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The ACOG acknowledges that maternal obesity affects labor curves and recommends allowing more time for cervical dilation before diagnosing labor arrest in obese patients. This approach aims to avoid unnecessary interventions, such as premature cesarean delivery, which may occur if standard labor curves are strictly applied to obese women. In this episode, we will review a new study from the AJOG (08 Nov 2025) which describes labor progression and duration according to maternal body mass index, validating the need (possibly) for a BMI -based labor curve. Has there been advocates of a BMI-based labor curve? Listen in for details.1. Edwards, Sara et al. Characterizing Labor Progression and Duration According to Maternal Body Mass Index. American Journal of Obstetrics & Gynecology, Volume 0, Issue 02. Lundborg L, Liu X, Åberg K, et al. Association of Body Mass Index and Maternal Age With First Stage Duration of Labour. Scientific Reports. 2021;11(1):13843. doi:10.1038/s41598-021-93217-5.3. Kominiarek MA, Zhang J, Vanveldhuisen P, et al. Contemporary Labor Patterns: The Impact of Maternal Body Mass Index. American Journal of Obstetrics and Gynecology. 2011;205(3):244.e1-8. doi:10.1016/j.ajog.2011.06.014.4. Norman SM, Tuuli MG, Odibo AO, et al. The Effects of Obesity on the First Stage of Labor.Obstetrics and Gynecology. 2012;120(1):130-5. doi:10.1097/AOG.0b013e318259589c.
MOPs & MOEs is powered by TrainHeroic, the best coaching app on the planet. Click here to get 14 days FREE and a consult with the coaches at TrainHeroic to help you get your coaching business rolling on TrainHeroic. MOPs & MOEs delivers our training through TrainHeroic and you can get your first 7 days of training with us FREE by clicking here.To continue the conversation, join our Discord! We have experts standing by to answer your questions.Dr. Rich Willy is a new Associate Professor in the PhD program in the School of Health and Rehabilitation Sciences at The Ohio State University. He holds a PhD in Biomechanics and Movement Science from the University of Delaware and a Master's of Physical Therapy from Ohio University. He is a licensed physical therapist with over two decades of clinical and academic experience. His research focuses on the biomechanics of running-related injuries, bone stress injuries, and rehabilitation strategies for tactical and athletic populations.Dr. Willy has authored more than 80 peer-reviewed publications and book chapters, and his work has been featured in high-impact journals such as British Journal of Sports Medicine, Journal of Orthopaedic & Sports Physical Therapy, and American Journal of Sports Medicine. Dr. Willy contributes to clinical practice guidelines for patellofemoral pain and running injuries. He is a frequently invited speaker at national and international conferences, including symposia for the US and International Olympic Committees, NBA teams, and sports medicine meetings.His research has been supported by the Department of Defense and APTA Orthopaedics, among others. Current projects include optimizing load carriage biomechanics, developing sex-specific training interventions, and advancing wearable technologies for injury prevention and rehabilitation.He and his wife also run Montana Running Lab, a hugely valuable resource curating the best clinical evidence for athletes and rehab professionals. We highly recommend their instagram as an evidence based source of information. We'll talk a bit about some of the resources available there at the end of this episode.
Bannon Warns MAGA Loyalists Will Be Jailed If GOP Loses Midterms & 2028 Presidential Election, Thousands More Flights Canceled Amid Gov't Shutdown, Muslims Declare New York An Islamic City & Much More
Soms blijft een gebeurtenis maar rondzingen in je hoofd.Je wéét dat het voorbij is, maar je lijf lijkt dat bericht niet te hebben ontvangen. EMDR helpt dan om die herinnering opnieuw te verwerken — zodat de scherpe randjes verdwijnen en het verleden niet telkens aan de deur klopt.Maar wat als je niet eens wéét waar je reactie vandaan komt?Wat als je gedrag al jaren wordt gestuurd door iets wat je je niet kunt herinneren?Daar, in dat onbewuste deel van je brein, werkt hypnose.Niet op het verhaal van wat er gebeurde, maar op de imprint die het heeft achtergelaten.En juist daar zit de sleutel naar rust.EMDR is inmiddels gemeengoed. Hypnose is dat nog niet — al wordt het al in meer dan 70 ziekenhuizen toegepast voor pijn, angst en trauma.Steeds meer artsen zien wat hypnotherapeuten al wisten: mensen zich na hypnotherapie niet alleen beter voelen, maar ook echt vrij.Luister deze aflevering als je nieuwsgierig bent naar wat er gebeurt wanneer het bewuste z'n werk heeft gedaan, maar het onbewuste nog iets te vertellen heeft.Bronnen:– Documentaire Hypnose op Doktersrecept (NPO)– Barabasz et al., American Journal of Clinical Hypnosis, 2014
Russia Closing In On Major Ukrainian City, Putin Mulls Resuming Nuclear Tests As POTUS Pushes For Friday Peace Talks
Mamdani Secures NYC Mayoral Victory, Texas Passes 17 Constitutional Amendments & All US Flights Could Be Grounded By Next Week
Air Traffic Controller Shortage Causes Travel Nightmare Amid Ongoing Schumer Shutdown
Liz Seegert is an award-winning, independent journalist. Liz has written about health for more than 30 years. Her main beats include aging, women's health, social determinants of health, and health policy. Liz's articles have appeared in dozens of national and local media outlets including Scientific American, TIME, The American Journal of Nursing, and Web MD/Medscape. […] The post Narrative Journalism: Stories to Make Points Clear and Compelling (HLOL #265) appeared first on Health Literacy Out Loud Podcast.
Description: Hosts Roz and Dr. Sanchez-Fueyo are joined by Christie Rampersad to discuss the key articles of the November issue of the American Journal of Transplantation. Christie Rampersad is clinical associate, in the Division of Nephrology at the University of Toronto in the Ajmera Transplant Centre [03:45] The early impacts of an attempt to standardize kidney procurement biopsy practices [13:40] The current state of simultaneous heart-liver transplantation in the United States [20:11] Engaging patients in organ transplant listing meetings: A survey study [37:32] Single-cell transcriptional landscape of liver transplant rejection reveals tissue persistence of clonally expanded, treatment-resistant T cells [45:32] Infectious disease surveillance and management in clinical xenotransplantation: Experience with the first human porcine kidney transplant
Trump Calls on Senate to Initiate “Nuclear Option” and Get Rid of Filibuster As SNAP Benefits Set to Run Out! Plus, US Poised to Strike Military Targets In Venezuela
Improving+Healthcare+for+Coptic+Egyptian+MigrantsOpening cultural doors: Providing culturally sensitive healthcare to Arab American and American Muslim patients - American Journal of Obstetrics & GynecologyCultural Competence in the Care of Muslim Patients and Their Families - StatPearls - NCBI Bookshelf No content or comments made in any TIPQC Healthy Mom Healthy Baby Podcast is intended to be comprehensive or medical advice. Neither healthcare providers nor patients should rely on TIPQC's Podcasts in determining the best practices for any particular patient. Additionally, standards and practices in medicine change as new information and data become available and the individual medical professional should consult a variety of sources in making clinical decisions for individual patients. TIPQC undertakes no duty to update or revise any particular Podcast. It is the responsibility of the treating physician or health care professional, relying on independent experience and knowledge of the patient, to determine appropriate treatment.
Trump Resumes US Nuclear Tests After 33-Year Hiatus, Minutes Before Meeting With China's Xi Jinping & Days After Russia Tested High-Tech Nukes
With Sotiria Liori, Attikon University Hospital, National and Kapodistrian University of Athens - Greece and Julie De Backer, Ghent University Hospital - Belgium. In this episode, Sotiria Liori and Julie De Backer discuss heart failure in adult congenital heart disease patients — covering how congenital lesions and prior repairs shape epidemiology and mechanisms (ventricular remodeling, valvular and conduit dysfunction, arrhythmias), as well as clinical assessment with imaging, biomarkers, and hemodynamics. They outline management with guideline-directed therapy, rhythm considerations, indications for advanced therapies (MCS and transplant), and pregnancy counseling. The episode also highlights multidisciplinary care models and key evidence gaps. Proposed reading: General Principles of Heart Failure Management in Adult Congenital Heart Disease. Tompkins R, Romfh A. Heart Failure Reviews. 2020;25(4):555-567. doi:10.1007/s10741-019-09895-x Chronic Heart Failure in Congenital Heart Disease: A Scientific Statement From the American Heart Association. Stout KK, Broberg CS, Book WM, et al. Circulation. 2016;133(8):770-801. doi:10.1161/CIR.0000000000000352. Relation Between New York Heart Association Functional Class and Objective Measures of Cardiopulmonary Exercise in Adults With Congenital Heart Disease. Das BB, Young ML, Niu J, et al. The American Journal of Cardiology. 2019;123(11):1868-1873. doi:10.1016/j.amjcard.2019.02.053. Heart Failure and Patient-Reported Outcomes in Adults With Congenital Heart Disease from 15 Countries. Lu CW, Wang JK, Yang HL, Kovacs AH, et al; APPROACH‐IS consortium, the International Society for Adult Congenital Heart Disease (ISACHD) *.J Am Heart Assoc. 2022 May 3;11(9):e024993. doi: 10.1161/JAHA.121.024993. Epub 2022 Apr 26. Pharmacological Therapy in Adult Congenital Heart Disease: Growing Need, Yet Limited Evidence. Brida M, Diller GP, Nashat H, et al. European Heart Journal. 2019;40(13):1049-1056. doi:10.1093/eurheartj/ehy480. Advanced Heart Failure Therapies For Adults With Congenital Heart Disease: JACC State-of-the-Art Review. Givertz MM, DeFilippis EM, Landzberg MJ, et al. Journal of the American College of Cardiology. 2019;74(18):2295-2312.doi:10.1016/j.jacc.2019.09.004. A Review of Heart Transplantation for Adults With Congenital Heart Disease. McMahon A, McNamara J, Griffin M. Journal of Cardiothoracic and Vascular Anesthesia. 2021;35(3):752-762. doi:10.1053/j.jvca.2020.07.027. Heart Failure in Adult Congenital Heart Disease: From Advanced Therapies to End-of-Life Care. Crossland DS, Van De Bruaene A, Silversides CK, Hickey EJ, Roche SL. The Canadian Journal of Cardiology. 2019;35(12):1723-1739. doi:10.1016/j.cjca.2019.07.626. This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.
