Podcasts about general pediatrics

Interview Summary So, you two, along with a number of other people in the field, wrote a chapter for a recently published book called The Handbook of Children and Screens. We discussed that book in an earlier podcast with its editors, Dmitri Christakis and Kris Perry, the executive director of the Children and Screens organization. And I'd like to emphasize to our listeners that the book can be downloaded at no cost. I'd like to read a quote if I may, from the chapter that the two of you wrote. 'Screen time continues to evolve with the advent of continuous and immersive video reels, voice activated assistance, social media influencers, augmented and virtual reality targeted advertising. Immersive worlds where children can virtually shop for food and beverages, cook or work in a fast-food outlet from a smartphone, a tablet, a computer, or an internet connected tv and more.' So as much as I follow the field, I still read that and I say, holy you know what. I mean that's just an absolutely alarming set of things that are coming at our children. And it really sounds like a tidal wave of digital sophistication that one could have never imagined even a short time ago. Amanda, let's start with you. Can you tell us a little bit more about these methods and how quickly they evolve and how much exposure children have? I think you're right, Kelly, that the world is changing fast. I've been looking at screen media for about 20 years now as a researcher. And in the earlier years, and Tom can attest to this as well, it was all about TV viewing. And you could ask parents how much time does your child spend watching TV? And they could say, well, they watch a couple shows every night and maybe a movie or two on the weekend, and they could come up with a pretty good estimate, 1, 2, 3 hours a day. Now, when we ask parents how much time their children spend with media, they have to stop and think, 'well, they're watching YouTube clips throughout the day. They're on their smartphone, their tablet, they're on social media, texting and playing all these different games.' It really becomes challenging to even get a grasp of the quantity of screen time let alone what kids are doing when they're using those screens. I will say for this book chapter, we found a really great review that summarized over 130 studies and found that kids are spending about three and a half or four hours a day using screens. Yet some of these studies are showing as high as seven or eight hours. I think it's probably under-reported because parents have a hard time really grasping how much time kids spend on screens. I've got a one-year-old and a five-year-old, and I've got some nieces and nephews and I'm constantly looking over their shoulder trying to figure out what games are they playing and where are they going online and what are they doing. Because this is changing really rapidly and we're trying to keep up with it and trying to make sure that screen time is a safe and perhaps healthy place to be. And that's really where a lot of our research is focused. I can only imagine how challenging it must be to work through that landscape. And because the technology advances way more quickly than the policies and legal landscape to control it, it really is pretty much whatever anybody wants to do, they do it and very little can be done about it. It's a really interesting picture, I know. We'll come back later and talk about what might be done about it. Tom, if you will help us understand the impact of all this. What are the effects on the diets of children and adolescents? I'm thinking particularly when Amanda was mentioning how many hours a day children are on it that three to four hours could be an underestimate of how much time they're spending. What did kids used to do with that time? I mean, if I think about when you and I were growing up, we did a lot of different things with that time. But what's it look like now? Well, that's one of the important questions that we don't really know a lot about because even experimental studies that I can talk about that look at reducing screen time have not been very good at being able to measure what else is going on or what substitutes for it. And so, a lot of the day we don't really know exactly what it's displacing and what happens when you reduce screen time. What replaces it? The assumption is that it's something that's more active than screen time. But, you know, it could be reading or homework or other sedentary behaviors that are more productive. But we really don't know. However, we do know that really the general consensus across all these studies that look at the relationship between screen time and nutrition is that the more time children spend using screens in general, the more calories they consume, the lower the nutritional quality of their diets and the greater their risk for obesity. A lot of these studies, as Amanda mentioned, were dominated by studies of television viewing, or looking at television viewing as a form of screen use. And there's much less and much more mixed results linking nutrition and obesity with other screens such as video games, computers, tablets, and smartphones. That doesn't mean those relationships don't exist. Only that the data are too limited at this point. And there's several reasons for that. One is that there just haven't been enough studies that single out one type of screen time versus another. Another is what Amanda brought up around the self-report issue, is that most of these studies depend on asking children or the parents how much time they spend using screens. And we know that children and adults have a very hard time accurately reporting how much time they're using screens. And, in fact when we measure this objectively, we find that they both underestimate and overestimate at times. It's not all in one direction, although our assumption is that they underestimate most of the time, we find it goes in both directions. That means that in addition to sort of not having that answer about exactly what the amount of screen time is, really makes it much tougher to be able to detect relationships because it adds a lot of error into our studies. Now there have been studies, as I mentioned, that have tried to avoid these limitations by doing randomized controlled trials. Including some that we conducted, in which we randomized children, families or schools in some cases to programs that help them reduce their screen time and then measure changes that occur in nutrition, physical activity, and measures of obesity compared to kids who are randomized to not receive those programs. And the randomized trials are really useful because they allow us to make a conclusion about cause-and-effect relationships. Some of these programs also targeted video games and computers as well as television. In fact, many of them do, although almost all of them were done before tablets and smartphones became very common in children. We still don't have a lot of information on those, although things are starting to come out. Most of these studies demonstrated that these interventions to reduce screen use can result in improved nutrition and less weight gain. And the differences seen between the treatment and control groups were sometimes even larger than those commonly observed from programs to improve nutrition and increased physical activity directly. Really, it's the strongest evidence we have of cause-and-effect relationships between screen use and poor nutrition and risk for obesity. Of course, we need a lot more of these studies, particularly more randomized controlled studies. And especially those including smartphones because that's where a lot of kids, especially starting in the preteen age and above, are starting to spend their time. But from what we know about the amount of apparent addictiveness that we see in the sophisticated marketing methods that are being used in today's media, I would predict that the relationships are even larger today than what we're seeing in all these other studies that we reviewed. It's really pretty stunning when one adds up all that science and it looks pretty conclusive that there's some bad things happening, and if you reduce screen time, some good things happen. So, Amanda, if you know the numbers off the top of your head, how many exposures are kids getting to advertisements for unhealthy foods? If I think about my own childhood, you know, we saw ads for sugar cereals during Saturday morning cartoon televisions. And there might have been a smattering if kids watch things that weren't necessarily just directed at kids like baseball games and stuff like that. But, and I'm just making this number up, my exposure to those ads for unhealthy foods might have been 20 a week, 30 a week, something like that. What does it look like now? That is a good question. Kelly. I'm not sure if anyone can give you a totally accurate answer, but I'll try. If you look at YouTube ads that are targeting children, a study found that over half of those ads were promoting foods and beverages, and the majority of those were considered unhealthy, low nutritional value, high calorie. It's hard to answer that question. What we used to do is we'd take, look at all the Saturday morning cartoons, and we'd actually record them and document them and count the number of food ads versus non-food ads. And it was just a much simpler time in a way, in terms of screen exposure. And we found in that case, throughout the '90s and early 2000s, a lot of food ads, a lot of instances of these food ads. And then you can look at food placement too, right? It's not an actual commercial, but these companies are paying to get their food products in the TV show or in the program. And it's just become much more complicated. I think it's hard to capture unless you have a study where you're putting a camera on a child, which some people are doing, to try to really capture everything they see throughout their day. It's really hard to answer, but I think it's very prolific and common and becoming more sophisticated. Okay, thanks. That is very helpful context. Whatever the number is, it's way more than it used to be. Definitely. And it also sounds as if and it's almost all for unhealthy foods, but it sounds like it's changed in other ways. I mean, at some point as I was growing up, I started to realize that these things are advertising and somebody's trying to sell me something. But that's a lot harder to discern now, isn't it with influencers and stuff built in the product placements and all that kind of stuff. So, to the extent we had any safeguards or guardrails in the beginning, it sounds like those are going to be much harder to have these days. That's right. It really takes until a child is 6, 7, 8 years old for them to even identify that this is a commercial. That this is a company that's trying to sell me something, trying to persuade. And then even older children are having to really understand those companies are trying to make money off the products that they sell, right? A lot of kids, they just look at things as face value. They don't discriminate against the commercial versus the non-commercial. And then like you're suggesting with social influencers, that they're getting paid to promote specific products. Or athletes. But to the child that is a character or a person that they've learned to love and trust and don't realize, and as adults, I think we forget sometimes too. That's very true. Amanda, let me ask about one thing that you and Tom had in your chapter. You had a diagram that I thought was very informative and it showed the mechanisms through which social media affects the diet and physical activity of children. Can you describe what you think some of the main pathways of influence might be? That figure was pretty fun to put together because we had a wonderful wealth of knowledge and expertise as authors on this chapter. And people provided different insight from the scientific evidence. I will say the main path we were trying to figure out how does this exposure to screen really explain changes in what children are eating, their risk for obesity, the inactivity and sedentary behavior they're engaging in? In terms of food, really what is I believe the strongest relationship is the exposure to food advertisement and the eating while engaging in screen time. You're getting direct consumption while you're watching screens, but also the taste preferences, the brand loyalty that's being built over time by constantly seeing these different food products consistently emerge as one of the strongest relationships. But we identified some other interesting potential mechanisms too. While kids are watching screens or engaging in screens, there's some evidence to indicate that they're not able to read their body as well. Their feelings of hunger, their feelings of satiety or fullness. That they're getting distracted for long periods of time. Also, this idea of instant gratification, just like the reward process of instant gratification with using the screen. They're so interactive. You can go online and get what you want and reach what you want. And the same thing is happening with food. It becomes habitual as well. Children get off of school and they go home, and they grab a snack, and they watch tv or they watch their YouTube clips or play their games. And it becomes an eating occasion that may not have otherwise existed. But they're just associating screen time with eating. There's some evidence even on screen time impacting inhibition and controlling impulse and memory. And that's more emerging, but it's interesting to just consider how this prolonged screen time where you're not interacting with someone in person, your eyes are focused on the screen, might actually be having other cognitive impacts that we may not even be aware of yet. If we ask the question why Is screen time having a bad impact on children and their diets? It's almost let us count the ways. There are a lot of possible things going on there. And speaking of that, there's one question in particular I'd like to ask you, Tom. Certainly marketing might affect what kids prefer. Like it might make them want to have a cereal or a beverage A or snack food B or whatever it happens to be. But could it also affect hunger? How much kids want to eat? I mean, you think, well, hunger is biological, and the body sends out signals that it's time to eat. How does that all figure in? The research suggests it can. Advertising in particular but even non-advertising references or images of food can trigger hunger and eating whether or not you felt hungry before you saw them. And I'm guessing almost everyone's experienced that themselves, where they see an image of food, and all of a sudden, they're craving it. It can be as simple as Pavlov's dogs, you know, salivating in response to cues about food. In addition, I think one of the mechanisms that Amanda brought up is this idea that when you're distracted with a screen, it actually overruns or overwhelms your normal feelings of fullness or satiety during eating. When distracted, people are less aware of how much they're eating. And when you're eating while using a screen, people tend to eat until they've finished the plate or the bag or the box, you know? And until that's empty, till they get to the bottom, instead of stopping when they start to get full. Well, there's sort of a double biological whammy going on there, isn't there? It is affecting your likelihood of eating in the first place, and how hungry you feel. But then it also is affecting when you stop and your satiety happening. And you put those two together there's a lot going on, isn't there? Exactly. And it's really one of the reasons why a lot of our programs to reduce weight gain and improve nutrition really put a lot of emphasis on not eating in front of screens. Because our studies have shown it accounts for a large proportion of the calories consumed during the day. Oh, that's so interesting. Amanda, you mentioned influencers. Tell us a little bit more about how this works in the food space. These social influencers are everywhere, particularly Instagram, TikTok, et cetera. Kids are seeing these all the time and as I mentioned earlier, you often build this trusting relationship with the influencer. And that becomes who you look to for fads and trends and what you should and shouldn't do. A lot of times these influencers are eating food or cooking or at restaurants, even the ones that are reaching kids. As you analyze that, oftentimes it's the poor nutrition, high calorie foods. And they're often being paid for the ads too, which as we discussed earlier, kids don't always realize. There's also a lot of misinformation about diet and dieting, which is of concern. Misinformation that could be harmful for kids as they're growing and trying to grow in a healthy way and eat healthy foods. But kids who may look to overly restrict their foods, for example, rather than eating in a healthier manner. So that's definitely a problem. And then also, oftentimes these social influencers really have these unattainable beauty standards. Maybe they're using a filter or maybe they are models or whatnot. They're projecting these ideal body images that are very difficult and sometimes inappropriate for children to try to attain. Now, we've seen this in other forms, right? We've seen this in magazines going back. We've seen this on websites. But now as soon as a kid turns on their smartphone or their tablet and they're online, it's in front of them all the time. And, and they're interacting, they're liking it, they're commenting and posting. I think the social influencers have just really become quite pervasive in children's lives. Somebody who's an influencer might be recording something that then goes out to lots and lots of people. They're eating some food or there's some food sitting in the background or something like that. And they're getting paid for it, but not saying they're getting paid for it. Probably very few people realize that money is changing hands in all of that, I'm suspecting, is that right? Yes, I do believe they're supposed to do hashtag ad and there are different indicators, but I'm not sure the accountability behind that. And I'm also not sure that kids are looking for that and really understand what that means or really care what that means. Okay. Because they're looking to sense what's popular. But there's an opportunity to perhaps further regulate, or at least to educate parents and kids in that regard that I think would be helpful. Tom, while we're on this issue of conflicts of interest, there was recent press coverage, and then there were reports by reporters at the Washington Post and The Examination showing that the food industry was paying dieticians to be influencers who then posted things favorable to industry without disclosing their funding. How big of a problem do you think this is sort of overall with professionals being paid and not disclosing the payments or being paid even if they disclose things. What kind of a negative impact that's having? Yes, I find it very concerning as you would guess, knowing me. And I believe one of the investigations found that about half of influencers who were being paid to promote foods, drinks, or supplements, didn't disclose that they were paid. It was quite a large magnitude. It goes throughout all types of health professionals who are supposed to be sources of quality information and professional organizations themselves which take advertising or take sponsorships and then don't necessarily disclose it. And you know in this day when we're already seeing drops in the public's trust in science and in research, I think this type of information, or this type of deception just makes it a lot worse. As you know, Kelly, there's quite a bit of research that suggests that being paid by a company actually changes the way you talk about their products and even conduct research in a way that's more favorable to those products. Whether you think it does or not, whether you're trying to be biased or not. Tom, just to insert one thing in my experience. If you ask people in the field, does taking money from industry affect the way scientists do their work and they'll almost always say yes. But if you say, does it influence your work, they'll almost always say no. There's this unbelievable blind spot. And one might conclude from what you were telling us is that disclosure is going to be the remedy to this. Like for the half of people who didn't disclose it, it would be okay if they took the