Podcasts about Global Academy

student youths global academy

Play Episode Listen Later May 20, 2021 34:35

This is the magic ingredients that go together make Global Academy's Youths Choice Radio Station

Vet Sustain & Regenerative Agriculture With Dr Laura Higham

Veterinary Ramblings

Play Episode Listen Later Apr 29, 2021 73:23

Join us as we sit down with Laura Higham, a veterinary consultant in sustainable livestock production at the Food Animal Initiative (FAI) and one of the directors at Vet Sustain. She is also studying for a PhD in antimicrobial use in agriculture at The Global Academy for Agriculture and Food Security at Edinburgh University and holds an MSc in international animal health.We discuss regenerative agriculture, the difference between consumers and citizens, One Health and how we can all do our bit, both on a personal and professional level, to make our planet better for future generations!

phd agriculture msc sustain food security veterinary medicine regenerative agriculture one health sustainable farming edinburgh university higham ecoliving global academy

Greg Collucci - NBA Global Academy

World of Basketball with Fran Fraschilla

Play Episode Listen Later Apr 22, 2021 43:54

Fran Fraschilla is joined by former George Washington player and current head of player pathways at the NBA Greg Collucci. The two discuss a variety of topics, including:Greg on basketball becoming a global gameGreg on where his interest in international hoops came from Greg on how the current crop of international players in the NBA have impacted the growth of basketball globally Greg on being around KD in ShanghaiGreg on Basketball Without BordersGreg on what the NBA is trying to achieve with their Global Academies Greg on grooming players to go to college Greg on the NBA Academy in IndiaGreg on the NBA Academy in SenegalGreg on the lack of gyms in AfricaGreg on how he keeps up with all of his former playersGreg on the NBA Academy in AustraliaGreg on international guys being great teammatesGreg on whether he wants to see the US have a basketball academyGreg on how he became a part of the NBA Academy

nba kevin durant george washington kd cameroon embiid pascal siakam fran fraschilla global academy

22: Juggling Mum & Boss Life, & Going Behind The Scenes Of The Advertising Industry With Rhiannon Lewis

Embrace Your Feminine Essence

Play Episode Listen Later Apr 11, 2021 71:04

In today's episode I talk to Senior Producer and Managing Partner at The Gate Films, Rhiannon Lewis. In today's episode we discuss Rhiannon's journey into TV production, the changes she has seen over the years with the rise of digital advertising and influencers, how she brings out her creativity, balancing mum life with boss life, some challenges she has faced with the sexualisation of women in advertising (it's not what you're going to be expecting), and so much more. I absolutely loved speaking to my dear friend Rhiannon in this episode and can't wait for you to listen. We love hearing your episode takeaways! Screenshot this episode, and tag @lynda.stretton & @thegatefilms on Instagram. If you love this episode, please leave a rating and review so we can reach and support more women worldwide. If you do, make sure you send an email to podcast@lyndastretton.com so I can send you your FREE Embrace Your Feminine Essence guide. Let's connect: Visit my website to find out more about working with me Come hang out on Instagram where I share a tonne of free content Join the podcast's FREE private Facebook group here Let's connect on clubhouse where I host free trainings: @lynda.stretton About Rhiannon Rhiannon Lewis is Managing Partner and Head of Production at The Gate Films. Rhiannon is passionate about creating film content. She prides herself on striving for that balance between the Director's interpretation and the Client's requirements, to find the best possible creative and practical solutions to any brief. Rhiannon has produced TV campaign for brands such as Tommee Tippee, Coors beer and Tresemme to name a few. She has also created award winning cross platform content campaigns for brands such as Very and Missguided. Her production for Missguided campaigns is now in it's 10th year, with many awards received for it along the way. Rhiannon is an enthusiastic mentor to many film students across Manchester and the North West. She sits on the industry board for the Global Academy and is a key speaker at the Women In Media conferences. A mother of four, she champions women in film and flexible working hours. She has some killer dance moves and a love of cake. And gin. About The Gate Films The Gate Films is a production company based in Manchester, working with the world's brightest and boldest agencies and brands to make great advertising content. They also have satellite offices in Cape Town, LA and Malaga. Visit their website Follow them on Instagram

Rethinking university traditions, practices and beliefs during a time of upheaval - Podcast

Campus Review Podcasts

Play Episode Listen Later Apr 8, 2021 20:32

The COVID-19 pandemic tore a hole in the Australian university sector, highlighting just how dependent many of our institutions have become on international student revenue. Now, roughly a year later, the sector is still adjusting to challenging conditions and many experts have questioned how universities will need to operate in the future to remain viable, trusted and valuable institutions. In this podcast I discuss this issue with Professor Andrew Jaspan. He is the director and editor of The Global Academy(hosted at Monash University)and founder of The Conversation. Jaspan explains that, while some recovery is underway, universities around the country are rethinking their approaches and beliefs towards everything from courses, delivery modes, future student markets and the qualifications, skills and qualities they are looking for in people taking up leadership positions. The appointment of Sydney university's new vice-chancellor Mark Scott is also discussed at length, in particular how non-academic appointments to the top job may now be considered for what they can bring, rather than what they don't possess. One thing is for sure, though. No university is absolutely certain about how it will be moving forward in the future.

covid-19 university conversations australian practices beliefs rethinking traditions monash university upheaval mark scott global academy

A Human Rights Approach to Land - (Kirsteen Shields)

Landscapes

Play Episode Listen Later Feb 17, 2021 22:50

The second episode of Landscapes features an interview with Dr Kirsteen Shields, Lecturer in International Law and Food Security at the Global Academy of Agriculture and Food Security at the University of Edinburgh. Kirsteen was the first person to introduce me to the Land Reform debate happening in Scotland and has played a role in informing high level thinking on the Acts themselves. Particularly, we talk about the fundamental balancing act between rights to property and rights to pretty much everything else. Episode Links Human Rights and the Work of the Scottish Land Commission, a discussion paper by Dr Kirsteen Shields An article from the Guardian in 2020 about the House of Commons debates on free school meals over holiday periods

Santiago Vescovi - Tennessee Volunteer

World of Basketball with Fran Fraschilla

Play Episode Listen Later Feb 11, 2021 46:15

Fran Fraschilla is joined by Tennessee Volunteer Santiago Vescovi. The two discuss a wide variety of topics, including:Santi on why he chose to play basketballSanti on Esteban BatistaSanti on the basketball culture in UruguaySanti on Basketball Without BordersSanti on the Global Academy in AustraliaSanti on playing against Josiah-Jordan James in San AntonioSanti on his teammates and playing at TennesseeSanti on the other players he played with or against in BWBSanti on being compared to Manu GinobiliSanti on being recruited by TennesseeSanti on making his debut for TennesseeSanti on Coach BarnesSanti on becoming one of the veteran players on the teamSanti on how different it has been playing during the pandemicSanti on the mental health of the players during the pandemicSanti on how he is feeling physicallySanti on what it’d feel like to make the NBASanti on what areas he needs to focus on to improve his gameSanti on the NCAA tournament

ncaa uruguay santi tennessee volunteers manu ginobili fran fraschilla vescovi global academy

Sign up today for Xtream FX Global Academy.

Open Your Ears

Play Episode Listen Later Jan 25, 2021 30:02

How to develop financial freedom and learn about crypto currencies and how to build a family legacy. --- Send in a voice message: https://anchor.fm/openyourears/message Support this podcast: https://anchor.fm/openyourears/support

global academy

Centro Português da OceanTeacher Global Academy

Geração Digital

Play Episode Listen Later Oct 10, 2020 15:09

centro portugu global academy

Bill White CEO PTrade Global/ PT Global Academy S 17 E 1

Her Business Her Voice Her Conversation

Play Episode Listen Later Aug 16, 2020 34:04

Businesses closing, looming financial depression. Bill White, CEO of PTrade Global has a solution - take the viable sustainable classes at PTrade Academy, skill up, or cease to be competitive. "Move where the puck is going." Takeaway: Give yourself permission to figure out what lifestyle you want and design it! Step 2 is to figure out how to fund your planned lifestyle. We must skill up to meet the challenge of competition in this world. Since the island is sinking, we don't have time to get out blueprints to redesign skills already created to meet today's needs, demand, and those of tomorrow. With P Trade Global, you have the opportunity to be a student at the Global Academy - learn Forex trading, podcasting, clean your credit up, real estate investment, and more. If you get excited and see what's going on at P Trade Global as an affiliate means of income, just ask!

ceo businesses forex bill white global academy

5. The Academy: The Best of the Global Academy, Brandon Guru's Young Audio Award nominated documentary on the Grenfell fire

young documentary gurus west london grenfell award nominated global academy

Play Episode Listen Later Jul 23, 2020 9:31

What effect did the Grenfell fire have on the young people of West London? Brandon Guru's documentary explores the fires aftermath and it' effect on the community.

3. The Academy: The Best of the Global Academy, Andrew Botcher explores how the Royal Family used to top the music charts.

explore royal family emi music charts global academy

Play Episode Listen Later Jul 23, 2020 10:37

Andrew Botcher explores the EMI archive and finds out that the royal family used to sell millions of records, top the charts but never sing a note.

4. The Academy: The Best of the Global Academy, Andrew Botcher finds out how Pink Floyd took a small piece of the The Beatles to heart.

beatles piece pink floyd global academy

Play Episode Listen Later Jul 23, 2020 7:50

Andrew Botcher finds out how Pink Floyd took a small piece of the The Beatles to heart.

