Podcasts about guidelines

Send us a textA packed hallway at the ACNM Annual Meeting turned into the perfect backdrop for a clear, compassionate deep dive on adolescent gynecology. We talk candidly about what really helps teens feel safe in care: transparent consent, real confidentiality, and avoiding unnecessary pelvic exams. From there, we walk through the high-yield topics every clinician faces with young patients—irregular cycles after menarche, painful periods that derail school days, and the difference between normal discharge and vaginitis that needs treatment.We spotlight the red flags that can't be missed, especially ovarian torsion posing as vague lower abdominal pain, and why transabdominal ultrasound often beats transvaginal imaging for adolescents. You'll hear how we build a thorough menstrual history that captures timing, flow, and impact on daily life; how we normalize the maturing hypothalamic-pituitary-ovarian axis; and where first-line therapies like NSAIDs, combined pills, progestin-only methods, and levonorgestrel IUDs fit. We also lay out a patient-led approach to contraception counseling—centered on goals like bleeding control, privacy, and ease of use—while weaving in emergency contraception, STI screening strategies, and the crucial role of the HPV vaccine in preventing cervical and other cancers.Throughout, we keep the focus on trauma-informed practice. That means offering safe words like stop and out during exams, letting teens handle instruments to reduce fear, and moving complex conversations to when patients are fully dressed. We include considerations for transgender and gender-diverse adolescents, from menstrual suppression to reputable clinical resources. By combining practical tools with a respectful tone, this episode gives you a roadmap to adolescent gyn that improves comfort, detects danger early, and builds trust that lasts into adulthood.If this conversation helps you care for teens with more confidence, subscribe, share with a colleague, and leave a quick review to help others find the show.

Revoyez avec Dr Guillaume POGU, l'essentiel à savoir concernant la gestion d'un patrimoine en MG :✅ Les erreurs classiques à éviter !✅ Assurance vie : oui ou non ? ✅ PER : indispensable ou piège ?✅ Immobilier : acheter tôt ou attendre ? ✅ Comptes titres, PEA, ETF : par où commencer ? ✅ Les conseillers en gestion de patrimoine : comment repérer les pièges ?Annexes : France inflationCalculatrice d'intérêts composésQuantalys

Send us a textA packed hallway at the ACNM Annual Meeting turned into the perfect backdrop for a clear, compassionate deep dive on adolescent gynecology. We talk candidly about what really helps teens feel safe in care: transparent consent, real confidentiality, and avoiding unnecessary pelvic exams. From there, we walk through the high-yield topics every clinician faces with young patients—irregular cycles after menarche, painful periods that derail school days, and the difference between normal discharge and vaginitis that needs treatment.We spotlight the red flags that can't be missed, especially ovarian torsion posing as vague lower abdominal pain, and why transabdominal ultrasound often beats transvaginal imaging for adolescents. You'll hear how we build a thorough menstrual history that captures timing, flow, and impact on daily life; how we normalize the maturing hypothalamic-pituitary-ovarian axis; and where first-line therapies like NSAIDs, combined pills, progestin-only methods, and levonorgestrel IUDs fit. We also lay out a patient-led approach to contraception counseling—centered on goals like bleeding control, privacy, and ease of use—while weaving in emergency contraception, STI screening strategies, and the crucial role of the HPV vaccine in preventing cervical and other cancers.Throughout, we keep the focus on trauma-informed practice. That means offering safe words like stop and out during exams, letting teens handle instruments to reduce fear, and moving complex conversations to when patients are fully dressed. We include considerations for transgender and gender-diverse adolescents, from menstrual suppression to reputable clinical resources. By combining practical tools with a respectful tone, this episode gives you a roadmap to adolescent gyn that improves comfort, detects danger early, and builds trust that lasts into adulthood.If this conversation helps you care for teens with more confidence, subscribe, share with a colleague, and leave a quick review to help others find the show.

Podcast Family, we have covered PCOS on this show many times in the past; and yet- again, there is new information! A new publication from AJOG (Gray journal) describes a new meta-analysis on preconception/continued metformin use in the first trimester. Is this helpful? How does this contrast with the 2023 international guidance update on PCOS? Listen in for details. 1. ASRM: Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023)2. Cheshire J, Garg A, Smith P, Devall AJ, Coomarasamy A, Dhillon-Smith RK. Preconception and first-trimester metformin on pregnancy outcomes in women with polycystic ovary syndrome: a systematic review and meta-analysis. Am J Obstet Gynecol. 2025 Dec;233(6):530-547.e8. doi: 10.1016/j.ajog.2025.05.038. Epub 2025 Jun 3. PMID: 40473092.3. Løvvik TS, Carlsen SM, Salvesen Ø, et al. Use of Metformin to Treat Pregnant Women With Polycystic Ovary Syndrome (PregMet2): A Randomised, Double-Blind, Placebo-Controlled Trial. The Lancet. Diabetes & Endocrinology. 2019;7(4):256-266. doi:10.1016/S2213-8587(19)30002-6.4. Teede HJ, Tay CT, Laven J, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertility and Sterility. 2023;120(4):767-793. doi:10.1016/j.fertnstert.2023.07.025.

In this episode of the Female Athlete Nutrition Podcast, host Lindsey Elizabeth Cortes, a sports dietitian and lifelong athlete, delves into the complex world of sugar. Lindsey discusses the different types of sugars (glucose, fructose, galactose, and others) and explains the importance of carbohydrates for athletes. She differentiates between natural sugars, added sugars, and artificial sweeteners, emphasizing their roles and impacts on athletic performance.   The podcast also highlights the general dietary guidelines for sugar intake and how they apply differently to athletes. Lindsey shares practical examples, fun facts, and even personal anecdotes to help listeners understand and normalize sugar consumption, especially in the context of sports nutrition. This episode aims to empower female athletes to make informed choices about their nutrition to perform at their highest level.   Episode Highlights: 01:22 The Reality of Period Pain 03:00 Welcome to New and Returning Listeners 03:29 Diving into Sugar: Basics and Misconceptions 05:11 Fun Facts About Sugar 10:10 Understanding Different Types of Sugar 22:29 Natural vs. Added Sugars 27:30 Understanding Sugar in Fermented Foods 28:05 Addressing Relative Energy Deficiency in Sport (RED-S) 30:37 Exploring Sugar Substitutes and Artificial Sweeteners 33:51 The Impact of Sugar Alcohols on Health 40:35 Guidelines for Sugar Intake in Athletes 42:53 The Role of Simple Sugars in Athletic Performance 53:53 Concluding Thoughts on Sugar and Nutrition Resources and Links: For more information about the show, head to work with Lindsey on improving your nutrition, head to: http://www.lindseycortes.com/ Join REDS Recovery Membership: http://www.lindseycortes.com/reds WaveBye Supplements – Menstrual cycle support code LindseyCortes for 15% off: http://wavebye.co Previnex Supplements – Joint Health Plus, Muscle Health Plus, plant-based protein, probiotics, and more; code CORTES15 for 15% off: previnex.com Female Athlete Nutrition Podcast Archive & Search Tool – Search by sport, condition, or topic: lindseycortes.com/podcast Female Athlete Nutrition Community – YouTube, Instagram @‌femaleathletenutrition, and private Facebook group