money as long as they disclosed it. But you're saying that's obviously not the case. That there's still all kinds of bias going on and people who are hearing some disclosure don't necessarily discount what they're hearing because of it. And it's still a pretty bad kettle of fish, even if disclosure occurs. It's especially pernicious when it doesn't, but it seems even when disclosure happens, it's not much of a remedy to anything. But you may not agree. No, I definitely agree with that. And that's only, you know, part of it too because there's the other side of the audience that Amanda brought up as well. And in particular what kids, but also adults, how they react to disclosures. And, while it's been possible to teach people to recognize potential bias, you know, when there's a disclosure. And to make people aware, which is a good thing, we want disclosure, I guess, so people are aware to be more vigilant in terms of thinking about what biases may be in the messages. There's not much evidence that teaching people that or making them aware of that changes their behavior. They still believe the advertising. Right. They still act in the same way. It's still just as persuasive to them. One more little editorial insertion. The thing that has always puzzled me about disclosure is that it implies that there's something bad going on or else, why would you have to disclose it? And the solution seems not to disclose it, but not to do the bad thing. And it's like, I could come up and kick you in the leg, but it's okay if I disclose that I kick you in the leg. I mean, it just makes no sense to me. But let me move on to something different. Amanda, I'd like to ask you this. I assume the food industry gets a lot more impact and reach per dollar they spend from when the only option was to run ads on national television and now, they're doing things at much less expense, I think, that can have, you know, orders of magnitude more impact and things. But is my perception correct? And how do you think through that? I think of it like the Tupperware model, right? You're building these trusted local or national celebrities, spokespeople for kids. Oftentimes these young adults or teenagers who are doing funny things and they're engaging, and so you're building this trust like you did with the Tupperware. Where you go and train people to go out to people's homes and their neighbors and their friends and their church and sell the product. It's really similar just in an online space. I think you're right; the cost is likely much less. And yet the reach and even the way these influencers are paid is all about the interaction, the likes, the comments, that sort of thing. The reposts. It's become quite sophisticated, and clearly, it's effective because companies are doing this. And one other thing to mention we haven't talked about yet is the food companies themselves have hired young people who use humor as a way to create a following for the different brands or products. It's not a person now, it's either the branded character or the actual company itself. And I think that has great influence of building some loyalty to the brand early in life. So that child is growing up and not only persuading their parents to purchase these products, but as they have more disposable income, they're going to continue purchasing the product. I wonder if Edward Tupper or I don't know if I remember his first name right, but I wonder if you could have ever imagined the how his plastic invention would permeate more of society than he ever thought? Tom, what about the argument that it's up to parents to decide and to monitor what their children are exposed to and the government needs to back off. Oh, it would be so nice if they were that easy, wouldn't it? If we could depend on parents. And I think every parent would love to be able to do that. But we're talking about individual parents and their kids who are being asked to stand up against billions, literally billions and billions of dollars spent every year to get them to stay on their screens as long as possible. To pay attention to their marketing, as Amanda was talking about the techniques they use. And to really want their products even more. If you could think of a parent with endless knowledge and time and resources, even they are really unable to stand up to such powerful forces working against them. Unfortunately, and this is not unique to the issues of screens in children's health, but really many of the issues around health, that in the absence of government regulation and really lack of any oversight, this really difficult job is dumped on parents. You know, not their choice, but it's sort of in their lap. We still try and help them to be better at this. While we're waiting for our elected representatives to stand up to lobbyists and do their jobs, we still in a lot of our interventions we develop, we still try and help parents as well as schools, afterschool programs, teachers, health professionals, develop the skills to really help families resist this pool of media and marketing. But that shouldn't be the way it is. You know, most parents are really already doing the best they can. But it's drastically unfair. It's really an unfair playing field. That all makes good sense. We've been talking thus far about the negative impacts of media, but Amanda, you've done some work on putting this technology to good use. Tell us about that if you will. I do enjoy trying to flip the script because technology is meant to help us, not harm us. It's meant to make our lives more efficient, to provide entertainment. Now with video chatting, to provide some social connection. A lot of my work over the past 20 years has been looking at what's commercially available, what kids are using, and then seeing let's test these products or these programs and can we flip them around to promote healthier eating? To promote physical activity? Can we integrate them for kids who are in a weight management program? Can we integrate the technology to really help them be successful? It doesn't always work, and we certainly aren't looking to increase screen time, but we also need to recognize that achieving zero hours of screen time is really unattainable pretty much universally. Let's try to evaluate the screen time that is being used and see if we can make it healthier. A few examples of that include when the Nintendo Wii came out about 18 years ago now. I was part of a group that was one of the first to test that video game console system because up until that point, most of the games you sat down to play, you held a remote in your hand. There were Dance Dance Revolution games and arcade halls so you could do a little bit of movement with games. But pretty much they were sedentary. Nintendo Wii came out and really changed a lot because now you had to get up off the couch, move your body, move your arms and legs to control the game. And we found it cut across all demographics. Men, women, boys, girls, different age groups. There was content available for a lot of different groups. These types of games became really popular. And I did some of the earlier studies to show that at least in a structured program that kids can engage in what we call moderate levels of physical activity. They're actually moving their bodies when they play these games. And over time, I and others have integrated these games into programs as a way to be an in with kids who may not be involved in sports, may not go outside to play, but they're willing to put on a video game and move in their living room at home. Building from that, we've developed and tested various apps. Some of these apps directly reach the parents, for example, teaching the parents. These are strategies to get your child to eat healthier. Prepare healthier meals, grocery shop, be more physically active as a family. We've looked at different wearables, wristwatches that can help kids and parents. Maybe they'll compete against each other to try to get the most steps of a day and that sort of thing. And then some of my recent work is now integrating chatbots and artificial intelligence as ways to provide some tailored feedback and support to kids and families who are looking to be more physically active, eat healthier. And then one study I'm really excited about uses mixed reality. This is virtual reality where you're putting on a headset. And for that study we are integrating children's homework that they would otherwise do on their Chromebook. And we're removing the keyboard and computer mouse so that they now have to use their body to click and point and drag and move the screen. And these are just a few examples. I do not think this is the magical solution. I think as Tom alluded to, there are different levels of government regulation, educating parents, working with schools. There's working with the food industry. There's a lot that we need to do to make this a healthier media space for kids. But I think this is something we should be open to, is figuring out if people are going to spend a lot of time using screens, what can we do to try to make those screens healthier? You make me smile when I'm hearing that because all these things sound really exciting and like there's plenty of potential. And you're right, I mean, if they're going to be on there anyway, maybe there can be some positive way to harness that time. And those all sound really important and really good. And let's hope that they spread enough to really touch lots and lots of children and their families. Tom, you and I keep caught up. We see each other at professional meetings or we just have periodic phone calls where we tell each other what we're up to. And you've been telling me over the past couple years about this really amazing project you're heading up tracking screen usage. Could you tell us a little bit about that? I'd love to. Really it addresses the problem that came up before, which is really how we measure what people are doing and seeing on their screens. Basically all the studies of media effects for the past a hundred plus years that the field has been studying media, has been dependent on people telling us what they do and what they saw. When in fact, we know that's not particularly accurate. So now we have technology that allows us to track exactly what people are doing and seeing on their screens. We call this screenomics, like genomics, except instead of studying how genes affect us, it's studying how screens affect us and how the screens we experience in our lives really are a reflection of our lives. The way we are doing this is we put software on your phone or your laptop, and it can be on other screens as well, and it runs in the background and takes a screenshot every five seconds. And it covers everything on the screen because it's just taking a picture of the screen. All the words, all the images. Then we use AI to help us decipher [00:34:00] what was on those screens. And so far, we've collected over 350 million screenshots from several hundred adults and teenagers who've participated in our studies for periods of six months to a year. Some of our most interesting findings, I think, is how much idiosyncrasy there is in people's screen use. And this has a huge impact on how we do research on the effects of screens, I believe. Because no two people really have the same screenomes, which is what we call the sequence of screenshots that people experience. And even for the same person, no two hours or days or weeks are the same. We're looking at both how different people differ in their screen use, and how that's related to their mental health, for example. But also how changes over time in a single person's screenome is related to their mental health, for example. Comparing your screen use this afternoon to your screen use this morning or yesterday, or last week or last month. And how that changes your health or is at least associated with changes in your health at this point. Eventually, we hope to move this into very precise interventions that would be able to monitor what your screen experience is and give you an appropriate either change in your screen or help you change your behavior appropriate to what you're feeling. One of our current studies is to learn really the details of what, when, how, why, and where foods and beverages appear in adolescent screenomes. And how these factors relate to foods and beverages they consume and their health. In fact, we're currently recruiting 13- to 17-year-olds all over the US who can participate in this study for six months of screenome collection and weekly surveys we do with them. Including detailed surveys of what they're eating. But this sort of goes back to an issue that came up before that you had asked us about how much is advertising? I can tell you that at least some of our preliminary data, looking at a small number of kids, suggests that food, it varies greatly across kids and what they're experiencing, especially on their phones. And, we found, for example, one young girl who 37% of all her screens had food on them. About a third, or more than a third of her entire screenome, had food in it. And it wasn't just through advertising and it wasn't just through social media or influencers. It was everywhere. It was pictures she was taking of food. It was influencers she was following who had food. It was games she was playing that were around food. There are games, they're all about running a restaurant or making food and serving and kitchen work. And then there were also videos that people watched that are actually fairly popular among where you watch other people eat. Apparently it's a phenomenon that came out of Korea first. And it's grown to be quite popular here over the last several years in which people just put on their camera and show themselves eating. I mean, nothing special, nothing staged, just people eating. There's all kinds of food exists everywhere throughout the screenome, not just in one place or another, and not just in advertising. Tom, a study with a hundred data points can be a lot. You've got 350 million, so I wish you the best of luck in sorting all that out. And boy, whatever you find is going to be really informative and important. Thanks for telling us about this. I'd like to end with kind of a basic question to each of you, and that is, is there any reason for hope. Amanda, let's, let's start with you. Do you see any reason to be optimistic about all this? We must be optimistic. No matter how we're facing. We have no choice. I think there's greater awareness. I think parents, policy makers, civic leaders are really recognizing this pervasive effective screen use on mental health, eating, obesity risk, even just the ability to have social interactions and talk to people face to face. And I think that's a good sign. I've seen even in my own state legislature in Louisiana, bills going through about appropriately restricting screens from schools and offering guidance to pediatricians on counseling related to screen use. The American Academy of Pediatrics changed their guidelines a number of years ago. Instead of just saying, no screens for the really little ones, and then limit to fewer than two hours a day for the older ones. They recognized and tried to be more practical and pragmatic with family. Sit down as a family, create some rules, create some boundaries. Make sure you're being healthy with your screen use. Put the screens away during mealtime. Get the screens out of the bedroom. And I think going towards those more practical strategies that families can actually do and sustain is really positive. I'd like to remain optimistic and let's just keep our eyes wide open and talk to the kids too. And ask the kids what they're doing and get them part of this because it's so hard to stay up to date on the technology. Thanks. I appreciate that positive note. Tom, what do you think? Yeah, I agree with Amanda. I can be positive about several things. First of all, I think last year, there were two bills, one to protect child privacy and the other to regulate technology aimed at children. COPPA 2.0 (Children's Online Private Protection Act) and KOSA (Kid's Online Safety Act). And they passed the Senate overwhelmingly. I mean, almost unanimously, or as close as you can get in our current senate. Unfortunately, they were never acted upon by the house, but in the absence of federal legislature regulation, we've had, as Amanda mentioned, a lot of states and also communities where they have actually started to pass bills or regulate social media. Things like prohibiting use under a certain age. For example, social media warning labels is another one. Limiting smartphone use in schools has become popular. However, a lot of these are being challenged in the courts by tech and media industries. And sadly, you know, that's a strategy they've borrowed, as you know well, Kelly, from tobacco and food industry. There also have been attempts that I think we need to fight against. For the federal legislature or the federal government, congress, to pass legislation to preempt state and local efforts, that would not allow states and local communities to make their own laws in this area. I think that's an important thing. But it's positive in that we're hearing advocacy against that, and people are getting involved. I'm also glad to hear people talking about efforts to promote alternative business models for media. I believe that technology itself is not inherently good or bad, as Amanda mentioned, but the advertising business models that are linked to this powerful technology has inevitably led to a lot of these problems we're seeing. Not just in nutrition and health, but many problems. Finally, I see a lot more parent advocacy to protect children and teens, especially around tech in schools and around the potential harms of social media. And more recently around AI even. As more people start to understand what the implications of AI are. I get the feeling these efforts are really starting to make a difference. Organizations, like Fair Play, for example, are doing a lot of organizing and advocacy with parents. And, we're starting to see advocacy in organizing among teens themselves. I think that's all really super positive that the public awareness is there, and people are starting to act. And hopefully, we'll start to see some more action to help children and families. Bios Developmental psychologist Dr. Amanda Staiano is an associate professor and Director of the Pediatric Obesity & Health Behavior Laboratory at Pennington Biomedical Research Center at Louisiana State University. She also holds an adjunct appointment in LSU's Department of Psychology. Dr. Staiano earned her PhD in developmental psychology and Master of Public Policy at Georgetown University, followed by a Master of Science in clinical research at Tulane University. Her primary interest is developing and testing family-based healthy lifestyle interventions that utilize innovative technology to decrease pediatric obesity and its comorbidities. Her research has involved over 2500 children and adolescents, including randomized controlled trials and prospective cohorts, to examine the influence of physical activity and sedentary behavior on body composition and cardiometabolic risk factors. Thomas N. Robinson, MD, MPH is the Irving Schulman, MD Endowed Professor in Child Health, Professor of Pediatrics and of Medicine, in the Division of General Pediatrics and the Stanford Prevention Research Center at Stanford University School of Medicine, and Director of the Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford. Dr. Robinson focuses on "solution-oriented" research, developing and evaluating health promotion and disease prevention interventions for children, adolescents and their families to directly inform medical and public health practice and policy. His research is largely experimental in design, conducting school-, family- and community-based randomized controlled trials to test the efficacy and/or effectiveness of theory-driven behavioral, social and environmental interventions to prevent and reduce obesity, improve nutrition, increase physical activity and decrease inactivity, reduce smoking, reduce children's television and media use, and demonstrate causal relationships between hypothesized risk factors and health outcomes. Robinson's research is grounded in social cognitive models of human behavior, uses rigorous methods, and is performed in generalizable settings with diverse populations, making the results of his research more relevant for clinical and public health practice and policy.