Reimagining Schools for Creativity (Jonty Archibald, Global Academy)

Rocket Fuel: Youth Marketing

Play Episode Listen Later Jul 23, 2020 48:24

Jonty Archibald is the principal of the Global Academy: a university technical college designed to equip young people for a career in the media and entertainment industries.Though still in its infancy, the Global Academy has already redefined what a school is and can be. Global provides 14-19 year olds accessibility to study oft reserved for university subjects, such as computer science, digital media, art and drama, within a learning environment that is state of the art and believes that the education of “every child matters.”Feeling disengaged from his own schooling, Jonty Archibald now finds himself as the leader of the kind of school he wished he could have attended as a youth. As principal, he brings his knowledge of education and industry together, helping to open the gates for young and aspiring creatives.Topics of discussion include: Jonty’s beginnings, creativity, school curriculum, schooling during the pandemic, online learning, the role of education, and how the youth have changed.This is Jonty Archibald’s Rocket Fuel.———————Follow James @JamesErskine (twitter.com/jameserskine)Connect with James on LinkedIn (linkedin.com/in/jameserskine)Follow Rocket @WeAreRocketHQ (twitter.com/wearerockethq)Follow Rocket on LinkedIn (linkedin.com/company/thebigshot)wearerocket.co.uk/Follow Global Academy @TheGAcademy twitter.com/thegacademyFollow Global Academy on Instagram instagram.com/thegacademyFollow Global on Facebook facebook.com/TheGAcademy/globalacademy.com/ See acast.com/privacy for privacy and opt-out information.

global creativity schools reimagining rocket fuel archibald jonty global academy

2. The Academy - The best of the Global Academy: Andrew Botcher takes us through the story of how The Beatles sold millions but didn't make millions.

beatles sold emi make millions global academy

Play Episode Listen Later Jul 23, 2020 9:36

Global Academy is located on the site of the former EMI vinyl factory, hundreds of millions of records were pressed here and this is the story of the artists behind those records. Andrew Botcher explains how The Beatles sold millions but didn't make millions.

1. The Academy - The Best of the Global Academy: The Boot Room, Josh Fraser's winning entry at the Young Audio Awards

Confidences particulières

Play Episode Listen Later Jul 14, 2020 13:07

This podcast looks at the science behind the beautiful game. Spurs and Ireland's Gary O'Reilly discusses the sports science, or lack of it in 1980s football. Big data and why it works hand in hand with the big match We discover the earliest form of doping, with monkey glands And Brentford's secret weapon, a sleep coach.

young ireland awards san antonio spurs boot global academy josh fraser winning entry

#2 - Karen Williams "I’m a better person and a stronger manager"

Play Episode Listen Later Mar 27, 2020 7:30

Karen Williams is Global Academy and Education Director at MAKE UP FOR EVER. Every day, she teaches young people how to become make-up artists. She came from a very polyglot family and lived all over the world: Germany, Africa, India, Portugal, wondering what she wanted to become. She dreamed herself as a make-up artist for horror films. Then she came to France and graduated from a make-up school. For twenty year, she has been working her way out to backstage, advertising, etc. in the make-up sector. One day, Karen Williams was working as a make-up trainer at Parfums Christian Dior, when she met with a neuroscientist researcher named Kate-Mary. Kate-Mary was working on people’s brain and how they learn. At first sight, she appeared to Karen as eccentric. But then she turned out to be her role model. Kate-Mary taught Karen how to be a better person and a much stronger manager. She checked Karen to be who she is today, including from a vocational perspective. She taught her about education. And when Karen became Global Academy and Education Director at MAKE UP FOR EVER three years ago, she wanted to pay tribute to Kate-Mary. Thanks to her she realized that education is everything.

france germany africa portugal stronger education director better person karen williams global academy

Coronavirus ALERT! Miracle drug: Vitamin C. W. Gifford-Jones, MD and Diana Gifford-Jones

Discussions of Truth

Play Episode Listen Later Mar 11, 2020 48:48

Discussions of Truth welcomes: W. Gifford-Jones, MD and his daughter/co-author Diana Gifford Jones. https://www.docgiff.com/about/ Dr. Ken Walker (who writes under the pseudonym of Dr. W. Gifford-Jones, MD) is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and his latest book, “90+ How I Got There!”. Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. His hobby is trap shooting. He is married to Susan and has four children and twelve grandchildren. Diana Gifford-Jones (pen name for Diana MacKay, pronounced mac-EYE The daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently written a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally! Her current work involves the launch of a new Institute on Global Health and Development and an Institute for Brain and Mind. --- Support this podcast: https://anchor.fm/iantrottier/support

#2 - Karen Williams "I’m a better person and a stronger manager"

Tips to the Top

Play Episode Listen Later Mar 5, 2020 7:30

Karen Williams is Global Academy and Education Director at MAKE UP FOR EVER. Every day, she teaches young people how to become make-up artists. She came from a very polyglot family and lived all over the world: Germany, Africa, India, Portugal, wondering what she wanted to become. She dreamed herself as a make-up artist for horror films. Then she came to France and graduated from a make-up school. For twenty year, she has been working her way out to backstage, advertising, etc. in the make-up sector. One day, Karen Williams was working as a make-up trainer at Parfums Christian Dior, when she met with a neuroscientist researcher named Kate-Mary. Kate-Mary was working on people’s brain and how they learn. At first sight, she appeared to Karen as eccentric. But then she turned out to be her role model. Kate-Mary taught Karen how to be a better person and a much stronger manager. She checked Karen to be who she is today, including from a vocational perspective. She taught her about education. And when Karen became Global Academy and Education Director at MAKE UP FOR EVER three years ago, she wanted to pay tribute to Kate-Mary. Thanks to her she realized that education is everything.

france germany career africa portugal stronger lvmh education director better person karen williams global academy

Late-life mood disorders with Dr. George T. Grossberg

Play Episode Listen Later Feb 5, 2020 21:53

George T. Grossberg, MD, conducts a Masterclass on treating mood disorders in geriatric patients from the CP/AACP Psychiatry Update 2019 meeting in Las Vegas. The meeting was sponsored by Global Academy for Medical Education and Current Psychiatry. Dr. Grossberg is the Samuel W. Fordyce professor and director of geriatric psychiatry at St. Louis University School of Medicine in St. Louis. Later, Renee Kohanski, MD, discusses the first thing psychiatrists can do for patients. Take-home points from Dr. Grossberg: The prevalence of major depressive disorder among older adults who reside in the community is similar to that of the general population (6%). In nursing homes, the prevalence of significant clinical depression is close to 25%. Depression in older adults in long-term care facilities is underrecognized and undertreated. Risk factors for depression include advanced age (80-90 years), loneliness and lack of social support, painful conditions, frailty, and medical comorbidities. Medications that are central nervous system depressants, such as opiates and benzodiazepines, also can contribute to depression. Alcohol can also be a depressant. Depression in the face of cognitive impairment is extremely common and can even speed cognitive decline. Apathy, defined as lack of motivation, can look like depression. However, depression will have amotivation coupled with vegetative symptoms, such as disrupted sleep and loss of appetite, and mood changes, such as sadness and tearfulness. Low-dose stimulants are effective for apathy, but antidepressants are not; so, it’s important to differentiate the two. Undiagnosed and untreated depression contributes to a significant degree of morbidity because it can slow recovery in rehabilitative settings and impair adherence to essential medications. Treating depression also can improve pain control by making it more tolerable as a somatic symptom. Individuals older than 65 years account for more than 20% of all completed suicides in the United States. Psychological autopsy studies suggest that many of these individuals had undiagnosed depression. Clinicians should not shy away from treating geriatric patients for depression with medication and interventions such as cognitive-behavioral therapy. With pharmacotherapy, start low, go slow, and titrate up to a therapeutic dose. Older adults may take longer, up to 8-12 weeks, to respond to SSRIs, so it’s imperative not to give up on medications too soon. Electroconvulsive therapy is the most effective treatment for severe depression in geriatric patients. Some consider advanced age an indication for ECT; medical comorbidities are not a contraindication for ECT. It is unclear how effective ketamine is in older patients, but it deserves consideration. Prompt diagnosis and treatment of mood disorders is paramount in patients of advanced age and those living in long-term care facilities. Treating depression in the older patient also improves the quality of life for caregivers and professional staff. References Birer RB et al. Depression in later life: A diagnostic and therapeutic challenge. Am Fam Physician. 2004 May 15;69(10):2375-82. Sjoberg L et al. Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults. J Affect Disord. 2017 Oct 15;221:123-31. Grossberg GT et al. Rapid depression assessment in geriatric patients. Clin Geriatr Med. 2017 Aug;33(3):383-91. *** For more MDedge podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