Dr. Alison Loren and Dr. Ann Partridge share the latest guideline from ASCO on the management of cancer during pregnancy. They highlight the importance of this multidisciplinary, evidence-based guideline and overarching principles for the management of cancer during pregnancy. Drs. Loren and Partridge discuss key recommendations from each section of the guideline, including diagnostic evaluation, oncologic management, obstetrical management, and psychological and social support. They also touch on the importance of this guideline and accompanying tools for clinicians and how this serves as a framework for pregnant patients with cancer. The conversation wraps up with a discussion on the unanswered questions and how future evidence will inform guideline updates.  Read the full guideline, "Management of Cancer During Pregnancy: ASCO Guideline" at www.asco.org/survivorship-guidelines TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/survivorship-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-25-02115   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. Alison Loren from the Perelman School of Medicine of the University of Pennsylvania and Dr. Ann Partridge from Dana-Farber Cancer Institute, co-chairs on "Management of Cancer During Pregnancy: ASCO Guideline." Thank you for being here today, Dr. Loren and Dr. Partridge. Dr. Alison Loren: Thanks for having us. Dr. Ann Partridge: It's a pleasure. 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. Partridge and Dr. Loren 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 to dive into the meat of this guideline, to start us off, Dr. Loren, could you provide an overview of the scope and purpose of this new guideline on the optimal management of cancer during pregnancy? Dr. Alison Loren: Sure, thanks, Brittany. So this was really born out of I think a lot of passion and concern for this really vulnerable patient population. We have observed, and I am sure it is not any surprise to your audience, that the incidence of cancer in young people is increasing. And simultaneously, people are choosing to become pregnant at older ages, and so we are seeing more and more people with a cancer diagnosis during their pregnancy. And for probably obvious reasons, there is really no way to do randomized clinical trials in this population. And so really trying to assemble and articulate the best evidence for safely managing the diagnosis of cancer, the management of cancer once it is confirmed, being thoughtful about obviously the health of the mom, but also attending to potential risks to the developing fetus, and really just trying to be really comprehensive and balanced about all the choices for these patients when they are facing some really challenging decisions in a very emotionally fraught environment. And I think it is really emotionally fraught for the providers, too. You know, this is obviously an extremely intense, very emotional set of decisions, and so trying to provide a rudder essentially to sort of help people frame the questions and trying to make as evidence-based a set of recommendations as possible. Dr. Ann Partridge: And I would just add that "evidence-based" is a strong word here because typically our, as you just heard, our gold standard evidence is a randomized trial, but you can't do that in this setting, in general. And so, what we were able to do with the support of the phenomenal ASCO staff was to pull together kind of the world's literature on the safety and outcomes of treatments during pregnancy, as well as consensus opinion. And I think that is a really, really critical difference about this particular guideline compared to many of the other ones that ASCO does, where consensus and good judgment needed to kind of rule the day when evidence is not available. So, there is a lot of that in our recommendations. Dr. Alison Loren: That is such a good point. And I just, before we move forward, I just want to reflect that the composition of the panel was really broad and wide-ranging. We had maternal medicine specialists, we had legal and ethical experts, we had representatives who understand pharmaceutical industries' perspectives, and then medical oncologists representing the full spectrum of oncology diagnoses. And so it was a really diverse, in terms of expertise, panel, internationally composed to try to really get the best consensus that we could in the absence of gold standard evidence. Brittany Harvey: Absolutely. That multidisciplinary panel is really key to developing this guideline and, as you said, looking at the evidence and even though it does not reach the level of randomized trials, still critically evaluating it and reviewing that along with consensus to come up with optimal management for diagnosis and management of cancer during pregnancy. So then to follow that up, I would like to next review the key recommendations of the guideline across the main sections that the expert panel provided. First, I will throw this out to either of you, but what are the important general principles for the management of cancer during pregnancy? Dr. Ann Partridge: I think there were three major principles that we hammer home in the guidelines. One is that this is a team sport. It is multidisciplinary care that is necessary in order to optimize outcomes for the patient and potentially for the fetus. And that you really need to, from the beginning, bring in a coordinated team, including not just oncologists but obstetricians, maternal-fetal medicine specialists, neonatologists, ethics consultants, and obviously the patient and potentially her family. So that, I think, is one of the most important things. Second would be that obviously in a pregnancy, there are two potential patients and that the nuances of safety and risk from treatment is really wrapped up in where in the trimester of the pregnancy the patient is diagnosed, along with the kind of cancer that it is, both the urgency of treatment and the risk of the cancer, as well as the potential risks of any given intervention across the cancer continuum. It is a broad guideline in that regard. And then finally, and this is particularly timely given what is going on from a sociopolitical standpoint in the U.S., really thinking about informed consent and potential ethical as well as legal implications of some of the choices that patients might have when they are thinking about, in particular, continuing a pregnancy or potential termination. Dr. Alison Loren: And I will just add that I think that the key to all of this guidance is nuance and individualization and also making sure that patients and their care providers understand all the choices that are available to them and also the consequences of those choices. You know, nobody would choose to receive chemotherapy during pregnancy if that wasn't necessary. So there are risks to treatment, but there are also risks to not treatment. And making sure that in a suboptimal situation where you do not have a lot of evidence, trying to weigh, the best you can, the risks and benefits of all of the choices so that the patient can come to a decision about the treatment plan that is right for her. Brittany Harvey: Definitely. And those core concepts really set the stage for individualized care on what is necessary for appropriate multidisciplinary care, prioritizing both patient autonomy and informed decision making. With those core concepts and key principles in mind, I would like to move into the recommendations section of the guideline. So what are the key recommendations regarding diagnostic evaluation for pregnant patients with signs or symptoms of cancer? Dr. Alison Loren: I think the most important thing is to not delay, that there are very careful and well-thought-out recommendations for how to evaluate a potential cancer. And while there are certain things that we know can be harmful, particularly when certain dose thresholds are exceeded - for instance, abdominal imaging, there are certain radiographic thresholds that you don't want to exceed because of risk of harm to the embryo or fetus - there are still lots of options for diagnosing cancer during pregnancy. And again, thinking about the costs of not doing versus the cost of doing, right? It is really important to make the diagnosis of cancer if that is a consideration or a concern. And sometimes going directly to biopsies or getting definitive studies, even if there is a small risk to the developing fetus, is really essential because if the mom does not survive, of course, the fetus is also not going to survive. And so we need to be thinking first about the patient who is sitting in front of us, the woman who needs to know what is going on in her body so she can make good decisions about her health. So, I think that is a key principle in thinking about this. Brittany Harvey: Absolutely. So, following that diagnosis of a new or recurrent cancer, what is recommended for oncologic management of patients who are diagnosed with cancer during their pregnancy? Dr. Ann Partridge: So, I think the general principle is, again, cancer is such a wide number of diseases and even within diseases, a range of stages and risks and associated opportunities for risk reduction and/or treatment depending on the type of cancer. Just by example, in the work that I do, which is breast cancer, once someone has had a surgery in the early-stage setting, a lot of our treatment is about risk reduction. And that is very different than from what Alison does, which is treating people with leukemia, where it is kind of binary. If you do not treat, including with cytotoxic drugs, the patient and an unborn fetus will die, especially early in the pregnancy, obviously. So this is where cancers are very, very different. So I think taking the approach of what would you do if the patient were not pregnant? And what is the best treatment for that particular patient with that particular kind of cancer? And then applying the pregnancy and where the patient is in that pregnancy in terms of the trimester of the pregnancy, and what is safe and what is unsafe from the options that you would give her if she were not pregnant. And then if the patient is choosing to keep the pregnancy, which in my practice, many people come and they come to me because they want to hold onto their pregnancy and want to figure out how to make it work, coming up with a regimen that tries to give them kind of the best bang for the buck, the best possible breast cancer therapy with the least harm, when possible, to the fetus. It is a bit of a balance, right? And then we cannot always give people the best approach. And sometimes it comes down to making a decision to give up something that may improve their survival so as not to harm the fetus. And sometimes it goes the opposite direction where a patient will say, "Oh, that is going to improve my survival by 5% and you can't give it to me now? I am going to choose to terminate." Even though that is obviously a very, very difficult and challenging decision to make in this setting because they want to optimize their survival and ideally live on to potentially have another pregnancy in the future if that is something that is of interest to her. So these are really, really hard conversations as you can imagine, but that is kind of where we go. Dr. Alison Loren: Yeah, and I think this is where the need for more research and understanding is really key because sometimes questions come up. I guess I am thinking about like HER2-directed agents, which we know are contraindicated in pregnancy. But what about sequencing? Does it matter when you get it? Can you get it later? I think that is something that we don't really fully understand. And similarly, again, this is obviously like a breast cancer and blood cancer focused discussion because that is what we do, but thinking about managing blood cancers, certainly with acute lymphoblastic leukemia, there is actually a lot of options now that, you know, you could potentially use to temporize or sort of get somebody through a pregnancy relatively safely. I am focusing on the word "relatively" because we do not know what the long-term impact might be of potentially not optimal therapy in the long run. And then thinking about other things like timing of a bone marrow transplant relative to either delivery or termination. I mean, again, we really do not know what are the right sets of sort of timing considerations for those. So there are just a lot of unknowns. And I think trying to be sort of self-aware and humble and honest about those unknowns so that the patient can engage in the conversation in a way that is meaningful to her and make the decisions that make the most sense for her. I think the most important thing is to make sure that the patient feels supported and safe to make those decisions with as little regret as possible. Brittany Harvey: Yes, I think it is really important that you mentioned that there is a wide range of cancers here, and that means that care really needs to be individualized for each patient. I will also note, just in this section, that I found really informative while reading through the guideline the list of oncologic agents that may be offered in each individual trimester, whether it is contraindicated or it can be used with caution, or if there is relatively good safety data on it for prioritizing maternal treatment needs and balancing fetal safety at the same time. I think that is, that is really key. And I think readers will really like that section of the guideline to provide concrete information for them and their patients. Dr. Alison Loren: Thank you. We actually spent a lot of time on that table and just thinking about what it should look like, what the format ought to be, what the language ought to be. Because of course, at the end of the day, everything should be used with caution. So what does that actually mean? And we sort of tried to explicate that a little bit in like the footnotes. We really tried to leverage what we know from clinical experience, from package labels, from mechanism of action to try to be as clear and definitive as we could be without overstating or understating what we know. Dr. Ann Partridge: Yeah, and I think we are focusing on breast and leukemia because that is what we do. But the truth is much of the data comes from those two areas. Leukemia, not because it is so common, but because you do not really have choices to treat or not treat. And so for decades, they have been treating and saying, "We hope the progeny comes out okay." And for many agents it does. The babies are okay. And so, we have reasonable observational data. And then in breast cancer, there have been actually some prospective registry-type studies where people have been followed and treated when pregnant, and the progeny have been accounted for, and so we have some good experience in that way too. Again, not randomized trials, but at least data that suggests certain agents are safe. And increasingly, because of that, when we have had to treat patients, we have said, "Okay, let us do it on this registry so that we can at least learn from every patient that comes in in this situation." And so, I think we will have more and more data given the growing number of young adults with cancer and the delays in childbearing that are happening around the world, and particularly in Westernized countries. I wish we did not. We wish we did not see this problem, but of course, when we do, we have to make sure that we learn from it and try and get patients enrolled in these registries and any kinds of studies that are available. Dr. Alison Loren: Yeah, I will just underscore that to say that, you know, there is outcomes of pregnancy and then there is outcomes of pregnancy, right? So there is like, "Okay, the baby was born with 10 fingers and 10 toes, and they passed their Apgar, and they are doing all their developmental processes along the way." But what happens when they are 10 or 15 or 20? Are they maturing normally? Are they cognitively intact? And then, of course, it is really inseparable from what is the impact on a family of having the mom with cancer? And how does that impact childhood development and intellectual development? And so these are really, really important questions that are very difficult to answer given the longitudinal information that you need, but it is a really critical question that, you know, patients ask and we do not know the answer. Dr. Ann Partridge: Yeah, that actually leads me to one of the important principles in the guideline that is a little bit of a change from when I first started practicing, which is we have learned from the wider neonatology literature, as they have followed up on the children that were born prematurely, that it is actually better not to be premature and to keep the baby in utero as long as it is safe for the fetus and the mother as long as possible, ideally to term rather than delivering early and then giving the chemo after that or separating the chemo from before and after. We used to try and deliver early and then give agents, but now we typically will give agents that are safe to be given at the end of pregnancy, ideally close to term, a couple weeks out, to allow for the ability of count recovery, and you do not want to go into preterm labor with chemotherapy on board, but we used to go much earlier and have an argument with our maternal-fetal medicine doctors. "How early can you get them out?" And they would say, "How long can they stay in?" And increasingly, we have been able to try and compromise to go even later and allow the fetus to go to term because of the neonatal outcomes that