Food Stamps Run Out In Days, Triggering Massive Unrest Intentionally Unleashed By Democrats' Schumer Shutdown
On this episode of the Hayek Program Podcast, Nina Bandelj delivers a keynote lecture at the 2023 Markets & Society conference on the social life of money for children. Drawing on research about what she calls the “parenting economy,” she shows that parents increasingly treat children as human capital investments, using savings plans, loans, and educational spending to secure their futures. Bandelj argues that the financialization of family life reflects parental pressures and social inequality, calling for children to be seen as a shared public responsibility rather than private investments.Dr. Nina Bandelj is Chancellor's Professor in the Department of Sociology at the University of California, Irvine and the President of the Sociological Research Association. Her articles have been published in top discipline and specialty journals such as the American Sociological Review, American Journal of Sociology, Social Forces, Theory and Society, and Socio-Economic Review. She has published various books, including Overinvested: The Emotional Economy of Modern Parenting (Princeton University Press, forthcoming), Money Talks: Explaining How Money Really Works (Princeton University Press, 2017) coauthored with Frederick Wherry and Viviana Zelizer), and Socialism Vanquished, Socialism Challenged: Eastern Europe and China, 1989-2009 (Oxford university Press, 2012) coedited with Dorothy Solinger.**This lecture was recorded October 22, 2023 at the second annual Markets & Society conference.If you like the show, please subscribe, leave a 5-star review, and tell others about the show! We're available on Apple Podcasts, Spotify, Amazon Music, and wherever you get your podcasts.Check out our other podcast from the Hayek Program! Virtual Sentiments is a podcast in which political theorist Kristen Collins interviews scholars and practitioners grappling with pressing problems in political economy with an eye to the past. Subscribe today!Follow the Hayek Program on Twitter: @HayekProgramFollow the Mercatus Center on Twitter: @mercatusCC Music: Twisterium
Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Dr. Andrew Lee, Vice President, Clinical Research at Uniquity Bio, about Thymic Stromal Lymphopoietin (TSLP) and eosinophilic esophagitis (EOE). Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own. Key Takeaways: [:49] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz. [1:13] Holly introduces today's topic, Thymic Stromal Lymphopoietin (TSLP) and eosinophilic esophagitis (EOE), and today's guest, Dr. Andrew Lee, Vice President, Clinical Research at Uniquity Bio. [1:36] Dr. Lee has nearly 20 years of experience in the clinical development of new vaccines, biologics, and drugs. Holly welcomes Dr. Lee. [1:52] Dr. Lee trained in internal medicine and infectious diseases. [1:58] Dr. Lee has been fascinated by the immune system and how it can protect people against infections, what happens when immunity is damaged, as in HIV and AIDS, and how to apply that knowledge to boost immunity with vaccines to prevent infections. [2:16] Dr. Lee led the clinical development for a pediatric combination vaccine for infants and toddlers. It is approved in the U.S. and the EU. [2:29] Dr. Lee led the Phase 3 Program for a monoclonal antibody to prevent RSV, a serious infection in infants. That antibody was approved in June 2025 for use in the U.S. [2:44] In his current company, Dr. Lee leads research into approaches to counteract an overactive immune system. They're looking at anti-inflammatory approaches to diseases like asthma, EoE, and COPD. [2:58] Dr. Lee directs the ongoing Phase 2 studies that they are running in those areas. [3:28] Dr. Lee sees drug development as a chance to apply cutting-edge research to benefit people. He trained at Bellevue Hospital in New York City in the 1990s. [3:40] When Dr. Lee started as an intern, there were dedicated ICU wards for AIDS patients because many of the sickest patients were dying of AIDS and its complications. [3:52] Before the end of Dr. Lee's residency, they shut down those wards because the patients were on anti-retroviral medications and were doing so well that they were treated as outpatients. They didn't need dedicated ICUs for AIDS patients anymore. [4:09] For Dr. Lee, that was a powerful example of how pharmaceutical research and drug regimen can impact patients' lives for the better by following the science. That's what drove Dr. Lee to go in the direction of research. [4:48] Dr. Lee explains Thymic Stromal Lymphopoietin (TSLP). TSLP serves as an alarm signal for Type 2 or TH2 inflammation, a branch of the immune responses responsible for allergic responses and also immunity against parasites. [5:17] When the cells that line the GI tract and the cells that line the airways in our lungs receive an insult or an injury, they get a danger signal, then they make TSLP. [5:28] This signal activates other immune cells, like eosinophils and dendritic cells, which make other inflammatory signals or cytokines like IL-4, IL-13, and IL-5. [5:47] That cascade leads to inflammation, which is designed to protect the body in response to the danger signal, but in some diseases, when there's continued exposure to allergens or irritants, that inflammation goes from being protective to being harmful. [6:15] That continued inflammation, over the years, can lead to things like the thickened esophagus with EoE, or lungs that are less pliant and less able to expand, in respiratory diseases. [6:48] Dr. Lee says he thinks of TSLP as being a master switch for this branch of immune responses. If you turn on TSLP, that turns on a lot of steps that lead to generating an allergic type of response. [7:06] It's also the same type of immune response that can fight off parasite infections. It's the first step in a cascade of other steps generating that type of immune response. [7:30] Dr. Lee says people have natural genetic variation in the genes that incur TSLP. [7:38] Observational studies have found that some people with genetic variations that lead to higher levels of TSLP in their bodies had an increased risk for allergic inflammatory diseases like EoE, atopic dermatitis, and asthma. [8:13] Studies like the one just mentioned point to TSLP being important for increased risk of developing atopic types of diseases like EoE and others. There's been some work done in the laboratory that shows that TSLP is important for activating eosinophils. [8:38] There's accumulating evidence that TSLP activation leads to eosinophil activation, other immune cells, or white blood cells getting activated. [9:07] Like a cascade, those cells turn on T-cells and B-cells, which are like vector cells. They lead to direct responses to fight off infections, in case that's the signal that leads to the turning on TSLP. [9:48] Ryan refers to a paper published in the American Journal of Gastroenterology exploring the role of TSLP in an experimental mouse model of eosinophilic esophagitis. Ryan asks what the researchers were aiming to find. [10:00] Dr. Lee says the researchers were looking at the genetic studies we talked about, the observational studies that are beginning to link more TSLP with more risk for EoE and those types of diseases. [10:12] The other type of evidence that's accumulating is from in vitro (in glass) experiments or test tube experiments, where you take a couple of cells that you think are relevant to what's going on. [10:28] For example, you could get some esophageal cells and a couple of immune cells, and put TSLP into the mix, and you see that TSLP leads to activation of those immune cells and that leads to some effects on the esophageal cells. [10:42] Those are nice studies, but they're very simplified compared to what you can do in the body. These researchers were interested in extending those initial observations from other studies, but working in the more realistic situation of a mouse model. [11:00] You have the whole body of the mouse being involved. You can explore what TSLP is doing and model a disease that closely mimics what's happening with EoE in humans. [12:23] They recreated the situation of what seems to be happening in EoE in people. We haven't identified it specifically, but there's some sort of food allergen in patients with EoE that the immune system is set off by. [12:55] What researchers are observing in this paper is that in these mice that were treated with oxazolone, there is inflammation in the esophagus, an increase in TSLP levels, and eosinophils going into the esophageal tissues. [13:15] Dr. Lee says, that's one of the main ways we diagnose EoE; we take a biopsy of the esophagus and count how many eosinophils there are. Researchers saw similar findings. The eosinophil count in the esophageal tissues went way up in these mice. [13:34] Researchers also saw other findings in these mice that are very similar to EoE in humans, such as the esophageal cells lining the esophagus proliferating. They even saw that new blood vessels were being created in that tissue that's getting inflamed. [14:00] Dr. Lee thinks it's a very nice paper because it shows that correlation: Increase TSLP and you see these eosinophils going to the esophagus, and these changes that are very reminiscent of what we see in people with EoE. [14:51] In this paper, the mice made the TSLP, and researchers were able to measure the TSLP in the esophageal tissue. The researchers didn't introduce TSLP into the mice. The mice made the TSLP in response to being repeatedly exposed to oxazolone. [15:20] That's key to the importance of the laboratory work. The fact that the TSLP is made by the mice is important. It makes it a very realistic model for what we're seeing in people. [15:41] In science, we like to see correlation. The researchers showed a nice correlation. [15:46] When TSLP went up in these mice, and the mice were making more TSLP on their own, at the same time, they saw all these changes in the esophagus that look a lot like what EoE looks like in people. [16:01] They saw the eosinophils coming into the esophagus. They saw the inflammation go up in the esophagus. What Dr. Lee liked about this paper is that they continued the story. [16:15] The researchers took something that decreases TSLP levels, an antibody that binds to and blocks TSLP, and when they did that, they saw the TSLP levels come down to half the peak level. [16:35] Then they saw improvement in the inflammation in the esophagus. They saw that the amount of eosinophils decreased, and the multiplication of the esophageal cells went down. The number of new blood vessels went down after the TSLP was reduced. [16:53] Dr. Lee says, you see correlation. The second part is evidence for causation. When you take TSLP away, things get better. That gives us a lot of confidence that this is a real finding. It's not just observational. There is causation evidence here. [18:26] Ryan asks if cutting TSLP also help reduce other immune response cells. Dr. Lee says TSLP is the master regulator for this Type 2 inflammation. It definitely touches and influences other cells besides eosinophils. [18:44] TSLP affects dendritic cells, which are an important type of immune cell, like a coordinating cell that instructs other cells within the immune system what to do. In this paper, they looked at a lot of other effects of TSLP on the tissues of the body. [19:10] Dr. Lee says, There's a lot of research on TSLP, and one of the reasons