studies have shown that even brief interactions with strangers — on a bus, in a coffee shop — can lift mood and reduce loneliness. But here's the catch: cities have to make those interactions possible.Or they don't.And that's the real test of infrastructure. We've spent decades designing systems to move people through. Fast. Clean. Efficient. But we've neglected the quiet spaces that let people just be. Sidewalks you're not rushed off of. Streets where kids can safely bike or play…or simply cross the street.Even pools — maybe especially pools. My wife runs a nonprofit called SplashForward that's working to build more public pools. Not just for fitness, but because pools are public space. You float next to people you may never talk to. And still, you're sharing something. Space. Water. Time.You see this clearly in places like Finland and Iceland, where pools and saunas are built into the rhythms of public life. They're not luxuries — they're civic necessities. People show up quietly, day after day, not to socialize loudly, but to be alone together. As one Finnish local told journalist Molly Young, “During this time, we don't have... colors.” It was about the long gray winter, sure — but also something deeper: a culture that values calm over spectacle. Stability over spark. A kind of contentment that doesn't perform.But cities don't have to choose between quiet and joy. We don't have to model every system on Helsinki in February. There's something beautiful in the American kind of happiness too — the loud, weird, spontaneous moments that erupt in public. The band on the subway. The dance party in the park. The loud kid at the pool. That kind of energy can be a nuisance, but it can also be joyful.Even Jarrett Walker, who's clear-eyed about transit, doesn't pretend it solves everything. Transit isn't always the answer. Sometimes a car is the right tool. What matters is whether everyone has a real choice — not just those with money or proximity or privilege. And he's quick to admit every city with effective transit has its local grievances.So no, I'm not arguing for perfection, or even socialism. I'm arguing for a city that knows how to hold difference. Fast and slow. Dense and quiet. A city that lets you step into the crowd, or sit at its edge, and still feel like you belong. A place to comfortably sit with the uncertainty of this great transformation emerging around us. Alone and together.REFERENCESCastellani, B. (2014). Complexity theory and the social sciences: The state of the art. Routledge.Cilliers, P. (1998). Complexity and postmodernism: Understanding complex systems. Routledge.David, P. A. (1985). Clio and the economics of QWERTY. The American Economic Review.Granovetter, M. (1973). The strength of weak ties. American Journal of Sociology.Hawking, S. (n.d.). The 21st century will be the century of complexity. [Attributed quote; primary source unavailable].O'Mara, S. (2019). In praise of walking: A new scientific exploration. W. W. Norton & Company.Roberts, D. (Host). (2025). Jarrett Walker on what makes good transit [Audio podcast episode]. In Volts.Storper, M., & Scott, A. J. (2016). Current debates in urban theory: A critical assessment. Urban Studies.Waldinger, R., & Schulz, M. (2023). The good life: Lessons from the world's longest scientific study of happiness. Simon & Schuster.Walker, J. (2011). Human transit: How clearer thinking about public transit can enrich our communities and our lives. Island Press.West, G., & Bettencourt, L. M. A. (2010). A unified theory of urban living. Nature.Young, M. (2025). My miserable week in the ‘happiest country on earth'. The New York Times Magazine. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit interplace.io
The controversial KETO-CTA study, tough decisions in subclinical AF, and another potentially huge benefit for GLP-1 agonist drugs are discussed by John Mandrola, MD, in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I The KETO-CTA Study JACC Advances Paper: https://www.jacc.org/doi/10.1016/j.jacadv.2025.101686 Meta-analysis https://doi.org/10.1016/j.ajcnut.2024.01.009 II Subclinical AF – Anticoagulate or Not? Anticoagulation in Subclinical AF May Offer Little Benefit https://www.medscape.com/viewarticle/anticoagulation-subclinical-af-may-offer-little-benefit-2025a1000b31 Treat AFib ‘Diagnosed' by Smartwatch https://www.medscape.com/viewarticle/treat-afib-diagnosed-smartwatch-2025a1000avp JAMA NO paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833437 NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 ARTESIA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 McIntyre meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067512 Singer et al https://pmc.ncbi.nlm.nih.gov/articles/PMC2777526/ Stroke paper https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.123.045843 American Journal of Medicine paper https://pubmed.ncbi.nlm.nih.gov/38331136/ III GLP1a for Treatment of Fatty Liver Disease ESSENCE trial https://www.nejm.org/doi/10.1056/NEJMoa2413258 Features CABG Still Superior to Stents Despite FAME 3 Endpoint Swap https://www.medscape.com/viewarticle/cabg-still-superior-stents-despite-fame-3-endpoint-swap-2025a1000ao5 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net
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The Boston Floating Hospital was a children’s hospital that operated on a boat in Boston Harbor in the late 19th and early 20th centuries. Research: Berkeley Temple. “Threescore years and ten, 1827-1897: Pine Street Church ; Berkeley Street Church ; Berkley Temple.” Boston : Press of Samuel Usher, 1897. https://catalog.hathitrust.org/Record/008416560 Boston Floating Hospital. “A brief history of the Boston Floating Hospital.” 1906. https://archive.org/details/101725502.nlm.nih.gov/ Boston Floating Hospital. “Historical sketch of the origin and development of the Boston Floating Hospital.” 1903. https://archive.org/details/101727275.nlm.nih.gov Egan, Sarah A. “A Reply from the Boston Floating Hospital.” The American Journal of Nursing, Vol. 11, No. 6 (Mar., 1911). Via JSTOR. https://www.jstor.org/stable/3405022 Friends of the Boston Harborwalk. “Precious Cargo On Board.” https://boshw.us/sign/precious-cargo-on-board/?lang=english Gilson, Grace. “Babies on a boat: When a floating hospital helped cure Boston’s children.” Boston Globe. 1/20/2022. https://www.bostonglobe.com/2022/01/20/metro/hospital-sea-that-once-cured-bostons-children/ Golden, Janet. “From Wet Nurse Directory to Milk Bank: Delivery of Human Milk in Boston, 1909-1927.” Bulletin of the History of Medicine. Vol. 62, No. 4. Winter 1988. Via JSTOR. https://www.jstor.org/stable/44443092 Halberstadt, Josephine. “The Boston Floating Hospital, Season of 1906.” The American Journal of Nursing , Feb., 1907, Vol. 7, No. 5 (Feb., 1907). Via JSTOR. https://www.jstor.org/stable/3403608 Hall, Mary I. “The Boston Floating Hospital.” The American Journal of Nursing, Vol. 11, No. 4 (Jan., 1911). Via JSTOR. https://www.jstor.org/stable/3404922 Hastings, Robert W. “The Boston Floating Hospital.” The American Journal of Nursing, Vol. 3, No. 7 (Apr., 1903).” Via JSTOR. https://www.jstor.org/stable/3401681 Hastings, Robert W. “The Boston Floating Hospital.” The American Journal of Nursing, Vol. 6, No. 7 (Apr., 1906). Via JSTOR. https://www.jstor.org/stable/3402905 Jimison, Robert. “Who’s the mystery child in this 103-year-old Floating Hospital photo?” CNN. 2/14/2017. https://www.cnn.com/2017/02/14/health/floating-hospital-1914-mystery-photo-history/index.html Keeling, Arlene. “Nursing On Board the Boston Floating Hospital.” Windows in Time. Center for Nursing Historical Inquiry. October 2015. Kulig, John. “12 Things You Didn't Know About The History Of Boston's Floating Hospital For Children.” WBUR. 10/3/2014. https://www.wbur.org/radioboston/2014/10/01/boston-floating-kulig NavSource Online: Identification Numbered Vessel Photo Archive. Boston Floating Hospital (ID 2366) https://www.navsource.org/archives/12/172366.htm “A History of the Boston Floating Hospital.” Vol. 19. No. 4. 1957. https://doi.org/10.1542/peds.19.4.629 Perry, Charlotte Mandeville. “Our Floating Hospitals.” The American Journal of Nursing, Nov., 1900, Vol. 1, No. 2 (Nov., 1900). Via JSTOR. http://www.jstor.com/stable/3402614 Prinz, Lucie with Jacoba Van Schaik. “The Boston Floating Hospital: How a Boston Harbor Barge Changed the Course of Pediatric Medicine.” Tufts Medical Center. 2014. Tufts Archival Research Center. “Boston Floating Hospital.” https://archives.tufts.edu/agents/corporate_entities/9474?&page=13 Tufts CHSP. “End of an Era: The Closing of Tufts Children’s Hospital, Putting Inpatient Pediatric Care in Context.” 4/8/2022. https://sites.tufts.edu/chsp/2022/04/08/end-of-an-era-the-closing-of-tufts-childrens-hospital-putting-inpatient-pediatric-care-in-context/ See omnystudio.com/listener for privacy information.