in longer term there is a suggestion that the children are developing better in the long run if they are kept in utero for as long as possible. Dr. Alison Loren: Yeah, that is such a great point. I think that is probably the most important thing for people to take away. For anyone who sort of does this, I mean, no one does this regularly because it is a rare event, although I think it is increasing as I mentioned. But this idea that the third trimester is, most of us know, is primarily a time for growth. Most of the critical development has already occurred, and so administering most chemotherapy agents towards the end of the third trimester seems to be preferable long term than delivering them early. So that is a really big change. I think we used to try to sort of, "Oh, get them to 30 or 32 weeks and then deliver," but we really are trying to get them closer to term, 37 weeks or more, and then coordinating the treatment so that they are not nadiring, as Ann said, at the time of planned delivery. Brittany Harvey: Yes, and that is a really important point related to evidence-based care and why we have changed that practice. And so then that actually leads nicely into my next question. But as you both mentioned, this is an important collaboration between oncologists and obstetricians. So the next section of the guideline addresses obstetrical practice. And so beyond what is standard, what additional recommendations are there in obstetrical management for pregnant patients with cancer? Dr. Alison Loren: That is a great question. So I will say we were really struggling with like how much do we cover? Like this is an oncology guideline. We are not obstetricians. We certainly had great representation from our maternal-fetal medicine colleagues on the panel. But really trying to sort of give useful information without overstepping. And so I think that the main recommendations are to increase the frequency of fetal monitoring, make sure that there is close attention to blood counts in the patient. But I think there is really still a gap in terms of what we know about optimal management of a pregnant person who is receiving therapy and how to handle the pregnancy itself. The delivery should be a usual delivery. Our colleagues did not recommend a planned C-section. They recommended usual care in terms of planning for the delivery. Obviously, if a C-section is indicated, then it should be done, but it should not be planned this way because of the cancer diagnosis. And I guess the other thing that we mentioned in the guideline, although we were reluctant to push it too hard because of access to these specialized services, was evaluating the placenta after birth to ensure that there were no metastases in the placenta itself. Dr. Ann Partridge: Those are the main things, and judicious and prudent obstetrical care, as I think, you know, is trying to be practiced regularly with MFM. Typically these patients should be followed not by your average OB/GYN, but a maternal-fetal medicine specialist because these patients will have special concerns, especially if they are sick. So oftentimes, especially Alison's patients, are actually sick with leukemia. And so you are monitoring them a lot, whereas, you know, a breast cancer patient typically isn't sick, although they could get sick with their chemotherapy. And so we really want to hand-in-hand manage these patients with our MFM colleagues. Dr. Alison Loren: I think we also highlighted in the guideline just for the refresher purposes of the oncology community, generally which drugs that would be given in a normal oncology setting are safe to be given to a pregnant person. So we talked a little bit about what kinds of steroids are recommended, antiemetics, DVT prophylaxis, peripartum. These are things that we think about a lot in oncology, but just want to make sure that it sort of intersected appropriately with the care of a pregnant patient. Brittany Harvey: Definitely. That specialized care is really important for patients who are pregnant and have cancer. And then the last section of the recommendations addresses psychological and social support. As you both mentioned before, this is a highly emotional time and it can be difficult and challenging to make decisions. So what is recommended for the psychological and social support of pregnant patients with cancer? Dr. Ann Partridge: Well, as I said, it is really something that needs to be considered at the beginning, through the diagnostic period, all the way into survivorship. Ironically, even though it is a highly fraught, emotional situation, I find that my pregnant patients actually are extraordinarily resilient, and what they are really focused on often is the safety of the fetus, because again, many of the people that come to me, it is a highly wanted pregnancy. They are also focused on their own health, of course, and often you need to bring in social work, sometimes a psychologist, professionals who are there just to help manage their emotions while we are focusing on what do they need medically to be as healthy as possible, both for the again, the mother, the patient, and the fetus. It is very tricky, and I will say also bringing in sometimes people on the ethics team in the hospital to help, both from the "Are you recommending and giving something that is safe?" That is number one. And then number two, sometimes patients want to be treated with drugs that we do not have any safety data for in pregnancy. What are our obligations? I think most of us would say we would not treat someone if we do not have safety data and there is suspicion for concern. But where is that line in terms of the right thing to do by that patient? And so we are all beholden to our ethics colleagues to help us when we make decisions like that. You know, we all want to do right by the patient, but we have to uphold our oaths and legal obligations. I don't know if you have to add on that because it's very tricky. Dr. Alison Loren: It is, it is very hard. I mean, I think, you know, there is a lot of emotion, obviously any cancer diagnosis is extremely charged and people are already at sort of a heightened, you know, they are anticipating a new baby and planning around that. And so it is just an extremely disruptive is the smallest word I can think of to describe it. And I think that often there is a co-parent, there might be parents and in-laws and other siblings, and then there is care after delivery. And so it is just a very complex set of dynamics. And having both our ethics colleagues and our psychology and social work colleagues to sort of just pitch in and make sure that the patient is being supported. I think there are sometimes really difficult situations where maybe what the patient wants is different from what the father of the baby wants or what the rest of the family wants. And so that can be really challenging. And you never really know where those landmines are going to pop up. So it is good to have the team on board early and often. Dr. Ann Partridge: Yeah, I would add to that, the other thing here that I think is really important, like in all of medicine but especially in situations like this, this is where we have to be very careful as professionals not to impose our own ethical, moral, emotional, personal views on the patient and to try to reserve judgment as much as possible. We are their navigator with the most important evidence and information that we can provide in the current situation. And that is where this guideline is extraordinarily helpful, we hope, for clinicians in the years to come. And at the same time, we cannot necessarily impose our own views and what we would do on a patient or what we tell our daughters, sisters, friends, family members. It is very tricky in that way. And so sometimes not just support for the patient, but support for the care team may be warranted in some of these very fraught situations. Dr. Alison Loren: Yeah, that is such a great point. And I was sort of thinking that too. I mean, it is, of course, the patient is front and center, but these are really difficult situations to navigate. And I will just add also that a lot of times these patients end up in academic centers, which I think is that's where the expertise or even just the experience may be. But the downside of that is that, you know, the teams are constantly changing. You have a new resident, you have a new intern, you have a new attending, a new fellow. And so, you know, the patients may be subjected to lots of different ways of communicating and sometimes those perceived differences can be really challenging. So sort of team huddles to sort of make sure that everybody is reading from the same script and everyone is comfortable with how the information is being presented so that the patient does not feel more confused or more overwhelmed, that they are kind of getting a consistent message from the whole team that, "This is what we know, this is what we are recommending, here are your other choices, and here are the pros and cons of each of these options." Brittany Harvey: Yes, I think you have both touched on this and that bringing in appropriate experts to support both clinicians and patients and their decision-making and their mental health is really important for this section of the guideline. We have already discussed this a fair bit throughout our conversation, but in your view, what is the importance of this guideline and how will it impact both clinicians and pregnant patients diagnosed with cancer? Dr. Ann Partridge: I could start with that. We just talked about experts and having them all around, but the fact is most people do not have the experts all around when they are dealing with this. And I think this is, you know, an expert-based, evidence-based guideline where having this in one's back pocket, whether you are in rural Montana or at a major cancer center on either coast, you will be armed with the latest and the greatest in terms of what we know and what we do not know, and some very helpful algorithms for how to think through the process of dealing with a patient who is diagnosed during pregnancy, whichever type of cancer it is. We could not cover every single specific thing about every cancer, although it is a pretty long guideline and there is a lot of nuance in there. So you might find a lot about specific cancers. And I think that that will be very, very helpful for people who are faced with this situation in the clinics just to frame it out, think through. Sometimes there is no answer that is the perfect answer and then, you know, using this as kind of a scaffolding and phoning a friend who may have more experience to help guide you and guide the patient, most importantly. I think it will be very helpful in that regard. Dr. Alison Loren: Yeah, I think so too. And I have talked about that we are working on this guideline and the anecdotal feedback has been, "This is so helpful." Like there really has not been, I think, an all-in-one place, diagnostic considerations, radiographic considerations, staging, treatment, all the modalities, surgical, radiation, systemic chemotherapy. We tried to include, when we could, novel agents including targeted agents and monoclonal antibodies and bispecifics and cellular immunotherapies and non-cellular immunotherapies. We really, really tried to cover in 2025 what are people using to treat cancer and to try to give the most balanced view of what we think is is safe or reasonably safe and what we think is either unproven or known to be risky, really to have it be kind of a go-to, like all-in-one, as much information as we have about these really challenging cases. We tried to include, Ann mentioned, you know, specific cancers, and I think when there were specific things to shout out with specific cancers, we really tried to highlight that. Like, "Okay, lots of young patients with cancer have Hodgkin's lymphoma, so what is safe and what is not for that specific case?" Or, "What is safe or what is not when you are thinking about colon cancers?" And we have a shout-out in here about considering checking for DPD deficiencies in patients who are pregnant. And I know it is generally recommended nowadays, but certainly for people who are pregnant, you know, you really want to avoid excess toxicity. So I think just really trying to be attentive to specifics about certain cancers in young patients and what would be valuable for a practicing oncologist and obstetrician to know when you are faced with this situation. Dr. Ann Partridge: Yeah, and I think the other critical thing that is great about this guideline is it's a starting place. And I anticipate that we will be building on this guideline for many years to come. And remember that when first, I was not around then, but probably three or four decades ago, when chemotherapy was just coming out and patients were coming in pregnant, there was a feeling I am sure that was, "We cannot give this to this person because it is purposefully going to destroy cells. And when you destroy cells in a growing fetus, you are going to destroy or harm that fetus." And yet, people did not have great choices. It was get treated or die, especially with things like leukemia early on. And bold patients along with their oncologist said, "Bring it on." And that is how some of this literature has been born. And so moving forward, there will be either purposeful exposures or inadvertent exposures of some of our therapies where we will learn ultimately. And this is a place where we can update these guidelines. That is the beautiful thing about the ASCO guidelines is that they are constantly being thought about to be updated. And then when there is enough of a change in practice, they will be updated such that they will continue to inform how we do this in the years to come for patients who come in pregnant. Dr. Allison Loren: Yeah, and I will say I have been doing this long enough now, we were just talking about a different guideline, the fertility guideline earlier today, and over the 20 years that the fertility guidelines have been out, just the amount of research has really skyrocketed. And you can see as you look at each guideline how much we have learned, what we can say, "Yes, this is working," "No, this is not working." Like, it is stuff that we used to say, "Oh, we do not really know," and now we have answers.  I think I speak for both of us when I say that we are hopeful that this will serve as, as Ann said, as a starting off point and really inspire people to ask the questions and do the research so that we can give better guidance moving forward, really trying to think about, you know, mechanisms and leaning on our colleagues in pharma and in the government who sort of think about safety and efficacy, to sort of make sure that they are contemplating not just non-pregnant patients, but also pregnant patients or as they are thinking about marking the package inserts with safety guidelines around this. Brittany Harvey: Yes, this is a critically important first guideline on the management of cancer during pregnancy, and we will look forward to continuing to build on that. I think as you mentioned, this guideline is far-reaching and has a lot of recommendations in it. And so both the full text of the guideline and those at-a-glance algorithms, figures, and tables will be really useful for clinicians in their clinic. Finally, to wrap us up, we have just been discussing this a little bit, but specifically, what are the outstanding questions on the management of pregnant patients with cancer, and where is this further research needed? Dr. Alison Loren: There are lots and lots and lots of unanswered questions. And I think if you look at the table, most of what we say is, "We are pretty sure this is okay, we are not so sure about this." I am paraphrasing, but we really just are operating in a paucity of what we would normally consider gold-standard evidence. It is hard to imagine, of course, there would ever be, as we mentioned in the beginning, randomized trials. But I think that preclinical data, mechanistic data, trying to think about including as we go through animal data, making sure that we are looking at female animals and pregnant animals so that we can sort of fully understand what the impact may be. And then I think thinking about more localized therapies around sort of radiation, you know, we are now moving into really hyper-focused radiation treatments like protons. Is that better because there is less scatter? Like I think those are real considerations that we just do not know the answer to. What do you think? Dr. Ann Partridge: I think so many unanswered questions, and this is a call to action to continue to and increase the documentation of the experiences and outcomes for patients diagnosed during pregnancy. Dr. Alison Loren: Yeah, and I think the long-term outcomes too are really going to be critical. Brittany Harvey: Yes, we will look forward to learning about more evidence across the spectrum of care to inform future updates to this guideline. So I want to thank you both so much for your work to develop this guideline, to review the extensive amounts of literature that you did, and work to create this guideline. And thank you also for your time today, Dr. Loren and Dr. Partridge. Dr. Alison Loren: Thanks. It was fun. Dr. Ann Partridge: Yeah, thank you. Brittany Harvey: And finally, thank you to all of our listeners for tuning into the ASCO Guidelines Podcast. To read the full guideline, go to www.asco.org/survivorship-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is 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. 

