Podcasts about duke university hospital

Does the type of anesthesia used during surgery impact cancer outcomes?  Today we're going to explore the relationship between cancer and anesthesia with Adam Flowe, Chief CRNA at Duke University Hospital. This topic goes beyond the operating room to cover patient outcomes, recovery and even reoccurrence. Join us to learn more about the growing field of Onco-Anesthesia and its critical role in cancer treatment and patient survival. Here are some of the key topics we discuss:

In this podcast episode we want to introduce you to our BCEN Friend, Reginald “Reggie” Santiago. Reginald Santiago is an inpatient care coordinator and case manager at Duke University Hospital's Raleigh campus. Over the past 30 years in healthcare, he has served in roles as a paramedic, adjunct paramedic instructor, tactical medical instructor, and Special Operations Forces Medical Instructor specializing in prolonged field care (PFC).  Additionally, Reginald is the creator and host of the Paramedic2RN podcast. Reginald's educational background includes an Associate's degree of Applied Sciences in Emergency Medical Science, an ADN from a Paramedic to RN bridge program, and as well as his BSN. Reginald is currently pursuing an MSN in Adult-Gerontology as a Clinical Nurse Specialist at East Carolina University. He holds board certifications as a CEN, TCRN, CCRN, CFRN, CTRN, and is a national registry paramedic. Transitioning between careers can be difficult and Reggie is no stranger to difficult challenges. From Paramedic to RN to podcast host, Reggie chats about the good, the hard, and the people who help get you through it all. This episode is called, "Start doing what you're meant to do." BCEN & Friends Podcast is presented by the Board of Certification for Emergency Nursing. We invite you to visit us online at https://bcen.org for additional information about emergency nursing certification, education, and much more.

On this episode of the Pretty Powerful Podcast, we sit down with the incredible Morgan Taylor—board-certified pediatric nurse practitioner, Chief Nursing Officer at Archer Review, and a true advocate for nursing education. Morgan shares her journey from working in pediatric ICUs at Duke University Hospital to leading innovative curriculum development for over half a million nursing and NP students. We discuss her mission to bridge critical gaps in nursing education, her passion for fostering a supportive community, and how to empower new nurses to stay in the profession during a time of unprecedented shortages.

Episode Resources:WOCN Society Pediatrics Community and Ostomy Community for members onlyJWOCN® evidence-based articles on pediatric carePediatric Ostomy Support Group (POGS) by the United Ostomy Associations of America (UOAA)Youth Rally, Pull-thru Network, Crohn's & Colitis Foundation, Girls with Guts, Shadow Buddies Foundation About the Speaker:Michelle Rice, MSN, RN, CWOCN, has been a WOC nurse since 1999 and currently practices at Duke University Hospital. Michelle's primary population is pediatrics and focuses on wound care and ostomy care.

Send Vanessa a Text MessageIn this special episode, I sit down with Chrissy Hicks to candidly discuss the MIRACLE journey of her daughter Yulia. After being adopted from Ukraine, Yulia was in need of a life-saving kidney transplant, but was denied the procedure by Duke University Hospital due to her Covid vaccination status.The story unfolds in the most incredible of ways, miracle after miracle...and Chrissy and her husband are still relentlessly dedicated towards raising awareness and sharing accommodating resources for other transplant patients. They believe it's critically important to continue to fight for EVERYONE'S freedoms and rights, and they are by no means done with trying to restructure and pass Yulia's Law. While this situation with Yulia went viral and reached the mainstream media, there is still much work to do when it comes to the protection of body autonomy for all citizens. With faith as their foundation, they are obediently and courageously open to do whatever it takes to create real, lasting change.Episode/Support Resources:Informational Page: https://www.givesendgo.com/kidneyforyuliaKidney for Yulia Facebook Page: https://www.facebook.com/groups/1570824836846037/?mibextid=S66gvFPodcast Resources:Podcast on Instagram: https://www.instagram.com/well.with.vanessa/Vanessa's Homebase (links/discount codes): https://linktr.ee/thegiftofgoodsVanessa on Instagram: https://www.instagram.com/thegiftofgoods/ Vanessa on Threads: https://www.threads.net/@thegiftofgoodsPodcast on YouTube: www.youtube.com/@IntentionallyWellPodcastPodcast on TikTok: www.tiktok.com/@well.with.vanessaPodcast on X: https://x.com/wellwithvanessaEmail: intentionallywellpodcast@gmail.comSupport the showPodcast Website: https://intentionallywellwithvanessalopez.buzzsprout.comThis episode is for informational purposes only. Please consult a trusted health practitioner for individual concerns.

Send us a textThere's no doubt that physicians who take money from pharmaceutical companies prescribe more expensive drugs.But is that really best for patients? And what are the real dangers of these financial incentives? In this episode of CareTalk, David Williams and John Driscoll talk with Dr. Aaron Mitchell, a genitourinary medical oncologist at Memorial Sloan Kettering Cancer Center, about the precarious role of financial incentives on physician behavior.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.TOPICS(0:22) Sponsorship: BetterHelp(1:44) Why Should We Care About Incentives in Healthcare?(2:40) The Nature of Relationships Between Doctors and Pharma(4:48) The Average Size of Incentives(6:53) The Impact of Incentives on Prescribing Patterns(7:45) How Pharma Justifies Financial Incentives(12:05) When Financial Incentives Lead to Prescribing Worse Drugs(14:44) A Doctor's Perspective on the Ethics of Incentives (17:31) Branded Drugs Versus Unbranded Drugs(20:26) How Doctors Have Reacted to Findings on Financial Incentives (23:26) Should Patients be Afraid of Getting the Wrong Drug?(27:15) What's Next for Dr. Aaron Mitchell?

Braydon Dymm, MD, is a board-certified neurologist and accomplished physician who specializes in cerebrovascular disease and stroke care.After graduating summa cum laude from the University of Detroit Mercy and earning his medical degree from Wayne State University School of Medicine, he completed his neurology residency at Michigan Medicine. Dr. Dymm recently finished an advanced fellowship in cerebrovascular neurology at Duke University Hospital. He has made significant research contributions with publications in respected journals like Neurology and Stroke. Currently, Dr. Dymm serves as a neurohospitalist in the Department of Neurology at Charleston Area Medical Center.His passion for advancing stroke care and medical education has established him as an emerging leader in the field. In this episode, we cover:The differences between ischemic and hemorrhagic strokes, including causes and symptoms.The critical of recognizing stroke symptoms quickly using the BFAST mnemonic.Gender disparities in stroke incidence, with a focus on why women are more affected and have worse outcomes.The role of high blood pressure and cholesterol in stroke risk and prevention strategies.The effectiveness of exercise, diet, and stress management in reducing stroke risk.Advances in stroke treatment, including the transition from TPA to tenecteplase for quicker administration.The potential for new technologies, like continuous blood pressure monitors, to improve stroke prevention.Sign up to The Neuro Athletics Newsletter: https://bit.ly/3ewI5P0Connect with BraydonTwitter: https://x.com/BraydonDymmMy Socials:Instagram: https://www.instagram.com/louisanicola_/Twitter : https://twitter.com/louisanicola_Sponsors for today's episode:Momentous - Use code NEURO to get 20%  off your first subscription order - code NEURO:  https://www.livemomentous.com/Inside Tracker - Use code LOUISA20 for 20% off - https://insidetracker.com/louisaZocDoc- Use code NEURO - https://www.zocdoc.com/neuro(00:00) Preview and Intro(00:36) Introducing Dr. Braydon Dymm(01:08) Gender Disparities in Stroke?(02:28) Pathology of Ischemic Stroke(06:29) Small Vessel Strokes(09:56) Alzheimer's as Vascular Dementia(11:18) Managing Blood Pressure and Cholesterol(13:15) Role of Exercise in Stroke Prevention(14:22) Resistance Training and Dementia Prevention(18:13) Golden Hour in Stroke Treatment(20:07) Recognizing Stroke Symptoms with BFAST(24:47) Anticoagulants vs. Antiplatelets(25:56) Preventing Strokes with Blood Thinners(26:45) Hemorrhagic Strokes(29:36) Medication Differences for Stroke Types(32:58) Gender Differences in Stroke Outcomes(33:04) Challenges of DeThe Neuro Athletics Newsletter Instagram: @louisanicola_Twitter : @louisanicola_YouTube: @Louisa NicolaThe Neuro Experience Podcast is proud to have hosted: Dr Andrew Huberman, Dr Gabrielle Lyon, Dr Layne Norton, Thomas DeLauer, Shawn Stevenson, Dr. Rocio Salas-Whalen, Saad Alam, Uma Naidoo, Dr. Lanna Cheuck, Angela Lee Pucci, Jillian Turecki, Dr. Jordan Feigenbaum, Dr. Darren Candow, Dr. Sue Varma, Evy Poumpouras, Dr Casey Means, Renee Deehan, Dr Chris Palmer, Dr Charles Brenner.

With Jozine ter Maaten, University Medical Center Groningen, Groningen - the Netherlands, Marta Cobo Marcos, Hospital Puerta de Hierro, Madrid - Spain, Mateusz Sokolski, Wroclaw Medical University, Wroclaw, Poland, Aferdita Spahillari, Duke University Hospital, Durham, NC - USA, Laura Cohen, Massachusets General Hospital, Boston, MA - USA, Antonio Cannata, King's College London, London - United Kingdom & Varun Sundaram, Case Western Reserve University, Cleveland, OH, USA This podcast discusses the results of four late-breaking clinical trials presented at the Heart Failure Congress 2024 in Lisbon, Portugal. First, Dr Cobo Marcos shares the results of the SALT-HF study, a randomised trial investigating the addition of hypertonic saline to diuretics in patients with worsening heart failure. Second, Dr Spahillari and Dr Cohen discuss the main findings and echo substudy of the TEAM-HF trial. Thirdly, Dr Sundaram gives us an insight into the results of the PRAISE-HFpEF trial. The podcast concludes with a brief discussion of some of the HFA Young highlights from the congress. This 2024 HFA CardioTalk podcast series is supported by Novartis in the form of an educational grant. The discussion has not been influenced in any way by its sponsor.

In this episode, Kirk and Amelia speak with Dr. Deepshikha Ashana about her research on racial disparities present in shared decision-making practices in critical care. Dr. Ashana shares how her research interests were motivated by her personal observations of racial disparities, from her childhood in India, her experience moving to the US, and her education in Philadelphia. Her recent research thematically analyzed audio recordings of conversations between families and clinicians of critical care patients, using inductive analysis to identify four ways that communication behaviors differed in clinicians' engagement with racially minoritized families. She discussed the racialized empathy gap, how cultural health capital is received differently from Black versus white families, and the striking disagreements in self-reports of conflict between clinicians and family members that fall along racial lines. She also discussed the importance for critical care clinicians to be trained in trauma-informed practices. In thinking about what is next in her research, she highlighted the importance of finding effective ways to mitigate the effects of structural racism on the healthcare system which go beyond the limitations of implicit bias training, and she emphasized her passion for empowering clinicians to offer the best care possible. Dr. Ashana is an assistant professor of medicine in Duke's Division of Pulmonary and Critical Care and a practitioner in the Duke University Hospital medical intensive care unit and at Duke Health Center at Southpoint. Her research focuses on understanding and addressing mechanisms of differences in critical illness care among underserved patients. She uses mixed methods to study epidemiologic trends in national health claims data and understand patient perspectives on serious illness care, with a particular focus on modifiable clinician and health system factors. Her work can be found here: https://medicine.duke.edu/profile/deepshikha-ashana Referenced articles: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2815259https://www.atsjournals.org/doi/10.1513/AnnalsATS.201909-700IP

Today we're exploring a topic that goes deeper into the realms of medicine and neuroscience, and it's something that affects us all: cognitive health post-surgery. Adam Flowe, Chief CRNA at Duke University Hospital, brings his 20 years of experience and a personal connection to the table, discussing the intricate relationship between anesthesia, surgical stress, and the brain. With the aging population and the rise in surgeries, the question of how these procedures affect our cognitive function is more pressing than ever.   Here's some of what we discuss in this episode: Post-op cognitive dysfunction is underreported and has greater incidence than expected. CRNAs are critical to prevention and optimization as direct care has major impacts (more so than they probably realize). Post-op cognitive decline might be caused by the surgery and not the anesthesia. The science behind post-op cognitive decline is expanding rapidly. Inflammation is a key factor and the blood-brain barrier is also key. Anesthesia has been awesome in improving safety through equipment and work on HARD OUTCOMES; the future of quality for us is in SOFT OUTCOMES.   About our guest: https://anesthesiology.duke.edu/personnel/adam-flowe-crna   Visit us online: https://beyondthemaskpodcast.com/   Get the CE Certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf   Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246   Donate to Our Heart Your Hands here: https://www.ourheartsyourhands.org/donate 

Host Polly Swingle is joined by Dr. Nick Mischel, MD, PhD, and Steve Watts, MOT, OTR/L, CSRS, CBIS, AIB-VR, to discuss Transcranial Magnetic Stimulation (TMS). This procedure is FDA approved to improve symptoms of major depression, obsessive-compulsive disorder (OCD), migraines, and to help people stop smoking when standard treatments haven't worked well. The group also discusses ongoing research on this procedure for other neurological conditions.Dr. Nick Mischel, MD, PhD, is an Assistant Professor of Psychiatry and Behavioral Neuroscience in the Department of Psychiatry at Wayne State University's School of Medicine, which is also where he completed his undergraduate medical training. He specialized in clinical electromagnetic brain stimulation during psychiatric residency training at Duke University Hospital from 2015-2019. He currently practices psychiatry under Wayne Health and Greenbrook TMS, treating adult patients with transcranial magnetic stimulation (TMS) and other interventions for medication-resistant neurobehavioral conditions. He is a leader in the Clinical TMS Society (CTMSS), Fellow in the American Psychiatric Association (FAPA), a proud father, and Michigander.Steve Watts, MOT, OTR/L, CSRS, CBIS, AIB-VR, has worked evaluating and treating individuals with stroke for over 10 years.Learn more about The Recovery Project! View our website at www.therecoveryproject.net Call us 855-877-1944 to become a patient Follow us on Instagram Like us on Facebook Thanks for listening!

About This EpisodeCarolyn Carpenter defines boldness as going beyond our limiting dimensions. She encourages us to push back against self-imposed boundaries and open ourselves to the possibilities that life offers. As President of Johns Hopkins National Capital Region and a mother of two, she discusses how this boldness manifests in both our personal and professional journeys. Carolyn encourages us to not allow the limitations we put on ourselves to restrict our potential to live authentically. It's not only about managing our energy, but about letting go of fear and anxiety and embracing optimism as well. Carolyn also describes how to recognize patterns of opportunity and tap into our creative intelligence.  About Carolyn CarpenterCarolyn Carpenter serves as President of Johns Hopkins National Capital Region (NCR), where she leads all hospital-based and community-based ambulatory sites across the National Capital Region on behalf of Johns Hopkins Medicine (JHM), including Sibley Memorial Hospital and Suburban Hospital. Prior to joining Johns Hopkins, Ms. Carpenter served as the President of Sentara Norfolk General Hospital and Corporate Vice President of Sentara Healthcare. Ms. Carpenter joined Sentara after twenty years of progressive leadership responsibility at Duke Health. During that time, she served in a variety of capacities including Chief Operating Officer of 900+-bed Duke University Hospital, Associate Dean of the Duke School of Medicine, Associate Vice President of Oncology Services for the Duke Health System, and Associate Chief Operating Officer for Medical/Surgical/Critical Care Services. Ms. Carpenter received her B.A. at the University of Pennsylvania and her MHA from Medical College of Virginia. She completed an administrative fellowship at Duke. She is a Fellow of the American College of Healthcare Executives and was an Adjunct Assistant Professor at the University of North Carolina at Chapel Hill School of Public Health. In 2016-7, Ms. Carpenter was among the inaugural class of Carol Emmott Fellows, a select fellowship for women leaders aimed at empowering female health executives to bridge the gender gap in the C-suite and transform health care. Additional ResourcesLinkedIn: @CarolynCarpenter

Our guest this time is Tiff Cagle, MD, CSC. Dr. Cagle is a board-certified family medicine physician, sex educator, sex counselor, and certified coach from Durham, North Carolina. She is the founder of Sensate Health, a virtual clinic providing medical consultations for sexual concerns at sensatehealthnc.com. She received her medical degree from UNC, where she first discovered her passion for sex-positivity while providing HIV testing and counseling. She went on to complete her residency training at Duke University Hospital with a concentration in Law, Ethics, and Health Policy, and she now holds a consulting position providing resident education in Duke's Department of Community and Family Medicine. She chose to specialize in family medicine because of her desire to provide care through the lens of each person's mind, body, relationships, and community, and she's delighted to bring this holistic approach to her work in sexual health. If you're interested in Dr. Tiff Cagle's information on how to avoid getting an STI, check out her blog and if you'd like to book an appointment with her, click here. And if you want to catch up on other shows, just visit our website and please subscribe! We love our listeners and welcome your feedback, so if you love Our Better Half, please give us a 5-star rating and follow us on Facebook and Instagram. It really helps support our show! As always, thanks for listening!  