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Listen to our latest podcast as we break down a recent paper in the American Journal of Sports Medicine looking at the interplay between ACL reconstruction and post-traumatic arthritis.
On behalf of Taiwan in the Indo-Pacific Region and its National Security Task Force the Hoover Institution held a Taiwan Roundtable Discussion on Tuesday, February 18, 2025, from 5:00 - 6:00 pm PT. Taiwan is facing a potential constitutional crisis. In December 2024, Taiwan's opposition-controlled legislature voted to impose a 2/3 supermajority quorum for the Constitutional Court to hear new cases. The legislature then voted down all the new nominees to the Court, leaving it with only 8 of members and unable to meet the new quorum requirement. The government has appealed to the Court to meet anyway and rule that the new amendments are unconstitutional. In this discussion, three experts on Taiwan's politics and judicial system discuss the factors leading up to this confrontation, the options facing the court, and the potential for deeper reforms to strengthen judicial independence in the face of a deepening confrontation between the ruling and opposition parties. ABOUT THE PARTICIPANTS Chien-Chih Lin is an associate research professor at Institutum Iurisprudentiae, Academia Sinica and an associate professor at the Graduate Institute of National Development, National Taiwan University. He received the LLM & JSD degrees from the University of Chicago. His academic interests focus on comparative constitutional law in Asia. Lin is the coauthor ofConstitutional Convergence in East Asia (2022) and Ultimate Economic Conflict between China and Democratic Countries (2022). His articles can be found in both peer-reviewed and student-edited law journals as well as edited volumes, including Oxford Handbook of Constitutional Law in Asia, American Journal of Comparative Law, and International Journal of Constitutional Law. He is the book review editor of International Journal of Constitutional Law. Weitseng Chen is a faculty member at the National University of Singapore Faculty of Law, specializing in law and economic development, law and politics, and legal history in the context of Greater China. He has recently published several books, including Regime Type and Beyond: The Transformation of Police in Asia (CUP, 2023), Authoritarian Legality in Asia: Formation, Development and Transition (CUP, 2019), The Beijing Consensus? How China Has Changed the Western Ideas of Law and Economic Development (CUP, 2017), Property and Trust Law: Taiwan (with Yun-Chien Chang & Y. J. Wu, Kluwer, 2017), and Law and Economic Miracle: Interaction Between Taiwan's Development and Economic Laws After WWII (in Chinese, 2000). Weitseng Chen earned his JSD from Yale Law School. Prior to joining NUS, he served as a Hewlett Fellow at Stanford's Center for Democracy,Development, and the Rule of Law (CDDRL) and practiced as a corporate lawyer in the Greater China region with Davis Polk & Wardwell. Kharis Templeman is a research fellow at the Hoover Institution and part of the Project on Taiwan in the Indo-Pacific. Templeman is a political scientist (Ph.D. 2012, Michigan) with research interests in Taiwan politics, democratization, elections and election management, party system development, and politics and security issues in Pacific Asia.
