Podcasts about guidelines

In this episode, we review key updates from the 2026 AHA/ASA Guideline for the Early Management of Patients With Acute Ischemic Stroke, including changes to IV thrombolysis, antiplatelet therapy, endovascular treatment, blood pressure goals, and glycemic goals. Key Concepts Tenecteplase (TNKase) is now equally preferred to alteplase (Activase) by the 2026 AHA/ASA guidelines. Tenecteplase has several advantages related to administration and the risk of medication errors. IV thrombolysis can be given in selected patients up to 9 hours after stroke symptom onset depending on brain imaging findings. Patients with symptom onset less than 4.5 hours are still eligible for IV thrombolysis regardless of brain imaging findings. IV thrombolysis should not be given for mild, non-disabling stroke symptoms. A "non-disabling" stroke means the symptoms do not impair activities of daily living or ability to return to work. The criteria for dual antiplatelet therapy (DAPT) has been updated. DAPT can be given for NIHSS of 4 or 5 (not just 3 or less) and can be started up to 72 hours after stroke onset (not just within 24 hours). References Prabhakaran S, Gonzalez NR, Zachrison KS, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. Published online January 26, 2026. doi:10.1161/STR.0000000000000513

NBC News medical reporter Dr. Akshay Syal shares a checklist on cholesterol — what it is, why it matters, and what's changed. Also, Sandra Hüller stops by to discuss her new role alongside Ryan Gosling in the upcoming film ‘Project Hail Mary.' Plus, the American Kennel Club exclusively reveals its list of the top five most popular dog breeds in the U.S. this year. And, Tony Shalhoub and Celia Keenan-Bolger discuss joining forces in the new Off-Broadway play ‘Antigone (I Read This Play in High School).' Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

The replay of the 4th Reversing Heart Disease Summit is going on now. Register here: drtalks.com/summits/reversing-heart-disease This week, Dr. Kahn addresses the newly published 2026 guidelines for the management of hyperlipidemia (high cholesterol), which will be studied and used by medical professionals all over the world. The top 10 takeaways are presented and are similar to the approach used at the Kahn Center for over a decade. Other topics include the challenge of staying vegan, the influence of cold temperatures on aortic dissection, the development of clogged arteries after a normal heart artery CT scan, the role of olive oil on the brain, red light therapy and music and the autonomic nervous system, plant-based diets and TMAO, bacteria and the brain, the role of a low uric acid level, the advantages of Eliquis over Xarelto in a new trial, and the FDA inquiry into the maker of Wegovy and Ozempic.  Thanks to Igennus.com for their support. Use the discount code DrKahn to save.

March 17, 2026: Your daily rundown of health and wellness news, in under 5 minutes. Today's top stories: American College of Sports Medicine updates resistance training guidelines for first time in 17 years, emphasizing consistency over perfect programming Peloton introduces Commercial Series bike and treadmill for gyms, pairing Precor-engineered hardware with instructor-led classes shipping late 2026 Costco partners with Sesame and IVI RMA to offer fertility care with up to 80% savings on medications, addressing one in six Americans facing infertility Today's episode is brought to you by AIIR — a modern communications and experiential agency for health, wellness, fitness, and performance brands. From earned media to events and creator-led campaigns, AIIR helps companies sharpen their story, earn attention, and build trust that compounds. Visit https://aiir.agency to learn more. More from Fitt: Fitt Insider breaks down the convergence of fitness, wellness, and healthcare — and what it means for business, culture, and capital. Subscribe to our newsletter → insider.fitt.co/subscribe Work with our recruiting firm → https://talent.fitt.co/ Follow us on Instagram → https://www.instagram.com/fittinsider/ Follow us on LinkedIn → linkedin.com/company/fittinsider Reach out → insider@fitt.co

The news to know for Monday, March 16, 2026! What to know about the latest targets hit in the Middle East and President Trump's new messages for enemies and allies as more American troops head that way. Also, a massive storm system with widely different impacts depending on where you live. We'll tell you which states are expected to see what today. Plus: who took top honors at last night's Academy Awards, how the White House is making billions of dollars from the TikTok deal, and the brackets are set! What you need to know about this year's March Madness. Those stories and even more news to know in about 10 minutes!    Join us every Mon-Fri for more daily news roundups!  See sources: https://www.theNewsWorthy.com/shownotes Become an INSIDER to get AD-FREE episodes here: https://www.theNewsWorthy.com/insider Get The NewsWorthy MERCH here: https://thenewsworthy.dashery.com/ Sponsors: Blueland has a special offer! Get 15% off your first order by going to Blueland.com/NEWSWORTHY For a limited time, Home Chef is offering my listeners 50% OFF and free shipping for your first box PLUS free dessert for life! Go to HomeChef.com/NEWSWORTHY To advertise on our podcast, please reach out to ad-sales@libsyn.com

This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  For March we are decluttering our wardrobes. Each Saturday episode will give you a very small area of your wardrobe to help you focus. You'll have all week to declutter that area before moving on to the next focus area. If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com  

The stroke guidelines just changed and it's exciting and nuanced! What you do in the first 30 minutes could drastically change your patient's outcome. In this episode, Dr. Shyam Prabhakaran, neurologist and chief writer of the new 2026 AHA Stroke Guidelines, explains what's changed and how these guidelines are changing practice at the bedside.Stroke treatment decisions are getting faster, more nuanced, and more imaging-driven. Inclusion/exclusion criteria and whether to give thrombolytics, who is a candidate for thrombectomy, and when to touch the blood pressure have all been updated. Know the updates before your next stroke alert!Topics discussed in this episode:Introducing the classic extended window patient caseThrombolytics vs. thrombectomy explainedEMS destination decision: Choosing primary vs. comprehensive stroke centerHow reperfusion time windows have changedAdvanced imaging: ASPECTS and thrombectomy eligibilityTreatment options for patients presenting outside of the 4.5 hr windowBlood pressure management recommendationsWhat nurses should do in the first 15-30 minutesLVO red flags at the bedsidePediatric ischemic strokeCheck out the new AHA Stroke Guidelines:https://newsroom.heart.org/news/new-guideline-expands-stroke-treatment-for-adults-offers-first-pediatric-stroke-guidanceMentioned in this episode:CONNECT

Episode Notes Complicated UTIs just got a whole lot less complicated—or did they? Dr. Dana Bowers and Kyle Molina (@kcmolinaID) join Dr. Whitney Buckel to break down what's new, what's controversial, and what this means for your day‑to‑day antimicrobial decisions. Join us as we dig into the biggest updates, the evidence behind them, and the clinical pearls you won't want to miss. References: Nelson Z, Aslan AT, Beahm NP, et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults: A WikiGuidelines Group Consensus Statement. JAMA Netw Open. 2024 Nov 4;7(11):e2444495. Trautner BW, Cortes-Penfield NW, Gupta K, et al. Complicated Urinary Tract Infections (cUTI): Clinical Guidelines for Treatment and Management. Published July 17, 2025. https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections/ Kadry N, Natarajan M, Bein E, Kim P, Farley J. Discordant Clinical and Microbiological Outcomes Are Associated With Late Clinical Relapse in Clinical Trials for Complicated Urinary Tract Infections. Clin Infect Dis 2023;76(10:1768-1775. https://academic.oup.com/cid/article/76/10/1768/6980780 USCAST Oral cephalosporin STIC against S. aureus and E. coli meeting recording. https://www.youtube.com/watch?v=HieaVFAC08s MacDougall C. A Cloudy Crystal Ball: Critically Assessing and Rethinking the Antibiogram. Clin Infect Dis. 2023;77(11):1501-1503. doi:10.1093/cid/ciad468 Koehl J, Spolsdoff D, Negaard B, et al. Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study. Ann Emerg Med. 2025;85(3):240-248. doi:10.1016/j.annemergmed.2024.10.013 Dunne MW, Aronin SI, Das AF, et al. Sulopenem for the Treatment of Complicated Urinary Tract Infections Including Pyelonephritis: A Phase 3, Randomized Trial. Clin Infect Dis. 2023;76(1):78-88. doi:10.1093/cid/ciac704 Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) or @breakpointspodcast_sidp (https://www.instagram.com/breakpointspodcast_sidp/)https://www.instagram.com/breakpointspodcast_sidp/?hl=en Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Reena Mehra, professor in the Division of Pulmonary, Critical Care and Sleep Medicine at the University of Washington in Seattle, and Dr. Dennis Aukley, professor in the Division of Pulmonary, Critical Care, and Sleep Medicine at MetroHealth Medical Center, Case Western Reserve University in Cleveland, to discuss the newly released AASM clinical practice guidelines for evaluating and managing obstructive sleep apnea in hospitalized adults. The guidelines address a significant gap in inpatient care: how to systematically screen for sleep apnea in hospitalized patients, prioritize high-risk groups, determine when and where to perform testing, and ensure appropriate outpatient follow-up. Dr. Mehra and Dr. Aukley explain the impetus behind developing these guidelines and the PICO question process used to examine existing evidence, acknowledging the challenges of working with limited data in this emerging field. The conversation systematically walks through the four key recommendations: in-hospital screening for OSA as part of an evaluation and management pathway, use of inpatient PAP treatment for newly diagnosed or untreated moderate-to-severe OSA, availability of sleep medicine consultation, and implementation of discharge management plans to ensure timely diagnosis and effective outpatient management. Practical implementation receives extensive attention. How should patients be screened—using STOP-Bang or facility-specific methods? Should screening be built into the EMR? Which patient populations and hospital units should be prioritized? Who performs the screening—sleep navigators, nursing staff, or hospitalists? Can sleep consultations be conducted via telemedicine at the bedside? The experts emphasize the critical need for a program champion and comprehensive education initiatives. Dr. Aukley shares invaluable lessons from his experience creating an inpatient sleep program, discussing what he wishes he'd known before starting and practical insights gained through implementation. A particularly frustrating issue receives attention: patients who bring their own PAP devices to the hospital but never have them set up or used during their stay. The guidelines address this common scenario and provide frameworks for ensuring treated patients continue therapy during hospitalization. Legal liability considerations are explored: What responsibilities exist for untreated patients diagnosed with OSA during hospitalization? What about high-risk patients who haven't been formally diagnosed? The experts discuss strategies for ensuring outpatient follow-up, recognizing that effective discharge planning is essential for translating inpatient identification into long-term management. Whether you're considering establishing an inpatient sleep program, frustrated by gaps in hospital-based sleep apnea care, or seeking evidence-based approaches to identifying and managing OSA in hospitalized patients, this episode provides essential guidance and practical implementation strategies. Join us for this important discussion about bringing systematic sleep apnea evaluation and management into the inpatient setting.