Parkinson’s-related psychosis with Dr. Alberto J. Espay

Play Episode Listen Later Jan 15, 2020 21:31

Alberto J. Espay, MD, MSc, conducts a Masterclass lecture on treating patients with Parkinson’s-related psychosis from the Psychopharmacology Update in Cincinnati. The meeting was sponsored by Global Academy for Medical Education and Current Psychiatry. Dr. Espay is professor of neurology at the University of Cincinnati. He also serves as director of the James J. and Joan A. Gardner Family Center Research Chair for Parkinson’s Disease and Movement Disorders. And later, in the “Dr. RK” segment, Renee Kohanski, MD, asks you to think about some of the complex issues tied to getting treatment for people who are both homeless and have serious mental illness. * * * Treatment of Parkinson’s-related psychosis Psychosis related to Parkinson’s disease (PD) is a common reason for hospitalization, institutionalization, and decline of patients with PD. The diagnosis of PD is required before the development of psychosis to diagnose patients with Parkinson's-related psychosis. Parkinsonism that appears after development of psychosis is Lewy body dementia. Many factors influence the development of psychosis in PD. Extrinsic factors include medical illnesses or metabolic derangement causing delirium with psychosis; nonessential dopaminergic medications such as ropinirole and selegiline; anticholinergic medications such as benztropine, amantadine, and bladder antispasmodics; and insomnia. The last resort for treatment of psychosis is levodopa because patients will experience motoric decline and loss of functioning. There are several mechanisms for psychosis to occur via the dopaminergic, serotonergic, and glutamatergic pathways; thus, three neurotransmitters – serotonin, dopamine, and glutamate – can be manipulated to treat psychosis. Quetiapine, clozapine, and pimavanserin are the three antipsychotics safe for use in Parkinson’s disease. Clozapine is infrequently used, because of the risk of neutropenia and required blood work monitoring, but evidence shows that the benefits usually outweigh the risks of motor decline. Quetiapine is commonly used, because it has a favorable effect on sleep and psychosis, but it negatively affects the movement disorder of Parkinson's disease. Pimavanserin (Nuplazid), the only medication FDA approved for hallucinations and delusions associated with psychosis in Parkinson’s disease, is highly selective for the 5-HT2A receptor as both an inverse agonist and antagonist. Primary adverse effects are peripheral edema and confusion, but overall the adverse effects profile is similar to that of placebo. In the pimavanserin clinical trials, a subset of patients worsened and experienced more visual hallucinations. In addition, pimavanserin can prolong the QT interval, so patients taking other QT-prolonging medications or who have cardiac comorbidities should be monitored with an EKG. Post hoc data analysis from as pivotal phase 3 study suggests that patients with cognitive impairment and dementia may receive more benefit from pimavanserin. * * * References Cruz MP. Pimavanserin (Nuplazid): A treatment for hallucinations and delusions associated with Parkinson’s disease. P T. 2017 Jun;42(6):368-71. Cummings J et al. Pimavanserin: Potential treatment for dementia-related psychosis. J Prev Alzheimers Dis. 2018;5(4):253-8. Huot P. 5HT2A receptors and Parkinson’s disease psychosis: A pharmacological discussion. Neurodegenerative Disease Management. 2018 Nov 19. doi: 10.2217/nmt-2018-0039. * * * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

university md disease treatments cincinnati masterclass fda primary parkinson msc pd interact psychosis medical education qt ekg extrinsic lewy james j movement disorders p t parkinsonism clozapine global academy quetiapine alberto j ht2a espay mdedge podcasts

Inflammation and mental illness revisited with Dr. Roger McIntyre

Play Episode Listen Later Jan 1, 2020 30:45

Lorenzo Norris, MD, and Roger McIntyre, MD, talk about obesity, inflammation, and mental illness. The conversation, which originally dropped a few months ago, took place at the Focus on Neuropsychiatry 2019 meeting. The meeting was sponsored by Current Psychiatry and Global Academy for Medical Education. The original podcast included robust Show Notes by Jacqueline Posada, MD. Also, you can watch the conversation between Dr. Norris and Dr. McIntyre on video or on YouTube. Later, Renee Kohanski, MD, talks about different ways to think about resolutions and behavioral change. For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

health news mental focus md mental illness psychiatry inflammation norris interact mcintyre medical education neuropsychiatry global academy mdedge podcasts

Postpartum depression with Dr. Ruta Nonacs

Play Episode Listen Later Dec 18, 2019 19:28

Ruta Nonacs, MD, PhD, conducts a Masterclass lecture on treating women with postpartum depression from the Psychopharmacology Update in Cincinnati. The meeting was sponsored by Global Academy for Medical Education and Current Psychiatry. Dr. Nonacs is a staff psychiatrist with the Perinatal and Reproductive Psychiatry Clinical Research Program at Massachusetts General Hospital in Boston. * * * Help us make this podcast better! Please take this short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * Features of postpartum depression Postpartum depression (PPD) affects 10%-15% of women after delivery. For many women, their depression starts in the third trimester and worsens after delivery. Unique symptoms of PPD include difficulties bonding with the baby, feeling like an inadequate mother, and experiencing severe sleep disturbance with anxiety and edginess. In a common scenario, the mother will not be able to sleep at night, though her baby is sleeping well. Anxiety is a common comorbidity, especially obsessive thoughts about the baby’s safety. Treatment of PPD Treatment in this population is complicated by many demands placed on a mother as the primary caregiver of an infant. The medication chosen must target depression and anxiety, improve sleep, yet not be too sedating. The concentration of antidepressants in breast milk is low, but many women will defer treatment for their depression until they’ve stopped breastfeeding. Treatment of mild PPD includes recruiting more support to help the mother with care of the infant and psychotherapy to identify stressors and coping skills. In moderate to severe PPD, antidepressants are needed. Selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) are the preferred treatments, and studies support the use of sertraline, fluoxetine, paroxetine, and venlafaxine at their standard dosages. SSRIs and SNRIs are compatible with breastfeeding, because the medications are detected in the breast milk at very low levels. Brexanolone (Zulresso) is the only Food and Drug Administration–approved medication for postpartum depression. It is a neurosteroid and derivative of allopregnanolone, which is a positive allosteric modulator of the gamma-aminobutyric acid receptor. Brexanolone has low oral bioavailability and is administered only as a 60-hour infusion in a certified medical setting with continuous monitoring. The trials for brexanolone included women with moderate to severe PPD, and Hamilton Depression Rating Scale scores (HAM-D) scores ranging from 20 to 25. After the 60-hour infusion, 45% of the subjects with severe PPD in the brexanolone group achieved remission by the end of treatment, compared with 23% in the placebo group. Women retained the antidepressant effect at the 30-day follow-up. The results in the moderate PPD group were not as impressive; these women had a decrease in their depression HAM-D scores, but the antidepressant effect did not continue to the 30-day follow-up. The FDA approval came with a Risk Evaluation Mitigation Strategy in place. Currently, approximately 100 sites are ready to administer brexanolone; however, some obstacles remain: Obstacles to using brexanolone The medication costs more than $30,000 per infusion, and it is uncertain how much insurance will cover. Since brexanolone is administered in hospital settings, women must be separated from their children for several days. Breastfeeding must be stopped while women are on the medication because of the lack of data about excretion in breast milk. Brexanolone is labeled as a Schedule IV medication because it has a similar mechanism of action to midazolam and diazepam. Likelihood of diversion is low, but some women with substance abuse histories might be concerned about this treatment. References Leader LD et al. Brexanolone for postpartum depression: Clinical evidence and practical considerations. Pharmacotherapy. 2019 Nov;39(11):1105-12. Meltzer-Brody S et al. Brexanolone injection in postpartum depression: Two multicenter, double-blind, randomized, placebo-controlled, phase 3 trials. Lancet. 2018 Sep 22;392(10152):1058-70. Nonacs R. A Deeper Shade of Blue: A Woman’s Guide to Recognizing and Treating Depression in Her Childbearing Years. New York, NY: Simon & Schuster; 2006. Massachusetts General Hospital Center for Women’s Mental Health. womensmentalhealth.org National Institutes of Health. Drugs and Lactation Database (LactMed). * * * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

Older–age bipolar disorder with Dr. Martha Sajatovic

Play Episode Listen Later Dec 4, 2019 15:01

Martha Sajatovic, MD, conducts a Masterclass lecture on older-age bipolar disorder from the Psychopharmacology Update in Cincinnati. The meeting was sponsored by Global Academy for Medical Education and Current Psychiatry. Dr. Sajatovic is professor of psychiatry and of neurology at Case Western Reserve University in Cleveland. She also directs the Neurological and Behavioral Outcomes Research Center at University Hospitals Cleveland Medical Center. * * * Help us make this podcast better! Please take this short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * Conceptualizing OABD Older–age bipolar disorder (OABD), defined as a person aged 60 years or older with bipolar disorder, makes up one-quarter of bipolar patients. It is a heterogeneous population that includes early- and late-onset disease. Late onset is diagnosed when a person has a manic or hypomanic episode at or after the age of 50 years. Bipolar depression in later life has long been seen as a “special population,” and the treatment has been extrapolated from larger clinical trials of younger patients. Late–onset bipolar disorder usually has attenuated manic episodes and depressive episodes are prolonged and severe. In OABD, the patients are more likely to have multiple morbidities, which makes medication management more complex. People with bipolar disorder lose 1-2 decades of life, compared with the general population. No medications are specifically approved by the Food and Drug Administration for bipolar disorder or bipolar depression in older adults. However, the treatment follows general geriatric psychiatry principles: Start low and go slow. International guidelines on treating bipolar disorder Starting low means using half or even less of the recommended dose that a clinician would use in mixed-aged populations. Titrate slowly to allow the person time to acclimate to side effects that usually resolve. Bipolar disorder is a chronic disease, so medication adherence is paramount. Adherence can be jeopardized when a person experiences excessive side effects from the beginning of treatment. First-line treatment for bipolar depression in OABD include lurasidone (Latuda) or quetiapine (Seroquel) with low dosing and slow titration. This recommendation is supported by data from a post hoc analysis of the clinical trial data of lurasidone for bipolar depression. Lithium is also recommended and underused. The level should be lower for OABD; an appropriate target for older adults with bipolar disorder is 0.4-0.8 mEq/L, especially in people who are older and frailer. Lamotrigine (Lamictal) also is helpful and fairly well tolerated. Clinicians need to be attentive to a patient’s medical comorbidities and psychosocial support to enhance adherence and improve outcomes. This approach would entail working closely with primary care clinicians and using an integrative approach as the medical comorbidities will influence the success of bipolar treatment. References Sajatovic M and Chen P. Geriatric bipolar disorder. Psychiatr Clin North Am. 2011 Jun 3;34(2):319-33. Eyler LT et al. Understanding aging in bipolar disorder by integrating archival clinical research datasets. Am J Geriatric Psychiatry. 2019 Oct;27(10):1122-34. Shulman Kl et al. Delphi survey about using lithium in OABD. Bipolar Disord. 2019 Mar;21(2):117-23. Forester BP. Safety and effectiveness of long-term treatment with lurasidone in older adults with bipolar depression: Post hoc analysis of a 6-month, open-label study. Am J Geriatr Psychiatry. 2018 Feb;26(2):150-9. * * * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