we're excited about the promise of TSLP is that it's so far upstream; so much of the beginning, that it's affecting other cells. [19:29] Its effects could be quite broad. If we're able to successfully block TSLP, we could block a lot of different effects. [19:40] One treatment for EoE is dupilumab, which blocks IL-4 and IL-13 specifically, and that works well, but TSLP has the potential to have an even greater effect than blocking IL-4 and IL-13, since it is one step before turning on IL-4 and IL-13. [20:14] That's one of the reasons researchers are excited about the promise of blocking TSLP. There are studies ongoing of TSLP blockers in people with EoE. [20:34] Ryan asks if there are negative repercussions from blocking TSLP. Dr. Lee says in this study and in people, we are not completely blocking TSLP by any means. There will still be residual TSLP activated, even with very potent drugs. [21:01] In the study, they block TSLP about 50%‒60%. TSLP is involved in immunity against parasites. In studies with people, they make sure not to include anybody who has an active parasitic infection. A person under treatment should not be in a study. [21:27] Dr. Lee says we haven't seen any problems with parasitic infections becoming more severe, but that is a theoretical possibility, so for that reason, in studies with TSLP blockers, we generally exclude patients with known parasitic infections. [22:17] What excited Dr. Lee in this paper was that they showed that when you block TSLP in the mice, then you get real effects in their tissues. Eosinophils went away. The thickening of the basal layers in the esophagus got much better. [22:38] That kind of real effect reflected in the tissue is super exciting to see. That gives us more confidence that this could work in people, since we're seeing it in a realistic whole-body model in the mice. [23:12] Dr. Lee says there are ongoing clinical studies on TSLP blockers for EoE. His company is studying an antibody that blocks TSLP in eczema, COPD, and EoE. One of the exciting things about immunology is that it affects many different parts of the body. [23:42] EoE is associated with other immune-type disorders. There's a high percentage of patients with EoE who have other diseases. EoE coexists with asthma, atopic dermatitis, and chronic rhinitis. [24:09] It's exciting that if you figure out something that's promising for one disease that TSLP affects, it could have very broad-ranging implications for a variety of diseases. [24:22] Ryan shares his experience of his doctor talking to him about a TSLP blocker, tezepelumab, as a potential option when it's out of clinical trials. It would target something a little higher up the chain and help with some of his remaining symptoms. [24:59] Ryan is excited to hear that this research is so encouraging and how it could potentially help treat EoE, asthma, and other conditions, all at once. [25:16] Dr. Lee says that being in these later-stage studies is super exciting. If these late-stage trials are successful, the next step is to apply for regulatory approval with the various agencies around the world. [26:40] Dr. Lee shares one takeaway for listeners to remember. Think of TSLP as an alarm that turns on inflammation. He compares TSLP to turning on an alarm during a robbery. There are multiple steps designed to protect the bank and the money. [27:20] To extend that analogy, with TSLP, once you turn it on, all these other steps are going to happen. Inflammation is designed to protect the body. It's a protective response. If there's an infection, it can clear the infection. [27:38] If the infection persists, as in HIV, the immune response, which is protective and beneficial, eventually becomes damaging. It becomes dysfunctional. In EoE, if you continually eat the allergic food, the inflammation becomes damaging to the esophagus. [28:27] Long-term inflammation leads to replacing the normal esophageal tissue with fibrotic tissue, and that's why the esophagus eventually gets hardened and less able to let the food go through. [28:40] In respiratory diseases, the soft tissue of the lung gets replaced with thicker tissue, and the lung is not able to expand. [28:54] Dr. Lee says he people to think about TSLP as this master alarm switch. We hope that if you could turn off that TSLP, you could then avoid a lot of the complications that we see with chronic inflammation in these conditions. [29:14] We're hopeful that you could even take away the symptoms that you see in these diseases, make patients feel better, and with extended treatment, you could begin to reverse some of the damage resulting from inflammation. [29:32] Ryan likes that analogy and how Dr. Lee has concisely explained these complicated concepts. [29:51] Dr. Lee thanks Holly and Ryan and adds one more plea to listeners. Please consider getting involved with research. Clinical trials cannot be done without patients. We need patients to advance new treatments. [30:27] Researchers like Dr. Lee spend a lot of time thinking about how to make the studies not only informative but also fair to patients who decide to become involved. It's a lot of work and a fair amount of time commitment. [30:44] If you don't want to be in a study, you can help by being on a patient feedback panel and reviewing protocols and informed consents. Follow your interests. Think about getting involved with research, however you can. [31:06] Ryan and Holly are very grateful for the community, with so many wonderful clinicians and researchers, and so many patients who are willing to volunteer their time and their data to help researchers find better solutions going forward. [31:26] Ryan thanks Dr. Lee for coming on and putting out that call to action. It's a great reminder for listeners and the patients in the community to look for those opportunities. Chat with your physician. Go to APFED's website. There's a link to active clinical trials. [31:47] For our listeners who want to learn more about eosinophilic disorders, we encourage you to visit apfed.org and check out the links in the show notes below. [31:53] For those looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at apfed.org/specialist. [32:01] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections. [32:11] Ryan thanks Dr. Andrew Lee for joining us today. We learned a lot. Holly also thanks APFED's Education Partners Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda for supporting this episode. Mentioned in This Episode: Andrew Lee, M.D., VP Clinical Research, Uniquity Bio "A Mouse Model for Eosinophilic Esophagitis (EoE)" Current Protocols, Wiley Online Library APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, GSK, Sanofi, Regeneron, and Takeda. Tweetables: "I see drug development as a chance to apply cutting-edge research to benefit people." — Andrew Lee, M.D. "When the cells that line the GI tract and the cells that line the airways in our lungs receive an insult or an injury, they get a danger signal, then they make TSLP." — Andrew Lee, M.D. "Observational studies have found that some people with genetic variations that lead to higher levels of TSLP in their bodies had an increased risk for allergic inflammatory diseases like EoE, atopic dermatitis, and asthma." — Andrew Lee, M.D. "There's a lot of research on TSLP, and one of the reasons we're excited about the promise of TSLP is that it's so far upstream; so much of the beginning, that it's affecting other cells." — Andrew Lee, M.D. "Please consider getting involved with research. We can't do these clinical trials without patients. We need patients to advance new treatments for patients." — Andrew Lee, M.D.
Venezuela Says It Captured CIA Group Planning False Flag Attack, Maduro Condemns US “Military Provocation” As White House Considers Air Force Strikes
In this episode of the Glowing Older podcast, host Nancy Griffin interviews Dr. Kenneth Pelletier, a clinical professor of medicine and psychiatry at UCSF, about the science of longevity and the role of epigenetics. Dr. Pelletier shares insights into the importance of healthspan over lifespan, and the impact of diet, stress, exercise, and social support on longevity. He also discusses the potential and limitations of biohacking and the growing field of integrative medicine. About Dr. Pelletier Kenneth R. Pelletier, PhD, MD is a Clinical Professor of Medicine, Department of Medicine; Department of Family and Community Medicine; and Department of Psychiatry at the University of California School of Medicine (UCSF) in San Francisco; and a Clinical Professor of Medicine in the Department of Medicine and Department Family and Community Medicine at the University of Arizona School of Medicine in Tucson. At the present time, Dr. Pelletier is a medical and business consultant to the US Department of Health and Human Services, the World Health Organization (WHO), the National Business Group on Health, the Federation of State Medical Boards, the Wild Dolphin Project, and major corporations including Cisco, IBM, American Airlines, Prudential, Dow, Disney, Ford, Mercer, Merck, Pepsico, Ford, Pfizer, Walgreens, NASA, Microsoft ENCARTA, Blue Cross/Blue Shield, United Healthcare, Health Net, the Pasteur Institute of Lille, France, the Alpha Group of Mexico, and the Singapore Ministry of Health. He also serves on the boards of the Rancho la Puerta (Mexico), Nova Institute, Fries Foundation, American Institute of Stress (AIS), American Journal of Health Promotion (AJHP), as a Founding Board Member of the American Board of Integrative Medicine (ABOIM), and as a peer reviewer for the Journal of the American Medical Association (JAMA), the Journal of Occupational and Environmental Medicine (JOEM), Annals of Internal Medicine, Health Affairs, and webMD. Dr. Pelletier is listed in Who's Who in America and in Who's Who in the World. He has been featured on ABC World News, the Today program, Good Morning America, Dr Oz, the CBS Evening News, 48 Hours, the McNeil-Lehrer Newshour, CNN, FOX News, and CBS Sunday Morning.Dr. Pelletier is the author of 15 major books including the international bestseller Mind as Healer, Mind as Slayer; Holistic Medicine: From Stress to Optimum Health; Longevity: Fulfilling Our Biological Potential; Healthy People in Unhealthy Places; Stress and Fitness at Work; Sound Mind – Sound Body: A New Model for Lifelong Health; The Best Alternative Medicine: What Works? What Does Not?; Stress Free for Good: Ten Scientifically Proven Life Skills for Health and Happiness; New Medicine: How to Integrate Conventional and Alternative Medicine for the Safest and Most Effective Treatment and Change Your Genes – Change Your Life: Creating Optimal Health with the New Science ofEpigenetics.Key TakeawaysEpigenetics is a relatively new science, developed in the last 15 years. Epigenetics are all of the influences that determine our health, wellbeing, and life expectancy after the sperm and ovum unite. Epigenetics plays a crucial role in determining health and life expectancy – 95 % of health, illness, and life expectancy are due to factors other than our genes. The role of diet, stress, physical activity and social support significantly influence genetic expression.There are no longitudinal studies for biohacking. Don'tgo into the periphery and engage in questionable practices. Sort hope from hype.Equal criteria for evaluating the outcomes of alternative and conventional medicine must be applied; both should be held to the same rigorous scientific standards to ensure their acceptability and effectiveness.