In this episode of the Neuroveda Podcast for Complex Health, Gillian Ehrlich, ARNP, sits down with Dr. Carley Squires to discuss apheresis, with a focus on therapeutic plasma exchange (TPE), also known as plasmapheresis.Apheresis means the removal of something from the blood, and the type of apheresis depends on what is being removed. At Neuroveda, the focus is plasma apheresis, meaning plasma is removed and replaced with albumin and saline. Therapeutic plasma exchange is an extracorporeal blood purification technique designed to remove a portion of plasma that may contain potentially harmful substances such as autoantibodies, inflammatory cytokines, immune complexes, and other immune mediators involved in immune dysregulation.Dr. Squires explains the broader umbrella of therapeutic apheresis, including red blood cell exchange, leukapheresis, plateletpheresis, lipid/LDL apheresis, extracorporeal photopheresis, and H.E.L.P. apheresis. While H.E.L.P. apheresis is not currently available in the United States, interest in apheresis expanded during the rise of long COVID, when patients began traveling internationally for treatment.Therapeutic plasma exchange has been used for decades in hospital settings, primarily for autoimmune disease, but is now being explored for additional applications including long COVID, neuroinflammatory conditions, and longevity medicine. Research suggests TPE may help support immune modulation through mechanisms such as:• Removal of immune complexes• Reduction of inflammatory cytokines• Correction of altered Th1/Th2 immune balance• Increased T regulatory and T suppressor cellsEmerging research has also explored TPE for PANDAS/PANS, pediatric autoimmune neuropsychiatric disorders triggered by infection.Referenceshttps://www.sciencedirect.com/science/article/pii/S0149763417305833https://pubmed.ncbi.nlm.nih.gov/10513708/While additional research is still needed for many of these applications, Neuroveda has also observed significant clinical improvements over the past several years, including reductions in toxic burden from mycotoxins, heavy metals, solvents, plastics, and other persistent environmental toxins.The episode also reviews current American Society for Apheresis (ASFA) guidance, which places many emerging uses of apheresis into Category III, meaning the optimal role is still being defined and treatment decisions should be individualized.ReferenceConnelly-Smith L, et al. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice. J Clin Apher. 2023.Listeners will also hear what to expect from a TPE treatment at Neuroveda. Each session lasts approximately 2–4 hours, during which blood circulates through a machine that separates and removes plasma while returning the remaining blood components with replacement fluid.Although the procedure may sound invasive, TPE is generally well tolerated and safely performed in outpatient settings. Vital signs are monitored throughout treatment, and most patients experience only mild side effects such as fatigue, lightheadedness, or temporary electrolyte shifts.One unique aspect of Neuroveda's approach is the integration of Ayurvedic medicine with modern therapeutic plasma exchange. Ayurvedic therapies use oils, massage, steam, and other treatments to mobilize lipophilic toxins from deeper tissues back into circulation. Because TPE removes substances circulating in the bloodstream, these therapies may help prepare the body for detoxification.This aligns with Panchakarma, Ayurveda's classical detoxification process, which includes rakta moksha, traditionally translated as “blood liberation.” In a modern context, TPE can be viewed as a technological evolution of this ancient concept.Rather than functioning as a stand-alone cure, TPE is often most effective as part of a comprehensive program that may include functional medicine, regenerative medicine,

Carl's work focuses on people who feel better outside of their house or office, helping building occupants understand and improve their indoor environments — particularly for people experiencing health symptoms tied to indoor exposures like mold, volatile organic compounds (VOCs), and fragrances. Because he originally experienced indoor environmental harm in his personal life, he brings a unique perspective to understanding and communicating the complications between clients and practitioners. Carl is a frequent presenter nationally and internationally, past President of IAQA (Indoor Air Quality Association), and past Vice President of Practice of ISIAQ. He has served on and chaired committees writing ANSI accredited standards like the original IICRC-S520, chaired the IAQA Healthy Home Committee, and was a committee member on the ACAAI-AAAAI Joint Task Force that wrote medical practice parameters. He is immediate past chair of the ASHRAE TC1.12 Moisture Management in Buildings, and Guideline 10, Interaction Affecting the Achievement of Acceptable Indoor Environments, plus the ASHRAE position document Health and Wellness in the Built Environment.

Send me a derm question or story!Allison Inga, DVM, DACVD is back on the podcast! In this week's episode, we review the systemic antimicrobial recommendations from the International Society for Companion Animal Infectious Diseases (ISCAID) and what they mean for veterinarians treating superficial or deep pyoderma.We highlight when systemic antibiotics are truly indicated, first-line drug selection, along with more resitant infections that may require second- or third-line antibiotic treatment. The discussion also reinforces antimicrobial stewardship principles, including avoiding unnecessary use of critically important antibiotics.A focused update designed to help veterinarians and staff members to apply ISCAID guidance confidently and responsibly in everyday clinical cases.Timestamps00:00 – Intro01:35 – When To Use Systemic Therapy02:32 – Topical Therapy 2-Week Period03:35 – Different Types of Pyoderma07:18 – First Choice Drugs10:20 – Go-To Drug Choice11:50 – Wiggle Room When Prescribing14:03 – Second Choice Drugs16:57 – Where To Dose18:54 – Usage in Dogs19:37 – Other Second Choice Considerations23:09 – Usage Experience with Rifampin25:52 – Systematic Use of Amikacin28:03 – Chloramphenicol Use in Patients31:08 – When To Limit Use32:46 – Other Considerations34:08 – Outro

In part one of this series, Dr. Tesha Monteith and Dr. Jennifer Robblee discuss an international consensus definition for refractory migraine and why clearer criteria are needed.  Show citations: Robblee J, Minen MT, Friedman BW, Cortel-LeBlanc MA, Cortel-LeBlanc A, Orr SL. 2025 Guideline Update to Acute Treatment of Migraine for Adults in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies. Headache. 2026;66(1):53-76. doi:10.1111/head.70016 Robblee J, Khan FA, Marmura MJ, et al. Reaching International Consensus on the Definition of Refractory Migraine Using the Delphi Method. Cephalalgia. 2025;45(9):3331024251367767. doi:10.1177/03331024251367767 Show transcript:  Dr. Tesha Monteith: Hi, this is Tesha Monteith with the Neurology Minute. I've just been speaking with Jennifer Robblee about her exciting work defining refractory migraine with an international consensus, as well as her work with the American Headache Society on a guideline update for parental pharmacotherapies for migraine in the emergency department. Hi, Jennifer. Thanks again for coming on our Neurology Minute. Dr. Jennifer Robblee: Thank you so much for having me. I'm delighted to be here. Dr. Tesha Monteith: You've done a lot of work in the area of refractory migraine. Why don't you tell us why you felt there need to be clarification on the definition? Dr. Jennifer Robblee: Well, this is a patient population that I'm really passionate about. There's not enough research out there. We don't really know who these patients are, why they're not responding to treatment, and we don't know how to help them because we have no guidelines, obviously, since they're refractory to what we use for treating. So I thought it was really good to get an international group to standardize our definition and hopefully help move the research forward. Dr. Tesha Monteith: Why don't you tell us a little bit about the consensus definition Dr. Jennifer Robblee: So we came up with an international consensus definition for refractory migraine that was laid out the same way that migraine is, say, laid out in the ICHD-3 diagnostic manual, if you want to call it that. So we have different criteria on. So criterion A basically allowed for it to be episodic or chronic migraine. Criterion B had three subcriteria, so you needed to have at least two out of three of severe to very severe disability and/or a constant background headache and/or at least eight monthly migraine days. Criterion C was about the lack of response to treatment. And basically it says that you needed to have failure of all medication categories, and there is an extra one for an other in case any new treatments emerge before the diagnostic criteria get updated. And what we considered a, quote, unquote, failure was that you did not have a 50% improvement in monthly migraine days, or you had intolerable side effects, or you had an absolute contraindication. There is a caveat that you need to have at least four true lack of efficacies. And then the CGRP monoclonal antibody or gepant category and the onabotulinumtoxin toxin category both had to be a true lack of response. And of course, there's a criterion B to say that this should not be from another diagnosis. Dr. Tesha Monteith: Thanks so much, Jennifer.