Botulinum toxin for depression with Dr. Michelle Magid

Play Episode Listen Later Nov 13, 2019 18:04

Michelle Magid, MD, conducts a Masterclass lecture on botulinum toxin for depression from the Psychopharmacology Update in Cincinnati. The meeting was sponsored by Global Academy for Medical Education and Current Psychiatry. Dr. Magid is associate professor University of Texas in Austin, and associate professor of Texas A&M University in College Station. She disclosed serving as a speaker for Ipsen, maker of Dysport (abobotulinumtoxinA, or ABO), and as a consultant for Allergan, maker of Botox (onabotulinumtoxinA). * * * Help us make this podcast better! Please take this short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * This week in psychiatry: Conduct disorder in girls gets overdue research attention by Bruce Jancin The physiological and emotion-procession abnormalities that underpin conduct disorder in teen girls are essentially the same as in teen boys. however, the clinical presentation of conduct disorder in the two groups is often different. What we know about botulinum toxin Botulinum toxin is the product of Clostridium botulinum. The neurotoxin inhibits the release of acetylcholine, resulting in flaccid muscle relaxation. Its clinical use started in 1989 to treat strabismus (crossed eyes) and blepharospasm, a dystonic reaction in the eyes. Currently, botulinum is a Food and Drug Administration–approved treatment of chronic migraine in adults. For use in depression, 30-40 units of botulinum toxin is injected into the glabellar region of the face (the forehead). A purported mechanism of action of botulism for depression includes the “facial feedback hypothesis,” in which the activation of muscles of facial expression, consciously or unconsciously, influences emotions. Botulinum toxin for depression is an off-label treatment with four case series, five randomized, controlled studies, and a phase 2 trial by supported by Allergan. New findings on use of botulinum toxin for depression Magid and colleagues completed a pooled analysis of three randomized, controlled trials totaling 134 patients. Fifty-nine people were included in the botulinum toxin intervention group with a Beck Depression Inventory (BDI) score of 29, and 75 individuals in the placebo group with BDI of 26. In each group, 64% of patients were continued on other medications for depression, and the groups had similar histories of long-standing depression. In the botulinum toxin group, 52% had a response to the intervention, with an at least 50% reduction in their baseline depression scores, compared with a limited response in the placebo group. In the pooled analysis, Dr. Magid’s group analyzed whether the cosmetic effect of botulinum toxin could be a confounding factor. The investigators ruled out that effect by using a subanalysis to evaluate whether the decrease in wrinkles correlated with decrease in depression, and it did not. Allergan moved forward with a phase 2 proof-of-concept trial; the results were mixed. The endpoint was response rate in Montgomery-Åsberg Depression Rating Scale (MADRS) at week 6. With a 30-unit Botox dose, there was a statistically significant decrease in MADRS at week 9, but not at week 6. There was no statistically significant divergence in data between the placebo and intervention group with the 50-unit dose. Given the response rate at week 9, Allergan is proceeding with a phase 3 trial. The cost is about $400 per treatment, and the treatment is given three to four times a year, which makes the cost comparable to that of other psychopharmacologic treatments. Adverse events are mild and include headache and local site irritation. In the current studies, botulinum treatment has been used as both monotherapy and augmentation; however, there are not enough data to know whether one is more effective than the other. In conclusion, burgeoning psychopharmacology research on treatments such as botulinum toxin for depression and novel medications, such as esketamine and brexanolone, broaden our understanding of the etiology of depression. This research is generating novel modes of treatment that will help more patients with refractory illness. References Magid M et al. Treating depression with botulinum toxin: A pooled analysis of randomized controlled trials. Psychopharmacology. 2015 Sep;48(6):205-10. Magid M et al. Treatment of major depressive disorder using botulinum toxin: A 24-week randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2014 Aug;75(8):837-44. * * * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

Masterclass on psychedelic-assisted psychotherapy with Andrew Penn

Play Episode Listen Later Nov 6, 2019 25:59

Andrew Penn, MS, NP, conducts a Masterclass lecture on psychedelic-assisted psychotherapy from the Psychopharmacology Update in Cincinnati. The meeting was sponsored by Global Academy for Medical Education and Current Psychiatry. Mr. Penn, a psychiatric nurse practitioner, is associate clinical professor of community health systems in the School of Nursing at the University of California, San Francisco. Later, Dr. Renee Kohanski is back – this time to discuss the need to call out the truth when we see it. * * * Help us make this podcast better! Please take this short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * Reemergence of MDMA for PTSD and psilocybin for MDD Psychedelic-assisted psychotherapy is currently being investigated with 3,4-methylenedioxy-methamphetamine (MDMA) for treatment-resistant post-traumatic stress disorder (PTSD) and psilocybin for the treatment of major depressive disorder (MDD). The use of these compounds would be highly regulated. These are not medications that would be dispensed for a patient to take home. Both would be given in the clinical setting of one or more psychotherapy sessions with two therapists who would continue to work with the patient over time. MDMA was first patented by Merck in 1912, synthesized again in the 1970s, and used by psychotherapists to assist treatment. However, its recreational use spread, leading to its classification as a Schedule I controlled substance, thus prohibiting research or use in a medical setting. Lobbying through the Multidisciplinary Association for Psychedelic Studies, also known as MAPS, managed to bring MDMA into phase 3 clinical trials, and in 2017 the Food and Drug Administration granted breakthrough therapy designation for its use with psychotherapy for PTSD. MDMA is a potent releaser of serotonin, oxytocin, and prolactin, which in combination, allow the patient to feel less fear, trust the psychotherapist more, and overcome the defenses blocking them from talking about traumatic experiences. MDMA permits patients to stay in the optimal arousal zone to discuss the traumatic event. After the psychedelic-assisted session, patients continue to process memories and sequelae of the event and integrate changes into their lives to overcome trauma. If MDMA is approved by the FDA, it would be available only under a REMS, or Risk Evaluation and Mitigation Strategy, or drug safety program. Psilocybin is a partial agonist on 5-HT2A serotonin receptors. The brain of a severely depressed person is extremely rigid with limitations on the usual predictive capacity of the human brain. Psilocybin facilitates plasticity to “reset” and see a situation as it truly is, rather than through the rigid cognitive distortions of depression. Although MDMA and psilocybin are controlled substances, we can think of these medications like anesthetics, which are drugs that can be prescribed in clinical settings under supervision only. These are old compounds used in a novel manner that can reduce suffering for patients who have not responded to the current modes of therapy for PTSD and MDD. References Mithoefer MC et al. MDMA-assisted psychotherapy for treatment of PTSD: Study design and rationale for phase 3 trials based on pooled analysis of six phase 3 randomized trials. Psychopharm (Berl). 2019 Sep;236(9):2735-45. Carhart-Harris RL et al. Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. Lancet. 2016 Jul 1:3(7):619-21. Pollan M. The Trip Treatment. New Yorker. 2015 Feb 9. Cooper A. Psilocybin sessions: Psychedelics could help people with addiction and anxiety. 60 Minutes. 2019 Oct 13. Sessa B. “The Psychedelic Renaissance: Reassessing the Role of Psychedelic Drugs in 21st Century Psychiatry and Society.” London: Muswell Hill Press, 2012. Usona Institute: News on Psychedelics For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