In this episode of The Intimate Marriage Podcast, Alexandra Stockwell, MD, is joined by Dr. Tiff Cagle, a board-certified family medicine physician, sex educator, and coach. Dr. Cagle talks about her passion for providing care through the lens of a person's mind, body, intimacy, relationships, and community. Dr. Cagle also shares her experience in decreasing stigma around sex and providing HIV testing and counseling. Dr. Cagle discusses sexual concerns including erectile dysfunction, premature ejaculation, orgasm difficulties, desire discrepancies, and living with sexually transmitted infections. She also provides tips on how to manage herpes in a committed relationship and describes the start-stop method for overcoming premature ejaculation. Dr. Cagle emphasizes the importance of clarifying expectations and refining perceptions when navigating sexual concerns. Also in this episode:  The importance of mentorship and sexual health How to deal with sexual health concerns like Herpes Treating premature ejaculation and discussing it with your partner The three principles of sensate focus in sex therapy The importance of undressing yourself when being intimate How partners can start touching one another The first three phases of sexual exploration   About Dr. Tiff Cagle Tiff Cagle, MD (she/they/Dr.) is a board-certified family medicine physician, sex educator, and certified coach from Durham, North Carolina. Like many others, she grew up in an environment where conversations about sex were rare and almost always centered around shame. Through challenging the sex-negative attitudes she was taught, she developed a passion for helping others feel empowered to embrace their authentic self. Dr. Cagle chose to specialize in family medicine because of her desire to provide care through the lens of each person's mind, body, relationships, and community. After years of traditional medical practice, she's now bringing this holistic approach to her work in sexual health. She received her medical degree from the University of North Carolina at Chapel Hill School of Medicine, where she first discovered her passion for decreasing stigma around sex while providing HIV testing and counseling. She went on to complete her residency training at Duke University Hospital with a concentration in Law, Ethics, and Health Policy, and now holds a consulting position in Duke's Department of Community and Family Medicine providing resident lectures and mentorship.   Contact Dr. Tiff Cagle Website: https://sensatehealthnc.com/   Subscribe To The Intimate Marriage Podcast: Apple Podcast | YouTube | Spotify Connect With Alexandra Stockwell, MD: Website | Linkedin | Instagram   Download the first chapter of Dr. Alexandra's bestselling book, “Uncompromising Intimacy,” here: https://www.alexandrastockwell.com/book Cultivate your intimacy skills (without compromise) in Aligned & Hot Marriage, Dr. Alexandra's proven method for smart couples ready to love more fully. www.alignedhotmarriage.com Join my email list to stay connected–it's where I share my latest insights and offer opportunities for live Q & A. https://www.alexandrastockwell.com/subscribe   About Alexandra Stockwell, MD Known as “The Intimacy Doctor,” Alexandra Stockwell, MD is a Relationship and Intimacy Coach and an Intimate Marriage Expert who specializes in coaching ambitious, successful couples to build beautiful, long-lasting, passionate relationships. She is the bestselling author of “Uncompromising Intimacy,” host of The Intimate Marriage Podcast and creator of the Aligned & Hot Marriage program.  For over two decades, she's been guiding men and women to bring pleasure and purpose into all aspects of life— from the daily grind of running a household to creating ecstatic experiences in the bedroom—all while maintaining extraordinary professional success!  

In this episode of The Intimate Marriage Podcast, Alexandra Stockwell, MD, is joined by Dr. Tiff Cagle, a board-certified family medicine physician, sex educator, and coach. Dr. Cagle talks about her passion for providing care through the lens of a person's mind, body, intimacy, relationships, and community. Dr. Cagle also shares her experience in decreasing stigma around sex and providing HIV testing and counseling. Dr. Cagle discusses sexual concerns including erectile dysfunction, premature ejaculation, orgasm difficulties, desire discrepancies, and living with sexually transmitted infections. She also provides tips on how to manage herpes in a committed relationship and describes the start-stop method for overcoming premature ejaculation. Dr. Cagle emphasizes the importance of clarifying expectations and refining perceptions when navigating sexual concerns. Also in this episode:  The importance of mentorship and sexual health How to deal with sexual health concerns like Herpes Treating premature ejaculation and discussing it with your partner The three principles of sensate focus in sex therapy The importance of undressing yourself when being intimate How partners can start touching one another The first three phases of sexual exploration   About Dr. Tiff Cagle Tiff Cagle, MD (she/they/Dr.) is a board-certified family medicine physician, sex educator, and certified coach from Durham, North Carolina. Like many others, she grew up in an environment where conversations about sex were rare and almost always centered around shame. Through challenging the sex-negative attitudes she was taught, she developed a passion for helping others feel empowered to embrace their authentic self. Dr. Cagle chose to specialize in family medicine because of her desire to provide care through the lens of each person's mind, body, relationships, and community. After years of traditional medical practice, she's now bringing this holistic approach to her work in sexual health. She received her medical degree from the University of North Carolina at Chapel Hill School of Medicine, where she first discovered her passion for decreasing stigma around sex while providing HIV testing and counseling. She went on to complete her residency training at Duke University Hospital with a concentration in Law, Ethics, and Health Policy, and now holds a consulting position in Duke's Department of Community and Family Medicine providing resident lectures and mentorship.   Contact Dr. Tiff Cagle Website: https://sensatehealthnc.com/   Download the first chapter of Dr. Alexandra's bestselling book, “Uncompromising Intimacy,” here: https://www.alexandrastockwell.com/book Cultivate your intimacy skills (without compromise) in Aligned & Hot Marriage, Dr. Alexandra's proven method for smart couples ready to love more fully. www.alignedhotmarriage.com Join my email list to stay connected–it's where I share my latest insights and offer opportunities for live Q & A. https://www.alexandrastockwell.com/subscribe Subscribe To The Intimate Marriage Podcast: Apple Podcast | YouTube | Spotify Connect With Alexandra Stockwell, MD: Website | Linkedin | Instagram     About Alexandra Stockwell, MD Known as “The Intimacy Doctor,” Alexandra Stockwell, MD is a Relationship and Intimacy Coach and an Intimate Marriage Expert who specializes in coaching ambitious, successful couples to build beautiful, long-lasting, passionate relationships. She is the bestselling author of “Uncompromising Intimacy,” host of The Intimate Marriage Podcast and creator of the Aligned & Hot Marriage program.  For over two decades, she's been guiding men and women to bring pleasure and purpose into all aspects of life— from the daily grind of running a household to creating ecstatic experiences in the bedroom—all while maintaining extraordinary professional success!  

In this episode, the team from the Duke University Hospital discuss their award-winning submission to the ASHP Best Practices. They will share how establishing a pharmacy technician training program provides a mechanism to ensure continuity and uniformity as health care continues to evolve. By providing a source of well-trained pharmacy technicians, the program allows the profession to continue to achieve its overarching aims.  The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

On this week's episode, Carmen and Jovin interviewed Dr. Micaela Hayes who is a PGY-2 Ambulatory Care Pharmacy Resident at Duke University Hospital. Also, Dr. Hayes is a social media influencer (@thefaithfulpharmd) who produces content to help individuals with the residency process. Please tune in to this episode to learn about her journey, how she handled imposter syndrome, and how she was able to develop faith in the process to get where she is today!  Please feel free to connect and follow Dr. Micaela Hayes on LinkedIn or Instagram (@thefaithfulpharmd). If you have any questions or would like to reach out to her directly, please feel free to email her at micaela@faithfulpharmd.com. Resources talked about during this episode:  - The Success Principles by Jack Canfield (book) - Search for Tony Guerra content for great job interview and residency tips If you are interested in any of our career services or want to learn more about them, please feel free to message me directly on LinkedIn or IG (@new_capsulerxpodcast) or you can check out the interest form below at tinyurl.com/capsulerxservices.

Episode Notes This episode features Dr. Shaefer Spires, DASON Medical Director, and Dr. Ethan Brenneman, PGY2 Infectious Diseases Pharmacy Resident for Duke University Hospital. The documents reviewed in this episode are: https://duke.box.com/s/7zvupbr81euvcujzq20jbpbj0yuqnafy and https://duke.box.com/s/738zmcuz4voh2urm1j0o3v2i540ziczp For more information about DASON, please visit: https://dason.medicine.duke.edu Find out more at https://dason-digest.pinecast.co

This week, please join author Xuerong Wen, Associate Editor Sandeep Das, and Guest Host Mercedes Carnethon as they discuss the article "Comparative Effectiveness and Safety of Direct Oral Anticoagulants and Warfarin in Patients With Atrial Fibrillation and Chronic Liver Disease: A Nationwide Cohort Study." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass of the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, associate editor, Director of the Poly Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Greg, I'm so excited about today's feature paper. It deals with the important condition where atrial fibrillation exists in patients with chronic liver disease and what do we do for anticoagulation in these patients. It's a comparative effectiveness and safety study of direct oral anticoagulants compared with warfarin in these patients. A huge, wonderful, important study that we're going to discuss. But before we get there, I'd like to tell you about some papers in this issue and I'd like you to tell me about some too. You got your coffee? Dr. Greg Hundley: Absolutely. Dr. Carolyn Lam: All right. I'll go first In this paper that describes a quantitative prognostic tool for the mitral valve prolapse spectrum and it's derived from the new mitral regurgitation international database quantitative or MIDA-Q registry, which enrolled more than 8,000 consecutive patients from North America, Europe, Middle East. And these were patients all diagnosed with isolated mitral valve prolapse or MVP in routine clinical practice of academic centers, all of which also did prospective degenerative mitral regurgitation quantification. The MIDA-Q score was calculated based on characteristics collected in routine practice combining the established MIDA score, which integrated guideline based markers of outcomes like age, New York Heart Association status, atrial fibrillation, LA size, pulmonary artery pressure left ventricular and systolic, I mentioned, and ejection fraction. Integrating that with scoring points based on the degenerative mitral regurgitation quantitation that is measuring effective regurgitant orifice and volume. Dr. Greg Hundley: Very interesting Carolyn. So a scoring system that combines clinical information with what we might assess with echocardiography like regurgitant volume or regurgitant orifice area. So how well did this mortality risk score perform? Dr. Carolyn Lam: So the new score was associated with an extreme range of predicted survival under medical management and that ranged from 97% to 5% at five years for the extreme score ranges. And it was strongly, independently and incrementally associated with long-term survival over all the markers of outcomes. So the authors concluded, and these by the way were authors led by Dr. Maurice Serrano from Mayo Clinic, Rochester, Minnesota. These authors concluded that the score should allow integrated risk assessment of patients with mitral valve prolapse to refine clinical decision making in routine practice and ultimately reduce degenerative mitral regurgitation under treatment. Dr. Greg Hundley: Wonderful description Carolyn. Well I'm going to switch to the world of electrophysiology, Carolyn. And so as you know, the Brugada syndrome is an inherited arrhythmia syndrome caused by loss of function variants in the cardiac sodium channel gene SCN5A and that occurs in about 20% of subjects. And these authors led by Dr. Dan Roden at Vanderbilt University School of Medicine identified a family with four individuals diagnosed with Brugada syndrome, harboring a rare missense variant in the cardiac transcription factor, TBX5, but no SCN5A variant. And upon identifying these individuals, their objective was to establish TBX5 as a causative gene in Brugada syndrome and to define the underlying mechanisms by which it would be operative. Dr. Carolyn Lam: Oh wow. So a new gene variant. So what was the relationship? Dr. Greg Hundley: Right Carolyn? So using induced pluripotent stem cell derived cardiomyocytes from members of the affected family, multiple electrophysiologic abnormalities were detected in these cardiomyocytes including decreased peak and enhanced late cardiac sodium current. In these cells these abnormalities were entirely corrected by CRISPR/Cas9 mediated editing of that TBX5 variant and transcriptional profiling and functional assays in unedited and edited pluripotent stem cell derived cardiomyocytes showed direct SCN5A down regulation caused decreased peak sodium current and that reduced PDGF receptor expression and blunted signal transduction to phosphoinositide-3-kinase. And interestingly, PDGF receptor blockade markedly prolonged normal induced pluripotent stem cell derived cardiomyocyte action potentials. And also Carolyn interestingly in this study they did a separate analysis. It reviewed plasma levels of PDGF in the Framingham Heart Study and they found that they were inversely correlated with the QT corrected interval. And so Carolyn, these results established decrease SCN5A transcription by the TBX5 variant as a cause of Brugada syndrome and also reveal a new general transcriptional mechanism of arrhythmogenesis of enhanced late sodium current caused by reduced PDGF receptor mediated phosphoinositide-3-kinase signaling. Dr. Carolyn Lam: Wow. Wow, that's significant. Thanks Greg. So this next paper is also really important and could change the practice in the field of cardiac resynchronization therapy or CRT. You see, it suggests that the practice of what we do now, which is combining right bundle branch block with intraventricular conduction delay patients into a single non-left bundle branch block category when we select patients for CRT, that this may not be the way to go. So let's go back a bit and remember that benefit from CRT varies with QRS characteristics and individual trials are actually underpowered to assess the benefit for relatively small subgroups. So the current authors led by Dr. Friedman from Duke University Hospital and colleagues, therefore performed a patient level meta-analysis of randomized trials of CRT to assess the relationship between QRS duration and morphology with outcomes. Dr. Greg Hundley: Very interesting Carolyn. So another wonderful paper from the world of electrophysiology in trying to understand optimal mechanisms to resynchronize the ventricle in patients with differing bundle branch blocks or intraventricular conduction delays. So what did they find? Dr. Carolyn Lam: They found that patients with intraventricular conduction delays and a QRS duration of 150 milliseconds or more, CRT was associated with lower rates of heart failure hospitalizations and all cause mortality. The magnitude of CRT benefit among these patients with the interventricular conduction delay of 150 milliseconds or more and those with the left bundle branch block of 150 milliseconds or more were similar. In contrast, there was no clear CRT benefit for patients with a right bundle branch block of any QRS duration, although the authors could not rule out the potential for benefit at a markedly prolonged QRS duration. So they concluded that the practice of combining right bundle branch block with intraventricular conduction delay patients into a single non-left bundle branch block category when we make patient selections for CRT is not supported by the current data. And in fact, patients with an intraventricular conduction delay of 150 milliseconds or more should be offered CRT as is done for patients with a left bundle branch block of 150 milliseconds or more. Dr. Greg Hundley: Wow, Carolyn, so really interesting point. No clear CRT benefit for patients with right bundle branch block regardless of the QRS duration. Well we've got some other articles in the issue. I'll describe a couple from the mail bag. There's a Research Letter from Professor Lassen entitled "Risk of Incident Thromboembolic and Ischemic Events Following COVID-19 Vaccination Compared with SARS-COV2 Infection." Also Bridget Kuhn has a wonderful Cardiology News piece entitled "Collaborative Care Model Helps Heart Failure Patients Meet End-of-Life Goals." Dr. Carolyn Lam: There's an exchange of letters between Doctors Donzelli and Hippisley-Cox regarding that risk of myocarditis after sequential doses of COVID-19 vaccine, there's an AHA Update by Dr. Churchwell on continuous Medicaid eligibility, the lessons from the pandemic. There's an On My Mind paper by Dr. Parkhomenko on Russia's war in Ukraine and cardiovascular healthcare. Wow, what an issue. Thanks so much, Greg. Shall we go on to the feature discussion? Dr. Greg Hundley: You bet. Dr. Mercedes Carnethon: Well welcome to this episode of Circulation on the Run podcast. I'm Mercedes Carnethon, associate editor of the journal Circulation and Professor and Vice Chair of Preventive Medicine at the Northwestern University Feinberg School of Medicine. I'm very excited to be here today with Xuerong Wen and Sandeep Das, my fellow associate editor here at Circulation to talk about a wonderful piece by Dr. Wen and colleagues from the University of Rhode Island. So welcome this morning Xuerong and thank you so much for sharing your important work with us. Dr. Xuerong Wen: Thank you Dr. Carnethon. It was great meeting you all and I'm the Associate Professor of Pharmacoepidemiology and Health Outcomes at the University of Rhode Island. I'm happy to introduce my study to everyone. Dr. Mercedes Carnethon: Well thank you so much and thank you as well Sandeep for identifying this fantastic article and bringing it forth. Dr. Sandeep Das: Thanks Mercedes. It's great to be with you. Dr. Mercedes Carnethon: Great. Well let's go ahead and get into it. There's so much here to talk about. So Dr. Wen and colleagues studied the comparative effectiveness and safety of direct oral anticoagulants or DOACs and warfarin in patients with atrial fibrillation and chronic liver disease. So this is such an important topic. Can you tell us a little bit about what your study found? Dr. Xuerong Wen: So our study is a comparative effectiveness and the safety analysis using a national health administrative data from private health plans. So we compared the risk of hospitalized ischemic stroke, systemic embolism and major bleeding between DOACs and warfarin in patients with atrial fibrillation and chronic liver disease. So we also had to had compare to these primary outcomes between apixaban and rivaroxaban in the study population. So our studies show that among patients with atrial fibrillation and chronic liver disease, DOACs as a class was associated with lower risk of hospitalization of ischemic stroke and systemic embolism and major bleeding, compared with warfarin. And when compared risk outcomes between individuals apixaban has lower risks as compared to rivaroxaban. So that's our study results. Dr. Mercedes Carnethon: Well thank you so much. This seems like such an important question. We hear a lot about DOACs and some of their risks as well as their considerable benefits. I think what leaves me the most curious is why did you choose to pursue this question and in particular in patients with both atrial fibrillation and liver disease. So why was the intersection of these two particular conditions of interest to your study team? Dr. Xuerong Wen: That's a great question. So the liver actually plays a central role in both the synthesis of coagulation factors and the metabolism of anticoagulant drugs. And the clearance of the anticoagulants in liver ranges from 20% to 100% for DOACs and warfarin. So in clinical practice anticoagulation abnormalities and elevated risk of spontaneous or unprovoked venous thrombotic complications have been reported in patients with liver disease. While these patients with cirrhosis were excluded from the clinical trials of DOACs and also population based, the real world experience is very limited. So that is why we initiated this retrospective cohort study and based on the real world data in this specific population. Dr. Mercedes Carnethon: Oh, thank you so much for explaining that. I definitely learned a lot and really enjoyed reading the piece. I think it was very well organized and well written and I know that our readership will appreciate it. It obviously stood out to you as well, Sandeep. Can you tell me a little bit about why you thought that this would be an excellent piece for circulation? Dr. Sandeep Das: Yeah, absolutely. Thanks for the question. So in the broad field of what we call observational comparative effectiveness research, so basically that's using large observational data sets to try to answer important clinical questions and it's a really challenging thing to do. I mean we're all very familiar with the idea of using randomized trials to assess important clinical questions because of the structure of that design allows you to mitigate some of the effects of confounding. Here, it has to be done analytically. So what's the important factor that really drives you towards a great observational comparative effectiveness piece? So first the clinical importance. I feel a little guilty because I'm old enough to remember when warfarin was the only option available, but really as a clinician, or every patient, I really prefer DOACs over warfarin just for ease of use and lifestyle. So there's a huge sort of importance to the question. Second, the patients with chronic liver disease were excluded from the larger RCTs and the DOAC trials. So really we don't have the answer to the question already. It's an important question. Obviously the bleeding risk is tied up with the liver, warfarin directly antagonizes vitamin K, so there's real questions about safety and so this is the perfect storm and then on top of it was a really well done and well executed study. So when this came across my desk, the very first thing I thought was not, "Is this something that we're interested?" But rather, "How do we make it better? How do we make it more useful to the reader?" This had me from hello. Dr. Mercedes Carnethon: Well thanks so much. We rarely have the opportunity when we read an article to be able to ask the authors questions. So Sandeep, I know that you had mentioned that you had some follow up questions as well. Dr. Sandeep Das: Yeah. So the real thought that I have then is would you argue based on this that we know enough that we should change our practice? And that do you feel comfortable advocating that people now prescribe DOACs to these patients? Dr. Xuerong Wen: I would say yes. Okay. Although this is not a clinical trial, but our study is actually systematically compare the effectiveness and safety between DOAC users and also the warfarin users. And if you look at our table one, we compare with so many variables between these two users and we use the propensity score adjustment and we after propensity score weighting and the two control group almost balanced. And I know right now FDA actually suggested that emulate the trial using the large real world data to do the emulated trial. So our study actually conducted is based on the large population using large data and we use the propensity score weighting to control all this potential compounding factors. Although there are still some limitations in this study. I think we mentioned that in the discussion section and we discussed all potential compounding factors that still may exist. And also there are some misclassifications and out of all this limitations and we still found the two drugs performed differently in this specific population. So we feel that comfortable to say that a DOAC drug performs better than warfarin. And also I think based on other studies that based on the clinical trial in the general population, DOAC drug is performs much better than warfarin and considering that the clearance in liver for DOAC is less than warfarin. So plus all this information together, I think DOAC may be safer than wafarin in the patients with AF and chronic liver disease. Dr. Sandeep Das: Yeah, I would say that I agree that these data, even if you're skeptical about observational CT generally, which I admit that I tend to be, these are really reassuring data that at least the DOACs are... There's absolutely nothing that suggests that they're any worse than warfarin and all of the sort of soft indications for ease of use and patient happiness really would seem to favor DOACs. So I think this is the sort of rare observational CT paper that may actually change my practice. Dr. Mercedes Carnethon: I have a follow-up question, Xuerong, related to the design and as well your strategy to address differences between the groups. So inverse probability weighting is certainly a standard in the field to be able to manage differences between groups when you have a situation where can't, where it's not a randomized trial. Do you as well, and educate me, I admit I'm an epidemiologist whose methodological skills are sometimes challenged. Do you have the opportunity using this design and with inverse probability weighting to evaluate subgroup effects? So my specific question is were you able to determine whether or not these associations were similar based on age and gender in particular? Dr. Xuerong Wen: That's a great question. We did conducted a lot of subgroup study but not by age or gender. We conducted I think this study in a lot of subgroups using the propensity score weighting, but the subgroup that I think we did a subgroup like a patient with a different chronic liver disease. So that's what we did. And we also tested different methods inverse probability score weighting. So we did trimming and we used a different percentage of trimming and to see how that affect the study results. So we have done a lot of subgroup studies. We did not check the age and the gender, but that's a very good point. Maybe later, well I'll ask my student to do that. Dr. Mercedes Carnethon: Well, you're a good mentor. So I think that is a really certainly an appropriate approach. Sandeep, did you have additional questions? Dr. Sandeep Das: No, I wish I had thought of yours before you did. I think exactly the older age, women, racial ethnic groups that are underrepresented historically in trials. I think that that's really, again, the sweet spot of this observational research. We definitely, and NH definitely working on trying to increase enrollment of all these groups in our CTs. However, while we wait for that, I think that's exactly what we should be doing. Dr. Mercedes Carnethon: Well that's great. And Xuerong, you really alluded to really, I think what is one of my final questions related to what do you think based on what you have observed in this study, what do you see as the next steps in the research field for your team, your students, or other people who are carrying out this type of work? Dr. Xuerong Wen: Well, that's a great question. We currently have a couple of more manuscripts ongoing in this field, and we will continue conducting the comparative effectiveness and analysis to compare drugs head to head as well as developing and implementing new methodologies to this field. And we hope our study provides real world evidence for clinical decision making, prescribing anticoagulants to patients with atrial fibrillation and chronic liver disease. We also expect the physicians and researchers more and more value the real world data studies, especially when clinical trials are not feasible or ethical. Dr. Mercedes Carnethon: Well, thank you so much. That was such an excellent vision that you provided us with and we're just very grateful that you submitted this fantastic work to the journal Circulation. I know that our readers will enjoy really digging in. The podcast is meant as a teaser to bring you to the journal so that you can read about this wonderful work by Dr. Wen and colleagues. So again, thank you. I'm Mercedes Carnethon, joined with my associate editor partner here, Dr. Sandeep Das. And thank you very much for spending your time with us today, Dr. Wen. Dr. Xuerong Wen: Thanks for this great opportunity to disseminate my study with us, thank you. Dr. Sandeep Das: Thanks Mercedes. Dr. Mercedes Carnethon: Thank you for joining us for this episode of Circulation on the Run. Dr. Greg Hundley: This program is copyright of the American Heart Association 2023. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Some perspective on the cybercriminal labor market. DocuSign is impersonated in a credential-harvesting campaign. Social engineering pursues financial advisors. Killnet is active against the US healthcare sector. Mr. Security Answer Person John Pescatore has thoughts on cryptocurrency. Ben Yelin and I debate the limits of section 230. And, hey, who's the real victim in cyberspace? A hint: probably not you, Mr. Putin. For links to all of today's stories check out our CyberWire daily news briefing: https://thecyberwire.com/newsletters/daily-briefing/12/20 Selected reading. Perspectives on the cybercriminal labor market. (CyberWire). IT specialists search and recruitment on the dark web (Securelist) Cybercrime job ads on the dark web pay up to $20k per month (BleepingComputer)  Report on hackers' salaries shows poor wages for developers (Register) Cybercrime groups offer six-figure salaries, bonuses, paid time off to attract talent on dark web (CyberScoop) Application security risks. (CyberWire) Survey gives insight into new app security challenges (Cisco App Dynamics) DocuSign impersonated in credential phishing attack. (CyberWIre) Breaking the Impersonation: Armorblox Stops DocuSign Attack (Armorblox) "Pig butchering" and financial advisor impersonation scams. (CyberWire) No Blocking, No Issue: The Curious Ecosystem of Financial Advisor Impersonation Scams (Domain Tools) Ukraine at D+341: Killnet hits US hospitals.(CyberWire) HC3 TLP Clear Analyst Note: Pro-Russian Hacktivist Group Threat to HPH Sector (American Hospital Association) HHS, AHA Warn of Surge in Russian DDoS Attacks on Hospitals (Gov Info Security)  Russian hackers allegedly take down Duke University Hospital's website (Carolina Journal) The Evolution of DDoS: Return of the Hacktivist (FSISAC) Russia becomes target of West's coordinated aggression in cyberspace — MFA (TASS)