This episode features an in-depth discussion on the use of vasopressors in critical care, focusing on epinephrine, norepinephrine, and fluid resuscitation strategies in sepsis and anaphylaxis. Learn about drug choices, side effects, and practical tips for managing shock in austere settings. Key topicsVasopressor selection in shock managementEpinephrine's versatility and side effectsFluid resuscitation guidelines in sepsis and anaphylaxisMonitoring and adjusting vasopressor therapyBalancing fluid therapy with vasopressor useChapters00:00 Introduction and Guest Credibility01:20 Why Epinephrine Is the Go-To Vasopressor02:58 Confusing Nomenclature and Alternatives to Epinephrine04:12 Side Effects of Epinephrine: Heart Rate and Blood Pressure Risks07:04 Lactic Acidosis and pH Considerations09:25 Fluid Resuscitation in Sepsis and Anaphylaxis11:50 When to Move from Fluids to Vasopressors13:53 Guidelines for Fluid Administration and Response18:13 Recognizing When Fluids Are Not Enough20:29 Dosing and Monitoring Push Dose Epinephrine23:17 Endpoints for Vasopressor Therapy and Safety Limits28:49 Managing Tachycardia and Heart Rate Responses30:03 Norepinephrine as the First-Line Vasopressor31:11 Controlling Shock with Limited Resources33:15 Summary: Choosing the Right Vasopressor Strategy34:19 Final Tips for Emergency Vasopressor UseFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠⁠⁠

In this episode of With Flying Colors, Mark Treichel sits down with Todd Miller to explore what makes credit union policies effective — and what separates the policy frameworks at high-performing credit unions from those that consistently generate examination findings. Todd, who spent over 33 years at NCUA including a decade as Director of Special Actions, draws on his experience examining credit unions across the full performance spectrum. He shares what he consistently saw in top-performing organizations: strong written policies that created transparency at every level, from the boardroom to the branch. The conversation covers why policies matter beyond regulatory compliance, including their role as training tools, culture builders, and accountability mechanisms. Todd outlines the general principles that underpin effective policy management — from top-down implementation and accessibility to the importance of consequences for non-compliance and the disciplined handling of policy exceptions. The heart of the episode is Todd's breakdown of common elements that should appear in every credit union policy, regardless of subject matter: purpose and objectives, accountability structures, risk appetite statements with real limits, systems of trend-based reporting, and scheduled review processes. He explains why policy limits should be unique to each credit union, why guidelines are no substitute for hard limits, and why trend reporting matters more to board members than point-in-time snapshots. Mark and Todd also discuss the connection between policy compliance and organizational culture, including how violations of individual authority limits can erode morale, create bond claim exposure, and — in the most serious cases — lead to insurance fund losses.

Opening Bible verse: 1 Corinthians 9:24-27 Vacation days are precious! If you're planning on taking vacation days this year to declutter, you'll want to make the most of them. On today's podcast episode I share seven steps to take before your day(s) off to ensure a successful decluttering session(s). In summary: Step 1. Define Success with Clear, Measurable Goals Step 2. Nourish Your Body and Mind Step 3. Hire Accountability Step 4. Gather Materials Ahead of Time Step 5. Practice Ahead of Time Step 6. Get lots of Sleep the Night Before Step 7. Take lots of Before and After Photos to Track Your Progres This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com    

Guideline de HA da SBC 2025- Parte 1 by Cardiopapers

Doctors Lisa and Sara talk to Consultant Nephrologist Dr James Tollitt about Chronic Kidney Disease. We started by defining this and asking detailed questions on diagnosis, pitfalls to avoid, before getting his advice on risk stratifying patients and options for management. Excellent key messages with some easy practice pointers to take away that will benefit your patients and practice.  Disclaimer: All educational content in this podcast was developed as part of the Circulation Health collaborative working project between Boehringer Ingelheim Limited, Greater Manchester Primary Care Provider Board and Health Innovation Manchester. Content has been created by Circulation Health Clinical Leads for educational purposes, reflecting NHS Clinical Lead and guideline-based recommendations. Boehringer Ingelheim had no input into content development. They have provided financial resources to support Podcast recordings related to this project. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Resources: NICE CKD Chronic kidney disease: assessment and management (last updated Nov 2021, accessed Feb 2026): https://www.nice.org.uk/guidance/ng203/chapter/recommendations GP Notebook Deteriorating eGFR (how to spot accelerating decline in renal function and advice on how to approach this): https://gpnotebook.com/en-GB/pages/renal-medicine/deteriorating-egfr-in-ckd The British Journal of General Practice: The National CKD Audit: a primary care condition that deserves more attention. Aug 2018: https://pmc.ncbi.nlm.nih.gov/articles/PMC6058639/ Ipsos MORI poll from 2014 looking at what the Public know about Kidneys: https://www.thinkkidneys.nhs.uk/aki/wp-content/uploads/2015/01/Think-Kidneys-Report-270115-Understanding-what-the-public-know-about-their-kidneys-and-what-they-do.pdf Liu et al. Accounting for Age in the Definition of Chronic Kidney Disease. JAMA Intern Med Oct 2021. https://pubmed.ncbi.nlm.nih.gov/34459844/ Clinical Digital Resource Collaborative: Renal Disease Search tools (EMIS and SystemOne): https://cdrc.nhs.uk/resources/systmone-resource-centre/specialties/systmone-renal-urology-overview/chronic-kidney-disease-ckd/ The Kidney Failure Risk Equation (UK): https://www.kidneyfailurerisk.co.uk/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

In this episode of New Frontiers in Functional Medicine, Dr. Kara Fitzgerald speaks with Dr. Robert Lustig about the new USDA dietary guidelines and the broader forces shaping nutrition and metabolic health. Dr. Lustig brings a characteristically direct and nuanced perspective on sugar, ultra-processed foods, and food policy—raising important questions about what drives real change. It's a thoughtful conversation that challenges assumptions and invites deeper reflection. Full show notes + references: https://www.drkarafitzgerald.com/fxmed-podcast/ GUEST DETAILS Robert H. Lustig, MD, MSL, is Emeritus Professor of Pediatric Endocrinology at UCSF and a neuroendocrinologist with expertise in obesity, metabolism, and nutrition. Known for his influential work on sugar and ultra-processed foods, Dr. Lustig focuses on improving metabolic health through food system reform, research, and advocacy. He is the author of Fat Chance, The Hacking of the American Mind, and Metabolical, and a leader with Eat REAL, Biolumen, SnapRecall, and Perfact. Website: https://robertlustig.com/ Email: rlustigmd@gmail.com THANKS TO OUR DIAMOND SPONSORS DUTCH: https://dutchtest.com/for-providers Biotics Research: https://www.bioticsresearch.com/ Time—Line Nutrition: https://tinyurl.com/bdzx2xms EXCLUSIVE OFFERS FROM OUR SPONSORS Find out why MitoQ's mitochondria-targeting is a critical step for your healthspan and longevity strategy. http://mitoq.com/drkara CONNECT with DrKF Want more? Join our newsletter here: https://www.drkarafitzgerald.com/newsletter/ Or take our pop quiz and test your BioAge! https://www.drkarafitzgerald.com/bioagequiz YouTube: https://tinyurl.com/hjpc8daz Instagram: https://www.instagram.com/drkarafitzgerald/ Facebook: https://www.facebook.com/DrKaraFitzgerald/ DrKF Clinic: Patient consults with DrKF physicians including Younger You Concierge: https://tinyurl.com/yx4fjhkb Younger You Practitioner Training Program: www.drkarafitzgerald.com/trainingyyi/ Younger You book: https://tinyurl.com/mr4d9tym Better Broths and Healing Tonics book: https://tinyurl.com/3644mrfw

