Leah Lopeteguy-Hoffman is a Licensed Marriage and Family Therapist and Licensed Professional Clinical Counselor who is passionate about people. As a jack of all trades, and ace of one, Leah has been able to utilize the knowledge and experiences gained from her employment within the service industry to work with diverse populations including senior and aging adults, students and families, spectrum disorders, law enforcement, and veterans. Leah currently works in private practice where she continues to engage with clients promoting positive change and compassion for all. Leah's most recent accomplishments include Certification in Eye Movement Desensitization and Reprocessing (EMDR) and becoming an EMDRIA approved EMDR Consultant in Training (CIT). Leah is a lover of learning and continues to expand her growth in the field of therapy for the benefit of those she serves. Leah holds a Master of Science in Counseling degree from University of Phoenix, Bachelor of Arts degree in Religious Studies from California State University of Bakersfield, and an Associate of Arts degree in Liberal Studies from Bakersfield College. She lives in Bakersfield, California with her charming husband, Patrick, their six children, and their cat, Gracie Lou Freebush. Kyle and Leah discuss the common misconceptions surrounding mental health and the barriers that prevent many from seeking professional help. They dive into Eye Movement Desensitization & Reprocessing (EMDR) Therapy and how it can significantly help those suffering from Post Traumatic Stress Disorder (PTSD). LEARN MORE ABOUT LEAH L. LOPETEGUY-HOFFMAN: Website: Simple_Practice Email: firstname.lastname@example.org Phone: 661-412-4291
The show many thought would never happen. After years of harboring unspoken animosity, Dale Earnhardt Jr. sits down with NASCAR Champion Kevin Harvick to bury the hatchet on some things from their past. Harvick made comments during a 2017 satellite radio program about Dale Earnhardt Jr,'s lack of success "stunting the growth of the sport." With Dale Jr. being in the midst of his retirement season, the comments came unexpected and cut deep for many. Today, the two drivers sit face to face to talk about what led to controversial criticism and clear the air by listening to all sides of the story. In 2014 Harvick drove for JR Motorsports, leading the team to a total of six wins in a two-year span. He made his mark in places other than performance, bringing some personnel, key partners, and a relentless desire for success. While JR Motorsports enjoyed the fruits of the relationship, Harvick felt otherwise. After he was separated from his crew chief and team, the relationship went south. It's something that has never been discussed either. Until now. Dale Jr., co-host Mike Davis, and Harvick tell all about what went down at JRM. Harvick's path to becoming a NASCAR Champion started on the streets of Bakersfield, California. His rapid ascension through West Coast Short Tracks led to some tough decisions and a severed relationship with his father. His on-track success led to an opportunity with the West Coast's only full-time NASCAR Truck Series team, Spears Racing. The relationship developed from towing a racecar with a shag-carpet Winnebago to a full-time chance in the big leagues of racing. When opportunity came knocking with legendary car owner Richard Childress there were a few more hurdles. A newly signed letter of intent with another team meant, Harvick had to gamble on himself, buying his way out of the contract and living off his girlfriend's credit card to make it. His first race in Childress' NASCAR Xfinity Series car went well. The second race? Well, the California hot-shoe shockingly didn't qualify. This led to a disappearance few have ever heard about, that had Harvick on a milk container. Once back on the scene, his confidence grew and so did his success, winning two Xfinity Series titles. Kevin lays out the game plan to Cup that few knew about. A plan that had him beginning a Cup effort in 2001. But on February 18, 2001 those plans changed. The untimely death of the legendary Dale Earnhardt Sr. at Daytona International Speedway created a void in Childress' race team that Harvick stepped in to fill. A win at Atlanta put Harvick's career into a stratosphere he never imagined. He admits it was a role he didn't necessarily want. Harvick opens up to Dale Jr, about how tough and awkward the 2001 season was. Before Dale Jr. and Kevin Harvick's relationship hit a stall in 2017, they had a good history together on and off the track. Did you know Kevin and his wife DeLana's first date was in Dale Jr.'s basement? It was a very memorable first date. While at "the table of truth" Kevin and Dale Jr. discuss a myriad of topics. The discussion begins with the heated discussions and rivalry Kevin had during the 2021 playoffs with Chase Elliott. Kevin reveals that he thinks there is a conversation that still needs to be had with the young Georgia driver. Then they talk about the NASCAR Next Gen car and the hurdles ahead for the new racecar and its upcoming debut in the 2022 season. Kevin isn't the only Harvick racing. Keelan is racing over 60-times this season. Harvick reveals his plans to put his son in a Late Model Stock Car. After Kevin's interview, Dale Jr. answers some incredible questions in one of the most entertaining and insightful AskJr's of the season. We learn about what Dale thinks of the new qualifying procedures, the news about Nashville Fairgrounds Speedway, and what he would think of a NASCAR / F1 double-header. We also learn that he has an itch to learn to play a popular stringed instrument. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Cyber Monday is usually all about savings, but on The Bo Show, it was all about the shoutouts. They began with our Associate Caller of the Day, Brandie from Store 2710 in Ketchikan, Alaska, who gave a shoutout to the whole team. Sheila from Store 632 in Mount Pleasant, South Carolina, kept the trend going by giving a shoutout to the entire store. The third time was a charm as the whole team at Store 3366 in Centerville, Utah, was recognized by Connor. More great shoutouts came in for the OGP team at Store 955 in Apopka, Florida, and Heather at Store 1090 in Jacksonville, Florida, gave a big shoutout to the Apparel team. With a day about savings and shoutouts, we also had some sensational anniversaries! Rebecca at Store 978 in Arkansas City, Kansas, celebrated 35 years with us, and both Dustin at Store 1624 in Bakersfield, California, and Randall from Club 6327 in Warren, Ohio, celebrated 30 years. Be sure to join us as we transform Cyber Monday into shoutout Monday.
This week we're replaying a classic GTP episode where your hosts Steve Lowry and Yvonne Godfrey interview Daniel Rodriguez, Chantal A. Trujillo & Danay Gonzalez of Rodriguez & Associates Trial Lawyers (https://www.rodriguezlaw.net/). Remember to rate and review GTP in iTunes: Click Here To Rate and Review Case Details: Rodriguez & Associates trial lawyers Daniel Rodriguez, Chantal A. Trujillo, and Danay Gonzalez explain how they became the first trial team to present a school shooting-related civil claim to a jury. On January 10, 2013, Bowe Cleveland was shot by a fellow student, who was repeatedly reported to Taft Union High School administrators for making violent threats, having a "hit list" and drawing scenes of killings. Administrators failed to update their threat assessment plan and implement intervention tactics. As a result, Bowe was shot in his science classroom and suffered multiple punctures in his right lung, massive blood loss, and fractured ribs, requiring over 30 surgical procedures. To this day, Bowe's chest is full of shotgun pellets, and he struggles with PTSD. A Bakersfield, California jury found eight individuals, including the school's assistant principal, negligent and partially responsible for Bowe's injuries, returning a verdict of $3.8 million. Click Here to Read/Download the Complete Trial Documents Guest Bios: Daniel Rodriguez Daniel Rodriguez has a background that is a little bit different than the typical lawyer. Daniel grew up in a migrant farm-worker family. He and his family were constantly on the move. He lived and worked in Texas, Louisiana, Mississippi, and California. Daniel and his five siblings attended between three and five different schools each year up until college. In addition to working in the fields, Daniel later held a variety of jobs going through college and law school. To name a few, Daniel worked as a dishwasher, worked for PG&E in their mapping department, worked as a salesperson for Sears, Roebuck & Co., sold encyclopedias door to door, and pumped gas at a full-service gas station. Another job that Daniel held was working as a roustabout and mechanic in the oilfields for Atlantic Richfield Co. in Kern County. All of these jobs helped mold Daniel's perspective on life. Namely, that there's no substitute for putting in the hard work. Daniel's career as a lawyer is also a little bit different than the typical plaintiff's lawyer. The vast majority of plaintiff's lawyers hardly ever go to trial. Most of them may take a case to trial once every five years or so. Daniel tried his first jury trial within one month of getting his license to practice law. Daniel's skill as a personal injury lawyer in Bakersfield has not gone unnoticed. Daniel is proud of the fact that he was selected to teach at Gerry Spence's Trial Lawyers College. This trial advocacy school is widely considered to be the best in the country. What does jury trial experience and trial skills mean to the client? That Daniel will obtain top and full value for the client's case because insurance companies respect and fear a skilled and experienced trial lawyer. Daniel's professional dedication to the Kern County community has earned him nationwide recognition. He's been selected to the California Super Lawyers list (by Super Lawyers®) every year since 2009. In 2015, he was named Best Lawyer in Bakersfield by the Best of Bakersfield Reader's Choice Awards. He is also a member of The National Trial Lawyers, an invitation-only group composed of the premier trial lawyers from across the United States. He's been a guest on Hot 94.1's “The Romeo Show”, Univision, and interviewed in major news outlets. Read Full Bio Danay Gonzalez Danay was born in Bakersfield and raised in Lamont, California. In this small town, her family owned a jewelry store where Danay grew up learning the value of community. There, she learned how to work hard and interact with customers. While they loved their home in Lamont, Danay's family moved to Bakersfield to pursue new opportunities when she was in the eighth grade. She went on to graduate from Ridgeview High School, where she enjoyed being in choir and theatre, reading and writing in her English classes, and debating politics with her fellow students in AP courses. After high school, Danay attended UCLA, where she earned her bachelor's degree in Political Science in 2013 (Once a Bruin, always a Bruin!). While she loved living in Los Angeles and experiencing a different life with new horizons in the city, she always knew that she wanted to come home and be a positive influence in her community. Growing up in Lamont, she saw that many of her classmates were afraid to speak up for themselves at the risk of being deported or getting their families in trouble. She saw them living in fear, and she knew that it wasn't right. She saw the way that the people of her community looked up to Daniel Rodriguez, not only for being a successful member of the Hispanic community but also for the way that he fought for the rights of her friends and neighbors. Because of his influence, she knew she wanted to become a lawyer and stand up for people's rights like he does. Coming from a family where her grandparents couldn't read, write, or speak English, Danay is passionate about giving a voice to the people who need it most. Read Full Bio Chantal A. Trujillo As a Bakersfield native, Chantal graduated from Centennial High School in 2004 (Go Golden Hawks!). Chantal then attended CSU Bakersfield for 2 years until transferring to the University of Texas where she earned her Bachelor of Arts in Communications. She further pursued her education at St. Mary's University School of Law in San Antonio, TX, earning her Juris Doctor in 2011. After venturing to the Lone Star state, Chantal found herself back in Bakersfield, where she was born and raised. In late 2011, she joined the team at Rodriguez & Associates, where she has gained a home away from home. She is well-known for late nights at the office, consistently putting in the extra hours to achieve positive results in all of her cases. During Chantal's time at the firm, she has handled numerous personal injury and wrongful death cases, some of which have gone to jury trial and produced great verdicts. Working in this field has shaped Chantal tremendously into the kind of lawyer you forget is a lawyer because of how much of herself she pours into her cases. She truly breaks the mold by taking the time to understand and meet her clients' requests and concerns throughout the civil litigation process. Read Full Bio Show Sponsors: Legal Technology Services - LTSatlanta.com Digital Law Marketing - DigitalLawMarketing.com Case Pacer - CasePacer.com Harris, Lowry, and Manton - hlmlawfirm.com Free Resources: Stages Of A Jury Trial - Part 1 Stages Of A Jury Trial - Part 2
Rabbi Jonathan Klein, rabbi at Temple Beth El in Bakersfield, CA (how to gain and retain the employees you need to grow your business), guides on the number one question sent to us on social media for the third year in a row: "Is it morally okay to have a financially successful business?" In addition, we talk about, how to overcome a merger that doesn't go well, and...with which hand do you light a menorah?