Episode 109 features Lee and Christine Hicks. They are the parents of Yulia Hicks who is the little 14 year old girl in NC who was denied a kidney transplant at Duke University Hospital because of her vaccine status.Yulia, a Ukrainian rescued refugee, was adopted by Lee and Christine Hicks at a time when Yulia's condition was known. Her new parents knowingly took on this life-saving challenge and solicited a partnership with Duke University Hospital based on the trust built through community PR. For two years they walk out every step to insure Yulia would properly receive a transplanted kidney. Alas, Duke denied the final step citing vaccine status. Yulia's kidneys are in terminal failure and the risk of the injection is too high.As Dr. Jeff Barke and Dr. Mark McDonald dive into this story you'll learn just how deep this Mass Delusional Psychosis goes in our nation and you'll learn how you can help Yulia. Listen and watch now to discover shore up your very own informed dissent.For more information visit yuliagrace.com or donate a givesendgo.com/kidneyforyuliaSupport the showFor more Informed Dissent visit our website at Informed Dissent Media

The parents of a 14-year-old girl who suffers from a rare degenerative kidney condition, say Duke University Hospital in Durham, North Carolina, denied their daughter a life-saving kidney transplant because she didn't get the COVID-19 shot.A retired Navy SEAL who announced almost a decade ago that he wanted to change his sex has revealed that he is now detransitioning.A conservative law firm has speculated that if the Respect for Marriage Act is signed into law by President Joe Biden, it could actually lead to the United States Supreme Court overturning its earlier ruling legalizing gay marriage nationwide.Christianity is not an "intolerant" religion because being theologically correct is not the same as being intolerant, an apologist contends.Subscribe to this Podcast Apple Podcasts Spotify Google Podcasts Overcast Subscribe to Generation Indoctrination Apple Podcasts Spotify Google Podcasts Get the Edifi App Download for iPhone Download for Android Subscribe to Our Newsletter Subscribe to the Freedom Post, delivered every Monday and Thursday Click here to get the top headlines delivered to your inbox every morning! Links to the News Child denied kidney transplant, hasn't had COVID-19 shot | U.S. News American Girl author cites doctor who promotes puberty blockers | U.S. News The doctor behind American Girl's puberty blocker push American Girl wants to trans your daughter Detransitioning Navy SEAL says transition 'destroyed my life' | U.S. News How the Respect for Marriage Act may backfire on LGBT activists | Politics News Nonbinary Biden admin. official charged again for luggage theft | Politics News Christianity isn't intolerant because it's true: apologist | Living News Four couples genetically tied to baby after IVF mix-up | World News

It is with a heavy heart that we replay this podcast this week, as we lost a truly great family man, leader, and mentor in the space of coaching, leadership and human development, Dr. Greg Dale. He was only 60 years old and left us far too soon, with so much more to give. He was a massive supporter of this podcast, Way of Champions, Changing the Game Project, and many others in the field of sport psychology and leadership. Who was Greg? In July of 2018, Dale was named to the newly-created Integrative Performance Excellence Group at Duke University, a unit comprised of directors in the areas of Sports Performance, Athletic Medicine, Sports Nutrition and Behavioral Health, as well as individuals representing psychological services, team physicians and primary care physicians.  He was the Director of Sports Psychology and Leadership. The goal of this working group is to enhance the experience of Duke student-athletes by providing an integrative approach to the care of each individual athlete throughout his or her collegiate career while continuing to cultivate partnerships with the Duke University Hospital, Duke Sports Science Institute, Duke Student Health and Duke Counseling and Psychological Services (CAPS) as part of its holistic approach to student-athlete health.  Dale wrote four books on leadership, coaching, parenting and performance and served as a consultant to numerous athletic and corporate organizations around the world. But more than that, he was a friend, mentor, and a kind soul who always lent a helping hand to those trying to change the game. We will miss you Greg. Highlights from the Podcast: – Teaching “sports athletics” at the university level – Are sports fundamentally good? – Coaches responding to sports during a pandemic – Servant Leadership – What is the essence of coaching? – Learning to coach by spending time with coaches from other sports – How do “one-and-done” athletes effect the culture of a university-level team? – C.U.L.T. Athletics (Connection, Ultimate caring, Love, Trust), a Jerry-ism made up on the spot – How can we build stronger connections with our athletes? – Growing from an assistant coach to a head coach BIG NEWS: Save the date, the 2023 Way of Champions Conference will be held August 4-6, 2023 at Colorado Academy in Denver, CO. Click here to learn more, registration will open January 1, and we will be announcing guest speakers and other conference related events soon. Its going to be amazing to be back in person in 2023!  This week's podcast is brought to you by our friends at Sprocket Sports.  Sprocket Sports is a new software platform for youth sports clubs.  There are a lot of these systems out there, but Sprocket provides the full enchilada. They give you all the cool front-end stuff to make your club look good– like websites and marketing tools – AND all the back-end transactions and services to run your business better so you can focus on what really matters – your players and your teams.  Sprocket is built for those clubs looking to thrive, not just survive, in the competitive world of youth sports clubs.  So if you've been looking for a true business partner – not just another app – check them out today at https://sprocketsports.me/CTG. Become a Podcast Champion! This weeks podcast is also sponsored by our Patreon Podcast Champions. Help Support the Podcast and get FREE access to our most popular online courses, a $300 value. If you love the podcast, we would love for you to become a Podcast Champion, (https://www.patreon.com/wayofchampions) for as little as a cup of coffee per month (OK, its a Venti Mocha), to help us up the ante and provide even better interviews, better sound, and an overall enhanced experience. Plus, as a $10 per month Podcast Super-Champion, you will have access to never before released and bonus material, including: Downloadable transcripts of our best podcasts, so you don't have to crash your car trying to take notes! A code to get free access to our online course called “Coaching Mastery,” usually a $97 course, plus four other courses worth over $100, all yours for free for becoming a patron. Other special bonus opportunities that come up time to time Access to an online community of coaches like you who are dedicated listeners of the podcast, and will be able to answer your questions and share their coaching experiences. Thank you for all your support these past four years, and a special big thank you to all of you who become part of our inner circle, our patrons, who will enable us to take our podcast to the next level. https://www.patreon.com/wayofchampions

This special podcast is part of the Ostomy Observations Series, a brand-new 6-part series that is included in the "Educating Today for Exceptional Outcomes Tomorrow" Program and is commercially supported through an educational grant from Hollister Incorporated.On this month's episode we sit down with Michelle Rice, MSN, RN, CWOCN to speak about the topic, “Do It Myself - Promoting Independence in Pediatric Ostomy Care”Michelle Rice, MSN, RN, CWOCN, has been a WOC nurse since 1999 and currently practices at Duke University Hospital. Michelle's primary population is pediatrics and focuses on wound care and ostomy care.This podcast is part of the OstomyObservations Podcast Series, a brand-new 6-part series that is included in the "Educating Today for Exceptional Outcomes Tomorrow" Program. Both the podcast series and the Educating Today for Exceptional Outcomes Tomorrow Program are commercially supported through an educational grant from Hollister Incorporated. For additional information, please visit: wocn.org/exceptionaloutcomes. The WOCN® Society does not endorse or support products or services.

Celebrating 5 years of TopMedTalk at 'Anesthesiology'; the Annual General Meeting of the American Society of Anesthesiologists (ASA). This piece is presented by Desiree Chappell and Monty Mythen with their guests JW Beard, Chief Medical Officer of GE Patient Care solutions, GE Healthcare, Eric Ruedinger, General Manager for Anesthesia and Respiratory Care, Patient Care Solutions, GE Healthcare and Guy Dear, Pediatric Anesthesiologist at Duke University Hospital. TopMedTalk is very proud to be partnered with the American Society of Anesthesiologists® at ANESTHESIOLOGY® 2022. Now in our fifth year TopMedTalk is bringing you our most comprehensive and extensive coverage of the largest gathering of anesthesiologists in the world! This audio is presented to you "as live" - if you'd like to see our coverage as it happens go now to: https://live.topmedtalk.com/ TopMedTalk is provided to you for free; if you want to help support our work and help give these conversations a wider audience please like and subscribe (if and where possible) before sharing it on your social media. TopMedTalk can be found on YouTube here: https://www.youtube.com/channel/UC-HYQmeIwcFCYO1hoQ8jShQ We are on Twitter here: https://twitter.com/topmedtalk We are on LinkedIn here: https://www.linkedin.com/company/topmedtalk We are on Facebook here: https://www.facebook.com/TopMedTalk1/

This episode is brought to you by Provider Solutions and Development, the leaders in physician and APC recruitment that deliver top-tier candidates for the right roles. Visit info.PSDconnect.org/outcomesrocket to start the conversation today, and get tailored support, dedicated recruitment, and efforts that lead to provider retention and longevity. Welcome to the weekly summary of what happened this week in the Outcomes Rocket Network! We got incredible episodes, and here's what we got: On our main channel, the Outcomes Rocket Podcast, Saul had Jason Hannon, executive director, and CEO at Mainstay Medical, talk about ReActiv8, a new groundbreaking therapy approach to help patients with back pain. Listen to it here: bit.ly/JasonHannon For Marketing Mondays, Andreea Borcea interviewed Brian Maurer, co-founder of Bristle Health. They talked about how Bristle makes oral microbiome tests to facilitate taking care of your own oral health, highlighting its importance, and why it's been a marketing challenge for them. Tune in to that episode here: http://bit.ly/MM-BrianMaurer The SONSIEL Podcast, welcomed Andrea Jaramillo, a hospice nurse, forest therapy guide, and nurse farmer. In this episode, they discussed finding what nursing means to you and designing a career that is sustainable for yourself and that makes you happy. Listen here: https://lnkd.in/gRzF2vyC The Sempre Health Podcast, hosted by Kyle Wildnauer-Haigney, had Bharti Rai, Vice President of Commercial Excellence, Insights, and Analytics at Novartis. They talked about how pharma as an industry has got to look at healthcare as a whole as opposed to medication only. Tune in to listen here: bit.ly/SEMPRE-BhartiRai On the Future of Global Informatics, host TJ Southern, interviewed Madeline Stadler, a nurse at Duke University Hospital. Madeline reflected on her education and highlights the importance of knowledge application and practice in the field. Listen to it here: https://lnkd.in/dQvgf4Ss LabOps Leadership Podcast, hosted by Samantha Black, invited Larina Burke, Laboratory Manager at Hyasynth Bio. They talked about her role as a laboratory manager in a small company, how Hyasynth Bio is the only company that produces a CBD isolate from yeast fermentation, and how being a part of the LabOps Unite Community has opened up many new opportunities for her. Tune in here: bit.ly/LabOps-LarinaBurke We had another episode on our main channel, the Outcomes Rocket Podcast, Saul had Tony Benedict, CEO at Omicron Partners. He talked about how the fundamental business model for delivering patient care has not changed in about half a century and why the healthcare industry is about 20 years behind other industries from both a technology and operations perspective. Listen here: http://bit.ly/TonyBenedict Tune in every week to discover something new about this industry! See you next week! Click this link to the show notes, transcript, and resources: outcomesrocket.health

Did you know? It's an exciting time to become involved in informatics! In this episode of the Future of Global Informatics, TJ Southern sits down to talk with Madeline Stadler, a nurse at Duke University Hospital, about education around nursing informatics. Madeline recently graduated from Duke, where she got her Quantitative Management Health Analytics Master's Degree, and is currently looking at how to get more involved in the informatics space, which is why she reached out to TJ and started a conversation around the subject. Madeline shares that she feels excited about the operations side of nursing informatics and running units with improved workflows. They discuss Duke University's informatics program and the benefits a new graduate can take from it. Madeline reflects on her education and highlights the importance of knowledge application and practice in the field. This episode was a delightful coaching session and chat. Tune in to listen to a new nursing informatics graduate and learn from her experience! Click this link to the show notes, transcript, and resources: outcomesrocket.health

Biden calls for better kids privacy laws in State of the Union During his state of the Union address Tuesday, President Joe Biden called for better regulation of social media companies. First Lady Jill Biden invited Facebook whistleblower Frances Haugen to the State of the Union – Haugen was the first to shed light on Facebook's (now, Meta's) internal efforts to target children as young as 6 on Instagram, and the fact that the company ignored its own research showing Instagram damaged teenage girls' self-esteem. Facebook is getting sensitive medical information The Markup reported yesterday that Facebook may have been receiving your medical information from a tracking tool – Pixel. Many hospitals use Pixel on their websites to track site visits. So let's say hypothetically that you search for a health condition on the hospital's website – well, for about a third of those sites, the tracking tool sends the information to Facebook. Johns Hopkins, UCLA ReaMgan, New York Presbyterian, Northwestern Memorial, and Duke University Hospital are among the hospitals that track site visitors with Pixel. Democrats led by Sen. Warren introduce bill that bans sale of location data In the wake of the leaked Supreme Court decision to overturn Roe v. Wade, which paves the way for red states to criminalize abortion procedures, Sen. Elizabeth Warren led a group of Democratic lawmakers to introduce a new bill – The Health and Location Data Protection Act – that would completely ban the sale of your location data. The bill also envisions empowering the Federal Trade Commission to intervene when necessary.   Advocates warn of hate speech problems in Klobuchar's antitrust bill Advocates including Free Press are pushing back against Amy Klobuchar's antitrust bill – the American Innovation and Choice Online Act – because they're concerned the bill would let companies that may have profited from hate speech and disinformation – like Infowars – to sue platforms like Google from banning them in search rankings. Advocates worry a provision that prohibits Google from favoring their own search results over smaller competitors  – could pave the way for disinformation profiteers to make anticompetitive accusations when platforms ban their sites. Elon Musk suggests  harmful content on Twitter should stay up if it's just entertainment Elon Musk announced to Twitter employees in a livestream that free speech issues should outweigh content moderation. Last month, said that he'd reinstate Donald Trump's account, although he said that prior to the commencement of the January 6th committee proceedings. Twitter's stock has steadily dropped from $54.20 per share, which was the price when Elon Musk made his $44 billion bid to purchase the company. At the closing bell today, Twitter was trading at $37.78. That's it for this week. You can find links to all of these stories in the show notes. Stay safe, stay informed, have a great weekend. See you Monday.