As our patients' age progresses, so should our definition of 'recovery'. In this episode of BackTable OBGYN, Dr. Mary Ackenbom, associate professor of urogynecology and reconstructive pelvic surgery at the University of Michigan, is welcomed by host Dr. Amy Park to discuss improving outcomes for older surgical patients. --- SYNPOSIS Dr. Ackenbom shares her journey from studying finance at Ohio State to ultimately specializing in urogynecology. The conversation mainly focuses on perioperative cognitive health, particularly in aging populations, and how conditions like frailty and comorbidities impact surgical risk and recovery. Dr. Ackenbom highlights the importance of individualized patient care, early mobility, enhanced recovery protocols, and prehabilitation in improving postoperative outcomes. The episode also explores the prevalence of postoperative cognitive decline and offers practical insights on counseling and managing older patients undergoing urogynecologic surgery. --- TIMESTAMPS 00:00 - Introduction02:18 - Dr. Ackenbom's Journey to Urogynecology04:47 - Research on Brain Fog06:18 - Personal Support and Hobbies09:54 - Age vs Frailty in Surgery13:05 - Procedures with Perioperative Complexity16:11 - Counseling on Operative Risk20:10 - ERAS and Earlier Discharge23:35 - Patient Goals and Tradeoffs27:53 - Surgical Clearance and Preop Consults33:30 - Prehabilitation Basics36:24 - Minimally Invasive Surgery Benefits37:15 - Surgical Cognitive Complications with Age41:42 - Finding the Surgery Window46:05 - Cognitive and Frailty Screening50:01 - Guidelines for Perioperative Care52:52 - Future Research 54:07 - Conclusion --- RESOURCES Incidence of postoperative cognitive dysfunction in older women undergoing pelvic organ prolapse surgeryhttps://pubmed.ncbi.nlm.nih.gov/32827107/ ACS NSQIP/AGS Optimal Perioperative Care of the Geriatric Patienthttps://www.facs.org/media/y5efmgox/acs-nsqip-geriatric-2016-guidelines.pdf

