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JCO Editorial Fellow Dr. Lauren Shih and JCO Associate Editor Dr. Stephanie Wheeler discuss the ASCO 25 Simultaneous Publication paper "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." Transcript The guest on this podcast episode has no disclosures to declare. Dr. Lauren Shih: Hello, and welcome to our 2025 ASCO annual meeting series where we cover some of the top JCO papers published simultaneously with their abstract presentations at this year's meeting. I'm your host, Dr. Lauren Shih, JCO editorial fellow, and I'm joined by JCO Associate Editor Dr. Stephanie Wheeler to discuss the Journal of Clinical Oncology article and abstract presentation "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." Let's start with the relevance of the article. Dr. Wheeler, can you explain this to our listeners? Dr. Stephanie Wheeler: Thank you so much. Let's get right into it. So this article is really about understanding different types of Medicare plans and what we should expect to see in terms of their use of low-value treatments for cancer patients. So, as Medicare really is focused on trying to limit the use of low-value cancer treatments, we really need to better understand the drivers of variability. So we know that many cancer patients have multiple treatment options available to them. We also know that the vast majority of older adults beyond age 65 are insured by Medicare, and about half of them are on Medicare Advantage plans, which are serviced by private insurance. And private insurance companies in this case are receiving capitated payments for Medicare beneficiaries to manage their service utilization and reduce costs. So, with respect to Medicare Advantage versus the traditional fee-for-service Medicare, it's not really been known to what extent low-value treatments are differentially used by these types of plans for cancer patients. And so that was really the focus of this article. What the authors found is that across six different types of treatments, in general, the folks who were enrolled in Medicare Advantage plans had reduced use of low-value treatment. So that's a good sign for Medicare beneficiaries. And although the relative difference in that use was somewhat low, this translates to a significant number of Medicare enrollees across the country not receiving these low-value treatments. And of course, this translates to considerable savings at the society level. Dr. Lauren Shih: Are there any additional key results that we should review? Dr. Stephanie Wheeler: Yeah. So I'll tell you just a little bit more about the methods and also their findings. So they looked at six different low-value treatments, and this was in, again, 100% of national Medicare enrollees from 2015 through 2021. So the six low-value treatments that they examined were the use of G-CSFs among patients receiving low-risk chemotherapy and denosumab for those who had castration-sensitive prostate cancer. Then they also looked at four high-cost treatments, including using nab-paclitaxel instead of paclitaxel for patients with breast or lung cancer; second, adding bevacizumab to carboplatin plus paclitaxel for ovarian cancer; third, using brand-name drugs instead of generics when generics were available; and fourth, using biologics instead of biosimilars when biosimilars were available. And these are all, by the way, non-recommended treatments according to a variety of guidelines, including NCCN and ASCO's Choosing Wisely guidelines. So they used the Medicare claims data to examine use of these regimens. They also analyzed results by type of Medicare Advantage plan, whether people were enrolled in a health maintenance organization plan, or an HMO, or a preferred provider organization plan, or a PPO. They also looked at the largest Medicare Advantage insurers—including Aetna, Blue Cross Blue Shield, Cigna, Humana, and UnitedHealth—and limited their analyses to those that had complete encounter data. And what they found across the board is that the enrollees in Medicare Advantage plans generally had lower use of these low-value treatments. And the largest differences between Medicare Advantage and traditional Medicare plans were in the outcomes, including G-CSF use and using denosumab for castration-resistant prostate cancer, and then the combination of bevacizumab, carboplatin, and paclitaxel versus carboplatin and paclitaxel. And all of these had a change in use ranging from about 19% change to 24% change in use. This is significant as a field as we look at ways in which different plan organization can influence use of treatments, particularly given the excess cost of cancer care. This is something we really want to pay attention to. So I'd encourage folks to look more closely at the results by treatment type as well as the results by plan type to see a little bit more about what was going on across different plan types. Dr. Lauren Shih: Great. And are there any outstanding questions that need to be answered? Dr. Stephanie Wheeler: Yes, there always are, of course. I think the study has several strengths that are worth noting. First, they have 100% of Medicare enrollees, so there's national coverage there, which is, you know, quite outstanding. They also use an appropriate choice of analysis to help deal with some of the selection. So they use inverse probability of treatment weights, and they control for practice and county indicators to try to get some realistic adjustment for the selection that happens in terms of how patients are enrolled in different Medicare Advantage versus traditional fee-for-Medicare plans. These statistical approaches are a good idea, but they are limited by the observed variables that we can use for these kinds of adjustments. And so any unobserved—confounding or any unobserved factors that would influence selection in these plans aren't going to be captured well. So preferences, for example, that patients may have about different types of plans when they're insuring themselves and their families may not be captured. Second, the data that are used are only encounter data from those plans with complete records. That may mean that smaller Medicare Advantage insurers or those that don't have as comprehensive records are not included. So this may not be reflective of their practice patterns. And then third, of course, this only looked at six different low-value cancer treatments. It remains to be seen whether this kind of finding extends to other types of low-value cancer treatments, and that's an opportunity for future study. Finally, I would say that we don't exactly know why these patterns exist. It could be that Medicare Advantage plans have different approaches to prior authorization. They could have more in-house quality control and management to really understand, among their population for whom they're receiving Medicare Advantage payments, to really look at care quality and assess Choosing Wisely guidelines. We don't know exactly how that's playing out. And so we need additional data to really figure out what's working here and what are opportunities for future policy and payment innovations that can further reduce low-value care. Dr. Lauren Shih: Great. Thank you so much, Dr. Wheeler, for speaking to us about the JCO article, "Use of Low-Value Cancer Treatments in Medicare Advantage Versus Traditional Medicare." We really appreciate your insights. Dr. Stephanie Wheeler: Thanks for having me. Dr. Lauren Shih: Join us again for the latest simultaneous publications from the ASCO 2025 Annual Meeting. Please take a moment to rate, review, and subscribe to all ASCO podcast shows at asco.org/podcasts. Until then, enjoy the rest of ASCO 2025. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
SummaryIn this episode, I reflect on the journey of solo moms, particularly focusing on the challenges of dating after experiencing trauma. I emphasize the importance of self-worth, healing, and understanding your readiness for a new relationship. The conversation encourages you to reflect on their past experiences, learn from them, and prioritize your emotional well-being before entering the dating scene. I also invite you to share your story and highlight the significance of connection and support within the community.Key TakeawaysIt's essential to reflect on your readiness for dating.Healing from past trauma is crucial before starting a new relationship.Understanding your self-worth can empower your dating choices.Growth comes from learning from past relationships.Solo moms should prioritize their emotional well-being.Dating should not be about filling a void but about sharing life.You deserve respect and connection in relationships.Children learn from their mothers' experiences in relationships.Taking time for self-reflection can prevent future heartache.Sharing your story can help others in similar situations.Chapters00:00 Introduction and Gratitude01:44 The Challenges of Dating as a Solo Mom05:11 Are You Ready for a New Relationship?10:26 Understanding Your Self-Worth15:52 Healing and Learning from Past Relationships20:41 Choosing Wisely in Dating21:39 Reflection and Invitation for Growth#solomoms #dating #self-worth #healing #relationships #parenting #emotionalsupport #personalgrowth #singlemothers #lifelessonshttps://solomomstalk.mysites.io/podcast-2-copy/are-you-ready-to-date-w-j-rosemarie-francis This podcast is hosted by Captivate, try it yourself for free. This podcast uses the following third-party services for analysis: Podcorn - https://podcorn.com/privacy
Welcome back, Pursuers! After a refreshing sabbatical, I'm diving into a conversation I couldn't wait to have. In this episode, I unpack the latest season of Love Is Blind and why it stirred up so much buzz in the conservative and Christian spaces. From mismatched convictions at the altar to the deeper question of spiritual maturity, we'll explore what Scripture says about relationships, alignment, and standing firm in your faith. I'll also share my own “Love Is Blind”-style love story and reflect on why love without shared values just isn't enough.Let's talk faith, conviction, and choosing wisely—because love might be blind, but discernment shouldn't be.Please leave a comment or review for this episode to help us share this content with others! Connect with us: Website: https://www.narcelyruiz.com/podcast Instagram: http://instagram.com/upstreampursuit Facebook: https://www.facebook.com/UpstreamPursuit/
Welcome to the Choosing Wisely Campaign series! This is the second episode of a 6-part series exploring the ABIM Foundation's Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures. The first of our case-based episodes presents a school age child with syncope. After a clear discussion of the case and thoughtful consideration of an acute care differential, we use the AAP's Choosing Wisely cardiac list to create a resource-conscious care plan that is safe and patient-centered. In the coming episodes, we'll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics. Series Learning Objectives: Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed. Competencies: AACN Essentials: 1: 1.1 g, 1.2f 2: 2.1 de, 2.2g, 2.5 ij 6: 6.1 i 7: 7.2 ghk 9: 9.1ij, 9.2ij, 9.3ik NONPF NP Core Competencies: 1: NP1.1h, NP 1.2km 2: NP2.1jg, NP2.2kn, NP2.5 lo 6: NP6.1o 7: NP7.2m 9: NP9.1mn, NP9.2n, NP9.3p References: AAP Section on Cardiology and Cardiac Surgery. (2020). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWCardio.pdf Gilpin, K., & Goode, Z. (2024). Syncope. Pediatrics in review, 45(10), 606–608. https://doi.org/10.1542/pir.2023-006053
Welcome to Episode 49 of our mediumship podcast, Finding Spirit with Tabs!In this episode, Tabs shares how the Akashic Records can be a powerful tool for gaining clarity around your career path, life direction, and soul purpose. Whether you're feeling stuck in your job, questioning your next steps, or craving more meaning in your work—this episode is here to guide you.Tabs shares a personal story about a recent Akashic session where a client's career crossroads became a doorway to deeper self-understanding. She explains how soul-level insight from the Records can help you make decisions from a place of alignment rather than fear or pressure.If you're seeking more purpose, clarity, or direction in your career, this episode will leave you with grounded guidance and inspiration to move forward with confidence.Mediumship 101 Class https://FindingSpiritWithTabs.as.me/Mediumship101Group Demonstrationhttps://FindingSpiritWithTabs.as.me/OnlineGroupReadingJoin Tabs on Instgram https://instagram.com/finding.spirit.with.tabsInterested in booking a 1:1 session with Tabs? You can book here www.tabsmccaffrey.com
Dive into an inspiring conversation with whitewater legend Todd Wells as he joins Anna Levesque to talk all things kayaking, courage, and community. This episode is packed with insight, heart, and a few splashes of river wisdom.