SHOW NOTES4:35 – 35th wedding anniversary5:25 – key qualities to a strong and meaningful relationship6:00 – team approach6:45 – facing unexpected fears, head on, one day at a time7:25 – discovering inner strength7:55 – Olivia, the amazing daughter and sister9:05 – Special Love, Inc., Tom and Sheila Baker9:35 ­– BRASS Camp11:10 – Ryan, first cancer diagnosis at two years old11:35 – ordinary family with an extraordinary circumstance11:50 – leukemia meets it match with Ryan's grit15:00 ­– choosing hope is choosing life15:15 – Make-a-Wish trips16:15 – leading through advocacy17:05 – management is key17:45 – gratitude for such remarkable support – it kept us going, it keeps us going19:25 – Camp Fantastic (Special Love, Inc.)20:15 – no one wants to join the club of parents of children with cancer21:00 – adult skills learned as a child through trial and error23:30 – rhythm of life, impact on traditions, a roller coaster of life24:35 – bringing home a puppy in the midst of the challenges25:45 – ready to go to the hospital on a moment's notice27:10 – selecting quotations that capture the essence of one's thoughts and intended message29:05 – meeting Ryan's bone marrow donor, Scott Harris31:05 – consider joining the bone marrow registry32:00 – graft versus host disease can be deadly32:40 – Sharon and Lee Johnson, the ultimate role models and friends35:15 – manufacturing sunshine36:00 – Ryan's loud pants37:05 – writing a second book (Joyride Journeys)38:30 – naming our cars and upcoming cross-country driving trip39:20 – post-traumatic growth and gains40:05 – how do we channel our loss?41:40 – advocate for yourself Focused Fight bookRyan's speechCamp FantasticBone Marrow Registry Terri's websitePost-Traumatic Growth articleMusic for Lead. Learn. Change. is Sweet Adrenaline by Delicate BeatsPodcast cover art is a view from Brunnkogel (mountaintop) over the mountains of the Salzkammergut in Austria, courtesy of photographer Simon Berger, published on www.unsplash.com.Professional Association of Georgia Educators  David's LinkedIn page

Hygiene, including daily bathing and oral care, is critical in the hospitalized patient. In this episode, MEDSURG Nursing Journal Editorial Board Member Dr. Kristi Campoe talks with Dr. Staci Reynolds, an Associate Professor at Duke University School of Nursing, and an Infection Prevention Clinical Nurse Specialist at Duke University Hospital, about her 2020 study focusing on patients' perspectives of missed hygiene care. In this discussion, Dr. Reynolds provides a deeper dive into her study findings, which will be published in the July/August 2022 issue of MEDSURG Nursing.Staci Reynolds, PhD, RN, ACNS-BC, CCRN, CNRN, SCRN, is an Associate Professor at Duke University School of Nursing, and an Infection Prevention Clinical Nurse Specialist at Duke University Hospital in Durham, North Carolina. This episode provides expanded information from Dr. Reynolds' article, “Patients' Perspectives of Missed Hygiene Care: A Focus Group Study,” published in the July/August 2022 issue of MEDSURG Nursing. Kristi R. Campoe, PhD, RN, CMSRN®, CPHQ, is a Professor of Nursing, Pasco-Hernando State College, Porter Campus at Wiregrass Ranch, in Wesley Chapel, FL, and a member of the MEDSURG Nursing Journal Editorial Board.For archived episodes of this podcast and to learn more about MEDSURG Nursing, the official journal of the Academy of Medical-Surgical Nurses, visit the journal's website at http://www.medsurgnursing.net/Music selections by Scott Holmeshttp://www.scottholmesmusic.com

In 2017, Victoria was diagnosed with multiple Paraganglioma, a brain-skull tumor and a carotid body tumor that required surgery and pin-point radiation treatment. During her time at Duke University Hospital, she voluntarily participated in a study to help more patients overcome rare tumor

Lisa is joined by Philanthropist/Model/Sports Illustrated Finalist and surviror Victoria Vesce is telling everyone who will listen. Ms. Vesce has a long history of advocacy and philanthropy with various organizations, but her advocacy took on new meaning when she became a cancer survivor at age 24. Today, Victoria is an advocate for the National Brain Tumor Society, an organization that helped her during her radiation treatments at Duke Cancer Institute.In 2017, Victoria was diagnosed with multiple Paraganglioma, a brain-skull tumor and a carotid body tumor that required surgery and pin-point radiation treatment. During her time at Duke University Hospital, she voluntarily participated in a study to help more patients overcome rare tumors.DiagnosisIn 2016 and 2017 while dancing in the NBA for the Charlotte Hornets, and studying for the LSAT, Victoria started losing her hearing and experiencing extreme headaches. She began experiencing symptoms like fainting, unexplained adrenalin rushes and dizziness. After a CAT scan and repeated visits to the doctor and ENT, she was diagnosed with a tumor.TreatmentVictoria was referred to Duke University Hospital, where they discovered another tumor (carotid artery) during an MRI. Surgery occurred 6 weeks later, and following that, Victoria underwent 30 rounds of experimental radiation treatment.RecoveryToday, Victoria is fully deaf in her right ear. She also suffers from tinnitus. At the same time, she enjoys a new perspective on life and has gratitude for the organizations and people who have helped her along the way."My motto in life now is that life is short. I have quit shaming myself or changing myself to please others. I own my life, imperfections and all. I want to help others to reach a point of good health, happiness and fulfillment - as I have," said Ms. Vesce. "Brain Tumor Awareness Month presents a chance to become educated about the issues that affect people with cancer diagnoses. It's also a chance to give to organizations that save lives."Ms. Vesce encourages others to donate to organizations like the National Brain Tumor Society. If you would like to interview her please let me know!For more information about how you can contribute to the National Brain Tumor Society, see their website, https://braintumor.orgAbout Victoria DeHart Vesce: now based in Miami, Florida, Victoria is a graduate of NC State University with a Bachelor of Arts in Media Communications and has obtained her Juris Doctorate from Charleston School of Law. She currently works with Berman Law Group in South Florida and continues to model and grow her social media platform. She is signed model with JL Model Management and Marilyn's Agency.In the past, Ms. Vesce has volunteered for and been a part of organizations such as Make-A-Wish, Toys for Tots, Relay for Life, Ronald McDonald House (Young Professional's Society) YMCA,

This piece is an essential guide to running your own perioperative pre-operative diabetes clinic as well as how to manage this condition before, during and after and operation.  With questions from the online audience and reference to the TopMedTalk presentation - linked to here: https://directory.libsyn.com/episode/index/id/21961259 - this podcast will get you and your colleagues thinking about how to add value and patient centered care to those who come through your institution with this condition. Introduced by Sol Aronson, Emeritus Professor, Duke University, Chaired by Owen O Sullivan, consultant anaesthestist, with Kathryn Evans Kreider, Associate Clinical Professor, Duke University School of Nursing, Nurse Practitioner, Division of Endocrinology, Metabolism and Nutrition; Duke University Medical Centre with questions and contributions from Niamh McAuliffe, Consultant Anaesthetist, Cork University Hospital, Tracy Setji, Medical Director, Endocrine Consultation Service, Duke University Hospital, Padraig O'Scannaill, National Coordinator for The Moped Study (Ireland), Feyce Peralta, Associate Professor, Northwester University, Feinberg School of Medicine.

In this week's episode, Chris speaks with Veteran Chaplain Adrian Dixon on his journey of becoming a spiritual leader as a Resident Chaplain at Duke Raleigh Hospital. While still in Divinity school, Adrian started working as a Staff Chaplain at Duke Raleigh Hospital providing pastoral services to patients.Through his diligent work, he slowly expanded the Chaplain program to include a new clinical pastoral program “Care For Eachother (CFE)”, a partnership with Duke University Hospital, and a team of five full-time chaplain residents and 8 to 10 interns to provide pastoral services. Adrian also shares two emotional stories that have resonated with him over his nearly 20 years with Duke.The first recounts a past patient's recovery and recognizes the gift of presence and the effect his support meant to the patient. The other talks about a dying patient's last wishes and how Adrian handled and came to terms with his final requests. Through these stories, Adrian shows how by simply being present and providing support during times of need deep connections can be created between patients, doctors, friends, families, and teammates. Furthermore, drawing from his own journey through illness at a young age, Adrian urges listeners to never lose faith and let the “seed of fear” deter them from pursuing the life and goals they want.Through diligent work and unwavering faith in God, Adrian overcame his obstacles and is destined to help his followers and patients do the same.More About Our Guest:Adrian is an experienced Chaplain Services & education department administrator with a demonstrated history of working in the hospital & health care industry. Skilled in nonprofit management, public speaking, pastoral ministry, entrepreneurial organizations, and healthcare chaplaincy, Adrian has a strong education with a Doctor of Ministry focused in Ministry Development from Virginia Theological Seminary.Adrian is the Founding/Lead Pastor of Northside Community Church. He is also the full-time Director of Chaplain Services & Education at Duke Raleigh Hospital where he has worked since 2003. Adrian grew up in the Raleigh area and earned a bachelor's degree at Campbell University, an M.Div. at Duke University, and a D.Min. at Virginia Theological Seminary.Adrian is married to Shoshannah and together they have three children. He's a fan of the NC State Wolfpack and loves Cincinnati Reds baseball.---------------------------------------------------------------------------------------------https://www.linkedin.com/in/adrian-dixon-31437a14/https://www.dukehealth.org/hospitals/duke-raleigh-hospital

It's officially Occupational Therapy Month and we celebrate Fowler and every OT and COTA across the world. Fleming is back from vacation and gives her tale of her adventures in Legoland! Ketanji Brown Jackson is our new SCOTUS and Joe Biden has extended the pause on student loan repayment yet again! We also discuss the travesty that was the Oscars and a social media influencer has alleged stabbed her boyfriend to death. In the Rehab Corner, we discuss Duke University Hospital implementation of Black Hair Care products in their supply regarding diversity and inclusion. Don't forget to follow us on all social media platforms including IG, Twitter and YouTube @thefaceoffpod. On FB, follow us @thisisthefaceoffpodcast Please Like, Comment, Share, Download and Subscribe! Visit www.myapothecary.com for all of your CBD needs to help you “Curate a Well-thy Lifestyle”! For sponsor information, please email us @thefaceoffpod@gmail.com

This episode features Dr. Travis Jones from DASON and Dr. Elizabeth Keil, current PGY2 Infectious Diseases Resident at Duke University Hospital. The article reviewed in this episode is available here: https://doi.org/10.1093/cid/ciab865. For more information about DASON, please visit: https://dason.medicine.duke.edu.

The pressures and stress of traumatic clinical events affects everyone in the room including pharmacists. Two pharmacists, Jennifer Mando-Vandrick, Clinical Pharmacist in Emergency Medicine at Duke University Hospital and Philippe Mentler, Consulting Director of Pharmacy at Vizient, discuss the emotional impact pharmacist may have when witnessing the distress of others when traumatic events happen in the clinical workplace.    Guest speakers: Jennifer Mando-Vandrick, PharmD, BCPS Clinical Pharmacist, Emergency Medicine Director, PGY2 Emergency Medicine Residency Department of Pharmacy Duke University Hospital   Philippe Mentler, PharmD, BCPS Consulting Director, Pharmacy Vizient   Moderator: Gretchen Brummel, PharmD, BCPS Pharmacy Executive Director Vizient Center for Pharmacy Practice Excellence   Show Notes: [3:31] Secondary traumatic stress or compassion fatigue is a state of emotional distress that results from indirect exposure to traumatic events [4:00] How secondary traumatic stress differs from burnout [6:15] How to manage your stress level [9:23] Acknowledge  and accept that you are feeling stress and be open to listening to other people's feelings [9:50] How leadership can help their employees deal with stress [12:00] Peer support [13:07] Talking to your learners and applicants about how your organization's culture manages employee stress   Links | Resources: CDC: Mental Health articles Psychology Today   Subscribe Today! Apple Podcasts Amazon Podcasts Google Podcasts Spotify Stitcher Android RSS Feed

A recent study conducted at Duke University Hospital and published in the Journal of Endourology found that a new single-use cystoscope demonstrated superior flexion and comparable optics to the reusable scopes already being used in a hospital urology department.  Dr. Michael Lipkin, a urologist in Durham, North Carolina, and one of the study's authors, joined Endoscopy Insights to discuss the findings. In our conversation, he talks about the key technological capabilities of the cystoscopes that he and his fellow researchers set out to assess, and other factors that impact the calculus of single-use vs. reusable. Lipkin also touches on a physician feedback survey that was done as part of the research and what his fellow urologists had to say, and other issues such as cost, infection prevention, and environmental factors.  

Tyler Zombro is a pitcher with the Tampa Bay Rays organization. He pitched in college with George Mason University and then signed with the Rays in 2017. After going a few years through the minor league system, Zombro reached as high as AAA in 2019 and in 2021, was back in AAA pitching with the Durham Bulls. On June 3, 2021, Tyler was facing Brent Cumberland of the Norfolk Tides when a pitch was hit back up the middle at over 100 mph and hit Zombro in the right side of the head just above the ear knocking him unconscious. After being taken to the hospital, neurosurgeons at Duke University Hospital installed 16 plates and 36 screws during 2 1/2 hours of emergency surgery to stabilize Zombro's skull Today on the podcast, we talk to Tyler about his journey of baseball, wisdom from his grandfather Wimpy, that scary day in June 2021, his desire to possibly pitch again, the prayer he prays on the mound, and how his faith in God has shown him that he's here for a bigger purpose than baseball.  --- Receive our 10-day Sports Spectrum Devotional written by professional athletes for FREE when you sign up for our Sports Spectrum Weekly Email Newsletter. Sign up here.

We recently asked you to tell us about the decisions you're struggling to make right now. There have been so many choices to make and risks to weigh lately, and after almost 18 months into this pandemic, many of us are feeling decision fatigue. So we decided to put your decisions to a panel of friends and experts: author and Emory University professor Tayari Jones, writer and ¡Hola Papi! columnist John Paul Brammer, and Tara Ilsley, a public health worker at Duke University Hospital in Durham, North Carolina. They shared their advice for listeners weighing big moves, going back to school, caretaking, and more.

In this episode, we are going to talk about the first artificial heart transplant with the Aaeson device and the Covid-19 lab leak hypothesis. A surgical team at Duke University Hospital, led by Drs. Jacob Schroder and Carmelo Milano, successfully implanted a new-generation artificial heart in a 39-year-old man with heart failure, becoming the first center in North America to perform the procedure. On the other hand, the Lab Leak theory of COVID-19: a group of scientists - shifted the debate about the origins of COVID-19, they published a letter in the journal of science saying the lab-leak theory needs to be taken more seriously by the scientific community. Join us as we discuss more about these two interesting topics.   Cup of Nurses: https://fanlink.to/CONsite Frontline Warriors: https://fanlink.to/FWsite Youtube https://fanlink.to/CONYT Apple https://fanlink.to/Applepodcast Spotify https://fanlink.to/Spotifypodcast Cup of Nurses Store https://fanlink.to/CONshop Frontline Warriors store https://fanlink.to/FWshop Interested in Travel Nursing? https://fanlink.to/TravelNurseNow Free Travel Nursing Guide  https://fanlink.to/Travelnursingchecklist Nclex Guide https://fanlink.to/NCLEXguide Cup of Nurses FB Group https://www.facebook.com/groups/cupofnurses Frontline Warriors FB group https://fanlink.to/FWFBgroup   0:17 |  Introduction with the Hosts 1:28 | Affiliates/Updates 7:22 | Heart Failures 7:38 | Stages of Heart Failures 8:26 | Device/process use in heart transplant 11:41 | Lab-leak hypothesis 15:21 | Origin of Covid-19 16:10 | A virus that came from nowhere  19:17 | Conflict of interest 25:26 | Beijing is seeking to counter the hypothesis 31:11 |Top 5 Pandemic 31:24 | Human Mistake 32:17 | Closing thoughts

This episode features Kuldip Patel, Senior Associate Chief Pharmacy Officer at Duke University Hospital. Here, he discusses priorities as Senior Associate Chief Pharmacy Officer, what his goals are for this year, lessons that he learned from COVID-19, and more.