Suicide prevention with Dr. John Mann

Play Episode Listen Later Sep 9, 2019 25:01

Show Notes J. John Mann, MD, joins Lorenzo Norris, MD, host of the MDedge Psychcast and editor in chief of MDedge Psychiatry, to talk about the need for medicine to shift its approaches to preventing suicide. They spoke at the Focus on Neuropsychiatry 2019 meeting, sponsored by Current Psychiatry and Global Academy for Medical Education. Dr. Mann is professor of translational neuroscience at Columbia University in New York. For a complete video of this interview, see this vodcast. Don’t miss the “Dr. RK” segment by Renee Kohanski, MD, who discusses how a religious wedding she attended made her think about the distinction between cults and cultures. Dr. Kohanski, a member of the MDedge Psychiatry Editorial Advisory Board, is a psychiatrist in private practice in Mystic, Conn. Show notes by Jacqueline Posada, MD, consultation-liaison psychiatry fellow with the Inova Fairfax Hospital/George Washington University program in Falls Church, Va. Why are suicide rates on the rise? In the United States, between 2001-2017, the suicide rate increased by 33%, making suicide the second-leading cause of death for people aged 15-34 years. Why the suicide rate has increased is unclear. Factors influencing rising suicide rates include the 2008 recession and the opioid crisis; however, these events cannot fully explain the trend because they occurred in the middle of the rising rates. As suicide rates increase, the medical community missed opportunities for prevention at both primary care and psychiatry visits. A Centers for Disease Control and Prevention study that examined suicide rates and psychiatric illness found approximately half of suicide decedents did not have a known mental health condition. Connections to untreated psychiatric illness Only 22% of people with psychiatric illness who die by suicide had their mental illness treated. The age of onset for major depressive disorder has been occurring earlier and indicates a greater pool of individuals is at risk of suicide. For example, during 2005-2014, major depressive episodes in adolescents increased by nearly one-third. Individuals who attempt and die by suicide have a predisposition to respond to their mental illness with suicidal behaviors. This trait poses a challenge in the face of rising rates of mental illness in the United States. Role of treatment by primary care physicians 45% of individuals who die from suicide see their primary care clinician within a month of their death. If nonpsychiatrist doctors or primary care physicians are trained to recognize depression and suicide, the rates of death and disability from depression can be decreased. Most people who die by suicide are seeking help by going to a health care professional. How should the clinician respond? If a person presents with somatic complaints with no clear causes (for example, normal lab values), this is a time for the primary care physicians to ask about depression and suicide. What steps can be taken to prevent suicide? Medicine needs an updated approach in education about depression and suicide that is similar to the changes that have taken place during the opioid crisis. Now all clinicians must complete continuing medical education about pain management and opioid prescribing, which has led to a decrease in deaths from prescription pain medications. All clinicians must be able to recognize and treat depression, because it is becoming a leading cause of death and disability. Clinicians need to do a better job of making connections between somatic complaints and mood disorders. References U.S. Department of Health and Human Services, National Institutes of Health. Mental health information: Suicide. Updated August 2019. Stene-Larsen K and A Reneflot. Contact with primary and mental health care prior to suicide: A systematic review of the literature from 2000 to 2017. Scand J Public Health. 2019 Feb;47(1):9-17. Reed J. Primary care: A crucial setting for suicide prevention. SAMHSA-HRSA Center for Integrated Solutions. U.S. Department of Health and Human Services. Adolescent mental health basics. Rising rates of MDD in adolescents. Bruce ML et al. Reducing suicidal ideation and depressive symptoms in depressed older patients. JAMA. 2004 Mar 3;291(9):1081-91. DA Brent and N Melhem. Familial transmission of suicidal behavior. Psychiatr Clin North Am. 2008 Jun;31(2):157-77. Mohatt NV et al. A menu of options: Resources for preventing veteran suicide in rural communities. Psychol Serv. 2018 Aug;15(3):262-9. For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

The role of inflammation in mental illness with Dr. Roger McIntyre

Play Episode Listen Later Aug 28, 2019 32:17

Show Notes Roger McIntyre, MD, joins Lorenzo Norris, MD, host of the MDedge Psychcast and editor in chief of MDedge Psychiatry, to talk about obesity, inflammation, and treatment implications for mental health conditions. They spoke at the Focus on Neuropsychiatry 2019 meeting, sponsored by Current Psychiatry and Global Academy for Medical Education. Dr. McIntyre is a professor of psychiatry and pharmacology at the University of Toronto, and head of the mood disorders psychopharmacology unit at the University Health Network, also in Toronto. For a complete video of this interview, please visit the vodcast. Don’t miss the “Dr. RK” segment by Renee Kohanski, MD, who discusses how to think through whether sharing personal information with patients helps move their therapy forward. Dr. Kohanski, a member of the MDedge Psychiatry Editorial Advisory Board, is a psychiatrist in private practice in Mystic, Conn. Show notes by Jacqueline Posada, MD, consultation-liaison psychiatry fellow with the Inova Fairfax Hospital/George Washington University program in Falls Church, Va. Reconceptualizing mental illness by looking at inflammation Mental illness should be viewed as a disease involving many organs – including the brain – and psychiatry should expand its understanding of the etiology of mental illness. Increasingly, research suggests that a subgroup of people with mental disorders, including those with a variety of diagnoses, have symptoms related to alterations in their immune system and inflammation. Inflammation plays a role in disparate psychiatric diagnoses, including childhood disorders such as obsessive-compulsive disorder, ADHD, and autism, and adult disorders such as schizophrenia, depression, and Alzheimer’s disease. Currently, psychiatry uses the monoamine paradigm to explain psychiatric diagnosis, and most medications were developed using that paradigm. A subgroup of people is not sufficiently helped by current medications, so looking at inflammation as a driver of mental illness provides another biological avenue to pursue drug development. Role of obesity and chronic health conditions in worsening inflammation Obesity, particularly abdominal obesity, is overrepresented in people with mental illness and is not fully explained by either social determinants of health or medication side effects. Obesity and mental illness have a bidirectional relationship; each affects the body as multiorgan system diseases. Mental illness can be conceptualized as a kind of “metastasis to the brain.” Adipose tissue releases a surfeit of neurochemicals hazardous to brain function and that disrupt neurocircuitry. For example, compared with an individual with major depressive disorder (MDD) only, an individual with MDD and obesity is more likely to have symptoms driven by inflammation, such as anhedonia, cognitive impairment, limited motivation, and a dysregulated reward system. Obesity should also be a target symptom worthy of a focused treatment plan. Heart disease is the leading cause of death in schizophrenia, and coronary artery disease is an inflammatory illness. Research is identifying connections between psychiatric illness such as schizophrenia and potentially inflammatory driven symptoms, often called “sickness behaviors,” such as low motivation, anhedonia, and cognitive impairment. Clinical implications of obesity and inflammation Alterations in inflammation and metabolism are not just a consequence of obesity. For example, patients will bipolar disorder who report sexual or physical trauma are more likely to be in a proinflammatory neurochemical state and benefit from anti-inflammatory interventions. Are patients with early trauma who do not respond fully to “traditional” monoamine medications part of the subpopulation who respond to anti-inflammatory interventions because trauma is driving inflammation? The genetics of mental illness already are complicated and will be influenced by the environment and a “proinflammatory milieu.” Which tests show inflammation? Current inflammatory markers, such as erythrocyte sedimentation rate and C-reactive protein, are not specific enough to direct treatment of inflammation in mental illness. Elements of a patient’s history, including history of trauma, disrupted sleep and circadian disturbances, cigarette smoking, poverty, housing dislocation, and exposure to racism, can indicate inflammation. We can conceptualize as anti-inflammatory several current treatments, such as mindfulness-based therapy, electroconvulsive therapy, and selective serotonin reuptake inhibitors. Alternative treatments to treat inflammation exist; however, specific anti-inflammatory treatments, such as NSAIDs, cyclooxgenase-2 inhibitors, and minocycline, are not yet recommended for patients with mental illness. Targeting inflammation as prevention of psychiatric illness Clinicians can target drivers of inflammation as a means of treatment and prevention of mental illness. They can also target the basics, such as sleep, diet, exercise, and socializing, as preventive measures that also target inflammation. The incidence of depression can be decreased by targeting lifestyle changes and metabolic illness with treatments such as exercise and statins. Interventions focused on inflammation are being investigated as a means of prevention for people at risk of mental illness. For example, a study in China in which Dr. McIntyre was involved explored whether exercise can decrease the development of bipolar disorder in children who have a genetic predisposition to the illness. Caloric restriction can reduce inflammation and improve cognition. Inflammation and the absence of ‘meaningful connections’ In social baseline theory, human beings allocate energy in proportion to their social connectivity. People with fewer social connections are more likely to be in a proinflammatory state and more likely to consume high-carbohydrate food. Loneliness can be conceptualized as an epidemic associated with serious health outcomes, such as suicide, addiction, and other chronic mental and physical health problems. We are living in a society of anxious despair. Psychiatry needs to broaden its understanding of mental illness by investigating a variety of underlying causes, from inflammation to the monoamine theory. References Rosenblat JD et al. Inflamed moods: A review of the interactions between inflammation and mood disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2014 Aug 4;53:23-34. Harvey SB et al. Exercise and prevention of depression: Results of the HUNT cohort study. Am J Psychiatry. 2018 Jan 1;175(1):28-36. Redlich C et al. Statin use and risk of depression: A Swedish national cohort study. BMJ Psychiatry. 2014 Dec 4;14:348. doi: 10.1186/s12888-014.0348-y. Leclerc E et al. The effect of caloric restriction on working memory in healthy non-obese adults. CNS Spectr. 2019 Apr 10:1-7. doi: 10.1017/S1092852918001566. Schwabel D. “Vivek Murthy: How to solve the work loneliness epidemic.” Forbes.com. Oct 7, 2017. Ho RCM et al. Factors associated with risk of developing coronary artery disease in medical patients with major depressive disorder. Int J Environ Res Public Health. 2018 Oct;15 (10): 2073. doi: 10.33901/ijerph1510102073. Dantzer R. Cytokine, sickness behavior, and depression. Immunol Allergy Clin North Am. 2009 May;29(2): 247-64. For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