Welcome to the Choosing Wisely Campaign series! This 6-part series will explore the ABIM Foundation's Choosing Wisely Campaign, its historical precedent, and its goals. We will discuss how this initiative aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures. The introduction episode dives into the historic 2010 editorial in the New England Journal of Medicine that inspired over 80 professional societies to write their “Top 5 Lists” of tests and procedures that could be avoided in evidence-based care. To better understand the problem, we then pick apart the survey that provided insight into why we over order and the harm it causes to vulnerable populations. In the coming episodes, we'll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics. Author: Becky Carson, DNP, APRN, CPNP-PC/AC www.thepedsnp.com Instagram: @thepedsnppodcast Series Learning Objectives: Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed. Competencies: AACN Essentials: 1: 1.1 g, 1.2f 2: 2.1 de, 2.2g, 2.5 ij 6: 6.1 i 7: 7.2 ghk 9: 9.1ij, 9.2ij, 9.3ik NONPF NP Core Competencies: 1: NP1.1h, NP 1.2km 2: NP2.1jg, NP2.2kn, NP2.5 lo 6: NP6.1o 7: NP7.2m 9: NP9.1mn, NP9.2n, NP9.3p Modified rMETRIQ Score: 15/15 Learn more about our peer review process at www.thepedsnp.com/peerreview References: ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf Brody, H. (2010). Medicine's ethical responsibility for health care reform--the Top Five list. The New England journal of medicine, 362(4), 283–285. https://doi.org/10.1056/NEJMp0911423 Lipitz-Snyderman, A., & Bach, P. B. (2013). Overuse of health care services: when less is more … more or less. JAMA internal medicine, 173(14), 1277–1278. https://doi.org/10.1001/jamainternmed.2013.6181 PerryUndem Research/Communication. (2014). Unnecessary tests and procedures in the health care system. Retrieved from https://www.choosingwisely.org/files/Final-Choosing-Wisely-Survey-Report.pdf Smith-Bindman, R., Chu, P. W., Azman Firdaus, H., Stewart, C., Malekhedayat, M., Alber, S., Bolch, W. E., Mahendra, M., Berrington de González, A., & Miglioretti, D. L. (2025). Projected Lifetime Cancer Risks From Current Computed Tomography Imaging. JAMA internal medicine, e250505. Advance online publication. https://doi.org/10.1001/jamainternmed.2025.0505 Wyman, O. (2019). Right Place, Right Time: Health Information & Vulnerable Populations. https://www.oliverwyman.com/RightPlaceRightTime.html
Proverbs 13:20 Our theme for this meditation from Proverbs 13 is choosing wisely and choosing life. Every morning choosing joy, happiness, and wisdom. Even when mistakes are made, I pray you will feel the freedom to recenter, surrender once again to the grace of God, and continue to choose wisely. Does Encounter help you choose joy? Please consider giving! Who is walking wisely that you can walk with?
Pastor Joyce Swingle continues our series "A Prophet's Life: Lessons Learned from Those Called to Communicate God's Truth" with a message on Daniel 2:24-30. Click the arrow below, or if you're reading this in an email you can click this link, to play the service: https://archive.org/details/joyce-daniel-2.24-30 This service is available for download free on iTunes, where you can also subscribe to our podcast. Search for "Westchester Chapel" on the iTunes Store. If you want to know more about starting a relationship with Jesus Christ visit www.WestchesterChapel.org/salvation.
Your frustration isn't really about the outcome. It's rooted in the failure to reflect inward and understand the path you're meant to take. What are you aiming for? It's time to reassess your personal choices. https://www.iamastrologyreadings.com/post/the-art-of-choosing-wisely-navigating-life-s-options-with-self-awareness
Welcome! and Thank you for listening. Do you want to live to 100 or perhaps longer than relatives? Is health span more important than longevity. How about living well until you die? These are common statements that I hear in my practice. But rarely do people have a detailed plan to achieve their goals. I believe most people want to live as long as they can. While many subscribe to supplements, life hacks and procedures, the most important thing you can do to achieve longevity is nutrition, exercise and sleep. Everyday matters and the rate of decline can actually be measured through changes in our DNA. What more details? Check out the podcast. Thanks for listening. Website: https://doctordulaney.com/membership/join-us/ Consultations: jami@doctordulaney.com Dietitian consult: addie@doctordulaney.com Strength training: nathan@doctordulaney.com Water distillers: https://mypurewater.com/?sld=jdulaney Cookbook: https://a.co/d/6zVUluq Ebook: https://doctordulaney.com/powerful-plates-ebook/
This story is CRAZY. It's not meant to scare you as a new cat breeder but it is a cautionary tale. It's about how choosing the right vet can be absolutely critical to your hobby being successful. The breeder involved was very lucky she looked further for advice. You can learn from her experience. CAT BREEDING FOR BEGINNERS PODCAST - EPISODE 65
In "Choosing Wisely: Navigating Relationships," we dive deep into the complex world of dating and relationships from a woman's perspective. Each episode explores the unique challenges and concerns that women face when choosing the right partner, as well as the common pitfalls that men notice and want to avoid. From red flags and deal-breakers to personal values and long-term compatibility, we cover it all with candid conversations and expert insights. Whether you're looking for love or aiming to better understand the dynamics of modern relationships, this podcast offers valuable advice, real-life stories, and practical tips to help you navigate your romantic journey with confidence. --- Support this podcast: https://podcasters.spotify.com/pod/show/romantictruth/support
Prayer for Choosing Wisely for her Daily Spiritual Espresso published on November 23, 2024 which you can access here: https://powerofloveministry.net/2024/11/this-need-not-be-2/ Learn more about your ad choices. Visit megaphone.fm/adchoices
En aquest Menys és Més ens fem ressò d'una altra iniciativa de la sèrie “Things We Do for No Reason™”, de les campanyes “Choosing Wisely”, publicada al Journal of Hospital Medicine de l'abril de 2020. En aquest cas ens parla de l'administració d'oxigen suplementari. Amb l'evidència disponible ens recomana administrar aquest suplement d'oxigen només en … Continua llegint «Administració d'oxigen suplementari»
Dr. Dionisia Quiroga discusses emerging approaches to personalizing locoregional treatment for breast cancer with Drs. Walter Paul Weber and Charlote Coles, who share insights on tailoring axillary surgery, escalating lymphatic surgery, and implementing hypofractionated radiotherapy. TRANSCRIPT Dr. Dionisia Quiroga: Hello, I'm Dr. Dionisia Quiroga, your guest host of the ASCO Daily News Podcast today. I'm a breast medical oncologist and assistant professor in the Division of Medical Oncology at the Ohio State University Comprehensive Cancer Center. On today's episode, we'll be discussing emerging approaches to personalize locoregional treatment for patients with breast cancer, including many of the latest updates on axillary surgical staging, lymphatic surgery, and evidence-based radiotherapy in the treatment of breast cancer. We're very fortunate to have joining me today for this discussion Dr. Walter Paul Weber, a professor and head at the Division of Breast Surgery at the University Hospital Basel in Switzerland, and Dr. Charlotte Coles, a professor of cancer clinical oncology and the deputy head of the Department of Oncology at the University of Cambridge in the United Kingdom. Our full disclosures are available in the transcript of this episode. Dr. Weber and Dr. Coles, it's very wonderful to have you on the podcast and thank you so much for being here. Dr. Walter Paul Weber: Thank you very much for having us. Dr. Charlotte Coles: Thank you. Dr. Dionisia Quiroga: Now, for many decades prior, axillary lymph node dissection has very much been our standard of care. But recently, axillary surgeries have been able to be gradually deescalated to spare some of our patients from relative and relevant long-term morbidity. There are still some indications in which axillary lymph node dissection still remain. And therefore, we still see breast cancer-related lymphedema, a well-known sequela of the axillary surgery to continue to be prevalent. And I think it's important also to acknowledge that today there's about an estimated 1.5 million cancer survivors who deal with breast cancer-related lymphedema. Now, Dr. Weber, at the recent ASCO Annual Meeting, you and your co-presenters discussed tailoring axillary surgery, escalating lymphatic surgery and implementing evidence-based hypofractionated radiotherapy to really personalize locoregional treatment for people who've been diagnosed with breast cancer. And in addition to that, you and Dr. Coles have also published this work in the 2024 ASCO Educational Book. Can you tell us about some of the recent advances in axillary surgery and what are really the current indications for axillary dissection? Dr. Walter Paul Weber: Yes, I'm happy to do so. So as you've said, we've known for a while that we can omit axillary dissection in patients with clinically known negative breast cancer and negative sentinel nodes. We've known for about 10-15 years that we can omit axillary dissection in patients with one or two positive sentinel nodes in many