You're listening to the Westerly Sun's podcast, where we talk about the best local events, new job postings, obituaries, and more. First, a bit of Rhode Island trivia. Today's trivia is brought to you by Perennial. Perennial's new plant-based drink “Daily Gut & Brain” is a blend of easily digestible nutrients crafted for gut and brain health. A convenient mini-meal, Daily Gut & Brain” is available now at the CVS Pharmacy in Wakefield. Now for some trivia. Did you know that Gilbert Stuart, famed Rhode Island painter, also painted the Lansdowne portrait of George Washington which currently hangs in the East Room of the White House? The painting was rescued during the burning of Washington in the War of 1812 thanks to First Lady Dolley Madison and Paul Jennings, one of James Madison's slaves.  Now, for our feature story: Stonington High School has earned a rank in the top 10% of public schools in the U.S.  They took the No. 3 spot in the Norwich metropolitan area. U.S. News & World Report released its annual rankings recently, listing Stonington High No. 1,781 out of the 18,000 eligible schools. The rank places the district in a top tier, and by earning a national ranking in the top 40%. Stonington High School also achieved status as a U.S. News Best High School. Dr. Van Riley, superintendent of Stonington Public Schools, said that the faculty and staff are best-in-class teachers, mentors, scholars, and most importantly, role models who work tirelessly to support students in all of their endeavors. SHS Principal Mark Friese said the recognition is a testament to the dedication of the entire school community.  Friese feels that the town and Board of Education supports the schools and programming immensely. He also praised the superintendent that encourages them to continuously move forward with new initiatives that are always focused on what is best for students.  For more information on the school, including a link to rankings check out our fully story at thewesterlysun.com Are you interested in a new opportunity? You're in luck! Today's Job posting comes from the University of Rhode Island in Kingston. They're looking for a full-time fiscal clerk. Bookkeeping experience is preferred. Pay starts at $21.00 per hour. If you're interested and think you'd be a good fit for the role you can apply using the link in our episode description. https://www.indeed.com/l-Westerly,-RI-jobs.html?vjk=c833267992db5c1a Today we're remembering the life of Dr. Henry B. Freye, 90, of Mystic. Henry was born in Koenigsberg (Kaliningrad today), East Prussia. In 1939, he and his family immigrated to Havana, Cuba and to the USA in 1940. During his important formative years in New York, he was very active in the Boy Scouts where he earned the Eagle Scout Award with Palms. In 1948, he enlisted in the Army artillery, 35th regimental combat team and played in the Army Band where he served 5 years in the Reserves in the Rainbow Division. He was awarded an Academic Scholarship to Wagner College, followed by Queens College, where he met his future wife of over 60 years, Virginia Anne Lucas. While in college, he played the tuba in the Lawton Symphony, Staten Island Symphony, Queens College Orchestra, NY Teachers Symphony & All City Orchestra & Band. Additionally, he played soccer, was the captain of the team, and was named All NY City fullback. After graduating in 1954, he began his preclinical medical studies at Basel University Medical School where he became the first American to play in the Stadt Musik Basel, and received a Swiss Music Passport. While in Switzerland, he continued playing soccer and subsequently Semi-Pro for the German American team, Eintracht. His medical studies were completed at Duke University Medical School, followed by his internship at Stanford University, division at San Francisco General Hospital, residency at Duke University Hospital, as well as a Fellowship in Allergy & Immunology, completed at the Childrens Hospital in Boston. After completing his Residency in 1963, he joined the pediatric practice of Neida Q. Ogden in Westerly and subsequently, founded Shoreline Allergy and Asthma Associates, with offices in Mystic, Waterford, and East Lyme. While in private practice, he published and presented numerous medical papers in the USA, Europe, and South America. He was on the clinical faculty of Brown Medical School for 25 years and on the medical staffs of Rhode Island Hospital, Westerly Hospital, Lawrence and Memorial Hospital, and the Childrens Hospital of California until his retirement in 2008. He served on a number of boards and associations and helped develop the health plan for the children of Rhode Island. He enjoyed his studies at the Lyme Academy of Art and the opportunity to sail, play tennis, golf, and fish. He also loved to travel and made yearly adventures to all corners of the world with his wife. His most precious memories are those spent with his beloved wife  and his family. Thank you for taking the time today to remember and celebrate Henry's life. That's it for today, we'll be back next time with more! Also, remember to check out our sponsor Perennial, Daily Gut & Brain, available at the CVS on Main St. in Wakefield! See omnystudio.com/listener for privacy information.

Today, Tuesday April 27 A Tribute to a Wonderful Friend Romans 16:1-16 A friend loves at all times….. A man who has friends must himself be friendly, But there is a friend who sticks closer than a brother. (Proverbs 17:17 & 18:24) Remember yesterday I mentioned that in this last chapter of Romans, Paul took the time to greet at least twenty-six individuals by name that he knew in Rome. Paul was a friend-maker as much as he was a soul-winner. I am so thankful that the Lord has blessed me with so many wonderful friendships over the years. I want to take the time to pay tribute to one of the dearest friends that I've had in ministry these past almost fifty years. When I came to Rainbow Forest Baptist Church twenty-five years ago, one of the first staff member to greet me and help me get settled was the church administrator George Young. Over the course of time we developed a close friendship. I always knew George had my back, genuinely cared for me and my family, was loyal, was thoughtful and considerate, and would do anything he could to help me be a better person and a better pastor. A couple months ago George went to Duke University Hospital for test to see if anything at all could be done to help his breathing problem that he has had these past number of years. He called and ask me if I could pick him up and bring him back home when he was released. I felt so privilege to do so and have this special time with him. Shortly after he got in the car he informed me that the doctors told him they could not find the cause of the problem and that there was nothing they could do to cure it. But that it was possible that some medicines would at least make him more comfortable with it. George was positive and his faith was strong and he assured me that he was ready to go be with his Lord and Savior. As always, George was always thinking of others and his main regret was he wanted to be here and help his precious wife, Nancy who had just been diagnosed with cancer, go through her treatments. We all need friends like George. We will all greatly miss him, and as sad as it was to say goodbye to him yesterday, we were also able to rejoice and celebrate his home-going to heaven. George was ready to meet his Lord and Maker because years ago he by faith had trusted Jesus Christ to be his personal Savior and had make peace with God. Its times like yesterday that make the book of Romans come alive! This passage fits George and his suffering and passing perfectly! Romans 5:1-5 “Therefore, having been justified by faith, we have peace with God through our Lord Jesus Christ, through whom also we have access by faith into this grace in which we stand, and rejoice in hope of the glory of God. And not only that, but we also glory in tribulations, knowing that tribulation produces perseverance; and perseverance, character; and character, hope. Now hope does not disappoint, because the love of God has been poured out in our hearts by the Holy Spirit who was given to us.” We love you George. We will miss you and look forward to that glorious day when we will see you again!!!! Friends, please join me in prayer for Nancy and his family! God bless!

In this episode of Breaking Down Dietetics, Casey is joined by Sarah Gregory, a pediatric dietitian employed by Duke University Hospital. Casey and Sarah discuss how to build rapport with not only the RD team, but also with other healthcare professionals and patients in a clinical setting. They also discuss some of the do's and dont's of interns and how to prepare a stellar case study presentation. 

Pulmonary Fibrosis News Columnist and Forum Moderator Charlene Marshall reads an article highlighting a new device being used at Duke University Hospital to help improve the successful transportation of donor lungs to recipients awaiting lung transplantation. LUNGguard is a device of Paragnox Technologies and is being used to cold store lungs to extend time between harvest from a donor to transplantation, subsequently resulting in more lungs being available to patients.Are you interested in learning more about Pulmonary Fibrosis? If so, please visit: https://pulmonaryfibrosisnews.com

Today's woman, as a young child, thought her family was rich. They had a big backyard and went on vacation but when she went to middle school, she became friends with wealthy children and realized she wanted to one day have that kind of life. So, in college she decided she would become a physical therapist. With her degree in hand, she eventually took a position at Duke University Hospital. In this academic medical setting, she realized she loved to be constantly learning and the routine of physical therapy started to bore her. So, at the age of 30, she decided she would become a doctor and one day be in a position where she could have incredible impact and influence. Today, she is walking that path to greatness as a department chair of internal medicine of a major hospital. It is my pleasure to introduce you to Dr. Cynthia Brown.

Dr. Greg Dale is the Director of Sport Psychology and Leadership Program for Duke Athletics. In his sport psychology role, Dale provides consultations for individual athletes, coaches and staff members. In addition, Dale provides team building services for athletic teams and other units within the athletic department. In his leadership role, Dale provides leadership training for athletes, coaches, and administrators within the department through various educational programs. He is also a professor of sport psychology and sport ethics in the Department of Health, Wellness and Physical Education. In July of 2018, Dale was named to the newly-created Integrative Performance Excellence Group, a unit comprised of directors in the areas of Sports Performance, Athletic Medicine, Sports Nutrition and Behavioral Health, as well as individuals representing psychological services, team physicians and primary care physicians. The goal of this working group is to enhance the experience of Duke student-athletes by providing an integrative approach to the care of each individual athlete throughout his or her collegiate career while continuing to cultivate partnerships with the Duke University Hospital, Duke Sports Science Institute, Duke Student Health and Duke Counseling and Psychological Services (CAPS) as part of its holistic approach to student-athlete health. Dale received his bachelor's degree from Stephen F. Austin State University in 1985. He went on to earn a master's from Columbia University in 1987 and his doctorate from The University of Tennessee in 1993. Dale, a native of Troy, Texas, has written four books on leadership, coaching, parenting and performance and serves as a consultant to numerous athletic and corporate organizations around the world. Check out his book the Seven Secrets to Success. About Sivonnia DeBarros Sivonnia DeBarros – the Protector of Athletes – is a first-generation lawyer and law business owner, woman in business and a former track and field Division-I College athlete. DeBarros is passionate about helping athletes in business protect their brands through collaborative partnerships, education and support necessary to carry them to the next level. DeBarros's practice areas are Business, Employment, Sports, and Entertainment. Learn more about her services at www.prosportlawyer.com and www.sldebarros.com.

Greg Dale, Phd.Dr. Greg Dale is the Director of Sport Psychology and Leadership Program for Duke Athletics. In his sport psychology role, Dale provides consultations for individual athletes, coaches and staff members. In addition, Dale provides team building services for athletic teams and other units within the athletic department.In his leadership role, Dale provides leadership training for athletes, coaches, and administrators within the department through various educational programs. He is also a professor of sport psychology and sport ethics in the Department of Health, Wellness and Physical Education.In July of 2018, Dale was named to the newly-created Integrative Performance Excellence Group, a unit comprised of directors in the areas of Sports Performance, Athletic Medicine, Sports Nutrition and Behavioral Health, as well as individuals representing psychological services, team physicians and primary care physicians. The goal of this working group is to enhance the experience of Duke student-athletes by providing an integrative approach to the care of each individual athlete throughout his or her collegiate career while continuing to cultivate partnerships with the Duke University Hospital, Duke Sports Science Institute, Duke Student Health and Duke Counseling and Psychological Services (CAPS) as part of its holistic approach to student-athlete health.Dale received his bachelor’s degree from Stephen F. Austin State University in 1985. He went on to earn a master’s from Columbia University in 1987 and his doctorate from The University of Tennessee in 1993. Dale, a native of Troy, Texas, has written four books on leadership, coaching, parenting and performance and serves as a consultant to numerous athletic and corporate organizations around the world. Check out his book the Seven Secrets to Success.About Sivonnia DeBarrosSivonnia DeBarros – the Protector of Athletes – is a first-generation lawyer and law business owner, woman in business and a former track and field Division-I College athlete. DeBarros is passionate about helping athletes in business protect their brands through collaborative partnerships, education and support necessary to carry them to the next level. DeBarros’s practice areas are Business, Employment, Sports, and Entertainment. Learn more about her services at www.prosportlawyer.com and www.sldebarros.com.What Are You Sporting About?https://businessinnovatorsradio.com/what-are-you-sporting-about/Source: https://businessinnovatorsradio.com/ep-36-greg-dale-phd-removing-pressure-creating-an-imprint-for-legacy-building-with-sivonnia-debarros-protector-of-athletes

Greg Dale, Phd.Dr. Greg Dale is the Director of Sport Psychology and Leadership Program for Duke Athletics. In his sport psychology role, Dale provides consultations for individual athletes, coaches and staff members. In addition, Dale provides team building services for athletic teams and other units within the athletic department.In his leadership role, Dale provides leadership training for athletes, coaches, and administrators within the department through various educational programs. He is also a professor of sport psychology and sport ethics in the Department of Health, Wellness and Physical Education.In July of 2018, Dale was named to the newly-created Integrative Performance Excellence Group, a unit comprised of directors in the areas of Sports Performance, Athletic Medicine, Sports Nutrition and Behavioral Health, as well as individuals representing psychological services, team physicians and primary care physicians. The goal of this working group is to enhance the experience of Duke student-athletes by providing an integrative approach to the care of each individual athlete throughout his or her collegiate career while continuing to cultivate partnerships with the Duke University Hospital, Duke Sports Science Institute, Duke Student Health and Duke Counseling and Psychological Services (CAPS) as part of its holistic approach to student-athlete health.Dale received his bachelor's degree from Stephen F. Austin State University in 1985. He went on to earn a master's from Columbia University in 1987 and his doctorate from The University of Tennessee in 1993. Dale, a native of Troy, Texas, has written four books on leadership, coaching, parenting and performance and serves as a consultant to numerous athletic and corporate organizations around the world. Check out his book the Seven Secrets to Success.About Sivonnia DeBarrosSivonnia DeBarros – the Protector of Athletes – is a first-generation lawyer and law business owner, woman in business and a former track and field Division-I College athlete. DeBarros is passionate about helping athletes in business protect their brands through collaborative partnerships, education and support necessary to carry them to the next level. DeBarros's practice areas are Business, Employment, Sports, and Entertainment. Learn more about her services at www.prosportlawyer.com and www.sldebarros.com.What Are You Sporting About?https://businessinnovatorsradio.com/what-are-you-sporting-about/Source: https://businessinnovatorsradio.com/ep-36-greg-dale-phd-removing-pressure-creating-an-imprint-for-legacy-building-with-sivonnia-debarros-protector-of-athletes

This episode we talk with guest Dr. Desirae Lindquist, internal medicine clinical pharmacist at Duke University Hospital, on the topic of finances transitioning to and throughout post-graduate training. Check out https://www.instagram.com/rxpalette/?hl=en (@rxpalette) on Instagram for hand-crafted, focused study guides on pertinent disease topics. Music by @https://soundcloud.com/LiQWYD (LiQWYD) 

This week on the Way of Champions Podcast we welcome Dr. Greg Dale. Dr. Dale is the Director of Sport Psychology and Leadership Program for Duke Athletics and author of The Seven Secrets of Successful Coaches. In his sport psychology role, Dale provides consultations for individual athletes, coaches and staff members. In addition, Dale provides team building services for athletic teams and other units within the athletic department.   We dive into the need to stop catastrophizing failure, how to build culture, how do approach change, and how do we recruit people to fit into our culture. Check out his website http://www.excellenceinperformance.com/. Highlights from the Podcast: Teaching "sports athletics" at the university level Are sports fundamentally good? Coaches responding to sports during a pandemic Servant Leadership What is the essence of coaching? Learning to coach by spending time with coaches from other sports How do "one-and-done" athletes effect the culture of a university-level team? C.U.L.T. Athletics (Connection, Ultimate caring, Love, Trust), a Jerry-ism made up on the spot How can we build stronger connections with our athletes? Growing from an assistant coach to a head coach More about Greg Dale: In his leadership role, Dale provides leadership training for athletes, coaches and administrators within the department through various educational programs. He is also a professor of sport psychology and sport ethics in the Department of Health, Wellness and Physical Education.   In July of 2018, Dale was named to the newly-created Integrative Performance Excellence Group, a unit comprised of directors in the areas of Sports Performance, Athletic Medicine, Sports Nutrition and Behavioral Health, as well as individuals representing psychological services, team physicians and primary care physicians.  The goal of this working group is to enhance the experience of Duke student-athletes by providing an integrative approach to the care of each individual athlete throughout his or her collegiate career while continuing to cultivate partnerships with the Duke University Hospital, Duke Sports Science Institute, Duke Student Health and Duke Counseling and Psychological Services (CAPS) as part of its holistic approach to student-athlete health.   Dale received his bachelor's degree from Stephen F. Austin State University in 1985. He went on to ear a master's from Columbia University in 1987 and his doctorate from The University of Tennessee in 1993.  Dale, a native of Troy, Texas, has written four books on leadership, coaching, parenting and performance and serves as a consultant to numerous athletic and corporate organizations around the world. Resources Mentioned in the Podcast: Freakonomics Podcast: The Hidden Side of Sports (https://freakonomics.com/hidden-sports/ Amazon Book Link for The Seven Secrets of Successful Coaches.   The Way of Champions Podcast is brought to you by Sports Refund. When kids sign up to play youth sports there are always fees involved. And parents pay those fees so their child can be on the team, not the injury report. That’s why I love Sports Refund, and parents will too. Sports Refund is low-cost sports fee insurance – NOT health insurance, sports fee insurance. So if your child becomes injured or sick and can’t play, you get your fees reimbursed for that lost time, from one game to an entire season. It’s that simple. This product not only saves families wasted fees, it saves injured athletes the stress of feeling like they’re wasting their parents’ money. The fees come back until the player comes back. So they can focus on fully recovering and making a healthy return to the game. Sports Refund has options for individuals and organizations. Ask your club if they offer it, or visit SportsRefund.com/Game to learn more and sign up today. That’s SportsRefund.com/Game. Can’t Play? Don’t Pay. With Sports Refund.   Help Support the Podcast!   Become a Podcast Champion! …and get FREE access to ALL of our online courses.   If you love the podcast, we would love for you to become a Podcast Champion, (https://www.patreon.com/wayofchampions) for as little as a cup of coffee per month (OK, its a Venti Mocha), to help us up the ante and provide even better interviews, better sound, and an overall enhanced experience. Plus, as a $10 per month Podcast Super-Champion, you will have access to never before released and bonus material, including:   Downloadable transcripts of the podcasts, so you don't have to crash your car trying to take notes! A monthly discussion with John, James, Jerry, and other special guests talking about the previous month's episodes and answering some of the FAQs we received that month A code to get free access to our online course called "Coaching Mastery," usually a $97 course, but yours for free for becoming a patron. Access to an online community of coaches like you who are dedicated listeners of the podcast, and will be able to answer your questions and share their coaching experiences.   Thank you for all your support these past two years, and a special big thank you to all of you who become part of our inner circle, our patrons, who will enable us to take our podcast to the next level. https://www.patreon.com/wayofchampions

Hosts- Dr. Afreen Shariff, MD, Endocrinologist, Assistant Professor of Medicine and Dr. Tian Zhang, MD, Genito-Urinary Oncologist, Assistant Professor of Medicine. Duke University Hospital.

How do you lead and take care of others? We sit down with the medical director of the ICU at Duke, Mashael Al-Hegelan. We talk about leadership and maintaining relationships in critical care.--Mashael Al-Hegelan, MD is an Assistant Professor in the division of Pulmonary, Allergy and Critical Care Medicine. Before joining Duke, she completed her medical school training and Internal Medicine (IM) residency training in Riyadh, Saudi Arabia where she spent most of her formative years.  In 2012, she joined Duke Faculty after completing a second Internal Medicine residency, followed by a Pulmonary & Critical Care fellowship at Duke. Mashael servesas the Medical Director of the ICU as well as Respiratory Care Service at Duke Regional Hospital. She is also the Interim Medical Director of Pulmonary & Critical Care services at Duke Raleigh.   Mashael also serves as the Secretary and Treasurer of the NC Thoracic Society and is an active board member on the Durham County Hospital Board of Trustee. Along with her administrative duties, Mashael enjoys the clinical challenges that present themselves while rounding in the Duke University Hospital, Duke Regional and Duke Raleigh Medical Intensive Care units (ICU). Mashael is also currently pursuing her MBA at Fuqua School of Business. Having been a clinician for over 15 years, she finds herself gravitating towards the administrative and business aspects of healthcare. The innovation, entrepreneurship, and strategic planning is something she enjoys and looks forward to using to bridge the gap between clinicians and the hospital administration landscape.--Please support on Patreon @norlundYour help goes a really long waysFollow on Twitter @chris_norlundFollow on Instagram @norlundStay positive and thank you so much for listening!