Masterclass on burnout; more on Hahnemann closure

Postcall Podcast

Play Episode Listen Later Aug 16, 2019 28:17

Dr. Richard Balon gives a lecture on physician burnout and mandated wellness and Nick Andrews talks to Damian McNamara about the final days of Hahnemann University Hospital in Philadelphia. Masterclass guest Richard Balon, MD: professor of psychiatry and training director at Wayne State University, Detroit. In March, Dr. Balon spoke at the American Academy of Clinical Psychiatrists 2019 annual meeting in Chicago, sponsored by Global Academy for Medical Education. Global Academy and this news organization are owned by the same company. Lecture Notes By Jacqueline Posada, MD, who is a consultation-liaison psychiatry fellow with the Inova Fairfax Hospital/George Washington University program in Falls Church, Va. Physician burnout and effective interventions The scales (for example, the Maslach Burnout Inventory) do not necessarily represent the full extent of burnout: If physicians work 12 hours but find fulfillment in work, they will be tired but not necessarily burned out. However, if physicians work 12 hours a day feeling frustrated by the systemic problems, then burnout can ensue. Common contributors to provider burnout: Excessive workload: Pressures of working with an electronic medical record, extensive time spent on documentation; lack of work satisfaction and job control; lack of respect for the work; and student loan burden. “Moral injury”: The emotional burden that occurs when physicians cannot deliver ideal care/treatment to patients, especially when limited by resources (such as insurance or poverty), or other systemic health care issues. Work environment and organizational culture: These factors also contribute to physician burnout. Burnout is a problem for health care organizations as a whole Two main ways to address burnout: physician-directed interventions (focused on individuals) and organization-directed interventions. Organization-directed burnout prevention strategies include: Reducing workload; reducing time spent on documentation, such as decreasing time spent in front of EMRs; cultivating effective teamwork; fostering a sense of job control. Organizations prefer individual-focused interventions over systemic changes: Examples include mindfulness teaching, yoga, cognitive-behavioral therapy techniques, education about burnout, and education. Individual-focused interventions are great, but they are not realistic for changing the culture that contributes to burnout. Interventions for burnout In a systematic review and meta-analysis in JAMA Internal Medicine, Maria Panagioti, PhD, and colleagues found that: Burnout interventions focused on individual physicians have small, significant effect on physician burnout. Organizational-directed approaches result in greater treatment effects, especially when interventions focus on promoting healthy individual/organization relationships. The impact of individual interventions can be improved when supported by organizational interventions. Interventions targeted at more experienced physicians within primary care settings show greater treatment effect than interventions targeted at less experienced physicians within secondary treatment settings. Approaches identified by staff can lead to meaningful change, as outlined by in a New England Journal of Medicine article by Melinda Ashton, MD. A Hawaiian health care system queried individuals (physicians and mid-level and nursing staff) to identify which parts of EMR documentation were poorly designed, unnecessary, and could lead to unintended burdens contributing to burnout. This type of survey improves the efficiency of a system and illustrates that the health care organization cares about preventing clinician burnout. References Panagioti M et al. Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis. JAMA Intern Med. 2017 Feb 1;777(2):195-205. Ashton M. Getting rid of stupid stuff. N Engl J Med. 2018 Nov. 8;379(10):1789-91.

Cultivating Community (Learning to Love) part 3 by Seth Butcher

butcher learning to love cultivating community community learning global academy

Play Episode Listen Later Jun 25, 2019 31:49

How do we cultivate a strong community and learn to love each other in church? In the final installment of a three part talk Global Academy member Seth encourages and challenges us all to be careful to speak well of others and to avoid common gossip. He also speaks out the benefits of meeting together regularly, and with a good attitude.

Cultivating Community (Learning to Love) part 2 by Seth Butcher

butcher learning to love cultivating community community learning global academy

Play Episode Listen Later Jun 17, 2019 28:54

How do we cultivate a strong community and learn to love each other in church? In part 2 of a 3 part talk Global Academy member Seth encourages and challenges us all to be be humble and courteous with each other, in order that we can create an awesome church where people feel that they can belong before they believe.

Total Football Analysis Podcast #11: Anders Jacobsen of the Norwegian Women's National Team

france norway norwegian jacobsen fifa women football analysis total football women's national team sean russell global academy

Play Episode Listen Later Jun 15, 2019 29:56

In this podcast, Ryan McCready talks with Anders Jacobson, the assistant coach of the Norwegian women’s national team. The two spoke after a public training session taking place ahead of Norway’s FIFA Women’s World Cup Group A fixture against hosts France. In this unmissable interview, Anders discusses his own entry into tactical coaching at international level, his own coaching philosophies, the differences between domestic and international management, and how data and statistics are used to build a successful tournament side. We also managed to get Anders’ perspective on how the game may change in the future. Rule changes and adaptations to positional roles have long dominated coaching debates in recent seasons, and this looks hardly likely to change. Many thanks to Anders and Terje Skeie at the Norwegian FA’s press office for allowing us to attend the training session, as well as to share time with them. Subscribe to this podcast so that you are notified of the next episode. Host: @RyanMcCready94Guest: @andesjacobson of @nff_landslag Podcast produced and edited by Sean Russell of Global Academy.

Cultivating Community (Learning to Love) part 1 by Seth Butcher

butcher learning to love cultivating community community learning global academy

Play Episode Listen Later Jun 11, 2019 31:00

How do we cultivate a strong community and learn to love each other in church? In part 1 of a 3 part talk Global Academy member Seth looks at being honest towards one another and encourages us to confront (where necessary) in love.

Alzheimer’s disease clinical update

Play Episode Listen Later Jun 5, 2019 21:29

Show Notes By Jacqueline Posada, MD, 4th-year resident in the department of psychiatry & behavioral sciences at George Washington University, Washington. Guest George T. Grossberg, MD: Samuel W. Fordyce Professor; director, geriatric psychiatry at Saint Louis University. Dr. Grossberg spoke at the American Academy of Clinical Psychiatrists 2019 annual meeting in Chicago, sponsored by Global Academy for Medical Education (GAME). GAME and the MDedge Psychcast are owned by the same company. New developments in Alzheimer’s research The Systolic Blood Pressure Intervention Trial, also known as the SPRINT MIND Study, showed that tightly controlled systolic blood pressure (SBP) of 120 mm Hg, compared with an SBP of 140 mm Hg, resulted in a 20% reduced risk of developing mild cognitive impairment. The SPRINT study was terminated early at the median follow-up of 3.26 years as its results showed that tightly controlled SBP significantly reduces the risk of stroke and heart disease. The Alzheimer’s Association has agreed to fund an additional 2 years of the SPRINT MIND Study to evaluate whether tightly controlled BP is effective in reducing the risk of Alzheimer’s disease. In the brain, the glymphatic system was discovered in 2012 and is similar to the lymphatic system in its role as a drainage system for removing toxins. Glial cells mediate toxin removal, and the glymphatic system removes toxins that eventually can cause cell death in the brain. Because the glymphatic system is involved in removing the beta-amyloid plaques that contribute to cell death in AD, the glymphatic system is another area of investigation in the pathogenesis of AD. Novel treatment of moderate to advanced AD involves using plasma infusion. Infusion of plasma products from healthy, nonimmunocompromised 18-year-old individuals into older patients with AD is a potential treatment for AD. Precedent for this intervention comes from animal studies investigating parabiosis, a procedure in which two animals are connected so that they share each other’s blood stream. When such a circulatory exchange occurs between a younger mouse and an older mouse with AD, the older AD model mouse regains cognitive abilities and is able to complete mazes that it was unable to complete before. How can this model be adapted to humans? One possibility might involve infusing plasma from young healthy individuals into older adults with advanced AD. A safety proof-of-concept study, published recently, found that plasma products can be safely infused. The next step is an efficacy study. A relationship has been found between AD and periodontal disease. The primary bacteria related to periodontal disease, Porphyromonas gingivalis, is found in close proximity in the brain to the plaques and tangles of AD. One theory posits that the presence of this bacteria is related to inflammation that may contribute to the causality of AD. Could AD be treated with the antibiotics used to treat periodontal disease? The answers remain unclear. Aducanumab, a monoclonal antibody targeting the beta-amyloid plaques of AD, initially showed favorable changes in imaging studies of the brains of people with AD. In March 2019, the study was halted because of futility. An independent data-monitoring committee determined that the early results seen on imaging did not result in clinically meaningful changes, compared with placebo. Some AD researchers consider this drug failure the “final nail in the coffin” of the amyloid hypothesis, and the pathogenesis of AD is most likely related to tau neurofibrillary tangles and other mediators, such as the immune system and inflammation. References SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 26 Nov 2015;373:2103-16. Jessen NA et al. The glymphatic system: A beginner’s guide. Neurochem Res. 2015 Dec;40(12):2583-99. Dominy SS et al. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science Advances. 23 Jan 2019;5(1): doi: 10.1126//sciadv.aau3333. Conese M et al. The fountain of youth: A tale of parabiosis, stem cells, and rejuvenation. Open Med (Wars). 2017;12:376-83. Phase 3 study of aducanumab in early Alzheimer’s disease. ClinicalTrials.gov Identifier: NCT02477800. For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych

game chicago washington doctors psychology students md medical phase alzheimer's disease physicians med clinical lecture sprint rn psychiatry american academy bp george washington university psych interact clinical trials bsn np infusion precedent hg saint louis university new england journal of medicine science advances sbp aducanumab glial global academy porphyromonas mdedge podcasts mdedge psychcast