Stephen Grootes speaks to Senior Legal Counsel at the Competition Commission and co-author of the draft guidelines, Simphiwe Gumede, about the the draft minority shareholder protections and their implications for merger control. The Money Show is a podcast hosted by well-known journalist and radio presenter, Stephen Grootes. He explores the latest economic trends, business developments, investment opportunities, and personal finance strategies. Each episode features engaging conversations with top newsmakers, industry experts, financial advisors, entrepreneurs, and politicians, offering you thought-provoking insights to navigate the ever-changing financial landscape.    Thank you for listening to a podcast from The Money Show Listen live Primedia+ weekdays from 18:00 and 20:00 (SA Time) to The Money Show with Stephen Grootes broadcast on 702 https://buff.ly/gk3y0Kj and CapeTalk https://buff.ly/NnFM3Nk For more from the show, go to https://buff.ly/7QpH0jY or find all the catch-up podcasts here https://buff.ly/PlhvUVe Subscribe to The Money Show Daily Newsletter and the Weekly Business Wrap here https://buff.ly/v5mfetc The Money Show is brought to you by Absa     Follow us on social media   702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/CapeTalk 702 on YouTube: https://www.youtube.com/@radio702   CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/Radio702 CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567 See omnystudio.com/listener for privacy information.

Is now the time to refinance your mortgage? Only if you meet certain criteria. Clark breaks it down.  Also - Are you with what Clark calls a Giant Monster Mega Bank? If so, you may be paying fees you don't have to! Clark's overview of the banking industry makes it clear, the regional, super regional and giant banks are not your wallet's friend. Hear how people are migrating their money in a way that's comfortable for them - a method called “soft switching”.  Mortgage Refi Guidelines: Segment 1 Ask Clark: Segment 2 Banish Bank Fees: Segment 3 Ask Clark: Segment 4 Mentioned on the show: How and When To Refinance Your Mortgage: A Step-By-Step Guide Mortgage Refinance Calculator - With Cash Out and Points What Can I Safely Use for Peer-to-Peer Payments? How To Freeze and Unfreeze Your Credit With Experian, Equifax and TransUnion How To Switch Banks in 4 Simple Steps Best Online Banks: Free Checking and High-Interest Savings Accounts Best Cash Management Account: Comparing Vanguard, Fidelity, and Schwab Costco Travel: 5 Things To Know Before You Book When Do You Need a Travel Agent? Clark's Christmas Kids Clark.com resources: Episode transcripts Community.Clark.com  /  Ask Clark Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices

Join us for our next webinar: Focus on Guidelines. Panelists will discuss their approaches to a range of difficult cases in multiple areas, including rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis and vasculitis, and discuss how they apply the guidelines in everyday practice. You'll hear different perspectives and practical tips you can use in clinic. Panelists: Audrey Gibson, PA-C Benjamin A. Smith, PA-C Jack Cush, MD Following the discussion, join a live Q & A with the panelists. Register now to reserve your spot!  This is our second Tuesday Night Rheumatology this month as part of our Mission: APP Partners in Care campaign

This episode dives into the complexities of postpartum running, emphasizing the importance of understanding recovery, the phased return to running, and the mental health aspects of postpartum life. The hosts discuss the evolution of exercise guidelines during and after pregnancy, the significance of individualized recovery plans, and the physiological advantages that can be leveraged postpartum. They also highlight the importance of mental health and identity shifts that occur during this period, encouraging listeners to be patient and kind to themselves as they navigate their postpartum journey.

This week, how the newly established Minnesota Sustainable Foraging Task Force is making decisions about state-wide foraging rules, plus a conversation with Mille Lacs Band of Ojibwe representatives about the newly named Grand Casino Arena in St. Paul.----- Producers: Xan Holston & Travis Zimmerman Editing: Britt AamodtEditorial support: Emily Krumberger Anchor: Marie Rock Mixing & mastering: Chris Harwood----- For the latest episode drops and updates, follow us on social media. instagram.com/ampersradio/instagram.com/mnnativenews/ Never miss a beat. Sign up for our email list to receive news, updates and content releases from AMPERS. ampers.org/about-ampers/staytuned/ This show is made possible by community support. Due to cuts in federal funding, the community radio you love is at risk. Your support is needed now more than ever. Donate now to power the community programs you love: ampers.org/fund

Please visit answersincme.com/RTS860 to participate, download slides and supporting materials, complete the post test, and get a certificate. In this activity, a pediatrician and a pediatric dermatologist discuss strategies for optimizing biologic treatment for moderate to severe atopic dermatitis (AD). Upon completion of this activity, participants should be better able to: Recognize when treatment escalation to systemic therapy is warranted in pediatric patients with atopic dermatitis (AD); Select the optimal biologic for a given pediatric patient with moderate to severe AD; and Outline strategies to optimize biologic treatment in pediatric patients with moderate to severe AD. This activity is intended for US healthcare professionals only.

Please visit answersincme.com/RTS860 to participate, download slides and supporting materials, complete the post test, and get a certificate. In this activity, a pediatrician and a pediatric dermatologist discuss strategies for optimizing biologic treatment for moderate to severe atopic dermatitis (AD). Upon completion of this activity, participants should be better able to: Recognize when treatment escalation to systemic therapy is warranted in pediatric patients with atopic dermatitis (AD); Select the optimal biologic for a given pediatric patient with moderate to severe AD; and Outline strategies to optimize biologic treatment in pediatric patients with moderate to severe AD. This activity is intended for US healthcare professionals only.

Please visit answersincme.com/RTS860 to participate, download slides and supporting materials, complete the post test, and get a certificate. In this activity, a pediatrician and a pediatric dermatologist discuss strategies for optimizing biologic treatment for moderate to severe atopic dermatitis (AD). Upon completion of this activity, participants should be better able to: Recognize when treatment escalation to systemic therapy is warranted in pediatric patients with atopic dermatitis (AD); Select the optimal biologic for a given pediatric patient with moderate to severe AD; and Outline strategies to optimize biologic treatment in pediatric patients with moderate to severe AD. This activity is intended for US healthcare professionals only.

This EAUN edition of EAU Podcasts presents the latest update of the intravesical instillation guidelines, featuring insights from experts Bente Thoft Jensen RN, PhD, Susanne Vahr Lauridsen RN, PhD, and Lisbeth Leinum RN, PhD.They discuss the key recommendations and changes since the previous version, as well as the impact on clinical practice, and how nurses and patients benefit from the guidelines. They also outline the evidence-based development process of the guidelines and highlight the focus on nurse and patient safety, education, risk stratification and management of complications. The speakers emphasise growing evidence on managing side effects and the increasing attention to patient perspectives and quality of life.A key message is the importance of improving patient adherence and ensuring nurses understand the differences between BCG and Mitomycin to maintain safety.-----Host: Lisbeth Leinum, EAUN board memberSpeakers: Bente Thoft Jensen, RN, senior researcher, chair of the Bladder Cancer SIG and the guideline panel; Susanne Vahr Lauridsen, RN, senior researcher, member of the guidelines panel.-----For more EAU podcasts, please go to your favourite podcast app and subscribe to our podcast channel for regular updates: Apple Podcasts, Spotify, EAU YouTube channel.

Neste vídeo, iniciamos a análise do Guideline Europeu sobre Menopausa, trazendo os pontos essenciais da primeira parte do documento. Atualize-se sobre as definições, diagnóstico e as abordagens iniciais recomendadas para o manejo do climatério.Endocrinologia descomplicada para médicos e residentes. Aqui você encontra conteúdos sobre atualização médica, casos clínicos e preparação para provas de título.

Please visit answersincme.com/RTS860 to participate, download slides and supporting materials, complete the post test, and get a certificate. In this activity, a pediatrician and a pediatric dermatologist discuss strategies for optimizing biologic treatment for moderate to severe atopic dermatitis (AD). Upon completion of this activity, participants should be better able to: Recognize when treatment escalation to systemic therapy is warranted in pediatric patients with atopic dermatitis (AD); Select the optimal biologic for a given pediatric patient with moderate to severe AD; and Outline strategies to optimize biologic treatment in pediatric patients with moderate to severe AD. This activity is intended for US healthcare professionals only.

Today we're kicking off another segment in our Guidelines Series, and doing a deep dive into the 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Over a series of episodes we'll talk about the most recent updates … Continue reading →

Send us a textThe hardest part of digital parenting isn't picking the right app or filter—it's building a home where conversation is constant and boundaries make sense. We walk through the simple guardrails that protected our kids and explain how relationship-first parenting can coexist with firm, clear rules that kids actually respect.Support the showKEEPING KIDS SAFE ONLINEConnect with us...www.nextTalk.orgFacebookInstagramContact Us...admin@nextTalk.orgP.O. BOX 160111 San Antonio, TX 78280

Aortic Regurgitation: Beyond the Valve   Guest: Vidhu Anand, M.B.B.S. Host: Kyle Klarich, M.D.   In this episode of Mayo Clinic's “Interviews With the Experts,” Dr. Klarich and Dr. Anand discuss evolving approaches to assessing left ventricular remodeling in chronic aortic regurgitation. Dr. Vidhu Anand discusses research showing that LV volumes, global longitudinal strain, and myocardial fibrosis can detect dysfunction earlier than traditional guideline thresholds. Listeners can expect to better understand the role of multimodality imaging, extra valvular involvement, and practical steps echocardiographers can take to optimize AR assessment.    Topics Discussed: What imaging markers help detect early myocardial dysfunction in AR, and how do they assist in risk stratification? Guidelines traditionally focus on LV dimensions and ejection fraction for surgical decision-making in AR. Is there any data that guidelines may not be capturing patients at the optimal time? Is there a role of multimodality imaging in AR? What practical steps can a sonographer or echocardiographer today to bring their AR assessment closer to what your research suggests is optimal?     Please reference Dr. Anand's research article(s) here: https://pubmed.ncbi.nlm.nih.gov/39545891/ https://pubmed.ncbi.nlm.nih.gov/33253815/ https://pubmed.ncbi.nlm.nih.gov/39218370/   Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.

Cllr Ian Doyle explains to PJ that without guidelines from the Guards, GDPR says the council cannot use their CCTV to catch criminals. Hosted on Acast. See acast.com/privacy for more information.

Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children's Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness.Learning Objectives:By the end of this podcast, listeners should be able to:Recognize the impact of nutritional status on outcomes of critically-ill children.Describe the key aspects of the metabolic stress response in critical illness.Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.Reflect on an expert's approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence. Selected references:Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844. Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

In this timely and eye-opening interview, host Mark Alyn sits down with Kevin Busque, Head of Gusto 401(k) powered by Guideline, to break down what California small-business owners urgently need to know about the state's retirement savings mandate—and why waiting could be a costly mistake. With the December 31, 2025 compliance deadline rapidly approaching, California employers with as few as one W-2 employee are legally required to offer a retirement savings option. Business owners must either enroll employees in the state-run CalSavers IRA program or implement a qualified private retirement plan, such as a 401(k). Yet, according to recent research shared in the interview, nearly 75% of small-business owners are unaware of CalSavers, and 65% don't realize they could face fines of up to $750 per employee for missing deadlines. Kevin clearly explains the penalty structure, which begins with $250 per eligible employee after 90 days of noncompliance and escalates to an additional $500 per employee after 180 days. But this conversation goes far beyond warnings—it's about smart, strategic action. Kevin outlines how today's modern 401(k) plans are far more affordable, flexible, and tax-advantaged than many business owners realize. With new federal tax credits and simplified administration, retirement plans are no longer just for big corporations. Mark and Kevin also explore how offering a quality retirement benefit can do more than satisfy a mandate—it can boost recruitment, strengthen employee loyalty, enhance your employer brand, and align with long-term business growth. Kevin's entrepreneurial background and leadership at Guideline and Gusto add practical insight into how small companies can implement powerful benefits without overwhelming cost or complexity. This interview is a must-watch for any California business owner who wants to avoid penalties, stay compliant, and turn a regulatory requirement into a competitive advantage. #CaliforniaBusiness #SmallBusinessOwners #RetirementPlanning #CalSavers #401kPlans #EmployeeBenefits #BusinessCompliance #MarkAlyn #Gusto401k #GuidelineRetirement #Entrepreneurship #HRCompliance #WorkplaceBenefitsBecome a supporter of this podcast: https://www.spreaker.com/podcast/late-night-health-radio--2804369/support.

It's The Ranch It Up Radio Show! Join Jeff Tigger Erhardt, Rebecca Wanner AKA BEC and their crew as they hear how feeding Farmatan to bred cows now can help prevent scours this upcoming calving season.  Plus news, markets, updates, bred cow prices and lots more on this all-new episode of The Ranch It Up Radio Show.  Be sure to subscribe on your favorite podcasting app or on the Ranch It Up Radio Show YouTube Channel. How To Prevent Calf Scours: Feed Farmatan   Feed Farmatan To Prevent Scours This Upcoming Calving Season Calving season is getting ready to start for many producers and for some others it is still a ways away yet.  Regardless, we need to get a jump on scours and make sure each and every calf that hits the ground has the best chance of survival.  A simple solution… FARMATAN from Imogene Ingredients.   WHAT CAUSES SCOURS IN BEEF CATTLE/CALVES Clostridia-Enterotoxemia The most common form of Clostridium in cattle is caused by Clostridia perfringens. The gram-positive bacteria are a challenge due to its ability to form spores and lay dormant for long-periods of time. The bacteria reproduce by releasing spores into its environment (soil, feed, manure). The spores can even lay dormant in the animal's intestine until opportunity presents itself. Infection takes place either through ingestion of spores or through an open wound. The most severe cases happen within the first month of a calf's life, and can result in sudden death. Clinical Signs Diarrhea - Bloody, Mucus Present, Bubbly Dehydrated Bloat Blindness Prevention/Treatment: Prevention can be difficult due to the Clostridia spores being extremely durable and present almost everywhere. Complete cleanout and disinfection between calves is helpful, but not always effective. A good vaccination program will reduce clinical disease. The best method is to develop good gut health and the immune system of the calf. Farmatan has been shown to strengthen the intestinal wall, helping to prevent infection from taking hold. Coccidiosis Cattle are host to numerous species of Coccidia, a single-celled protozoal parasite. Infection and clinical symptoms can happen any time during a calf's life, with the most severe reaction usually occurring between 3-6 weeks of age. The life-cycle of coccidia requires time to infect the intestine causing destruction of the mucosal and epithelial lining. The oocytes mature outside the host in warm, moist environments before being consumed, causing infection of a new host. Clinical Signs Diarrhea - Watery, Bloody Depression Weight Loss Prevention/Treatment: Prevention of Coccidiosis is possible by keeping young calves separate from older animals, providing clean water and feed, and dry conditions. Isolation of infected animals is key to preventing transmission. Keeping the pen dry is the most important step a farmer/rancher can take in preventing Coccidiosis. Treatment can have a good impact on reducing secondary disease, and speeding up recovery time. Farmatan has been shown to disrupt the reproductive cycle of Coccidia; and may help strengthen the intestinal wall to prevent infection, in both the cow and calf. Coronavirus Bovine Coronavirus is a ubiquitous, envelope-viral disease, causing respiratory and enteric infection. There are many serotypes for this virus, making it difficult to test for, and create a vaccine. Coronavirus can present as either diarrhea and/or respiratory illness; transmitted through nasal discharge and/or feces. Animal reservoirs continue to spread the disease, and make eradication almost impossible. Clinical disease will likely occur between days 10-14, and present for up to 4 days. Clinical Signs Diarrhea - Watery Nasal Discharge Coughing Prevention/Treatment: Prevention is difficult due to wild animals transmitting the disease. Keeping wild animals out of animal enclosures is essential. Isolation of infected animals is critical to preventing the spread of Coronavirus. Adequate colostrum intake, along with a good vaccination program will help prevent clinical disease. Learn more about the positive effects of Farmtan's active ingredient on Coronavirus HERE. Cryptosporidium Cryptosporidium Parvum is a single-celled parasite responsible for causing infection in young calves. The infection takes place within the first four weeks of a calves' life, afterwards immunity has developed within the calf. The parasite is either passed from the cow or spread through infected water sources. Clinical Signs Diarrhea - Watery, Bloody, Mucus present Colic Depression Prevention/Treatment: Good sanitary conditions, especially clean water is essential in preventing transmission of cryptosporidium. Isolation of sick calves will help reduce the effect on the overall herd. There is some good effect of calves given adequate colostrum, however this is likely helping by reducing other pathogenic loads rather than a direct effect on Cryptosporidium, itself. Farmatan fed prior to calving has been shown to disrupt the life-cycle and reduce transmission from the cow. The direct action of Farmatan on the parasite makes it an excellent choice for treating calves. Learn more about the positive effect of Farmatan's active ingredient HERE. E-Coli Escherichia Coli is a bacterial infection that affects calves within the first week of their life. The bacteria colonize in the lower intestine and produce a toxin. The toxin causes excessive secretion of fluids. The zoonotic disease has special importance in food safety and human health. Colostrum and natural immunity are often not sufficient in preventing infection in cases of high bacterial concentrations. Clinical Signs Diarrhea - Creamy, Yellow Abdominal Pains Fever Vomiting Prevention/Treatment: The best prevention methods for E. Coli include: clean water, dry bedding/environment, isolation of infected animals, and vaccination. Treatment with antibiotics and oral fluids have great benefits in reducing clinical symptoms of the disease. Farmatan has been shown to reduce bacterial load and help prevent infection. Learn more about the positive effects of Farmatan's active ingredient HERE. Rotavirus Rotavirus in calves is caused by a virus belonging to the Reoviridae family, as a non-envelope RNA virus. Rotavirus is thought to be the most common cause of neonatal diarrhea in calves. The virus tends to affect calves between the age of 1-day-old up to a month, with most cases presenting within the first week of life. Shedding and reinfection can happen in older calves and cows. Clinical symptoms are rarely present after the first month of life; older animals tend to either be carriers or asymptomatic. The majority of herds have some level present, with transmission likely happening during or shortly after birth. Clinical Signs Diarrhea - Pale Yellow, Bloody Dehydrated Dull calves Reluctant to drink Prevention/Treatment: The ideal scenario is to prevent infection through, sanitary facilities (calving barn), outdoor calf housing, and a good vaccination program. Colostrum will provide much needed antibodies, protecting the calf before their immune system is fully developed to combat the disease. Farmatan fed prior to calving can help reduce the pathogen load of the cow, reducing the likelihood of transmission. Farmatan supplemented in the milk has been shown to decrease the virus' ability to cause infection and clinical disease. The best treatment for calves already presenting clinical disease is to administer oral fluids/electrolytes to rehydrate the calf. Learn more about the positive effect of Farmatan's active ingredient HERE. Salmonella Salmonella infection of cattle is caused by a variety of species within the family. While the disease is uncommon in cattle with little effect on calf health, it has massive implications for human health and food safety. The bacteria spreads through direct contact or contaminated feed & water. This disease is highly regulated by the USDA. The most severe cases of salmonella affect calves between the ages of 7-10 days old. Clinical Signs Diarrhea - Bloody (flakes of slough tissue), Watery, Mucus present Lethargic Fever Prevention/Treatment: Prevention is always the best option: provide clean water, feed, and bedding. Isolate infected animals, ensure adequate colostrum intake, and develop a vaccination program with your veterinarian. Treatment with antibiotics and fluids (oral or intravenous) greatly increases the survival rate of calves infected with Salmonella. Farmatan has been shown to help reduce the likelihood of infection by protecting the gut, and reduce recovery time of infected animals.  LEARN MORE ABOUT IMOGENE INGREDIENTS  PRODUCTS Paul Mitchell & Paul Martin on RFD TV Rural America Live!  WATCH: https://vimeo.com/759549430/bd063fcc1f Beef Industry News Possible Slow Beef Trend in 2026 According To Rabobank Beef production by major global producers is expected to remain sluggish next year, according to analysts at the Dutch financial services cooperative Rabobank. The recent contraction in beef production is expected to affect major producers in Brazil, Canada and the United States, with New Zealand being likely to see the sharpest percentage drop in beef production, the Rabobank report predicted. Several issues are contributing to the 2025 decline and the expected drop next year, especially in light of limited cattle herds ready for slaughter in both the United States and Brazil, the report added. The long-term contraction of available cattle is being blamed for significant price hikes for retail beef in the last few years, Rabobank noted. Canada is experiencing a tighter pattern that has resulted in a decline of 41,000 metric tons of beef available for export in 2025 versus levels in 2024, according to the report. Canadian beef output in 2026 is expected to be “more limited” compared with this year for reasons also being experienced south of the Canadian border in terms of the available cattle herd. References: https://meatingplace.com/slower-beef-production-trend-to-continue-in-2026-rabobank/?utm_source=omeda&utm_medium=email&utm_cid=1103020073&utm_campaign=MTGMCD251201004&utm_date=20251201-1300 New World Screwworm Website Tracks Parasite There's a new way for producers and other stakeholders to track the fight against the New World Screwworm — a parasite that threatens live cattle herds. The USDA has launched a dedicated website with up-to-date information on the spread of the screwworm, which so far has been confined to cattle in several Mexican states near the U.S. border. The site includes resources for livestock producers, veterinarians, animal-health officials, wildlife experts, healthcare providers, pet owners, researchers, drug manufacturers, and the general public. Reports of the pest in Mexican cattle prompted the U.S. to halt cattle imports from Mexico back in May. USDA also committed $21 million to boost sterile fly production in Mexico as part of its response. The new website pulls together information from multiple federal partners, including the FDA, the Department of Energy, Homeland Security, the EPA, and the State Department.  Reference: https://www.aphis.usda.gov/livestock-poultry-disease/stop-screwworm Nightshade In Corn Residue Could Be Toxic Have you noticed any black nightshade in your corn stalks that you are grazing or plan to graze? If these fields have too much black nightshade, be careful — it might be toxic. Black nightshade is common in many corn fields in the fall, especially those that had hail damage in the summer or any situation where the corn canopy became thin or open. It usually isn't a problem, but if the density of nightshade is very high, there is the potential that it could poison livestock. Almost all livestock, including cattle, sheep, swine, horses and poultry are susceptible.   Black nightshade plants average about two feet in height and have simple alternating leaves. In the fall, berries are green and become black as the plant matures. All plant parts contain some of the toxin and the concentration increases as plants mature, except in the berries. Freezing temperatures will not reduce the toxicity. It is very difficult to determine exactly how much black nightshade is risky. Guidelines say that a cow would need to consume three to four pounds of fresh black nightshade to be at risk of being poisoned. These guidelines, though, are considered conservative since there is little data on the actual toxicity of nightshade plants. Fortunately, even though nightshade plants remain green fairly late into the fall, cattle usually don't appear to seek out nightshade plants to graze. However, green plants of nightshade might become tempting toward the end of a field's grazing period when there is less grain, husks or leaves to consume.  References: https://www.nationalbeefwire.com/nightshade-in-corn-residue-grazing-could-be-toxic Featured Experts in the Cattle Industry Paul Mitchell – Imogene Ingredients https://www.imogeneingredients.com/ Follow on Facebook: @FarmatanUSA Kirk Donsbach – Financial Analyst at StoneX https://www.stonex.com/ Follow on Facebook: @StoneXGroupInc Shaye Wanner – Host of Casual Cattle Conversation https://www.casualcattleconversations.com/ Follow on Facebook: @cattleconvos Contact Us with Questions or Concerns Have questions or feedback? Feel free to reach out via: Call/Text: 707-RANCH20 or 707-726-2420 Email: RanchItUpShow@gmail.com Follow us: Facebook/Instagram: @RanchItUpShow YouTube: Subscribe to Ranch It Up Channel: https://www.youtube.com/c/RanchItUp Catch all episodes of the Ranch It Up Podcast available on all major podcasting platforms. Discover the Heart of Rural America with Tigger & BEC Ranching, farming, and the Western lifestyle are at the heart of everything we do. Tigger & BEC bring you exclusive insights from the world of working ranches, cattle farming, and sustainable beef production. Learn more about Jeff 'Tigger' Erhardt & Rebecca Wanner (BEC) and their mission to promote the Western way of life at Tigger and BEC. https://tiggerandbec.com/ Industry References, Partners and Resources For additional information on industry trends, products, and services, check out these trusted resources: Allied Genetic Resources: https://alliedgeneticresources.com/ American Gelbvieh Association: https://gelbvieh.org/ Axiota Animal Health: https://axiota.com/multimin-campaign-landing-page/ Imogene Ingredients: https://www.imogeneingredients.com/ Jorgensen Land & Cattle: https://jorgensenfarms.com/#/?ranchchannel=view Medora Boot: https://medoraboot.com/ RFD-TV: https://www.rfdtv.com/ Rural Radio Network: https://www.ruralradio147.com/ Superior Livestock Auctions: https://superiorlivestock.com/ Transova Genetics: https://transova.com/ Westway Feed Products: https://westwayfeed.com/ Wrangler: https://www.wrangler.com/ Wulf Cattle: https://www.wulfcattle.com/