Hear from the experts in our conversations on a genetic disorder: Duchenne Muscular Dystrophy. We cover Duchenne diagnosis, new treatment options, and how to connect with the Duchenne community. Experts in this episode include: *Ann Martin, MS, CGC - Certified genetic counselor with Parent Project Muscular Dystrophy, and Director of The Duchenne Registry. *Edward C. Smith, MD - Pediatric Neurologist at Duke University Hospital. *Debra Miller - CEO and founder of CureDuchenne. More resources and information for you: raredisease.com/dmd

Dr. Robert Mentz, director of the Heart Failure section in the Duke Division of Cardiology, discusses diuretics, anti-hyperglycemic therapies including SGLT2/GLP1 agents, angiotensin receptor-neprilysin inhibitors (ARNi), iron as therapies for Heart Failure with Preserved Ejection Fraction (HFpEF). Additionally, study design and ongoing research in HFpEF is discussed. At the end of the episode Dr. Mentz provides an additional update that highlights how the COVID-19 pandemic has influenced clinical trials around the world. Special thanks to guest interviewers, Duke cardiology fellows, Dr. Kelly Arps and Dr. Rahul Loungani! On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic PageTake me to episode topics pageAcute Decompensated Heart Failure Primer – Youtube Dr. Robert Mentz completed internal medicine training at Brigham and Women’s Hospital and cardiology fellowship followed by advanced heart failure and transplant cardiology training at Duke University Hospital and the Duke Clinical Research Institute. He is the new director of the Heart Failure section in the Duke Division of Cardiology. His areas of clinical and research focus include treating comorbid diseases in heart failure patients, use of biomarkers and surrogate and non-fatal outcomes in heart failure trials, and novel therapeutic approaches to heart failure. Dr. Mentz is heavily involved in many clinical trials and serves as the associate editor at Circulation: Heart Failure. In addition to his clinical and research endeavors, Dr. Mentz is heavily invested in the cardiology fellowship where he serves as associated program director and renown mentor for which he has won many fellow-nominated awards. Finally, as former director of the Duke University Cooperative Cardiovascular Society, he expanded the network of current and former Duke trainees to be a leading enroller in clinical trials. We are really excited about him joining the show to discuss Diuretics ARNi SGLT2/GLP1 therapies for HFpEF. Dr. Rahul Loungani completed medical school at the medical university of SC and then traveled to Baltimore for internal medicine training in the Osler Residency Program at the Johns Hopkins Hospital.  Here he fell in love with the management and hemodynamics of critically ill patients. He is currently a third-year cardiology fellow at Duke University Medical Center where he will also be pursuing fellowship in advanced heart failure and transplant cardiology next year. His current interests are in Cardiac amyloid, in particular it's arrhythmic manifestations, early diagnosis, and novel therapeutics. He also loves teaching the housestaff and was awarded the Cassell-Saperstein award at Duke,  recognizing the fellow who most demonstrates a commitment to teaching and passion for clinical education. Outside of the hospital loves being a new dad to baby Arya. Dr. Kelly Arps completed medical school at Emory University school of medicine and internal medicine training in the Osler Residency Program at the Johns Hopkins Hospital. She is currently is pursuing her cardiology fellowship at Duke University Medical Center.  CardioNerds Heart Failure Series

Keep up with current episodes of Morning Cup of Murder at morningcupofmurder.com INFORMATION UPDATE: Recently I was contacted with more information regarding the above case and I wanted to share this information with you: "The State officials and media have hidden the real cause and manner of Daye's death... which had no nexus to the non-fatal stab wound that Mangum inflicted.  The wound was successfully treated surgically, but on the third postoperative day, Mr. Daye, an alcoholic, went into delirium tremens.  In treating this situation Duke University Hospital staff intubated Mr. Daye in his esophagus instead of trachea which led to his brain death.  Following a week of observation without neurologic improvement he was electively removed from life-support and he died.  He did not die of a complication as the media would have the general public believe.  The media is aware that Duke University medical staff was responsible for Daye's brain-death and actual death.  I notified legislators about this in an e-mail dated February 11, 2015. LINK to e-mail to legislators about Mangum's wrongful conviction On October 25, 2019, world-renowned forensic pathologist Dr. Cyril H. Wecht issued a report on Crystal Mangum's case in which he determined that the manner of death was an accident due to malpractice by Duke University Hospital staff and not a homicide secondary to complications of a stab wound inflicted by Mangum.  The last paragraph of his eight page report stated that the opinion of the medical examiner regarding the manner and cause of death were not credible because his autopsy report had significant discrepancies with the medical records. LINK to Dr. Cyril Wecht's October 25, 2019 report Since I began notifying the media on October 31, 2019, there's been only one media source to discuss Dr. Wecht's exonerative report about Crystal Mangum and that was a "Women & Crime" podcast, Episode 30 posted on November 3, 2020. Dr.s Meghan Sacks and Amy Shlosberg, two criminology professors discussed Mangum's case and both concluded that she shoud not have been prosecuted for murder.   A link to it can be found on my blog site: LINK to my blog site Sid Sidney B. Harr, M.D., Lay Advocate Committee on Justice for Mike Nifong." April 18th: Crystal Mangum Indicted (2011) The little boy that cried wolf. It's a nursery rhyme our parents read to us to teach us the value of always telling the truth. That we would be pre-judged and not taken at our word if we lived a less than truthful life. On April 18th 2011 a woman was indicted for the murder of her live-in boyfriend. This was a woman that everyone knew. Because, just years before her name was in every newspaper and on every newscaster's lips for an accusation that was later deemed as her crying wolf. This story isn't like our typical daily murder story. But, it's one worth knowing. Become a supporter of this podcast on Patreon: https://www.patreon.com/morningcupofmurder Follow Morning Cup of Murder on Twitter: https://twitter.com/cupofmurder @cupofmurder Follow MCOM on Instagram: @morningcupofmurder Have a Murder or strange true crime story you want to share, email the show here: morningcupofmurder@gmail.com Morning Cup of Murder is researched, written and performed by Korina Biemesderfer. Follow Korina on Instagram: @kbiemesderfer

Duke University Seems a Bit Underwhelmed by the #CoronavirusWhy are we still shutdown?https://youtu.be/UKK2pfH0vF4#ReOpenAmericahttps://www.spreaker.com/user/9922149/duke-university-hospital-underwhelmed-wh

In this episode of the Mastering Intensive Care podcast we replay a previous episode which featured Paul Wischmeyer (broadcast originally as episode 35). Paul is a Professor of Anesthesiology and Surgery, the Director of Perioperative Research at the Duke Clinical Research Institute and the Co-Director of the Nutrition Support Service at Duke University Hospital in the United States. Paul works mainly as a perioperative, critical care, and nutrition physician focused on enhancing preparation and recovery from surgery and critical care. His academic career has led to large numbers of publications, grants and invited presentations. And what’s unique about Paul is that his passion for helping patients stems from his own personal experience as a patient. In this replayed interview from 2018, Paul describes how he ended up as a physician, after having disturbing and traumatic patient experiences (including procedures, medications and suboptimal communication) and how this has helped him to be a better doctor and an example and teacher to others. He also discusses topics including ward rounds, cooperating with a palliative care team, caring for ourselves, the importance of nutrition and exercise, good onstage presentation techniques, and some valuable closing tips for all of us.   I invite you to listen to this replay episode with Paul Wischmeyer.   Andrew Davies   --------------------   About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. The hope is you’ll glean insights to move you closer towards being the best and most human healthcare professionals you can be, so you can make the most valuable contribution to your patient’s lives.   --------------------   Links related to Paul Wischmeyer Paul Wischmeyer website Paul Wischmeyer at Duke University Paul Wischmeyer at Duke Health Paul Wischmeyer on Twitter: @Paul_Wischmeyer Paul Wischmeyer on LinkedIn   Links to other resources (in order of mentioning) 2019/2020 Australian Bush Fires American Delirium Society Prof Wes Ely SCCM ICU liberation initiative Book “Presentation Zen Design” (by Garr Reynolds) Prof Jean-Louis Vincent Prof Mervyn Singer   Links related to Mastering Intensive Care podcast Mastering Intensive Care podcast - Episode 31 with Jean-Louis Vincent Mastering Intensive Care podcast - Episode 33 with Wes Ely Mastering Intensive Care podcast - Episode 35 with Paul Wischmeyer Mastering Intensive Care podcast - Episode 49 with Hugh Montgomery Mastering Intensive Care podcast - Episode 52 with Martin Bromiley Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Andrew Davies on LinkedIn Email Andrew Davies Audio Producer Chris Burke Burke Sound & Media

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

The Theology, Medicine, and Culture Initiative at Duke Divinity School and the Trent Center for Bioethics, Humanities & History of Medicine at Duke held a seminar on October 18, 2019 with Ray Barfield, MD, PhD, pediatric oncologist and palliative care physician at Duke University Hospital and Associate Professor of Christian Philosophy at Duke Divinity School. His talk is entitled, "On Beautiful Clinical Encounters: Resisting the Corporatization of American Medicine."

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

Join Tony DUrso as he interviews Vince Baiera - Creator Step2Health Brand! Vince Baiera started his career working as an ICU Nurse at The Cleveland Clinic and Duke University Hospital in the Cardiac ICU. After working as a traveling ICU Nurse, Vince stepped away from nursing to pursue Healthcare Consulting and Teaching. He moved on to start Baiera Wellness Products, a Product Development Company, as a result of dealing with his own grandparents who struggled with mobility and falls, Vince developed the Step2bed to help solve this problem. Listen to The Tony DUrso Show on VoiceAmerica Influencers Platform every Friday at 2pm Pacific or on our mobile app at tonydurso.com/mobile.

In this edition of Occupation Station Mike Canale, Team Lead for Maestro Care Willow at Duke University Hospital, talks about his responsibilities for the management and oversight of Pharmacy and Oncology applications using the Epic software system. Mike is an operational partner with pharmacy and oncology leadership across the Maestro Care Willow health system, serving as an IT liaison to several stakeholder groups. He talks about why his ACPHS clinical experience and problem solving skills are so important in today’s job market.

Duke employees Kara Lyven and Marianne Drexler wake up every day and go to work at the very place that saved their lives. They share their patient stories, and reflect on how their experiences help them find joy and gratitude in everything they do. Lyven is senior associate for patient safety at Duke University Hospital. Drexler is program coordinator for the Longitudinal Clinical Skills Foundation course in the Duke School of Medicine. Find the full transcript at www.listeningbooth.info.