Episode 76: Eating Disorders. The malaria vaccine is announced by Dr Parker, eating disorders such as anorexia and bulimia are briefly discussed by Sophia, Jeffrey and Dr Arreaza. Introduction: Introducing the malaria vaccine (RTS,S)Written by Hector Arreaza, MD; read by Tana Parker, MD. Today is November 26, 2021.Malaria is a devastating disease that continues to kill thousands of people every year around the world. Since the year 2000, there have been 1.5 billion cases of malaria and 7.6 million deaths. In 2019, there were 229 million new cases, and 409,000 deaths, mostly children under 5 years of age.Effective vaccines for many protozoal diseases are available for animals (for example, the vaccine against toxoplasmosis in sheep, babesiosis in cows, and more.) However, vaccines for protozoal disease in humans had not been widely available … until now. The RTS,S is a vaccine against malaria approved by the European Medicines Agency in July 2015 for babies at risk, and it was rolled out in pilot projects in Malawi, Ghana and Kenya in 2019. In October 2021, the World Health Organization announced the recommendation of this anti-malaria vaccine. The trade name of this vaccine is Mosquirix®. The vaccination is recommended for children in sub-Saharan Africa and other regions with moderate to high transmission of Plasmodium falciparum, which is considered the deadliest parasite in humans. The approved vaccine has shown low to moderate efficacy, preventing about 30% of severe malaria after 4 doses in children younger than five years old. Implementation of vaccination is not free from challenges, and it should be executed not as the solution for the disease, but as part of the solution, along with other efforts such as mosquito control, effective health care, and more.RTS,S is an add-on to continue the fight against malaria worldwide. Hopefully we can lighten the heavy burden of malaria for more than 87 countries that suffer the severe consequences of poor control of this devastating disease. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ___________________________Eating Disorders. Written by Sophia Dhillon, MS3, Jeffrey Nguyen, MS3. Discussion with Hector Arreaza, MD. This is not intended to be a comprehensive lecture on eating disorders. This episode is intended to give you basic information, hoping to motivate you keep learning about it. Let's start talking about eating disorders today, specifically anorexia nervosa and bulimia nervosa. What is an eating disorder? An eating disorder is a disturbance of eating that interferes with health. As a reminder, health is “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.” So, an eating disorder, in a wide context, is any eating pattern that is out of what is considered “normal”, and that variation in feeding causes health problems. But in general, when we talk about eating disorders in medicine, we refer to anorexia nervosa and bulimia nervosa, but it includes also avoidant/restrictive food intake disorder, binge eating disorder, night eating disorder, pica, and rumination disorder. ANOREXIAIn general, anorexia is characterized by immoderate food restriction, inappropriate eating habits or rituals, obsession with having a thin figure or an irrational fear of weight gain as well as distorted body self-perception. There are 2 main subtypes of anorexia: restricting type vs binge-eating/purging type. Tell us the difference between anorexia restrictive type and binge eating-purging type.Anorexia, restrictive type is when weight loss is achieved by diet, fasting and/or excessive exercise, meanwhile the binge-eating/purging type entails eating binges followed by self-induced vomiting and/or using laxatives, enemas or diuretics. These patients will have intense fear of gaining weight or becoming fat. They will have a distorted perception of body weight and shape or denial of the medical seriousness of one's low body weight.Anorexia nervosa is different than avoidant/restrictive food intake disorder. In anorexia, you have an altered perception of your body (“I'm fat”), but in avoidant/restrictive food intake disorder, your perception of your body weight and shape is not abnormal. “I'm skinny, and I'm OK with that.” This is new information for me. I thought anorexia was present always when a patient refused to eat, whether you liked your body or not.Why do people develop eating disorders? There are so many reasons why people develop eating disorders. First, it can be psychological due to low self-esteem, feelings of inadequacy or failure, feeling of being out of control, response to change (i. e. puberty) or response to stress. Second, it can be due to interpersonal issues like having trouble with family and personal relationships, difficult expressing emotions or feelings, or even history of being teased based on size or weight. Lastly, it is the social and cultural norms that we grow up in. There are cultural pressures that glorify thinness and place value on obtaining the perfect body, narrow definitions of beauty that include women and men of specific body weights and shapes. Sometimes there is no reason. Some people just get obsessed with their weight and perceive themselves as “fat”. Effect of anorexia on different parts of the bodySince these patients are scared of gaining weight, how does it affect the entire body?Anorexia can affect multiple systems in our body. Just to name a few symptoms that it can manifest as: amenorrhea, infertility, constipation, dizziness, hypothermia, bradycardia, hypotension, dry skin and even hair loss. Starvation induces protein and fat catabolism that leads to loss of cellular volume and atrophy of the heart, brain, liver, intestines, kidneys, and muscles. Cardiac: It can decrease cardiac mass, decrease cardiac chamber volumes, cause myocardial fibrosis and pericardial effusion. These manifestations are reversible if the patient gains weight. Functionally, it can cause bradycardia due to increased parasympathetic activity, hypotension, decreased heart rate variability and QT prolongation on ECG. Lungs: shortness of breath due to weakened and wasting of the respiratory muscles, pneumothorax and aspiration pneumonia. GI system: it leads to gastroparesis with bloating, constipation, severe pancreatitis and mild transaminitis. Hematologic: anemia, leukopenia and thrombocytopenia. Skin manifestations include dry/scaly skin, hair loss, acne, hyperpigmentation and acrocyanosis. You can also find lanugo, which is a very thin, light colored hair on the face and body. It is thought that the lanugo is an adaptation from the body to keep it warm. Lanugo is common in patients with anorexia nervosa or other causes of malnourishment. That's why wearing coats in warm weather can be a silent sign of anorexia. Other subtle signs include social withdrawal, fidgeting (to burn calories), and always “eating” in private. It is important to remember that all these manifestation that Jeffrey mentioned are not present with intermittent fasting because intermittent fasting is an intermittent restriction of food, the nutritional needs are met during the “feasting” periods after “fasting”. Some may argue that intermittent fasting may promote eating disorders, but I believe intermittent fasting is just an effective treatment for obesity.Treatment plan for anorexiaThere are several treatment options for these patients. We can refer them to nutritional rehabilitation where they can supervise meals. We can refer them to psychotherapy, such as cognitive behavioral therapy or motivational interviewing. There is also a drug called Olanzapine for this condition. Sometimes, patients may need admission to the hospital. I learned recently that UCLA has an Eating Disorder Program which includes inpatient services. Some centers are very specialized and include family therapy and group therapy. Listeners, you can continue to research about anorexia, it's is fascinating. The prevalence of anorexia in the US is estimated to be 0.6%. BULIMIABy definition, bulimia nervosa is when a person binge eats and then uses certain behaviors to prevent weight gain. These behaviors may include self-induced vomiting, using laxatives or diuretics, exercising excessively, or fasting and having a restrictive diet. Signs and symptoms to look forA physical examination is key. On physical presentation, these people usually can have overweight or obesity. That's the main difference with anorexia. Anorexia: skinny people, bulimia: normal weight, overweight or obesity. Regardless of their weight, these patients are malnourished. They may lack some essential nutrients causing serious health consequences. That's why nutrition cannot be assessed by BMI only. Common signs they will present with will include tachycardia, hypotension (systolic blood pressure below 90), dry skin, and hair loss. If the person uses self-induced vomiting to prevent weight gain, they may have erosion of the dental enamel from all the acid that comes up when they vomit. There may also be scarring or calluses on the dorsum side of the hand from all the acid too. Their parotid glands, that are located on the side of the jaws will also be swollen, causing a sign known as chipmunk face of bulimia.From talking to this person and getting a detailed history, we will learn of the symptoms bulimia nervosa can cause. This will include lethargy and fatigue, irregular menstrual periods in a female, abdominal pain and bloating, and constipationThis disorder really does take a toll on the body. There's plenty of complications that come with it as well. Let's try to break it down by system. GI system has the most complications: esophageal tears from the vomiting called Mallory-Weiss syndrome, which will present with bloody vomits, a loss of gag reflex, esophageal dysmotility, abdominal pain and bloating, GERD, diarrhea and malabsorption of nutrients, fatty stools known as steatorrhea, colonic dysmotility leading to constipation, irritable bowel syndrome, rectal prolapse, and pancreatitis. Cardiac: serious complication is ipeac-induced myopathy, let's spend a little time on this. Ipecac is a syrup that someone with bulimia nervosa may use to make themselves vomit. If a person uses this syrup frequently or for a long amount of time, there is a component called emetine will accumulate in muscle, including cardiac muscle. If a person uses ipecac chronically, it can be detected in the urine for up to 60 days. This will damage the heart muscles or myocardium and lead to cardiomyopathy. It will present with symptoms such as chest pain, shortness of breath, hypotension, tachycardia or bradycardia, T wave abnormalities on ECG, conduction delays, arrythmias, pericardial effusions, and even congestive heart failure. Cardiomyopathy may be irreversible. Renal system: dehydration, hypokalemia, hypochloremia, hyponatremia, and metabolic alkalosis. This could happen in patient who use diuretics as a purging mechanism. Endocrine system: Electrolytes and hormones imbalance. The endocrine system primarily impacts the reproductive and skeletal systems. Among 82 women treated for bulimia nervosa, menstrual irregularities were present in 45 percent at pretreatment and in 31 percent at 12-month follow-up. These irregularities may look like spotty or very light menstrual cycles. Cycles may be very erratic or completely absent. Skeletal system: osteopenia and osteoporosis are common with bulimia nervosa. Osteopenia means weaker and more brittle bones. Osteoporosis is more serious than osteopenia and can more easily result in fractures.The diagnosis of bulimia nervosa can usually be made clinically. And after the diagnosis with bulimia nervosa, the first step in helping them is always getting a full lab work up to see what systems to the body have been impacted. Treatment options include nutritional counseling, behavioral therapy, and even medications. If a person needs help connecting with someone that can help with this disorder, there are organizations that they can contact which will connect them with proper resources in their area. Organizations include the Academy for Eating Disorders and the National Eating Disorders Association. Bulimia nervosa is more prevalent in females than males in all age groups. In the US, adult prevalence is 1.0% and adolescent prevalence is 0.9%, with the median age of onset of 18 years. After comparing different age groups, we have seen the prevalence of bulimia nervosa has increased over time. Conclusion: Anorexia nervosa and bulimia nervosa are eating disorders that can have consequences on the health of our patients. We should know the difference between these two diseases and know the resources available in our community to assist these patients. The diagnosis may be done clinically, but you will need to order labs or imaging for a full assessment. Eating disorders are an example of the direct effect a mental illness can have in the body. In the specific case, anorexia and bulimia cause malnutrition. The treatment of these diseases requires a multidisciplinary team to treat the patient and the family as well.____________________________Conclusion: Now we conclude our episode number 76 “Eating Disorders.” We started this episode with exciting news about the new malaria vaccine, a step forward on our fight against malaria. Sophia, Jeffrey, and Dr Arreaza presented an interesting overview about anorexia and bulimia. They taught us that if a patient perceives him or herself as “fat”, but they are actually underweight, they may have anorexia. Patients with bulimia tend to have normal or above normal BMI but have periods of binging and purging. Be aware of these conditions while assessing your patients' nutritional status and treat appropriately or refer as needed. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Tana Parker, Sophia Dhillon, and Jeffrey Nguyen. Audio edition: Suraj Amrutia. See you next week! _____________________References: Malaria's Impact Worldwide, Centers for Disease Control and Prevention, https://www.cdc.gov/malaria/malaria_worldwide/impact.html, accessed on November 15, 2021. Constitution of the World Health Organization, Basic Documents, Forty-fifth edition, Supplement, October 2006, accessed on Aug 26, 2021. Accessed on November 15, 2021. https://www.who.int/governance/eb/who_constitution_en.pdf. 12 Secret Signs of Anorexia, CBS News, August 12, 2010, https://www.cbsnews.com/pictures/12-secret-signs-of-anorexia/3/. Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007 Feb 1;61(3):348-58. doi: 10.1016/j.biopsych.2006.03.040. Epub 2006 Jul 3. Erratum in: Biol Psychiatry. 2012 Jul 15;72(2):164. PMID: 16815322; PMCID: PMC1892232. https://pubmed.ncbi.nlm.nih.gov/16815322/. Mitchell, James E, MD; and Christie Zunker, PhD, CPH, CHES, Bulimia nervosa and binge eating disorder in adults: Medical complications and their management, UpToDate, October 2021. https://www.uptodate.com/contents/bulimia-nervosa-and-binge-eating-disorder-in-adults-medical-complications-and-their-management?search=Bulimia%20nervosa%20and%20binge%20eating%20disorder%20in%20adults:%20Medical%20complications%20and%20their%20management&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 Yager, Joel, MD, Eating disorders: Overview of epidemiology, clinical features, and diagnosis, UpToDate, October 2021. https://www.uptodate.com/contents/eating-disorders-overview-of-epidemiology-clinical-features-and-diagnosis?search=Eating%20disorders:%20Overview%20of%20epidemiology,%20clinical%20features,%20and%20diagnosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 Yager, Joel, MD, Eating disorders: Overview of prevention and treatment, UpToDate, October 2021. https://www.uptodate.com/contents/eating-disorders-overview-of-prevention-and-treatment?search=Eating%20disorders:%20Overview%20of%20prevention%20and%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Sponsors: Orange Beach Invasion, Scrapin the Coast, & Bayou Showdown + Mini Truck Showdown (June 2022 Las Vegas) & Kern County Showdown (Feb 2022 Bakersfield, CA) ODB intros the episode covering Scene Updates ODB touches base with Ron Perkins to discuss HDWW's Black Friday, Open Enrollment & more Ruben Arteaga to discuss Dino's Git Down & a bit of the Sport Truck Era Eddie Gordy Junior to discuss his setup and showing at the 61st Houston Auto Rama ODB touches base with Max Fish to see what he's been up to since his initial interview on OLP RIP Mark “Papa Smurf” Ballard! We miss you Dad. Stay On Da Rise!