patients. But what we've learned recently is that we can omit axillary dissection also in patients with one or two positive sentinel nodes who have larger primary tumors who undergo mastectomy or who have extranodal extension. This is a landmark trial that was published just a few months ago, the SENOMAC trial that established this. The remaining indications for axillary dissection are situations where you expect a heavy tumor load in the axilla. For example, when you have more than two positive sentinel nodes or you have a patient with clinically node-positive breast cancer who undergoes upfront surgery and has palpable disease or significant disease on imaging. Patients with locally advanced breast cancer, who are considered by some to be not eligible for nodal downstaging, such as patients with CN2, CN3 disease or CT4 breast cancer. And then the big group of patients who have residual disease after neoadjuvant chemotherapy in the nodes, standard of care is still axillary dissection. But we now have some real-world evidence that it's safe for selected patients with low volume nodal disease left in the nodes, mostly isolated tumor cells, to not undergo axillary dissection. So these are the remaining indications today. Dr. Dionisia Quiroga: Can you speak to situations where maybe even sentinel lymph node biopsies might be omitted? I know you spoke a little bit about the use of imaging in your work. Dr. Walter Paul Weber: Yes, this is correct. So, we started about maybe 7 or 8 years ago to omit sentinel lymph node biopsy in older patients above 70 years of age who have luminal disease, according to recommendations from the Choosing Wisely initiative. And now indeed there are several ongoing randomized trials that investigate if axillary imaging can replace surgical staging of the axilla. And the first of these trials was published recently, the SOUND trial with almost 1,500 patients, who underwent breast conserving surgery and had small tumors and all had a negative ultrasound of the axilla. And then they were randomized into a sentinel lymph node biopsy versus no axillary surgery. And that trial showed non-inferiority of the omission of sentinel lymph node biopsy in these patients. Now, it's a bit early to roll out the Choosing Wisely recommendation to all patients who have a negative ultrasound. The SOUND trial showed that about 14% had a false-negative ultrasound. So, in the control arm, they actually did have a positive sentinel node. And in patients where that one missed sentinel node makes a big difference in terms of systemic therapy, most experts would still recommend sentinel biopsy, and these are patients mainly with HER2-positive or triple-negative breast cancer or premenopausal patients or those who have G3 biology. Dr. Dionisia Quiroga: I think you bring up a very important point. Coming from the side of a breast medical oncologist, we're also very interested to see what these studies show because many of our practices are based on what we find out from our lymph node biopsies. So, I think a lot of interesting prospective studies to look at in the future. Dr. Walter Paul Weber: Absolutely. Dr. Dionisia Quiroga: One other topic we wanted to discuss was local regional management of stage four disease and particularly oligometastatic disease. And this is not a new topic of interest. We've been speaking about this for a long time in breast cancer management, but can you address some of the axillary management strategies that you currently use for stage 4 disease? Dr. Walter Paul Weber: Yes, it depends on your intention. If your intention is to cure the patient, then you would apply all the locoregional standards that apply in the curative setting, which means lymph node biopsy with or without axillary dissection. Now in a palliative situation, it's individualized. Very often you don't touch the axilla and sometimes you open it and just remove palpable disease, trying to minimize morbidity. The question of which intent you should follow is controversial; three out of the four randomized trials did not show a benefit for locoregional surgery in patients with de novo stage 4 disease. However, experts seem to disagree. The last St. Gallen consensus recommendation was in favor of the curative intent in such a patient with oligometastatic disease; 85% favored the curative intent. So there's a bit of discrepancy there, but everybody would agree, and this is what has been done in all of these trials, that if you try to cure the patient, then you should apply the curative standards of sentinel and axillary dissection that you use also in early-stage breast cancer. Dr. Dionisia Quiroga: Thank you. Now, moving on from surgical axillary management and more into lymphedema prevention and treatment. Can you speak to some of the promising advances that have happened in this field? Dr. Walter Paul Weber: Yes, so the best way to prevent lymphedema still is not to perform axillary dissection, which is the number 1 risk factor, which is all the axillary surgery de-escalation research that we've just discussed is all about. Prevention of lymphedema is one major aim of this. Now, once you indicate axillary dissection and you expect the patient to be at high risk – for example, if there are other risk factors such as obesity or neoadjuvant chemotherapy or extended regional nodal radiotherapy, then indeed there are emerging techniques that really seem to work. There is some evidence supporting it, which is categorizable as immediate lymphatic repair basically or bypass. And that is usually in a patient who undergoes axillary dissection, and also undergoes axillary reverse mapping. That allows the identification of the lymph nodes that are probably most relevant to the drainage of the lymphatic fluid from the arm. And then you can try to spare these. But if you decide, and this is effective, there is a consistent body of evidence, not phase 3 trials, but pretty consistent evidence that axillary reverse mapping works just by sparing the identified nodes. But if you decide that you have to remove these nodes as part of the radical concept of axillary dissection, then immediate lymphatic repair is also increasingly being done and is also supported by consistent evidence, even some single center randomized trials, low volume, but all consistently showing quite a striking benefit of this immediate lymphatic repair technique. There are different ways you can do it. You can either use it the microscope, and it's being done by the plastic surgeons, but it's also a simplified technique described that can be used by specialized general and breast surgeons. Both techniques seem to really work based on what we know from the studies, but also based on our common sense. Dr. Dionisia Quiroga: You talked about the procedures that can be offered to patients at time of breast surgery. And unfortunately, many of our patients maybe did not have the availability of those techniques when they undergo their initial breast cancer treatment. Once lymphedema is developed in a limb following breast cancer diagnosis, can you speak to other interventions that can be done to potentially help mitigate lymphedema? Dr. Walter Paul Weber: Right, so for patients who no longer benefit from or wish to further undergo conservative treatment of lymphedema, there are emerging procedures that are now out of my personal comfort zone because they're being performed by plastic surgeons; they use the microscope. There are two groups, the lymphovenous anastomosis and then the real vascular lymph node transfer as a free flap. And both of these procedures (there are no randomized trials yet published), but some really good ones are on the way and currently recruiting based on the evidence we have, which is over 20 observational studies all consistently again showing a benefit in terms of what you can measure in terms of centimeters or with a bioimpedance spectroscopy, or also when you ask the patients, you see quite some dramatic improvements by both of these techniques. And it's increasingly being done. Personally, I strongly believe that it works based on everything we know and understand from lymphedema development, but also prevention and treatment. So I am quite sure that in 5-10 years, we will see much more surgical treatment of patients with lymphedema by highly specialized plastic surgeons. Dr. Dionisia Quiroga: That's my hope as well. Now, another important component of local regional treatment we know is of course radiotherapy. And there have been many incredible advances in breast radiotherapy over the past decades, which has really improved cancer control and decreased side effects in our patients. Dr. Coles, you've led practice changing radiotherapy trials in the past and your research has really influenced international hypofractionation policy. Can you expand upon the emergence of hypofractionated radiation for breast cancer and the effects that it can have on our patient care? Dr. Charlotte Coles: Yes, so thank you very much, Dr. Quiroga. So I think the first thing to say is that radiotherapy hypofractionation isn't a new concept. And in fact, the breast radiotherapy hypofractionation trial started around three decades ago. And the rationale for this was the hypothesis that breast cancer is as sensitive to fraction, which is the treatments that we give, we split it into fractions, is sensitive as late responding tissue. So what does this mean? It means that the small traditional 2 Gy fraction spare tumor and normal