Host Roz is joined by Timucin Taner, MD, PhD and Dami Ko, PhD to discuss the key articles of the May issue of the American Journal of Transplantation. Dr. Timucin Taner is a professor of surgery at Mayo Clinic, Rochester, MN. Dr. Dami Ko is an assistant professor at the School of Nursing at Northeastern University. [02:51] Development and validation of the Neuro-Score: a specific scale to detect and monitor cognitive impairment in kidney or liver transplant recipients Editorial: Cognitive impairment after liver and kidney transplant: An easy way to check [14:16] Randomized trial investigating the utility of a liver tissue transcriptional biomarker in identifying adult liver transplant recipients not requiring maintenance immunosuppression [20:46] Donor-specific immune senescence as a candidate biomarker of operational tolerance following liver transplantation in adults: Results of a prospective, multicenter cohort study Editorial: Acquired immune tolerance 2.0 [29:10] Major histocompatibility complex and peptide specificity underpin CD8+ T cell direct alloresponse Editorial: Direct and indirect allorecognition—not so different after all?
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Humans are a collection of their daily habits, which ultimately affect their health and long-term risk for disease. Sandra and Rob discuss the power of celebrating your small wins and how important it is to just keep improving with small, consistent, incremental changes.Resources:Stages of Change for Behaviour Changehttps://pubmed.ncbi.nlm.nih.gov/10170434/ Prochaska, James O.; Velicer, Wayne F. (September 1997). "The transtheoretical model of health behavior change" (PDF). American Journal of Health Promotion. 12 (1): 38–48. doi:10.4278/0890-1171-12.1.38. PMID 10170434. S2CID 46879746. Archived from the original (PDF) on 2010-06-02.Ep 53 SMART Goals - https://youtu.be/TQGTg8HsKwYEp 93 Toni Toledo, RD - PathPod, Positive Approaches to Health - https://youtu.be/TQGTg8HsKwYEp 74. Craving Change with Wendy Shah, RD https://youtu.be/NOlCc7eqsj0Ep 107. Food is Medicine with Dr. Wesley McWhorter https://youtu.be/doju3guWHyc RD Books mentioned:The Obstacle is the Way - Ryan HolidayPower of Habits - Charles DuhiggAtomic Habits - James ClearGetting Things Done - David AllenEnjoying the show? Consider leaving a 5 star review, and/or sharing this episode with your friends and family :)Sign up for our newsletter on our website for weekly updates and other fun info. You can also visit our social media pages. We're on Facebook, Instagram, and YouTube.Your support helps fuel the stoke and keeps the show going strong every week. Thanks!Website: www.mywifethedietitian.comEmail: mywifetherd@gmail.com
“They Should All Be In Jail!” President Trump Calls For Dems Behind Biden Autopen & ActBlue Fundraising Scam To Be Imprisoned
I had the privilege of going into Infowars studio last week to discuss the new Alex Jones Clip Genie tool! Rob Dew was gracious enough to host me on The American Journal where we demo'd it lived on the air! GET THE FULL LIST OF SOURCES AND BECOME A PREMIUM MEMBER ON SUBSTACK: https://rebunked.substack.com PLEASE HELP ME OVERRIDE THE TYRANTS AND GO SUBSCRIBE TO MY YOUTUBE CHANNEL, LIKE, COMMENT AND SHARE THIS EPISODE FROM YOUTUBE! WE CAN TAKE BACK THAT PLATFORM! https://www.youtube.com/@rebunked Trade In Your State Sponsored Indoctrination for a Method of Learning o Create Self-Reliance with Autonomy (SEASON 13 STARTS SOON!) https://www.universityofreason.com/a/2147825829/2WU6ALrf Links to ALL of my Projects: https://linktr.ee/Rebunked Get my New Album “Universal Basic Awesome” with unreleased track and MERCH at https://RebunkedRecords.com ALL THE MUSIC VIDEOS: https://youtube.com/@RebunkedRecords INSTAGRAM: https://www.instagram.com/rebunkednew TWITTER: https://twitter.com/rebunkednews TELEGRAM: https://t.me/Rebunkednews Start your Heavy Metal Detox: https://TruthTRS.com Tip Jar: https://GiveSendGo.com/Rebunked Rebunked on Substack: https://Rebunked.substack.com Rebunked News is happy to shout out: Supercharge your health with the amazing supplements at Chemical Free Body! https://chemicalfreebody.com/?rfsn=7505813.fa2d09 VALUE-FOR-VALUE DONATION: https://Rebunked.news VENMO: https://account.venmo.com/u/rebunked CASHAPP: https://cash.app/$rebunked PAYPAL: https://Paypal.me/Rebunked T-SHIRTS: https://Rebunked.news/Shirts