Eating disorders: Part II

Play Episode Listen Later May 22, 2019 22:24

For more MDedge Podcasts go to mdedge.com/podcasts In part II of this Psychcast Masterclass, Patricia Westmoreland, MD, returns to discuss severe, enduring eating disorders, including management and ethical questions. In Dr. RK this week, Renee Kohanksi explores the impact of censorship and self-censorship. Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych Show Notes By Jacqueline Posada, MD, 4th-year resident in the department of psychiatry & behavioral sciences at George Washington University, Washington. Guest Patricia Westmoreland, MD, a forensic psychiatrist at the University of Colorado Denver, Aurora; attending psychiatrist for Eating Recovery Center, Denver; adjunct assistant professor of psychiatry at the University of Colorado Denver. Dr. Westmoreland spoke at the American Academy of Clinical Psychiatrists 2019 annual meeting in Chicago, sponsored by Global Academy for Medical Education (GAME). GAME and the MDedge Psychcast are owned by the same company. Harm reduction, palliative care, and futility Harm reduction model: A focus on returning to reasonable level of functioning without focus on full weight restoration, especially if full weight restoration has not proven sustainable with previous treatment. Harm reduction is managed an as outpatient with regular check-ups. Team collaborates for attainable, mutual treatment goals. Patients are allowed to stay at a lower body mass index (BMI) and are able to partially function and do things they enjoy, such as living with family and working part time. Patients maintain an agreed-upon weight and regularly check labs. Inpatient hospitalization is pursued only to restore weight back to previously agreed-upon goal: BMI is a marker of risk; BMI greater than 15 kg/m2 is lower risk, and BMI less than 13 kg/m2 is higher risk (lower BMI is tied to higher immunocompromised risk, more fractures, and other illnesses, as well as a greater risk of suicide, etc.) Palliative care is offered when patients have failed harm reduction and cannot sustain an acceptable body weight (not weight restored): Palliative care is NOT hospice, and therefore, there are no specific expectations. Treatment goal is comfort care, i.e., analgesics for fractures and decubitus ulcers, anxiolytics for refractory anxiety. Ethics and futility: When to say “enough is enough”? In anorexia nervosa (AN), frequently, many treatments have been implemented, and there may be no cure. Some think that anorexia should never be an end-stage diagnosis. Cynthia Geppert, MD, MPH, a health care ethicist and a professor of psychiatry and internal medicine at the University of New Mexico, Albuquerque, who wrote in the American Journal of Bioethics: “Futility and chronic anorexia nervosa: A concept whose time has not yet come,” argues against futility: AN does not meet definition of a terminal illness: The patient’s depleted weight renders a patient as having a life-threatening illness. Can a patient be terminal and is care futile if there is hope for long-term recovery? Legally: Cognitive distortions make up the core of AN as an illness. Do patients with AN have the capacity to decide that further treatment is futile? Cognitive impairments often normalize with treatment. Are physicians obligated to treat first in order to restore a patient’s decision-making capacity before allowing them to choose palliative care? People with AN may lack capacity because they cannot appreciate the consequences of their decision, which is one of the four components of capacity. In support of futility, Cushla McKinney, PhD, of the biochemistry department at University of Otago (New Zealand), argues against the complete rejection of the concept of futility, saying it risks forcing a small and chronic group of patients into an intolerable situation. Arguments for futility: Not EVERY individual with AN lacks capacity. Some argue for futility, and allowing patients to make choices in line with what they value in life. Prognosis, even with treatment, is poor, especially for older individuals with years of failed treatments and medical comorbidities. Are we doing harm by forcing an invasive treatment that patients don't want – especially after much treatment? Illustrative case of AG, a 29-year-old female with chronic AN, who had a guardian for medical decision making: The guardian had decided in favor of tube feedings many times; AG had suffered complications such as heart failure. AG wanted to enter palliative care, arguing that she did not want to die, but if death were the result of AN, then “so be it.” The judge ruled she could refuse treatment. He did not comment on capacity, but ruled she could make this decision to die on her terms. Emerging concerns: Is anorexia nervosa an end-stage illness or not? How will physician aid-in-dying overlap with AN? Do eating disorder patients have the capacity to request aid-in-dying, and what is the physician obligation? References Eddy J. Recovery from anorexia nervosa and bulimia nervosa at 22-year follow-up. Clin Psychiatry. 2017 Feb;78(2):184-9. Sjostrand M et al. Ethical deliberations about involuntary treatment: Interviews with Swedish psychiatrists. BMC Med Ethics. 2015;16:37. Geppert C. Futility in chronic anorexia nervosa: A concept whose time has not yet come. Am J Bioethics. 2015. 15(17):34-43. Cushla M. Is resistance (n)ever futile? A response to “Futility in chronic anorexia nervosa: A concept whose time has not yet come,” by Cynthia Geppert. Am J Bioethics. 2015 Jul 6. 15(7):53-4.

Eating disorders: Masterclass lecture part I

Play Episode Listen Later May 15, 2019 27:01

In Episode 59 Patricia Westmoreland, MD, gives a masterclass lecture on managing severe and enduring eating disorder (SEERS). Renee Kohanksi, MD, poses the question, "What do we want?" Contact us: podcasts@mdedge.com Twitter: @mdedgepsych Show Notes By Jacqueline Posada, MD, 4th-year resident in the department of psychiatry & behavioral sciences at George Washington University, Washington. Guest Patricia Westmoreland, MD: forensic psychiatrist at University of Colorado Denver, Aurora; attending psychiatrist for Eating Recovery Center, Denver; and adjunct assistant professor at University of Colorado Denver in department of psychiatry. Dr. Westmoreland spoke at the American Academy of Clinical Psychiatrists 2019 annual meeting in Chicago, sponsored by Global Academy for Medical Education (GAME). GAME and the MDedge Psychcast are owned by the same company. Introduction, definition, role of involuntary treatment, and novel treatment options Introduction: Prognosis: Anorexia nervosa (AN) has the highest mortality of any psychiatric disorder. Risk factors for death: Older age at first presentation, lower weight at presentation, greater duration of illness, comorbid alcohol or diuretic abuse, comorbid mood disorder, history of psychiatric hospitalization and suicide attempts, and self-harm. Less than 50% recover completely, about 30% improve somewhat but require frequent hospitalizations or treatments, and 20% develop a SEED. Eddy et al. longitudinal study of eating disorders (EDs): AN patients can recover over the long term. Overall, 31% were better at 9 years; 63% better at 22 years of follow-up. Treatment: Treat ASAP, especially if patient is seen at a young/pediatric age before symptoms are fully developed and weight loss is profound. Weight gain as the central treatment: Many patients are reluctant to get treatment that focuses only on food intake and weight gain. Predictors of improvement: Weight gain that is parallel to improvement in physical and psychological well-being, diagnosis at a younger age, and shorter duration of illness. Medications: Fluoxetine is the only Food and Drug Administration-approved treatment for EDs, including bulimia, at doses of 60 mg and above. Patients with EDs have poor response to selective serotonin reuptake inhibitors because of starvation and limited production of serotonin and serotonin receptor abnormalities. Severe and enduring eating disorders (SEED) definition: 6-12 years of an ED can qualify as chronic. Lower likelihood of recovery with symptoms substantially interfering with quality of life. Role for involuntary treatment in EDs: Few treatment centers do involuntary treatment of ED. Involuntary treatment can involve guardianship for medical decisions. Guardianship is useful for medical treatment and admission to a medical ward, for example, when a patient requires forcible tube feeding for life-threatening starvation. Commitment or certification is required for involuntary treatment in a psychiatric hospital. Commitment is sought by a psychiatrist and is a tool in cases when the patient is dangerous to self or others and is gravely disabled. It is useful to commit a patient who is refusing care and has not been sick for long. Often, commitment/certification is used as a last resort, and the patient is too sick to truly recover. Pros and cons of involuntary treatment: Pro: No difference in weight restoration in voluntary vs. involuntary treatment, and patients are often grateful after involuntary treatment. Cons: Involuntary tube feeding has unclear long-term outcomes. Some studies show poor outcomes for people who are treated involuntarily, though this is likely because of their comorbidities. Novel treatment options: Ketamine has been used in EDs. Concerns remain about the drug’s addictive potential and inability to clearly change eating disorder pathology. Oxytocin: There are reduced cerebrospinal fluid levels of oxytocin in AN, and oxytocin restores during recovery. Experimentally in rats, oxytocin may reduce the fear and social phobias related to eating. Electroconvulsive therapy does not reduce ED symptoms such as restricted eating and fear of fatness, but it can improve depression. People with ED are often medically ill, so the patient must be physically able to undergo treatment. Because of medical comorbidities, AN patients are more likely to have complications like delirium. Transcranial magnetic stimulation: Dorsolateral prefrontal cortex involved in self-regulatory control, inhibitory control, and cognitive flexibility. Some studies show promising results of using this intervention with ED and mild side effects like syncope and headache. Deep brain stimulation (DBS): Treatment targets the nucleus accumbens and the subcallosal cingulate gyrus, which theoretically alter balance between reward and cognitive inhibitory and control systems that are related to pathological eating behaviors. DBS has strongest theoretical rationale in terms of neurocircuitry targets. References Eddy J. Recovery from anorexia nervosa and bulimia nervosa at 22-year follow-up. Clin Psychiatry. 2017 Feb;78(2):184-9. Sjostrand M et al. Ethical deliberations about involuntary treatment: Interviews with Swedish psychiatrists. BMC Med Ethics. 2015;16:37. Geppert C. Futility in chronic anorexia nervosa: A concept whose time has not yet come. Am J Bioethics. 2015. 15(17):34-43. Cushla M. Is resistance (n)ever futile? A response to “Futility in chronic anorexia nervosa: A concept whose time has not yet come,” by Cynthia Geppert. Am J Bioethics. 2015 Jul 6. 15(7):53-4. In part 2, Dr. Westmoreland will discuss harm reduction, palliative care, and futility.