tissues equally, so there's no advantage. So therefore, fewer fractions with a larger dose per fraction are worth testing. The problem is there's a concern that hypofractionation might increase the risk of side effects, and that includes the really important one we've been talking about, lymphedema. But we can reduce this risk by reducing the total radiotherapy dose over the whole course. But the question was by how much. So that's why randomized trials were needed. And there's been really high-quality trials with robust radiotherapy quality assurance, and they've been designed in partnership with patients. So just a very quick run through: A landmark trial was the UK START B trial. And this was a pragmatic design that compared 50 Gy in 25 fractions, which was commonly used in the south of the country with 40 Gy in 15 fractions, which was used at that time in the north [of the UK]. And this recruitment was around in the late 1990s and early 2000s. What we knew was that the three-week regimen was actually radiobiologically lower dose. And therefore the results that we got, it wasn't surprising that the 40 Gy was actually gentler on the normal tissue. So that's an advantage for patients. But what was surprising was it wasn't gentler on the tumor and non-inferiority was proven. So this suggests that overall treatment time is important for local control. So this fits with hypofractionation. Way back in 2009, 40 Gy in 15 fractions to both the breast and regional nodes became standard of care in the UK. But five-week nodal and actually breast as well remained standard of care in many countries for many years after that, a little bit to do with the fact that there were few patients treated in the START trial in terms of treating the node. So more recently we've had more randomized trials, particularly for nodal radiotherapy. And this includes the recently reported Danish SKAGEN 1 trial and also the French HypoG-01 trial, which was actually presented at ESMO in Barcelona a couple of weeks ago. So we've now got data for over 5,800 participants in really high-quality randomized trials testing three weeks and five weeks of nodal radiotherapy. And there's no statistically significant difference in late normal tissues for any of these, including lymphedema. So certainly, in my opinion and reflecting in many of the European guidelines, five-week radiotherapy is no longer indicated and three-week nodal radiotherapy is the international standard of care. So, in conclusion, the question is can we hypofractionate even further? So the UK FAST-Forward trial tested three weeks with two different dose levels of one week for the whole breast. Primary endpoint was ipsilateral breast tumor response. More than 4,000 patients participated and this was reported in 2020 with a median follow -up of six years and this was very timely because this is a time of COVID and the results showed non-inferiority for local control with similar late normal tissue side effects and we've also had other results from the UK IMPORT HIGH trial which shows that we can safely deliver a small, highly targeted team of boost simultaneously with the whole breast in all in three weeks. Finally, these two landmark trials have come together for the design of the UK FAST-Forward Boost Study led by my colleague Dr. Anna Kirby. And this is going to test three-week simultaneous integrated boost with two levels of one-week simultaneous integrated boost. And it's also going to test the safety of 5 fraction nodal radiotherapy, including the internal mammary node. Primary endpoint is ipsilateral breast tumor response, multiple normal tissue endpoints, including patient-reported outcomes of course, and the target recall is large with 4,800 participants. So, in summary, I would say that hypofractionation is efficacious, has similarly reduced toxicity. Importantly, it reduces patient burden and that's incredibly important because it means that people can get back on with their life quicker. It reduces health system costs, and also increases equity of access. So we really do need to continue to recruit and design high quality trials in this area. Dr. Dionisia Quiroga: Thank you, Dr. Coles. I think you highlight that there really aren't any downsides to looking into hypofractionated radiotherapy at this point. So excited to see what those future trials yield. And I want to thank you so much, Dr. Weber and Dr. Coles for sharing your valuable insights with us today on the ASCO Daily News Podcast. Dr. Walter Paul Weber: Thank you very much. Dr. Charlotte Coles: Thank you. Dr. Dionisia Quiroga: And thank you to our listeners for joining us today. Our listeners will find a link to our guests' article from the ASCO Educational Book in the transcript of this episode, as well as a link to their presentation from the most recent ASCO Annual Meeting. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcast. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers: Dr. Dionisia Quiroga @quirogad Dr. Walter Paul Weber Dr. Charlotte Coles Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Dionisia Quiroga: No relationships to disclose Dr. Walter Weber: Honoraria: MSD Dr. Charlotte Coles: No relationships to disclose
Send us a textUp to 30% of all healthcare offers no clinical value to patients. Reducing this care has the co-benefit of decreasing healthcare's carbon footprint. In this special CSIM episode, host Dr. Zahra Merali sits down with guests Dr. Billy Silverstein @WKSilverstein (General Internist, University of Toronto) and Dr. Owen Luo @OwenLuo5 (Internal Medicine Resident, McGill University) to discuss 4 of the Choosing Wisely Canada's climate-conscious recommendations (https://choosingwiselycanada.org/climate/). They were integral in creating these recommendations, and have a wealth of practical tips about how we can implement them into our own practice! Infographic by Julia Simone (medical student). If you have not heard Part 1- make sure to go back and listen to other Canada-wide experts in this area.Support the show
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It's All-In August!When you're tempted to do something you know you shouldn't... you'll feel better if you don't. Here's a few thoughts on the neuroscience and the scripture of why waiting a bit to make a decision is usually best. Check out a brand-new episode of Tuesdays with Tata over on The Spiritual Brain Surgery Podcast today as well! Books mentioned:All In, by Mark Batterson, Turning Pro by Steven Pressfield, Hope Is the First Dose by me, The One Thing by Gary Keller, and Play the Man by Mark BattersonScripture: II Corinthians 5:14-17, Luke 9:23-25, Galatians 5:22-23, I Corinthians 2:16 Are you with us? Send a voicemail and let us know who you are, where you live, and that you're All-In!Follow me @drleewarren on Instagram for daily inspiration. Leave a voicemail with your question or comment!Five Ways You Can Support this show:Pray for us!Subscribe, like, and share it with your friends! (We even have a YouTube channel!)Leave reviews and comments wherever you listen to podcasts!You can become a paid partner of the podcast and get special bonus episodes and lots more content by clicking here. Visit one of our affiliate partners and consider using their products (we use them every day):Improve your gut health, support your immune system, and protect your brain with Pique!Other Helpful Links:Click here to access the Hope Is the First Dose playlist of hopeful, healing songs!Be sure to check out my new book, Hope Is the First Dose!Here's a free 5-day Bible study on YouVersion/BibleApp based on my new book!Sign up for my weekly Self-Brain Surgery Newsletter here!All recent episodes with transcripts are available here! (00:00) - All In Together (02:05) - Hitting a Wall (04:16) - Be Careful How You Live (06:09) - Choosing Wisely (08:38) - The Issue of Temptation (10:17) - Overcoming Temptation (14:03) - You'll Feel Better If You Don't (16:19) - Using Your Frontal Lobes (17:47) - Self-Brain Surgery
Summary In this podcast episode, Amanda, Laura, and Kendra discuss the concept of busyness and how it affects our lives. They explore the glorification of busyness in society and the importance of aligning our activities with our values. The hosts emphasize the need to say yes with purpose and eliminate tasks that don't align with our values. They also discuss the importance of rest and play in combating busyness and finding balance. The episode concludes with a challenge to say no, prioritize rest and play, and align our time with what truly matters. Keywords busyness, values, purpose, rest, play, alignment, balance Takeaways Busyness is often glorified in society, but it's important to align our activities with our values.Saying yes with purpose means eliminating tasks that don't align with our values.Rest and play are essential antidotes to busyness and should be prioritized.Clarity of purpose helps us allocate our time and energy to what truly matters.It's important to regularly assess how we're spending our time and ensure it aligns with our values. Chapters 00:00 Introduction00:07 The Glorification of Busyness06:43 Choosing Wisely and Allocating Time13:32 Offloading and Delegating20:05 The Ego and Importance of Busyness24:03 Rest and Play as Antidotes28:13 Clarity of Purpose29:24 Assessing Time Allocation35:42 Conclusion and Challenge