A reading of articles and features from the October/November 2025 Issue of the Polish American Journal
Russia Tests High-Tech Nukes While Trump Asks Xi For Help Ending Ukraine War & USA Prepares To Strike Venezuela
This week on The Sausage of Science, Chris and Cara talk with Dr. Josh Brahinsky, a researcher in the Transcultural Psychiatry Department at McGill University and the Department of Religious Studies at Stanford University, whose work sits at the intersection of anthropology, psychology, and neuroscience. Josh explores how contemplative practices like prayer and meditation shape sensory experience, perception, and emotion, focusing especially on the embodied and affective dimensions of charismatic evangelical worship. With a background that bridges the humanities and sciences, a PhD in the History of Consciousness from UCSC, and a postdoctoral fellowship in Anthropology at Stanford, Josh brings a truly interdisciplinary lens to understanding what happens when people reach for the divine, and how those moments transform the body and mind alike. ------------------------------ Find the book discussed in this episode: Tongues of Fire: How Charismatic Prayer Changes Evangelical Brains and Mobilizes Spirit-Filled Activism www.bloomsbury.com/us/tongues-of-f…-9798881804992/ Find the Article: Brahinsky, J., Mago, J., Miller, M., Catherine, S., & Lifshitz, M. (2024). The Spiral of Attention, Arousal, and Release: A Comparative Phenomenology of Jhāna Meditation and Speaking in Tongues. American Journal of Human Biology, 36(12), e24189. doi.org/10.1002/ajhb.24189 ------------------------------ Contact Dr. Brahinsky: jbrahins@gmail.com ------------------------------ Contact the Sausage of Science Podcast and Human Biology Association: Facebook: facebook.com/groups/humanbiologyassociation/, Website: humbio.org, Twitter: @HumBioAssoc Chris Lynn, Host Website: cdlynn.people.ua.edu/, E-mail: cdlynn@ua.edu, Twitter:@Chris_Ly Cara Ocobock, Host Website: sites.nd.edu/cara-ocobock/, Email:cocobock@nd.edu, Twitter:@CaraOcobock Cristina Gildee, SoS Co-Producer, HBA Fellow Website: cristinagildee.org, E-mail: cgildee@uw.edu,
Chocolate, cheese, and wine — the holy trinity of migraine “triggers.” But what if they're not villains, after all, but messengers from your body asking you to listen more closely?In this episode of Migraine Heroes Podcast, host Diane Ducarme explores the real story behind these indulgences — and why your reactions to them may reveal more about your brain and gut health than about the foods themselves.We blend neuroscience, gut microbiome research, and Eastern medicine wisdom to uncover how pleasure and balance coexist — even in the migraine world.You'll discover:
Bondi Tells Pelosi to “Preserve Her Emails” After She Called For ICE Agents To Be Arrested
Gov't Shutdown Enters Day 23 As Democrats Attempt To Implode Trump Economy, Launch Domestic Uprising & Blame MAGA For It All
Dr. Ryan Sultan is a Board Certified Adult and Child Psychiatrist, researcher and Assistant Professor of Clinical Psychiatry at Columbia University Irving Medical Center. He is also in private practice with expertise in the evaluation and treatment of ADHD. One in six American boys is now diagnosed with ADHD. In France, it's one in 200. American children are diagnosed with ADHD at rates 30 times higher than other Western nations. We consume 80% of the world's ADHD stimulants despite being 4% of the population.There's no blood test, no brain scan, no biological evidence this "disorder" actually exists - just subjective checklists and lines of questioning. In this essential episode, Dr. McFillin challenges the validity and reliability of ADHD diagnosis, and what unfolds is a stunning revelation about how 7 million children ended up on amphetamines. References:MTA Study (Multimodal Treatment Study of ADHD):MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for ADHD. Archives of General Psychiatry, 56(12), 1073-1086.Molina, B. S., et al. (2009). MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 48(5), 484-500.Key finding: No difference in outcomes between medicated and non-medicated groups at 3-year and 8-year follow-upsCDC ADHD Statistics:CDC. (2022). Data and Statistics About ADHD. Centers for Disease Control and Prevention.7.1 million US children diagnosed with ADHD (11.4% of all children)15.5% of boys diagnosed vs. 7.5% of girls1 in 6 boys aged 4-17 diagnosed with ADHD3.3 million children aged 3-17 currently on ADHD medicationRacial Disparities in Diagnosis of ADHDDSM-5 Field Trial Reliability:Regier, D. A., et al. (2013). DSM-5 field trials in the United States and Canada. American Journal of Psychiatry, 170(1), 59-70.ADHD kappa reliability: 0.61 (research settings) to 0.35 (clinical practice)Financial Data:ADHD medication market: $19.8 billion (2024, Market Research Reports)10-fold increase in stimulant prescriptions: 1990-2024 (DEA production quotas) Faraone, S.V., Sergeant, J., Gillberg, C., & Biederman, J. (2003). The worldwide prevalence of ADHD: Is it an American condition? World Psychiatry, 2(2), 104-113.Funded by Johnson & Johnson (pharmaceutical company)Co-authored by Joseph Biederman (who later had to admit taking $1.6 million from drug companies without disclosure)What This Article Inadvertently Reveals:The Diagnosis Shopping Game: The article admits that using DSM-IV criteria produces the "highest prevalence rates" compared to other diagnostic systems. Translation: American psychiatry created diagnostic criteria that captures the most kids. This isn't discovering disease - it's widening the net.The 20-Fold Difference They Can't Explain: The article acknowledges a "20-fold greater prevalence of childhood hyperactivity in North America compared with England" in 1970s studies. Their explanation? Different diagnostic practices, not different children. So they're admitting the "disease" depends entirely on who's doing the diagnosing.The Admission Hidden in Plain Sight: The authors state that differences in prevalence "reflect differences in diagnostic practice rather than true differences in behavior." They're literally admitting ADHD prevalence is about diagnostic opinion, not biological reality.Even establishment researchers like Faraone admit that ADHD prevalence varies 20-fold based on diagnostic criteria used, not actual differences in children's behavior. They acknowledge it's diagnostic practice, not disease prevalence, that creates these massive variations. This 2003 paper proves psychiatry has known for decades that ADHD rates are artificially inflated by American diagnostic criteria.The Irony: This paper, trying to prove ADHD is universal, actually proves it's a diagnostic construct that changes based on which manual you use. That's not how real diseases work. Visit Center for Integrated Behavioral HealthDr. Roger McFillin / Radically Genuine WebsiteYouTube @RadicallyGenuineDr. Roger McFillin (@DrMcFillin) / XSubstack | Radically Genuine | Dr. Roger McFillinInstagram @radicallygenuineContact Radically GenuineConscious Clinician CollectivePLEASE SUPPORT OUR PARTNERS15% Off Pure Spectrum CBD (Code: RadicallyGenuine)10% off Lovetuner click here
Feds Face Off With Antifa Outside Portland ICE Facility As Local Police Continue Protecting Commies Instead Of Federal Agents
Democrat Chicago Judge Rules ICE Agents Can Be Arrested For Apprehending Illegals
On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Melanie T. Turk, PhD, RN, an associate professor in the School of Nursing at Duquesne University and author of a study published in the October 2025 issue. Despite its potential, her study, "Opportunities and Obstacles Associated With the Medicare Diabetes Prevention Program," examines the challenges of implementing the Medicare Diabetes Prevention Program (MDPP) from the perspective of program suppliers nationwide. In this conversation, Turk discusses the limited adoption of the MDPP and the inspiration behind her study. She also outlines her key findings and shares next steps for implementing and sustaining the program.
A study published in the American Journal of Clinical Nutrition showed that eating two eggs daily lowered LDL cholesterol, while high saturated fat diets raised it Researchers found cholesterol from eggs did not raise LDL, but saturated fat from foods like bacon and sausage did, showing food context makes a major difference Eggs provide cholesterol without overloading the liver, allowing it to clear LDL efficiently and preventing artery buildup that increases heart disease and stroke risk Weekly egg intake reduced heart disease deaths by 29% and all-cause mortality by 17% in older adults, highlighting the importance of moderation for protective benefits Choosing pastured eggs, avoiding vegetable oils, and pairing eggs with nutrient-rich whole foods further boost benefits while minimizing harmful omega-6 linoleic acid (LA) intake
Trump Warns Zelensky To Accept Russia's Terms Or Be Destroyed Ahead Of Budapest Peace Summit Meeting With Putin
US Special Ops & B-52s Train Near Venezuela, Trump Threatens American Military Action In Gaza As Dems Activate Leftist Mob For Civil Unrest
This week on The Sausage of Science, Chris and Cara talk with Dr. Josh Brahinsky, a researcher in the Transcultural Psychiatry Department at McGill University and the Department of Religious Studies at Stanford University, whose work sits at the intersection of anthropology, psychology, and neuroscience. Josh explores how contemplative practices like prayer and meditation shape sensory experience, perception, and emotion, focusing especially on the embodied and affective dimensions of charismatic evangelical worship. With a background that bridges the humanities and sciences, a PhD in the History of Consciousness from UCSC, and a postdoctoral fellowship in Anthropology at Stanford, Josh brings a truly interdisciplinary lens to understanding what happens when people reach for the divine, and how those moments transform the body and mind alike. ------------------------------ Find the book discussed in this episode: Tongues of Fire: How Charismatic Prayer Changes Evangelical Brains and Mobilizes Spirit-Filled Activism https://www.bloomsbury.com/us/tongues-of-fire-9798881804992/ Find the Article: Brahinsky, J., Mago, J., Miller, M., Catherine, S., & Lifshitz, M. (2024). The Spiral of Attention, Arousal, and Release: A Comparative Phenomenology of Jhāna Meditation and Speaking in Tongues. American Journal of Human Biology, 36(12), e24189. https://doi.org/10.1002/ajhb.24189 ------------------------------ Contact Dr. Brahinsky: jbrahins@gmail.com ------------------------------ Contact the Sausage of Science Podcast and Human Biology Association: Facebook: facebook.com/groups/humanbiologyassociation/, Website: humbio.org, Twitter: @HumBioAssoc Chris Lynn, Host Website: cdlynn.people.ua.edu/, E-mail: cdlynn@ua.edu, Twitter:@Chris_Ly Cara Ocobock, Host Website: sites.nd.edu/cara-ocobock/, Email:cocobock@nd.edu, Twitter:@CaraOcobock Cristina Gildee, SoS Co-Producer, HBA Fellow Website: cristinagildee.org, E-mail: cgildee@uw.edu,
The objective of the American Journal of Endocannabinoid Medicine is to help educate medical professionals on the role of the endocannabinoid system in homeostasis, and as a therapeutic target for cannabis and cannabinoid prescription and non-prescription products. Ken Watkins is the Publisher of the American Journal of Endocannabinoid Medicine.