Dr. Timothy Gilligan and Dr. Calvin Chou discuss the updated guideline on patient-clinician communication in oncology. They highlight clinical recommendations and strategies on topics such as communication skills and practices that apply at every visit, principles for telehealth interactions, cross-disciplinary communication, facilitating involvement of the patient's support network, discussing prognosis, goals of care, treatment selection – including clinical trials, end-of-life discussions, overcoming barriers to communication, facilitating discussions of cost of care and financial toxicity, mitigating stigma, and setting boundaries with patients. Dr. Gilligan and Dr. Chou also share how clinicians can enhance their communication skills through skills practice opportunities and experiential learning. They discuss how fundamental communication is to optimal patient care and look to the future on how generative AI may impact healthcare communication. Read the full guideline, "Patient-Clinician Communication: ASCO Guideline Update"  TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/supportive-care-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-26-00118       Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I am interviewing Dr. Timothy Gilligan from Taussig Cancer Institute and the Center for Excellence in Healthcare Communication at Cleveland Clinic, and Dr. Calvin Chou from the University of California and Veterans Affairs Health Care System in San Francisco, co-chairs on "Patient-Clinician Communication: ASCO Guideline Update." Thank you for being here today, Dr. Gilligan and Dr. Chou. Dr. Timothy Gilligan: Thank you for having us. Dr. Calvin Chou: Delighted to be here. Brittany Harvey: And then just before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Gilligan and Dr. Chou who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then I would like to dive into what we are here really today to talk about. So Dr. Gilligan, this guideline updates the patient-clinician communication guideline that was first published in 2017. What prompted this update and what is the scope of this updated guideline? Dr. Timothy Gilligan: So I think with the first guideline, that was the first draft of it that we published five or six, seven years ago, really we were focused on getting the content right, what was the state of the knowledge at that time, and I was very happy with what came out of that. But when I looked back on it, I thought there were ways we could make it more accessible and more practical. Because what we really would like would be for people to apply what we know and then communicate more effectively with patients and colleagues. And one of the reasons I was really excited on the membership of the panel we had this time was I thought they were very well selected to help us do that, is to really think about what are practical guidelines, practical steps we can tell people to take that will improve their own experience and the experience of patients and the quality of care. Brittany Harvey: Absolutely, thinking about operationalizing that guideline really improves the dissemination and the uptake of these recommendations. So then, Dr. Chou, I would like to review the key recommendations and strategies across the clinical questions that the guideline addressed. I realize today with our limited time we may not be able to go through every recommendation and strategy, so we will start with some of the highlights. First, let's address the highlights of the process of communication with patients and their support networks. This includes the questions that address what communication skills and practices apply at every visit across the continuum of care, principles for telehealth interactions, cross-disciplinary communication, and facilitating involvement of the patient's support network. In your view, what are the most important recommendations across these clinical questions? Dr. Calvin Chou: I think the thing that all clinicians know in their bones that they want to be able to do effectively with patients is to communicate information clearly, as well as to communicate in a way that really deepens the relationship, demonstrates empathy, and also demonstrates understanding bilaterally between the various parties. So the communication guidelines that we established in this group, they are fundamental to communication in all conversations throughout healthcare. And the first guideline talks about how clinicians and their team can communicate effectively with the patient and the patient's support network. And those include things like preparing ahead of time; getting a list of the topics that are important to the patient support network so that we can consider them in the visit; making certain that we are hearing what the patients' and the patients' support networks are saying very, very closely; responding to those empathically; and being able to have conversations about care throughout the visit that demonstrate respect and deepen the trust; and then finally, to have some kind of bidirectional understanding, usually through teach-back, that allow both sides to know that communication has occurred as opposed to just been downloaded. The guidelines also talk about applying these same communication skills throughout telehealth communication - that is both in terms of synchronous communication, audio or video, as well as asynchronous communication, i.e., through secure messaging. We also talk about how we can use these same communication skills to communicate effectively with members of our own team. Interprofessional communication is an important part of all the work that we do, and how we can use these very, very same skills in communication with colleagues, with nursing staff, with social workers, and other allied health professionals. These are all very, very important, crucial members of our healthcare team in the delivery of care to our patients. And that is something that we really need to emphasize throughout to try to bring the best of communication in every conversation that we have. Dr. Timothy Gilligan: I totally agree with that. Those are really important points. When I was looking over it in preparation for this podcast, it struck me that we have a lot of recommendations and a lot of small things that we can do either well or not well. And it reminded me of a quotation from a famous chef, Marco Pierre White, who said that perfection is a lot of little things done well. This guideline has a lot of little things that if you do them well, you get better outcomes. And I think the chef's point was that if you want a really delicious dish, you have to pay attention to all those little details. And I think if people go through the guidelines carefully and apply the skills that are along the lines of what Dr. Chou was talking about, we get better results. And those results are really important results. It is not only patient satisfaction, which is really important, but it is also quality of care and outcomes for patients. It is better medical care. It is a better day for us, we have a better day if we have better conversations. Poor communication creates endless headaches for everybody. What I see in the guidelines is it is a lot of little best practices and it requires discipline to learn those. The good news is none of them I don't think are all that hard. The bad news is doing it consistently well every day requires discipline and practice. And what I would hope for these guidelines is that people will read them carefully and think about what they can do to apply what we know more consistently. And I think the interprofessional communication piece, that was something we added this year, is really critical. Medicine has a bad history of really disrespectful behavior. It was almost normalized that different specialties would make fun of each other, that different professions would talk disrespectfully of each other. And we know now that uncivil behavior results in more healthcare errors. And it is not only bad for our teams and our culture, but it is bad for our patients if we are not communicating well with each other. So I thought it was really critical that we added that piece to the update. Brittany Harvey: Absolutely. Those fundamental principles that Dr. Chou outlined are really key across every healthcare interaction, including those interdisciplinary interactions. And as you alluded to, Dr. Gilligan, I think it will really serve clinicians well to review the details and go through every table to read the recommendations and each individual strategy to help them improve their communication in day-to-day interactions. Moving to some of those day-to-day clinical communication scenarios, Dr. Gilligan, I'd like to think through some of those key points. So what is recommended for discussion of prognosis, goals of care, treatment selection, including discussion of clinical trials, and end-of-life discussions? Dr. Timothy Gilligan: So my perspective is that there is a broad theme of flattening the hierarchy that runs through these recommendations and this part of the guideline - that the sections that Dr. Chou just talked about really have a lot to do with the details. What does good communication look like? What are best practices that we can adopt? And I think these other sections are a little bit more, they also have a lot of specific guidelines, but there is a philosophical point that we do better when we talk to the patient at their own level. And we sometimes fail to do that. I remember from about 10 years ago I was in a room with a patient and one of the other doctors said to the patient, "We're going to bronch you tomorrow." And I was trying to think, like, what do they think the patient hears when we use language like that? Like they don't understand what the word means. We are just expecting them to step up to our level. We are not accommodating them, and I think that really interferes with our ability to form effective relationships with patients and communicate clearly. So if we are going to talk about prognosis, goals of care, treatment selection, clinical trials, end of life, the first step for me is that we have to get down to the patient's level, which means listening. We have to ask them what they know, we have to get their perspective. We have to understand what their health literacy level is so that we can have a conversation that takes into account the patient's perspective. And we need to be humble and remember that the patient often has information that we do not have yet unless we ask them and listen to what they say. That is going to change what we think is the best plan of care. And so shared decision-making is really a critical piece of that. One of my favorite trainers who I follow online says, "I make suggestions, you make decisions." And I like to bring that attitude into the room when I talk to patients. It is their life, it is their body, it is their health, it is their decision. It is not my decision. I don't get to tell them what to do. I want to make sure that they make a decision that is based on the best available evidence, but also a decision that is based on who they are and what their values are. And we try to give pointers to how we can have these conversations in a way that is really fully respectful of the patient's autonomy and the importance of the patient's expertise in their own body, their own lived experience. Because there is a risk that we come in with our white coat and we overpower them with our authority, our medical authority, our medical knowledge, and no one likes to be overpowered. And I think we all have a better day if we go in and have a conversation as human beings with each other. Dr. Calvin Chou: I want to underscore this point of having the patient and their support network make the ultimate decisions. Reviewing the evidence from more general literature, it is clear that across demographics that only 10% of patients want us to make decisions for them. 90% of patients want to have at least some say, if not full say, in the decisions that they make, and this is true across age, across gender, educational status, socioeconomic status, veteran status. This is a very, very important point. I think oftentimes we go in thinking we know what's going to happen and we need to make them do that. Thinking about this as a conversation as opposed to a download is an important point. Dr. Timothy Gilligan: And one thing that I think that the guidelines are relevant for here, which is I think one way to achieve honoring the patient autonomy, is to really make a commitment to having a good process, to not be committed to an outcome. So that when we start the conversation, we're not going to say it's a good conversation based on whether it ends up where I wanted it to end up. It's a good conversation based on whether we have a good process, a fair process. And the steps of good communication that are outlined in this guideline help us to establish a good process. And I think if we have a good process, we can trust it will take us to the appropriate outcome, which may be different than the outcome we thought was going to be the appropriate outcome when we started the conversation. Brittany Harvey: Definitely. I think, as you mentioned, tailoring discussions to each individual patient and situation is really critical. And I think in every other podcast episode across guidelines we've really emphasized the importance of shared decision-making. And so talking through the process of it in this guideline will really have impacts across all of ASCO's guidelines. Moving on to the next section of the guideline, this guideline also addresses barriers in the communication process. So Dr. Gilligan, what highlights are there for overcoming barriers to communication, facilitating discussions of cost of care and financial toxicity, mitigating stigma, and setting boundaries with patients? Dr. Timothy Gilligan: Yeah, it's interesting. I want to hear Dr. Chou's perspective on this too. I thought that the communication skills are really important for these conversations, but less powerful or less effective, potentially. For instance, barriers to communication, the big one that comes to mind is language differences. If the patient and the clinician do not share the same language, that results in less good care unfortunately. It results in less good communication. Having skilled translators or interpreters there is essential, and using them with skill is essential, but it does not get us to equality. I mean the best thing for a patient is to have a clinician who speaks their language. Unfortunately, that's not possible. So the second best thing we can do is to have good interpreters or translators to help us work. And then for us to use those people effectively, because oftentimes we cut corners when working with interpreters and shortchange the patient. So it is important to do the best we can. I think it is also important to acknowledge that it's a challenge and no matter how good your communication skills are, it's not going to be the same conversation if you're talking through another person versus directly to the patient. Similarly, with financial toxicity, it is important to talk about it. We need to be open about it. We need to talk to patients about it, but financial stress from healthcare is a real problem, and however well you communicate it, it doesn't make that problem go away. You know, in oncology, our drugs are obscenely expensive, and I can't communicate my way to lower prices. So I can talk about it and legitimize it and empathize, but I feel like I have more power in the other sections to really change the outcome by communicating well than I do with these. But it is important to talk about it. Patients are hugely affected by the cost of care and we need to talk about it with them. I do think for mitigating stigma and setting boundaries, then our communication skills become more powerful. We see everyone in the healthcare system, and when working with individuals who have been subject to stigma because of aspects of their identity, we can help lessen their vulnerability and fear by proactively letting them know that we will strive to avoid perpetuating that stigma, that we will treat them with respect and address them as they wish to be addressed, that we will care for them as dignified and valued human beings. That is not always their experience in the system, but we can choose to be different. We can choose to do better. And our communication skills are important because listening and curiosity are super important in that space. Because if we are talking to people who may be different from us, we need to learn about them by listening and being open and being curious, and replacing, if we have any tendency towards judgment, to replace judgment with curiosity. With setting boundaries, I think it is also really important. I don't think you can show up and be fully present with patients the way I want to, the way we want other people to, if we don't know that there are boundaries. And we know this in other aspects of our care, right? I go into the room and I do intimate physical exams and I ask about intimate aspects of the patient's life. And I'm allowed to do that because there is a non-negotiable barrier to any kind of sexual or romantic contact between me and my patients. We know there's a hard wall there that we don't cross that line, so that when I am doing an intimate exam, we know where that stops and that we're not going to cross boundaries there. But the same thing applies verbally, and I think doctors sometimes and other healthcare professionals sometimes feel like they need to accommodate the patient no matter what. I was hoping the guidelines would send a strong message that, you know, we don't need to put up with disrespectful behavior. That when you go into the room, as a clinician or as a patient, you should be treated with respect. You should feel safe, you should feel like you belong, and if patients are behaving in a way that violates that, then clinicians have a right to speak up and to set limits and to set boundaries. And if we know those boundaries are there, then I think we can lean in closer. If we don't know those boundaries are there, then we kind of have to hold back to protect ourselves. And just to give one of like a million examples you can give, I don't know a woman in healthcare who hasn't had a patient say something sexually inappropriate to them at some point. And that's not okay. I want my colleagues to know that's not okay, and it's okay to set boundaries and they don't have to put up with that. And my hope is that if we know where the boundaries are, then we can step in closer. That's my perspective on these, but Calvin, please, I'd love to hear your thoughts. Dr. Calvin Chou: I want to double-click on everything that you said, Tim. It is so important that we recognize what we have control over and what we don't have control over. And what we don't have control over, for example, language discordance or financial woes of a patient, I have no possible way of controlling that. And so the best I can do in those situations is to sit with them, empathize, and do what I can, whatever power I might have in advocacy or I often refer folks to a social worker that I work very, very closely with, because I have no agency over any of that. At the same time, when we talk about mitigating stigma in healthcare encounters, we have full control over the biases that we have. We may not be aware of them, but we do have control over them ultimately. And so it is up to us really to examine our practices, to see where we have maybe been steered in the wrong direction, where we double down on internal implicit biases that we have carried for our entire lives. And that requires that we approach all of our encounters with everybody in healthcare, with humility, and with an extra eye toward understanding how we are coming across to them, and whether or not at least some of those interactions are infused with bias that we can decrease. And then finally, with the idea of boundaries, there are boundaries in two directions, as Tim was saying a moment ago, that there are boundaries that we must place in between ourselves and patients during examinations and also during interactions. And there's also boundaries that we have to set up that require that we uphold the standards ethically of clinical medicine. And that is, there are certain things- I would never ask a patient out, for example, on a date. And that's an important proscription; that's an important boundary that we must set up between ourselves and patients. Those are clear barriers that we must not breach. There are some barriers that are a little bit less clear. For example, there are some instances where physicians are asking patients who have means to perhaps contribute to a foundation or contribute to the university or to make a large donation to an institution. In some instances, that's a much less clear boundary. For myself, I feel uncomfortable making those kinds of requests, and there are other instances where those requests are actually not just okay to do, but the patient is willing to do those kinds of things. So I think we need to consider that these boundaries are not always set in stone. Sometimes the boundaries move, sometimes the boundaries are different. Brittany Harvey: Absolutely. I think this latest question covered a lot of ground, and I think some key points here are that treating everyone with dignity is really paramount to this guideline. Recognizing the challenges even when they're not solvable is really important, such as thinking about financial issues or perhaps not speaking the same language as a patient. And then building trust and mutual respect between patients and clinicians to establish clear boundaries is really important as well. So, I want to thank you both for reviewing at a high level the recommendations and the strategies from this guideline, and I encourage listeners to review the full guideline and tables for all of the recommendations and strategies to implement these clinical recommendations. So, Dr. Chou, this guideline panel also addressed one education question. So, what are the recommendations for effective ways for clinicians to enhance their communication skills? Dr. Calvin Chou: Thanks for asking, Brittany. When we talk about all of these communication skills, Dr. Gilligan and I have talked for a long time about all these individual communication skills. These are not skills that are necessarily naturally formed within us and that we just roll out without any practice. And that's why we both feel, if I can speak for you, Tim, that we both feel that communication skills training, and high-quality communication skills training, is deeply important. This is training that is less about I'm listening to this podcast and therefore I can communicate better, it's more about skills practice opportunities, experiential learning, oftentimes using that horrifying word 'roleplay' that people don't like to think about roleplay before they're in it, but then once they've done those skills exercises they realize how important it is to actually have practiced some of these skills so that when you get into the real situation, you have an approach to it as opposed to trying to just improvise or make it up on the fly. The other aspect of communication skills training that is deeply important is not just forming the words and speaking to somebody else, it also needs to incorporate practitioner self-awareness and situational awareness that allows us to understand what's going on within us emotionally and attitudinally so that we are interacting moment by moment with patients and their support networks in a way that's authentic, that brings the appropriate amount of vulnerability and expertise to deepen trust between all of those relationships. And finally, when we talk about communication skills training, there are ways to do this kind of training that, I've used ChatGPT, for example, when I'm having some difficulty wondering how to navigate a particular situation, sometimes you can use ChatGPT to give you some suggestions on how to approach that interaction. But at the same time, the most important thing is to be able to have really meaningful practice with other people, with other human beings. Because as much as I might interact with a computer, that computer is not a human being. And what we are talking about is interpersonal communication with emphasis on 'person'. And us as human beings, we understand, in a way that ChatGPT probably will never fully understand, the nuances of the emotional reactions and the importance of human connection between people when we talk to each other. And so therefore, if we can't depend on computers to do this communication skills training, we need institutions to emphasize and invest in all of our continuing ability to communicate effectively with everybody in healthcare. This is probably one of the most important outcomes of this guideline, is not just that communication skills are important, and not just that communication skills training is important, it's that we need everybody to invest in everybody's ability to communicate with each other on the highest possible level that we can bring. Brittany Harvey: Yes, I think it's really important that the panel addressed this question, to emphasize that it's not just individual clinicians, but institutions that really need to value communication and this training to make sure that clinicians are being the most effective communicators that they can be. So, I'd like to move on to the next question, and Dr. Gilligan, ask, in your view, what is the importance of this guideline and how will it impact both clinicians and people with cancer? Dr. Timothy Gilligan: So I would build off of what Dr. Chou was just talking about, which is what we're hoping is that it will serve as a resource that will give people interested in communicating better guidance on where to go, what to do, what are the best practices, what do we know at this time. if you want to get better, what are the methods that are going to help you get better. And ideally I hope it will inspire people to want to get better. Communicating is such a fundamental part of our day-to-day work in healthcare that it needs to be something that we're very, very good at. And as professionals we should aspire to be as good as possible. A lot of this stuff is pretty basic, but we forget to do it. When I had young kids and was teaching them to ski, one of the ski instructors said to me once that there were Olympic skiers who trained at the same mountain where my kids were learning. And he said they would go down easy slopes and just practice basic techniques still. They were good enough to ski in the Olympics going at crazy speeds, but they kept going back to their fundamentals. And my son is a serious soccer player and they do role plays in soccer. They practice drills. They have scenarios they know are going to come up and they artificially recreate that scenario and they practice it over and over again. There's a famous line from a college football coach that you don't practice it until you get it right, you practice it until you can't get it wrong. And I think if people would bring that sense of professionalism to communication, it's a lifelong journey. I'm still trying to get better. It requires practice, it requires discipline. There's a lot that we know, but it doesn't happen without practice. And as Dr. Chou was saying, it's a motor skill. You don't learn it by reading about it. You don't learn it by listening to us talk about it. You learn it by practicing it. And I practice with patients. Not in the sense that I'm doing an experiment, but I work on my skills with patients. And I see how it goes. And when things don't go well, I think of what I could have done differently. And when things do go well, I think of what did I do that helped it go well that I need to make sure I do again next time. And I think I'd love to see people adopt an attitude that they want to be fantastic communicators and they want to get better. And I think the guidelines provide a lot of clues and steps to take for all of us to get better. Dr. Calvin Chou: I heard Tim, you talk about communication being a procedure and that we would never think about going into a room and sticking a central line into a patient without having practiced that over and over and over again to get it right. Not to get it right, to never get it wrong, like you were just saying. And so if we think about communication as the most common procedure in healthcare, then it behooves us all to do the best we can with it. It is a frame shift because we are communicating with each other all the time, oftentimes without thinking. And what we're advocating right now is for everyone to really bring it in terms of communication skills in all settings, because the effect of ineffective communication is not necessarily just making people feel bad. As Tim said at the top of the program, it also impinges on quality of care. It's not just the right thing to do, it's the safe thing to do. Brittany Harvey: Absolutely. And highlighting the fundamentals here and practicing them as clinicians will improve each healthcare interaction. So then, finally, to wrap us up, Dr. Chou, earlier you mentioned ChatGPT and thinking about maybe some technological advances and how those will impact in the future. What are the outstanding questions and priorities for future research for optimal patient-clinician communication? Dr. Calvin Chou: I think there's a lot we still need to learn about in this very, very nascent time of interacting with generative artificial intelligence. We won't know what things are going to be like probably even tomorrow given the vast advances that AI is allowing us to do. And also, as I was mentioning earlier, what AI can never do is to bring the human element into these interactions. And I think that's part of what, maybe that's a lot of what brings people to healthcare, is if they're in need and they have some physical issue that we need to help them solve, it's not just a physical issue, it also is a deep emotional experience. And we have heard many times now cautionary tales of when AI has led people astray to then, for example, allow them to die by suicide. And that is the last thing that we can allow to happen in healthcare. That is the ultimate low-quality item. We need to make certain that everybody is cared for with high quality and high safety. And we're definitely not there yet with AI. We hope that at some point we'll be able to work with AI in order to bring even better healthcare than we have right now, and I think that has been demonstrated to be possible. That is one major outstanding question that we're all going to have to wrestle with. Brittany Harvey: I think that's absolutely a key point. With generative AI quickly evolving, there need to be guardrails in place. And like any intervention, thinking about how to maximize the benefits of it and reduce the harms to make sure that you're preserving that human interaction and communicating effectively, and that patients can receive their health information in an appropriate way. So I want to thank you both so much for your work to update this guideline, to draft all of these recommendations and the strategies, and work with the entire panel to create this excellent product. So thank you for all that work and thank you for your time today, Dr. Chou and Dr. Gilligan. Dr. Timothy Gilligan: Thank you. Dr. Calvin Chou: Thank you, Brittany, so much. Brittany Harvey: And finally, thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