Official Website: https://www.lawabidingbiker.com In part 1 of 2 of this series, I have Popeye and Squirt on the mics. They and a few others from the Sworn Few Law Enforcement Motorcycle Club completed a recent 10-day 3500-mile motorcycle road trip from Washington State to Arizona. They have a ton of stories and it was fun hearing about this trip as I was not able to go. SUPPORT US AND SHOP IN THE OFFICIAL LAW ABIDING BIKER STORE Many of the Law Abiding Biker™ Media crew are also members of the Sworn Few LEMC and ride motorcycles often. Each year we like to take a larger long-distance road trip together. This year it was two large trips to include this trip and a trip south along the West Coast to San Francisco and back inland and to the north. With many of these long-distance motorcycle road trips, a documentary film is produced. Make sure to see all our Motorcycle Documentary Films here! CHECK OUT OUR HUNDREDS OF FREE HELPFUL VIDEOS ON OUR YOUTUBE CHANNEL AND SUBSCRIBE! This motorcycle road trip would start in Washington State and take them through Oregon, Idaho, Nevada, California, Utah, and Arizona. Popeye organized this trip like all our trips, using Harley Ride Planner, a free online trip planning tool available to anyone who creates a free account. If you want to get the most out of Harley Ride Planner and flatten the learning curve then make sure to check out our very popular Harley Ride Planner Tutorial Video. Additionally, learn in detail how to use all models of the Harley Boom Box Infotainment System once you upload the ride plan by viewing our very popular Harley Boom Box Tutorial Videos. You'll learn everything you need to know about the Harley Boom Box, which is a very capable unit but can be confusing to learn. We'll show you all the tips and tricks we've learned over the years using the Harley Boom Box. And we'll show you all the hidden menus and features. We're just a bunch of bikers helping bikers. While listening to this episode, you can view the actual Harley Ride Plan for this trip and the stops made by clicking the logo to the left. You can even ride it if you want using this plan! New Free Video Mentioned: Reax 215 Protective Motorcycle Riding Jeans Review Sponsor-Ciro 3D CLICK HERE! Innovative products for Harley-Davidson & Goldwing Affordable chrome, lighting, and comfort products Ciro 3D has a passion for design and innovation Sponsor-RickRak CLICK HERE The Ultimate Motorcycle Luggage Rack Solution Forget those messy straps and bungee cords Go strapless with a RickRak quick attach luggage system & quality bag New Patrons: Jerry Ochoa of Casper, Wyoming Albert Panozzo of Libertyville, Illinois Corey Vanwinkle of Bakersfield, California Sky Neary of Locust Grove, GA Glen C of Pensacola, FL Glen Ridout of Ingersoll, Ontario, Canada Dawayne Rakoczy of Keizer, Oregon Eric Poirier of Lorraine, Quebec, Canada Thomas Alms of Lehi, Utah Christoper Pratt of Madison, New Hampshire Craig Thompson of Kansas City, Missouri James Vanderhoof of Allen Park, Michigan If you appreciate the content we put out and want to make sure it keeps on coming your way then become a Patron too! There are benefits and there is no risk. Thanks to the following bikers for supporting us via a flat donation: James Evans of Fayetteville, NC Simeon Cumberbatch _______________________________________________________ FURTHER INFORMATION: Official Website: http://www.LawAbidingBiker.com Email & Voicemail: http://www.LawAbidingBiker.com/Contact Podcast Hotline Phone: 509-731-3548 HELP SUPPORT US! JOIN THE BIKER REVOLUTION! #BikerRevolution #LawAbidingBiker
With C class properties selling for cap rates equivalent to B and A class properties, a number of operators are exchanging into A class. These properties are easier to hold for the long-term because they don't have the same looming cap-ex to deal with over the next several years. Today's guest, Keith Wasserman, Co-Founder of Gelt Inc. in Southern California, started out with heavier value-add projects in Bakersfield, then Phoenix, plus other Western markets. More recently, he's been trading up to newer vintage properties for longer-term holds. Learn more at https://www.streetsmartsuccess.com
Noon Top Stories:-An SUV plowed into a Christmas parade in Wisconsin on Sunday, killing at least five people and injuring 48-A male found with a gunshot wound Sunday night in southeast Bakersfield has died, according to sheriff's officials.-"Gas prices" are dominating Google searches just as people get ready to travel for Thanksgiving.
This week we welcome Jesus Fuentes, from the 'Words R Hard' podcast, back to the show. Art couldn't make it this week BUT we still bring you a bange This week we keep it SUPER local as we tell you a local legend that has been around since the 1950's. A legend that "Pizzagate" wish it was ....because it's actually TRUE. Ladies and gentlemen we're talking about 'The Lords of Bakersfield'. In brief "The Lords of Bakersfield" was a group of men involved in local government and law enforcement who were involved in a secret "Good ol' Boys' society that preyed upon under aged boys and used their positions and influence to get away with their crimes..... As always follow us on the stuff Merch Store- http://tee.pub/lic/doEoXMI_oPI Patreon- https://www.patreon.com/Artandjacobdoamerica Website- https://artandjacobdoamerica.com/ Network- https://podbelly.com/ Instagram- https://www.instagram.com/artandjacobdoamerica YouTube Channel- https://www.youtube.com/channel/UC0rT6h3N2pWtlkxaqgIvaZw?view_as=subscriber Twitter- https://twitter.com/ArtandJacobDoA1 Facebook- https://www.facebook.com/artandjacobdoamerica/ ALSO! Make sure you're checking out our sponsors https://cavemancoffeeco.com Suiker Apparel: Graphic Statement Tees & Accessories Use Promo code "AMERICA" for 15% off at Caveman Coffee Use Promo code "Artandjacob" for 10% off at Suiker Apparel
In this episode of The Remote CEO Show, I had the pleasure to interview Joel Sandoval. Joel Sandoval, CPA is the owner and founder of Sandoval Tax based in Bakersfield, California. Joel has a passion for helping small businesses with all aspects of their accounting needs, whether it's helping business owners save money on taxes, providing tax-ready financial statements with bookkeeping, or training and consulting with QuickBooks. Joel has a deep care for customer service and is always striving to make sure that his clients are happy. He will go the extra-mile to make sure that his clients feel they are in good hands when it comes to their needs in bookkeeping and taxes.
Episode 75: Multisystem Inflammatory Syndrome in Children (MIS-C). Dr Schlaerth explains the signs, symptoms, and basic management of MIS-C. Lam explain the role of anti-obesity medications in weight management. Introduction: The Role of Drugs in Weight Loss Management By Lam Chau, MS3, Ross University School of Medicine Today about 70% of adult Americans are overweight or obese. Obesity is associated with increased risk of heart disease, stroke, and diabetes, among many other diseases. Studies have shown losing 5-10% of your body weight can substantially reduce your risk of cardiovascular disease. Traditional belief is that weight loss can only be attributed to diet and exercise. While there are certainly elements of truth to that statement, medication is a safe and proven method for weight management that is often overlooked. The fact of the matter is that weight loss is an ongoing field of study with constant new research and innovations. In June of this year, a medication named Wegovy was approved for weight loss management by the FDA. This drug is indicated for chronic weight management in patients with a BMI of 27 or greater with an accompanying weight-related ailment or in a patient with a BMI of 30 or greater. Rachel Batterham, PhD, of the Centre for Obesity Research at University College London, shared: "The findings of this study represent a major breakthrough for improving the health of people with obesity. No other drug has come close to producing this level of weight loss — this really is a game changer.” Despite breakthroughs like these, the use of medication for weight loss is still relatively low. Dr. Erin Bohula, a cardiologist and assistant professor at Harvard Medical School, believes “there are probably a few reasons for this, including cost, if not covered by insurance, and a perception these agents are not safe in light of the history with weight loss agents.” A study from 2019 examined the medical records from eight geographically dispersed healthcare organizations. They found that out of 2.2 million patients who were eligible for weight loss medication, only 1.3% filled at least 1 prescription. Weight loss is a dynamic process with many different variables. While it may not necessarily be for everyone, medication can help tremendously and is an option you should consider if you are interested in weight loss[1,2]. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ___________________________Multisystem Inflammatory Syndrome in Children (MIS-C). By Katherine Schlaerth, MD, and Hector Arreaza, MD. History and epidemiologyMost children who get COVID-19 have either no symptoms or very mild symptoms. However, about 18 months ago, a new pediatric complication of COVID-19, possibly postinfectious, was described. The eight children who were initially described had a clinical presentation which was similar to either Kawasaki Disease or perhaps toxic shock syndrome, and since these children had signs of a hyperinflammatory state coupled with shock, the new syndrome was named Multisystem Inflammatory Syndrome in Children, or MIS-C for short. By midsummer of 2021, the United States had about two thousand cases and 30 deaths in children under 21. Other name for this condition is Pediatric Hyperinflammatory Shock. DiagnosisWhat are the criteria for a diagnosis of Multisystem Inflammatory Syndrome? They include:Age below 21Fever above 100.4 degrees Fahrenheit or 38 degrees centigrade for 24 hours (a subjective fever for more than 24 hours counts too). Laboratory evidence of inflammation which should include at least two of the following tests: elevated CRP, elevated ESR, elevated fibrinogen level, procalcitonin, D-dimer, ferritin, lactic acid dehydrogenase (LDH), interleukin-6, and neutrophil counts, low lymphocyte count and low albumin.Severe disease necessitating hospitalization with multisystem organs affected. The systems affected include cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic, and neurologic (at least three systems need to be involved). No creditable other diagnosis. Other symptoms include:GI complaints (diarrhea, vomiting, abdominal pain)Skin rashConjunctivitisHeadacheLethargyConfusionRespiratory distressSore throatMyalgiasSwollen hands/feetLymphadenopathyCardiac signs and symptoms include troponin/BNP elevation and arrhythmia. Findings on ECHO may include depressed LVEF, coronary artery abnormalities, including dilation or aneurysm, mitral regurgitation, and pericardial effusion. There also must be a positive test for SARS-CoV-2 and this test can be either a reverse transcriptase polymerase chain reaction (RT-PCR), serologic, or antigen testing. Exposure to someone who has had or is suspected of having had COVID-19 within the last 4 weeks also counts. Patients with MIS-C may have predominately gastrointestinal symptoms, mucocutaneous findings, and may be hypotensive or “shocky” on presentation. Up to 80% require ICU admission. Thrombocytopenia and /or elevated transaminase levels can also be seen. MIS-C vs Kawasaki DiseaseThe big issue in diagnosing MIS-C is the overlap with Kawasaki's disease and with toxic shock syndrome. Patients with Kawasaki Disease in their second week of illness often will have thrombosis, not thrombocytopenia. Whereas MIS-C usually affects school age children or adolescents, Kawasaki Disease is more commonly a problem in younger children, who have an average age of 2 years. Kawasaki Disease is also more common in Asian children and MIS-C disproportionately seems to affect Black and Hispanic children. Obesity seems