Trump Reportedly Approves CIA Regime Change In Venezuela, Mulls Lethal Strikes
Los Angeles Declares State Of Emergency & Chicagoans Fight ICE In The Streets As Democrat ‘Podesta Plan' Of Civil Unrest Kicks Into High Gear
Internationally renouned kidney stone dietitian & researcher. Dr. Kristina Penniston PhD RDN, dives into updates in research for kidney stones, what diets are best for kidney stones and an updated approach to managing oxalate. Bio: Dr. Kristina Penniston References: Noori N, et al. Urinary Lithogenic Risk Profile in Recurrent Stone Formers With Hyperoxaluria: A Randomized Controlled Trial Comparing DASH (Dietary Approaches to Stop Hypertension)-Style and Low-Oxalate Diets. American Journal of Kidney Diseases. 2014;63(3):456-463. Rodriguez A, et al. Mediterranean diet adherence and risk of incident kidney stones. The American Journal of Clinical Nutrition. 2020;111(5):1100-1106. Oxalate Blog Posts: Is a Low Oxalate Diet Necessary? How a Low Oxalate Diet Could Make Kidney Stones Worse Submit a question for Melanie to answer on the podcast! Connect with The Kidney Dietitian! Work with Us! | Instagram | Facebook | Pinterest | Facebook Group | Newsletter www.thekidneydietitian.org FREE Webinar: The 3-Step Method to Prevent Kidney Stones All information in this podcast is meant for educational purposes only and should not be used in place of advice from a medical professional.
Senate To Vote On Gov't Spending Bill, Portland Antifa Insurrectionists Receive U-Haul Full Of Supplies, Schumer Promotes Anti-Trump Uprising
From CAR-T therapies to viral vectors, cell and gene treatments are redefining the boundaries of pharmacy practice—but with innovation comes complexity. Host Carolyn Liptak welcomes Dr. Mark Wiencek, Principal Microbiologist with the Technical Services Group at Contec, and Dr. Amanda Frick, Senior Clinical Manager of Market Intelligence at Vizient, to break down the challenges of compounding these advanced therapies. Listen in as they discuss real-world risk assessments, biosafety considerations, and how hospital pharmacies can safely manage these groundbreaking yet high-risk treatments. Guest speakers: Mark Wiencek, PhD Principal Microbiologist, Technical Services Group Contec Amanda Frick, PharmD, BCPS Senior Clinical Manager, Market Intelligence Vizient Host: Carolyn Liptak, MBA, RPh Pharmacy Executive Director Vizient Show Notes: [01:02-01:51] Mark shares his background and experience in microbiology [01:52-04:04] Overview of the types of cell and gene therapies (CGT) currently used in clinical practice [04:05-05:14] Which CGT therapies are most applicable to pharmacy compounding and why [05:15-10:29] Things not on the NIOSH list and the risks [10:30-12:03] Evaluating whether viral vectors can penetrate intact skin and the true occupational exposure risks [12:04-13:18] If hazards are not defined by the NIOSH list, how should these CGT hazards be classified [13:19-15:03] Determining the safest environment for compounding CGT therapies [15:04-20:14] Best practices for decontamination, disinfection, and viral vector handling [20:15-20:59] Do you need a dedicated biosafety cabinet for CGT therapies [21:00-22:55] Recommended resources for further learning Links | Resources: Blind and colleagues (Nationwide): Click here Wang and colleagues (Stanford): Click here CONTEC HEALTHCARE WEBINAR Using Bugs as Drugs: Compounding Viral Vectors in Cell & Gene Therapy for Hospital Pharmacies, Mark Wiencek, May 13, 2025: Click here Blind, J.E., Ghosh, S., Niese, T.D., Gardner, J.C., Stack-Simone, S., Dean, A. and Washam, M., 2024. A comprehensive literature scoping review of infection prevention and control methods for viral-mediated gene therapies. Antimicrobial Stewardship & Healthcare Epidemiology, 4(1), p.e15. Click here Deramoudt, L., Pinturaud, M., Bouquet, P., Goffard, A., Simon, N. and Odou, P., 2024. Method for the detection and quantification of viral contamination during the preparation of gene therapy drugs in a hospital pharmacy. Occupational and Environmental Medicine, 81(12), pp.615-621. Click here Korte, J., Mienert, J., Hennigs, J.K. and Körbelin, J., 2021. Inactivation of adeno-associated viral vectors by oxidant-based disinfectants. Human Gene Therapy, 32(13-14), pp.771-781. Click here (abstract only; full article available for purchase) Martino, J.G., McConnell, K., Greathouse, L., Rosario, B.D. and Jaskowiak, J.M., 2024. Cellular therapy site-preparedness: Inpatient pharmacy implementation at a large academic medical center. Journal of Oncology Pharmacy Practice, 30(8), pp.1442-1449. Click here Penzien, C., 2023. Safe handling of BioSafety drugs and live virus vaccines. Pharm Purch Prod, 20(4), p.12. Click here Petrich, J., Marchese, D., Jenkins, C., Storey, M. and Blind, J., 2020. Gene replacement therapy: a primer for the health-system pharmacist. Journal of Pharmacy Practice, 33(6), pp.846-855. Click here Wang, A., Ngo, Z., Yu, S.J. and MacDonald, E.A., 2025. Implementing standard practices in the safe handling of gene therapy and biohazardous drugs in a health-system setting. American Journal of Health-System Pharmacy, p.zxaf026. Click here VerifiedRx Listener Feedback Survey: We would love to hear from you - Please click here Subscribe Today! Apple Podcasts Spotify YouTube RSS Feed
On this episode of Managed Care Cast, The American Journal of Managed Care® spoke with Gen Li, PhD, CEO and cofounder of Phesi, a clinical data company that provides AI-driven insights to sponsors and providers to optimize clinical trial efficacy. A recent analysis from Phesi found over 100 diseases currently being studied using GLP-1 RA therapies. The rapid growth of GLP-1 RA therapies being used across multiple, overlapping conditions creates an incentive for efficient and easily accessible clinical trial data to aid sponsors and researchers in establishing control cohorts using Phesi's Trial Accelerator platform and digital patient profiles.
In this episode you will discover: Diversity Means Everyone - Race is just one piece. Consider how age, language, immigration status, religion, sexual orientation, and geography intersect to shape each person's experience with aphasia. Go Into the Community to Build Trust - Sustainable partnerships require leaving your institution and showing up consistently. Visit centers, share meals, and invest time where people gather. Trust develops gradually through authentic presence. Listen to Real-Life Struggles First - Before starting therapy protocols, hear what families actually face: shifted gender roles, children as language brokers, lack of community aphasia awareness, and disrupted family dynamics. Train Future Clinicians Differently - If you're building or revising academic programs, front-load diversity with a foundational intersectionality course in semester one, then integrate these principles across every subsequent course and clinical practicum. If you've ever wondered how to better support multilingual families navigating aphasia, or felt uncertain about cultural considerations in your practice, this conversation will give you both the framework and the practical insights you need. Welcome to the Aphasia Access Aphasia Conversations Podcast. I'm Katie Strong, a faculty member at Central Michigan University where I lead the Strong Story Lab, and I'm a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's host for an episode that tackles one of the most important conversations happening in our field right now - how do we truly serve the increasingly diverse communities that need aphasia care? We're featuring Dr. Jose Centeno, whose work is reshaping how we think about equity, social justice, and what it really means to expand our diversity umbrella. Dr. Centeno isn't just talking about these issues from an ivory tower - he's in the trenches, working directly with communities and training the next generation of clinicians to do better. Before we get into the conversation, let me tell you a bit more about our guest. Dr. Jose Centeno is Professor in the Speech-Language Pathology Program at Rutgers University. What makes his work unique is how he bridges the worlds of clinical practice and research, focusing on an often overlooked intersection: what happens when stroke survivors who speak multiple languages need aphasia care? Dr. Centeno is currently exploring a critical question - what barriers do Latinx families face when caring for loved ones with post-stroke aphasia, and what actually helps them navigate daily life? His newest initiative takes this work directly into the community, where he's training students to bring brain health activities to underserved older adults in Newark's community centers. As an ASHA Fellow and frequent international speaker, Dr. Centeno has made it his mission to ensure that aphasia research and care truly serve diverse communities. His extensive work on professional committees reflects his commitment to making the field more inclusive and culturally responsive. So let's get into the conversation. Katie Strong: As we get started, I love hearing about how you came into doing this work, and I know when we spoke earlier you started out studying verb usage after stroke and very impairment-based sort of way of coming about things. And now you're doing such different work with that centers around equity and minoritized populations. I was hoping you could tell our listeners about the journey and what sparked that shift for you. Jose Centeno: That's a great question. In fact, I very often start my presentations at conferences, explaining to people, explaining to the audience, how I got to where I am right now, because I did my doctoral work focused on verb morphology, because it was very interesting. It is an area that I found very, very interesting. But then I realized that the data that I collected for my doctorate, and led to different articles, was connected to social linguistics. I took several linguistics courses in the linguistics department for my doctorate, and I needed to look at the results of my doctoral work in terms of sociolinguistic theory and cognition. And that really motivated me to look at more at discourse and how the way that we talk can have an impact on that post stroke language use. So, I kept writing my papers based on my doctoral data, and I became interested in finding out how our colleagues working with adults with aphasia that are bilingual, were digesting all this literature. I thought, wait a minute. Anyway, I'm writing about theory in verb morphology, I wonder where the gaps are. What do people need? Are people reading this type of work? And I started searching the literature, and I found very little in terms of assessing strengths and limitations of clinical work with people with aphasia. And what I found out is that our colleagues in childhood bilingualism have been doing that work. They have been doing a lot of great work trying to find out what the needs are when you work with bilingual children in educational settings. So that research served as my foundational literature to create my work. And then I adopted that to identifying where the strengths and needs working with people by new people with aphasia were by using that type of work that worked from bilingual children. And I adapted it, and I got some money to do some pilot work at the from the former school where I was. And with that money I recruited some friends that were doing research with bilingual aphasia to help me create this survey. So that led to several papers and very interesting data. And the turning point that I always share, and I highlight was an editorial comment that I got when I when I submitted, I think, the third or fourth paper based on the survey research that I did. The assessment research. And one of the reviewers said, “you should take a look at the public health literature more in depth to explain what's going on in terms of the needs in the bilingual population with aphasia”. So, I started looking at that and that opened up a huge area of interest. Katie Strong: I love that. Jose Centeno: Yeah, that's where I ended up, you know, from an editorial comment based on the studies of survey research. And that comment motivated me to see what the gaps were more in depth. And that was in 2015 when that paper came out. I kept working, and that data led to some special issues that I invited colleagues from different parts of the world to contribute. And then three years later, Rutgers invited me to apply for this position to start a diversity focused program at Rutgers, speech language pathology. At Rutgers I met a woman that has been my mentor in qualitative research. Pamela Rothpletz-Puglia is in nutrition, and she does qualitative, mixed methods research. So, her work combined with my interest in identifying where the needs were, led me to identify the needs in the work with people with aphasia through the caregivers using her methodology. And I'll come talk more about it, because it's related to a lot of different projects that I am pursuing right now. Katie Strong: I love this. So, it sounds like, well, one you got a really positive experience from a reviewer, which is great news. Jose Centeno: Well, it was! It's a good thing that you say that because when we submit articles, you get a