Summary In this episode, we dive into the world of caffeine as a legal performance enhancer. We'll talk about why having a solid foundation in nutrition and wellness is essential before considering caffeine use. We'll break down what caffeine is, where it comes from, and how it works in the body. Plus, we'll discuss its benefits for both physical and cognitive performance and provide tips on safe and mindful consumption. Remember, it's all about individual experimentation to find what works best for you. We'll also highlight the importance of choosing your caffeine sources wisely and staying hydrated. Keywords Caffeine, legal performance enhancers, foundation, nutrition, wellness, natural sources, synthetic sources, benefits, physical performance, cognitive performance, safe consumption, recommended amounts, timing, experimentation, overconsumption, hydration Takeaways Foundation First: Before considering caffeine, ensure you have a strong foundation in nutrition and overall wellness. Understanding Caffeine: Caffeine is a natural stimulant found in various natural and synthetic sources, working primarily within the central nervous system. Performance Benefits: Caffeine can enhance both physical and cognitive performance, though effects vary among individuals. Mindful Consumption: Safe and mindful consumption involves monitoring daily amounts and timing. Experimentation is Key: Individual experimentation is necessary to find your optimal caffeine intake. Avoid Overconsumption: Overconsumption can lead to jitters, anxiety, and insomnia. Consult Professionals: If you have preexisting medical conditions, consult with a healthcare professional about caffeine use. Stay Hydrated: Choosing your caffeine sources and amounts wisely and staying hydrated are essential. Sound Bites “Caffeine is a natural stimulant that works inside of your central nervous system.” “Caffeine and other legal performance enhancers are compliments to foundational habits and rituals.” “Caffeine is not actually giving you energy, food gives you energy.” Chapters Introduction and Season Format Change: We kick off the episode with an introduction and discuss the new format for the season. Building a Strong Foundation for Performance Enhancement: Emphasizing the importance of a strong nutritional and wellness foundation. Understanding the Basics of Caffeine: Breaking down what caffeine is, its natural and synthetic sources, and how it works in the body. The Benefits of Caffeine for Physical Performance: Exploring how caffeine can boost physical performance. The Benefits of Caffeine for Cognitive Performance: Discussing the cognitive benefits of caffeine consumption. Safe and Mindful Consumption of Caffeine: Providing guidance on how to consume caffeine safely and mindfully. The Potential Downsides of Caffeine: Highlighting the potential negative side effects of overconsumption. Choosing Wisely and Staying Hydrated: Wrapping up with tips on choosing your caffeine sources wisely and the importance of staying hydrated. Links & Resources: Check out our new Podpage! : Connect with Us: @deziabeyta and @imadeitpod on Instagram Review & Subscribe: Love what you're hearing? Please leave a review and subscribe to our podcast on Youtube! Signing Off: To our vibrant community of High Performers, remember, each step you take towards understanding and optimizing your performance brings you closer to your goals. Keep striving, stay curious, and support one another. Until next time, keep thriving in your quest for health and excellence! --- Send in a voice message: https://podcasters.spotify.com/pod/show/cbimi/message
We have more choices to exercise, moment to moment, than we often consciously realize. But as we become more aware of this truth, we also become more empowered inside our own lives. On today's Love Notes episode we're taking a closer look at the power of choosing wisely and also the subtle difference between seeking to solve our perceived problems vs seeking to witness them. I hope you'll join us! You can find more support for your healing journey at: marywelch.com
Welcome to The Speakeasy! In this episode, titled "Choosing Wisely: Navigating the Dating Game with Clarity and Confidence," we delve into the art of making smart choices in the dating world, and stories of when we didn't make the right choices. Join us as we explore key strategies for approaching dating with clarity and confidence. From identifying your values and priorities to setting healthy boundaries, we provide actionable tips to help you navigate the complexities of modern dating. Whether you're single and looking for love or simply seeking to enhance your dating experiences, this episode offers valuable insights to empower you on your journey to finding meaningful connections. Tune in to The Speakeasy Podcast and unlock the secrets to making wise choices in the dating game!
Much of who we are, we develop from the relationships we???re in. Whether we like it or not - we model things that we see in other people, in our own lives. So - we need to choose wisely. Join Berni Dymet as He looks at building lasting relationships - from A Different Perspective.Support the show: https://christianityworks.com/channels/adp/See omnystudio.com/listener for privacy information.
This week on the podcast, Mark and Corey delve into the intricacies of selecting a listing agent, advising sellers to proceed with caution during the interview process. They emphasize that the agent who provides the highest price estimate isn't necessarily the best choice.
“Even if both of you compromise, you're not enjoying the thing that you're compromising on.” Today, Alex (@AlexHormozi) explores the intricacies of relationships, emphasizing self-awareness, compatibility, and mutual respect as foundations for a thriving partnership. He highlights the importance of personal growth, breaking away from societal expectations in mate selection, and the crucial role of understanding and appreciating diversity in dating and relationships.Welcome to The Game w/Alex Hormozi, hosted by entrepreneur, founder, investor, author, public speaker, and content creator Alex Hormozi. On this podcast you'll hear how to get more customers, make more profit per customer, how to keep them longer, and the many failures and lessons Alex has learned on his path from $100M to $1B in net worth.Timestamps:(0:29) - Navigating the complexities of dating and relationships(1:37) - Understanding and appreciating diversity in relationships(3:33) - The importance of compatibility and shared goals in marriage(6:13) - Embracing pragmatism and realistic expectations in love(9:24) - The power of being brutally honest in relationships(15:57) - Avoiding common pitfalls in marriages and embracing appreciation(20:44) - Optimizing relationship dynamics through understanding and compromise(22:29) - Thoughts on prioritizing in relationshipsFollow Alex Hormozi's Socials:LinkedIn | Instagram | Facebook | YouTube | Twitter | Acquisition
Recently, Brandon added "An Authorized Infinite Banking Practitioner" to his status as a Bank On Yourself® Professional. Here's proof: https://infinitebanking.org/agents/neely758. Who better to share their perspective on what BOTH Bank On Yourself AND Infinite Banking bring to bettering your financial future? As Brandon shares in the episode, we don't want to be so much AGAINST anything or anyone. We want to be FOR our clients! Get the books: The Bank On Yourself Revolution: https://www.bankonyourself.com/shop/the-bank-on-yourself-revolution-paperback Becoming Your Own Banker: https://infinitebanking.org/product/becoming-your-own-banker/ Start the process: Schedule a Discovery Call: https://www.wealthwisdomfp.com/call 00:00 The Power of Positivity in Finance 01:48 The Impact of Faith and Financial Books on Our Lives 02:06 Exploring the Bank On Yourself Concept 04:04 The Influence of R. Nelson Nash and Infinite Banking 07:13 The Importance of Choosing the Right Financial Professional 08:10 Why Bank On Yourself and Infinite Banking Matter 12:01 The Significance of Education and Choosing Wisely
When his girlfriend started pressuring him to shack up, Angie's son drew on a lifetime of hearing Dr. Laura's values to make his decision.Call 1-800-DR-LAURA / 1-800-375-2872 or make an appointment at DrLaura.comFollow me on social media:Facebook.com/DrLauraInstagram.com/DrLauraProgramYouTube.com/DrLaura
In this transformative episode of "The Dark Horse Entrepreneur Podcast," dive deep into the art of honing your entrepreneurial focus amidst the overwhelming sea of online money-making methods. Discover the power of the three critical filters—proven effectiveness, alignment with personal capabilities, and true passion—to sift through the noise and pinpoint the path that resonates with your core. Learn the psychological strategy behind 'Closing the Doors' to other opportunities, ensuring your undivided commitment and focus on your chosen venture. This episode is not just a guide; it's a beacon for those ready to transition from dreamer to doer, offering actionable insights and the compelling narrative needed to navigate the complexities of entrepreneurship. Embrace the Whiskered Wisdom segment's top tip: "Embrace the power of singular focus. Let your chosen path be your only path until it leads you to success," and unlock the doors to your entrepreneurial journey with unmatched clarity and purpose. Whether you're an aspiring digital nomad, a budding infopreneur, or a parent striving for financial independence, this episode is your compass in the vast sea of possibilities, guiding you to the island of success that awaits your focused endeavor.