In this episode, I address the common questions I'm asked about the risk of urinary incontinence following surgery, specifically focusing on hysterectomy, prolapse repairs, and hip replacement. I discuss several key studies, including a 2000meta-analysis by Jeanette Brown and a 2023 paper in the American Journal of Obstetrics and Gynecology, which highlights the significant risks associated with these surgeries. I also provide tips on pelvic floor strengthening and the benefits of different surgical approaches to help minimize incontinence. I discuss how hip replacement surgery can have varying impacts on bladder function and the importance of a holistic view of the body's interconnectedness.https://pubmed.ncbi.nlm.nih.gov/10950229/https://www.nejm.org/doi/full/10.1056/NEJMoa054208https://pubmed.ncbi.nlm.nih.gov/24408744/https://pubmed.ncbi.nlm.nih.gov/36300551/Timeline:00:30 Introduction to Urinary Incontinence Risks00:59 Hysterectomy and Urinary Incontinence04:17 Prolapse Repairs and Bladder Leaking06:15 Hip Replacement and Bladder Function08:59 Conclusion and Key Takeaways
In 1937, a Rhode Island psychiatrist named Charles Bradley ran an experiment on 30 child patients who had complained of headaches. He gave them an amphetamine, that is a stimulant, called Benzedrine, which was popular at the time among jazz musicians and college students. The experiment failed, in one sense. The headaches persisted. But he noted that half of the children responded in what he called spectacular fashion, as teachers said these children seemed instantly transformed by the drug. Rather than being bored by their homework, they were interested in it. Rather than being hyperactive, they became more “placid and easygoing.” Rather than complaining to parents about chores, they would make comments like: “I start to make my bed, and before I know it, it is done.” Bradley published the results in The American Journal of Insanity, and it marks perhaps the origins of our treatment model for ADHD. Attention-deficit/hyperactivity disorder, or ADHD, has always been hard to define. It's harder still in an age when everybody feels like modern entertainment and the omnipresence of our screens make it hard for anybody to concentrate and sit still. But clearly, some people struggle with concentration and stillness more than others. ADHD has many classic symptoms, but it is typically marked by patterns of inattentiveness—frequently losing items, failing to follow multistep instructions—or by hyperactivity: say, fidgeting, or, for some children, being literally incapable of sitting in one place for more than half a second. In a way, I've always disliked the phrase "attention-deficit disorder," because ADHD is not about a deficit of ordinary attention but a surplus of feral attention—an overflowing of raw, uncontrollable noticing. Last week, the journalist Paul Tough published a long, 9,000-word essay in The New York Times Magazine about ADHD called "Have We Been Thinking About ADHD All Wrong?" Tough asked hard questions about why diagnoses are soaring. Is this evidence of an epidemic? Or is it evidence of overdiagnosis? Paul is today's guest. We talk about his blockbuster essay, what its loudest critics said about it, what its loudest advocates said about it, and why they both might be wrong. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Paul Tough Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices
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The Psychology of Self-Injury: Exploring Self-Harm & Mental Health
In this episode, Dr. Moye Xin from the School of Economic and Administration at Xi'an University in the Shaanxi Province of central China discusses how nonsuicidal self-injury (NSSI) is viewed in Asia and shares his thoughts about how gender role conflict may affect rates of self-harm among university students, particularly young Chinese men. Connect with Dr. Xin on ResearchGate at www.researchgate.net/profile/Moye-Xin or visit his work on SciProfiles at sciprofiles.com/profile/1469611. Below are a few of his research studies referenced in this episode:Xin, M., Petrovic, J., Yang, C., Zhang L., & Yang, X. (2024). Nonsuicidal self-injury among Chinese university students during the post-COVID-19 era: analysis of sex differences and the impact of gender role conflict. Frontiers in Psychology, 15, 1362762.Xin, M., Zhang, L., Yang, C., Yang, X., and Xiang, M. (2022). Risky or protective? Online social support's impact on nssi amongst Chinese youth experiencing stressful life events. BMC Psychiatry, 22, 782.Yang, X., & Xin, M. (2018). "Boy crisis" or "girl risk"? The gender difference in nonsuicidal self-injurious behavior among middle-school students in China and its relationship to gender role conflict and violent experiences. American Journal of Men's Health, 12(5), 1275–1285.Want to have a bigger role on the podcast?:Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it's a good fit.Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at thepsychologyofselfinjury@gmail.comWant to be involved in research? Send us a message at thepsychologyofselfinjury@gmail.com and we will see if we can match you to an active study.Want to interact with us through comments and polls? You can on Spotify!Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS).The Psychology of Self-Injury podcast has been rated as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."
More and more people are, “doing their own research.” Self-identified experts and influencers on podcasts (podcasts!) and social media endorse treatments that are potentially harmful and have little to no evidence of benefit, or have only been studied in animals. An increasing number of federal leaders have a track record of endorsing such products. We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. Ivermectin to treat cancer. Stem cell treatments. Chelation therapy. Daneila Lamas wrote about this issue in the New York Times this week -after we recorded - in her story, a family requested an herbal infusion for their dying mother via feeding tube. Our guests today, Adam Marks, Laura Taylor, & Jill Schneiderhan, have coined a term for such therapies, for Potentially Unsafe Low-evidence Treatments, or PULET. Rhymes with mullet (On the podcast we debate using the French pronunciation, though it sounds the same as the French word for chicken). We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? Key ingredients are both potentially unsafe and low evidence. If it's low evidence but not unsafe, not generally an issue. Think vitamins. If it's potentially unsafe, but has robust evidence, well that's most of the treatments we offer seriously ill patients! Think chemo. What counts as potentially unsafe? They include what might be obvious, e.g. health risks, and less obvious, e.g. financial toxicity. What counts as low-evidence? Animal studies? Theoretical only? Does PULET account for avoiding known effective treatments? Do elements of care that are often administered to seriously ill patients count? Yes. Think chemotherapy to imminently dying patients, or CPR. How does integrative medicine fit in with this? Jill Schneiderhan, a family medicine and integrative medicine doc, helps us think through this. How ought clinicians respond? Hint: If you're arguing over the scientific merits of a research study, you're probably not doing it right. Instead, think VitalTalk, REMAP, and uncover and align with the emotion behind the request. Does the approach shift when it's a caregiver requesting PULET for an older relative who lost capacity? How about parents advocating for a child? For more, Laura suggests a book titled, How to Talk to a Science Denier. And I am particularly happy that the idea for this podcast arose from my visit to Michigan to give Grand Rounds, and the conversations I had with Adam and Laura during the visit. We love it when listeners engage with us to suggest topics that practicing clinicians find challenging. And I get to sing Bon Jovi's Bad Medicine, which is such a fun song! -Alex Smith
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How does play shape our minds and our bodies? And why do the experts say it's just as important for adults as it is for kids? Most importantly, how do we integrate it into our everyday lives? This hour, guest host Noelle Evans explores those questions. She talks about the science and joy of play with a panel of researchers and facilitators who say fun is serious business. Scott Eberle, former vice president of The Strong National Museum of Play and past editor of the American Journal of Play Stephen Demanchick, a licensed mental health counselor and registered play therapist-supervisor Keith Gomez, IMPROV coach and co-owner of the Focus Theater in Rochester
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