mixed bag of reviews sometimes. But, this person was very encouraging. And some of the other reviews were not as encouraging, but this was very encouraging, and I was able to work on that article in such a way that got published and it has been cited quite a bit, and it's, I think it's the only one that has pretty much collected very in depth data in terms of this area. Katie Strong: Yeah, well, it sounds like that really widened your lens in how you were viewing things and taking an approach to thinking about the information that you had obtained. Jose Centeno: And it led to looking at the public health literature and actually meeting Pamela. In fact, I just saw her last week, and we met because we're collaborating on different projects. I always thank her because we met, when our Dean created an Equity Committee and she invited the two of us and somebody else to be to run that committee. And when Pamela and I talked, I said to her, “that qualitative work that you are doing can be adapted to my people with aphasia and their caregivers”. And that's how we collaborated, we put a grant proposal together, we got the money, and that led to the current study. Katie Strong: I love that, which we're going to talk about in a little bit. Okay, thank you. Yeah, I love it. Okay, well, before we get into that, you know, one of the things I was hoping you could talk about are the demographics of people living with aphasia is becoming really increasingly more diverse. And I was hoping you could talk about population trends that are driving the change or challenges and opportunities that this presents for our field. Jose Centeno: Yeah, that is actually something that I've been very interested in after looking at the public health literature because that led to looking at the literature in cardiology, nursing, social work, psychology, in terms of diversity, particularly the census data that people in public health were using to discuss what was going on in terms of the impact of population trends in healthcare. And I realized when I started looking at those numbers that and interestingly, the Census published later. The Census was published in 2020, several years after I started digging into the public health literature. The Census published this fantastic report where they the Census Bureau, discussed how population trends were going to be very critical in 2030 in the country. In 2030 two population trends are going to merge. The country gradually has been getting older and at the same time in 2030 as the country is getting older, 2030 is going to be a turning point that demographic transition, when the population is going to be more older people than younger people. So that's why those population trends are very important for us because people are getting older, there is higher incidence for vulnerabilities, health complications. And of those health complications, neurological, cardiovascular problems, stroke and also dementia. Katie Strong: Yes. So interesting. And maybe we can link, after we finish the conversation, I'll see if I can get the link for that 2020 census report, because I think maybe some people might be interested in checking that out a little bit more. Jose Centeno: So yeah, definitely, yeah. Katie Strong: Well, you know, you've talked about diversity from a multilingual, bilingual perspective, but you also, in your research, the articles I've read, you talk about expanding the diversity umbrella beyond race to consider things like sexual orientation, socioeconomic background and rural populations. Can you talk to us a little bit about what made you think about diversity in this way? Jose Centeno: Very good question, you know, because I realized that there is more to all of us than race. When we see a client, a patient, whatever term people use in healthcare and we start working with that person there is more that person brings into the clinical setting, beyond the persons being white or African American or Chinese or Latino and Latina or whatever. All those different ethnic categories, race and ethnicity. People bring their race and ethnicity into the clinical setting, but beyond that, there is age, there is sexual orientation, there is religion, there is geographic origins, whether it's rural versus urban, there is immigration status, language barriers, all of those things. So, it makes me think, and at that time when I'm thinking about this beyond race, I'm collecting the pilot data, and a lot of the pilot data that was collected from caregivers were highlighting all of those issues that beyond race, there are many other issues. And of course, you know, our colleagues in in aphasia research have touched on some of those issues, but I think there hasn't been there. There's been emphasis on those issues but separately. There hasn't been too much emphasis in looking at all of those issues overlapping for patient-centered care, you know, bringing all those issues together and how they have an impact on that post stroke life reconfiguration. You know, when somebody is gay. Where somebody is gay, Catholic, immigrant, bilingual, you know, looking at all of those things you know. And how do we work with that? Of course, we're not experts in everything, and that leads to interprofessional collaborations, working with psychologists, social workers and so on. So that's why my work started evolving in the direction that looks at race in a very intersectional, very interactional way to look at race interacting with all these other factors. Because for instance, I am an immigrant, but I also lived in rural and urban environments, and I have my religious and my spiritual thoughts and all of those, all of those factors I carry with me everywhere you know. So, when somebody has a stroke and has aphasia, how we can promote, facilitate recovery and work with the family in such a way that we pay attention to this ecology of factors, family person to make it all function instead of being isolated. Katie Strong: Yeah, I love that. As you were talking, you use the term intersectionality. And you have a beautiful paper that talks about transformative intersectional Life Participation Approach for Aphasia (LPAA) intervention. And I'd love to talk about the paper, but I was hoping first you could tell us what you really mean by intersectionality in the context of aphasia care, and why is it so important to think about this framework. Jose Centeno: Wow. It's related to looking at these factors to really work with the person with aphasia and the family, looking at all these different factors that the person with aphasia brings into the clinical setting. And these factors are part of the person's life history. It's not like these are factors that just showed up in the person's life. This person has lived like this. And all of a sudden, the person has a stroke. So there is another dimension that we need to add that there in that intersectional combined profile of a person's background. How we can for aphasia, is particularly interesting, because when you work with diverse populations, and that includes all of us. You know, because I need to highlight that sometimes people…my impression is, and I noticed this from the answers from my students, that when I asked about diversity, that they focused on minoritized populations. But in fact, all this diverse society in which we live is all of us. Diversity means all of us sharing this part, you know, sharing this world. So, this intersectionality applies to all of us, but when it comes to underrepresented groups that haven't been studied or researched, that's why I feel that it's very important to pay a lot of attention, because applying models that have been developed to work with monolingual, middle class Anglo background…it just doesn't work. You know, to apply this norm to somebody that has all of these different dimensions, it's just unfair to the person and it's something that people have to be aware of. Yeah. Katie Strong: Yeah. And I think you know, as you're talking about that and thinking about the tenets of the Life Participation Approach, they really do support one another in thinking about people as individuals and supporting them in what their goals are and including their family. You're really thinking about this kind of energized in a way to help some clinicians who are maybe thinking, “Oh, I do, LPAA, but it's hard for me to do it in this way”. You probably are already on you road to doing this, but you really need, just need to be thinking about how, how the diversity umbrella, really, you know, impacts everybody as a clinician, as a person with a stroke, as a family member. Jose Centeno: Yeah, and, you know, what is very interesting is that COVID was a time of transition. A lot of factors were highlighted, in terms of diversity, in terms of the infection rate and the mortality was higher in individuals from minoritized backgrounds. There were a lot of issues to look at there. But you know, what's very interesting in 2020 COVID was focusing our attention on taking care of each other, taking care of ourselves, taking care of our families. The LPAA approach turned 20 years old. And that made me think, because I was thinking of at that time of disability, and it made me think of intersectionality. And I just thought it would be very helpful for us to connect this concept of intersectionality to the LPAA, because these issues that we are experiencing right now are very related to the work we do as therapists to facilitate people with aphasia, social reconnection after a stroke and life reconfiguration. So, all of this thinking happened, motivated by COVID, because people were talking about intersectionality, all the people that were getting sick. And I just thought, wait a minute, this concept of intersectionality, LPAA turning 20 years old, let's connect those two, because my caregiver study is showing me that that intersectionality is needed in the work that we're doing with people in aphasia from underrepresented backgrounds. Katie Strong: Yeah, I'm so glad that you shared that insight as to how you came to pulling the concepts together. And the paper is lovely, and I'll make sure that we put that in the link to the show notes as well, because I know that people will, if they haven't had the chance to take a look at it, will enjoy reading it. Jose Centeno: And just let me add a bit more about that. Aura Kagan's paper on, I forgot where it was in [ASHA] Perspectives, or one of the journals where she talks about the LPAA turning 20 years old. [And I thought], “But wait a minute, here's the paper! Here's the paper, and that I can connect with intersectionality”. And at the same time, you know, I started reading more about your work and Jackie Hinckley's work and all the discourse work and narrative work because that's what I was doing at the time. So that's how several projects have emerged from that paper that I can share later on. Katie Strong: I love it. I love it. Yeah, hold on! The suspense! We are there, right? Jose Centeno: This is turning into a coffee chat without coffee! Katie Strong: As I was reading your work, something that stood out to me was this idea of building sustainable community relationships in both research and clinical work with minoritized populations. You've been really successful in doing this. I was hoping you could discuss your experiences in this relationship building, and you also talk about this idea of cultural brokers. Jose Centeno: Wow! You know this is all connected. It's part of my evolution, my journey. Because as I started collecting data in the community from for my caregiver study, I realized that community engagement to do this type of qualitative work, but also to bring our students into the community. It's very important to do that work, because I you know this is something that I learned because I was pretty much functioning within an academic and research environment and writing about equity and social justice and all these different areas regarding aphasia, but not connecting real life situations with the community. For example, like having the students there and me as an academician taking that hat off and going into the community, to have lunch, to have coffee with people in the community, at Community Centers. So those ideas came up from starting to talk with the caregivers, because I felt like I needed to be there more. Leave the classroom. Leave the institution. Where I was in the community it's not easy. I'm not going to say that happened overnight, because going into any community, going into any social context, requires time. People don't open their doors automatically and right away. You know you have to be there frequently. Talk about yourself, share experiences. So be a friend, be a partner, be a collaborator, be all of these things together, and this gradually evolved to what I am doing right now, which is I started the one particular connection in the community with a community center. How did I do that? Well, I went all over the place by myself. Health fairs, churches, community centers. People were friendly, but there wasn't something happening in terms of a connection. But one person returned my email and said, “we have a senior program here. Why don't we meet and talk?” So, I went over to talk with them, and since then, I have already created a course to bring the students there. I started by going there frequently for lunch, and I feel very comfortable. It is a community center that has programs for children and adults in the community. They go there for computer classes, for after school programs for the children. The adults go there for English lessons or activities and they have games and so on. And it's very focused on individuals from the community. And the community in Newark is very diverse. Very diverse. So that led to this fantastic relationship and partnership with the community. In fact, I feel like I'm going home there because I have lunch with them. There's hugs and kissed. It's like seeing friends that that you've known for a long time. But that happened gradually. Trust. Trust happens gradually, and it happens in any social context. So, I said to them, “Let's start slowly. I'll bring the students first to an orientation so they get to know the center.” Then I had the opportunity to develop a course for summer. And I developed a course that involved activities in the community center and a lecture. Six weeks in the summer. So this project now that I call Brain Health a health program for older adults, is a multi-ethnic, multilingual program in which the students start by going to the center first in the spring, getting to know people there, going back there for six weeks in the summer, one morning a week, and taking a lecture related to what brain health is, and focusing that program on cognitive stimulation using reminiscence therapy. And it's done multilingually. How did that happen? Thank God at the center there are people that speak Portuguese, Spanish and English. And those people were my interpreters. They work with the students. They all got guidelines. They got the theoretical content from the lectures, and we just finished the first season that I called it. That course they ran this July, August, and the students loved it, and the community members loved it! But it was a lot of work. Katie Strong: Yeah, of course! What a beautiful experience for everybody, and also ideas for like, how those current students who will be soon to be clinicians, thinking about how they can engage with their communities. Jose Centeno: Right! Thank you for highlighting that, because that's exactly how I focus the course. It wasn't a clinical course, it was a prevention course, okay? And part of our professional standards is prevention of communication disorders. So, we are there doing cognitive stimulation through reminiscence activities multilingually, so we didn't leave anybody behind. And luckily, we have people that spoke those languages there that could help us translate. And my dream now the next step is to turn that Brain Health course into another course that involves people with aphasia. Katie Strong: Oh, lovely. Jose Centeno: Yeah, so that is being planned as we speak. Katie Strong: I love everything about this. I love it! I know you just finished the course but I hope you have plans to write it up so that others can learn from your expertise. Jose Centeno: Yeah, I'm already thinking about that. Katie Strong: I don't want to put more work on you… Jose Centeno: It's already in my attention. I might knock on your door too. We're gonna talk about that later. Katie Strong: Let's get into the work about your caregivers and the work that you did. Why don't you tell us what that was all about. Jose Centeno: Well, it's a study that focuses on my interest in finding out and this came from the assessment work that I did earlier when I asked clinicians working in healthcare what their areas of need were. But after meeting Pamela Rothpletz-Puglia at Rutgers, I thought, “Wait a minute, I would like to find out, from the caregivers perspective, what the challenges are, what they need, what's good, what's working, and what's not working.” And later on hopefully, with some money, some grant, I can involve people with aphasia to also ask them for their needs. So, I started with the caregivers to find out in terms of the intersectionality of social determinants of health, where the challenges were in terms of living with somebody with aphasia from a Latinx background, Latino Latina, Latinx, whatever categories or labels people use these days. So, I wanted to see what this intersectionality of social determinants of health at the individual level. Living with the person at home, what happens? You know, this person, there is a disability there, but there are other things going on at home that the literature sites as being gender, religion, and all these different things happening. But from the perspective of the caregivers. And also I wanted to find out when the person goes into the community, what happens when the person with aphasia goes into the community when the person tries to go to the post office or the bank or buy groceries, what happens? Or when the person is socializing with other members of the family and goes out to family gatherings? And also, what happens at the medical appointment, the higher level of social determinants in terms of health care? I wanted to find out individual, community and health care. The questions that I asked during these interviews were; what are the challenges?, what's good?, what's working?, what's not working?, at home?, in the community?, and when you go with your spouse or your grandfather or whoever that has a stroke into the medical setting?, and that's what the interviews were about. I learned so much, and I learned the technique from reading your literature and reading Aura Kagen's literature and other people, Jackie Hindley literature, and also Pamela's help to how to conduct those interviews, because it's a skill that you have to learn. It happens gradually. Pamela mentored me, and I learned so much from the caregivers that opened all these areas of work to go into the community, to engage community and sustainable relationships and bring the students into the community. I learned so much and some of the things that were raised that I am already writing the pilot data up. Hopefully that paper will be out next year. All these issues such as gender shifting, I would say gender issues, because whether is the wife or the mother that had a stroke or the father that had the stroke. Their life roles before the stroke get shifted around because person has to take over, and how the children react to that. I learned so much in terms of gender, but also in terms of how people use their religions for support and resilience. Family support. I learned about the impact of not knowing the language, and the impact of not having interpreters, and the impact of not having literature in the language to understand what aphasia is or to understand what happens after stroke in general to somebody. And something also that was very important. There are different factors that emerge from the data is the role of language brokers, young people in college that have to put their lives on hold when mom or dad have a stroke and those two parents don't speak English well in such a way that they can manage a health care appointment. So, this college student has to give up their life or some time, to take care of mom or dad at home, because they have to go to appointments. They have to go into the community, and I had two young people, college age, talk to me about that, and that had such an impact on me, because I wasn't aware of it at all. I was aware of other issues, but not the impact on us language brokers. And in terms of cultural brokers, it is these young people, or somebody that is fluent in the language can be language brokers and cultural brokers at the same time, because in the Latinx community, the family is, is everything. It's not very different from a lot of other cultures, but telling somebody when, when somebody goes into a hospital and telling family members, or whoever was there from the family to leave the room, creates a lot of stress. I had somebody tell me that they couldn't understand her husband when he was by himself in the appointment, and she was asked to step out, and he got frustrated. He couldn't talk. So that tension, the way that the person explained that to me is something that we regularly don't know unless we actually explore that through this type of interview. So anyway, this this kind of work has opened up so many different factors to look at to create this environment, clinical environment, with all professions, social work, psychology and whoever else we need to promote the best care for patient-centered care that we can. Katie Strong: Yeah. It's beautiful work. And if I remember correctly, during the interviews, you were using some personal narratives or stories to be able to learn from the care partners. And I know you know, stories are certainly something you and I share a passion about. And I was just wondering if you could talk with our listeners about how stories from people with aphasia or their care partners families can help us better understand and serve diverse communities. Jose Centeno: You know, the factors that I just went through, they are areas that we need to pay attention to that usually we don't know. Because very often, the information that we collect during the clinical intake do not consider those areas. We never talk about family dynamics. How did the stroke impact family dynamics? How does aphasia impact family dynamics? Those types of questions are important, and I'll tell you why that's important. Because when the person comes to the session with us, sometimes the language might not be the focus. They are so stressed because they cannot connect with their children as before, as prior to the stroke. In their minds, there is a there are distracted when they come into the session, because they might not want to focus on that vocabulary or sentence or picture. They want to talk about what's going on at home. Katie Strong: Something real. Jose Centeno: And taking some time to listen to the person to find out, “Okay, how was your day? How what's going on at home prior?” So I started thinking brainstorming, because I haven't gotten to that stage yet. Is how we can create, using this data, some kind of clinical context where there is like an ice breaker before the therapies, to find out how the person was, what happened in the last three days, before coming back to the session and then going into that and attempting to go into those issues. You know, home, the community. Because something else that I forgot to mention when I was going through the factors that were highlighted during the interviews, is the lack of awareness about aphasia in the community. And the expectations that several caregivers highlighted, the fact that people expected that problem that the difficulty with language to be something that was temporary. Katie Strong: Yeah, not a chronic health condition. Jose Centeno: Exactly. And, in fact, the caregivers have turned into educators, who when they go into community based on their own research, googling what aphasia is and how people in aphasia, what the struggles are. They had started educating the community and their family members, because the same thing that happens in the community can happen within the family network that are not living with this person on a day-to-day basis. So, yeah. All of this information that that you know, that has made me think on how clinically we can apply it to and also something how we can focus intervention, using the LPAA in a way that respects, that pays attention to all of these variables, or whatever variables we can or the most variables. Because we're not perfect, and there is always something missing in the intervention context, because there is so much that we have to include into it, but pay attention to the psychosocial context, based on the culture, based on the limitations, based on their life, on the disruption in the family dynamics. Katie Strong: Yeah, yeah. It's a lot to think about. Jose Centeno: Yeah. It's not easy. But I, you know. I think that you know these data that I collected made me think more in terms of our work, how we can go from focusing the language to being a little more psychosocially or involved. It's a skill that is not taught in these programs. My impression is that programs focus on the intervention that is very language based, and doing all this very formal intervention. It's not a formula, it's a protocol that is sometimes can be very rigid, but we have to pay attention to the fact that there are behavioral issues here that need to be addressed in order to facilitate progress. Katie Strong: Yeah, and it just seems like it's such more. Thinking about how aphasia doesn't just impact the person who has it. And, you know, really bringing in the family into this. Okay, well, we talked about your amazing new class, but you just talked a little bit about, you know, training the new workforce. Could you highlight a few ideas about what you think, if we're training socially responsive professionals to go out and be into the workforce. I know we're coming near the end of our time together. We could probably spend a whole hour talking about this. What are some things that you might like to plant in the ears of students