In this timely and eye-opening interview, host Mark Alyn sits down with Kevin Busque, Head of Gusto 401(k) powered by Guideline, to break down what California small-business owners urgently need to know about the state's retirement savings mandate—and why waiting could be a costly mistake. With the December 31, 2025 compliance deadline rapidly approaching, California employers with as few as one W-2 employee are legally required to offer a retirement savings option. Business owners must either enroll employees in the state-run CalSavers IRA program or implement a qualified private retirement plan, such as a 401(k). Yet, according to recent research shared in the interview, nearly 75% of small-business owners are unaware of CalSavers, and 65% don't realize they could face fines of up to $750 per employee for missing deadlines. Kevin clearly explains the penalty structure, which begins with $250 per eligible employee after 90 days of noncompliance and escalates to an additional $500 per employee after 180 days. But this conversation goes far beyond warnings—it's about smart, strategic action. Kevin outlines how today's modern 401(k) plans are far more affordable, flexible, and tax-advantaged than many business owners realize. With new federal tax credits and simplified administration, retirement plans are no longer just for big corporations. Mark and Kevin also explore how offering a quality retirement benefit can do more than satisfy a mandate—it can boost recruitment, strengthen employee loyalty, enhance your employer brand, and align with long-term business growth. Kevin's entrepreneurial background and leadership at Guideline and Gusto add practical insight into how small companies can implement powerful benefits without overwhelming cost or complexity. This interview is a must-watch for any California business owner who wants to avoid penalties, stay compliant, and turn a regulatory requirement into a competitive advantage. #CaliforniaBusiness #SmallBusinessOwners #RetirementPlanning #CalSavers #401kPlans #EmployeeBenefits #BusinessCompliance #MarkAlyn #Gusto401k #GuidelineRetirement #Entrepreneurship #HRCompliance #WorkplaceBenefitsBecome a supporter of this podcast: https://www.spreaker.com/podcast/late-night-health-radio--2804369/support.

As a certified insurance agent, staying CMS compliant is a crucial component to your success. Listen to this episode for a mini crash-course on best practices, guidelines, and resources to stay compliant.   Read the text version  

Record cold temperatures are impacting parts of the U.S. and the frigid conditions are expected to persist through the weekend. Tom Hanson has more, and Rob Marciano gives the latest forecast. The American Cancer Society is suggesting a change to cervical cancer screening guidelines so women have the option for self-collection of samples. CBS News medical contributor Dr. Céline Gounder explains. A 19-year-old college student said she was on her way home to Texas to surprise her family for Thanksgiving when ICE detained her at Boston Logan International Airport. She was then deported to Honduras despite a judge's order. Jericka Duncan reports. Cincinnati Bengals cornerback Marco Wilson's passion for painting is making a mark. He became the first active player in the NFL to be featured in its Artist Replay program. Wilson sits down with Natalie Morales to talk about art's impact on his life. Amy Allen, who is up for four Grammys, including songwriter of the year, sits down with Anthony Mason to talk about how she went from a nursing student to writing Grammy-nominated hits for Sabrina Carpenter and other pop stars. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

The Jeffrey Epstein scandal has exposed in brutal clarity the fact that the elite play by a completely different set of rules than ordinary people. Epstein and the powerful circle surrounding him — billionaires, politicians, executives, royalty, intelligence-connected figures — operated in a world where consequences simply didn't apply. While everyday people's lives are governed by strict accountability, surveillance, and rigid legal systems, Epstein's network existed in a realm of private islands, private jets, sealed court files, and protections purchased through money, influence, and institutional loyalty. Even after Epstein was first arrested in 2006, he received a secret sweetheart plea deal that was deliberately hidden from the victims themselves — something that would never even be imagined for a regular person. It wasn't justice; it was a privilege machine shielding the powerful from the rules everyone else is expected to follow.Even after his death, that dual system has remained plainly visible. Documents are released slowly or heavily redacted, names are shielded, grand juries remain sealed, and institutions scramble to protect reputations rather than tell the full truth. Meanwhile, the public watches as banks escape criminal charges with fines small enough to be considered a business expense, universities refuse to return Epstein-linked donations, and high-profile associates deny everything with straight faces despite overwhelming evidence. For ordinary people, accountability is immediate and merciless. For the elite, accountability is optional — managed by high-priced lawyers and PR teams until the outrage subsides. The Epstein saga is not just a crime story; it is a window into the two-tiered system that defines modern power: one law for the wealthy and connected, and another for everyone else.to contact me:bobbycapucci@protonmail.comBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-epstein-chronicles--5003294/support.

In this episode, host Nene Glenn Gianfala sits down with Greg Endicott, a seasoned valuation professional and technology innovator, to discuss the transformative impact of artificial intelligence on the valuation industry.  Greg shares practical insights and a detailed 8-step framework for successfully integrating AI into valuation practices—whether you're part of a large firm or a solo practitioner there are opportunities for efficiency, automation, and market expansion. Key takeaways AI Is transforming every aspect of valuation Transparency, auditability, and professional standards are critical risks A structured, 8-Step framework for successful AI implementation Guest: Greg Endicott, CPA/ABV. ASA, Managing Director, Strategic Value Group, LLC and Founder and President of ValueVision, Inc. a Microsoft Partner developing an AI-enabled valuation workflow and knowledge management platform. Host:  Nene Glenn Gianfala, CPA/ABV, Senior VP and Shareholder, Chaffe & Associates, Inc.  Please share your thoughts about the episode - click here to leave us a review   Want to get involved with future FVS conferences, committees, task forces, or the standing ovation program? Send a message to infoFVS@aicpa-cima.com RESOURCES FOR FURTHER EXPLORATION If you're using a podcast app that does not hyperlink to the resources, please visit our podcast platform to access the show notes with direct links.  JOIN:  The FVS Engage365 Member Community to collaborate with fellow AICPA® members, exchange ideas, and shape the future of the profession together. EARLY CAREER GUIDANCE:  Welcome to a career in forensic and valuation services Guidelines for Responsible Use of Artificial Intelligence (AI) in Forensic and Valuation Services Engagements Exclusive content available with AICPA FVS Section membership: Click here to join this active community of your FVS peers. You will get 16 credits of complimentary CPE and access to rich technical content The state of AI and machine learning in financial instrument valuation | FVS webcast archive The FVS Valuation Podcast archives Using AI in Your Valuation Practice – Part 1 Using AI in Your Valuation Practice – Part 2 ESOPs: Preserving Culture, Valuation and Empowering Employees LEARN MORE ABOUT THE FOLLOWING AICPA CREDENTIALS: Accredited in Business Valuation (ABV®) – Visit the home page and check out the ABV infographic Certified in the Valuation of Financial Instruments (CVFI®) – Visit the home page and check out the CVFI infographic Certified in Financial Forensics (CFF®) - Visit the home page and check out the CFF infographic This is a podcast from AICPA & CIMA, together as the Association of International Certified Professional Accountants. To enjoy more conversations from our global community of accounting and finance professionals, explore our network of free shows here. Your feedback and comments are welcomed at podcast@aicpa-cima.com      

A must-listen for anyone treating autoimmune disease or cancer in the era of immunotherapy.