Send us a textIn this enlightening episode of the I AM Well MD Podcast, we welcome Ravinder Taylor, a distinguished researcher, author, and expert in the field of self-help and mind training. For over 30 years, Ravinder has been a guiding light for individuals seeking to break through personal barriers and step into empowered versions of themselves.She joins us today to explore the science behind mind training, how we can rewire thought patterns, tap into deeper mental potential, and create a life aligned with purpose, power, and inner peace.Together, we unpack:What “mind training” really means and why it mattersPractical tools and evidence-based techniques for mind trainingWhy mindset is the key to well-being, performance, and fulfillmentAs co-author of over 200 personal motivation programs and a seasoned guest on major platforms like Coast to Coast AM, Ravinder brings both depth and clarity to the self-help conversation, bridging science, intuition, and empowerment.Whether you're a healer, parent, or seeker on the path of self-mastery, this episode is your invitation to go deeper and train your mind to work for you, not against you.Connect with Ravinder:Website: ravindertaylor.comIG: ravindertaylor Facebook: Ravinder K TaylorDr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, health, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Learn more at iamwellmd.com. Join our email list or drop us a message by going to iamwellmd.com/contact. Follow I AM Well MD: Instagram | LinkedIn | FacebookDisclaimer: The information shared on the I AM Well MD Podcast is for educational purposes only and should not be considered medical advice. All health-related decisions should be made in consultation with your personal medical provider. The views expressed by me are my own and do not reflect those of my guests, employers, or affiliated institutions. Likewise, the views of any guest do not represent my personal or professional opinions. The content shared on this podcast is intended to inspire thoughtful reflection, not to provide medical diagnosis or treat...

Send us a textIn this transformational episode, Executive Performance Coach, Dr. Vanessa Calderón, dives into the science and soul of conscious leadership. Drawing from her Harvard-level education, neuroscience background, and two decades guiding global executives, she reveals how leaders can elevate their impact without sacrificing personal well-being.What You'll Learn:Balancing Performance with Purpose - Practical ways to drive results while cultivating a culture of compassion, vulnerability, and authenticity.Breaking Through Blind Spots - How to uncover and dismantle limiting beliefs that hold individuals and their teams back.Why It Matters:Whether you're raising a family or building a company, “Conscious Leadership” isn't just a buzz phrase. It's a shift toward a more mindful, intentional way of leading that boosts performance, increases engagement, and fuels sustained morale and fulfillment. About Our Guest:Dr. Vanessa Calderón, MD, MPP, is a Harvard graduate, board-certified physician, and Master Certified Coach with 20+ years of leadership and business development experience. She currently coaches senior leaders in a billion-dollar organization, specializes in subconscious habit rewiring, and is the host of Purpose, Profit, Healing and founder of The Journey. Website: vanessacalderon.comPodcast: Purpose Profit HealingInstagram: vanessacalderonmdDr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can also join our email list or drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode! Follow I AM Well MD on Instagram | LinkedIn | FacebookWelcome home!Disclaimer: While I am a practicing physician, in this space, I function as a life coach and wellness advocate. The information provided here is for educational purposes only and does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Send us a textIn this thought-provoking episode, we're joined by Dr. Jordan Grumet, MD, physician, author, and host of the award-winning Earn & Invest Podcast. Together, we dive into the intricate connections between financial independence, legacy, and finding purpose in this world. We explore how:wealth and purpose can and should coexisttrauma can be transformed into growth and meaninglessons from hospice patients can reshape your financial and life prioritiesJordan offers deep, often personal insights that will challenge how you think about success and what it means to live fully.About Jordan Grumet:Dr. Jordan Grumet is a hospice physician and financial educator. His blog and his podcast, Earn & Invest, explore financial independence with philosophical depth. Jordan is the author of Taking Stock: A Hospice Doctor's Advice on Financial Independence, Building Wealth, and Living a Regret-Free Life and The Purpose Code, which are valuable resources for individuals seeking direction on how to build their financial goals while simultaneously creating a life with meaning, purpose, connection, and deep personal contentment. Learn more at jordangrumet.comDr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can also join our email list or drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode! Follow I AM Well MD on Instagram | LinkedIn | FacebookWelcome home!Disclaimer: While I am a practicing physician, in this space, I function as a life coach and wellness advocate. The information provided here is for educational purposes only and does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