Dr. Tesha Monteith talks with Dr. Jennifer Robblee about the latest consensus on refractory migraine, its definition, and management strategies, including new guidelines for emergency treatment.  Read the related article in Cephalalgia.  Read the related article in Headache. Disclosures can be found at Neurology.org. 

Dr. Edward Mariano, co-chair of ASA's Acute Pain Taskforce, discusses ASA's new guideline on acute postoperative pain management with Dr. Adam Striker. Find out why this new guideline is needed, who the recommendations are for, what's changed, and more. Recorded February 2026. 

Learn how meta-analyses were manipulated and guidelines corrupted to promote statins for healthy people, especially women and the elderly. #StatinScandal #ConflictOfInterest #GuidelineBias #HealthTalks

This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com  

The episode centers on a structural governance gap within the managed services industry as it attempts to address mental health using relationship-driven models typical of event and community management. This approach is exemplified by the launch of MSPWell, a not-for-profit mental wellness initiative incorporated in Ontario, Canada, targeting participants in the IT channel. The initiative operates as a live community—particularly via Discord—without formalized clinical oversight or published operational guardrails such as moderation standards, crisis escalation protocols, or sponsor influence controls. Evidence for an urgent governance concern is provided by industry data and operational decisions. According to MSPWell, burnout affects significant percentages of the workforce—citing an 82% burnout risk from a Mercer report and 66% from separate research. Despite the recurrence of staffing challenges in the MSP industry, MSPWell's infrastructure is underway with participation at industry events and vendor sponsorship, but formal governance documentation remains incomplete. The initiative explicitly confirms the absence of licensed mental health professionals in published leadership or advisory roles, positioning its support as peer-led. Supporting developments highlight how rapid community launch and sponsor-driven funding amplify risks when core protections are missing. Early coverage focused on recognizable names and event presence, while Dave Sobel emphasizes that, in mental health-adjacent contexts, moderation, privacy, and escalation protocols are not only differentiators but essential safeguards. At present, MSPWell's Discord community operates without visible guidelines or documented procedures, which exposes participants to predictable failure modes such as oversharing, privacy breaches, and harmful peer advice. Operationally, MSPs and IT service providers face heightened liability when participating in or supporting such initiatives without robust controls. Dave Sobel advises operators to request moderation, crisis, and data retention policies before endorsing participation, to treat involvement as networking rather than clinical support, and to monitor for the integration of licensed professionals into governance. The absence of enforceable governance exposes both individuals and sponsoring vendors to reputational and legal risk, and sets problematic precedent for future wellness platforms in the industry. 00:00 MSPWell Builds Mental-Health Platform on Sponsor-Funded Community Model 03:21 Guardrails, Guidelines, and Moderation  06:15 The Consequences 08:09 Why Do We Care? & What to Consider Supported by:  TimeZest   

Dan ends the week talking about the change at the helm of DHS, and a local reporter in Nashville is detained by ICE | aired on Friday, March 6th, 2026 on Nashville's Morning News with Dan Mandis See omnystudio.com/listener for privacy information.