Can benchmarking data actually improve antibiotic prescribing for kids? In this episode of AJIC: Science into Practice, hosts Nicki and Jess talk with Dr. Rana El Feghaly and Dr. Matthew Kronman about how collaborative reporting, smart guidelines, and EMR nudges help reduce unnecessary prescriptions. Hear how 22 institutions are reshaping outpatient stewardship with one smarter antibiotic choice at a time. With special guests: Rana El Feghaly, MD, MSCI, CPHQ, Pediatric Infectious Diseases Physician, Infectious Diseases Clinical Director, Pediatric Department Director of Quality and Safety, Children's Mercy Kansas City Matthew P. Kronman, MD, MSCE, Professor of Pediatric Infectious Diseases and Associate Vice Chair for Education in the Department of Pediatrics, University of Washington

Doctors Lisa and Sara speak to Consultant Neurologist Dr Antonella Macerollo about Essential Tremor (ET). We take a case and go through what ET is, how it might present, differentials and the differences between other conditions, how it might affect people and what management options there are.  This is the first of two Episodes with Dr Antonella Macerollo, our next one is about Parkinson's Disease. Thanks to Alison Day at Parkison's UK for making the connection between ourselves and Antonella to make these episodes possible. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Resources: More Differentials and details of clinical assessment of Tremors: https://patient.info/doctor/history-examination/tremor-pro?utm_source=gpoptin Revisiting the assessment of tremor: clinical review. Vijiaratnam N, Wirth T and Morris HR. British Journal of General Practice 2020; 70 (701): 611-614. https://bjgp.org/content/70/701/611 Treatment for essential tremor: a systematic review and Bayesian Model-based Network Meta-analysis of RCTs. Zhang, Junjiao et al. eClinicalMedicine, Volume 77, 102889: https://www.thelancet.com/action/showCitFormats?doi=10.1016%2Fj.eclinm.2024.102889&pii=S2589-5370%2824%2900468-1 Parkinson's UK: https://www.parkinsons.org.uk/ The epidemiological link between Essential Tremor and Parkinson's Disease: https://www.nature.com/articles/s41531-023-00577-y  ___ 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.

0000019a-e4e1-d2c0-a7db-feef6bae0000https://www.wvik.org/podcast/good-morning-from-wvik-news/2025-12-03/gov-pritzker-signs-bill-allowing-illinois-to-issue-state-specific-vaccine-guidelinesJoseph LeahyGov. Pritzker signs bill allowing Illinois to issue state-specific vaccine

This episode examines how Wichita Public Schools is preparing its educators for the rapidly evolving age of generative AI through deliberate policy development and clear instructional guidelines. Guest Katelyn Schoenhofer, the district's AI Specialist, explains how the organization built a positive culture around AI use by establishing legal policy, creating practical guidance for instructors, and helping staff view generative AI as a responsible and effective tool. She also discusses why educators should focus on the learning process behind student work—rather than solely the final product—when integrating AI into instruction. As part one of a two-episode series, this discussion sets the stage for the next episode focused on classroom-level use.“This podcast is for informational purposes only. The views and opinions expressed in this podcast are those of the individuals involved and do not necessarily reflect the official policy or position of Emporia State University or the Teachers College. Any mention of products, individuals, or organizations within this podcast does not constitute an endorsement. Listeners are encouraged to conduct their own research and consult with appropriate professionals before making any decisions based on information provided in this podcast.” 

In this episode, Rob and Magi dive into batch operations and the unique complexities they pose when compared to continuous processes. They discuss following guidelines from the book Guidelines for Process Safety in Batch Reaction Systems, written in 1999, and other safeguards that can be added when dealing with batch processes. Tune in to find out more!Interested in learning more about Batch Systems? Order Guidelines for Process Safety in Batch Reaction Systems here!

Enid Martinez, MD is a Senior Associate in Critical Care at Boston Children's Hospital, and an Assistant Professor of Anaesthesia at Harvard Medical School. She is the Director of the Pediatric Critical Care Nutrition Program in the Division of Critical Care Medicine and Principal Investigator for a clinical-translational research program on gastrointestinal function and nutrition in pediatric critical illness. Learning Objectives:By the end of this podcast, listeners should be able to:Recognize the impact of nutritional status on outcomes of critically-ill children.Describe the key aspects of the metabolic stress response in critical illness.Discuss a clinical approach to accurately estimating and prescribing nutrition in critically-ill children.Reflect on an expert's approach to managing aspects of nutrition in critically-ill children where there may not be high-quality evidence. Selected references:Mehta et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):706-742. doi: 10.1177/0148607117711387. Epub 2017 Jun 2. PMID: 28686844. Fivez et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016 Mar 24;374(12):1111-22. doi: 10.1056/NEJMoa1514762. Epub 2016 Mar 15. PMID: 26975590.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

In today's episode, we had the pleasure of speaking with Jacob Sands, MD, and Shailee Shah, MD, about considerations for diagnosing and managing Lambert-Eaton myasthenic syndrome (LEMS), particularly in the context of small cell lung cancer (SCLC). Dr Sands is associate chief of the Lowe Center for Thoracic Oncology and the Oncology Medical Director of the International Patient Center at Dana-Farber Cancer Institute, as well as an assistant professor at Harvard Medical School in Boston, Massachusetts. Dr Shah is a clinical assistant professor of neurology (MS/neuroimmunology) at the Northwestern University Feinberg School of Medicine in Chicago, Illinois.  In our exclusive interview, Drs Sands and Shah discussed LEMS symptom identification, the importance of paraneoplastic panels for assessing neurologic dysfunction in patients with SCLC, the need for specific autoantibody testing, and what guidelines currently note as best practices for the diagnosis of this disease. 

In this episode, host Sloan Simmons joins Title IX experts Sarah Fama and Sinead McDonough for a comprehensive discussion regarding the status of the law as it pertains to gender identity, students, and schools.  Topics covered include the current status of California and federal law and policy on point, as well as the wide-ranging scope of pending litigation poised to impact this area of school law. Show Notes & References 1:54 – Foundational cases impacting Title IX policy (Bostock v. Clayton County (2020) 140 S. Ct. 1731) (Client News Brief 50 - June 2020) 2:55 – Grabowski v. Arizona Board of Regents (9th Cir. 2023) 69 F.4th 1110 5:51 – Parents for Privacy vs. Barr (9th Cir. 2020) 949 F.3d 1210 (Client News Brief 40 - May 2020) 10:48 – Roe vs. Critchfield (9th Cir. 2025) 137 F.4th 912 (Client News Brief 14 - April 2025) 12:49 – Jones, et al. v. Critchfield, et al., Ninth Circuit Case No. 25-5413 13:44 – Regino vs. Blake (formerly Staley) (9th Cir. 2025) (Client News Brief 17 - April 2025) 14:57 – Assembly Bill (AB) 1266 20:00 – United States v. Skrmetti (2025) 605 U.S. 495 22:24 – The law in California 23:25 – CIF (California Interscholastic Federation) Rule 300D and Guidelines for Gender Identity Participation 24:36 – Interactions with federal law 25:56 – Executive Order (EO) 14168 (Client News Brief 12 - February 2025) 27:01 – Tennessee v. Cardona decision 28:29 – Dear Colleague letter - February 4, 2025 30:32 – Federal government's approach and reaction to CIF and AB 1266 (USDOE Press Releases: February 12, 2025; March 27, 2025; June 25, 2025) 34:00 – Related Supreme Court cases (Little v. Hecox, Case No. No. 24-38; West Virginia v. B.P.J., Case No. 24-43) 35:09 – T.S. et al. v. Riverside Unified School District et al., U.S.D.C., Central District of California, Case No. 5:24-cv-02480-SSS-SP, and order on motion to dismiss, (C.D. Cal. Sept. 24, 2025) 2025 WL 2884416 36:25 – Protections for student privacy and their interactions with parental rights 39:22 – Mirabelli vs. Olson et al.¸U.S.D.C., Southern District of California, Case No. 3:23-cv-00768-BEN-VET 40:00 – The SAFETY Act (AB 1955) 44:13 – The dynamic between the federal government and California post-AB 1955 enactment (United States of America v. California Interscholastic Federation et al., U.S.D.C., Central District of California, 8:25-cv-01485-CV-JDE) 50:26 – Foote v. Ludlow School Committee, Case No. 25-77 52:19 – Mahmoud v. Taylor (2025) 606 U.S. 522 (Listen to Episode 97 Mahmoud v. Taylor) (Client News Brief 28 - July 2025) 53:31 – Access to facilities 55:15 – Grimm v. Gloucester County School Board (4th Cir. 2020) 972 F.3d 586 56:06 – Million Dollar Question: Does Title IX protect individuals based on gender identity or not?   For more information on the topics discussed in this podcast, please visit our website at: www.lozanosmith.com/podcast

The 2025 AHA Guidelines for CPR and Emergency Cardiovascular Care introduce significant updates, including a focus on on-scene resuscitation, cautious use of mechanical CPR devices, and prioritizing IV over IO access. While these changes aim to improve outcomes, they've sparked debate among seasoned paramedics like Jimmy Apple, the “EMS Avenger,” who highlights the challenges of implementation.   Key Points: • On-Scene Resuscitation: Emphasis on achieving ROSC on scene rather than rapid transport. • Mechanical CPR Devices: AHA advises against routine use, but paramedics argue they're essential for small or rural teams. • IV vs. IO Access: IV is prioritized, but practicality for resource-limited teams is questioned. • Empowering EMS Providers: Focus on critical thinking, quality compressions, and timely defibrillation. • Cultural Shift: Training crews for compassionate death notifications and clear family communication.

CBS Reporter Brad Gibson explains the new rules for doctors set out by the World Health Organization as GLP-1 drugs are becoming easier to obtain. With Megan Lynch.

Marketing is a vital part of any business. But when it comes to marketing your services as an agent selling Medicare, there are specific rules and regulations. To help you out, we've compiled a list of FAQs around compliant Medicare marketing. Press play to get started!   Read the text version  