to be another risk factor for MIS-C. Kawasaki's Disease also has different cardiac manifestations from MIS-C. Coronary artery dilatation is common in Kawasaki's disease and left ventricular dysfunction in MIS-C, although sometimes coronary artery dilatation and rarely aneurisms can be noted on echocardiogram in putative MIS-C, which is why differentiation from Kawasaki's Disease is an issue. PathophysiologyThe cause of MIS-C is probably postinfectious immune dysregulation. Only a minority of MIS-C patients are identified as having COVID-19 by RT-PCR, but most have positive tests for immunoglobulin G. Statistically, there is a lag of 4-6 weeks between peak community cases of COVID-19 and the time at which children present with MIS-C. Although research is being done on MIS-C, and theories abound about etiology, there is no clear-cut answer to why some children get MIS-C and the vast majority do not. In a review of the literature on MIS-C using literature from December 2019 through May 2020, gastrointestinal symptoms such as diarrhea, and abdominal pain were 4-5 times more common than cough and respiratory distress. There was a slight preponderance of male patients and mean age was 8 ½ years. ICU admission was common and 2/3 required inotropic support, over ¼ needed respiratory help with extracorporeal membrane oxygenation warranted in 31 children. The death rate was 1.5 % of these very sick children treated in hospital. In another smaller study, 80% had mild, but 44% had moderate to severe EKG abnormalities including coronary involvement. The good news was that coronary arteries were normal in all children after a month, and at 4-9 months, only 2-4% had mild heart abnormalities. Unfortunately, mechanisms of MIS-C as well as universal treatment is still being worked out. Published articles may be delayed due to time constraints in publishing. Other immunologic interventions do not have sufficient data. TreatmentWhat about the treatment of children diagnosed with MIS-C?Usually, a variety of specialists become involved initially. These can include pediatric rheumatology, infectious disease, cardiology, and hematology. If children with MIS-C meet criteria for complete or incomplete Kawasaki disease as well, regardless of COVID-19 testing results, IVIG and aspirin are reasonable. Corticosteroid use must be individualized, and if used it may require a taper. An echocardiogram can be done initially looking for coronary aneurisms and repeated in a week. In severe cases, shock may be a presenting factor needing urgent attention. Generally, the treatments used are decided by the aforementioned consults and may consist of immunomodulating therapy, including possibly IVIG (2g/kg), and/or corticosteroids methylprednisolone (30mg/kg). AntiviralsThe role of antiviral therapy is unclear and remdesivir should be reserved for children with acute COVID-19. COVID-19 vaccination-associated myocarditisAnother entity which needs further evaluation is COVID-19 vaccination-associated myocarditis in adolescents. This problem is more common in young males and may occur after the administration of mRNA based COVID-19 vaccines. The presentation occurs within 2 weeks of COVID-19 vaccination, and clinical presentation can include chest pressure, abnormal biomarkers (elevated troponins), and cardiac imaging findings. It is unknown if subclinical cases occur. COVID-19 infection in children, while usually benign, has the potential to become serious, and the association between some mRNA vaccines and the occurrence of myocarditis has yet to be thoroughly studied. We look forward to more and better data to guide the care of children and young adults in these spheres. The risk of having myocarditis is still higher with the actual COVID-19 than the COVID-19 vaccine. The incidence of myocarditis after BioNtech/Pfizer vaccine was 2.13 cases per 100,000 persons in a large study done in a large health care organization in Israel where more than 2 million people were vaccinated (that represents 0.00213%). Another US study showed that there were 77 cases per million doses of vaccines in young male, in contrast, there were 450 cases of myocarditis per million COVID-19 cases in the same age group.____________________________Conclusion: Now we conclude our episode number 74 “Multisystem Inflammatory Syndrome in Children.” Dr. Schlaerth explained that MIS-C is a work in progress in terms of pathophysiology, diagnosis, treatment, and prognosis. MIS-C and Kawasaki Disease are very similar, but, for example, GI symptoms, cardiac dysfunction, shock and multisystem dysfunction are more prominent in MIS-C than Kawasaki Disease. Whereas coronary artery aneurysms are more common in Kawasaki disease than MIS-C. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Katherine Schlaerth, and Lam Chau. Audio edition: Suraj Amrutia. See you next week! _____________________References:FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014, June 04, 2021, U.S. Food and Drug Administration (FDA), https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014. Saxon DR, Iwamoto SJ, Mettenbrink CJ, et al. Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009-2015. Obesity (Silver Spring). 2019;27(12):1975-1981. doi:10.1002/oby.22581. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6868321/. Carroll, Linda, Weight-loss pills can help. So why don't more people use them? NBC News Health Care, September 2, 2018. https://www.nbcnews.com/health/health-care/weight-loss-pills-can-help-so-why-don-t-more-n905211 World Health Organization, WHO recommends groundbreaking malaria vaccine for children at risk, October 6, 2021. https://www.who.int/news/item/06-10-2021-who-recommends-groundbreaking-malaria-vaccine-for-children-at-risk Lee, Min-Sheng et. al, Similarities and Differences Between COVID-19-Related Multisystem Inflammatory Syndrome in Children and Kawasaki Disease, Front. Pediatr., 18 June 2021, https://doi.org/10.3389/fped.2021.640118. Gail F. Shust, Vijaya L. Soma, Philip Kahn and Adam J. Ratner, Pediatrics in Review July 2021, 42 (7) 399-401; DOI: https://doi.org/10.1542/pir.2020-004770. Jain SS, Steele JM, Fonseca B, et al. COVID-19 vaccination-associated myocarditis in adolescents. Pediatrics. 2021; doi:10.1542/peds.2021-053427. https://pediatrics.aappublications.org/content/pediatrics/early/2021/08/12/peds.2021-053427.full.pdf. Wilson, Clare, Myocarditis is more common after covid-19 infection than vaccination, New Scientist, 4 August 2021, https://www.newscientist.com/article/mg25133462-800-myocarditis-is-more-common-after-covid-19-infection-than-vaccination/#ixzz79JPn2E47. Son, Mary Beth F, MD, and Kevin Friedman, MD, COVID-19: Multisystem inflammatory syndrome in children (MIS-C) clinical features, evaluation, and diagnosis, Up to Date, September 2021, https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-clinical-features-evaluation-and-diagnosis?search=kawasaki%20vs%20misc&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Sponsors: Orange Beach Invasion, Scrapin the Coast, & Bayou Showdown + Mini Truck Showdown (June 2022 Las Vegas) & Kern County Showdown (Feb 2022 Bakersfield, CA) ODB & The Mayor intro the episode covering Scene Updates Sean Randall provides updates on Bayou Showdown which is THIS weekend in Slidell, LA ODB interviews Jeremy Kaufman discussing How he got involved in the automotive / mini truck scene Fab work including body dropping trucks in the early 90s Local Finesse and the club's history + so much more! RIP Mark “Papa Smurf” Ballard! We miss you Dad. Stay On Da Rise!
TJ Cox is officially out of the running for a rematch against Congressman David Valadao in 2022 and has instead endorsed Democratic candidate Rudy Salas of Bakersfield. In preparation of the holidays, the Central Valley Blue Star Moms have prepared 400 care packages to send to military folks who won't be home for the holidays. Congressman Paul Gosar of AZ has been censured and removed from his committee assignments as punishment for his sharing of an edited anime that depicted him engaged in violence against Biden and AOC. See omnystudio.com/listener for privacy information.
It's Gulls Thursday, and JD Hernandez finally gets to talk about the GOAL OF THE YEAR in the AHL. Jacob Perreault pulled off "The Michigan" in Bakersfield, and it was spectacular... but was it the best lacrosse goal in Gulls' history? Also, we take a look around the AHL and check in on some former Gulls. Finally, the Gulls' 3rd jerseys were revealed and becomes an instant classic. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Top Stories:-A man was shot and killed in east Bakersfield last night-Local business leaders came together yesterday to share their ongoing projects in Downtown Bakersfield-The Kern County Airports Department will hold an emergency response exercise this morning – simulating a commercial plane crash
Eric D. Johnson, AKA Fruit bats, met Neal Casal through their mutual friend Thom Monahan, and Neal subsequently added his signature touch to several songs on four of Eric's records. Thom produced many of Eric's records and also produced Neal's 2012 album Sweeten the Distance. That album features the song "Feathers for Bakersfield," which Eric covered for Highway Butterfly: The Songs of Neal Casal. In this episode, Eric discusses why he chose this tune, how Bob Weir almost snatched it up first, and memories of what it was like to record with Neal. Learn more about Fruit Bats at http://www.fruitbatsmusic.com/.“Feathers for Bakersfield” - Fruit Bats, Highway Butterfly: The Songs of Neal Casal “Feathers for Bakersfield - Neal Casal, Sweeten the Distance “Shivering Fawn” - Fruit Bats, Tripper “The Banishment Song” - Fruit Bats, Tripper “My Sweet Midwest” - Fruit Bats, Absolute Loser “Mandy from Mohawk” - Fruit Bats, Gold Past Life See acast.com/privacy for privacy and opt-out information.
En este episodio de Voces del Campo, Martin Guerena, especialista en agricultura sostenible de NCAT, es entrevistado por Pepe Reyes de Radio El Gallito de Bakersfield, California, sobre cómo encontrar tierras agrícolas y cómo asegurarla para alquiler, arrendamiento o compra. Martin trabaja en la Oficina Regional Occidental de NCAT en Davis, California.Para obtener más información sobre este tema, puede ponerse en contacto con Martin Guerena directamente en email@example.comLlame a la línea de "ATTRA en Español" con cualquier pregunta sobre agricultura sostenible al 800 411-3222 o por correo electrónico a firstname.lastname@example.org o email@example.com. Nuestros especialistas pueden ayudarle con una amplia gama de temas, inclusivamente: planificación de fincas, manejo de plagas, producción hortícola, ganadería, suelos, acuicultura, y mucho más. Recursos de ATTRA Recursos en Español La Conferencia del Agricultor Latino Facebook Please complete a brief survey to let us know your thoughts about the content of this podcast. NCAT Facebook Granja SIFT de NCAT SITIO Website Oficina del suroeste: Website / Facebook Oficina occidental: Website / Facebook Oficina de Rocky Mountain West: Website / Facebook Oficina de los Estados del Golfo: Website / Facebook Oficina sureste: Website / Facebook Oficina del noreste: Website / Facebook
Noon Top Stories:-A married couple whose bodies were found last week at a home in southeast Bakersfield died in a murder-suicide, according to coroner's officials.-KGET Holiday Food Drive benefitting the Community Action Partnership of Kern Food Bank is happening today until 7 p.m.-Woman in critical condition after multi-vehicle crash on 21st Street and Union Avenue Tuesday, suspect driver fled
Buddy Kofoid went back-to-back at Bakersfield last night with the USAC National Midgets and now holds a very slight championship lead over Chris Windom. We'll recap the action today, plus we've got an update on Daison Pursley, and we dive into a big question from a listener.
Today we double back and talk about the 2022 schedule for the World of Outlaws Late Model Series, plus we preview tonight's USAC Midget race at Bakersfield and look at how Chris Windom has climbed back into the championship fight.