Send me a question or story!In this week's podcast episode, I get to interview Allison Inga, DVM, DACVD who practices at Animal Dermatology Clinic in Robbinsville, NJ. We take a practical, clinician-focused look at the latest guidelines from the International Society of for Companion Animal Infectious Diseases (ISCAID) on the use of topical therapy in managing bacterial skin infections.Topical therapy is no longer just an adjunct — it's a central component of antimicrobial stewardship in dermatology. We review how the ISCAID guidelines support cytology-driven diagnosis, when topical therapy can be used as sole treatment, and how it helps reduce systemic antibiotic use in cases of superficial pyoderma and Malassezia dermatitis. 00:00 – Intro01:25 – Dr. Inga 03:50 – Advantages of Topical Therapy in Pyoderma Cases05:40 – Evidence of Using Chlorhexidine Percentages08:22 – Factors to Consider In Chlorhexidine Cases09:30 – Other Topical Anti-Septics to Consider10:44 – Diluting Bleach 13:50 – Addressing Concerns Around Bleach15:00 – Topical Antibiotic Use17:26 – Efficacy of Topical Therapy21:20 – Simple Things That Yield Good Results23:10 – Concurrent Use26:10 – Outro

Episode 524 ~ March 5, 2026 Podcast Info / Topics The Andaman and Nicobar Islands are putting new guidelines in place in regards to night time sea kayaking During the Sail4th 250 tall ships event being held in New York this summer, paddle craft will not be permitted on the water A kayaking guide put […]

Tell us what you think about this podcast!In this episode, we walk through the biblical guidelines for giving offering and why it matters in the life of a believer. Giving is more than a financial act. It is an expression of worship, obedience, and trust in God. We'll talk about the heart posture behind giving, the principles Scripture lays out, and how cheerful, faithful stewardship honors the Lord and strengthens the church. Whether you're new to the faith or have been walking with God for years, this episode will help you approach giving with clarity and purpose.For more lessons and sermons, follow our YouTube channel at https://www.youtube.com/@GBT

Episode 524 ~ March 5, 2026 Podcast Info / Topics The Andaman and Nicobar Islands are putting new guidelines in place in regards to night time sea kayaking During the Sail4th 250 tall ships event being held in New York this summer, paddle craft will not be permitted on the water A kayaking guide put […]

Host: Sabiha Gati Guest: Thomas F. Luescher Want to watch that extended interview on The future of guidelines in an era of Big Data and AI, go to: https://esc365.escardio.org/event/2556?resource=interview Want to watch the full episode? Go to: https://esc365.escardio.org/event/2556 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode.  The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Sabiha Gati, Nicolle Kraenkel and Thomas F. Luescher have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

This episode covers: Cardiology this Week: A concise summary of recent studies The future of guidelines in an era of big data and AI Exercise in hypertrophic cardiomyopathy Snapshots Host: Sabiha Gati Guests: Kostas Koskinas, Thomas F. Luescher, Michael Papadakis, Stephan Achenbach Want to watch that episode? Go to: https://esc365.escardio.org/event/2556 Want to watch the extended interview on The future of guidelines in an era of Big Data and AI, go to: https://esc365.escardio.org/event/2556?resource=interview Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode.  The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Sabiha Gati, Nicolle Kraenkel and Thomas F. Luescher have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Welcome to March! We are moving on from decluttering our kitchens to decluttering our wardrobes! I thought I would kick off the month with a special guest, Heather Riggs. Heather is the founder of Her Style, LLC and host of the top 10 Fashion and Beauty Show, Her Style Podcast. As an 18 year Certified Image Consultant and Color Specialist, Heather teaches ambitious women a smarter way to dress- taking the art and science of personal style and turning it into a clear, repeatable system to build a wardrobe that actually works. Take her 5 minute style quiz here: herstylellc.com/quiz. If you would like to join her style collective, send Heather an email at: support@herstylellc.com and mention that you heard her here on Pruning to Prosper to enjoy an additional month for free! https://herstylellc.com/collective     ***This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com    

Big news in the public health world this week. The Celiac Disease Foundation just released a paper outlining recommended supports for students with Celiac in college. All of their recommendations align exactly with what I've been teaching my families for years. One exception: I do recommend requesting priority class registration. Seeing these requirements in black and white, backed by professionals from all sectors, adds gravitas to our cause. It's a win for visibility and a validation of the challenges our students face every day in the dining hall, dorms, and beyond.We know colleges are large, slow-moving institutions. They aren't going to overhaul their kitchens or rewrite their disability policies tomorrow just because this paper exists. To them, this is a recommendation; to us, it's our child's safety.But this paper is a good tool in our toolbox.We can (and should!) bring this document to the table during the accommodations process. We can point to it and say, "The experts agree that this accommodation is a standard of care." If you have a senior in high school, or are preparing for the Accommodations Process, please join us on 3/25 or 3/26 for the next Accommodations Workshop.I would love to hear from you! Leave your messages for Andrea at contact@baltimoreglutenfree.com and check out www.baltimoreglutenfree.comInstagramFacebookGluten Free College 101Website: www.glutenfreecollege.comFacebook: http://www.Facebook.com/Glutenfreecollege Hosted on Acast. See acast.com/privacy for more information.

The rush to the bomb shelters can be more than stressful. At least two people have died and many injured by the scramble and anxiety over safely reaching shelters. Reporter Arieh O’Sullivan spoke with Dr. Yael Benvenisti, a gerontologist and healthy lifestyle researcher, about some practical guidance for the senior population and their families. (photo: Tomer Newbey/Reuters) See omnystudio.com/listener for privacy information.

Episode 442 | The First 10 Minutes (How Martial Arts Schools Win or Lose New Families) Podcast Description In this episode of School Owner Talk, Duane Brumitt and Shihan Allie Alberigo break down a growth lever that most school owners underestimate: the intro experience. A lot of schools assume they have a marketing problem. However, Duane and Allie argue that in many cases it's not marketing — it's what happens after someone clicks, fills out a form, and schedules their first class. Because you only get one shot to make a first impression, and families are deciding fast whether they trust you. They frame the “first 10 minutes” as a three-phase process: The digital first impression (what families experience online) The pre-visit first impression (texts/emails/calls before they arrive) The in-studio first impression (the first few minutes inside your school) Key Takeaways Simple doesn't mean easy. One small mistake early can create big problems downstream. Your first impression usually happens online. Your website, form, confirmation texts, and follow-ups are part of the intro experience. Congruency matters. Your words, photos, colors, and vibe should match what families will experience in your school. Don't cast a “wide net” with fake promises. Listing styles you don't teach (just to catch traffic) makes people click off fast. Pre-visit communication reduces anxiety. Clear directions, parking info, and “here's what to expect” messaging prevents confusion and no-shows. The in-person greeting is make-or-break. Allie shares how she's walked into schools and sat for 15–20 minutes without being greeted — and how one school owner impressed her by greeting immediately and professionally. The goal isn't to “sell” them on day one. The goal is to help families feel known, safe, and confident they chose the right place. Use names to create connection. Duane shares the “three times rule” — use the parent/child's name multiple times to build familiarity. A tour should be an experience, not a checklist. Tie everything you show to a benefit the family cares about. Guidelines beat rigid scripts. Scripts can make staff robotic; guidelines create consistency while letting people sound natural. Questions at enrollment are feedback. If families still have basic questions at the close, it's a sign you need to address those earlier in the process. Action Steps for School Owners Audit your intro experience in three phases. Digital (website, ads, Google listing, forms) Pre-visit (texts, emails, calls, reminders) In-studio (greeting, tour, first class, next steps) Make your online presence congruent.Ensure your photos, language, colors, and promises match what you actually deliver. Stop trying to be everything to everyone.If you're a Taekwondo school, be a Taekwondo school — don't list Kenpo, Kung Fu, Karate, Jiu Jitsu, etc. if you don't teach them. Build a pre-visit “confidence package.”Reduce friction before they arrive: Where to park Where to enter What to wear What will happen when they arrive Train your team to greet fast and warmly.Don't let families stand at the counter feeling invisible. A quick “Hey, I see you — I'll be right with you” changes everything. Turn your dojo tour into a story.Don't just point at things. Connect each part of the tour to benefits: Safety (mats, layout) Community (lobby culture) Trust (standards, structure, professionalism) Use guidelines, not robotic scripts.Give staff a step-by-step structure, but allow them to speak naturally and adapt to the family. Systematize the process with ownership.Decide who owns each part: Who responds to leads Who greets Who tours Who teaches the first class Who closes Roleplay and pressure-test your process.Practice curveballs (price shock, shy kids, skeptical parents) so staff stays confident. Use enrollment questions as “upstream” feedback.If families keep asking the same questions at the close, add those answers earlier (videos, texts, emails, handouts). Additional Resources Mentioned Three-phase intro experience: digital → pre-visit → in-studio Congruency principle: your online presence should match your real school experience The “three times rule” (use names to build connection) Guidelines vs. scripts for staff consistency Mystery shopper idea to test your intro experience Book reference: Upstream (prevent problems before they happen)