Physician burnout

Play Episode Listen Later May 1, 2019 23:30

Show Notes By Jacqueline Posada, MD, 4th-year resident in the department of psychiatry & behavioral sciences at George Washington University, Washington. Masterclass guest Richard Balon, MD: professor of psychiatry and training director at Wayne State University, Detroit. In March, Dr. Balon spoke at the American Academy of Clinical Psychiatrists 2019 annual meeting in Chicago, sponsored by Global Academy for Medical Education (GAME). GAME and the MDedge Psychcast are owned by the same company. Physician burnout and effective interventions The scales (for example, the Maslach Burnout Inventory) do not necessarily represent the full extent of burnout: If physicians work 12 hours but find fulfillment in work, they will be tired but not necessarily burned out. However, if physicians work 12 hours a day feeling frustrated by the systemic problems, then burnout can ensue. Common contributors to provider burnout: Excessive workload: Pressures of working with an electronic medical record, extensive time spent on documentation; lack of work satisfaction and job control; lack of respect for the work; student loan burden. “Moral injury”: The emotional burden, which occurs when physicians cannot deliver ideal care/treatment to patients, especially when limited by resources (such as insurance or poverty), or other systemic health care issues. Work environment and organizational culture: These factors also contribute to physician burnout. Burnout is a problem for health care organizations as a whole Two main ways to address burnout: Physician-directed interventions (focused on individuals) and organization-directed interventions. Organization-directed burnout prevention strategies include: Reducing workload; reducing time spent on documentation, such as decreasing time spent in front of EMRs; cultivating effective teamwork; fostering a sense of job control. Organizations prefer individual-focused interventions over systemic changes. Examples include mindfulness teaching, yoga, cognitive-behavioral therapy techniques, education about burnout, and education. Individual-focused interventions are great, but they are not realistic for changing the culture that contributes to burnout. Interventions for burnout In a systematic review and meta-analysis in JAMA Internal Medicine, Maria Panagioti, PhD, and colleagues found that: Burnout interventions focused on individual physicians have small, significant effect on physician burnout. Organizational-directed approaches result in greater treatment effects, especially when interventions focus on promoting healthy individual-organization relationships. The impact of individual interventions can be improved when supported by organizational interventions. Interventions targeted at more experienced physicians within primary care settings show greater treatment effect than interventions targeted at less experienced physicians within secondary treatment settings. Approaches identified by staff, as outlined in a New England Journal of Medicine article, can lead to meaningful change. A Hawaiian health care system queried individuals (physicians, mid-levels, and nursing staff) to identify parts of EMR documentation that are poorly designed and unnecessary, and lead to unintended burdens contributing to burnout. This type of survey improves efficiency of a system and shows that the health care organization cares about preventing clinician burnout. References Panagioti M et al. “Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis.” JAMA Intern Med. 2017 Feb 1;777(2):195-205. Ashton M. “Getting rid of stupid stuff.” N Engl J Med. 2018 Nov. 8;379(10):1789-91.

Total Football Analysis Podcast #10: Interview with Jordan McCann of Luton Town

head academy mccann luton luton town football analysis total football sean russell global academy

Play Episode Listen Later Apr 24, 2019 87:24

In this podcast, Chris Darwen talks to Jordan McCann, Head of Academy Coaching at English League One club Luton Town. In a fascinating chat, Jordan gives us excellent insight to is ten years at Luton. We cover how important analysis is within the Academy structure and how it used to develop the next generation of Luton players. We also talk in detail about the culture and environment with the Academy; one that is geared towards challenge and discovery. Thanks to Jordan for giving up so much of his time for this interview - the amount of detail we go into is incredible. Subscribe to the podcast so that you are notified of the next episode. Host: @ronniedogchris Guest: @Jordan_McCann of @LutonTown Podcast produced and edited by Sean Russell of Global Academy

Total Football Analysis Podcast #9: Interview with Haydn Rockall of Newcastle United

academy premier league newcastle united haydn u23 football analysis total football rockall sean russell global academy

Play Episode Listen Later Apr 17, 2019 57:33

In this podcast, Chris was invited up to Newcastle United’s Academy to talk with U23 Performance Analyst Haydn Rockall. Haydn gives us excellent insight into the working week of an U23 analyst in the Premier League 2, discussing that balance between player development and getting results at that level. Sean Longstaff and the impact a player graduating from the Academy and becoming a first-team player has on his peer group is also discussed. Host: @ronniedogchris Guest: @HaydnRockall Don’t forget to check our our tactical analysis website, totalfootballanalysis.com and support ad-free analysis content by subscribing to the daily content and the monthly digital magazine. Podcast produced and edited by Sean Russell of Global Academy.

Total Football Analysis Podcast #8: Interview with Huw Jennings of Fulham FC

academy jennings fulham english premier league academy director fulham fc football analysis total football sean russell global academy

Play Episode Listen Later Apr 2, 2019 41:29

Chris is joined by Huw Jennings, Academy Director at English Premier League side Fulham FC. This discussion is around analysis as a development tool at all levels of an elite Academy. Huw was good enough to give some insight into how Fulham analyse their players throughout their Academy journey and their philosophy for development. Host: @ronniedogchris Guest: Huw Jennings, Fulham FC Edited and produced by Sean Russell of Global Academy

Total Football Analysis Podcast #7: Interview with Eelco Schattorie of NorthEast United

head coach northeast isl eelco football analysis total football indian super league sean russell global academy

Play Episode Listen Later Mar 29, 2019 58:00

Chris Darwen is joined by the Head Coach of Indian Super League side NorthEast United, Eelco Schattorie. Eelco is fresh from leading NEUFC to their first ever ISL playoff this season, achieving this with the smallest budget in the league. We get insight into Eelco’s analysis process looking it pre-match, in-game, post-match and scouting players. As ever, subscribe to the podcast and leave a review. Host: @ronniedogchris Guest: @ESchattorie Today’s podcast is edited and produced by Sean Russell of Global Academy

Total Football Analysis Podcast #6: Interview with Ben Smith of Macclesfield Town

ben smith football analysis total football sean russell macclesfield town global academy

Play Episode Listen Later Mar 26, 2019 40:51

Chris talks to Macclesfield Town’s performance analyst, Ben Smith. Ben talks about analysis when in a relegation battle, what it is like to be an analyst when the management team changes three times in the same season and how he got into performance analysis rather than strength and conditioning. As ever, please subscribe to the podcast and leave a review. Host: @ronniedogchris (chris@totalfootballanalysis.com) Guest: Ben Smith (benmeiklesmith@gmail.com) Podcast edited and produced by Sean Russell of Global Academy.

Total Football Analysis Podcast #5: Interview with Enda Barron of Bristol Rovers

wembley barron enda fa cup final bristol rovers league cup final football analysis total football sean russell global academy

Play Episode Listen Later Mar 19, 2019 59:13

Chris Darwen talks to Enda Barron who is the performance analyst for English League One side Bristol Rovers. Enda has over 14 years of experience being an analyst in professional football (including an FA Cup Final and a League Cup Final at Wembley) and is good enough to share some of that experience and insight with us over the course of the conversation. We get a glimpse of the structure of Enda’s working week, what he is looking for when analysing matches and how he feels people looking to break into performance analysis should go about it. If you wish to contact Enda following the podcast you can reach him on LinkedIn here: https://www.linkedin.com/in/enda-barron-35910814/ Today’s podcast is edited and produced by Sean Russell of the Global Academy.

Total Football Analysis Podcast #4

bundesliga ranieri tfa niko kovac football analysis piatek total football sean russell global academy

Play Episode Listen Later Mar 11, 2019 41:47

In today’s podcast Chris Darwen is joined by TFA senior analyst David Selini. The agenda is: AC Milan What are the key reasons behind their recent form? What has been the impact of new signings Piatek and Paqueta? How do they set up tactically under Gattuso? AS Roma Where did it all go wrong for Di Francesco? How much of the blame should be directed to Monchi? What impact will Ranieri have? Who should be their long-term coach? Bayern Munich Bayern are back at the top of Bundesliga. Will they win it now? What has Niko Kovac changed? How will they approach the game tactically vs Liverpool? Follow us on Twitter: @totalanalysis Host: @ronniedogchris Guest: @daveselini Edited and produced by Sean Russell of the Global Academy.

Total Football Analysis Podcast #2

french barcelona analysis lyon pochettino football analysis total football global academy

Play Episode Listen Later Feb 18, 2019 55:28

Chris Darwen is joined by TFA Lead Analyst Lee Scott and first team analyst Simon Doyle. In this podcast; ️⚽️ The reemergence of Lyon as a force in French football ️⚽️ Analysis of how Pochettino continues to get so much out of Tottenham ️⚽️ Real Madrid and how they are coping with their period of transition ️⚽️ Analysis of Barcelona and the negativity surrounding Valverde Just under one hour of football analysis conversation. Host: @ronniedogchris Guest #1: @fmanalysis Guest #2: @SimonWDoyle Follow us! Twitter: @totalanalysis Facebook: @totalfootballanalysismagazine Produced by Global Academy

The Total Football Analysis Podcast #1

psg solskjaer allegri empoli football analysis total football lee scott global academy

Play Episode Listen Later Feb 12, 2019 60:48

The Total Football Analysis Podcast is back! Chris Darwen is joined by lead analyst Lee Scott and senior writer Dave Selini to big up Bosz, analyse Allegri, evaluate Empoli and, of course, smile with Solskjaer (although this was recorded before the PSG game so he might not be smiling so much now). If you like tactical analysis and want to know more about the tactical side of the game, this is the podcast for you. Host: @ronniedogchris Guests: @fmanalysis and @daveselini Produced by Global Academy

The Purity Test, The Prison Test, The Prophecy Test.

prison prophecy purity test global academy

Play Episode Listen Later Nov 14, 2018 28:23

Check out 3 more preachers talk about Joseph’s Tests Part 2. Lynne Carty is our Global London Church Plant Leader and James and Valerie are both part of our Global Academy.

The Pride Test, The Pit Test, The Palace Test