Episode 74: Breast Cancer Screening. Salwa and Veronic discuss who, how, and when to screen for breast cancer. The Pfizer COVID-19 vaccine was authorized for use in children 5-11 years of age.Introduction: Pediatric COVID-19 VaccinesBy Lam Chau, MS3, Ross University School of MedicineOn November 2nd, 2021, the CDC endorsed a unanimous recommendation to allow the use of the Pfizer COVID-19 vaccine for children ages 5-11 years of age. The White House has secured 28 million pediatric doses of the Pfizer vaccine, enough to cover every child ages 5-11 within the United States without cost. The official CDC recommendation is that all children aged 5 and older get vaccinated, regardless of past infection history. The Pfizer vaccine for children is given in two doses, 3 weeks apart.Individuals older than 12 are given a 30-microgram dose, while pediatric individuals are given a 10-microgram dose. For extra precaution, the pediatric vaccine vials are being shipped with a unique orange cap to clearly distinguish itself from higher dose vaccines. Clinical trials with the lower dose vaccine demonstrated a strong antibody response and a prevention rate of symptomatic COVID-19 of 90%. The reported side effects were minimal, and no serious adverse events or myocarditis were reported during the trials. The vaccination of children cannot be understated. The benefits go well beyond just the physiological processes of vaccination. It will foster a safer environment for our children and help improve their emotional and social development. While there is still a lot to be done to end the pandemic, this recent announcement is an enormous step in the right direction in returning to normalcy. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ___________________________Breast Cancer. By Salwa Sadiqali, MS3, Ross University Medical School; Veronica Phung, MS3, Ross University School of Medicine; and Hector Arreaza, MD. Salwa: Welcome back from Spooky season! Did you see all the flyers and advertisements about Breast cancer awareness last month? Veronica: I did! It's because October was breast cancer awareness month.Salwa: And spooky season, and of course pumpkin spice season! I got my dose of pumpkin spice this morning. Well, every morning to be exact, Starbucks is my second home. What do you know about breast cancer? Veronica: Well...breast cancer is the most commonly diagnosed cancer worldwide. And, fun fact, I know that Angelina Jolie had an increased risk of breast cancer, so she had surgery to remove them.Arreaza: I remember it being all over the news back in 2013. It caused “The Angelina Effect.” There was an increase in people searching about breast cancer on the internet. Let's dive into this topic a bit more. What exactly is breast cancer?Salwa: It's a process in which normal cells of the breast start growing too quickly, out of control. It can happen in males too, but it's much rarer.Veronica: And there are different types of breast cancers that originate from the different types of tissue in the breast. There's ductal carcinoma, lobular, inflammatory, Paget's, and phyllodes to name a few. Salwa: Not only are there different types of breast cancers, but some can also be hereditary meaning mutated genetic information is passed on from generation to generation.Arreaza: That's what happened with Angelina Jolie. She had a BRCA1 gene mutation. Veronica: BRCA1 and BRCA2 mutations are the most common causes of hereditary breast cancer. Normally, the BRCA gene helps make proteins that repair damaged DNA. When this gene is mutated, it can't make those proteins, so damaged DNA stays damaged. But this only makes up 5-10% of all breast cancers.Salwa: Exactly! Here's an interesting fact, women of Ashkenazi Jewish heritage are at a much higher risk of developing a BRCA mutation. There are several other genes that are also linked to hereditary breast cancer. But those genes aren't that common. Non-hereditary breast cancers are much more common - they make up about 85% of breast cancers. Arreaza: Ok so you two gave us a lot of good information, but do you know how to screen for breast cancer?Salwa: When and how often you screen depends on which guidelines your physician is following. Generally, you'll get a mammogram, basically an X Ray of the breast. Veronica: The US Preventative Screening Task Force or USPSTF is a panel of experts that uses medicine-based evidence to make screening and vaccination guidelines. These guidelines are reviewed and updated yearly. For breast cancer, the USPSTF recommends women ages 50-74 have a mammogram every other year. Salwa: The American College of Obstetrics and Gynecologists recommends mammograms starting at the age of 40 and repeating the test every year or every other year. While the American Cancer Society recommends annual mammograms from 40 to 54 years of age and then every other year for women 55 years or older. Veronica: Dr. Arreaza, you see a lot of patients and I'm sure you've referred plenty of them for breast cancer screening. How do you decide which guidelines to follow? Arreaza: When you have a patient between 40-50 years old, you have an opportunity to talk about screening, and make a shared decision. The USPSTF recommends that women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or an ancestry associated with BRCA1/2 gene mutation be screened with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing.Some instruments use to assess the need for BRCA mutation screening include Ontario Family History Assessment Tool, Manchester Scoring System, Referral Screening Tool, Pedigree Assessment Tool, 7-Question Family History Screening Tool, International Breast Cancer Intervention Study instrument (Tyrer-Cuzick).Salwa: What about the self-breast exams? I remember those were recommended all the time.Veronica: That's a great question! Current research suggests that doing a self-breast exam doesn't necessarily help detect tumors early – whether cancerous or not. And, sometimes, while doing self-breast exams you may feel a lump that's actually normal breast tissue and it may cause unnecessary anxiety. That being said, you should always know how your breasts normally look - as in are they symmetrical, how the nipples look, how the skin normally looks. And of course, if you notice any changes or have any concerns, please visit your primary care provider. Arreaza: Breast awareness. The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects.Salwa: As medical students, we have the opportunity to work with different departments in the hospital. I'm currently doing my surgery rotation and Veronica completed hers in September. As part of the rotation, we had the opportunity to work at the Breast Clinic with Dr. Snyder. We saw a lot of patients from CSV because their PCPs were screening them for breast cancer and all those women were able to get the higher level of care they needed. Find available resources in your community for free screening mammograms. For example, Cancer Detection Program/Every Woman Counts by Clinica Sierra Vista.____________________________Now we conclude our episode number 74 “Breast Cancer Screening.” October was breast cancer awareness month, but it is not too late to remind everyone of the need to screen for breast cancer. Whether you follow the American Cancer Society, the USPSTF or the ACOG guidelines, just do not forget to screen. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Lam Chau, Salwa Sadiqali, and Veronica Phung. Audio edition: Suraj Amrutia. See you next week! _____________________References:AAFP Signs Off on Pediatric COVID-19 Vaccine Recommendations, American Academy of Family Physicians, November 3, 2021. https://www.aafp.org/news/health-of-the-public/20211103covidvaccchildren.html?%20cid=DM63464&bid=188450701 ACS Breast Cancer Early Detection Recommendations. American Cancer Society. (n.d.). Retrieved October 11, 2021, from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html. Basu, N.N., Hodson, J., Chatterjee, S. et al. The Angelina Jolie effect: Contralateral risk-reducing mastectomy trends in patients at increased risk of breast cancer. Sci Rep 11, 2847 (2021). https://doi.org/10.1038/s41598-021-82654-x Breast cancer information and support. Breastcancer.org. (n.d.). Retrieved October 10, 2021, from https://www.breastcancer.org/. Breast cancer: Screening. Recommendation: Breast Cancer: Screening | United States Preventive Services Taskforce. (2016, January 11). Retrieved October 10, 2021, from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening. Practice Bulletin Number 179: Breast Cancer Risk Assessment and Screening in Average-Risk Women. (2017). Obstetrics and gynecology, 130(1), e1–e16. https://doi.org/10.1097/AOG.0000000000002158
Sponsors: Orange Beach Invasion, Scrapin the Coast, & Bayou Showdown + Mini Truck Showdown (June 2022 Las Vegas) & Kern County Showdown (Feb 2022 Bakersfield, CA) ODB & The Mayor intro the episode covering Scene Updates ODB interviews Robert Kamalski discussing 'Local Finesse: Roads to Ruin' which he wrote Being in Local Finesse West Coast River Runs + so much more! RIP Mark “Papa Smurf” Ballard! We miss you Dad. Stay On Da Rise!
The Moneywise Guys Thursday, November 11th BE MONEYWISE. Moneywise Wealth Management I "The Moneywise Guys" podcast call: 661-463-8264 text in anytime: 661-396-1000 email: firstname.lastname@example.org website: www.MoneywiseGuys.com Guest: John Cox, Business Writer for the Bakersfield Californian www.Bakersfield.com
Bakersfield has been experiencing a massive growth in the craft beer scene over these last few years, and today we chat with one of those breweries that keeps pushing things forward - Temblor Brewing Company. The folks at Temblor have a knack for using ingredients in an evenly-handed way, and that shows in the beers they produce! Learn more about your ad choices. Visit megaphone.fm/adchoices
Anna Marie is a business owner, author, podcaster, and lover of life. She is a doctor of traditional naturopathy, certified brain health professional, and life-guide coach. Her company is called Happy Whole You and they have locations in Bakersfield, California, and Reighly, North Carolina. Her mission is to help people become more Happy & Whole using holistic health modalities and strategies. Anna Marie just launched her own line of brain supporting nutraceuticals and is excited to share brain health tips with you today. Show note links: You can find Anna Marie on Instagram @HappyWholeYou. Visit her line of brain nutraceuticals here. Learn about Bemer therapy here. Learn about BioCharger therapy here. Check out some guided meditations here. Watch this video to learn more about Anna Marie's formulations. Listen to the Happy Whole You Podcast here. CLICK HERE TO JOIN THE 2021 WELLNESS RETREAT (Dec 10-12) Support breast cancer with the LIMITED edition Alpha Long Sleeves My online membership -Join PREMIUM and get 1 30 min call with me EACH month! drhalieschoff.com Connect with me on social: @drhalieschoff and @alpha.chiro.health.wellness
Host Becky Hennesy catches up with Tony Kim, who was one of the many guest speakers at the recent Reformers Collective Conference held at Trinity Church (Cedar Hill, Texas) on October 18-19, 2021.Tony is the lead pastor at Renaissance Church in Bakersfield, California, a church he planted 12 years ago. He also launched a reformation movement called Roar Collective five years ago as well as Roar Academy (a two-year program designed to educate and train young reformers). He is also the executive director Harvest International Ministry, an initiative under the leadership of Che Ahn.In addition, they discuss Tony's top three reformers across history. You may have heard of John Wesley...but what about Johann Hess and St. Gregory of Nyssa? These three reformers each lived centuries apart and reshaped the culture around them well beyond their own lifetimes.The Reformers Collective podcast is part of the expanding Charisma Podcast Network (CPN). Click here to visit the CPN main page. While at CPN, look for additional Reformers Collective resources such as Becky's blog articles on the topic of reformation.
Episode 73: Anticoagulation in Afib. When should you start anticoagulation in atrial fibrillation? What medications are appropriate? Virginia Bustamante, Charizza Besmanos and Dr Arreaza discuss this topic. By Charizza Besmanos, MS4; Virginia Bustamante, MS4; and Hector Arreaza, MDCharizza: Hello, welcome to today's episode of Rio Bravo qWeek Podcast. My name is Charizza Besmanos, a 4th year medical student from American University of the Caribbean and I am joined here today by Virginia Bustamante. Virginia: I'm Virginia Bustamante, an incoming 4th year medical student from Ross University. Arreaza: And I'll be here just to make sure that you guys behave during this episode. Charizza: Before we get started on our discussion, I have a quick patient case to share with you. This is a 66-year-old woman who is brought to the ED with sudden onset of severe difficulty speaking and weakness while having breakfast. She has hypertension, hyperlipidemia, severe left atrial enlargement seen on previous ECHO, and is noncompliant with her medications. She is a lifetime nonsmoker and does not drink alcohol. On admission, her blood pressure is 152/90 and pulse is 124/min and irregularly irregular. She is awake and alert but has difficulty finding words while trying to speak. She has severe right lower facial droop and marked weakness and sensory loss in the right arm and mild weakness in right leg. Fingerstick glucose is at 105. ECG shows atrial fibrillation. Acute stroke management is started right away. CT shows occlusion of the left MCA. What management could have prevented this complication? Virginia: This patient clearly has multiple risk factors for thromboembolism events but given her irregularly irregular pulse consistent with atrial fibrillation, she would've warranted long-term anticoagulation to prevent stroke, which she most likely had. Charizza: Exactly. Today's topic is atrial fibrillation, specifically the use of anticoagulation. __________________This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. __________________ Virginia: Anticoagulation is indicated to decrease the risk of thromboembolic events such as ischemic stroke in patients with atrial fibrillation (A-fib). Not all patients receive anticoagulation. Like most things in medicine, you must decide to start anticoagulation when the benefits of decreasing the risk of stroke outweighs the risk of bleeding. So, for assessing the risk of stroke in A-fib, the American College of Cardiology along with American Heart Association and the Heart Rhythm Society published a guideline in the Journal of the American College of Cardiology in 2014 and was recently updated in 2019 detailing in which patients anticoagulation is recommended. Charizza: Yes, according to the guideline, “high risk patients” are all patients with valvular A-fib, and those with nonvalvular A-fib with a CHADVASC score of >/= 2 in men or >/= 3 in women, and those with nonvalvular Afib and hypertrophic cardiomyopathy. Those with “medium risk” are patients with nonvalvular Afib with CHAD2VASc score of 1 in men or 2 in women. In these patients, anticoagulation is considered but the risk and benefits are discussed with the patient. Those with “low risk” are patients with CHAD2VASc score of 0 in men or 1 in women and anticoagulation is not routinely recommended in these patients. Can you tell us briefly what CHA2DVASc score is? Virginia: CHA2DS2-VASc score is the stroke risk assessment tool of choice by the AHA/ACC/HRS guideline. It is great because it is a mnemonic. Each letter is assignment 1 point except for 2 criteria. C stands for congestive heart failure, H for HTN defined as >140/90, A2 is for or Age>75 which is for 2 points, D for diabetes, S2 is for stroke or TIA and it's for 2 points, V for vascular disease such as MI, A for age 65-74, S for female sex. Charizza: That certainly makes it easy to remember. Not only that, but you can also find CHA2DS2-VASc score of MDCalc to make it even easier. Virginia: Now that we've established which patients should receive anticoagulation, how do we choose which anticoagulant? Charizza: For this discussion today, I would like to focus on nonpregnant patients. There really are 2 main anticoagulants, DOACs (or the direct oral anticoagulants) and warfarin. DOACs are the direct thrombin INH (dabigatran) and the direct factor Xa INH (rivaroxaban, apixaban, and edoxaban). DOAC is recommended as first-line in the long-term management of nonvalvular afib as trials have shown DOACs are more successful at reducing risk of thromboembolic events and have a lower risk of bleeding than warfarin and warfarin requires INR monitoring with dose adjustments. Although, in patients with valvular Afib, warfarin is preferred. Arreaza: All of them are by mouth. Virginia: Dosing of DOACs depends on the kidney function, so it is important to obtain the creatinine clearance. For dabigatran, the direct thrombin INH, the recommended dose for patients with CrCl >30 mL/min is 150mg PO twice daily based on the results from the RE-LY trial (2), which evaluated the efficacy and safety of dabigatran with warfarin in patients with Afib. For patients with CrCl of 15-30 mL/min, the recommended dose is 75mg PO BID. Those with CrCl 1.5, patient who is > 80years old or body weight
Sponsors: Orange Beach Invasion, Scrapin the Coast, & Bayou Showdown + Mini Truck Showdown (June 2022 Las Vegas) & Kern County Showdown (Feb 2022 Bakersfield, CA) ODB & Geoff from Mini Garage intro the episode covering SEMA 2021 & more ODB touches base with many great peeps onsite including Ron from HammerD Weekend Wear aka HDWW Ruben Arteaga aka The Booka James (@83day2nite) from Canada who helped build a killer laid out Jeep for a friend Michelle Boone from Relaxed Atmosphere Brandon from Brand X Customs who helped build a truck in the Ford booth Kyle Fannin from Maryland a true truck enthusiast Billy Bob who had his '63 Datsun in the Engaged Media booth representing Relaxed Atmosphere RIP Mark “Papa Smurf” Ballard! We miss you Dad. Stay On Da Rise!
Noon Top Stories:-Report of aircraft crash in Shafter-Kern Public Health reports 21 new COVID-19 deaths, 402 cases-With Aaron Rodgers out with COVID, Green Bay's backup quarterback and Bakersfield native Jordan Love is set to start this Sunday.
Top Stories:-Law enforcement confirm the man wanted in connection to a murder in Tulare County, is the same man at the center of a 2019 Bakersfield immigration controversy-A sheriff's office review board has ruled an officer-involved shooting that occurred last month was justified
Bakersfield, CA is a city with a reputation and many ghost stories. Bakersfield High School, for example, has a number of ghost stories. However, the stories of ghosts in Bakersfield can be based on scant evidence, and be mainly on levels of folk tales told around the campfire. However, there is one case of a ghost in Bakersfield that a retired professor from CSUB has claimed to have studied. In this special Halloween episode, Podcaster Ian Tash performs a dramatic reading of The Kern City Poltergeist story with the permission of Dr. Stafford Betty.
Episode 72: Depression in Adolescents. COVID-19 vaccine updates including booster shots and mix and match options. Depression in adolescents is discussed by Virginia Bustamante, Charizza Besmanos, and Hector Arreaza. Introduction: COVID Vaccines Update October 2021Written by Hector Arreaza, MD. Participation: Lillian Petersen, RN, and Nathan Heathcoat, MS3. The FDA granted emergency use authorization for a booster shot with the Pfizer/BioNtech COVID-19 vaccine in September 2020.On October 20, 2021, the FDA also granted emergency use authorization for a booster shot with the Moderna AND Johnson & Johnson (also known as Janssen or J&J) COVID-19 vaccines. Pfizer/BioNtech: Brand name Comirnaty®. It has full FDA approval for patients who are 18 years and older for the prevention of COVID-19. The rest of the indications of this vaccine are under the Emergency Use Authorization (EUA). It is authorized for 12 years and older. Total of two doses, 21 days apart. Authorized for 3rd dose in immunocompromised patients (on active cancer treatment, organ transplant recipients, taking immunosuppressive or high dose corticosteroids, have moderate to severe immunodeficiency). 3rd dose is given at least 1 month after the second dose. It is authorized for a single booster shot in special populations (older than 65 years of age OR 18-64 years of age at high risk of severe COVID-19 or with frequent occupational exposure). The booster shot must be given 6 months after the primary series is complete.Moderna: No brand name yet. All uses are under emergency use authorization. It is authorized for 18 years and older for the prevention of COVID-19. Give a total of two doses, 4 weeks apart. A third dose is authorized to be given 1 month after the second dose. Patients who can receive a third dose include patients on active cancer treatment, organ transplant recipients, taking immunosuppressive or high dose corticosteroids, or have an immunodeficiency. It is authorized for a single booster shot 6 months after completing primary series. The booster shot of Moderna should be half dose. People who may receive a booster shot are those who are older than 65 years of age OR 18-64 years of age at high risk of severe COVID-19 or with frequent occupational exposure.Johnson & Johnson (Janssen): No brand name yet. Authorized as a single dose vaccine. Authorized for a single booster shot 2 months after the first dose. Mix and Match Approval: The FDA authorized on October 20, 2021, heterologous booster dose for currently approved or authorized COVID-19 vaccines. You can give a booster shot with a different vaccine than the one you received primarily. For example, a patient who received J&J vaccine may receive a booster shot with Pfizer or Moderna 2 months later. Another example, a patient received primary series of Pfizer vaccine, may receive a booster shot with Moderna, Pfizer or J&J 6 months after completing primary series. Booster shots are authorized, again, for patients who are 65 years and older, 18-64 years of age at high-risk for severe COVID-19 or with frequent occupational exposure.The vaccination of children 5-11 years old is still under discussion, more updates coming soon.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ___________________________Depression in Adolescents. By Virginia Bustamante, MS4; Charizza Besmanos, MS4; and Hector Arreaza, MD. Vicky: We will talk about adolescence and depression today. I was reading a piece on the Impact of COVID-19 Pandemic on Adolescent Mental Health on Psychiatry Advisor by Tori Rodriguez. She is a licensed professional counselor with a master's in arts in counseling psychology. This article really got me thinking, how prevalent is depression in adolescents? Even before COVID-19. I read the article and I wasn't even aware of the numbers. So, I decided to do some research on the topic. Charizza: When you brought up the topic for discussion, I asked myself how much do I even know? I found that the CDC reported that “more than 1 in 3 high school students had experienced persistent feelings of sadness or hopelessness in 2019.” This was a 40% increase since 2009. It also said that, “in 2019 about 1 in 6 youth reported making a suicide plan in in the past year. That was a 44% increase since 2009.” 44% increase! That is almost unbelievable. Now I'm asking myself what is causing such a drastic increase.Vicky: When I read Rodriguez's piece it really got me thinking. What is or are there even known causes linked to this huge increase?Charizza: Are adolescents more open to talk about mental illness? Or are there other factors affecting their mental illness? For example, increasing social media presence or other home/ social pressures. Vicky: Actually, that may be partially why. The U.S. News and World Report wrote a piece that highlighted the possible contributing factors that have led to this increase. They stated that data hasn't really shown a conclusive answer but there are some common themes that have emerged. And I'd like to spend much of this podcast really going into those themes and discussing them. The U.S. News and World Report listed five common themes. Theme one, what they called “a modern-day diagnosis” - where they reference a John Hopkins Health Review which explained that adolescent depression is somewhat of a new diagnosis. Charizza: Up until about the 1980's mental health professionals were reluctant to diagnose adolescents with a mood disorder. Because their brains were still developing, they thought it was not appropriate to diagnose someone so young with, for example depression. Vicky: Yes exactly, so the current thought is, that perhaps this change of thinking has played a part in the increasing numbers in the form of increased reporting and/or documentation. The second theme they listed was “hyper-connected & overstimulated.” This stems from how our world is today. Where electronic devices and social media are a big part of young people's lives. The idea that they have a life in the real world and the virtual world. Charizza: I read a study on Teens, Social Media and Technology, a Pew Research Center study, that more than 95% of teenagers have access to a smartphone and 45% of them described themselves as being online “almost constantly.” Vicky: To think, how does this affect the way they see themselves? For maybe a lot of us listening right now we've been on social media. That could be Facebook, Instagram, Tik-Tok, and going way back Myspace. We know that social media can be an amazing place to share our lives but can also be filled with a lot of criticism.Arreaza: Have you heard of “FOMO”? It's “Fear of Missing Out”. It's a condition that can cause severe anxiety because others are having fun, or you missed a particular event, memorable experience, or an opportunity to connect with someone famous, or an online investment. People with FOMO need to stay always connected. Vicky: The Journal of Abnormal Psychology explained that the spike in depression and suicidal tendencies may be connected to social media among young people. They went on to describe how it's not uncommon for young people to measure their self-worth based on the likes. I've been there. Questioning myself whether to post or not post a picture based on whether it's “Instagram worthy”? Will it get enough likes to be posted? Rather than sharing moments of my life with friends and family as the platform was intended to. Charizza: It's not something I'm proud of but I've gotten sucked into the fake reality of online. That's why I reduced my social media presence. Vicky: Was there a specific reason or situation that led to that?Charizza: I just felt like that it was taking more energy than it was meant for. And honestly I've felt happier since not really using my Facebook anymore. Vicky: If that makes you happier, I support it. I mean I might consider it myself. Arreaza: Yes, a social media “fasting” may be beneficial for some people. Vicky: For the third theme, the article referred to what they called “uncertain times.”Charizza: What does that even mean?Vicky: Each generation is influenced and shaped, in a positive or negative way, by the events happening at that time in history. And sadly, today's young people have grown up in a post-9-1-1 world, mass terrorist attacks, and shootings whether that be high schools, malls, and even churches. All these events mean that young people may know the fear of terrorism. A sense of security has been taken from them by these awful and cowardly attacks of others. Charizza: I had a friend who was afraid to go to the movies after the 2012 Aurora Colorado shooting. For a long time, every time she went, she couldn't sit there and enjoy the movie. She kept turning around looking at the door every time it opened. Afraid something would happen. So, thinking of that and thinking that others may be going through similar and even more difficult times, I can completely understand this contributing depression among young people. Vicky: This fear and stress appears to be contributing to the increase in depression. The fourth theme was “not enough sleep.” The Nation Sleep Foundations recommends teens get 8.5 to 9.5 hours and instead teens get around 7 hours. When I am well rested, I perform my best. My energy, memory and overall mood is better. But with school, work, and everything else it's hard sometimes to get the hours I need. I mean I don't know about you Charizza, but I can work on getting more sleep. Charizza: Sadly, I struggle with it too. But for adolescents where they're still developing and undergoing different physiological changes those hours are especially important. The Sleep Foundation stressed the importance of sleep for teens. They talk about how it helps with physical development - with all the changes they are undergoing, academic achievement - by promoting attention, improving memory (like you brought up), and definitely helps with emotional health. The website states that mental health disorders for example anxiety, depression, and even bipolar disorder have been linked to poor sleep. They even stated that sleep deprivation in teenagers can increase the risk for suicide.Arreaza: A poor sleep also can lead to obesity in adolescents and adults. Something we should remember is also the timing of sleep for adolescents. The sleep pattern changes over the lifetime of people, and it's not only in duration, but also the time they sleep. Normally, a teenager tends to go to bed late and wake up late. For this reason, high school schedules are being changed in California to start at 8:00 AM. Vicky: It sounds like improving sleep in adolescents can be a great way of preventing mental health disorders or even reducing their symptoms. The last and fifth theme discussed in The U.S. News and World Report as a possible contributing factor to the increase in adolescent depression is a “lack of community.” This goes back to the world we live in today. We live with this - what the article quotes as - “go-go mentality” and the community we would have previously built or created around us have gotten smaller. So as they quoted “our face-to-face connections” have decreased.Charizza: Is there anything they suggest?Vicky: The U.S. Preventive Services Task Force recommends primary caregivers screen adolescents 12-18 for depression. But this doesn't always happen. They suggested that identifying adolescent depression should NOT be something that only falls on the medical provider but something we should ALL be responsible for. We can do this by building healthy and trusting relationships with our young people. Hopefully also rebuild this sense of community. Today we highlighted some themes that are possibly related to the increase in adolescent depression. Those were: the idea of a modern-day diagnosis, second being hyper-connected & overstimulated, third the uncertain times we live in, fourth not enough sleep, and lastly the sense of a lack of community. Charizza: We hope you guys all really enjoyed listening. And remember if you are or know someone struggling with depression and/or suicide thoughts reach out to someone. Let someone know how you are doing. Tell a teacher, adult, someone. Vicky: If you for whatever reason don't feel comfortable doing that or feel you may not have someone to reach out to and are in danger of hurting yourself or others please call 911. Charizza: There are also national suicide prevention hotlines. That is 1-800-SUICIDE and that's 1-800-SUICIDE. There is also 1-800-273-TALK, again that's 1-800-273-TALKVicky: There is also the Mary K Shell Mental Health Center with a walk-in crisis center. They are located here in Bakersfield on College and Mt. Vernon. They are actually in the same parking lot as Kern Medical Center. Their number is 661- 868-8123.________________________________Conclusion: Now we conclude our episode number 72 “Depression in Adolescents.” Our adolescent patients are a special population, so special that you can even do a fellowship after finishing your residency. Our adolescents are under a lot of pressure, especially during this era of social media. Remember to screen for depression and start treatment right away with behavioral therapy and medications as needed or refer your depressed patients to a psychiatrist to start treatment promptly. Do not forget to assess risk of suicide and act fast to prevent suicide in your patients. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Lillian Petersen, Nathan Heathcoat, Virginia Bustamante, and Charizza Besmanos. Audio edition: Suraj Amrutia. See you next week! _____________________References:Mental Health, Adolescent and School Health, Centers for Disease Control and Prevention, CDC.gov, https://www.cdc.gov/healthyyouth/mental-health/index.htm, accessed on September 20, 2021. Lohmann, Rachel Cassada, What's Driving the Rise in Teen Depression?, US News, April 22, 2019. https://health.usnews.com/wellness/for-parents/articles/2019-04-22/teen-depression-is-on-the-rise. Anderson, Monica and Jingjing Jiang, Teens, Social Media and Technology 2018, Pew Research Center, May 31, 2018. https://www.pewresearch.org/internet/2018/05/31/teens-social-media-technology-2018/. Rodriguez, Tori, Impact of the COVID-19 Pandemic on Adolescent Mental Health, Psychiatry Advisor, April 30, 2021, https://www.psychiatryadvisor.com/home/topics/child-adolescent-psychiatry/adolescent-mental-health-issues-are-further-exacerbated-by-the-covid-19-pandemic/.
Sponsors: Orange Beach Invasion, Scrapin the Coast, & Bayou Showdown + Mini Truck Showdown (June 2022 Las Vegas) & Kern County Showdown (Feb 2022 Bakersfield, CA) ODB & The Mayor intro the episode covering Scene Updates & more The Mayor tries to answer a tougher 80s question... does he succeed? ODB touches base with the following kinfolk to discuss SEMA 2021 week Chad Loque from //NC LA discussing "Difficult Times" Chris Burns & Ruben Arteaga from C&S Metalworks discussing their SEMA project Bob Hase to discuss the Mini Truck Hall of Fame 2020/2021 inductees Billy Bob discussing this Datsun which will be featured in the Engaged Media booth + so much more! RIP Mark “Papa Smurf” Ballard! We miss you Dad. Also, #RIPNeilStark Stay On Da Rise!
Top Stories:-A storm is poised to drop more than an inch of rain in Bakersfield and the Kern County mountains-Sheriff's deputies are searching for a shooter who killed a man early Saturday morning in Northwest Bakersfield-Community members, stakeholders, and organizations are invited to provide input on the redistricting process at Kern County Board of Supervisors meeting tomorrow
Today we welcome California Senator Melissa Hurtado of the 14th Senate District which covers parts of the southern Central Valley between Fresno and Bakersfield. She starts the podcast with a lovely tribute to Scott Lay, then talks about how the Great Recession affected her, her road to the senate, and how reelection is shaping up. The majority of the conversation focused on her district and her work fixing water issues in California, and the connection between water, food and environmental security. She also discusses her work on President Biden's Latino Leadership Committee. SacTown Talks is a podcast about California politics, policy and culture. We feature interviews with California political leaders, and analysis by experts and insiders focusing on the Capitol. Like, share, and subscribe to learn more!
Voilà un groupe qui a sacrément brouillé les pistes, alternant rock progressif et soft rock, travaillant avec des musiciens mondialement réputés comme Alan Parsons et faisant preuve d’une vigueur et d’une longévité exemplaire, et cela, sans jamais devenir vraiment populaire… Il s’agit du groupe Ambrosia, de ses débuts jusqu’aux années 80. ---San Francisco, Los Angeles, Bakersfield, San Diego… , Classic 21 vous invite à bord d’une belle décapotable très flashy sur une longue route bordée de hauts palmiers. Le Pacifique est en vue. Sous le soleil de Californie, le son typique West Coast des seventies et au-delà ; Carole King, Steely Dan, Jackson Brown, Nicolette Larson… La bande-son est américaine ! Le samedi à 14h15, soft et cool sur Classic 21 avec Jean-Yves Louis.
Since 1989, October has been designated as Domestic Violence Awareness Month. But misperceptions about domestic violence continue to permeate our culture. To learn more, Valley Edition Host Kathleen Schock spoke with Tracey Salisbury, assistant professor of interdisciplinary and ethnic studies at California State University, Bakersfield.
Sponsors: Orange Beach Invasion, Scrapin the Coast, & Bayou Showdown + Mini Truck Showdown (June 2022 Las Vegas) & Kern County Showdown (Feb 2022 Bakersfield, CA) ODB & The Mayor intro the episode covering Scene Updates & more ODB interviews Chad Moss to discuss Layin At The Lake 2021 in Nov ODB interviews Ed Eyster from Gulf Breeze Customs covering How he got involved in the scene Being in Gulf Breeze Customs His Mazda "Whiplash" + so much more! RIP Mark “Papa Smurf” Ballard! We miss you Dad Stay On Da Rise!
Joe Peters is a born and raised Bakersfield native who has a background in the oil and gas industry for the last 13 years. He recently purchased a new company and stepped out of the oil industry all while being a self managed and independent touring musician/singer songwriter. Joe discusses his reasoning for leaving the Oil industry and the different companies he and his family have had the opportunity to be involved in. He takes us on the journey of his music career from the beginning to the road ahead. Joe leaves us with some exciting news about what he has planned for the future. LEARN MORE ABOUT JOE PETERS: Websites: https://americalawning.com/ https://joepetersmusic.com/ Email: email@example.com Phone: 661-328-1292 Instagram: @joepeters_music
On this episode of Lala's Land (sponsored by Heckler's Handiwork) Lala speaks with Russ a.k.a. our Ex-Resident Vanilla who we are slowly corrupting with our kinky mind-melding. On this episode of The Gotham Press Podcast, the gang is entertained by a titty pic before talking to our guest about how and who brought him into the local kink community. Russ talks us through his first experience topping someone in a scene and the learning process behind it. Anemic shares an adventure story from the local Bakersfield nightlife. Greedy creeps all over our first-time guest. The gang discusses what they had wished they had learned when they were new to the lifestyle. The gang gives the not-so Vanilla Russ some advice on his new adventures into Kink. -------------------------------------------------------------------------------- Patreon/FetLife/Discord/Facebook/BDSMlr/Twitter/YouTube/Spotify/Kandi's Sweet Box: 805-303-1173 -------------------------------------------------------------------------------- In Association with JW Paddles Piercings By Bee LLC Steel Brat Pacis Thief's Touch
The Moneywise Guys Monday, October 18th BE MONEYWISE. Moneywise Wealth Management I "The Moneywise Guys" podcast call: 661-463-8264 text in anytime: 661-396-1000 email: firstname.lastname@example.org website: www.MoneywiseGuys.com Guest: John Cox, Business Editor of the Bakersfield Californian www.Bakersfield.com
Growing up in Bakersfield, California Jerome experienced trauma with domestic abuse in his family, not having a father growing up, and trying to avoid the gang lifestyle that was prevalent in his neighborhood. He saw a lot of the people he knew in & out of jail and wanted no part of that. He found refuge in sports and was able to focus his energy and after-school time on something productive. Jerome eventually went to the College of Sequoias to play football. This is when the partying lifestyle started to take shape in his life. He felt the peer pressure of his friends to do all kinds of drugs. He tried cocaine & ecstasy for the first time, drank heavily, and partied every week. They partied so much, that they even went to Las Vegas 8 times in one month. He eventually started smoking crack, PCP, and even meth. It quickly spiraled out of control before he could get a hold of his addiction. The police even raided his grandparents' house, and this was a huge wake-up call for him. Jerome was arrested at one point, and this really shook him up. Also, When his third child, his youngest daughter was born this was a major turning point for him. They gave him the ultimatum of choosing his daughter or choosing the drugs. He chose his daughter. All this time he was going to school to be a teacher, and he came to a crossroads in his lifestyle, where it eventually caught up with him and his health and realized he needed help. He relapsed many times, and shifted careers many times, but eventually regained his stability. The facility that ended up helping him stay sober was the Sierra Vista Ebony Counseling center. His counselor inspired him to start a new career helping others. Jerome decided to start studying drug and addiction counseling. Now, at this stage in his life, Jerome wants to be of service to the community. He currently holds the title of Substance Use Disorder Certified Counselor (SUDCC) under the California Association of DUI Treatment Programs, and he is also a Certified Alcohol and Drug Counselor. Now his goal is to reach kids as early as possible in their lives so that they get a chance to grow and develop their minds without the hindrance of drugs or alcohol. He will go out of his way to help kids who can't afford his services and give them his personal cell which he says he will answer at any time of the day or night, to help these kids. For more on Jerome Piper https://aspirecounselingservice.com/fresno-program-staff/ This is Jerome Piper in his own words, on Knockin' Doorz Down. For more on the Knockin' Doorz Down podcast and to follow us on social media https://linktr.ee/knockindoorzdown For Carlos Vieira's autobiography Knockin' Doorz Down https://www.kddmediacompany.com/ For 51FIFTY use the discount code KDD20 for 20% off! https://51fiftyltm.com/ For more information on the Carlos Vieira Foundation and the Race 2B Drug-Free, Race to End the Stigma and Race for Autism programs visit: https://www.carlosvieirafoundation.org/ For more on the Recovery in the Middle Ages podcast www.MiddleAgesrecovery.com Listen to and Subscribe to the podcast wherever you listen for more Celebrity, everyday folks, and expert conversations at https://www.KDDPodcast.com © 2021 by KDD Media Company. All rights reserved.
The last three of 31 teams C.C. and Sean have previewed for The Calder Farmstead this offseason, the boys take a look at the Ontario Reign, San Diego Gulls, and Bakersfield Condors ahead of their 2021-22 AHL campaigns!
Episode 70: HIV Prevention. Prevention is key in controlling HIV-AIDS. Listen to ways to prevent HIV, mainly by using condoms, PrEP and PEP.Introduction: HIV and AIDSBy Robert Dunn, MS3.Introduction: The Human Immunodeficiency Virus (HIV) is a retrovirus that is primarily transmitted via sex, needles or from mother to fetus. Once infected, the virus increases in its copies and decreases the individual's CD4+ cell count, thus leading to an immunocompromised state known as Acquired Immune Deficiency Syndrome (AIDS). Once with AIDS, the patient is susceptible to opportunistic infections. Prevention from AIDS includes several options. Condoms for safe sex practices are the least invasive and most readily accessible option for all patients. Pre-exposure prophylaxis (PrEP) is also an option for men who have sex with men (MSM) and transgender women. If the patient is also exposed to HIV, post-exposure prophylaxis (PEP) may also be an option to prevent infection but must be administer ideally 1-2 hours after exposure but no later than 72 hours after. Today we will briefly discuss how to prevent HIV infection.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home.___________________________HIV Series IV: HIV Prevention. By Robert Dunn, MS3.Participation by Huda Quanungo, MS3; Bahar Hamidi, MS3; and Hector Arreaza, MD. HIV PreventionIntroductionThe Human Immunodeficiency Virus (HIV) is a retrovirus that is primarily transmitted via sex, needles or from mother to fetus. Once infected, the virus increases in its copies and decreases the individual's CD4+ cell count, thus leading to an immunocompromised state known as Acquired Immune Deficiency Syndrome (AIDS). Once with AIDS, the patient is susceptible to opportunistic infections. Prevention from AIDS includes several options. Condoms for safe sex practices are the least invasive and most readily accessible option for all patients. Pre-exposure prophylaxis (PrEP) is also an option for men who have sex with men (MSM) and transgender women. If the patient is also exposed to HIV, post-exposure prophylaxis (PEP) may also be an option to prevent infection, but it must be administered ideally 1-2 hours after exposure but no later than 72 hours after. We will concentrate in prevention during this episode. What is HIV?The Human Immunodeficiency Virus (HIV) is a retrovirus. When the virus gains access to our body via cuts on the skin or mucosa:The virus injects its 10kb sized RNA genome into our cells. The RNA is transcribed to DNA via viral reverse transcriptase and is incorporated into our cellular DNA genome. This causes our cells to become a virus producer. Viral proteins translated in the cell are transported to the edge of the cell and can bud off into new viruses without lysing the cell. Acute HIV symptoms. Some potential early symptoms of HIV can include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, lymphadenopathy, and mouth ulcers. The most common acute symptom is NO SYMPTOM. Many people do not feel sick with the acute infection of HIV. Some people can live years with HIV in “clinical latency” without knowing they are infected, but they can still be contagious during this time. As viral load (the amount of virus copies you have in your blood stream) increases, the CD4+ cells that contribute to our adaptive immunity continues to fall. That's why the best test during this period is not going to be HIV antibody but you should test for antigens. Specifically, the 4th Generation HIV test, which tests for both antibody and p24 antigens.Chronic symptoms. Once patients begin to present with opportunistic infections (i.e. Pneumocystis pneumonia – PCP), or have a CD4 count below 200, the patient is considered to have Acquired Immune Deficiency Syndrome (AIDS) and makes them susceptible to more serious infections. Without treatment, patients with AIDS typically survive about 3 years. Epidemiology of HIVHIV incidence: In 2019, there were 34,800 new HIV infections in the United States. This is an 8% decline from 2015. Amongst age groups: Age 25-34 had the highest rate of incidence (30.1 per 100,000)Age 35-44 had the second highest rate (16.5 per 100,000)Age 45-54 remained stableAge 13-24 had decreasing rates of incidence Amongst ethnic groups: Black/African-American groups has the highest rate of incidence (42.1 per 100,000)Hispanic/Latino had the second highest rate (21.7 per 100,000)Person of multiple races had the third highest (18.4 per 100,000) Amongst sex: Males had the highest rate of incidence (21 per 100,000)Females had the lowest rate of incidence (4.5 per 100,000) HIV Prevalence:In 2019, 1.2 million people (Ages 13 and older) in the US have HIV and 13% of them do not even know it. In 2020, there were an estimated 1.5 million people worldwide that acquired a new HIV infection. This is a 30% decline since 2020. An estimated 66% are receiving some HIV care and 57% were virally suppressed. Mortality: In 2019, there were 15,815 deaths among adults and adolescents diagnosed with HIV in the US. Preventative ScreeningThe USPSTF gives a Grade A recommendation for HIV screening for: Pregnant people and everyone between 15-65 years of age. All pregnant people at any point of their pregnancy, including those who present in labor or delivery and have an unknown status of HIV.The USPSTF only recommends a one-time screening and shows no benefit of repeat screening thereafter. Women may also be screened for subsequent pregnanciesAlso screen all Adolescents and adults ages 15-65. An effective approach is routine opt-out HIV screening. This approach includes HIV screening as part of the standard preventive tests. This approach removes the stigma associated with HIV testing, it promotes earlier diagnosis and treatment, reduces risk of transmission, and it is cost-effective. The determination for repeated screening of individuals should take into account the following risk factors: -Men who have sex with men (MSM)-Individuals who live in areas with high prevalence of HIVIncluding attending to tuberculosis clinics, stay in a correctional facility, or homelessness-Injection drug use-Transactional/commercial sex work-1 or more new sexual partners -History of previous STIs Annual screening for HIV is reasonable, however, clinicians may want to screen patients every 3-6 months if they have an increased risk of HIV. CondomsA simple and very effective method in HIV prevention is the use of condoms for safe sex practices. In 2009, the American College of Physicians (ACP) and the HIV medicine Association called for the wider availability of condoms and education to minimize HIV transmission. A meta-analysis of 12 HIV studies amongst heterosexual couples demonstrated the use of condoms in all penetrative sex acts reduced the risk of HIV transmission 7.4 times in comparison to those who never used condoms. Other studies show a 90-95% effectiveness in HIV prevention when “consistently” using condoms. A Cochrane review shoed that the use of a male latex condom in all acts of penetrative vaginal sex reduced HIV incidence by 80%. Overall, condoms are effective in HIV prevention.Pre-Exposure Prophylaxis (PrEP)Truvada and Descovy:Another option for prevention amongst HIV negative individuals is the use of Pre-Exposure Prophylaxis (PrEP). It is an anti-retroviral pill that is taken daily to maintain a steady-state level of the medication in the blood stream. The medication specifically a combination of 2 antiretroviral medications – Tenofovir and Emtricitabine. Both medications are nucleoside reverse transcriptase inhibitors (NRTIs) that work by blocking the viral reverse transcriptase from HIV and prevent the enzyme from copying the RNA genome into DNA. Therefore, it stops viral replications. There are 2 formulations of PrEP: Truvada and Descovy. Truvada's primary side effects are renal and bone toxicity with long-term use. Descovy's primary side effects are mild weight gain and dyslipidemia. Truvada is the most commonly prescribed PrEP because it has the most data since it has been around the longest. However, extra consideration should be taken for: Adolescents should weigh at least 35 kg before being prescribed PrEPDescovy may be preferred for adolescents by the prescribing physician as it is not associated with reduction in bone density, as Truvada is. Estimated GFR between 30 – 60Truvada is associated with acute and chronic kidney disease whereas Descovy is safe for patients with a GFR greater than 30Patients with osteoporosisTruvada is associated with bone toxicity, whereas Descovy is not. It is important to note that PrEP has only been studied in men or people who were assigned men at birth. So, its efficacy in vaginal sex and with vaginal fluids cannot be generalized at this time. Future of PrEP: In May 2020, the HIV Prevention Trials Network (HPTN) 083 randomized trial demonstrated the potential of an injectable PrEP. Carbotegravir, is an integrase inhibitor, which prevents the HIV integrase from incorporating the HIV genome into the cellular genome. This study demonstrated its efficacy as PrEP in comparison to Truvada with few new infections (13 versus 39, respectively). Carbotegravir would be given via injection once every 8 weeks. In September 2021, the pharmaceutical company Moderna will begin 2 human clinical trials for an HIV vaccine that use mRNA technology. Previous studies conducted with non-mRNA vaccines demonstrated that B cells can be stimulated to create antibodies against HIV. Since HIV becomes integrated in the cellular genome within 72 hours of transmission, a high level of antibodies must be produced and present in the body to offer an adequate level of immunity. Post-Exposure Prophylaxis (PEP)If an individual is exposed to blood or bodily fluids with high risk of HIV via percutaneous, mucus membrane or nonintact skin route, post-exposure prophylaxis (PEP) may be an option. PEP is indicated when the HIV status of the exposure source is unknown and are awaiting test results, or if the exposure source is HIV positive. Therapy should be started within 1 or 2 hours of exposure and it is not effective after 72 hours of initial exposure. The recommended duration of therapy is 4 weeks but no evidence has been shown for an optimal duration. Occupational exposure. There are 2 regimens for PEP: Truvada with Dolutegravir Truvada with Raltegravir Both Doltegravir and Raltegravir are integrase inhibitors which block the integration of the viral genome into the cellular DNA. The regiments are chosen based on efficacy, side effects, patient convenience, and completion rates. Dolutegravir is chosen because it is given once daily. While Raltegravir is taken twice daily, most experience with PEP has been with Raltegravir. Other risk with Raltegravir are potential skeletal muscle toxicity and systemic-cutaneous reactions resembling Steven-Johnson syndrome. One final word about prevention of vertical transmission is making sure pregnant women are treated during pregnancy and if the baby is delivered from a patient whose viral load is “detectable”, the baby needs to be treated, but we'll let that topic for another time to discuss. Joke: What do you call the patient zero of HIV? First Aids.HIV incidence is decreasing thanks to many prevention measures taken globally, and we discussed screening, condoms, PrEP and PEP as part of this prevention efforts. Stay tuned for more relevant medical information in our next episode. ____ Now we conclude our episode number 70 “HIV Prevention.” Robert, Huda and Bahar explained some ways to prevent HIV, mainly by screening those at risk, using condoms, PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis). Let's also remember that having a monogamous relationship and avoiding high risk sexual behaviors confer significant protection against HIV. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Robert Dunn, Huda Quanungo, and Bahar Hamidi. Audio edition: Suraj Amrutia. See you next week! References:About HIV. Center for Disease Control and Prevention, CDC.gov, June 1, 2021. https://www.cdc.gov/hiv/basics/whatishiv.html . Accessed September 21, 2021. Simon V, Ho DD, Abdool Karim Q. HIV/AIDS epidemiology, pathogenesis, prevention, and treatment. Lancet. 2006 Aug 5;368(9534):489-504. doi: 10.1016/S0140-6736(06)69157-5. PMID: 16890836; PMCID: PMC2913538. [https://pubmed.ncbi.nlm.nih.gov/16890836/] US Statistics. HIV.gov, June 2, 2021. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics . Accessed September 21, 2021. The global HIV/AIDS Epidemic. HIV.gov, June 25, 2021. https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics. Accessed September 21, 2021. Human Immunodeficiency Virus (HIV) Infection: Screening. U.S. Preventative Services Task Force, June 11, 2019. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Accessed September 21, 2021. Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ. 2004 Jun;82(6):454-61. PMID: 15356939; PMCID: PMC2622864. [https://pubmed.ncbi.nlm.nih.gov/15356939/] Weller S, Davis K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002;(1):CD003255. doi: 10.1002/14651858.CD003255. PMID: 11869658. [https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003255/full] Mayer, Kenneth H, MD, and Douglas Krakower, MD. Administration of pre-exposure prophylaxis against HIV infection. UpToDate, June 24, 2020. Accessed September 21, 2021. [https://www.uptodate.com/contents/administration-of-pre-exposure-prophylaxis-against-hiv-infection?search=8)%09Administration%20of%20pre-exposure%20prophylaxis%20against%20HIV%20infection&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1] Zachary, Kimon C, MD. Management of health care personnel exposed to HIV. UpToDate, June 07, 2019. Accessed September 21, 2021. [https://www.uptodate.com/contents/management-of-health-care-personnel-exposed-to-hiv?search=9)%09Management%20of%20health%20care%20personnel%20exposed%20to%20HIV&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1]
Sponsors: Orange Beach Invasion, Scrapin the Coast, & Bayou Showdown + Mini Truck Showdown (June 2022 Las Vegas) & Kern County Showdown (Feb 2022 Bakersfield, CA) ODB intros the episode covering Scene Updates & more ODB interviews Kimberly Miller from Acrophobia Car & Truck Club covering How she got involved in the scene Her amazing F-100 which has been featured in national publications including Street Trucks Magazine F-100 Builder's Guide An upcoming project Altered Metal Car & Truck show So much more! RIP Mark “Papa Smurf” Ballard! We miss you Dad Note: the top image in the cover art was taken by A. Dooley for ST & F-100 Builder's Guide Mags Stay On Da Rise!