March brings higher energy and lower stamina, and suddenly your classroom feels louder, messier, and harder to manage. In this episode, we explain why spring classroom management isn't about cracking down harder, but about rebuilding structure. We walk through four common spring trouble spots: transitions, messiness, chattiness, and behavior outside the classroom. We also share practical ways to reset expectations so the environment does more of the work for you. The goal is simple: create structure now so your day requires less of you tomorrow.Prefer to read? Grab the episode transcript and resources in the show notes here: https://www.secondstorywindow.net/podcast/spring-classroom-management-headaches/Resources:Pre-order Structure and SparkStain StrikerClay MooJoin The Teacher Approved ClubConnect with us on Instagram @2ndstorywindowShop our teacher-approved resourcesJoin our Teacher Approved Facebook groupLeave a review on Apple PodcastsLeave a comment or rating on SpotifyRelated Episodes to Enjoy:Episode 48. How to Make Classroom Transitions Simple With Clear Beginnings and EndingsEpisode 49. Rapid Classroom Transitions: How to Save 45 Hours a YearEpisode 50. 3 Guidelines to Make Classroom Transitions Work Smarter Not HarderEpisode 119. Chatty Class Management: 5 Ways to Handle a Talkative ClassMentioned in this episode:Try the Teacher Approved Club free for 10 days and get one perfectly timed, research-backed strategy each month—plus support from Heidi and Emily to help you actually use it when it matters most. Start your free trial at https://secondstorywindow.net/trial

Google Ads Text Guidelines Are Now Universal & More Digital Marketing News | Ep. 422This week on Marketing O'Clock: Google Ads announced that it's expanding its beta to make text guidelines universal. Also, as ChatGPT's ad rollout continues, trigger patterns are emerging and highlighting what is really bringing in commercial intent.Visit us at - https://marketingoclock.com/

What if the solution to AI policy challenges isn't stricter rules but bringing students into the conversation? AI, Unscripted returns for another season on MTN with Yasmine Kotturi, Assistant Professor, UMBC. Dr. Kotturi shares her groundbreaking approach to AI governance in higher education with co-hosts Jennifer Potter and Mary Crowley-Farrell. Instead of top-down policies that students resist, Dr. Koturri's research demonstrates how participatory policy design transforms the conversation, turning enforcement into engagement and compliance into critical thinking. Yasmine Kotturi: https://ykotturi.github.io/

This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com

Send us a message!In this episode we will be covering Facebook Live Questions 2/10-2/24/26  from Dana's free Facebook Group Registered Dietitian Exam Study Group with Dana RD!Check out the Practice Questions Program here.  Grab the Acronym flashcards here.Get the free RD Exam Prep Masterclass here. test out the recorded classes with the Free Trial.  Looking for additional tutoring service? Visit my website! Shop all recorded courses at https://danajfryernutritiontutoring.teachable.comJoin the RD Exam Prep Mastery Program for access to the Situational Practice Questions,  Key Topics Review, Vocab Classes, Wed 8pest Group tutoring , study guides and a new trouble area video each week!Need a Crash Course before your exam? Check out the 4 part Pre-Exam Crash Course: Key Topics Review.

Welcome to the Wholesale Hotline Podcast Weekend Edition (Flipping Mastery Edition), where Jerry teaches how to master the art of house flipping, wholesaling, and new construction development.Show notes -- in this episode we'll cover:Straightforward, step-by-step training on making six and seven figures from real estate deals.Insider tactics for finding motivated sellers, analyzing deals, and raising private money.Learn how to flip houses virtually from anywhere—even with zero experience.Whether you're a beginner or scaling up, Jerry gives you the blueprint to build real wealth through real estate.  Please give us a rating and let us know how we are doing!➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖ ☎️ Welcome to Wholesale Hotline & Flipping Mastery Breakout! ☎️Jerry Norton went from digging holes for minimum wage in his mid 20's to becoming a millionaire by the age of 30. Today he's the nation's leading expert on flipping houses and has taught thousands of people how to live their dream lifestyle through real estate. **NOTE: To Download any of Jerry's FREE training, tools, or resources…Click on the link provided and enter your email. The download is automatically emailed to you. If you don't see it, check your junk/spam folder, in case your email provider put it there. If you still don't see it, contact our support at: support@flippingmastery.com or 888) 958-3028. ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖ 

Dr. Andy Southerland and Dr. Shyam Prabhakaran explain the significance of these guidelines and why they are important.  Show citation:  Prabhakaran S, Gonzalez NR, Zachrison KS, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. Published online January 26, 2026. doi:10.1161/STR.0000000000000513  Show transcript:  Dr. Andy Southerland: Hello everyone. This is Andy Southerland from the University of Virginia. And for this week's Neurology Minute, I've just been speaking with my colleague, Shyam Prabhakaran, from the University of Chicago, who was the Chair of the 2026 AHA/ASA guidelines for the early management of patients with Acute Ischemic stroke published in the January 2026 online version of the journal, Stroke. So Shyam, in our brief Neurology Minute today, why don't you just give a plea about why these guidelines are so important? Dr. Shyam Prabhakaran: Thanks, Andy. These guidelines are the first guidelines since 2019, so a lot has happened. So when you look at these guidelines, you'll see a lot of new recommendations. In fact, I think the majority have been revised in some way or another. And I'd point to the actual guideline document, which is in the journal Stroke online January '26, and the print version will be for the March edition of the journal Stroke. In addition to that, I'd say because you want to have interpretability and ease of practice, there are a bunch of derivatives on the AHA website that are very useful. They include case studies, they include figures and workflows that could be really useful for you to have these conversations. And there's even a slide deck that was prepared by our AHA ambassadors. There are these young whippersnappers that did a great job putting together a slide deck for anyone to use. They can use that to have conversations locally or anywhere they want. I encourage people, read the guidelines, but then also use the derivative products that people spent a lot of time on developing. Dr. Andy Southerland: Thank you, Shyam. I think that's a great message from the Chair of the writing group, that when you look at these guidelines, they can seem daunting. But the way you all have provided all these additional resources and analogs for people to interpret it and apply it in their own stroke centers and practice, I think folks definitely will be running out to do that, just to seek out the full guideline, and let's apply all this great new evidence to better care for our patients. So Shyam, thanks again for joining us for this week's Neurology Minute. 

New AHA/ACC guidelines overhaul pulmonary embolism management with a five-tier risk classification, endorsing ED discharge for low-risk patients and DOACs as first-line therapy. A JAMA trial confirms IV acetaminophen adds modest but real pain relief when combined with morphine. A large cohort study shows SGLT2 inhibitors dramatically reduce kidney, cardiovascular, and liver complications in diabetic cirrhosis patients.

Dr. Andy Southerland talks with Dr. Shyam Prabhakaran about the 2026 AHA/ASA guidelines for the early management of acute ischemic stroke, highlighting key recommendations, the role of advanced imaging, and the importance of thrombolysis and thrombectomy.  Read the related article in the journal Stroke.  Disclosures can be found at Neurology.org. 

In this episode, Dr. Cristina Castagnini sits down with Binge Eating Recovery Coach Stefanie Michele to discuss the alarming parallels between modern "wellness" food guidelines and eating disorder behaviors. They dismantle the fear-mongering around carbohydrates, the elitism of "clean eating," and the dangers of new inverted food pyramid trends that demonize essential macronutrients. Stefanie shares her personal 25-year battle with eating disorders and how she finally found recovery at age 40. Together, they explore the dangerous intersection of GLP-1 medications and restrictive diet culture, offering a compassionate perspective on why you might feel stressed about food and how to find your way back to balance. SHOW NOTES: Click here Follow me on Instagram: https://www.instagram.com/behind_the_bite Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This episode is a deep dive into the new 2026 guidelines on type 2 diabetes, applying the guidelines to various case-based scenarios. Zero to GP podcast: https://www.buzzsprout.com/2590332Zero to GP YouTube channel: https://www.youtube.com/@ZeroToGPZero to AKT course: https://zerotofinals.com/courses/zerotoakt/Books: https://zerotofinalsshop.com/

Opening Bible Verse: 1 Corinthians 15:5 This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com