SEND US A TEXT MESSAGE!!! Let Drs. Nii & Renee know what you think about the show!Nii sits down with Trevor Cabrera, who completed his residency training in General Pediatrics at the University of Texas Health Science Center in Houston and then transitioned to working as an exclusive Locum Tenens provider. Listen in as Dr. Cabrera, also known as The Nomadic Pediatrician, talks about his first locum job, paying off student loans, the lifestyle locum work affords him, and his blog that documents his travels and experiences.Things to expect in this episode:Trevor discusses why he pivoted to locum workThe early, lean locum daysConsistent locum work and paying off student loansThe lifestyle of a locum, especially the benefitsGrowing through locum workCheck out The Nomadic Pediatrician Blog: www.thenomadicpediatrician.comAdditional Dr. Cabrera writings:5 ways to make locums housing feel like homeFrom medical school to residency to…locums?Paying off medical school debtThe social life of a locum physicianWE WANT TO HEAR FROM YOU!!!!TELL US WHAT YOU WANT TO HEAR ON FUTURE EPISODES!!!!FILL OUT THE DOCS OUTSIDE THE BOX PODCAST SURVEY (in partnership w INCROWD)WATCH THIS EPISODE ON YOUTUBE!Join our communityText word PODCAST to 833-230-2860Twitter: @drniidarkoInstagram: @drniidarkoEmail: team@drniidarko.comPodcasting Course: www.docswhopodcast.comMerch: https://docs-outside-the-box.creator-spring.comThis episode is edited by: Your Podcast PalThis episode is sponsored by:Locumstory. Learn how locum tenens helps doctors make more and have the lifestyle they deserve!. Check them outHERE!

Send us a textIn this empowering episode, Dr. Sasha Shillcutt joins us to unpack the transformative power of setting boundaries, especially for women in demanding roles. With wisdom rooted in her own journey and extensive work with thousands of professionals, Sasha reveals how we can reclaim our time, protect our energy, and live more authentically.We discuss:What sparked her passion for coaching women on boundariesHow to know when and where boundaries are neededPractical strategies for setting and sustaining boundariesThe common internal and external roadblocks we faceHow to identify what's truly controlling your timeGenerational healing through bold boundary-settingWhether you're a busy professional, a caregiver, or someone trying to find balance in a chaotic world, this episode is your blueprint for drawing the line with courage and clarity.About our guest:Dr. Sasha K. Shillcutt is a tenured and endowed Professor and Vice Chair of Strategy in the Department of Anesthesiology at the University of Nebraska Medical Center. She is a double-boarded cardiac anesthesiologist, international speaker, best-selling author, and the CEO & Founder of Brave Enough, a global community that empowers women leaders through coaching, courses, and conferences.Her TEDx talk "Resilience: The Art of Failing Forward" and best-selling books Brave Boundaries and Between Grit and Grace continue to inspire women around the world to lead boldly, protect their peace, and live without apology.Connect with Sasha:Website: www.becomebraveenough.comInstagram: @becomebraveenoughFacebook: facebook.com/becomebraveenoughLinkedIn: linkedin.com/company/becomebraveenoughPodcast: The Brave Enough ShowEmail: info@becomebraveenough.comTune in now and learn how to say "no" to what drains you and "yes" to the life you truly want.Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can also join our email list or drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode! Follow I AM Well MD on Instagram | LinkedIn | FacebookWelcome home!Disclaimer: While I am a practicing physician, in this space, I function as a life coach and wellness advocate. The information provided here is for educational purposes only and does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Send us a textIn this deeply reflective and empowering episode, Dr. Amna Shabbir joins us to unpack two silent but powerful forces that often affect high-achieving professionals: imposterism and perfectionism. With heartfelt honesty, Dr. Shabbir shares her personal journey through medicine, motherhood, and mission-driven work, highlighting the internal struggles many face despite external success.We discuss how perfectionism feeds the imposter within and how these patterns can sabotage confidence, limit joy, and cause burnout especially for women and those navigating both demanding careers and personal responsibilities. Dr. Shabbir offers thoughtful insights on regaining balance, challenging unrealistic standards, and embracing self-compassion in the pursuit of excellence.You'll also hear:How Dr. Shabbir found her footing as a leader and coach after struggling with identity and burnoutWhat imposter syndrome really looks like in action and how to stop it from holding you backThe connection between generational healing and self-acceptanceHer message for future changemakers: you can thrive without perfectionWhether you're a young professional, a working parent, or someone striving for more peace in your ambition, this episode is for you.Guest Bio:Dr. Amna Shabbir is a dual board-certified Geriatrician and Internist, Master Certified Life Coach, and National Board-Certified Health and Wellness Coach trained at Duke Integrative Medicine. As Founder of the Early Career Physicians Institute® and Amna Shabbir Wellness Coaching, she helps high achievers, particularly in medicine, prioritize well-being while pursuing success. She also hosts the Success Reimagined podcast and advocates for mental health through the Dr. Lorna Breen Heroes' Foundation. Above all, she's proud to be a Super Mom to two young girls.Connect with Dr. Shabbir:Instagram: @dr.amnashabbirLinkedIn: Amna Shabbir, MDYouTube: @Dr.AmnaShabbirPodcast: Success ReimaginedDr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can also join our email list or drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode! Follow I AM Well MD on Instagram | LinkedIn | FacebookWelcome home!Disclaimer: While I am a practicing physician, in this space, I function as a life coach and wellness advocate. The information provided here is for educational purposes only and does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Send us a textIn today's episode of the I AM Well MD podcast, we are thrilled to welcome Dr. Sharon L. Stein, MD, FACS, FASCRS, a renowned colorectal surgeon, educator, and leader in the field of surgery. Dr. Stein brings a wealth of knowledge and a powerful perspective on diversity, leadership, and overcoming challenges in the medical field. She shares her non-traditional path to becoming a leading colorectal surgeon, her experience in balancing family and career, and the important role that intention played as she built her beautiful life. The wisdom she shares is invaluable: life doesn't need to just “happen” to you – living with thoughtful intention can help transform your life in immeasurable ways.  In addition to her work as a surgeon, Dr. Stein is the founder of The Intentional Surgeon, where she provides professional development and leadership coaching to elevate surgeons and healthcare professionals worldwide. She shares her insights on leadership and growth through her podcast, The Intentional Surgeon, which can be found on your favorite podcast platforms or though her website. Whether you're a surgeon looking to enhance your leadership skills or someone interested in learning more about the intersection of personal development and career, this conversation with Dr. Stein is packed with valuable pearls. To learn more about Dr. Stein, you may visit her at: Website: https://www.intentionalsurgeon.com/Instagram: @slsteinmdwww.linkedin.com/in/sharonsteinmdwww.facebook.com/sharon.stein.355@IntentionalSurgeon.bsky.socialDr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can also join our email list or drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode! Follow I AM Well MD on Instagram | LinkedIn | FacebookWelcome home!Disclaimer: While I am a practicing physician, in this space, I function as a life coach and wellness advocate. The information provided here is for educational purposes only and does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Send us a textIn this empowering episode of the I AM Well MD podcast, Dr. Santi sits down with Amanda DeCesar and Amber Schiffert, the dynamic co-founders of TARA Wealth, a financial planning firm rooted in transparency, authenticity, and real advice. These two powerhouse women are on a mission to help individuals, especially women, build a healthier relationship with money through education and values-based guidance.Meet the Guests:Amanda DeCesar, CFP® - Co-Founder of TARA WealthAmanda is on a mission to promote healthy relationships with money through financial education, guidance, and actionable advice. She is passionate about helping clients use their money as a tool to achieve their dreams and break through financial roadblocks.With 20 years of knowledge and experience in the financial services industry, Amanda continues to pursue her passion for helping clients gain clarity, confidence, and control of their finances through founding TARA Wealth with Amber. Amber Schiffert - Co-Founder of TARA WealthAmber has a passion for making a lasting impact on the lives of others. Because of this, in 2017 she changed careers and entered the financial services industry. Recognizing the outdated practices of the industry, she sought to redefine financial education and empowerment in a more meaningful and personalized way which led her and Amanda to launch TARA Wealth in 2023. TARA Wealth is a women-led financial firm built on transparency and empathy, aiming to support clients in achieving long-term financial wellness. They're reshaping how we think about financial planning, making it more personal, approachable, and aligned with long-term well-being. Learn more at www.tarawealth.com and connect on LinkedIn! Visit our website at iamwellmd.com.Follow I AM Well MD on Instagram | LinkedIn | FacebookSubscribe, leave a review, and share this episode with someone who's ready to take control of her financial wellness!Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our email list or drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode! Follow I AM Well MD on Instagram | LinkedIn | FacebookWelcome home!Disclaimer: While I am a practicing physician, in this space, I function as a life coach and wellness advocate. The information provided here is for educational purposes only and does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

In this timely discussion, Dr. Jennifer Reid listens in as Dr. Megan Moreno, Co-Medical Director for the AAP's Center of Excellence on Social Media and Youth Mental Health, challenges the outdated "addiction" narrative and reveals a transformative framework that empowers both parents and adolescents. Drawing from 15+ years of research at the intersection of technology and teen health, Dr. Moreno offers a refreshingly nuanced roadmap for families navigating the complex digital landscape—where the goal isn't to simply limit screen time, but to foster healthy, balanced relationships with technology in a world where screens are unavoidable.Key Points* Moving Beyond the "Addiction" Framework* Youth have grown weary of the addiction framework for social media use* The term "addiction" makes teens feel powerless* Focus instead on empowering conversations where teens feel they have control* Understanding Problematic Use* Three key aspects of problematic technology use:* Content: Repeatedly seeking harmful or inaccurate content* Crowding Out: When technology displaces important activities (sleep, relationships, schoolwork)* Relationship with Technology: Feeling anxious or unable to disconnect* The "Digital Native" Challenge* Today's adolescents are "digital natives" interacting with screens from a young age* Parents need to model healthy online-offline balance* Self-imposed limits can be effective role modeling* Identity Development Online* Teens use social media as part of identity development* They often "try out" new identities, hobbies, or friendships online* Multiple platforms allow teens to curate different aspects of their identity* Vulnerability Factors* Some teens are more vulnerable to negative effects of social media* Pre-existing mental health conditions can make online experiences more challenging* Strong offline support systems help mitigate negative online experiences* The Five C's Framework for Healthy Media Use* Child: Understanding each child's unique needs and characteristics* Content: Focusing on the quality and type of media being consumed* Calm: Building diverse tools for emotional regulation beyond screens* Crowding Out: Ensuring media doesn't displace essential activities like sleep* Communication: Maintaining open dialogue about technology use* Parental Guidance Approach* Parents can be curious learners alongside their teens* Focus on transferable skills: treating others well, maintaining safety, setting boundaries* Ask questions from a place of curiosity rather than judgmentResources Mentioned* American Academy of Pediatrics Family Media Plan tool (or Google "AAP Family Media Plan")* Common Sense Media for app and game reviews* The five C's framework: Child, Content, Calm, Crowding Out, Communication* American Academy of Pediatrics Center of Excellence on Social Media and Youth Mental HealthGuest: Dr. Megan Moreno - Professor of Pediatrics and Affiliate Professor of Educational Psychology at the University of Wisconsin-Madison; Academic Chief for the Division of General Pediatrics and Adolescent Medicine; Principal Investigator of the Social Media and Adolescent Health Research Team. Dr. Moreno has authored over 200 research articles as well as written and edited several textbooks. She is particularly interested in incorporation of youth voice in research, dissemination of research to reach teens and families, and the impact of research on clinical practice and policy. Dr. Moreno currently serves as the Co-Medical Director for the AAP's Center of Excellence on Social Media and Youth Mental Health.Ongoing ResearchDr. Moreno mentioned a current study examining the impact of social media on adolescent brain development using functional MRI scans to better understand how teen brains process information from social media over time.Dr. Reid on Instagram: @jenreidmd and LinkedInAlso check out Dr. Reid's regular contributions to Psychology Today: Think Like a Shrink.Thanks for reading A Mind of Her Own and listening to The Reflective Mind podcast! Subscribe for free to receive new posts and support my work.Seeking a mental health provider? Try Psychology TodayNational Suicide Prevention Lifeline: 1-800-273-8255Dial 988 for mental health crisis supportSAMHSA's National Helpline - 1-800-662-HELP (4357)-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.Disclaimer:The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site.The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit amindofherown.substack.com