Gina Rapacz is a 48 year old mother of 2 teenage daughters living in the Chicago suburbs.  She recently had a liver transplant after hers failed and she lingered on the transplant list in Chicago for over a year.  Her transplant was completed at Duke Medical Center in Durham, NC. She is now on her way to a healthier life with a new liver. See Transcript of this show below. Transcript  Lita: [00:00:16] Hello and welcome to podcast DX. This show that brings you interviews with people just like you whose lives were forever changed by a diagnosis. [00:00:24][8.7] Lita: [00:00:26] I'm Lita. [00:00:26][0.2] Ron: [00:00:27] I'm Ron. [00:00:28][0.2] Jean: [00:00:28] And I'm Jean Marie. [00:00:28][0.6] Lita: [00:00:29] Collectively we are the hosts of podcast d x. This podcast is not intended to be a substitute for professional medical advice diagnosis or treatment. Always ask the advice of your physician or other qualified health care provider for any questions you may have regarding a medical condition or treatment and before undertaking any new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast. [00:01:03][33.5] Ron: [00:01:05] On today's show we will be interviewing Gina a liver transplant recipient. [00:01:09][3.8] Jean: [00:01:10] Gina is a 48 year old from a Chicago suburb, where she lives with her husband two teenage daughters Nikki Sarah and their adorable puppy. Coco. [00:01:18][8.1] Lita: [00:01:19] Hi Gina thank you for joining us today. [00:01:21][2.0] Gina: [00:01:22] Hello. Thank you for having me. [00:01:24][1.2] Ron: [00:01:25] I understand it's been almost six months since you had a liver transplant. Yes I was transplanted September 30th 2017. [00:01:32][6.7] Gina: [00:01:33] In North Carolina at Duke University Hospital. [00:01:35][1.6] Lita: [00:01:36] Well you look great. [00:01:37][0.6] Gina: [00:01:38] Thanks. I actually I feel great. This is the best I've ever felt actually. For. A long long time. [00:01:43][5.4] Lita: [00:01:43] . Gina, what symptoms first led you to the doctor. [00:01:48][4.8] Gina: [00:01:49] Well. As far back as I can remember 2016 I had a really bad swollen. Ankles from water retention. Very tired. I was always cold. The doctors were. Thinking I had cancer. Which. Led my disease to. Worsen. As they were testing me for cancer. But it was not. [00:02:11][21.6] Jean: [00:02:13] How long did it actually take before you got. A correct diagnosis? [00:02:15][2.1] Gina: [00:02:17] My symptoms were bothering me for at least five months before they diagnosed my liver problem. [00:02:21][4.4] Ron: [00:02:24] Gina, Can you recall any specific symptoms that really stood out. [00:02:27][3.2] Gina: [00:02:28] Yes of course. My stomach. I look like I was nine months pregnant. And the build up of ascites is a toxic fluid. That forms in your stomach. Making it. Enlarged. My eyes were no longer clear they were. Foggy. and my skin was chapped & itchy. Always thirsty. Almost like you want to stick your head in the swimming pool. I lost my appetite. I had dry heaves almost throwing up but not quite. Always had leg cramps. My calves were so painful they'd wake me up at night. I would try standing up. They were. Very. Painfully twitching. And the muscles would cramp up. You. It's like a charlie horse times 10. Very painful. Terrible terrible. [00:03:13][45.0] Lita: [00:03:14] Were there any embarrassing symptoms that you had? [00:03:17][2.5] Gina: [00:03:18] Yes I actually would. I, I had. A bad case of diarrhea all day I would go maybe eight to 10 times a day never knowing when it was an attack. But usually when I was at Target or Wal-Mart shopping. And I would have to use a public bathroom for no reason at all my nose would start bleeding. And. It was on a daily basis. [00:03:43][24.7] Jean: [00:03:44] Did anything help relieve any symptoms. [00:03:46][1.3] Gina: [00:03:47] Well for the chills I would layer up. I would layer clothes use the electric blanket at night. wear socks, which, I am not a socks person. I also spend time in the sun which helped. I never used air conditioning or a fan never wanted to cause a breeze my way because the chills. You can never. you, that feeling was intense. [00:04:07][20.3] Ron: [00:04:10] You mentioned that you're always thirsty. How do you deal with the thirst. Even though you're thirsty all the time. [00:04:17][6.7] Gina: [00:04:18] The doctor puts you on a water intake a day. So I was on a two liter a day intake. Of liquid. After. My water intake. I would move over to a frozen. freezy pop. Like a Popsicle. Yeah because a popsicle had flavor to it and it would break up the monotonous taste of the water. Also. They give you a little sponge like. Device at the doctor's office where you dip it in water. And you kind of stuff the water on this little sponge. And that helped. [00:04:48][30.6] Lita: [00:04:51] Did anything help with the swelling that you had? [00:04:54][3.0] Lita: [00:04:55] Your stomach was swollen. [00:04:56][0.6] Gina: [00:04:57] Yes actually. There's a procedure they call Paracentesis. [00:04:59][2.6] Lita: [00:05:00] Wait a minute, Paracent- whatis? [00:05:01][0.3] Gina: [00:05:02] Paracentesis. you're in the hospital outpatient. Procedure where they go in. To your stomach with a needle like, device. And they hook up the hose, to a JAR, glass jar liters and the fluid is flushed out of your stomach. Out of your abdomen. Very painful. But. When you leave. After that. Procedure. You're about five to six liters. Of fluid. Down. Where the relief is amazing. [00:05:35][32.5] Lita: [00:05:36] So besides the Paracentesis. Was there anything else that you. Could do that would help the swelling. [00:05:41][5.4] Gina: [00:05:43] Yes, you could watch what you eat. Restricted salt diet and limiting my fluid intake helped the swelling. At night we tried to get comfortable by putting a wedge under my legs. To help with the cramping. When the cramping got real bad. I tried to walk it off. As early as I could. Sometimes when you check the sodium levels of the food that you're eating you'd be shocked that a lot of things have sodium. So. You do have to read labels and watch your sodium intake because that will cause fluid to accumulate in your stomach. Also I was a member at a health club that I had access to a Hot water Jacuzzi. Which helped. My legs in the cramping and feel less tense. I suggest that for anybody. And also. I self meditate. Myself out of pain. And that helped me get through a lot of my symptoms. [00:06:37][54.2] Lita: [00:06:40] Well that's really great. That's probably a good suggestion for anybody. Did you know what to expect when your doctors. Actually inform you that you have cirrhosis and now end stage liver disease? [00:06:53][13.2] Gina: [00:06:54] I didn't even know really a part of cirrhosis of the liver but I never really knew what. It. Was or what it untailed. I assumed it was kind of like if somebody had a heart attack. You go into the emergency room. You get back to a goal you undergo surgery. And. That's the end of it. I do not know. What end stage liver meant. But. It was. They gave me weeks to live. And that was scary because you're you don't know what to expect. Day to day. Now 48 years old and this, all the time this, and the rest of you. Yes very much very and very sudden. [00:07:37][43.1] Ron: [00:07:39] I understand that the hospital provided a number of classes to help prepare you for life with a new liver? [00:07:44][4.8] Gina: [00:07:44] Yes. You explained. Hospitals they go over everything that you need to do to prepare yourself before transplant and what you need to do. It was so it was terrible. At the time you're so sick that you can't even concentrate on what they're telling you. My caregiver was with me thank God because she took notes for me. During these meetings it's like a three day process where you meet different actors and different people on the team. Transplant team. It's very consuming. The information is very hard to understand because you're so sickly at the time. The toxins built up in my. In my brain. That. The liver. Isn't processing. And I became very confused and even I became combative. [00:08:33][48.9] Jean: [00:08:35] Did you realize that you were confused or combative?. [00:08:36][1.5] Gina: [00:08:37] No really. Well. When the nurse came in to check on me she asked me a couple of questions like What was my name and who was the president. What state do I live in. I answered. "Gina" To all the answers to all the questions. Yes. And. She knew from being a liver nurse she knew that was a symptom of toxins build up. In the brain. So immediately they put me to the emergency room and took care of me and they had to flush the toxins from my abdomen. [00:09:10][32.7] Lita: [00:09:12] Dangerous dangerous. You're from Chicago. But your transplant was in North Carolina. Why is that? [00:09:20][7.8] Gina: [00:09:20] Yes. Well I heard. They had some regions have faster results and you could register in more than one region. My caregiver told me about North Carolina because I was. Actually listed in Illinois where I live. For over a year. I only university. When she told me. About North Carolina and the turnaround in the. Past transplants. Turn around that they have their high. Low down and got on their list. And. High on their list. Actually in August of 2017 and I was transplanted. September 30th twenty seventeen. [00:09:55][34.6] Ron: [00:09:57] Definitely a lot there. What would you say was the worst part of this process. [00:10:02][5.1] Gina: [00:10:04] The worst part was waiting. Waiting. To. You know you don't know when you're going to get the phone call for the transplant. Getting sicker by the day. Ascities... The fluid retention in my stomach. Hurting. Constant swelling bloating. My legs were starting to give out because they were so swollen felt like my skin was going to rip open. There was nothing that they were prescribing me at that point that was helping me to get any kind of comfort. My sleep was lost. It was painful. Actually to even take a deep breath. Because the fluid was so. There was so much fluid in my stomach it was pushing the rest of my organs up. Through. My chest. And. Cause it Hard to breathe. [00:10:48][44.4] Jean: [00:10:49] It's sounds Awful. Did anything at all help with the swelling? [00:10:52][2.6] Gina: [00:10:52] . Well doctors told me to wear compression socks. Trying to stay positive thinking and moving about. Staying busy with my everyday life. The swelling in my stomach like I said before was released. Through. Paracentesis. That was the draining of the fluid. At the hospital. [00:11:12][20.0] Lita: [00:11:13] Sure. How did you feel when you first got that call saying. You know. We have a liver waiting for you. Was that was a surprise? Especially, you say it was only a month after you signed up over North Carolina! How did you how did that make you feel? [00:11:29][15.8] Gina: [00:11:30] Well I was shocked when I got the call I was actually at the store picking up. A prescription. And they told me to go home pack a bag and go to the hospital right away that they had a perfect liver. Well. I was excited. I was sad. I got very emotional I think every emotion went through me. When I got to the hospital. Yes I was excited but I had to wait for about. 10 hours before they actually operated on me. So I had time. For this information to sink in. Yeah. But it was at first it was a shock and I was. Like I went through every emotion. [00:12:05][35.4] Ron: [00:12:07] I understand you were released from the hospital sooner than some people, what do you think, what do you think about that? What aided you in your recovery? [00:12:16][9.4] Gina: [00:12:18] Well. I listened to my doctors I did everything they told me. Walking. Well actually let me back up. I'm sorry. I did. Exercise a lot before my transplant even though I was very sick. I had to try to build up muscle. They told me that after her transplant you would lose a lot of muscle. And I'm happy that I listened in that way because they after transplant you have to lock. And build up strength. But I'm glad that I was physically fit free for transplant. That makes sense. Also. I'm sorry but also eating healthy. As much as you can. You have to. Know a lot of protein low sodium a chicken and peanut butter nut protein bars protein shakes anything with high protein. That would build up muscle mass. [00:13:11][52.9] Jean: [00:13:12] Did you to take a lot of medication. [00:13:13][1.3] Gina: [00:13:15] After transplant? Yes I was on 40 pills a day, and it was four times a day. So yes when they, when the pharmacy rep brought in the pill box, the day before I got discharged, I said it looked like a fishing tackle box! (laughter from co-hosts) I thought to myself there's no way I would ever understand this! I'm not a pill person. And I just, I didn't think I could do it. But as time went on I, now fill up my pillbox blindfolded. (more laughter from co-hosts) Actually, I'm down to 16 pills a day so there is a big difference. [00:13:53][38.2] Ron: [00:13:54] Yeah. That's a lot to swallow. (co-hosts and guest laugh) Has anything changed since your procedure? [00:14:04][9.5] Gina: [00:14:05] Yes I mean I learned that I have to stay very active, walking is important. I wasn't able to lift anything five pounds or heavier. But now that I am six months out I am able to lift 25 pounds and more. I mean. I have to watch what I do because. They don't want me to get a hernia where the incision is. Absolutely there's no smoking no alcohol even sun exposure is considered high risk because of the medicine that I'm on can cause skin cancer. [00:14:37][32.4] Jean: [00:14:38] And just to keep an eye on your vitals. [00:14:41][2.1] Gina: [00:14:41] Yes every day I have to check my blood sugar because of the medicine intake could raise my blood sugar. I have to check my temperature. Make sure there's no type of fever. Virus going on I maintain a healthy diet. And again I do high protein and low sodium. [00:14:58][17.1] Jean: [00:14:59] Were there any rules, things that you cannot eat? Or is there anything that interferes with your medication? [00:15:05][5.5] Gina: [00:15:06] Yeah. The grapefruit you're not allowed to have any grapefruit or any product that has grapefruit in it. I was shocked to see that I I do. I used to use minced garlic in a jar and I found out that there's grapefruit juice in there some kind of preservative. And. Yeah. I was shocked. So you have to read every label. You have to make sure. The product is dated and if you can't read the day don't buy it don't chance it. If you. Touch something at the grocery store it is supposed to be cold and it's not. Don't buy it. Also. I would always use after transplant right after transplant when I was going to the stores or restaurants or out in the public I would wear face masks and I would bring wipes and wipe down everything handles of the grocery cart. Even menus at the restaurant. [00:15:53][47.0] Jean: [00:15:55] That's probably a good tip for everybody. Did anything make a recovery. Recovery period easier? [00:16:01][5.5] Gina: [00:16:01] While I was recovering at my house. I get it. Very great caregivers taking care of me. But also when I was by myself like taking a shower. I did use a grab bar in the shower. I did use the handlebars on the toilet seat. To get up and down because you are still sore. Compression sox would help my legs from getting to swollen. Squatty-Potty would help, so you don't have to, I'm sorry but, push while you go to the bathroom. You don't want anything. You don't want any tension around that. Incision. I also, like I said, the antibacterial wipes are very good. Use them Lysol spray. Wipe down everything. Just be cautious be careful. And you don't want to touch any germs. If you can't if you can rent a lift chair. [00:16:51][49.6] Lita: [00:16:53] Right. All of those products that you recommended like the squatty- potty and the handlebars for the toilet area. And the grab bars for the shower will be listed. On our Web site. For purchase. For anyone that's interested. And. The lady. Ready. Them back. Yes we'll be getting these products. From the Amazon Web site directly for you to show that you don't have to search too hard for these helpful aspects. You know there was good information. What would you. Like our audience to know about the importance of being an organ donor. [00:17:30][36.5] Gina: [00:17:31] Well I personally was never an organ donor myself but now I am. On Through. totally unknown it. I think everybody should be a donor if anything of ours can help. Two three. More people. I don't. Being a donor. I say. Definitely do it. [00:17:51][19.7] Ron: [00:17:52] That is an amazing story. Any other advice for the listeners out there. [00:17:57][5.1] Gina: [00:17:58] Oh yes I do actually. When you go to the doctor's office. Make sure that you. Tell them. Exactly. Your symptoms like if you. If you're feeling like you have a headache every other day or a sore throat once in a while just tell them everything that you feel or tell them. You are a drinker or tell them that you do diet pills or. Just. Be honest with them you're there for a reason you they're not going to judge you. And. Possibly they'll. Test you. And they'll before a disease. Occurs. They can help you. And treat you. [00:18:31][33.1] Jean: [00:18:31] That's great Gina, Thank you so much. Oh I want to thank you, on behalf of the podcast staff, and our listeners. And we really appreciate you taking the time today to speak with us. [00:18:41][9.9] Lita: [00:18:42] If you have any questions or comments related to today's show you can contact us at podcast D X at Yahoo dot com through our Web site where you can link to our Facebook page and also see more information as we build our site. Please go to podcast D X dot com. [00:19:01][19.3] Ron: [00:19:02] And if You have a moment. Please give us a five star review on the ITunes Podcast App.. [00:19:02][0.0] [1042.8]

Episode 112: Larry West started his EMS career in 1989 in Ventura, California. Somehow he ended up in North Carolina. Larry tells how he went from Southern California to the South and ended up at Cary Area EMS as a volunteer. Larry spent time as a Paramedic at Six Flags Amusement Park and also became a RN. Larry is a Clinic Manager for Duke University Hospital. Larry was the first person who I met when I arrived for my interview at Cary. Larry and I discuss his beginning days in EMS, how he arrived at Cary Area EMS, why his certification lapsed and why he will be a lifelong volunteer.

Mr. Kevin Sowers, the President of Duke University Hospital, joins us to explore what they are doing to battle healthcare burnout. Mr. Sowers is one of eleven healthcare leaders that published a call to action in March 2017 that challenges healthcare organizations acrosst the country to make the focus on burnout a national priority. 

Will You Die Well? Please take your Bibles and look with me at Romans 8. We're going to be looking at verses 18-25, and the issue of present suffering and future glory. Recently I've thought much about a particular question. I'm not meaning to be dreary, but the question's been pressed on my mind and that is, "Andy, will you die well?" "Will you die well? Will you die filled with faith? Will you die filled with hope in our Lord Jesus Christ? Will your death be a testimony to those standing around of the power of the resurrection of Jesus Christ? Will you die well?" Now that question came to my mind because of reading Pilgrim's Progress, a book I love and I allude to frequently. You know that in that allegory of the Christian life, Christian and Hopeful come to the end of their journey and there is a river, and they have to cross the river, and the river symbolizes death. And they're looking left and right and everywhere for a place or a way to get across that doesn't include going through the river and there is none. And the angel that is there to counsel with them at that time, answers their question, "Is there another way?" And he says, "There is another way, but only two have gotten across there and none since that time. Only two, Enoch and Elijah went to heaven directly without passing through that river of death. Now we know it's possible the Lord could return in our lifetime, and that we will not have to die. That is a mystery discussed in 1 Corinthians 15. But if He does not, we will have to cross through that river. The question is, will we do it well? Now, when they looked at the river, they wondered how deep it was. Isn't that a natural question? You look and you say, "How deep is the river? Will it overflow me? Will it overwhelm me? Will I suffer? What is it going to be like?" And the angel said, "We don't know. We don't know, it's going to be as deep or as shallow in proportion to your trusting in the King of that place." It's as deep or shallow as your faith makes it. Now, how strong is your faith? Will you be like Hopeful who went across and found it to be like a little stream, a trickle barely that kind of came up to his knees and he went... Started going right across. But then there was Christian who started to suffer and struggle and drown and sputter. And needed all the help that his friend Hopeful could give him. Is your faith going to be strong at that time? And if not, you need to get ready now. You need to prepare now and how do we get ready? How do we strengthen our faith? How do we become hopeful? By reading the Scripture and believing the promises. The outcome of our text today is Christian hope. That you may have hope as Hopeful did. And ultimately as Christian did as well. I. Surrounded by Beauty and by Suffering Now, we live in a world in which we are surrounded by physical beauty. We see around us all the time, the beauty of God's creation, and it is beautiful. We also look at our own bodies and we confess with David that they are fearfully and wonderfully made. Our bodies are astonishing, and they are amazing and yet there is tremendous suffering. Both in the physical world and even with our own bodies. Recently, I was going up to Duke University Hospital, and actually I was coming out, I visited somebody. And I'll tell you, since I've been pastor, I've never been to a hospital so much as I have in the last three and a half years. And it's made these issues very real to me. It's helped me to realize that I myself someday will be in a hospital bed probably. And that people will be coming and visiting me and that it's going to be me facing my own end. But I've thought about these things. And so Romans 8:18-25, it's very sweet to me, it's very strong. It's on this that I'm basing my hope and other promises as well. But I was coming out of the hospital and I saw a woman, and she was pushing a stroller. And I caught her eye and our eyes met, and we looked at each other and she looked very, very care warren. And she looked sad and I don't really know why, but I thought going into the hospital, maybe she's visiting somebody who was sick. And then I looked down at her child and the child was too large really to be in a stroller and was completely bald. And I realized then that the child probably had cancer and they were going in for some more treatments and more consultation. Just looking at that symbolized the kind of things that we're talking about in Romans 8:18-25. Namely the physical suffering we see in the world in a sense of where is God in all of this? On September 11th, when those airplanes crashed into those buildings, there were many people questioning God. They were wondering, "Where is God in that physical suffering and all that death?" Handling Human Suffering Essential to Worldview It was shocking to people. And so as we come to the issue of suffering in this world, we're coming to what I consider to be one of the number one doorways or portals the church has taken into heresy and false teaching. It's when we get to physical suffering that we start to adjust things in our theology accordingly. And that's the very thing we must not do. We must come to the Scripture instead and say, "You teach me about suffering, help me to understand what death is, help me to understand the things that are going to happen to my body." Now we know that Romans chapter 8 is given for assurance, it's given for comfort, it's given a word of encouragement, and it is a tremendous word. We've seen it right from the very beginning to the very end in verse one it says, "There is therefore, now no condemnation for those who are in Christ Jesus." And then at the end, "Nothing shall separate us from the love of God in Christ Jesus our Lord." No condemnation all the way through to no separation, a tremendous word of encouragement. But yet in the middle, there's a word about suffering, isn't there? And that's the thing I love about Scripture. We would never want a comforter who you call up that person, maybe a woman or a man who just cares about you and you start to say some situation that's come up. Maybe you received a medical report or maybe some other issues come up in your life. And they immediately cut you off and say, "It'll be fine." "It'll be okay, everything's going to work out alright." See, we haven't even heard my problem yet. You haven't felt the weight of what I'm dealing with yet. You don't feel the weight of the issues. How can you tell me it's going to be fine if you don't deal with what really is facing me? Romans 8 doesn't do that, does it? It's not singing a few of your favorite things that's going to get you through this. Rain drops and roses, and pink satin sashes. I don't know the rest of it, but you know the song I'm singing. Singing a song like that is not going to get you through this kind of suffering. You need solid meat, you need doctrine. You need teaching that will get you through this. If you want to be a mighty Redwood, that's going to survive all of the storms and trials of life and not a little sapling that's going to get blown over when things come, you need to take in the word of God. II. Context Take in Romans chapter 8 and understand. Now, we have seen the context of Romans 8, he's speaking a word of assurance and comfort, but only to a certain category of person. He's speaking it to Christians. "There is therefore now no condemnation for those who are in Christ Jesus." You see that? It's for those who are in Christ. And he's very careful to delineate what that means. You're not controlled any longer by the flesh, your mind is not controlled any longer by the sinful nature. Rather it's controlled by the Spirit. You are in the Spirit, you're not in the flesh any longer. You've been rescued, you've been transferred, you're a new person in Christ, and therefore you can have this comfort and this assurance. And in the first half of this chapter, the focus has been on the indwelling Holy Spirit. The work, the energetic work of the Holy Spirit within you, a great sense of assurance and comfort to you as a Christian. But then at the end here in Verse 17, he strikes a dark final cord. Look what it says in verse 17, "If we are children…" To be a child of God, what a title? We've talked about that for two weeks, to be a child of God. Oh my goodness, the privileges and the joys of being a child of God. "But if we are children, then we are heirs, heirs of God and co-heirs with Christ. If indeed we share in His sufferings in order that we may also share in His glory." Boil it down at the end, no suffering, no glory. You will go through suffering. Jesus said, "In this world, you will have trouble, but take heart. I have overcome the world." Therefore, what is before us here is, what is the nature? What is the origin? What is the purpose of this suffering? And how can we as Christians, as children of God face it? III. Past: Creation, Subjection and Curse Now, in order to answer this question, we have to look back... We have to look back in time to the origins of creation itself, and what has gotten us into this present situation. We have to look back in the Bible. Now, the physical universe itself was created perfect by God. Now, this is contrary to the way that other religions or philosophical systems deal with the problem of evil. What they do... Like Greek philosophy, some types of Greek philosophy or Buddhism say that the physical world is intrinsically evil. And you're going to have evil as long as you are in the physical world. You understand that. So what you need to do is get away from the physical world, deny all physical things, become hyper spiritual, not physical, and in this way, you will be free from suffering. This is not what the Bible teaches, not at all. Rather, the Bible teaches that the physical world was created perfectly good. God created the world in six days, and at the end of it, He declared all that He had made to be good. And so the world is a good place, and much of that goodness is still around us, isn't it? It's a delightful thing to see. The cosmos, the Heavens declare the glory of God. Do they not? The sun, the moon and the stars. They just declare the brightness and the glory, the beauty of God and His creation. Lofty mountains, rolling hills, sweeping planes, deep valleys, hot deserts, grasslands, savannas, swamps, ice lands, all of them together sing the praise of God. Don't they? Just the variety on this earth, and they are delightful. The clouds, oceans, seas, rivers, springs, all of them trickling down ultimately to the ocean. They declare the glory of God and the goodness of God. It is a good world that He's made. And the variety of plants, Palm Trees, Oaks, Maples, Rhododendron, Roses. All of these things declare the glory of God. How much more the physical, the birds, and the animals, and the fish that He's made, and all the variety there? And then all the way up to human beings created in the image of God, male and female, created in the image of God. And when God saw all that He had made, He declared it what? He declared it good. It is a good physical world that He's made it. And if you don't understand that, you will not understand what God is doing in redemption. He's bringing us back to, actually even better, a perfect physical creation, a new heaven and a new earth. That's where we're heading. God is restoring and renewing, actually, even surpassing what He originally made. Physical Universe Cursed Because of Humanity The physical world, therefore, is not intrinsically evil because it's physical. That's a wrong way of thinking. Well then what happened? Well, the physical universe was subjected to humanity. God took the physical world, this Earth and everything in it, and subjected it to the human race. Remember what it said in Genesis 1:28 and following, it said, "God, blessed them and said to them, male and female, be fruitful and increase in number, fill the earth, and subdue it. Rule over the fish and the sea, and the birds of the air, and over every living creature that moves on the ground." So the earth and everything in it was subjected to man. Now, the cosmos was not subjected in the same way, but still, we read in scripture that when human history ends in this earth, the cosmos history will end as well. The stars, the sun, the moon, all of them will cease, and God will make a new Heavens as well as a new earth. And so even they focus on what's happening on the earth. So what's happening with the human race has a tremendous impact on the physical universe. And so, the creation in all of its glory was wrapped up and subjected in one sense to the human race. That's an important step, because what happened next? The human race sinned in Adam. We fell, we sinned. And so as a result of that sin, God cursed the physical universe. Do you see that? The physical universe was put under our dominion and therefore, God just sees it that way and curses the physical universe under Adam and Eve. You remember that curse in Genesis 3:17, and following to Adam, He said, "Cursed is the ground because of you." Do you hear that? Cursed is the ground because of you. And so the ground was cursed and therefore, it would produce thorns and thistles for him rather than the abundant harvest that God originally intended. And death entered the world as a result through one man. The first record we have of death was of the animal that was killed in Genesis 3 to make the skin for covering for Adam and Eve. And so death enters because of sin, as a result of sin. Now sin spread and multiplied and God had to judge it in Genesis chapter 6. There's a worldwide flood. Does that not establish also the connection between the human race and the physical world? What perished in the flood? Everything that breathed the life through its nostrils, all the animals died, except those that were on the ark. And so there is a bond, a link between what happens with human beings, and God and the physical universe. The physical universe, therefore, has been subjected, it says, to futility. Now, this bond is going to be even clearer at the end of the world. Some of you think, well, I hope that we are the final generation and I don't have to die. Well, have you not read what the final generation is going to have to go through? It's an amazing thing. Now, I know we can talk about the pre-tribulation rapture. That's another topic, but the fact of the matter is the world is not going to end easily. It's going to be a very, very difficult end. And so we're going to see very plainly, again, the bonding or the uniting between the physical universe and what's happening with the human race. Earthquakes are going to rend the surface of the earth. Stars are going to fall to the Earth like ripe figs from a tree. Rivers, lakes, seas and oceans are going to be poisoned. Every living thing in the sea will die. Trees, grass burned up. Therefore it makes sense that redemption, namely the death of Jesus Christ, will have a physical effect on the universe. Do you see that? And so what happened on the day that Jesus died, you remember from the sixth hour until the ninth hour what happened? Darkness came over the entire Earth. Do you remember that? Over that entire area there was darkness. Some think it was an eclipse. It doesn't say. It just says there was darkness for that period of three hours. And the moment Jesus died, we already had eluded Bill mentioned about the curtain being torn in two from top to bottom, but what else happened? The earth shook and the rocks were split. That's a little foretaste of the effect of the cross of Jesus Christ on the physical world. There is a connection, therefore, between redemption and the future. Now look down at verse 19-22. This is clearly described in the verses we're looking at today. It says, "The creation waits in eager expectation for the sons of God to be revealed. For the creation was subjected to frustration, not by its own choice, but by the will of the one who subjected it in hope that the creation will be itself, will be liberated from its bondage to decay and brought into the glorious freedom of the children of God. We know that the whole creation has been groaning as in the pains of childbirth, right up to the present time." And so creation is waiting, it's waiting, waiting for what? Waiting for us to finish, waiting for the children of God to be revealed, to be finished. Creation is waiting and groaning, it's been subjected to it, says "futility." The word means vanity or emptiness. A sense of purposelessness. You get the same thing in the book of Ecclesiastes. Ecclesiastes 1:2-8, "‘Vanity! Vanity!’ says the Teacher. ‘Utter vanity. Everything is vanity.’ What does man gain from all this labor, at which he toils under the sun. Generations come and generations go, but the earth remains forever. The sun rises and the sun sets and hurries back to where it rises. The wind blows to the south and turns to the north, round and round it goes ever returning on its course. All the streams flow into the sea and yet the sea is never full. To the place the streams come from there, they return again. All things are wearisome more than one can say." That is a poetic representation of what Paul says here in Romans eight. That everything physically has been subjected to vanity or frustration, futility, and therefore we see the Principal of death and decay ruling everything under the sun, right? Everything under the sun. Look at verses 20-21 again. "The creation was subjected to frustration, not by its own choice, but by the will of the one who subjected in hope that the creation itself will be liberated from its bondage to decay." Now, the word decay means, corruption, and anybody who knows anything about biology knows that everything's breaking down all the time. There's a principle of rotting and breaking apart all the time. Things are not getting more and more complex. They're always breaking down. Water attacks things and makes it rust. Sunlight affects, and destroys things so that your cells... Even the cells in your own body, because of radiation don't replicate perfectly. And so we rightly can say, we begin to die the moment that we're born, and that's because of this curse that everything physical is under. Well, that's the past, and that's why we're in what we're in now. IV. Present Suffering, Future Promises The present suffering, therefore unfolds as a result. Look at verse 18, it says in the NIV, "I consider that our present sufferings are not worth comparing..." That's not really a good translation. I like it better this way. "I consider that the sufferings of this present age are not worth comparing with the glory that will be revealed in us." This is a time of physical suffering and you can't escape. There's no way to escape it. God has not promised that to you. It's part of the age, the era, the time that we're in now, and he will not remove it. He enables us to bear up under it, but he will not remove it. And so we have present suffering. The physical universe groans and labors, (verse 22) we know that. The whole creation has been groaning as in the pains of childbirth, right up to the present time. It's not just the physical creation that's groaning. Human beings groan as well. Infants die in the Third World from malnutrition, and from poor medical care. Infants die in America from accidents and from other problems. Loved ones die. They face terrible sufferings and death. Malaria, and pneumonia, AIDS, multiple sclerosis, cancer and heart disease. And from that hospital bed comes a lamentable cry of suffering, and you say, "What is going to free us from this?" There's a sense of groaning. If you're in the medical community, you know what I'm talking about. There's a sense of groaning and you wonder, "What is God doing? Where is God in all of this?" Surprisingly, given the joy of this chapter, Children of God suffer too, don't we? We groan as well. Look at verse 23, "Not only so, but we ourselves who have the first fruits of the Spirit we groan inwardly as we await eagerly our adoption as sons, the redemption of our bodies." How can it be that we are exalted by the title, Children of God, and yet we groan and die the way that beast die. Really? How can that be? And so we groan inwardly. Well how do we respond? What is the answer? Well, the answer is words. Words from God. Promises that tend to actually run contrary to what we see and hear and experience in our lives. Promises of God. That if you believe, alleviate the suffering we go through. We have two here, future promise, number one, namely our glorification. We have an aspect to our salvation presently today. And we have an aspect to our salvation that we haven't received yet. There's an already and there's a not yet. And actually much of it, we haven't gotten yet. The best is yet to come. The best is yet to come. And so, we have a future salvation and future promises. It says in this text we have the first fruits of the Spirit. We have the Holy Spirit now. If you don't have the Holy Spirit now you're not a Christian. We already learned that in Romans 8. If anyone does not have the Spirit of Christ, he does not belong to Christ, verse 9. And so, we must have the indwelling Spirit, that's just however the first fruits of the Spirit. We have an experience with God based on the indwelling Spirit that's called the first fruits. What does that mean? Full harvest later. We get the rest of it later on. Ephesians 1 says the Holy Spirit is given us a down payment or deposit guaranteeing the final inheritance. So we get most of it later. Right now, we get the indwelling Spirit. He testifies that we're children of God, helps us when we pray. Talk about that next time, God willing. He does all these things. He leads us and guides us, helps us to put sin to death. That's what we get now, but that's just the foretaste. That's just part of it. That's just the first fruits of the Spirit. We have a future glory, yet to come. More than that, we have been raised from the dead, spiritually. Look at verse 10 again, this is by way of review, but we've already talked about it. "If Christ is in you, [look at what it says] your body is dead because of sin and yet your spirit is alive because of righteousness." Physical death is already at work in you and nothing will stop that. But your spirit is a new creation entity. It exists at the Word of God. God spoke it into existence. Let there be light, He said, in your soul and you got a new creation spirit. If anyone is in Christ, therefore he is what? A new creation. The old is gone, everything's become new. That new creation spirit, that person you are in Christ, can never die. Amen. It can never die, it will survive the inoperable tumor statement from the doctor. It will survive hospice. It will survive your last fleeting breaths as you lay on your back. It will survive any accidents you face in this world. That new creation entity cannot be killed. And that is glorious good news. You have been raised from the dead spiritually and you cannot die, again. You're alive with Christ, and you have the first fruit of the Spirit. But you have something better promised. Future physical bodily resurrection is promised here in this text. And why? Because Jesus received a physical body. If you don't believe in the physical resurrection of Christ, I don't think you're a Christian. I don't know how you could be. If Christ has not been raised, then we're still in our sins. But Christ has been raised what, the first fruits from the dead. What does that mean? He's not the only one that's going to get a resurrection body. Now that resurrection body that was special, wasn't it? It could appear and disappear, remember the road to Emmaus? He's eating with the disciples, and then after He gives thanks, their eyes are open, they realize who He is. And then what happened? Boom. He's gone. Resurrection body. Remember? On the night of the resurrection the doors were shut and locked for fear of the Jews and Jesus came and stood amongst them. How did He do that? I don't know. But He did. And Jesus made us a promise, "Because I live, you also will live." "I am the resurrection and the life, he who believes in Me will live even though he dies. And whoever lives and believes in Me will never die." Jesus is the resurrection and because of His resurrection, we have a promise of future glory. Now, here's the beauty of it. Look at verse 18 again, "I consider that the sufferings of this present age are not even worth considering to be equal to the glory that will be revealed in us." Now, I love the NASB, but I think they have it wrong here. The venerable NASB has it wrong. It's not glory that will be revealed to us. What does that mean? Well, we get to see it. We'll get to see the streets of gold. We'll get to see the new Heaven and new Earth. We'll get to see Jesus. All of that is true. We Shall Not Only See Glory, but We Shall Also Be Glory But this says more than that, it says that the glory will be revealed in us. How do I know that? Well, look what it says next in verse 19, "For the anxious longing of the creation waits eagerly for the revealing of the sons of God." You see that? The sons of God are going to be revealed, the children of God are going to be put on display. The word revealed is “apokalupsis.” We're going to be unveiled, we're going to be revealed. What does that mean we'll be revealed? In some sense now we're concealed. What we are has not been made known. And so the world doesn't recognize us, it doesn't see us the way it should. 1 John 3, it says very plainly. It says, "Dear friends, now we are children of God, and what we will be has not yet been made known, but we know that when He appears we shall be like Him, for we shall see Him as He is." So, the world doesn't see us right. The World sees us as people like in this jar of clay, but that's not who we really are, is it? It's not who we really are, we're going to be revealed. 1 Corinthians 4:7 says, "We have this treasure in jars of clay to show that it's all surpassing powers from God, not from us." What is this treasure? It's your new creation person, that new creation spirit is stuck in a jar of clay. It's stuck there, do you feel it? I'm stuck in this body and I'm dragging it around day after day and it doesn't want to go where I want to go. It doesn't want to do the things I want to do. I want to pray longer, I want to witness boldly, I want to give more, I want to serve, serve, serve, serve, but this body holds me back. What a wretched thing it is, but it's there and so we rely on God, we've got to stick with God, we got to trust Him and follow the Spirit and put sin to death and beat our body and make it our slave so that it can serve Christ. But that's where we are, we're stuck in this jar of clay. And so meanwhile, we groan, Paul says, we want to be out, we want to be out, we want to be free, and we want that resurrection body. So we're not only going to see glory, we are going to be glory. Do you understand the significance of that? You are going to shine. Look at verses 29-30. We're going to get to these God willing in two weeks, but I've got to look at them now. Verses 29-30, it says, "Those God foreknew He also predestined," look, predestined for what? "To be conformed to the likeness of His Son." Do you know what that means? You're going to be like Jesus top to bottom. Perfect in your spirit, perfect in your body as well. He has a perfectly whole Spirit, Holy Spirit, and He has a perfectly glorified body, and you're going to be like Him. You are predestined to be like Jesus. You're going to end up like Jesus, perfect like Him. "And those He predestined, He also called and those He called, He also justified, and those He justified…" What? "He also glorified." You're going to be glorious, just like you were justified and you were called and you were chosen. All of these things were done to you, so also will glory be done to you. You'll become glorious for the resurrection body. Perfectly conformed to the body of Christ. And so, Jesus says in Matthew 13:43, "Then the righteous will shine like the sun in the kingdom of their Father." You're going to shine like the sun if you're a Christian. The Redemption of the Universe Wow, that's the first promise. What about the second promise? Promise number two. Well, the perfection of the physical universe, the universe is going to get its day too. It's groaning now, but someday it's going to be free. It's going to be free from its bondage to decay, it's going to come into... It says the glorious freedom of the children of God, it's going to be a perfect place. Well, what's the process? Well, it's got to die first, just like us, right? And so, the universe, the physical universe has to go through death, a kind of a death. Hebrews 1:10 and following says, "In the beginning oh Lord, you laid the foundation of the Earth and the heavens are the work of your hands. They will perish, but You remain. They will all wear out like a garment, You will roll them up and throw them away." Why? So that He can make a new heaven and a new earth, the home of righteousness. He's going to roll up this place and throw it away, so don't invest in this place. It's not just Enron, don't invest in this place. Enron is just a picture of what's going to happen to everything physical, it's going to go away, but the spiritual realm will last forever, 2 Peter 3 says, "The day of the Lord will come like a thief. The heavens will disappear with a roar, the elements will be destroyed by fire and the Earth and everything in it will be laid bare." Don't invest in this world, that's application come later. Don't invest, the point is it's all going to go away. There's going to be a new heaven and a new earth, the home of righteousness, 2nd Peter 3:13. Revelation 21:1, "Then I saw a new heaven and a new earth for the first heaven and the first earth had passed away, and there was no longer any sea." Future promise number two, a beautiful physical creation that God can look over and say, it is very good. V. Application: Suffering in Hope So how do we face suffering? What is our application? I want to bring it down to just a four letter word, the word "hope." The word hope. We end in hope. Look what it says in verse 24-25, "For in this hope we were saved." What does it mean? The hope I've been talking about, the hope that someday you will be perfect like Jesus physically and spiritually, and that someday the physical universe will be reclaimed and made perfect, in this hope you were saved. A hope that is seen is no hope at all, who hope through what he already has? But if we hope for what we do not yet have we do what? We wait for it patiently. We wait for it patiently. We yearn for it and we wait. We don't have it yet, we have some things already, but much of it we don't have yet, and so, we wait patiently. Well, what do we do while we're waiting? What should we do while we're waiting? Well, number one, I'd like you to consider the promises. We've had a short time together so far, a little over half an hour to consider the promises. You can do this all week long. Take Romans 8 and read over these things. Look again at verse 18, "I consider that the sufferings of this present age aren't worth comparing with the glory that is to be revealed." What does consider mean? It's a weighing out. I don't think it's worth comparing. I've reckoned it, I've accounted... And like an accountant, I've accounted it, and it's lightweight compared to what we're going to get. It is nothing, but he has to do the thinking. It's not like singing the song A Few of My Favorite Things. We don't have Ostrich Assurance, do we? What is Ostrich Assurance? Stick your head in the ground and pretend that everything's wonderful, and then you can be assured. Not at all, get your head out of the ground and face it. Look at it. Look it square in the face. I am going to die, physically. Praise God for that, because flesh and blood cannot inherit the Kingdom of God anyway. So yes, let's pray for each other when we're sick, but pray even more for what God's doing through it. Pray for His spiritual work through it, but do your considerations. See, I don't even think it's worth comparing. Secondly, believe the Word. Do you know that all that I've done here is just speak words? And if you don't have faith in Jesus Christ, this means nothing. If you're not a believer in Jesus Christ, you've been listening to what I've said, none of these things matter to you. There is no comfort therefore. And so, you're left to face death without any hope. Please come to Christ. Don't walk out of this place without having given your life to Jesus Christ. Without having trusted that His death was your death, that His resurrection may be, also, your resurrection. Believe the Word. And if you're a Christian, believe the Word. And have a strong hope in God. Don't use the word hope the way we usually do, like, "I hope it doesn't rain on our picnic," or "I hope that our team wins the city championship," or "I hope that my kids come visit me when I'm in the nursing home." That's the way we use hope. That's not the hope we're talking about here. This is a hope that's as secure as the truthfulness and faithfulness of God. He's made us some promises. Has He ever broken His word? These things will happen. This is our hope. This kind of hope we have. Not a weak and feeble earthly hope. Then persevere and suffering, wait patiently and persevere. Remember Romans 5:3-5, "Not only so, but we rejoice in our sufferings because we know that suffering produces perseverance, perseverance, character, and character produces hope, and hope does not disappoint, because God has poured out His love into our hearts by the Holy Spirit." Let the trials do their work on you. Let your diseases do their work on you. Let the suffering of you and of your loved ones do its good work in your soul. Trust in God and realize that these are small problems, temporary, and this is spoken by a man who got beaten more times than he could count. Who was shipwrecked and who suffered. 2 Corinthians 13:12 talks about it. Suffering was part of Paul's everyday life, he says, it's not even worth comparing the future glory. Meanwhile, I know that this isn't an a joyful application, but groan. Don't pretend it doesn't hurt. Don't pretend it doesn't hurt when your loved one dies. Don't act that way. Of course it hurts when you don't have that person around anymore. Of course it hurts. Paul said, "Meanwhile, we groan." We go through it with our eyes open, and we do mourn with those who mourn, as though it were something we were going through. Jesus wept at Lazarus' tomb. We do mourn, and we hurt, and we go through it. And finally, love the children of God. How can you look at each other just like people anymore? Don't you realize that, if you're looking at a child of God, someday he or she is going to be so glorious that you'd want to worship them, if you didn't know better? Just like John wanted to worship the angel that brought him revelation. You'd want to get down and worship them, because they're just so stunning and glorious. But we won't, because we'll be stunning and glorious too, and so, it should affect the way we treat each other. And everything you do, every interaction you have with another person, you're either helping them along toward Heaven or toward Hell, one or the other. C.S. Lewis brought this out in a sermon, Weight of Glory. It says it may be possible for each of us to think too much of his own potential glory hereafter, but it is hardly possible for him to think too often, or too deeply, about that of his neighbor. The load, or weight, or burden of my neighbor's glory should be laid daily on my back, a load so heavy, that only humility can carry it, and the backs of the proud will be broken. It is in the light of these overwhelming possibilities that we should conduct all our dealings with one another. All friendships, all loves, all play, all politics. There are no ordinary people. Do you understand that? There are no ordinary people. You've never talked to a mere mortal. Nations, cultures, arts, civilization, these are mortal, and their life to ours is like the life of a gnat, compared to us. Do you realize that? You'll spend eternity somewhere, but it is immortals with whom we joke, and work, and marry, and snub and exploit. Immortal horrors or everlasting splendors, said CS Lewis. We can't see each other the same way ever again. We are dealing with people who will someday be glorious, or someday, be under the wrath of God, eternally. We have to deal with these things with a weight that they deserve.