We are joined by Kurt Bramer from Advanced CPR Solutions again this week to continue the series on Heads Up CPR and other promising sudden cardiac arrest treatments. He and Dr. Joe Holley kicked off the discussion in two previous episodes. Elevated CPR Series Episode One Elevated CPR Series Episdoe Two We open this week’s episode with a holiday severe weather update from our disaster meteorologist, Dan DePodwin. He reports on several storm systems that will impact Thanksgiving holiday travel across the eastern half of the country. Following that update, we kick off episode 3 of our heads-up CPR series with a look at the long history of the evolutionary changes to cardiac arrest treatment. Kurt Bramer from Advanced CPR Solutions leads off with a response to some comments to the first two episodes in this series. A few listeners worried that we might sound like we were criticizing the individual responders on cardiac arrest calls over the low survival rates for the condition. The team made a joint statement that no criticism of providers in the field was intended. We all are providers ourselves and are merely commenting on the results that everyone has been getting in response to treating cardiac arrest. Some systems do better with resource management than others, but even those areas fail to save even a simple majority of their cardiac arrest patients. CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary CPR Challenges and Future Improvements The meeting began with a discussion about travel weather for the Thanksgiving weekend, with Dan DePodwin warning of widespread lake effect snow in the eastern United States and a potential ground blizzard in the Dakotas and Minnesota. The group then transitioned to their main topic, CPR, where Joe clarified that their previous discussion about CPR’s limitations was not meant to criticize CPR providers, but rather to highlight the challenges and lack of progress in the field over the past 50 years. They planned to explore potential improvements to CPR in future episodes. Advancements in CPR Techniques Kurt Bramer, with 40 years of experience in EMS and emergency management, discussed the history of CPR, highlighting its evolution from mouth-to-mouth resuscitation to modern techniques. He emphasized the need for better tools and more effective methods for emergency responders, as current practices are often based on outdated or insufficiently tested techniques. The group acknowledged that while responders are doing their best with limited tools, recent research may lead to positive changes in CPR practices. They also touched on the introduction of high-performance CPR in the 2010s, which aimed to maximize the effectiveness of current technologies and minimize detrimental pauses during resuscitation efforts. Mechanical CPR Guidelines Review The discussion focused on the American Heart Association’s recent guidelines regarding mechanical CPR, which recommend against routine use but allow for exceptions like transport scenarios. Kurt and Joe highlighted that the guidelines lump together different types of mechanical compressors, ignoring their unique physiological effects and training limitations. They emphasized that current research primarily focuses on patient survival as an endpoint, which may not fully capture the benefits of mechanical CPR, such as improved blood flow and reduced pauses during resuscitation. The conversation also touched on the importance of considering neurological outcomes beyond mere survival and the need for better training on integrating mechanical devices into overall cardiac arrest management. Bundle Care Approach in Resuscitation The group discussed the bundle of care approach in resuscitation, focusing on the use of multiple therapies simultaneously to improve patient outcomes. Kurt and Joe highlighted the success of the ITD (Impedance Threshold Device) when used with high-quality CPR, leading to a 50% increase in one-year survival. They also noted that only a small percentage of resuscitation guidelines are supported by randomized control trials, emphasizing the challenges in interpreting research data. The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group. Catch the full episode using the player above or on your favorite podcast platform, and don't forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!

Are you confident in spotting a child at risk of neglect? Do you know what to do if you witness abuse in your practice? How can you raise concerns safely while protecting both the child and your team? This episode with Dr. Christine Park provides tangible actions, practical scripts, and clear guidance for managing challenging scenarios—like seeing an adult hit a child in the waiting room or recognizing neglect in the dental chair. These are situations dental school rarely prepares us for. Every practice needs clear protocols for safeguarding. This episode acts as a North Star, helping you stay compliant while ethically doing the right thing. If you treat children, you must listen to this episode and share it with every colleague who treats children. https://youtu.be/-kYs23Xa4Ls Watch PDP251 on YouTube Protrusive Dental Pearl: Find the phone number of your local child safeguarding board / social services. Verify it, then display it where you and your team can quickly access it. Key Takeaways Dentists are trained observers of family dynamics. Recognizing normal behavior is key in dental care. Unconscious observations can guide professionals. Feeling uncomfortable about a situation is a valid signal. Empowerment comes from trusting your instincts. Dental care professionals see many aspects of families. It’s important to act on uncomfortable feelings. Observation skills are crucial for effective care. Children’s interactions reveal much about family health. Awareness of discomfort can lead to better outcomes. Highlights of this episode: 00:00 Teaser 00:59 Intro 02:40 Pearl – Child Protection Hotline 05:23 Dr. Christine Park’s Background and Expertise 08:37 The Role of Dentists in Safeguarding Children 11:19 Practical Scenarios and Guidelines for Safeguarding 15:35 Recognizing Silent Cases of Neglect 17:29 Team Collaboration and Support in Safeguarding 21:58 Guidelines and Policies for Effective Safeguarding 22:03 Midroll 25:24 Guidelines and Policies for Effective Safeguarding 28:32 Handling a Tough Safeguarding Scenario 32:18 Dealing with Poor Oral Hygiene and Neglect 39:12 Managing Parental Reactions and Consent 43:08 The Importance of Safeguarding in Dentistry 45:34 Further Guidance and Resources 46:10 Outro

This week primary care physicians Gary, Henry, Kate and Mark discuss the safety of CBD, a new guideline for managing adults with hypertension, whether COVID-19 vaccines are still effective, and a living guideline from the BMJ to help us choose the best diabetes drugs. Links to stuffEssential Evidence Plus Illinois Academy of Family Physicians meeting Dec 6 in Naperville, IL (Kate, Gary and Mark)   North Dakota Academy of Family Physicians Big Sky Conference Jan 19 in Big Sky, Montana (Gary and Kate) Safety of CBDACC/AHA Hypertension guidelinePREVENT-CVD risk calculatorEfficacy of COVID-19 vaccinesBMJ living guideline for diabetesBMJ MATCH-IT interactive tool for selecting drugs

On today's episode, we're joined by Jeff Keckley and Ron Rosenthal, both Partners at Meridian Compensation Partners, LLC.Jeff and Ron break down the purpose of stock ownership guidelines, how they support alignment with shareholders and why companies should revisit these policies as their compensation programs evolve. They outline how guidelines are typically structured, what counts as ownership, how external stakeholders evaluate them and the growing use of holding requirements as a complement or alternative to traditional ownership timelines.Key Takeaways:00:00 Introduction.02:02 Ownership guidelines encourage executives to think and act like owners.04:17 Tiered ownership levels help clarify expectations across the leadership team.07:11 Pay mix influences how quickly executives can reach ownership requirements.11:16 Ownership guidelines focus on vested value while holding power focuses on unvested awards.13:07 Participation decisions reflect the company's culture and overall pay philosophy.15:58 Companies make judgment calls on which share types to count toward ownership.24:30 Holding requirements help executives build and maintain ownership over time.28:01 Periodic reviews keep guidelines aligned with market practice and business needs.Resources Mentioned:Jeff Keckleyhttps://www.linkedin.com/in/jeffkeckley/Ron Rosenthalhttps://www.linkedin.com/in/ron-rosenthal-a48ab5ab/Meridian Compensation Partners, LLChttps://www.linkedin.com/company/meridian-compensation-partners-llc/This episode is brought to you by Meridian Compensation Partners, LLC. Learn more by visiting MeridianCP.com. #Compensation #Wages #SPAC

Harvard-educated entrepreneur Eric Hughes joins us to share his riveting journey from the corporate retail world to founding Rental Income Advisors. Starting with a summer job selling Cutco Knives, Eric honed skills that would serve him throughout his career, while also recognizing the invaluable network forged during his time at Harvard. We laugh over early podcast mishaps and muse about the shifting role of college education, especially as it relates to our children's aspirations and the connections they build.Our conversation takes a turn into the world of retail and hospitality, where Eric regales us with tales from his days waiting tables and encountering the unique challenges of the retail industry. From Stephen Berry's to Macy's, Eric reflects on the environmental and ethical dilemmas that shaped his journey, eventually nudging him towards real estate investment. Together, we compare New York City's appreciation-focused market with the cashflow-rich opportunities in Memphis, delving into Eric's strategies for financial growth through real estate.Finally, we unravel the intricacies of real estate investing amid economic fluctuations. Eric shares strategies for maintaining profitability, emphasizing the importance of effective property management and the value of expert firms in securing passive income. We dive into the common mistakes rookie investors make and explore the potential of lease-to-own arrangements and BRRRR strategy. With a keen eye on market dynamics, we discuss how to navigate the complex world of real estate investing, ultimately guiding you toward making informed decisions for your financial future.CHAPTERS (00:00) - Becoming a Billionaire Through Networking(11:12) - Corporate Career to Retail Sustainability(16:27) - Real Estate Cashflow Investing Strategy(27:29) - Real Estate Investing Strategies and Tips(37:08) - Real Estate Investment Strategies and Mistakes(43:28) - Real Estate Investment Strategies and Guidelines(50:27) - Escaping the Drift

About this episode: Since 2015, the American Academy of Pediatrics has recommended that parents and caregivers introduce peanuts to children's diets at around four to six months old to avoid the onset of a peanut allergy. In this episode: Pediatric allergist David Hill explains why early allergen introduction is safe and effective and how these recommendations have led to a significant reduction in peanut allergies in children. Guests: Dr. David Hill, PhD, is an allergist, immunologist, and an attending physician at the Children's Hospital of Philadelphia. He is also an assistant professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Host: Stephanie Desmon, MA, is a former journalist, author, and the director of public relations and communications for the Johns Hopkins Center for Communication Programs. Show links and related content: Guidelines for Early Food Introduction and Patterns of Food Allergy—Pediatrics Peanut Allergies Have Plummeted in Children, Study Shows—New York Times Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy—New England Journal of Medicine Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌JohnsHopkinsSPH on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed Note: These podcasts are a conversation between the participants, and do not represent the position of Johns Hopkins University.

Dr. K digs into the emerging research on “AI-induced psychosis” and why he changed his mind from thinking it was media fearmongering to seeing real psychiatric risk. He explains how chatbots can act like a technological folie à deux (shared delusion), where empathic, sycophantic AI slowly amplifies your paranoia, isolates you from other people, and erodes your reality testing. Drawing from recent papers, he walks through how different models compare in delusion confirmation, harm enablement, and safety interventions, and then gives a practical checklist so you can tell if your own AI use is drifting into dangerous territory. Topics include: What “technological folie à deux” is and how shared delusions can form with a chatbot Bidirectional belief amplification: you vent, AI validates, your paranoia escalates Anthropomorphizing AI and why “I know it's just a tool” doesn't protect your emotional brain How sycophantic design (always trying to please the user) directly opposes healthy psychotherapy Epistemic drift: slowly moving from normal thinking into increasingly delusional narratives Case example of harmful, unsafe advice (e.g., “healthy” bromine alternative leading to toxicity) Research comparing models on delusion confirmation, harm enablement, and safety response The ways AI can weaken reality testing, reinforce suicidal or paranoid ideas, and increase isolation Self-assessment questions: frequency of use, emotional attachment, replacing friends, following AI advice Guidelines for using AI more safely and when elevated risk means you should talk to a professional HG Coaching : https://bit.ly/46bIkdo Dr. K's Guide to Mental Health: https://bit.ly/44z3Szt HG Memberships : https://bit.ly/3TNoMVf Products & Services : https://bit.ly/44kz7x0 HealthyGamer.GG: https://bit.ly/3ZOopgQ Learn more about your ad choices. Visit megaphone.fm/adchoices

We are in the height of the charitable solicitation season. How do you know what charities are going to use your money in a responsible way? Clark has some guidance for making sure your charity counts.  Also, there are value wars happening in the food world that can help you spend less - IF you know how to find the deals.  Holiday Giving: Segment 1 Ask Clark: Segment 2 Fast-Food Value Wars: Segment 3 Ask Clark: Segment 4 Mentioned on the show: How To Choose the Best Charities for Your Donations - Clark.com Before you donate, find out where the money is going Homeowners Insurance Archives - Clark Howard Axios: The value wars are back as big brands cut prices amid tariffs Should You Ever Buy Travel Medical Insurance? Is Annual Travel Insurance Worth It? Is Chase Sapphire Reserve® Worth It? What's the Total Value of All the Chase Sapphire Reserve® Perks? Clark.com resources: Episode transcripts Community.Clark.com  /  Ask Clark Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices