Podcasts about American Journal

FBI Arrests J6 Pipe Bomb Suspect, Deep State Going After Hegseth To Get To Trump & DOJ Moves To Clean Voter Rolls

Much like the amount of time the New England sun stays up, enjoy a short preview of what's coming out in the darkest days of December on the podcast. This month we've got three special guests including SLP, Judy Southey leading us through the new "How To" all about PECS; Denisha Gingles to lead us through a discussion of leadership practices in ABA, and Matt Cicoria leading us into the new year by reviewing what happened in ABA in 2025 in our yearly special episode. And, to round things out, a discussion about exactly what makes up assent practices. Yule love it all! Articles for December 2025 Tutorial: PECS with Judy Southey Robertson, M. & Harris, T. (2024, December 30th). How to best determine if an autistic individual is using an effective communication system. Autism Spectrum News. https://autismspectrumnews.org/how-to-best-determine-if-an-autistic-individual-is-using-an-effective-communication-system Wannapaschaiyong, P., Vivattanasinchai, T., & Wongkwanmuang, A. (2025). Predictors of successful Picture Exchange Communication System training in children with communication impairments: Insights from a real-world intervention in a resource-limited setting. BMJ Paediatrics Open, 9, 1-13. doi: 10.1136/bmjpo-2024-003282 Ganz, J.B., Mason, R.A., Goodwyn, F.D., Boles, M.B., Heath, A.K., & Davis, J.L. (2014). Interaction of participant characteristics and type of AAC with individuals with ASD: A meta-analysis. American Journal on Intellectual and Developmental Disabilities, 119, 516-535. doi: 10.1352/1944-7558-119.6.516   Culturally Reponsive Leadership Practices in ABA w/ Denisha Gingles Sriram, V., Atwal, A., & McKay, E.A. (2024). Exploring aspects of mentoring for black and minoritised healthcare professionals in the UK: A nominal group technique study. BMJ Open, 14. doi: 10.1136/bmjopen-2024-089121 Kemzang, J., Bekolo, G., Jaunky, S., Mathieu, J., Contant, H., Oguntala, J., Rahmani, M., Louisme, M.C., Medina, N., Kendall, C.E., Ewurabena, S., Hubert, D., Omecq, M.C., & Fotsing, S. (2024). Mentoring for admission and retention of black socio-ethnic minorities in medicine: A scoping review. Journal of Medical Education and Curricular Development, 11, 1-9. doi: 10.1177/23821205241283805 Shaikh, A.N., Gummaluri, S., Dhar, J., Carter, H., Kwag, D. (2024). Application of the principles of anti-oppression to address marginalized students and faculty's experiences in counselor education. Teaching and Supervision in Counseling, 6, 94-105. doi: 10.7290/tsc06laio Laloo, E. (2022). Ubuntu leadership - an explication of an Afrocentric leadership style. The Journal of Values-Based Leadership, 15, 1-9. doi: 10.22543/1948-0733.1383 Mathur, S.K. & Rodriguez, K.A. (2022). Cultural responsiveness curriculum for behavior analysts: A meaningful step toward social justice. Behavior Analysis in Practice, 15, 1023-1031. doi: 10.1007/s40617-021-00579-3   Operationalizing Assent Mead Jasperse, S.C., Kelly, M.P., Ward, S.N., Fernand, J.K., Joslyn, P.R., & van Dijk, W. (2025). Consent and assent practices in behavior analytic research. Behavior Analysis in Practice, 18, 826-841. doi: 10.1007/s40617-023-00838-5  Flowers, J. & Dawes, J. (2023). Dignity and respect: Why therapeutic assent matters. Behavior Analysis in Practice, 16, 913-920. doi: 10.1007/s40617-023-00772-6

In the original Løvset maneuver (described for breech presentations), the fetus is rotated in one direction to facilitate arm delivery. For shoulder dystocia, the reverse Løvset applies rotation in the opposite direction—specifically rotating the posterior shoulder toward a "belly down" position through up to 180 degrees of rotation. These maneuvers were first described by Norwegian obstetrician Jørgen Løvset in the 1940s. Now, in the current November 2025 AJOG, this maneuver is back in the spotlight. In this episode, we will review the reverse Løvset maneuver for shoulder dystocia and review its effectiveness. Which maneuver is more likely to result in fetal brachial plexus injury? Listen in for details. 1. A critical evaluation of the external and internal maneuvers for resolution of shoulder dystocia, March 2024; AJOG. https://www.ajog.org/article/S0002-9378(23)00022-4/fulltext2. Grindheim, Sindre et al.Reverse Løvset maneuver for shoulder dystocia, American Journal of Obstetrics & Gynecology, Volume 233, Issue 5, 505.e1 - 505.e43. Leung TY, Stuart O, Suen SS, Sahota DS, Lau TK, Lao TT. Comparison of perinatal outcomes of shoulder dystocia alleviated by different type and sequence of manoeuvres: a retrospective review. BJOG. 2011 Jul;118(8):985-90. doi: 10.1111/j.1471-0528.2011.02968.x. Epub 2011 Apr 12. PMID: 21481159.4. Grobman WA, Miller D, Burke C, Hornbogen A, Tam K, Costello R. Outcomes associated with introduction of a shoulder dystocia protocol. Am J Obstet Gynecol. 2011;205(6):513−517.STRONG COFFEE PROMO CODE:https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Trump Floats “Military Tribunal” For Obama, Hegseth Doubles Down On Striking Narco Boats & GOP Wins Tennessee Special Election

Where did arbitrary cut scores for norm-referenced language assessments come from, and why do they feel “safer” than relying on clinical judgement?I discuss this question and more in this third part of a three-part series, bilingual SLPs Destiny Johnson and Tiffany Shahoumian-Ruiz join me to continue our conversation about advocating for effective language evaluation practices in schools.Across these conversations, we explore:Sensitivity, specificity, reference standards, and diagnostic accuracyHow test development has evolved over time and why this matters Why the same cut-off score shouldn't apply across all testsThe math behind using two norm-referenced tests, and why it may complicate rather than clarify in some casesOther reasons we test beyond diagnosis (treatment planning, severity, monitoring progress)How do we do we to “sell” the concept of dynamic assessment to administratorsCase studies that show the pitfalls of over-reliance on standardized scoresMisconceptions clinicians often hold, and what they should know about assessmentDifferences in state eligibility standards, and what this means for service decisionsThis series is part myth-busting, part practical strategies, and part advocacy playbook—perfect for clinicians who want to move beyond compliance-driven evaluations toward assessments that truly reflect students' needs.Destiny Johnson, M.S., CCC-SLP, is a bilingual speech-language pathologist (English/Spanish) with a deep passion for culturally responsive assessment and treatment practices, as well as advocating for policy change. She has presented on dynamic assessment at the CSHA Convergence 2024, focusing on the importance of dynamic assessment in bilingual children. Destiny has experience working as a school-based SLP, in private practice, and in early intervention. She is also the founder and CEO of Multimodal Communication Speech Clinic P.C.Connect with Destiny on Instagram @destinyjohnsonslp, on her private practice website here, and on LinkedIn here.Listen to Destiny's previous episode on De Facto Leaders here: EP 187: Dynamic Assessment: Evaluations are a process, not a test (with Destiny Johnson)Tiffany Shahoumian-Ruiz is a bilingual high school SLP from Southern California who has primarily worked in the school systems and has experience at both the elementary and secondary level. She's also a member of Language Therapy Advance Foundations, and is involved in state and local advocacy work relating to dynamic assessments and special education eligibility.Connect with Tiffany on Instagram @tiffany.shahoumianListen to Tiffany's previous episode on De Facto Leaders here: High school language therapy: Do we still have time to make an impact? (with Tiffany Shahoumian-Ruiz)In this episode, I mention Language Therapy Advance Foundations, my program that gives SLPs and other service providers a system for language therapy. You can learn more about the program here.Additional Resources Mentioned in the episode:Daub, O., Cunningham, B. J., Bagatto, M. P., Johnson, A. M., Kwok, E. Y., Smyth, R. E., & Oram Cardy, J. (2021). Adopting a conceptual validity framework for testing in speech-language pathology. American Journal of Speech-Language Pathology, 30(4), 1894–1908. https://doi.org/10.1044/2021_AJSLP-20-00032Spaulding, T. J., Plante, E., & Farinella, K. A. (2006). Eligibility criteria for language impairment: Is the low end of normal always appropriate? Language, Speech, and Hearing Services in Schools, 37(1), 61–72. https://doi.org/10.1044/0161-1461(2006/007)DYMOND Norm-Referenced Dynamic AssessmentBilingual English-Spanish Assessment (BESA) We're thrilled to be sponsored by IXL. IXL's comprehensive teaching and learning platform for math, language arts, science, and social studies is accelerating achievement in 95 of the top 100 U.S. school districts. Loved by teachers and backed by independent research from Johns Hopkins University, IXL can help you do the following and more:Simplify and streamline technologySave teachers' timeReliably meet Tier 1 standardsImprove student performance on state assessments

Dems Call On Hegseth To Testify Before Congress Over Narco-Terror Boat Strikes, Trump Envoy Meets With Putin For Ukraine War Negotiations

A reading of articles and features from the December 2025/January 2026 Issue of the Polish American Journal

Marty Rowland, an environmental engineer with nearly five decades of experience, discusses his career highlights, including his work at the NASA facility in New Orleans and recent retirement from the New York City Parks Department. He addresses the controversy surrounding his dismissal from the American Journal of Economic Sociology due to his stance on climate skepticism, emphasizing the importance of hearing all sides of the debate. Rowland also shares his ongoing efforts in advocating for Henry George's philosophy on ending poverty, his upcoming book on the Rowland Triangle, and his continued involvement in environmental and social justice initiatives.00:00 Introduction to Marty Rowland00:39 The May Crok Controversy01:16 Climate Indifference and Skepticism03:40 Doubt, Faith, and Global Temperature07:28 The Role of the American Journal of Economic Sociology17:47 The Rowland Triangle and Public Policy23:31 Infrastructure and AI Guardrails28:35 Capturing Land Value and Public Discussions29:34 Obstacles Toward a Net Zero Grid29:56 The Role of Nuclear Energy33:27 The National Debt and Economic Policies45:08 Environmental Career and Challenges50:55 Guardrails and Public Safety55:50 Final Thoughts and ResourcesX: https://x.com/drmarty8Marty's Common Ground USA page: https://commonground-usa.net/marty-rowland-ph-d-p-e/Henry George School of Social Science: https://www.hgsss.org/========Slides, summaries, references, and transcripts of my podcasts: https://tomn.substack.com/p/podcast-summariesMy Linktree: https://linktr.ee/tomanelson1

Trump Goes Scorched Earth On Third World Immigration, Halts Asylum Claims & Says All Biden Autopen Actions Will Be “Terminated

Did you know that a single crumb of bread is enough to cause an autoimmune response in children with celiac disease? Dr. Pankaj Vohra, Professor of Pediatrics and Board-Certified Pediatric Gastroenterologist, joins medical student Andrea Smith to discuss the evaluation and management of celiac disease, as well as essential guidance for following a gluten-free diet. Specifically, they will: Review the epidemiology of celiac disease and identify common symptoms and presentations of celiac disease Describe the pathophysiology of celiac disease including histopathological changes to the duodenum Identify diagnostic tests and criteria for diagnosing celiac disease in the pediatric population Identify common sources of gluten and the basics of identifying gluten on food labels Discuss typical management of celiac disease including appropriate screening tests and managing accidental gluten ingestion Special thanks to Dr. Rebecca Yang and Dr. Neeharika Bade for peer reviewing this episode. CME available free with sign up: Link coming soon! References: Bolia, R., & Thapar, N. (2023). Celiac Disease in Children: A 2023 Update. In Indian Journal of Pediatrics. Springer. https://doi.org/10.1007/s12098-023-04659-w Gidrewicz, D., Potter, K., Trevenen, C. L., Lyon, M., & Butzner, J. D. (2015). Evaluation of the ESPGHAN celiac guidelines in a North American pediatric population. American Journal of Gastroenterology, 110(5), 760–767. https://doi.org/10.1038/ajg.2015.87 Hill, I. D., Fasano, A., Guandalini, S., Hoffenberg, E., Levy, J., Reilly, N., & Verma, R. (2016). NASPGHAN clinical report on the diagnosis and treatment of gluten-related disorders. Journal of Pediatric Gastroenterology and Nutrition, 63(1), 156–165. https://doi.org/10.1097/MPG.0000000000001216 Husby, S., Koletzko, S., Korponay-Szabó, I., Kurppa, K., Mearin, M. L., Ribes-Koninckx, C., Shamir, R., Troncone, R., Auricchio, R., Castillejo, G., Christensen, R., Dolinsek, J., Gillett, P., Hróbjartsson, A., Koltai, T., Maki, M., Nielsen, S. M., Popp, A., Størdal, K., … Wessels, M. (2020). European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. In Journal of Pediatric Gastroenterology and Nutrition (Vol. 70, Issue 1, pp. 141–156). Lippincott Williams and Wilkins. https://doi.org/10.1097/MPG.0000000000002497 Nenna, R., Tiberti, C., Petrarca, L., Lucantoni, F., Mennini, M., Luparia, R. P. L., Panimolle, F., Mastrogiorgio, G., Pietropaoli, N., Magliocca, F. M., & Bonamico, M. (2013). The celiac iceberg: Characterization of the disease in primary schoolchildren. Journal of Pediatric Gastroenterology and Nutrition, 56(4), 416–421. https://doi.org/10.1097/MPG.0b013e31827b7f64 Sahin, Y. (2021). Celiac disease in children: A review of the literature. In World Journal of Clinical Pediatrics (Vol. 10, Issue 4, pp. 53–71). Baishideng Publishing Group Co. https://doi.org/10.5409/wjcp.v10.i4.53 Salden, B. N., Monserrat, V., Troost, F. J., Bruins, M. J., Edens, L., Bartholomé, R., Haenen, G. R., Winkens, B., Koning, F., & Masclee, A. A. (2015). Randomised clinical study: Aspergillus niger-derived enzyme digests gluten in the stomach of healthy volunteers. Alimentary Pharmacology and Therapeutics, 42(3), 273–285. https://doi.org/10.1111/apt.13266 Schuppan, D., Mäki, M., Lundin, K. E. A., Isola, J., Friesing-Sosnik, T., Taavela, J., Popp, A., Koskenpato, J., Langhorst, J., Hovde, Ø., Lähdeaho, M.-L., Fusco, S., Schumann, M., Török, H. P., Kupcinskas, J., Zopf, Y., Lohse, A. W., Scheinin, M., Kull, K., … Greinwald, R. (2021). A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease. New England Journal of Medicine, 385(1), 35–45. https://doi.org/10.1056/nejmoa2032441 Tack, G. J., van de Water, J. M. W., Bruins, M. J., Kooy-Winkelaar, E. M. C., van Bergen, J., Bonnet, P., Vreugdenhil, A. C. E., Korponay-Szabo, I., Edens, L., von Blomberg, B. M. E., Schreurs, M. W. J., Mulder, C. J., & Koning, F. (2013). Consumption of gluten with gluten-degrading enzyme by celiac patients: A pilot-study. World Journal of Gastroenterology, 19(35), 5837–5847. https://doi.org/10.3748/wjg.v19.i35.5837 Husby S, Koletzko S, Korponay-Szabó IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54: 136–160

AJT December 2025 Editors' Picks Description:  Hosts Roz and Dr. Sanchez-Fueyo are joined by Hannah Bahakel to discuss the key articles of the December issue of the American Journal of Transplantation. Hannah Bahakel is a Clinical Immunodeficiency fellow at Cincinnati Children's Hospital Medical Center [03:34] Higher vs standard mean arterial pressure target in the immediate postoperative period of liver transplantation to prevent acute kidney injury: A randomized clinical trial (LIVER-PAM) [13:51] Donor-derived cell-free DNA significantly improves rejection yield in kidney transplant biopsies [26:27] Tolerogenic lung allograft microenvironment suppresses pathogenic tissue remodeling following respiratory virus infection in mice [37:11] Therapeutic needs in solid organ transplant recipients: The American Society of Transplantation patient survey [48:19] Impact of kidney function on 200 days of antiviral prophylaxis for cytomegalovirus disease in cytomegalovirus-seronegative recipients of cytomegalovirus-seropositive donor kidneys: Post hoc analysis of a randomized, phase 3 trial of letermovir vs valganciclovir prophylaxis

Welcome to the Psychedelic Conversations Podcast!In this episode, we discuss the emerging frontier of psychedelic-assisted neurorehabilitation with clinical neurologist Burton Tabaac. We explore his path into psychedelic science, his work with Johns Hopkins University, and the groundbreaking Fathom Trial—a study investigating whether psilocybin, paired with enriched, non-task-based play, can reopen critical periods of neuroplasticity to support stroke recovery far beyond the traditional healing window. We also dive into the legal and regulatory challenges of Schedule I substances, the evolving balance between clinical and ceremonial approaches, and the importance of honoring indigenous lineages while expanding patient access. Together, we reflect on the art of medicine, the role of set and setting, and the hopeful future of psychedelics in neurological healing.About Burton:Dr. Burton J. Tabaac, MD, FAHA, brings a wealth of expertise in neurology and stroke rehabilitation to Rose Hill. As an Associate Professor and Section Chief of Neurology at The University of Nevada's Reno School of Medicine, and Medical Director of Stroke at Carson Tahoe Health, Dr. Tabaac has been at the forefront of innovative neurological treatments. A graduate of the prestigious cerebrovascular neurology fellowship program at The Johns Hopkins University Hospital, Dr. Tabaac's accolades include being a three-time recipient of The Arnold P. Gold Foundation's Humanism and Excellence in Teaching Award and induction into the Alpha Omega Alpha Honor Medical Society. He recently published an eight-part paper in the American Journal of Therapeutics reviewing psychedelics as therapeutics for primary care clinicians. Dr. Tabaac's groundbreaking research focuses on the application of psychedelics in brain injury and stroke rehabilitation. Dr. Tabaac was recently appointed by the Governor of Nevada to serve as a member of the state's Psychedelic Medicines Working Group, which provides expertise and testimony relating to the therapeutic use of entheogens. As the host of The Zero Hour Podcast, he engages with leading experts in psychedelic research. His commitment to advancing the field was further highlighted in his 2022 TEDx talk at UCLA, “Mental Health Meets Psychedelics.”Connect with Burton:- Website: https://rosehill.life/- Twitter: https://x.com/burtontabaac?lang=en- LinkedIn: https://www.linkedin.com/in/burtontabaacThank you so much for joining us! Psychedelic Conversations Podcast is designed to educate, inform, and expand awareness.For more information, please head over to https://www.psychedelicconversations.comPlease share with your friends or leave a review so that we can reach more people and feel free to join us in our private Facebook group to keep the conversation going. https://www.facebook.com/groups/psychedelicconversationsThis show is for information purposes only, and is not intended to provide mental health or medical advice.About Susan Guner:Susan Guner is a holistic psychotherapist with a mindfulness-based approach grounded in Transpersonal Psychology, focusing on trauma-informed, community-centric processes that offer a broader understanding of human potential and well-being.Connect with Susan:Website: https://www.psychedelicconversations.com/Facebook: http://www.facebook.com/susan.gunerLinkedIn: https://www.linkedin.com/in/susan-guner/Instagram: http://www.instagram.com/susangunerTwitter: http://www.twitter.com/susangunerBlog: https://susanguner.medium.com/Podcast: https://anchor.fm/susan-guner#PsychedelicConversations #SusanGuner #BurtonTabaac #PsychedelicPodcast #Microdosing #PsychedelicScience

Trump To Halt Third World Immigration & Deport Migrants Who Are “Non-Compatible With Western Civilization!” Plus, Billboards Emerge Calling On Troops To Defy Chain Of Command & Drive Country Into Civil War

Thanksgiving Broadcast: National Guard Shooter Identified As Afghan Illegal Brought To US Via Biden's “Operation Allies Welcome

FBI Counterterrorism Division Opens Inquiry Into “Seditious Six” Sen. Slotkin & Trump Admin “DOGEing” The UN, Already Saving USA $1 Billion

Clinton-Appointed Judge Dismisses Comey Indictment, Pentagon Investigating Dem Sen. Mark Kelly's Seditious Video

When we choose evaluation tools for language, are we clear on WHY we're assessing? Most people think of diagnosis, but that's not the only reason we assess students. I discuss this question and more in this second part of a three-part series, bilingual SLPs Destiny Johnson and Tiffany Shahoumian-Ruiz join me to continue our conversation about language evaluation practices in schools.Across these conversations, we explore:Sensitivity, specificity, reference standards, and diagnostic accuracyHow test development has evolved over time and why this matters Why the same cut-off score shouldn't apply across all testsThe math behind using two norm-referenced tests, and why it may complicate rather than clarify in some casesOther reasons we test beyond diagnosis (treatment planning, severity, monitoring progress)How do we do we to “sell” the concept of dynamic assessment to administratorsCase studies that show the pitfalls of over-reliance on standardized scoresMisconceptions clinicians often hold, and what they should know about assessmentDifferences in state eligibility standards, and what this means for service decisionsThis series is part myth-busting, part practical strategies, and part advocacy playbook—perfect for clinicians who want to move beyond compliance-driven evaluations toward assessments that truly reflect students' needs.Destiny Johnson, M.S., CCC-SLP, is a bilingual speech-language pathologist (English/Spanish) with a deep passion for culturally responsive assessment and treatment practices, as well as advocating for policy change. She has presented on dynamic assessment at the CSHA Convergence 2024, focusing on the importance of dynamic assessment in bilingual children. Destiny has experience working as a school-based SLP, in private practice, and in early intervention. She is also the founder and CEO of Multimodal Communication Speech Clinic P.C.Connect with Destiny on Instagram @destinyjohnsonslp, on her private practice website here, and on LinkedIn here.Listen to Destiny's previous episode on De Facto Leaders here: EP 187: Dynamic Assessment: Evaluations are a process, not a test (with Destiny Johnson)Tiffany Shahoumian-Ruiz is a bilingual high school SLP from Southern California who has primarily worked in the school systems and has experience at both the elementary and secondary level. She's also a member of Language Therapy Advance Foundations, and is involved in state and local advocacy work relating to dynamic assessments and special education eligibility.Connect with Tiffany on Instagram @tiffany.shahoumianListen to Tiffany's previous episode on De Facto Leaders here: High school language therapy: Do we still have time to make an impact? (with Tiffany Shahoumian-Ruiz)In this episode, I mention Language Therapy Advance Foundations, my program that gives SLPs and other service providers create a system for language therapy. You can learn more about the program here.Additional Resources Mentioned in the episode:Daub, O., Cunningham, B. J., Bagatto, M. P., Johnson, A. M., Kwok, E. Y., Smyth, R. E., & Oram Cardy, J. (2021). Adopting a conceptual validity framework for testing in speech-language pathology. American Journal of Speech-Language Pathology, 30(4), 1894–1908. https://doi.org/10.1044/2021_AJSLP-20-00032Spaulding, T. J., Plante, E., & Farinella, K. A. (2006). Eligibility criteria for language impairment: Is the low end of normal always appropriate? Language, Speech, and Hearing Services in Schools, 37(1), 61–72. https://doi.org/10.1044/0161-1461(2006/007)DYMOND Norm-Referenced Dynamic AssessmentBilingual English-Spanish Assessment (BESA) We're thrilled to be sponsored by IXL. IXL's comprehensive teaching and learning platform for math, language arts, science, and social studies is accelerating achievement in 95 of the top 100 U.S. school districts. Loved by teachers and backed by independent research from Johns Hopkins University, IXL can help you do the following and more:Simplify and streamline technologySave teachers' timeReliably meet Tier 1 standardsImprove student performance on state assessments

SHOWNOTES: • American Journal of Preventive Medicine. (2025). The health and economic burden of employee burnout to U.S. employers. American Journal of Preventive Medicine, 68(4). https://www.ajpmonline.org/article/S0749-3797(25)00023-6/abstract • Breathe HR. (2024). The unused holiday & burnout epidemic. https://www.breathehr.com/en-gb/resources/holiday-burnout-report-2024 • Champion Health. (2024). Workplace health report 2024. • Deloitte. (2024, May 17). The projected costs and economic impact of mental health inequities in the United States. Deloitte Insights. https://www2.deloitte.com/us/en/insights/industry/health-care/economic-burden-mental-health-inequities.html • Eagle Hill Consulting. (2024, December 5). Nearing 2025, almost half of workers expect to leave some vacation time unused. HR Dive. https://www.hrdive.com/news/nearing-2025-almost-half-of-workers-unused-vacation-time/734609/ • Effectory. (2024, January 11). The emotional and economic costs of overlooking wellbeing in the workplace. https://www.effectory.com/knowledge/the-emotional-and-economic-costs-of-overlooking-wellbeing-in-the-workplace/ • Gallup. (2025, March 27). The economic cost of poor employee mental health. https://www.gallup.com/workplace/404174/economic-cost-poor-employee-mental-health.aspx • Illinois Department of Labor. (2024). Paid Leave for All Workers Act. https://labor.illinois.gov/laws-rules/paidleave.html • Illinois Department of Labor. (2024). Paid Leave for All Workers Act FAQ. https://labor.illinois.gov/faqs/paidleavefaq.html • Lane Report. (2024, July 24). One-third of U.S. employees' PTO, vacation days go unused. https://www.lanereport.com/175306/2024/07/one-third-of-u-s-employees-pto-vacation-days-go-unused/ • MHFA England. (2024, November 21). Key workplace mental health statistics for 2024. https://mhfaengland.org/mhfa-centre/blog/Key-workplace-mental-health-statistics-for-2024/ • National Alliance on Mental Illness. (2025, February 18). The 2024 NAMI workplace mental health poll. https://www.nami.org/support-education/publications-reports/survey-reports/the-2024-nami-workplace-mental-health-poll/ • Nekoei, A., et al. (2024). The economics of burnout. Centre for Economic Policy Research. https://cepr.org/voxeu/columns/economics-burnout • SHRM. (2024, April 12). Why mental health will be one of the biggest topics of 2024. https://www.shrm.org/topics-tools/news/benefits-compensation/mental-health-burnout-top-trend-aflac-report • Sorbet. (2024). PTO Report 2024. • Spill. (2024). 64 workplace burnout statistics you need to know for 2024. https://www.spill.chat/mental-health-statistics/workplace-burnout-statistics • The Washington Post. (2023, December 30). The mystery of the disappearing vacation day. https://www.washingtonpost.com/business/2023/02/10/disappearing-vacation-days/

American Deep State Partnered With China & Venezuela To Rig US Elections For DECADES!

In this episode I'm joined by Lyman Stone and Diana Fleischman for a debate on eugenics – specifically, Diana's argument that most people support ‘negative eugenic' policies to some degree, and that governments ought to go further by encouraging the use of sterilisation or long term contraception among, for instance, drug addicts.Lyman Stone is the Director of Research of the consulting firm Demographic Intelligence, the director of the Pronatalism Initiative at the Institute for Family Studies, and an author on Substack - Diana Fleischman is an evolutionary psychologist, Associate Research Professor at the University of New Mexico, and author of the Dissentient Substack - https://dissentient.substack.comDiscussed in the episode:* Diana's essay ‘You're probably a eugenicist' https://dissentient.substack.com/p/eugenicist* Shor, E., & Simchai, D. (2009). Incest avoidance, the incest taboo, and social cohesion: Revisiting Westermarck and the case of the Israeli kibbutzim. American Journal of Sociology, 114(6), 1803–1842.* Gipson, J. D., Bornstein, M., Berger, A., & Rocca, C. H. (2021). Desire to avoid pregnancy and contraceptive use among female methadone patients in Los Angeles. Contraception, 103(5), 322–327* Donohue, J. J., & Levitt, S. D. (2001). The Impact of Legalized Abortion on Crime. The Quarterly Journal of Economics, 116(2), 379–420. https://doi.org/10.1162/00335530151144050 This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.louiseperry.co.uk/subscribe

Deep State Democrats PANIC After Trump Calls Out Their Seditious Video Demanding US Military Insubordination

Trump Signs Epstein Files Bill, Prepares To Meet With NYC Socialist Mayor Mamdani, Approves 28-Point Russia/Ukraine Peace Plan

Amniotic fluid embolism (AFE) is life-threatening, unpredictable, sudden, and complex. Miranda Klassen and Kayleigh Summers are two remarkable survivors and leading voices in AFE advocacy, education, and research. In this episode, they describe their life changing experiences, reflect on how AFE can impact nurses and other health care professionals, and share their mission driven work to heal. Immerse yourself in this episode in order to connect with the tools and resources you need to prepare for an AFE or to support survivors. Meet our guests: Miranda Klassen, BSc Read More Miranda Klassen is the Executive Director of the Amniotic Fluid Embolism Foundation, a non-profit organization she founded in 2008, after surviving an AFE during the birth of her son. Miranda is also a co-investigator for the Amniotic Fluid Embolism Registry and Biorepository and has authored several publications on AFE and support after a severe maternal event. She is a frequent lecturer and serves on multiple boards and maternal health initiatives. She lives in San Diego, CA, with her husband Bryce, a critical care nurse, and their son, Van. Kayleigh Summers, LCSW, PMH-C Read More Kayleigh Summers is a licensed therapist, writer, and content expert in perinatal trauma. Drawing from her clinical expertise and lived experience as an amniotic fluid embolism survivor, Kayleigh is dedicated to supporting families navigating perinatal trauma and collaborating with healthcare institutions to implement trauma-informed care tailored to pregnant and postpartum populations. As The Birth Trauma Mama, Kayleigh has cultivated vibrant support communities through Instagram, TikTok, and her podcast, offering connection, storytelling, and valuable resources for individuals impacted by perinatal trauma. Her work bridges clinical knowledge and personal insight, fostering hope and healing for those in need. Episode Resources Amniotic Fluid Embolism Foundation  Crisis Hotline Call: 1-307-363-2337 (1-307-END-AFES)  Course: Amniotic Fluid Embolism: A Practical Approach  AFE Effective Communication Guide  Klassen, M., Summers, K. (2025). Effective communication during and after an amniotic fluid embolism. MCN. The American Journal of Maternal Child Nursing, 50(5), 269-276. doi: 10.1097/NMC.0000000000001121.  AFE Management and Treatment  Pacheco, L. D., Clark, S. M., Fox, K., Bauer, M. E., & Clark, S. L. (2025). Use of atropine, ondansetron, and ketorolac in suspected amniotic fluid embolism. Obstetrics and Gynecology.  doi: 10.1097/AOG.0000000000006095.  Cao, D., Arens, A. M., Chow, S. L., Easter, S. R., Hoffman, R. S., Lagina, III, A. T., Lavonas, E. J., Patil, K. D., Sutherland, L. D., Tijssen, J. A., Wang, G. S., Zelop, C. M., Rodriguez, A. J., Drennan, I. R., & McBride, M. E. (2025). Part 10: Adult and pediatric special circumstances of resuscitation: 2025 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 152(suppl 2), S578–S672. doi: 10.1161/CIR.0000000000001380.  Ripoll, J. G., Kahn-Pascual, Y. O., Seelhammer, T. G., Bittner, E. A., Chang, M. G., Ortoleva, J., Soto, J. C. D., Elmadhoun, O., Naoum, E. E., Wieruszewski, P. M., Nabzdyk, C. G., & Ramakrishna, H. (2025). ECMO in pregnancy: Analysis of indications, management and outcomes. Journal of Cardiothoracic and Vascular Anesthesia. https://doi.org/10.1053/j.jvca.2025.08.030.  The Birth Trauma Mama Podcast  Holding Hope Perinatal   Documentary: 24 Days Without You  Postpartum Support International: Karen Kleinman's Postpartum Stress Center  Preeclampsia Foundation  Eye Movement Desensitization and Reprocessing (EMDR) Theory       The post Understanding AFE: A Dual Survivor Perspective appeared first on AWHONN.

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Language assessments shape who gets services, how goals are written, and how progress is measured, but there are many misconceptions about how to follow best-practices when doing an evaluation. In this three-part series, bilingual SLPs Destiny Johnson and Tiffany Shahoumian-Ruiz join me to dig into the science, the myths, and the policies that shape evaluation practices in schools.Across these conversations, we explore:Sensitivity, specificity, reference standards, and diagnostic accuracyHow test development has evolved over time and why this matters Why the same cut-off score shouldn't apply across all testsThe math behind using two norm-referenced tests, and why it may complicate rather than clarify in some casesOther reasons we test beyond diagnosis (treatment planning, severity, monitoring progress)How do we do we to “sell” the concept of dynamic assessment to administratorsCase studies that show the pitfalls of over-reliance on standardized scoresMisconceptions clinicians often hold, and what they should know about assessmentDifferences in state eligibility standards, and what this means for service decisionsThis series is part myth-busting, part practical strategies, and part advocacy playbook—perfect for clinicians who want to move beyond compliance-driven evaluations toward assessments that truly reflect students' needs.You can listen to Part 1 of the series here.Destiny Johnson, M.S., CCC-SLP, is a bilingual speech-language pathologist (English/Spanish) with a deep passion for culturally responsive assessment and treatment practices, as well as advocating for policy change. She has presented on dynamic assessment at the CSHA Convergence 2024, focusing on the importance of dynamic assessment in bilingual children. Destiny has experience working as a school-based SLP, in private practice, and in early intervention. She is also the founder and CEO of Multimodal Communication Speech Clinic P.C.Connect with Destiny on Instagram @destinyjohnsonslp, on her private practice website here, and on LinkedIn here.Listen to Destiny's previous episode on De Facto Leaders here: EP 187: Dynamic Assessment: Evaluations are a process, not a test (with Destiny Johnson)Tiffany Shahoumian-Ruiz is a bilingual high school SLP from Southern California who has primarily worked in the school systems and has experience at both the elementary and secondary level. She's also a member of Language Therapy Advance Foundations, and is involved in state and local advocacy work relating to dynamic assessments and special education eligibility.Connect with Tiffany on Instagram @tiffany.shahoumianListen to Tiffany's previous episode on De Facto Leaders here: High school language therapy: Do we still have time to make an impact? (with Tiffany Shahoumian-Ruiz)In this episode, I mention Language Therapy Advance Foundations, my program that gives SLPs and other service providers create a system for language therapy. You can learn more about the program here.Additional Resources Mentioned in the episode:Daub, O., Cunningham, B. J., Bagatto, M. P., Johnson, A. M., Kwok, E. Y., Smyth, R. E., & Oram Cardy, J. (2021). Adopting a conceptual validity framework for testing in speech-language pathology. American Journal of Speech-Language Pathology, 30(4), 1894–1908. https://doi.org/10.1044/2021_AJSLP-20-00032Spaulding, T. J., Plante, E., & Farinella, K. A. (2006). Eligibility criteria for language impairment: Is the low end of normal always appropriate? Language, Speech, and Hearing Services in Schools, 37(1), 61–72. https://doi.org/10.1044/0161-1461(2006/007)DYMOND Norm-Referenced Dynamic AssessmentBilingual English-Spanish Assessment (BESA) We're thrilled to be sponsored by IXL. IXL's comprehensive teaching and learning platform for math, language arts, science, and social studies is accelerating achievement in 95 of the top 100 U.S. school districts. Loved by teachers and backed by independent research from Johns Hopkins University, IXL can help you do the following and more:Simplify and streamline technologySave teachers' timeReliably meet Tier 1 standardsImprove student performance on state assessments

Ever wonder if it is ok (or even good!?) to follow a vegetarian or vegan diet with kidney stones? Melanie breaks down the benefits and risks in this episode. Blog: Magnesium & Kidney Stones: The 411 Blog: Oxalate in Coconut Milk: And Other Plant Based Milks Blog: Calcium Sources for Kidney Stones References: 1. Zayed S, Goldfarb DS, Joshi S. Popular Diets and Kidney Stones. Advances in Kidney Disease and Health. 2023;30(6):529-536. 2. Rodriguez A, Curhan GC, Gambaro G, Taylor EN, Ferraro PM. Mediterranean diet adherence and risk of incident kidney stones. The American Journal of Clinical Nutrition. 2020;111(5):1100-1106.  3. Maddahi N, Aghamir SMK, Moddaresi SS, Mirzaei K, Alizadeh S, Yekaninejad MS. The association of Dietary Approaches to Stop Hypertension-style diet with urinary risk factors of kidney stones formation in men with nephrolithiasis. Clinical Nutrition ESPEN. 2020;39:173-179.  4. Noori N, Honarkar E, Goldfarb DS, 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.    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.  

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 Evan S. Dellon, MD, and Elizabeth T. Jensen, PhD, about a paper they published on predictors of patients receiving no medication for treatment of eosinophilic esophagitis. 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: [:52] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:14] Holly introduces today's topic, predictors of not using medication for EoE, and today's guests, Dr. Evan Dellon and Dr. Elizabeth Jensen.   [1:29] Dr. Dellon is an Adjunct Professor of Epidemiology at the University of North Carolina School of Medicine in Chapel Hill. He is also the Director of the UNC Center for Esophageal Diseases and Swallowing.   [1:42] Dr. Dellon's main research interest is in the epidemiology, pathogenesis, diagnosis, treatment, and outcomes of eosinophilic esophagitis (EoE) and eosinophilic GI diseases (EGIDs).   [1:55] Dr. Jensen is a Professor of Epidemiology with a specific expertise in reproductive, perinatal, and pediatric epidemiology. She has appointments at both Wake Forest University School of Medicine and the University of North Carolina at Chapel Hill.   [2:07] Her research primarily focuses on etiologic factors in the development of pediatric immune-mediated chronic diseases, including understanding factors contributing to disparities in health outcomes.   [2:19] Both Dr. Dellon and Dr. Jensen also serve on the Steering Committee for EGID Partners Registry.   [2:24] Ryan thanks Dr. Dellon and Dr. Jensen for joining the podcast today.   [2:29] Dr. Dellon was the first guest on this podcast. It is wonderful to have him back for the 50th episode! Dr. Dellon is one of Ryan's GI specialists. Ryan recently went to North Carolina to get a scope with him.   [3:03] Dr. Dellon is an adult gastroenterologist at the University of North Carolina at Chapel Hill. He directs the Center for Esophageal Diseases and Swallowing. Clinically and research-wise, he is focused on EoE and other eosinophilic GI diseases.   [3:19] His research interests span the entire field, from epidemiology, diagnosis, biomarkers, risk factors, outcomes, and a lot of work, more recently, on treatments.   [3:33] Dr. Jensen has been on the podcast before, on Episode 27. Holly invites Dr. Jensen to tell the listeners more about herself and her work with eosinophilic diseases.   [3:46] Dr. Jensen has been working on eosinophilic gastrointestinal diseases for about 15 years. She started some of the early work around understanding possible risk factors for the development of disease.   [4:04] She has gone on to support lots of other research projects, including some with Dr. Dellon, where they're looking at gene-environment interactions in relation to developing EoE.   [4:15] She is also looking at reproductive factors as they relate to EoE, disparities in diagnosis, and more. It's been an exciting research trajectory, starting with what we knew very little about and building to an increasing understanding of why EoE develops.   [5:00] Dr. Dellon explains that EoE stands for eosinophilic esophagitis, a chronic allergic condition of the esophagus.   [5:08] You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have EoE, it is a long-term condition.   [5:24] Eosinophils are a type of white blood cell, specializing in allergy responses. Normally, they are not in the esophagus. When we see them there, we worry about an allergic process. When that happens, that's EoE.   [5:40] Over time, the inflammation seen in EoE and other allergic cell activity causes swelling and irritation in the esophagus. Early on, this often leads to a range of upper GI symptoms — including poor growth or failure to thrive in young children, abdominal pain, nausea, and symptoms that can mimic reflux.   [5:58] In older kids, symptoms are more about trouble swallowing. That's because the swelling that happens initially, over time, may turn into scar tissue. So the esophagus can narrow and cause swallowing symptoms like food impaction.   [6:16] Ryan speaks of living with EoE for decades and trying the full range of treatment options: food elimination, PPIs, steroids, and, more recently, biologics.   [6:36] Dr. Dellon says Ryan's history is a good overview of how EoE is treated. There are two general approaches to treating the underlying condition: using medicines and/or eliminating foods that we think may trigger EoE from the diet.   [6:57] For a lot of people, EoE is a food-triggered allergic condition.   [7:01] The other thing that has to happen in parallel is surveying for scar tissue in the esophagus. If that's present and people have trouble swallowing, sometimes stretching the esophagus is needed through esophageal dilation.   [7:14] There are three categories of medicines used for treatment. Proton pump inhibitors are reflux meds, but they also have an anti-allergy effect in the esophagus.   [7:29] Topical steroids are used to coat the esophagus and produce an anti-inflammatory effect. The FDA has approved a budesonide oral suspension for that.   [7:39] Biologics, which are generally systemic medications, often injectable, can target different allergic factors. Dupilumab is approved now, and there are other biologics that are being researched as potential treatments.   [7:51] Even though EoE is considered an allergic condition, we don't have a test to tell people what they are allergic to. If it's a food allergy, we do an empiric elimination diet because allergy tests aren't accurate enough to tell us what the EoE triggers are.   [8:10] People will eliminate foods that we know are the most common triggers, like milk protein, dairy, wheat, egg, soy, and other top allergens. You can create a diet like that and then have a response to the diet elimination.   [8:31] Dr. Jensen and Dr. Dellon recently published an abstract in the American Journal of Gastroenterology about people with EoE who are not taking any medicine for it. Dr. Jensen calls it a real-world data study, leveraging electronic health record patient data.   [8:51] It gives you an impression of what is actually happening, in terms of treatments for patients, as opposed to a randomized control trial, which is a fairly selected patient population. This is everybody who has been diagnosed, and then what happens with them.   [9:10] Because of that, it gives you a wide spectrum of patients. Some patients are going to be relatively asymptomatic. It may be that we arrived at their diagnosis while working them up for other potential diagnoses.   [9:28] Other patients are going to have rather significant impacts from the disease. We wanted to get an idea of what is actually happening out there with the full breadth of the patient population that is getting diagnosed with EoE.   [9:45] Dr. Jensen was not surprised to learn that there are patients who had no pharmacologic treatment.   [9:58] Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are early in their disease process and still exploring dietary treatment options.   [10:28] Holly sees patients from infancy to geriatrics, and if they're not having symptoms, they wonder why bother treating it.   [10:42] Dr. Jensen says it's a point of debate on the implications of somebody who has the disease and goes untreated. What does that look like long-term? Are they going to develop more of that fibrostenotic pattern in their esophagus without treatment?   [11:07] This is a question we're still trying to answer. There is some suggestion that for some patients who don't manage their disease, we very well may be looking at a food impaction in the future.   [11:19] Dr. Dellon says we know overall for the population of EoE patients, but it's hard to know for a specific patient. We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range.   [11:39] Some people get symptoms and get diagnosed right away. Others might have symptoms for 20 or 30 years that they ignore, or don't have access to healthcare, or the diagnosis is missed.   [11:51] What we see consistently is that people who may be diagnosed within a year or two may only have a 10 or 20% chance of having that stricture and scar tissue in the esophagus, whereas people who go 20 years, it might be 80% or more.   [12:06] It's not everybody who has EoE who might end up with that scar tissue, but certainly, it's suggested that it's a large majority.   [12:16] That's before diagnosis. We have data that shows that after diagnosis, if people go a long time without treatment or without being seen in care, they also have an increasing rate of developing strictures.    [12:29] In general, the idea is yes, you should treat EoE, because on average, people are going to develop scar tissue and more symptoms. For the patient in front of you with EoE but no symptoms, what are the chances it's going to get worse? You don't know.   [13:04] There are two caveats with that. The first is what we mean by symptoms. Kids may have vomiting and growth problems. Adults can eat carefully, avoiding foods that hang up in the esophagus, like breads and overcooked meats, sticky rice, and other foods.   [13:24] Adults can eat slowly, drink a lot of liquid, and not perceive they have symptoms. When someone tells Dr. Dellon they don't have symptoms, he will quiz them about that. He'll even ask about swallowing pills.    [13:40] Often, you can pick up symptoms that maybe the person didn't even realize they were having. In that case, that can give you some impetus to treat.   [13:48] If there really are no symptoms, Dr. Dellon thinks we're at a point where we don't really know what to do.   [13:54] Dr. Dellon just saw a patient who had a lot of eosinophils in their small bowel with absolutely no GI symptoms. He said, "I can't diagnose you with eosinophilic enteritis, but you may develop symptoms." People like that, he will monitor in the clinic.   [14:14] Dr. Dellon will discuss it with them each time they come back for a clinic visit.   [14:19] Holly is a speech pathologist, but also sees people for feeding and swallowing. The local gastroenterologist refers patients who choose not to treat their EoE to her. Holly teaches them things they should be looking out for.   [14:39] If your pills get stuck or if you're downing 18 ounces during a mealtime, maybe it's time to treat it. People don't see these coping mechanisms they use that are impacting their quality of life. They've normalized it.   [15:30] Dr. Dellon says, of these people who aren't treated, there's probably a subset who appropriately are being observed and don't have a medicine treatment or are on a diet elimination.   [15:43] There's also probably a subset who are inappropriately not on treatment. It especially can happen with students who were under good control with their pediatric provider, but moved away to college and didn't transfer to adult care.   [16:08] They ultimately come back with a lot of symptoms that have progressed over six to eight years.   [16:18] Ryan meets newly diagnosed adult patients at APFED's conferences, who say they have no symptoms, but chicken gets caught in their throat. They got diagnosed when they went to the ER with a food impaction.   [16:38] Ryan says you have to wonder at what point that starts to get reflected in patient charts. Are those cases documented where someone is untreated and now has EoE?   [16:49] Ryan asks in the study, "What is the target EGID Cohort and why was it selected to study EoE? What sort of patients were captured as part of that data set?"   [16:58] Dr. Jensen said they identified patients with the ICD-10 code for a diagnosis of EoE. Then they looked to see if there was evidence of symptoms or complications in relation to EoE. This was hard; some of these are relatively non-specific symptoms.   [17:23] These patients may have been seeking care and may have been experiencing some symptoms that may or may not have made it into the chart. That's one of the challenges with real-world data analyses.   [17:38] Dr. Jensen says they are using data that was collected for documenting clinical care and for billing for clinical care, not for research, so it comes with some caveats when doing research with this data.   [18:08] Research using electronic health records gives a real-world perspective on patients who are seeking care or have a diagnosis of EoE, as opposed to a study trying to enroll a patient population that potentially isn't representative of the breadth of individuals living with EoE.   [18:39] Dr. Dellon says another advantage of real-world data is the number of patients. The largest randomized controlled trials in EoE might have 400 patients, and they are incredibly expensive to do.   [18:52] A study of electronic health records (EHR) is reporting on the analysis of just under 1,000. The cohort, combined from three different centers, has more than 1,400 people, a more representative, larger population.    [19:16] Dr. Dellon says when you read the results, understand the limitations and strengths of a study of health records, to help contextualize the information.   [19:41] Dr. Dellon says it's always easier to recognize the typical presentations. Materials about EoE and studies he has done that led to medicine approvals have focused on trouble swallowing. That can be relatively easily measured.   [20:01] Patients often come to receive care with a food impaction, which can be impactful on life, and somewhat public, if in a restaurant or at work. Typical symptoms are also the ones that get you diagnosed and may be easier to treat.   [20:26] Dr. Dellon wonders if maybe people don't treat some of the atypical symptoms because it's not appreciated that they can be related to EoE.   [20:42] Holly was diagnosed as an adult. Ryan was diagnosed as a toddler. Holly asks what are some of the challenges people face in getting an EoE diagnosis.   [20:56] Dr. Jensen says symptoms can sometimes be fairly non-specific. There's some ongoing work by the CEGIR Consortium trying to understand what happens when patients come into the emergency department with a food bolus impaction.   [21:28] Dr. Jensen explains that we see there's quite a bit of variation in how that gets managed, and if they get a biopsy. You have to have a biopsy of the esophagus to get a diagnosis of EoE.   [21:45] If you think about the steps that need to happen to get a diagnosis of EoE, that can present barriers for some groups to ultimately get that diagnosis.   [21:56] There's also been some literature around a potential assumption about which patients are more likely to be at risk. Some of that is still ongoing. We know that EoE occurs more commonly in males in roughly a two-to-one ratio. Not exclusively in males, obviously, but a little more often in males.   [22:20] We don't know anything about other groups of patients that may be at higher risk. That's ongoing work that we're still trying to understand. That in itself can also be a barrier when there are assumptions about who is or isn't likely to have EoE.   [23:02] Dr. Dellon says that in adolescents and adults, the typical symptoms are trouble swallowing and food sticking, which have many causes besides EoE, some of which are more common.   [23:18] In that population, heartburn is common. Patients may report terrible reflux that, on questioning, sounds more like trouble swallowing than GERD. Sometimes, with EoE, you may have reflux that doesn't improve. Is it EoE, reflux, or both?   [24:05] Some people will have chest discomfort. There are some reports of worsening symptoms with exercise, which brings up cardiac questions that have to be ruled out first.   [24:19] Dr. Dellon mentions some more atypical symptoms. An adult having pain in the upper abdomen could have EoE. In children, the symptoms could be anything in the GI tract. Some women might have atypical symptoms with less trouble swallowing.   [24:58] Some racial minorities may have those kinds of symptoms, as well. If you're not thinking of the condition, it's hard to make the diagnosis.   [25:08] Dr. Jensen notes that there are different cultural norms around expressing symptoms and dietary patterns, which may make it difficult to parse out a diagnosis.   [25:27] Ryan cites a past episode where access to a GI specialist played a role in diagnosing patients with EoE. Do white males have more EoE, or are their concerns just listened to more seriously?   [25:57] Ryan's parents were told when he was two that he was throwing up for attention. He believes that these days, he'd have a much easier time convincing a doctor to listen to him. From speaking to physicians, Ryan believes access is a wide issue in the field.   [26:23] Dr. Dellon tells of working with researchers at Mayo in Arizona and the Children's Hospital of Phoenix. They have a large population of Hispanic children with EoE, much larger than has been reported elsewhere. They're working on characterizing that.   [26:49] Dr. Dellon describes an experience with a visiting trainee from Mexico City, where there was not a lot of EoE reported. The trainee went back and looked at the biopsies there, and it turned out they were not performing biopsies on patients with dysphagia in Mexico City.   [27:13] When he looked at the patients who ended up getting biopsies, they found EoE in 10% of patients. That's similar to what's reported out of centers in the developed world. As people are thinking about it more, we will see more detection of it.   [27:30] Dr. Dellon believes those kinds of papers will be out in the next couple of months, to a year.   [27:36] Holly has had licensure in Arizona for about 11 years. She has had nine referrals recently of children with EoE from Arizona. Normally, it's been one or two that she met at a conference.   [28:00] Ryan asks about the research on patients not having their EoE treated pharmacologically. Some treat it with food avoidance and dietary therapy. Ryan notes that he can't have applesauce, as it is a trigger for his EoE.   [28:54] Dr. Jensen says that's one of the challenges in using the EHR data. That kind of information is only available to the researchers through free text. That's a limitation of the study, assessing the use of dietary elimination approaches.   [29:11] Holly says some of her patients have things listed as allergies that are food sensitivities. Ryan says it's helpful for the patients to have their food sensitivities listed along with their food allergies, but it makes records more difficult to parse for research.   [30:14] Dr. Dellon says they identify EoE by billing code, but the codes are not always used accurately. Natural Language Processing can train a computer system to find important phrases. Their collaborators working on the real-world data are using it.   [30:59] Dr. Dellon hopes that this will be a future direction for this research to find anything in the text related to diet elimination.   [31:32] Dr. Jensen says that older patients were less likely to seek medication therapy. She says it's probably for a couple of reasons. First, older patients may have been living with the disease for a long time and have had compensatory mechanisms in place.   [32:03] The other reason may be senescence or burnout of the disease, long-term. Patients may be less symptomatic as they get older. That's a question that remains to be answered for EoE. It has been seen in some other disease processes.   [32:32] Dr. Dellon says there's not much data specifically looking at EoE in the older population. Dr. Dellon did work years ago with another doctor, and they found that older patients had a better response to some treatments, particularly topical steroids.   [32:54] It wasn't clear whether it was a milder aspect of the disease, easier to treat, or because they were older and more responsible, taking their medicines as prescribed, and having a better response rate. It's the flip side of work in the pediatric population.   [33:16] There is an increasingly aging population with EoE. Young EoE patients will someday be over 65. Dr. Dellon hopes there will be a cure by that point, but it's an expanding population now.   [33:38] Dr. Jensen says only a few sites are contributing data, so they hope to add additional sites to the study. For some of the less common outcomes, they need a pretty large patient sample to ask some of those kinds of questions.   [33:55] They will continue to follow up on some of the work that this abstract touched on and try to understand some of these issues more deeply.   [34:06] Dr. Dellon mentions other work within the cohort. Using Natural Language Processing, they are looking at characterizing endoscopy information and reporting it without a manual review of reports and codes. You can't get that from billing data.   [34:29] Similarly, they are trying to classify patient severity by the Index of Severity with EoE, and layer that on looking at treatments and outcomes based on disease severity. Those are a couple of other directions where this cohort is going.   [34:43] Holly mentions that this is one of many research projects Dr. Jensen and Dr. Dellon have collaborated on together. They also collaborate through EGID Partners. Holly asks them to share a little bit about that.   [34:53] Dr. Jensen says EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join.   [35:07] EGID Partners also needs people who don't live with an EGID to join, as controls. That gives the ability to compare those who are experiencing an EGID relative to those who aren't.   [35:22] When you join EGID Partners, they provide you with a set of questionnaires to complete. Periodically, they push out a few more questionnaires.   [35:33] EGID Partners has provided some really great information about patient experience and answered questions that patients want to know about, like joint pain and symptoms outside the GI tract.   [36:04] To date, there are close to 900 participants in the registry from all over the world. As it continues to grow, it will give the ability to look at the patient experience in different geographical areas.   [36:26] Dr. Dellon says we try to have it be interactive, because it is a collaboration with patients. The Steering Committee works with APFED and other patient advocacy groups from around the world.    [36:41] The EGID Partners website shows general patient locations anonymously. It shows the breakdown of adults with the condition and caregivers of children with the condition, the symptom distribution, and the treatment distribution.   [37:03] As papers get published and abstracts are presented, EGID Partners puts them on the website. Once someone joins, they can suggest a research idea. Many of the studies they have done have come from patient suggestions.   [37:20] If there's an interesting idea for a survey, EGID Partners can push out a survey to everybody in the group and answer questions relatively quickly.   [37:57] Dr. Dellon says a paper came out recently about telehealth. EoE care, in particular, is a good model for telehealth because it can expand access for patients who don't have providers in their area.   [38:22] EoE is a condition where care involves a lot of discussion but not a lot of need for physical exams and direct contact, so telehealth can make things very efficient.    [38:52] EGID Partners surveyed patients about telehealth. They thought it was efficient and saved time, and they had the same kind of interactions as in person. In general, in-state insurance covered it. Patients were happy to do those kinds of visits again.   [39:27] Holly says Dr. Furuta, herself, and others were published in the Gastroenterology journal in 2019 about starting to do telehealth because patients coming to the Children's Hospital of Colorado from out of state had no local access to feeding therapy.   [39:50] Holly went to the board, and they allowed her to get licensure in different states. She started with some of the most impacted patients in Texas and Florida in 2011 and 2012. They collected data. They published in 2019 about telehealth's positive impact.   [40:13] When 2020 rolled around, Holly had trained a bunch of people on how to do feeding therapy via telehealth. You have to do all kinds of things, like make yourself disappear, to keep the kids engaged and in their chairs!   [40:25] Now it is Holly's primary practice. She has licenses in nine states. She sees people all over the country. With her diagnosis, her physicians at Mass General have telehealth licensure in Maine. She gets to do telehealth with them instead of driving two hours.   [40:53] Dr. Jensen tells of two of the things they hope to do at EGID Partners. One is trying to understand more about reproductive health for patients with an EGID diagnosis. Only a few studies have looked at this question, and with very small samples.   [41:15] As more people register for EGID Partners, Dr. Jensen is hoping to be able to ask some questions related to reproductive health outcomes.   [41:27] The second goal is a survey suggested by the Student Advisory Committee, asking questions related to the burden of disease specific to the teen population.   [41:48] This diagnosis can hit that population particularly hard, at a time when they are trying to build and sustain friendships and are transitioning to adult care and moving away from home. This patient population has a unique perspective we wanted to hear.   [42:11] Dr. Jensen and Dr. Dellon work on all kinds of other projects, too.   [42:22] Dr. Dellon says they have done a lot of work on the early-life factors that may predispose to EoE. They are working on a large epidemiologic study to get some insight into early-life factors, including factors that can be measured in baby teeth.   [42:42] That's outside of EGID Partners. It's been ongoing, and they're getting close, maybe over the next couple of years, to having some results.   [43:03] Ryan says all of those projects sound so interesting. We need to have you guys back to dive into those results when you have something finalized.   [43:15] 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.   [43:22] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at apfed.org/specialist.   [43:31] 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.   [43:41] Ryan thanks Dr. Dellon and Dr. Jensen for joining us today. This was a fantastic conversation. Holly also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Evan S. Dellon, MD, MPH, Academic Gastroenterologist, University of North Carolina School of Medicine   Elizabeth T. Jensen, MPH, PhD, Epidemiologist, Wake Forest University School of Medicine, University of North Carolina at Chapel Hill   Predictors of Patients Receiving No Medication for Treatment of Eosinophilic Esophagitis in the United States: Data from the TARGET-EGIDS Cohort   Episode 15: Access to Specialty Care for Eosinophilic Esophagitis (EoE)   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 GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   "I've been working on eosinophilic gastrointestinal diseases for about 15 years. I started some of the early work around understanding possible risk factors for the development of disease. I've gone on to support lots of other research projects." — Elizabeth T. Jensen, MPH, PhD   "You can think of EoE as asthma of the esophagus or eczema of the esophagus, although in general, people don't grow out of EoE, like they might grow out of eczema or asthma. When people have it, it really is a long-term condition." — Evan S. Dellon, MD, MPH   "There are two general approaches to treating the underlying condition, … using medicines and/or eliminating foods from the diet that we think may trigger EoE. I should say, for a lot of people, EoE is a food-triggered allergic condition." — Evan S. Dellon, MD, MPH   "I didn't find it that surprising [that there are patients who had no treatment]. Some patients are relatively asymptomatic, and others are not interested in pursuing medications initially or are … still exploring dietary treatment options." — Elizabeth T. Jensen, MPH, PhD   "We have a bunch of studies now that look at how long people have symptoms before they're diagnosed. There's a wide range. Some people get symptoms and are diagnosed right away. Other people might have symptoms for 20 or 30 years." — Evan S. Dellon, MD, MPH   "EGID Partners is an online registry where individuals, caregivers, and parents of children affected with EGIDs can join. EGID Partners also needs people who don't live with an EGID to join, as controls." — Elizabeth T. Jensen, MPH, PhD

The US has no shortage of lidocaine patch television commercials. Topical lidocaine has a role for local, topical, minor aches and pains. What about lidocaine patches for post-op cesarean section pain? Is there data for that? A brand-new meta-analysis in AJOG-MFM (Nov 13, 2025) looks at this option. However, there has been 3 prior reviews on the same topic from 2019, 2022, and 2023. Do they all arrive at the same result? Listen in for details!1.     Smoker J, Cohen A, Rasouli MR, Schwenk ES. TransdermalLidocaine for Perioperative Pain: A Systematic Review of the Literature. Current Pain and Headache Reports.2019;23(12):89. doi:10.1007/s11916-019-0830-9.2.     Koo CH, Kim J, Na HS, Ryu JH, Shin HJ. TheEffect of Lidocaine Patch for Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Anesthesia. 2022;81:110918.doi:10.1016/j.jclinane.2022.110918.3.     Wu X, Wei X, Jiang L, et al. Is Lidocaine PatchBeneficial for Postoperative Pain?: A Meta-Analysis of Randomized Clinical Trials. The Clinical Journal of Pain. 2023;39(9):484-490. doi:10.1097/AJP.00000000000011354.     Parisi, Nadia et al.Lidocaine patches aftercesarean delivery: a meta-analysis of randomized controlled trials. American Journal of Obstetrics & Gynecology MFM, Volume 0, Issue 0, 101832

Infowars And Other Sites Affected By MASSIVE Cloudflare Outage, House Votes To Release Epstein Files, Border Patrol Cleans Up Charlotte

On this episode of Managed Care Cast, Rachel A. Prusynski, DPT, PhD, an assistant professor at the University of Washington's School of Medicine, speaks with The American Journal of Managed Care® about her research published in the November 2025 issue. Her study, "Medicare Advantage Reimbursement Structures Impact Home Health Delivery and Outcomes," explores how home health care delivery and patient outcomes differ between 3 plan types: traditional Medicare, episodic Medicare Advantage, and per-visit Medicare Advantage. Throughout the conversation, Prusynski discusses what motivated the research, the study's key findings, and the broader implications for improving the quality and accessibility of future home health care.

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Well, from time to time we cover RANDOM tidbits of information which cover RANDOM questions and/or RANDOM patient care issues that we encounter. In this episode we will cover one OB issue related to recurrent pregnancy loss, one GYN issue related to unilateral breast swelling in a patient with SLE, and one RANDOM life perspective response from a mock interview that I participated in for a residency candidate. Listen in fordetails!1.     Viviana DO; Giugni, Claudio Schenone MD; Ros, Stephanie T. MD, MSCI. Factor V and recurrent pregnancy loss: de Assis, Evaluation of Recurrent Pregnancy Loss. Obstetrics & Gynecology 143(5):p 645-659, May 2024. | DOI: 10.1097/AOG.0000000000005498Unilateral Breast Swelling with SLE: 2.     Voizard B, Lalonde L, Sanchez LM, et al. LupusMastitis as a First Manifestation of Systemic Disease: About Two Cases With a Review of the Literature. European Journal of Radiology. 2017;92:124-131. doi:10.1016/j.ejrad.2017.04.023.3.     Kinonen C, Gattuso P, Reddy VB. Lupus Mastitis:An Uncommon Complication of Systemic or Discoid Lupus. The American Journal of Surgical Pathology. 2010;34(6):901-6. doi:10.1097/PAS.0b013e3181da00fb.4.      Summers TA, Lehman MB, Barner R, Royer MC. Lupus Mastitis: A Clinicopathologic Review and Addition of a Case. Advances in Anatomic Pathology.2009;16(1):56-61. doi:10.1097/PAP.0b013e3181915ff7.5.     Jiménez-Antón A, Jiménez-Gallo D,Millán-Cayetano JF, Navarro-Navarro I, Linares-Barrios M. Unilateral Lupus Mastitis.Lupus. 2023;32(3):438-440. doi:10.1177/09612033221151011.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

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Lecture summary: Over centuries and across continents, authoritarian governments have demonstrated a large appetite for international cooperation to target political opponents across borders. As the world's premier body for international police cooperation, Interpol is not supposed to facilitate this kind of transnational repression -- and yet, in recent years, there is growing concern that authoritarian governments are abusing Interpol's tools. Interpol has taken meaningful steps to curb such abuse, but the durability of those protections is in doubt given the rising influence of authoritarian governments in that organization. The looming question is at what point universal multilateral cooperation with respect to law enforcement might cease to be viable.Kristina Daugirdas is the Francis A. Allen Collegiate Professor of Law at the University of Michigan Law School. She teaches and writes primarily in the fields of international law and institutions.Her scholarship currently focuses on international organizations, accountability mechanisms, and the ongoing evolution of the international legal system. She is a member of the editorial board of the International Organizations Law Review and the State Department's Advisory Committee on International Law. She also serves as an adviser to the American Law Institute's Restatement (Fourth) of Foreign Relations Law.In 2016–2017, Daugirdas was a visiting fellow at the Graduate Institute of International and Development Studies in Geneva and served as a consultant on public international law issues for the World Intellectual Property Organization. From 2014 to 2017, she co-authored the Contemporary Practice of the United States Relating to International Law: A section of the American Journal of International Law. In 2014, she was awarded the Francis Deák Prize for an outstanding article published in the American Journal of International Law by a younger author.Daugirdas has taken on significant leadership roles at the law school, including serving as Associate Dean for Academic Programming from 2021 to 2024. She also led a subcommittee of the Advisory Committee on the University of Michigan Principles on Diversity of Thought and Freedom of Expression.Prior to entering academia, Daugirdas was an attorney-adviser at the State Department's Office of the Legal Adviser, receiving multiple honors for her service. As an attorney-adviser, she provided guidance on the negotiation and implementation of UN Security Council sanctions and amicus participation by the US government in lawsuits with foreign policy implications.Chair: Prof Fernando Lusa BordinThis lecture was given on 7 November 2025 and is part of the Friday Lunchtime Lecture series at the Lauterpacht Centre.

Senate Dems Break With Schumer, Advance Plan To End Record-Breaking Gov't Shutdown 

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.

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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