Ready for a real talk on successful business partnerships? In this episode of The Real enTREpreneur™ Podcast, we're diving into the nitty-gritty of what makes a partnership thrive in both business and real estate. Join me as I share insights on the importance of alignment, the rarity of true partnerships, and the positive impact they can have on your journey. I'll walk you through the key elements, from building trust to due diligence, and why effective communication is the game-changer. If you're on the partnership path or considering teaming up, this episode is your guide. Tune in and let's explore the art of Choosing Wisely. Grab Your [FREE] Ticket to Wholesale Workshop LIVE: https://treuniversity.com/wholesale-workshop Social Media: Instagram: www.instagram.com/realalexcoffman Facebook: www.facebook.com/realalexcoffman Tiktok: www.tiktok.com/@realalexcoffman
Transform Your Roof, Transform Your Home! Choose Roof Painting Wellington for top-tier roof restoration and vibrant metal roof painting in Wellington. Elevate your home's appeal and value effortlessly. Dial 028 469 3495 now for flawless results! Discover more at https://roofpaintingwellington.nz/aboutus-affordable-roof-painting Roof Painting Wellington City: Wellington Address: 2 Tyers Road Website: https://roofpaintingwellington.nz Phone: +64 28 469 3495
In this gripping episode, we delve deep into the intricate world of decision-making and the art of making the right choices. Join host Angela Hudson as she embarks on a thought-provoking journey through the twists and turns of our decision-making process. From seemingly insignificant choices to life-altering decisions, we explore the factors that influence our ability to make the best decisions for ourselves that propels us forward towards our goals, calling and purpose. We'll uncover the ideas that hinder us while shedding light on the consequences we can endure from not choosing wisley. Through real-life anecdotes and relatable examples, we'll examine the importance of mindfulness and self-awareness in the decision-making process. So, if you've ever found yourself grappling with a tough decision or questioning whether you made the right choice, tune in to this enlightening episode. You'll walk away with a newfound understanding of how to navigate the maze of decision-making and make choices that align with your values, goals and purpsose
It's not your picker that's broken. It's your connection to yourself. Choosing love that's better for you means choosing the love that is right for you. Here's how. Mentioned in this episode: Episode 4 of Mother Mayhem: Navigating Relationships After Narcissistic Abuse You can find it in the podcast app you are using for this episode. --- Send in a voice message: https://podcasters.spotify.com/pod/show/mothermayhem/message
The Vulnerability Dilemma, The Trust Factor, Choosing Wisely, The Ripple Effect, and Protecting Your Peace are all important factors to consider when it comes to sharing one's inner thoughts and emotions. Knowing when and with whom to share such personal experiences can be challenging, but it's crucial for maintaining healthy relationships and safeguarding one's emotional well-being. This episode provides valuable insights into effective communication without oversharing, setting boundaries, and finding the right outlets for specific concerns. By listening in, you'll learn how to build a supportive network that uplifts and understands, creating a balance between connection and self-preservation. Don't miss out on this opportunity to gain a deeper understanding of Selective Venting, Mindful Communication, and Protecting Your Peace.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/BFU865. CME/MOC/AAPA credit will be available until November 7, 2024.Choosing Wisely, Achieving Control With BTKi in CLL: Perspectives on Safety-Informed Approaches to Enhanced Therapeutic Efficacy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerJohn C. Byrd, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; AstraZeneca; Eilean Therapeutics; Janssen Pharmaceuticals, Inc.; Kura Oncology, Inc.; Newave Pharmaceutical Inc; Novartis Pharmaceuticals Corporation; Orange Grove Bio; Syndax; Trillium Therapeutics; and Vincerx Pharma.Grant/Research Support from Eilean Therapeutics; Newave Pharmaceutical Inc; and OrbiMed.Stock Shareholder in Eilean Therapeutics; Kura Oncology, Inc.; and Vincerx Pharma.Other Financial or Material Support in the form of patents for Ohio State University.Faculty/PlannerDaniel Addison, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from American Heart Association-Robert Wood Johnson Foundation and National Institutes of Health (NIH) grants: K23-HL155890 and R01HL170038.Faculty/PlannerMatthew S. Davids, MD, MMSc, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; Adaptive Biotechnologies; Ascentage Pharma; AstraZeneca; BeiGene, Inc.; Bristol Myers Squibb; Genentech, Inc.; Genmab; Janssen Pharmaceuticals, Inc.; Lilly; Merck & Co., Inc.; Mingsight Pharmaceuticals Inc.; Secura Bio; Takeda Pharmaceutical Company Ltd.; and TG Therapeutics, Inc.Grant/Research Support from AbbVie; Ascentage Pharma; AstraZeneca; Genentech, Inc.; Novartis Pharmaceuticals Corporation; Secura Bio; and TG Therapeutics, Inc.Honoraria from Aptitude Health; Bio Ascend; and Curio Science.Other Financial or Material Support in the form of Royalties from Up-to-Date.Faculty/PlannerJennifer Woyach, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for ArQule, Inc.; AstraZeneca; BeiGene; Genentech, Inc.; Janssen Pharmaceuticals, Inc.; Loxo Oncology; Newave Pharmaceutical Inc; and Pharmacyclics LLC.Grant/Research Support from AstraZeneca; Karyopharm Therapeutics; Loxo Oncology; MingSight Pharmaceuticals, Inc.; MorphoSys US Inc.; Schrödinger, Inc.; and Verastem Oncology.Faculty/PlannerPaolo Ghia, MD, PhD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; BeiGene, Inc./Merck Sharp & Dohme; Bristol Myers Squibb; and F. Hoffmann-La Roche Ltd.Grant/Research Support from Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; and Bristol Myers Squibb.Speaker for AstraZeneca/Janssen Pharmaceuticals, Inc. and BeiGene, Inc./Merck Sharp & Dohme.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/BFU865. CME/MOC/AAPA credit will be available until November 7, 2024.Choosing Wisely, Achieving Control With BTKi in CLL: Perspectives on Safety-Informed Approaches to Enhanced Therapeutic Efficacy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerJohn C. Byrd, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; AstraZeneca; Eilean Therapeutics; Janssen Pharmaceuticals, Inc.; Kura Oncology, Inc.; Newave Pharmaceutical Inc; Novartis Pharmaceuticals Corporation; Orange Grove Bio; Syndax; Trillium Therapeutics; and Vincerx Pharma.Grant/Research Support from Eilean Therapeutics; Newave Pharmaceutical Inc; and OrbiMed.Stock Shareholder in Eilean Therapeutics; Kura Oncology, Inc.; and Vincerx Pharma.Other Financial or Material Support in the form of patents for Ohio State University.Faculty/PlannerDaniel Addison, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from American Heart Association-Robert Wood Johnson Foundation and National Institutes of Health (NIH) grants: K23-HL155890 and R01HL170038.Faculty/PlannerMatthew S. Davids, MD, MMSc, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; Adaptive Biotechnologies; Ascentage Pharma; AstraZeneca; BeiGene, Inc.; Bristol Myers Squibb; Genentech, Inc.; Genmab; Janssen Pharmaceuticals, Inc.; Lilly; Merck & Co., Inc.; Mingsight Pharmaceuticals Inc.; Secura Bio; Takeda Pharmaceutical Company Ltd.; and TG Therapeutics, Inc.Grant/Research Support from AbbVie; Ascentage Pharma; AstraZeneca; Genentech, Inc.; Novartis Pharmaceuticals Corporation; Secura Bio; and TG Therapeutics, Inc.Honoraria from Aptitude Health; Bio Ascend; and Curio Science.Other Financial or Material Support in the form of Royalties from Up-to-Date.Faculty/PlannerJennifer Woyach, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for ArQule, Inc.; AstraZeneca; BeiGene; Genentech, Inc.; Janssen Pharmaceuticals, Inc.; Loxo Oncology; Newave Pharmaceutical Inc; and Pharmacyclics LLC.Grant/Research Support from AstraZeneca; Karyopharm Therapeutics; Loxo Oncology; MingSight Pharmaceuticals, Inc.; MorphoSys US Inc.; Schrödinger, Inc.; and Verastem Oncology.Faculty/PlannerPaolo Ghia, MD, PhD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; BeiGene, Inc./Merck Sharp & Dohme; Bristol Myers Squibb; and F. Hoffmann-La Roche Ltd.Grant/Research Support from Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; and Bristol Myers Squibb.Speaker for AstraZeneca/Janssen Pharmaceuticals, Inc. and BeiGene, Inc./Merck Sharp & Dohme.