or clinicians or educators that are listening to the podcast? Jose Centeno: You know this is something Katie that was part of my evolution, my growth as a clinical researcher. I thought that creating a program, and Rutgers gave us that opportunity, to be able to create a program in such a way that everybody's included in the curriculum. We created a program in which the coursework and the clinical experiences. And this happened because we started developing this room from scratch. It's not like we arrived and there was a program in place which is more difficult. I mean creating a program when you have the faculty together and you can brainstorm as to based on professional standards and ASHA's priorities and so on, how we can create a program, right? So, we started from scratch, and when I was hired as founding faculty, where the person that was the program director, we worked together, and we created the curriculum, clinically and education academically, in such a way that everybody, but everybody, was included from the first semester until the last semester. And I created a course that I teach based on the research that I've done that brings together public health intersectionality and applied to speech language pathology. So, this course that students take in the first semester, and in fact, I just gave the first lecture yesterday. We just started this semester year. So it sets the tone for the rest of the program because this course covers diversity across the board, applying it to children, adults and brings together public health, brings together linguistics, brings together sociology. All of that to understand how the intersectionality, all those different dimensions. So, the way that the I structured the course was theory, clinical principle and application theory, and then at the end we have case scenarios. So that's how I did it. And of course, you know, it was changing as the students gave me feedback and so on. But that, that is the first course, and then everybody else in their courses in acquired motor disorders, swallowing, aphasia, dementia. You know, all those courses, the adult courses I teach, but you know the people in child language and literacy. They cover diversity. Everybody covers diversity. So, in the area more relevant to our conversation here, aphasia and also dementia. In those courses, I cover social determinants of health. I expand on social determinants of health. I cover a vulnerability to stroke and dementia in underrepresented populations and so on. So going back to the question, creating a curriculum, I understand you know that not every program has the faculty or has the resources the community. But whatever we can do to acknowledge the fact that diversity is here to stay. Diversity is not going to go away. We've been diverse since the very beginning. You know, like, even if you look, if you look at any community anywhere, it's already diverse as it is. So, incorporating that content in the curriculum and try to make the connections clinically. Luckily, we were able to do that. We have a clinic director that is also focused on diversity, and we cover everything there, from gender issues, race, ethnicity, all of those, as much as we can. So, the curriculum and taking the students into the community as much as we can. Katie Strong: Yeah, I love that. So, you're talking about front loading a course in the curriculum, where you're getting people thinking about these and then, it's supplemented and augmented in each of the courses that they're taking. But also, I'm hearing you say you can't just stay in a classroom and learn about this. You need to go out. Jose Centeno: Exactly! It's a lot. It didn't happen overnight. A lot of this was gradual, based on students feedback. And, you know, realizing that within ourselves, we within the course, when we were teaching it, oh, I need to change this, right, to move this around, whatever. But the next step I realized is, let's go into the community. Katie Strong: Yeah, yeah. Well how lucky those students are at Rutgers. Jose Centeno: Thank you. Katie Strong: Well, we're nearing the end of our time together today. Jose and I just wanted, before we wrap up, I just wanted to ask you, “what, what excites you most about where aphasia research and care could go, or what do you think might need our most attention?” Jose Centeno: That's a great question, because I thought of it quite a bit. But I'll focus it in terms of our diverse population, where the aphasia research should be. I think my impression is that there should be more attempts to connect the theoretical aspects of language with the psychosocial aspect. In other words, and this is how I teach my aphasia class. I focus the students on the continuum of care. The person comes in after stroke. We try to understand aphasia, but we aim to promoting life reconfiguration, life readaptation, going back into the community. So, here's the person with aphasia, and this is where we're heading to facilitating functioning, effective communication in the best way we can for this person, right? So, if these are all the different models that have been proposed regarding lexicon, vocabulary and sentence production and so on. How can we connect those therapeutic approaches in a way that they are functionally usable to bring this person back? Because there is a lot of literature that I enjoy reading, but how can we bring that and translate that to intervention, particularly with people that speak other languages. Which is very difficult because there isn't a lot of literature. But at least making an attempt to recruit the students from different backgrounds, ethnic backgrounds. And this, regardless of the backgrounds, there are students studying, interested in studying other cultures. And the curriculum exposes students to ways that we that there is some literature, there is a lot but there is some literature out there to explain vocabulary sentences in other languages post stroke in people with aphasia that, you know, we can use therapeutically. I mean, this is what's been created. So, let's look at this literature and be more open-minded. It's difficult. We don't speak every language in the world, but at least try to connect through the students that speak those languages in class, or languages departments that we have on campus, how those projects can be worked on. I'm just trying to be ambitious and creative here, because there's got to be a way that we should connect those theoretical models that are pretty much English focused intervention paradigms that will facilitate social function/ Katie Strong: It's a lot a lot of work, a lot of work to be done, a lot of a lot of projects and PhD students and all of that. Amazing. Jose Centeno: I think it's as you said, a monumental amount of work, but, but I think that there should be attempts, of course, to include some of that content in class, to encourage students attention to the fact that there is a lot of literature in aphasia that is based on English speakers, that is based on models, on monolingual middle class…whoever shows up for the research project, the participants. But those are the participants. Now, I mean those that data is not applicable to the people [who you may be treating]. So, it's a challenge, but it's something to be aware of. This is a challenge to me that, and some people have highlighted that in the aphasia literature, the fact that we need more diversity in terms of let's study other languages and let's study intervention in other populations that don't speak English. Katie Strong: Absolutely. Well, lots of amazing food for thought, and this has been such a beautiful conversation. I so appreciate you being here today, Jose. Thank you very, very much. Jose Centeno: Thank you, Katie. I appreciate the invitation and I hope the future is bright for this type of research and clinical work and thank you so much for this time to talk about my work. Resources Centeno, J. G., (2024). A call for transformative intersectional LPAA intervention for equity and social justice in ethnosocially diverse post-stroke aphasia services. Seminars in Speech and Language, 45(01): 071-083. https://doi.org/10.1055/s-0043-1777131 Centeno, J. G., & Harris, J. L. (2021). Implications of United States service evidence for growing multiethnic adult neurorehabilitation caseloads worldwide. Canadian Journal of Speech-Language Pathology and Audiology, 45(2), 77-97. Centeno, J. G., Kiran, S., & Armstrong, E. (2020). Aphasia management in growing multiethnic populations. Aphasiology, 34(11), 1314-1318. https://doi.org/10.1080/02687038.2020.1781420 Centeno, J. G., Kiran, S., & Armstrong, E. (2020). Epilogue: harnessing the experimental and clinical resources to address service imperatives in multiethnic aphasia caseloads. Aphasiology, 34(11), 1451–1455. http://dx.doi.org/10.1080/02687038.2020.1781421 Centeno, J. G., Obler, L. K., Collins, L., Wallace, G., Fleming, V. B., & Guendouzi, J. (2023). Focusing our attention on socially-responsive professional education to serve ethnogeriatric populations with neurogenic communication disorders in the United States. American Journal of Speech-Language Pathology, 32(4), 1782–1792. https://doi.org/10.1044/2023_AJSLP-22-00325 Kagan, A. (2020). The life participation approach to aphasia: A 20-year milestone. Perspectives of the ASHA Special Interest Groups, 5(2), 370. https://doi.org/10.1044/2020_PERSP-20-00017 Vespa, J., Medina, L., & Armstrong, D. M. (2020). Demographic turning points for the United States: population projections for 2020 to 2060. Current Population Reports, P25-1144. https://www.census.gov/library/publications/2020/demo/p25-1144.html
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Today on the podcast, I interviewed award-winning researcher, speaker and author, Jessica Grossmeier. We talk about the three main pillars of well-being: Purpose, Social Connection and Transcendance. Jessica shares research backed practices that can enhance our well-being. She reminds us our purpose can change over time and work isn't the only place we can have a sense of purpose. Jessica also shares ways we can find more balance in our life by paying attention to "Harmonious Passion" and "Obsessive Passion." Jessica also invites us to think about how we are fostering meaningful relationships in and outside of work. And why spirituality is an essential piece to enhancing our well-being. Take a listen to this episode and share your takeaways with us on LinkedIn at Jessica and Wade. Resurces: Discover your unique Overwhelm Archetype by taking this free quiz and learn how to cultivate a path to balance. Download your Centered Walks Here. Want support with your individual self-care practices? Check out my interactive self-care journal: 100 Mindful Moments to Balance & Energize Order Well At Work here. Jessica Grossmeier is an award-winning researcher, speaker, and author of two books: Reimagining Workplace Well-being and Well At Work. As a leading authority in workforce well-being, she collaborates with employers and well-being service providers to create evidence-based strategies to support individual and organizational thriving. Recognized as one of the most influential women leaders in health promotion by the American Journal of Health Promotion, Jessica serves as a Senior Fellow for the Health Enhancement Research Organization, Strategic Advisor, ROI of Care for Compassion 2.0, Chairs the Workplace Wellbeing Initiative of the Global Wellness Institute, and serves on several advisory boards. Jessica holds doctoral and master's degrees in public health, specializing in community health education. For more information, visit www.jessicagrossmeier.com
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Is your smartwatch just a fun gadget, or a serious medical device? In this episode, Jonathan Wolf is joined by Dr. Malcolm Findlay, a leading consultant cardiologist, to explore the powerful health data available on your wrist. They decode the most misunderstood metric, Heart Rate Variability (HRV), and reveal how your wearable can provide clinical-grade insights into your heart's health. Dr. Findlay explains the counter-intuitive science behind HRV — why more ‘wobble' in your heartbeat is a sign of good health — and breaks down the two opposing nervous systems that control it. He shares the latest on how these devices can accurately detect serious conditions like atrial fibrillation and why he, as a cardiologist, trusts the ECG function on a consumer smartwatch to make diagnoses. For listeners who track their own data, this episode is a practical guide to what your numbers actually mean. Dr. Findlay explains how to interpret your personal HRV trends, what constitutes a significant change, and when you should use the ECG feature. He also debunks common myths about heart rate zones, revealing the level of exercise intensity that truly benefits your long-term health. The episode concludes with an empowering look at how this technology is shifting control into our own hands. Can a simple alert from your watch really help prevent a catastrophic event like a stroke? Discover which metrics matter most and how to use them to guide your wellness journey.
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