Send us a textIn this episode, Dr. Kristine Goins, Child and Adolescent Psychiatrist,  shares how she transformed the ashes from her burnout into the greatest gift ever. We explore how our fear is often rooted in the opinions of others or our own self-perception rather than actual threats, and how developing self-awareness and resilience can help us navigate challenges with confidence. We also delve into various lifestyle and holistic approaches that can be used to promote our emotional wellbeing, particularly when it comes to ADHD and anxiety. Dr. Goins encourages all of us to pay attention to those inner whispers—your intuition is guiding you for a reason!Tune in!Dr. Kristine Goins is a board-certified integrative adult & pediatric psychiatrist and digital nomad. Having served in several healthcare settings and various leadership positions within academic centers, Dr. Goins has witnessed firsthand the impact that burnout, stress, and work-life imbalance can have on physicians' lives. Motivated by a desire to make a difference, Dr. Goins founded Nomad MD, where she empowers doctors to achieve a balanced and fulfilling life, where they can work less and live anywhere.Website/Blog: thenomadmd.comFacebook: https://www.facebook.com/thenomadmds  @thenomadmds Instagram: https://www.instagram.com/thenomadmds   @thenomadmdsConnect With Us:Website: iamwellmd.comInstagram: @iamwell_mdFacebook: https://www.facebook.com/iamwellmd/Thank you for listening! If you found this episode helpful, please share it with someone who could benefit from it. Don't forget to subscribe and leave a review!Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!Disclaimer: While I am a practicing physician, in this space, I function as a life coach and wellness advocate. The information provided here is for educational purposes only and does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

In this exciting episode of the podcast, Dr. Jennie Berkovich interviews Dr. Sarah Cohen, an expert in dysautonomia, to explore the complexities of this often misunderstood condition. Dr. Cohen shares insights into the types of patients she typically works with and how her journey led her to specialize in dysautonomia. They discuss common misconceptions physicians and medical professionals have about patients with dysautonomia and explore potential risk factors, including early signs that may predict the development of the condition. The conversation delves into the gap in Western medicine when it comes to treating dysautonomia and offers an explanation of Ehlers-Danlos Syndrome (EDS), its typical presentations, and the conditions associated with it. Dr. Cohen also reflects on how treatments for dysautonomia have evolved over the years, providing listeners with the latest updates in care. The episode further explores whether there are any preventive measures available for dysautonomic conditions or ways to slow their progression. This episode is a must-listen for anyone interested in dysautonomia, whether you're a healthcare professional or simply curious about the condition. Tune in for expert insights and a deeper understanding of this important health topic! Sarah Cohen Solomon, MD FAAP is the ABP Board Certified Pediatrician at PRISM Spine and Joint, where she specializes in caring for patients with hypermobile Ehlers Danlos Syndrome and related conditions, including Dysautonomia (POTS) and Mast Cell Activation Syndrome. This interest stems from her own lifelong experience with these conditions. After graduating from Sidney Kimmel Medical College of Thomas Jefferson University, Dr. Cohen Solomon remained at the affiliated Nemours Hospital for Children, where she was awarded the Pediatric Academic Excellence Award for Outstanding Research, Education, and/or Advocacy in General Pediatrics for her work expanding the Advocacy curriculum for their residency program. Dr. Cohen Solomon is passionate about breaking down barriers to healthcare and education, by providing children with appropriate accommodations so they can thrive at school among their peers and mentoring medical students with disabilities. _________________________________________________ Sponsor the JOWMA Podcast! Email digitalcontent@jowma.org Become a JOWMA Member! www.jowma.org Follow us on Instagram! www.instagram.com/JOWMA_org Follow us on Twitter! www.twitter.com/JOWMA_med Follow us on Facebook! https://www.facebook.com/JOWMAorg Stay up-to-date with JOWMA news! Sign up for the JOWMA newsletter! https://jowma.us6.list-manage.com/subscribe?u=9b4e9beb287874f9dc7f80289&id=ea3ef44644&mc_cid=dfb442d2a7&mc_eid=e9eee6e41e

Send us a textIn this  episode, I'll be delving into the pervasive issue of mom guilt that affects mothers across all walks of life. While guilt feels burdensome, it's actually an emotion that is symbolic of how much you care for your children. We will explore the origins of this emotion and some practical strategies to help you navigate and alleviate guilt.If you're interested in one-on-one coaching, I'm happy to support you! Click on this link to reach out: https://www.iamwellmd.com/contactFor more insights and support, visit our website: I AM Well, MDLike social media? Connect on:Instagram: @iamwell_mdFacebook: I AM Well, MDLinked-In: Santi Tanikella, MDIf you enjoyed this episode or found it helpful, please share it with a mom who could use a little love. Don't forget to leave a review and let me know what topics you'd like to hear about in the future!Thank you for tuning in to this episode. Sending love to you amazing mothers out there!

In this episode, Lukas Voss talks with Dr. Ryan Fulton, Section Chief at Carilion Children's General Pediatrics and Assistant Professor at Virginia Tech Carilion School of Medicine. They discuss AI, technology's impact on patient care, and the future of medicine. Tune in for key insights on advancing clinical practice.This episode is sponsored by Microsoft (Nuance).

In this episode, Lukas Voss talks with Dr. Ryan Fulton, Section Chief at Carilion Children's General Pediatrics and Assistant Professor at Virginia Tech Carilion School of Medicine. They discuss AI, technology's impact on patient care, and the future of medicine. Tune in for key insights on advancing clinical practice.This episode is sponsored by Microsoft (Nuance).

Send us a textWelcome to Episode 27 of the podcast, "Love to the New Mamas Out There!" In this heartfelt episode, I'm reaching out to all the amazing new and expecting moms, sharing wisdom, encouragement, and some real talk about the journey of motherhood. Whether you're a first-time mom or supporting someone who is, this episode is for you.What We'll Cover:Why your birth plan doesn't have to be perfect: Learn how to adjust expectations and embrace the unexpected.Breastfeeding truths: The challenges that no one talks about and why formula isn't the enemy.The power of accepting help: Letting others support you and why it's essential for your well-being and that of your child.Finding joy and connection: How to make space for joy and self-care in the early days of motherhood.Motherhood is beautiful, but it's okay to feel overwhelmed. You're not alone. Some of this is a normal part of entering new and unfamiliar territory. If you need some resources, particularly with breastfeeding - reach out to your local lactation consultant or your pediatrician. If you think you may be feeling more sad/depressed or anxious than the situation calls for, your Ob/GYN or primary care provider can be an amazing touch point. If you're interested in one-on-one coaching, I'm happy to support you! Click on this link to reach out: https://www.iamwellmd.com/contactIf you enjoyed this episode or found it helpful, please share it with a new or expecting mom who could use a little encouragement. Don't forget to leave a review and let me know what topics you'd like to hear about in the future!You can also follow me on social media for more tips and inspiration.Thank you for tuning in to this episode. Sending love to all the amazing mamas out there!

Did you know that sleep-deprived doctors are more likely to make critical errors or that poor communication during patient handoffs can jeopardize care? In this episode, Dr. Christopher Landrigan, Chief of General Pediatrics at Boston Children's Hospital and co-founder of the I-PASS Patient Safety Institute, emphasizes the importance of systemic changes, improved communication, and financial support to enhance patient safety. Dr. Christopher Landrigan has spent his career addressing patient safety issues, particularly focusing on resident work hours and communication failures in hospitals. His early research revealed that sleep-deprived medical residents made significantly more errors, prompting changes to duty-hour policies to reduce risks to patients and providers. Recognizing that frequent handoffs during shorter shifts could lead to information loss, Dr. Landrigan co-developed the I-PASS system, a standardized communication framework to improve patient care transitions. I-PASS, now adapted for various specialties and roles, has been implemented across hospitals nationwide with support from organizations like the I-PASS Institute and regional partnerships such as the Kentucky Hospital Association. While progress has been made, Dr. Landrigan emphasizes the need for systemic change, behavior adaptation, and financial backing to scale successful patient safety programs across the complex health care system. Tune in to learn about Dr. Landrigan's work on resident hours and the I-PASS system's impact on patient safety! About CareQuest: CareQuest Institute for Oral Health is a national nonprofit dedicated to creating an oral health care system that is accessible, equitable, and integrated. Learn more about how their advocacy, philanthropy, research, and education are creating a better oral health system at carequest.org/turnonthelights Learn more about your ad choices. Visit megaphone.fm/adchoices

My guest today is Dr. Nikki Johnson, a former pediatrician and co-director of FAIR in Medicine. We dive deep into the challenges parents face in finding trustworthy medical providers for their children and the broader implications of the current healthcare system. Dr. Nikki shares her journey through medical training and her eventual departure from clinical practice due to ethical concerns and the corporatization of medicine.We discuss the concept of perverse incentives in healthcare, particularly how insurance reimbursement structures can compromise the quality of care. Dr. Nikki highlights the shift in focus from patient-centered care to a more corporate-driven model, which often prioritizes profit over patient well-being. We also explore some lesser-known impacts of the Affordable Care Act on the medical landscape, including the rise of non-physician providers, and the challenges this poses for traditional medical practices.Throughout our conversation, we aim to empower parents to trust their instincts when it comes to their children's health and to advocate for better care. We also touch on the importance of transparency in healthcare and the need for a return to a more personal, relationship-driven approach to medicine. This episode is a call to action for parents to be informed and engaged in their children's healthcare decisions.Nicole “Dr. Nikki” M. Johnson, MD DNBPAS, has a B.S. in Biology from Case Western Reserve University and a medical degree from Case Western Reserve University School of Medicine. Dr. Nikki earned certification in both General Pediatrics and Pediatric Critical Care Medicine. She is passionate about reforming healthcare and wishes to see medicine restored to a focus on the individual doctor-patient relationship where physicians are bound by the Hippocratic Oath, and patients have affordable evidence-based care, choice, and transparency. She works as an independent consultant with those who help her achieve her mission. Dr. Nikki has a record of advocacy and service. She is the director of FAIR In Medicine and an advisor for Affirming Reality Connected. She is the past President and a Co-founder of PHYSICIANS FOR PATIENTS and a contributing author of Free2Care's A Physician-Led Roadmap to Patient-Centered Medical Care. Dr. Nikki also served as a Senior Fellow for Restore Childhood and a team member of Urgency of Normal. She lives in Northeast Ohio with her husband and two daughters. 00:00 Start[00:00:11] Parental responsibility in healthcare.[00:06:34] Corporate influence in healthcare.[00:10:21] Loss of patient care autonomy.[00:12:13] Healthcare system challenges and solutions.[00:16:00] Affordable Care Act implications.[00:19:34] Nursing shortage and healthcare changes.[00:24:14] ROGD Repair for Parents.[00:29:43] Medical ethics and political influence.[00:32:14] Perverse incentives in healthcare.[00:36:56] Therapy payout disparities and ethics.[00:40:36] Direct primary care transparency.[00:43:43] Direct primary care benefits.[00:49:21] Corporate infiltration in healthcare.[00:50:39] Pediatric endocrinologists and gender identity.[00:54:02] Finding the right therapist.[00:58:06] Parental instincts in healthcare.[01:01:38] Empowering parental decision-making.[01:06:55] Parental challenges in healthcare.[01:10:14] Parental advice on medical issues.[01:12:54] Parental influence on children's choices.[01:17:10] Parenting and device management.[01:21:34] Advocacy against gender ideology.ROGD REPAIR Course + Community for Parents is available now! Are you concerned about an adolescent or young adult with Rapid Onset Gender Dysphoria? Join at ROGDrepair.com and get instant access to over 100 lessons designed to equip you with the psychological insights and communication tools you need to get through to your kid. Use code SOMETHERAPIST2024 to take 50% off your first month.TALK TO ME: book a discovery call.LOCALS: Ask questions of me & guests; get early access to new episodes + exclusive content. Join my community.SUPPORT THE SHOW: subscribe, like, comment, & share or donate.EIGHTSLEEP: Take $200 off your EightSleep Pod Pro Cover with code SOMETHERAPIST.ORGANIFI: Take 20% off Organifi with code SOMETHERAPIST.Watch NO WAY BACK: The Reality of Gender-Affirming Care. Use code SOMETHERAPIST to take 20% off your order. Follow us on X @2022affirmation or Instagram at @affirmationgeneration. SHOW NOTES & transcript with help from SwellAI.MUSIC: Thanks to Joey Pecoraro for our song, “Half Awake,” used with gratitude & permission.PRODUCTION: Looking for your own podcast producer? Visit PodsByNick.com and mention my podcast for 20% off your initial services. To support this show, please leave a rating & review on Apple, Spotify, or wherever you get your podcasts. Subscribe, like, comment & share via my YouTube channel. Or recommend this to a friend!Learn more about Do No Harm.Take $200 off your EightSleep Pod Pro Cover with code SOMETHERAPIST at EightSleep.com.Take 20% off all superfood beverages with code SOMETHERAPIST at Organifi.Check out my shop for book recommendations + wellness products.Show notes & transcript provided with the help of SwellAI.Special thanks to Joey Pecoraro for our theme song, “Half Awake,” used with gratitude and permission.Watch NO WAY BACK: The Reality of Gender-Affirming Care (our medical ethics documentary, formerly known as Affirmation Generation). Stream the film or purchase a DVD. Use code SOMETHERAPIST to take 20% off your order. Follow us on X @2022affirmation or Instagram at @affirmationgeneration.Have a question for me? Looking to go deeper and discuss these ideas with other listeners? Join...

Send us a textHave you been having some trouble navigating the emotional aftermath of the recent election results? Me too. We can all easily see the writing on the wall: there are definitely going to be some societal challenges coming up ahead.I learned about the election results as I watched the sun rise through airport windows. It got me thinking about my culture, my gender, and how I've come to where I am today. In this podcast, I share stories of the women in my family, and some personal experiences about resilience, self-awareness, and breaking free from societal expectations.This isn't a political rant—it's about personal and collective empowerment and how we move forward. It's about choosing love over hate, showing up for ourselves and others, and taking control of our lives. It's about financial independence, challenging gender norms, and confronting some of the unconscious biases we carry. If you've ever felt stuck or like you're navigating the same struggles that I do, this episode is for you. Let's break barriers, build each other up, and create the life we deserve—together.As promised, here is the link to the article I recently wrote, entitled "The Tale of Two Books (and How I Broke the Binding on my Unwritten Instruction Manual)."Pause and ask yourself why things are the way they are... and who told you it had to be that way. We don't need to be victims to societal norms. We are allowed to question things when they are unjust or don't make sense. We are allowed to make changes in our lives for the better. Are you ready?Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!Disclaimer: While I am a practicing physician, in this space, I will be functioning as a life coach and wellness advocate. The information provided here does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Send us a textIt's Halloween! While the kids are gearing up in their costumes, ready to take on magical roles, I'm thinking about the masks we all wear—not just on Halloween, but in our everyday lives. From superheroes to witches, kids transform in an instant. As adults, our ‘masks' often hide who we really are. In this episode, I share a story from my days as a pediatric resident, where putting on a ‘strong' mask helped me survive, but left me feeling isolated. Let's talk about the masks we wear, the roles we play, and what it might feel like to set one of them down. Are you ready to let your true self shine?Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!Disclaimer: While I am a practicing physician, in this space, I will be functioning as a life coach and wellness advocate. The information provided here does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Send us a textWelcome to Episode 24 of the podcast!This week, we're diving deep into parental stress and how it impacts our mental health and family dynamics. In this special episode, I'll reflect on my own journey as a parent. This year marks my 10th anniversary of motherhood—and I've been celebrating it all year long! We're also going to discuss some of the common challenges we parents face, how important "the village" is to our families, and the recent Advisory put out by the US Surgeon General on Parental Stress. Supporting parental mental health isn't just "nice" to do—it's essential for the health and wellbeing of our entire society. You can be a part of the solution by offering support to the parents in your life. Parental stress is real, but it's not just a personal issue—it's a public health concern. Support networks and community involvement are vital for parents' mental health. Workplaces, policies, and open discussions can play a role in easing the stress burden on parents. And, parents, it's okay to ask for help! It's not a sign of failure, it's a sign of strength!Resources:U.S. Surgeon General's Advisory on Parental Mental Health: "Parents Under Pressure"https://www.hhs.gov/surgeongeneral/priorities/parents/index.htmlStay Connected: Follow me on social media for more insights and support strategies! Check out our Facebook page, or visit us on Instagram. If you need extra support, check out I AM Well, MD for resources on building a healthy you, and a resilient family.Thanks for listening, and be sure to hug your kids (and your parents!) today!Subscribe and leave a review to help us reach more parents looking for support.Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!Disclaimer: While I am a practicing physician, in this space, I will be functioning as a life coach and wellness advocate. The information provided here does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Dr. Sandra Hassink is joined by Dr. Mona Sharifi, and Dr. Sarah Armstrong. Dr. Sharifi is an Associate Professor of Pediatrics (General Pediatrics) and of Biomedical Informatics and Data Science, at the Yale University School of Medicine; as well as the Chief of Pediatrics. Dr. Armstrong is a Professor of Pediatrics and Populations Health Sciences, and the Division Chief of General Pediatrics and Adolescent Health at Duke. Related Resources: • Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity (tinyurl.com/yc53upmr) • Obesity CPG Homepage (tinyurl.com/52nz6m2m) • US Preventive Services Task Force Recommendation Statement (tinyurl.com/3rxb794v)

Send us a textIt's the most wonderful time of the year! The time where our kids return to school and our lives start to take on a slightly more regular schedule - even if that means it might be a bit busier. Yes, it means that working parents can finally feel a little respite... but what about our kids? Some of them are excited to return, while others are fraught with... well... other feelings. How can we as parents help them to navigate the new school year with greater ease? Is it possible to instill our kids with resilience and confidence? Tune in to find out...!Staples commercial – It's the most wonderful time of the year!https://youtu.be/CD1PffNbZls?si=X414mGV-eimYKNOY  WNEP news segment on Easing Back to School Anxiety:https://www.wnep.com/article/news/health/healthwatch-16/easing-back-to-school-anxiety-healthwatch-16-pennsylvania/523-b6fc31bb-d919-4cc5-ad74-2aa1d13cf650?fbclid=IwY2xjawFCoqhleHRuA2FlbQIxMAABHTMT3mJHk0s1WfztNSgD2RaeMVF0rNARG-htV6Y2EK8gGaI-XCYmpywNpA_aem_5X0NnxmPwkcFa17ni11yXQDr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!Disclaimer: While I am a practicing physician, in this space, I will be functioning as a life coach and wellness advocate. The information provided here does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Join us this week as Meena Mallipeddi welcome's guests Dr. Christopher Landrigan, Chief of General Peditarics at Boston Children's Hospital & Deborah Campbell, VP Clinical Strategy and Transformation at Kentucky Hospital Association.What you'll get from this episode:Introduction of Deborah Campbell and Dr. Christopher Landrigan, leaders in the I-PASS Initiative.Insights into the career paths of Campbell and Landrigan, highlighting their journey in healthcare.Explanation of the I-PASS Initiative and its focus on improving transitions of care.Discussion on the implementation and impact of I-PASS in various healthcare settings.Exploration of the future of I-PASS and other related initiatives in healthcare communication.Learn More About Our Guests:Boston Children's Hospital Website https://www.childrenshospital.org/ Kentucky Hospital Association Website https://www.kyha.com/ Guest Dr. Christopher Landrigan's LinkedIn https://www.linkedin.com/in/christopher-landrigan-md-b5472abb/Guest Deborah Campbell's LinkedIn https://www.linkedin.com/in/deborah-campbell-a3809a5a/“AmplifyMD immediately connects medical facilities to a large network of physicians in all of the most essential specialties, including Neurology, Cardiology, Infectious Disease, Pulmonology and Heme/Onc.” Their mission is access, by becoming the definitive specialty care platform that connects every medical facility to the specialty care they need to improve patient outcomes. - https://amplifymd.com/Follow The Seamless Connection: https://www.linkedin.com/company/the-seamless-connection

Stress. It's everywhere. Sometimes the weight of it can be unbearable. It can be the source of a lot of drama - work place drama, family drama, even drama with our personal health. There are so many different ways of reducing stress out there - going on long walks, being in nature; surrounding yourself with supportive family and friends; taking breaks or even vacations; meditating, doing yoga; journaling.... the list goes on and on. For each person, the recipe for stress prevention and reduction will be a little different, and so it needs to be tailored to the individual. Even this may evolve over time and with changes in life. One thing's for sure, though: if we have a tendency to depend on factors outside of us to meet our needs and bring us happiness and peace, we are setting ourselves up to go right into a stress response. We can't always control what happens externally... but we might just be able to change our inner dialogue. In many cases, that alone can be a game-changer. Tune in to learn more!Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!Disclaimer: While I am a practicing physician, in this space, I will be functioning as a life coach and wellness advocate. The information provided here does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

Last Fall, the World Health Organization declared that loneliness is a threat to our well-being. In fact, it can be just as detrimental to our health as smoking, excessive alcohol intake, or obesity. I think for most of us, this is shocking news because we tend to separate our emotional and mental health from our physical health, but this just shows how interconnected these areas are. They went on to say that people who are socially isolated tend to have a higher risk of anxiety, depression, dementia, and stroke.  What is it about social connection that is so protective? How can we tap into that?  Listen in to find out how.References:WHO launches commission to foster social connection: https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connectionCheck out Brene Brown's Ted Talk on the Power of Vulnerability: https://www.youtube.com/watch?v=iCvmsMzlF7o Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!Disclaimer: While I am a practicing physician, in this space, I will be functioning as a life coach and wellness advocate. The information provided here does not necessarily reflect that of my employers. If you need medical or psychological services, I strongly recommend that you contact your physician. If you are having an emergency, please call 911 and proceed to the ER.

We know that we really ought to avoid things like alcohol, tobacco, and illicit substances....But what about the things that are not so obvious? Toxic habits and ideas can limit our lives, and the crazy thing is we don't always realize it... which means that we don't empower ourselves to take control and avoid those things that aren't serving us. Tune in to learn more about where toxic influences can exist, and how to free ourselves from them. Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!

We keep hearing a lot about RSV - and now there are vaccines that can help fight it. But how safe are they? Who should get them? And what is RSV and how does it compare to the FLU and COVID? Dr. Jeanine Cook-Garard talks with Dr. Matthew Harris, a Pediatric Emergency Medicine and EMS Physician who is triple-board certified in General Pediatrics, Pediatric Emergency Medicine, and EMS/Disaster Medicine. He serves as the medical director for the Cohen Children's Medical Center Pediatric Critical Care Transport team and as Associate Medical Director for the Northwell Center for Emergency Medical Services.

Nilay Shah, MD is a clinician-scientist and Associate Professor in the Division of Hematology/Oncology/BMT at Nationwide Children's Hospital. His primary clinical focus is on pediatric solid tumors, including neuroblastomas, tumors of the kidneys, and rare solid tumors of childhood. His research focuses on the molecular drivers of pediatric cancers and how new treatment approaches can be taken to better target those drivers. In this role, he works to identify new uses of currently available anticancer treatments, including drugs originally developed for use against cancers in adults.  He serves as Associate Director for Liver Tumor, Kidney Tumor, Germ Cell, and Neuroblastoma Targeted Therapies, and is currently the Sponsor and Study Principal Investigator the CaboMain trial, a Phase 2 study evaluating the efficacy of the oral anticancer agent cabozantinib as a maintenance therapy for ultra-high-risk solid tumors.He also serves as co-director of the Cancer Genetics Program. This program serves to advance the use of genetic and genomic evaluations for the benefits of patients. In this role, he sees patients in the Cancer Predisposition Clinic for evaluation, surveillance, and management of patients with genetic alterations that predispose to cancer development. He also consults on patients for precision oncology, partnering with the Institute for Genomic Medicine to identify therapeutic approaches based on patient tumor and germline genomics.Dr. Shah is a graduate of the Honors Program in Medical Education at Northwestern University, earning his medical degree in 2003. Dr. Shah completed a residency in General Pediatrics in 2006 at the Children's Hospital of Wisconsin, and a fellowship in Pediatric Hematology/Oncology at Johns Hopkins University and the National Cancer Institute in 2011. He also was a Research Instructor at the Lombardi Comprehensive Cancer Center at Georgetown University in Washington, D.C., prior to his arrival at Nationwide Children's Hospital in 2013.

Rachel Offenbacher, MD, is an attending physician at Children's Hospital at Montefiore (CHAM) and Assistant Professor, Pediatric Hematology, Oncology, Marrow and Blood Cell Transplantation at Montefiore Einstein. She joins us on OsteoBites to share her work on targeting urea cycle dysfunction to prevent and treat osteosarcoma metastasis.Since joining the Montefiore team, Dr. Offenbacher's clinical focus has been pediatric sarcomas. As a member of a translational sarcoma research lab, Dr. Offenbacher is fascinated by the ability to explore the biological processes behind novel therapeutic approaches before they are used in the clinic. Her research focuses on utilizing difluoromethylornithine to prevent and treat metastatic osteosarcoma. She has seen impressive results in her in vitro and in vivo models and is working to initiate a clinical trial. She is simultaneously working on a project funded by the American Association of Cancer Research, Targeting the Tumor Microenvironment of Metastasis to Treat Metastatic Ewing Sarcoma, which is demonstrating promising results. Dr. Offenbacher's work has been published in numerous peer-reviewed journals and presented nationally and internationally. Dr. Offenbacher is board certified in General Pediatrics by the American Board of Pediatrics. She is a member of several professional organizations, including the American Association for Cancer Research, the Children's Oncology Group and the American Society of Pediatric Hematology/Oncology. Dr. Offenbacher is also an active member of the National Pediatric Cancer Foundation. In 2020 and 2022, she won the Leo M. Davidoff Society Teaching Award; in 2022, she won the Pediatric Research Day Oral Presentation Award from CHAM. Dr. Offenbacher is a volunteer pediatric oncologist at Camp Simcha, a residential camp for children with cancer.

Remember that quote, "I'll sleep when I'm dead"? Many people take sleep for granted. The fact is, lots of important things happen when our bodies are sleeping. AND sleep is different from rest. Poor quality sleep and chronic sleep deprivation can  take a toll on your body, mind, and emotional health. Tune in to learn more about the importance of sleep, and how we can improve the quality of our sleep.  An Irish proverb puts it best:  “A good laugh and a long sleep are the best cures in the doctor's book.”Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!

In this podcast episode, we are going to talk some of the amazing benefits of exercise. There are some of the obvious ones, like strengthening our bodies and weight management... but there are also some that may come as a surprise to you! Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!

In this podcast episode, we are going to talk about nutrition! This is a topic that is discussed in my pediatric practice multiple times a day, and I find that there is a lot of confusion about it. Why wouldn't there be? We are constantly bombarded with information regarding the latest diet and nutrition fads. The American College of Lifestyle Medicine recommends a whole foods plant based diet, which is essentially a vegan diet (without the non-nutritive vegan foods that are highly processed, like doritos, fritos, chips!).  There's a good bit of research out there regarding this, and more can be found on their website at https://lifestylemedicine.org/In this conversation, for the sake of simplicity, I wanted to provide some broad recommendations for vegans, vegetarians, and omnivores alike, so that we can all move towards a healthier life and reduce our risk for common chronic diseases, like diabetes, high cholesterol, and heart disease. We deserve a life where we can be active with our kids and grandkids, and empower them to be healthy as well. Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!

You won't want to sleep through this eye opening review of Pediatric Obstructive Sleep Apnea with our guest, Dr. Ignacio Tapia. He is the Chief of the Division of Pediatric Pulmonology and Batchelor professor of Cystic Fibrosis and Pediatric Pulmonology at the University of Miami.He is board certified in General Pediatrics, Pediatric Pulmonology and Sleep Medicine. His main research interests are the pathophysiology of the Obstructive Sleep Apnea Syndrome (OSAS) in children, clinical trials focusing on treatment of OSAS in children, health disparities in pediatric sleep, and the consequences of OSAS in individuals with Down syndrome. He teaches us about risk factors, screening, diagnosis, and treatment of pediatric OSA. 

In this special episode of Public Health Matters, Dr. Christina Madison and special guest, Dr. Jose Cucalon Calderon emphasize the steps that need to be made in improving both language and cultural competency in health care. They also discuss Dr. Cucalon Calderon's advocacy work—particularly in vaccine advocacy—in public health, preventative health services, and health equities in underserved communities. About the Guest: Jose Cucalon Calderon MD FAAP is a Board-Certified Pediatrician practicing as an Associate Professor of Pediatrics for the University of Nevada, Reno School of Medicine after training in General Pediatrics at the University of South Alabama followed by working in Rural Alabama. Currently sited at Renown Children's in Reno, Nevada, Dr. Cucalon Calderon is a well-known anti-tobacco and e-cigarette, preventive health services, minority health and health care access advocate both in his state of practice, at the national and international level. He serves as the Nevada Chapter of the AAP's E-cigarette Chapter Champion and Vaccination representative as well as in multiple advisory and academic roles across our state. Being a native of Ecuador, Dr. Cucalon Calderon has experience on connecting non-English speaking families to preventive health services and among his special interests are tobacco related health care disparities, ethnic minority over representation of tobacco product use, chronic disease prevention, mental health destigmatization, mentorship and cultural humility in patient care and medical education. Key Takeaways: Trust in health care is crucial, and being a trusted messenger within a community can significantly impact health outcomes for patients. Understanding any cultural nuances and language barriers is essential for effective communication with patients while improving their access to and understanding of health care services. Collaboration among health care providers—including pharmacists—is necessary for holistic patient care and improving health outcomes within underserved communities. To promote health equity for minorities, health care providers should prioritize patient-centered care and cultural humility while addressing the social determinants of health to promote health equity.

Do you  feel like you're constantly  juggling the parts of your life that are important to you? Kids? Spouse? Parents? Career? When that list gets long, it's easy to start dropping the balls... no matter how hard we try not to.  Let's talk about  strategies we can use to make things easier, so that we can enjoy the things we truly value.Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our amazing community by joining our email list. Feel free to drop us a message by going to iamwellmd.com/contact. You may just get a shout out in the next episode!Welcome home!

The "Wellness" umbrella covers lots of things - physical wellness, mental/emotional wellness, spiritual wellness... but we don't often talk about financial wellness. Financial security in this day in age is vital so that we have the capacity to step back from our work if and when we need to. Some of us avoid learning about finances because it seems complicated and there's a sense of hopelessness.  If you're one of these people, this podcast is for you. Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com. You can join our community or drop us a message by going to iamwellmd.com/contact. Welcome home!

It's so easy in today's busy world to get overwhelmed - especially when we're balancing work, kids, and the seemingly insurmountable needs of the day. Let's talk a little about "indulgent emotions" like overwhelm, and how to get ourselves out of the rut it creates. Have questions or comments? Pop onto www.iamwellmd.com/contact and leave us a note. You may get a shout-out on the next podcast episode!Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

Elizabeth Killien, MD MPH is an Assistant Professor of Pediatrics at the University of Washington and an attending physician in the Pediatric ICU at Seattle Children's. She earned her MD from Dartmouth Medical School in 2011. She completed her residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at the University of Washington. She underwent additional training in pediatric trauma research at the Harborview Injury Prevention and Research Center in the Pediatric Injury Research Training Program from 2017-2019, and completed her Master of Public Health degree in Epidemiology at the University of Washington in 2019. She is a member of the Society of Critical Care Medicine, Pediatric Acute Lung Injury and Sepsis Investigators, and American Thoracic Society. Her scholarly work focuses on organ failure after traumatic injury and long-term outcomes after critical illness.Learning Objectives:By the end of this podcast, listeners should be able to:Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.Recognize common risk factors of post-intensive care syndrome in children.Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.Recall key next steps in post-intensive care syndrome research.How to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.References:Manning, Joseph C. RN, PhD1,2,3; Pinto, Neethi P. MD, MS4; Rennick, Janet E. RN, PhD5,6; Colville, Gillian MPhil, CPsychol7; Curley, Martha A. Q. RN, PhD8,9,10. Conceptualizing Post Intensive Care Syndrome in Children—The PICS-p Framework*. Pediatric Critical Care Medicine 19(4):p 298-300, April 2018. | DOI: 10.1097/PCC.0000000000001476 https://www.palisi.org/ Killien EY, Zimmerman JJ, Di Gennaro JL, Watson RS. Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor. 2022 Jun 15;4(6):e0716. doi: 10.1097/CCE.0000000000000716. PMID: 35733611; PMCID: PMC9203075.Smith MB, Killien EY, Dervan LA, Rivara FP, Weiss NS, Watson RS. The association of severe pain experienced in the pediatric intensive care unit and postdischarge health-related quality of life: A retrospective cohort study. Paediatr Anaesth. 2022 Aug;32(8):899-906. doi: 10.1111/pan.14460. Epub 2022 Apr 22. PMID: 35426458; PMCID: PMC9990726.Support the show

Everywhere we turn, there's information. We are constantly absorbing it. Sometimes it happens so fast that we don't even realize that it's happened.  Have you ever listened to a song that was sad and found yourself moping around for hours afterwards? Maybe you've listened to someone talk heatedly about something and now you're feeling irritated, too. If you're someone who tends to soak up and internalize the emotions of the people around you, how does that make you feel? How does it impact your day? Let's talk about how we can separate our baggage from their baggage... because, let's face it, we  have enough of our own, and we don't need to carry someone else's! Tune in to find out how!Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

Elizabeth Killien, MD MPH is an Assistant Professor of Pediatrics at the University of Washington and an attending physician in the Pediatric ICU at Seattle Children's. She earned her MD from Dartmouth Medical School in 2011. She completed her residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at the University of Washington. She underwent additional training in pediatric trauma research at the Harborview Injury Prevention and Research Center in the Pediatric Injury Research Training Program from 2017-2019, and completed her Master of Public Health degree in Epidemiology at the University of Washington in 2019. She is a member of the Society of Critical Care Medicine, Pediatric Acute Lung Injury and Sepsis Investigators, and American Thoracic Society. Her scholarly work focuses on organ failure after traumatic injury and long-term outcomes after critical illness.Learning Objectives:By the end of this podcast, listeners should be able to:Define post-intensive care syndrome, recognize the clinical presentation and make the presumptive diagnosis.Recognize common risk factors of post-intensive care syndrome in children.Discuss practical ways to reduce the risk of post-intensive care syndrome in children admitted to the pediatric ICU.Discuss management strategies to optimize the care provided to children suffering from post-intensive care syndrome.Recall key next steps in post-intensive care syndrome research.How to support PedsCrit:Please rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.References:Manning, Joseph C. RN, PhD1,2,3; Pinto, Neethi P. MD, MS4; Rennick, Janet E. RN, PhD5,6; Colville, Gillian MPhil, CPsychol7; Curley, Martha A. Q. RN, PhD8,9,10. Conceptualizing Post Intensive Care Syndrome in Children—The PICS-p Framework*. Pediatric Critical Care Medicine 19(4):p 298-300, April 2018. | DOI: 10.1097/PCC.0000000000001476 https://www.palisi.org/ Killien EY, Zimmerman JJ, Di Gennaro JL, Watson RS. Association of Illness Severity With Family Outcomes Following Pediatric Septic Shock. Crit Care Explor. 2022 Jun 15;4(6):e0716. doi: 10.1097/CCE.0000000000000716. PMID: 35733611; PMCID: PMC9203075.Smith MB, Killien EY, Dervan LA, Rivara FP, Weiss NS, Watson RS. The association of severe pain experienced in the pediatric intensive care unit and postdischarge health-related quality of life: A retrospective cohort study. Paediatr Anaesth. 2022 Aug;32(8):899-906. doi: 10.1111/pan.14460. Epub 2022 Apr 22. PMID: 35426458; PMCID: PMC9990726.Support the show

In this Complex Care Journal Club podcast episode, Dr. Arda Hotz discusses a cross-sectional study of the use of durable medical equipment and supplies by pediatric patients. She describes implications for the care of children with complex chronic conditions, key stakeholders involved in the analysis, and next steps from this work. SPEAKERS Arda Hotz, MD, MPH Instructor of Pediatrics, Harvard Medical School Pediatrician, Division of General Pediatrics, Boston Children's Hospital HOST Emily Goodwin, MD Clinical Associate Professor of Pediatrics, University of Missouri Kansas City School of Medicine Pediatrician, General Academic Pediatrics Beacon Program, Children's Mercy Kansas City DATES Initial publication: January 5, 2024. ARTICLES REFERENCED Hotz A, Sprecher E, Bastianelli L, Rodean J, Stringfellow I, Barkoudah E, Cohen LE, Estrada C, Graham R, Greenwood J, Kyle J, Mann N, Pinkham M, Solari T, Rosen R, Saleeb S, Shah AS, Watters K, Wells S, Berry JG. Categorization of a Universal Coding System to Distinguish Use of Durable Medical Equipment and Supplies in Pediatric Patients. JAMA Netw Open. 2023 Oct 2;6(10):e2339449. doi: 10.1001/jamanetworkopen.2023.39449. PMID: 37874565; PMCID: PMC10599121. Adegboro CO, Coller RJ. An Important Tool to Understand Durable Medical Equipment and Supply Use in Children. JAMA Netw Open. 2023 Oct 2;6(10):e2339581. doi: 10.1001/jamanetworkopen.2023.39581. PMID: 37874568 ‌ Children and Youth with Special Health Care Needs National Research Network. Emerging Investigator Program. https://cyshcnet.org/emerging-investigator-program/‌‌‌ Feudtner C, Feinstein JA, Zhong W, Hall M, Dai D. Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation. BMC Pediatr. 2014 Aug 8;14:199. doi: 10.1186/1471-2431-14-199. PMID: 25102958; PMCID: PMC4134331.‌‌‌‌ TRANSCRIPT https://op-docebo-images.s3.amazonaws.com/Transcripts/Getting+Equipped_Understanding+the+Use+of+Durable+Medical+Equipment+in+Children_Hotz_010824.pdf Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: forms.gle/Bdxb86Sw5qq1uFhW6 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Hotz A, Goodwin EJ. Getting Equipped: Understanding the Use of Durable Medical Equipment in Pediatrics. 1/2024. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/getting-equipped-understanding-the-use-of-durable-medical-equipment-in-pediatrics.

A manual is a booklet that's written to help us understand how something works. In the coaching world, however, "the manual" refers to an unspoken set of beliefs and expectations that we set for the people in our lives. Because it's unspoken, the other person doesn't even know it exists... and, to be honest, you may not even realize it exists until you shed some light on it. Once we see it, it's easier to understand how this set of expectations and beliefs can negatively affect us. It can also give us some helpful insight into what we need to do to improve the quality of our relationships. Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

Every year on December 31st, we all look towards the new year with high hopes and aspirations. It represents a new page in the next chapter of our books. We end the year thinking about how we want the next 365 days (or, in this case, 366 days) to look and what we want to accomplish. For those of us who might be recovering high achievers, perfectionists, workaholics... it's easy to get a little crazy with our goals. My 2024 version of myself just set one of the hardest goals ever. Listen to find out more!Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

We're all busy people. It's hard when an obstacle, no matter how petty it is, springs up and messes with our flow. Everyone reacts to stressors a little differently. We have choices, though, and while we may initially be disappointed or upset, we get to make the final call on how we want to approach the disruption at hand. We can either let it ruin our day, or we can step back and give ourselves an opportunity to put things in perspective. Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

Burnout is work place related stress which is characterized by a state of physical and/or emotional exhaustion, a sense of reduced accomplishment, and, often, a loss of personal identity.The repercussions of burnout/moral injury are serious. In fact, in the United States, an estimated 300 to 400 doctors die by suicide each year, which is more than double that of general population.We are in a health care crisis. This affects not just the medical team, but also the patients we serve. The band-aids that are tenuously holding the system together are starting to come undone. I ask that we, as a community, come together to seek out and implement solutions that sustainable. It is time for change.If you are in support of this, please share this episode with your friends and family. You can also visit me at iamwellmd.com to learn more about how I'm working with individuals to help heal some of the wounds of burnout and moral injury. Click on my picture and join our mailing list to stay in the loop. If we raise awareness, we can create change.Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

The Motivational Triad is a theory that sheds light on how our desires to maintain comfort, avoid pain, and be efficient with our energy influence our motivation to change (or not change!) It highlights why we humans like to stay in our comfort zone. What's the key to getting us to move out of that space and into bigger and better things? Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

We all have values that we developed as we were growing up. These values and goals shaped who we were in that moment and who we became. What were some of your core values? How have they shaped you into your present-day self? Are your values still the same now? While we may have gotten a little older, it doesn't mean that this is where the road ends! How do you want your life to reflect your values? What would you like the next chapter of your life to look like? Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

From an evolutionary perspective, our brain is primed to scan for everything that's wrong in our environment. This is an amazing asset, because it quite literally ensures our survival. But in this day in age, we're generally not being chased by predators... and this instinct we have can actually get our way, especially as we try to leave our comfort zone and move on to bigger and better things. Learn more on Episode 6 - "Can our brain be a barrier to our success?"Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.

Let's continue the conversation on breaking through glass ceilings! We've started to deconstruct some beliefs that aren't serving us any longer... so, now what? If your wheels are starting to turn and you're getting ready to make changes in your life, this episode is for you. As we set goals for our futures, it's natural for some not-so-lovely emotions to spring up, especially when we hit an obstacle. How do we manage those feelings and move towards success?Dr. Tanikella practices General Pediatrics, Integrative Medicine, and is an expert in Mind-Body medicine. She has traveled the world to learn more about the intersection where mind, body, personal beliefs, and motivation meet. She is founder and CEO of Integrative Approaches to Mastering Wellness, where she brings the wisdom of mind body medicine and the power of life coaching together to help her clients break through their glass ceilings. Want to learn more? Visit Dr. Tanikella at iamwellmd.com and subscribe to her mailing list.You can also join her Facebook group at www.facebook.com/iamwellmd.