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/BFU865. CME/MOC/AAPA credit will be available until November 7, 2024.Choosing Wisely, Achieving Control With BTKi in CLL: Perspectives on Safety-Informed Approaches to Enhanced Therapeutic Efficacy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerJohn C. Byrd, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; AstraZeneca; Eilean Therapeutics; Janssen Pharmaceuticals, Inc.; Kura Oncology, Inc.; Newave Pharmaceutical Inc; Novartis Pharmaceuticals Corporation; Orange Grove Bio; Syndax; Trillium Therapeutics; and Vincerx Pharma.Grant/Research Support from Eilean Therapeutics; Newave Pharmaceutical Inc; and OrbiMed.Stock Shareholder in Eilean Therapeutics; Kura Oncology, Inc.; and Vincerx Pharma.Other Financial or Material Support in the form of patents for Ohio State University.Faculty/PlannerDaniel Addison, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from American Heart Association-Robert Wood Johnson Foundation and National Institutes of Health (NIH) grants: K23-HL155890 and R01HL170038.Faculty/PlannerMatthew S. Davids, MD, MMSc, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; Adaptive Biotechnologies; Ascentage Pharma; AstraZeneca; BeiGene, Inc.; Bristol Myers Squibb; Genentech, Inc.; Genmab; Janssen Pharmaceuticals, Inc.; Lilly; Merck & Co., Inc.; Mingsight Pharmaceuticals Inc.; Secura Bio; Takeda Pharmaceutical Company Ltd.; and TG Therapeutics, Inc.Grant/Research Support from AbbVie; Ascentage Pharma; AstraZeneca; Genentech, Inc.; Novartis Pharmaceuticals Corporation; Secura Bio; and TG Therapeutics, Inc.Honoraria from Aptitude Health; Bio Ascend; and Curio Science.Other Financial or Material Support in the form of Royalties from Up-to-Date.Faculty/PlannerJennifer Woyach, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for ArQule, Inc.; AstraZeneca; BeiGene; Genentech, Inc.; Janssen Pharmaceuticals, Inc.; Loxo Oncology; Newave Pharmaceutical Inc; and Pharmacyclics LLC.Grant/Research Support from AstraZeneca; Karyopharm Therapeutics; Loxo Oncology; MingSight Pharmaceuticals, Inc.; MorphoSys US Inc.; Schrödinger, Inc.; and Verastem Oncology.Faculty/PlannerPaolo Ghia, MD, PhD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; BeiGene, Inc./Merck Sharp & Dohme; Bristol Myers Squibb; and F. Hoffmann-La Roche Ltd.Grant/Research Support from Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; and Bristol Myers Squibb.Speaker for AstraZeneca/Janssen Pharmaceuticals, Inc. and BeiGene, Inc./Merck Sharp & Dohme.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/BFU865. CME/MOC/AAPA credit will be available until November 7, 2024.Choosing Wisely, Achieving Control With BTKi in CLL: Perspectives on Safety-Informed Approaches to Enhanced Therapeutic Efficacy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerJohn C. Byrd, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; AstraZeneca; Eilean Therapeutics; Janssen Pharmaceuticals, Inc.; Kura Oncology, Inc.; Newave Pharmaceutical Inc; Novartis Pharmaceuticals Corporation; Orange Grove Bio; Syndax; Trillium Therapeutics; and Vincerx Pharma.Grant/Research Support from Eilean Therapeutics; Newave Pharmaceutical Inc; and OrbiMed.Stock Shareholder in Eilean Therapeutics; Kura Oncology, Inc.; and Vincerx Pharma.Other Financial or Material Support in the form of patents for Ohio State University.Faculty/PlannerDaniel Addison, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from American Heart Association-Robert Wood Johnson Foundation and National Institutes of Health (NIH) grants: K23-HL155890 and R01HL170038.Faculty/PlannerMatthew S. Davids, MD, MMSc, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AbbVie; Adaptive Biotechnologies; Ascentage Pharma; AstraZeneca; BeiGene, Inc.; Bristol Myers Squibb; Genentech, Inc.; Genmab; Janssen Pharmaceuticals, Inc.; Lilly; Merck & Co., Inc.; Mingsight Pharmaceuticals Inc.; Secura Bio; Takeda Pharmaceutical Company Ltd.; and TG Therapeutics, Inc.Grant/Research Support from AbbVie; Ascentage Pharma; AstraZeneca; Genentech, Inc.; Novartis Pharmaceuticals Corporation; Secura Bio; and TG Therapeutics, Inc.Honoraria from Aptitude Health; Bio Ascend; and Curio Science.Other Financial or Material Support in the form of Royalties from Up-to-Date.Faculty/PlannerJennifer Woyach, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for ArQule, Inc.; AstraZeneca; BeiGene; Genentech, Inc.; Janssen Pharmaceuticals, Inc.; Loxo Oncology; Newave Pharmaceutical Inc; and Pharmacyclics LLC.Grant/Research Support from AstraZeneca; Karyopharm Therapeutics; Loxo Oncology; MingSight Pharmaceuticals, Inc.; MorphoSys US Inc.; Schrödinger, Inc.; and Verastem Oncology.Faculty/PlannerPaolo Ghia, MD, PhD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; BeiGene, Inc./Merck Sharp & Dohme; Bristol Myers Squibb; and F. Hoffmann-La Roche Ltd.Grant/Research Support from Abbvie, Inc.; AstraZeneca/Janssen Pharmaceuticals, Inc.; and Bristol Myers Squibb.Speaker for AstraZeneca/Janssen Pharmaceuticals, Inc. and BeiGene, Inc./Merck Sharp & Dohme.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below
In this episode, I discuss the 3 types of relationships you can have (whether romantic, friends, family etc) that hold the 3 different potentials in impacting you and your life. Tune in to discover these 3 types and see how you can choose to show up in a way that is going to mirror to you the highest version of the 3, and ultimately support you in your / those around you highest evolution. Intro / Outro: Steffan Ki Connect with me on IG To apply and work 1:1 with me or book a private VIP retreat, please email me at "shaktiunleashed@gmail.com" Ladies, I am SO EXCITED to officially announce my next in person women's retreat: "The Unearthing" held in Costa Rica October 27 - November 3, 2023. This is for the woman ready to tap into her eros, life force and vitality. For the woman ready to activate her dark feminine, as we journey together working with themes of Scorpionic energies to unearth and liberate your greatest potential and transformation. Get ready to go dark + deep ladies. Please email me at shaktiunleashed@gmail.com for more details on how to apply / join.
Where else is the poop going to be? Constipation is by and large a clinical diagnosis. This episode reviews how to make the diagnosis, red flags, and why X-Rays don't necessarily help assess stool burden adequately in most children. This podcast episode is designed to disseminate the important work of Choosing Wisely, an initiative of the […]
Joanne gives an overview of the first six of the 14 Mindfulness Trainings, showing that they are guidelines for us, to help us choose our actions wisely as we go through our lives. She shows us how they can guide us to avoid causing more suffering in the world, and to transform our own.
Cultivating H.E.R. Space: Uplifting Conversations for the Black Woman
Hey lady! Kick off your shoes and relax your feet because this week Dr. Dom and Terri have some girl talk and chit chat with Tamika Scott, one-fourth of the legendary 90s R&B girl group Xscape and star of upcoming holiday film Christmas Ringer, to dish on all of the latest happenings in her life. She gives the deets on life after The Great Xscape tour, how she's dealing with the fallout with her sister following the revelations on SWV & Xscape: The Queens of R&B, and her new single "Tonight" featuring everyone's favorite hunk – Method Man. Tamika has so many gems to share and you won't want to miss this week's episode. Head to Patreon and tune in to the Aftershow for more juicy convo!Quote of the Day:"Choose wisely."– Tamika Scott Where to find Tamika Scott:Website: Tamika Scott's Southern FuseFacebook: Tamika ScottTikTok: @therealtamikascottIG: @therealtamikascottLinkedIn: Tamika ScottTwitter (X): @officialTScott YouTube: @TheRealTamikaScott Control Body Odor ANYWHERE with @lumedeodorant and get $5 off of your Starter Pack (that's over 40% off) with promo code HERSPACE at lumedeodorant.com! #lumepodThis episode is sponsored and brought to you by BetterHelp. Give online therapy a try at betterhelp.com/CULTIVATING and get on your way to being your best self.Register here for the Vibrate Higher Empowerment Workshop! Wisdom Wednesdays with TerriCultivating H.E.R. Space Sanctuary Resources:Dr. Dom's Therapy PracticeBranding with TerriMelanin and Mental HealthTherapy for Black Girls Psychology TodayTherapy for QPOC Where to find us:Twitter: @HERspacepodcastInstagram: @herspacepodcastFacebook: @herspacepodcastWebsite: cultivatingherspace.comThis show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/5470036/advertisement
Join Don Gaede, an internal medicine and vascular medicine physician, to discuss the "existential threat of greed in U.S. health care" highlighted in a JAMA editorial. Don shares his firsthand encounters with unethical practices within his specialty of vascular medicine, where patients are urged to undergo unnecessary procedures. We delve into the impact on vulnerable populations and the challenges of addressing these issues. Explore the role of initiatives like Choosing Wisely in promoting appropriate care and advocating for patients. Don emphasizes the importance of physicians taking a stand against greed in all health care sectors to protect the medical profession's noble status. Don Gaede is an internal medicine and vascular medicine physician. He discusses his KevinMD article, "The dark side of medicine: an urgent call to action against greed." The Podcast by KevinMD is brought to you by the Nuance Dragon Ambient eXperience. With a growing physician shortage, increasing burnout, and declining patient satisfaction, a dramatic change is needed to make health care more efficient and effective and bring back the joy of practicing medicine. AI-driven ambient clinical intelligence promises to help by revolutionizing patient and provider experiences with clinical documentation that writes itself. The Nuance Dragon Ambient eXperience, or DAX for short, is a voice-enabled, ambient clinical intelligence solution that automatically captures patient encounters securely and accurately at the point of care. Physicians who use DAX have reported a 50 percent decrease in documentation time and a 70 percent reduction in feelings of burnout, and 83 percent of patients say their physician is more personable and conversational. Rediscover the joy of medicine with clinical documentation that writes itself, all within the EHR. VISIT SPONSOR → https://nuance.com/daxinaction SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://earnc.me/Cs8yjF Powered by CMEfy.
What are you allergic to? Do you know? Do you get all itchy and snotty in the spring and summer? Does it seem worse this year than in the past?? Do we have to just stop going outside?? (Spoiler alert, the answer is no to this last one.. :)Let's answer all these questions and more! Our expert today is Dave Stukus MD!Dr. Stukus (or “Dr. Dave, as his patients call him” ;) is a Clinical Professor of Pediatrics, Division of Allergy/Immunology Nationwide Children's Hospital and The Ohio State University College of Medicine. He's also the director of the Food Allergy Treatment Center. He's very active on social media with @AllergyKidsDoc on Twitter and Instagram.Key highlights in this episode include:What actually ARE allergies?Why do seasonal allergies seem so much worse lately?ARE they actually worse? Why?Does lactose intolerance count as an allergy?How often are people "really" allergic to penicillin?What medicines help with seasonal allergies? Is Benadryl good?How do you know if your kid has allergies, as opposed to something else causing their symptoms?Does allergy testing work? Who should do it?What about allergy shots? Do they help?Follow Dr. Stukus via his handle "allergykidsdoc" on Instagram and Twitter!Dr. Stukus recommends the following resources to learn about allergies:The American Academy of Allergy, Asthma and Immunology, particularly their page on Choosing Wisely Videos, as well as the Choosing Wisely website.(BONUS- Check out Dr. Dave's Choosing Wisely video HERE explaining IgG testing and allergies!)The American College of Allergy, Asthma, and Immunology website. For more episodes, limited edition merch, or to become a Friend of Your Doctor Friends (and more), follow this link!Also, CHECK OUT AMAZING HEALTH PODCASTS on The Health Podcast Network(For real, this network is AMAZING and has fantastic, evidence-based, honest health information, and we are so happy to partner with them!) Find us at:Website: yourdoctorfriendspodcast.com Email: yourdoctorfriendspodcast@gmail.com Call the DOCLINE on 312-380-5005 and leave us a message. We will listen and maybe even respond/play it on the show! (Disclaimer: we will not answer specific medical questions or offer medical advice. Consult your healthcare professional with any and all personal health questions.) Connect with us:@your_doctor_friends (IG)@JeremyAllandMD (IG, FB,
Ever follow a friend's advice only to realize that it was never gonna work for you? They meant well, but all you got was frustration and heartache. Who do you look to for guidance on your ADHD? When you want to learn how to swim, you choose a swim instructor who knows what it's like to be in the water. Are you looking for someone on dry land to give you swim instructions? When you have ADHD, comparing yourself to anyone who doesn't have ADHD is a surefire recipe for low self-esteem. And taking advice from them is good in theory, but somehow never comes together. So how do you find the right person to help you be successful? Let's discuss. Join the Time Management Mastery for ADHD Moms waitlist to be the first to know when registration opens! Find links to everything mentioned in this episode & read the transcript here: https://www.patriciasung.com/podcast/episode-180-follow-the-right-leader-for-your-adhd-family
How do you avoid getting bogged down in the quicksand of competing demands? According to Mark Miller, Vice President of High-Performance Leadership at Chick-fil-A, it all boils down to your choices. In this episode, Mark shares insights from over 20 years of leadership coaching and team development. With over one million books in print in more than 25 languages, you will see how Mark's insights into leadership are sought by organizations across the globe.Guest Links:Mark's LinkedInLead Every Day WebsiteChick-fil-A HomepageCulture Rules: The Leader's Guide to Creating the Ultimate Competitive Advantage by Mark MillerSmart Leadership: Four Simple Choices to Scale Your Impact by Mark MillerCredits: Lisa Nichols, Host; Scott Crosby, Executive Producer; Jenny Heal, Guest Coordinator; Kendall Brewer, Leadership Programs; Joe Szynkowski, Marketing Support
Change Maker's Mind-La Mente de los Creadores de Cambio with Cristina Pujol
Agreements play a vital role in almost all areas of life, helping to set expectations, build trust, and facilitate cooperation and collaboration. While there may be some areas of our lives where agreements are less prominent, they are an integral part of human interaction and relationships, and the relationship with ourselves.What agreements do you have with others?What agreements do you have with yourself?Do you let your inner judge sabotage you?Discover the 4 agreements of Don Miguel Ruíz, and how they can help you transform your reality.Thank you so much for sharing your LOVE for the Podcast by sharing it with Friends, Subscribing, Rating & Leaving a Review.With Love - CristinaTo support the podcast:Patreon: Patreon.com/ChangeMakerTo contact Cristina Pujol: LinkedIn: @cpujoljensen Web: TuyTuMente.com Instagram: @CristinaPujol7 @changemakersmind Instagram of "Tú y Tu Mente": @tu_ytumente Facebook: @tuytumenteMusic: Gonzalo Grau - Frutero ModernoEl Frutero Moderno en Spotify
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